Supplies, drugs & other prices at North Big Horn Hospital District

Lovell, WY · every code in this section with a posted price and a Medicare benchmark.

35 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $40
Admin influenza virus vac (G0008) $40
Admin pneumococcal vaccine (G0009) $40
Chemo extend iv infus w/pump (G0498) $328
Colon ca scrn not hi rsk ind (G0121) $5,712.95
Colorectal scrn; hi risk ind (G0105) $5,551.52
Covid-19 lab test non-cdc (U0002) $169.50
Direct refer hospital observ (G0379) $478
Drug test def 1-7 classes (G0480) $101
Eia hiv-1/hiv-2 screen (G0432) $129
Ekg tracing for initial prev (G0404) $232
Hep c screen high risk/other (G0472) $179
Hiv combination assay (G0475) $229.50
Hospital outpt clinic visit (G0463) $464.40
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $330.50
Inj for sacroiliac jt anesth (G0260) $710
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 Other… (0027U) $1,182.50
Mra w/cont, lwr ext (C8912) $2,685
Mra w/cont, pelvis (C8918) $2,656.50
Mra w/o cont, lwr ext (C8913) $2,685
Mra w/o cont, pelvis (C8919) $2,656.50
Mra w/o fol w/cont, lwr ext (C8914) $2,685
Mra w/o fol w/cont, pelvis (C8920) $2,656.50
Mra, w/dye, spinal canal (C8931) $2,977
Mra, w/dye, upper extremity (C8934) $2,412.50
Mra, w/o dye, spinal canal (C8932) $2,977
Mra, w/o dye, upper extr (C8935) $2,412.50
Mra, w/o&w/dye, spinal canal (C8933) $2,977
Mra, w/o&w/dye, upper extr (C8936) $2,412.50
Psa screening (G0103) $182.50
Therapeutic procd strg endur (G0237) $232
Trauma respons w/hosp criti (G0390) $2,319.50
Tte w or w/o contr, cont ecg (C8930) $1,880
Tte w or w/o fol w/con,stres (C8928) $1,312
Tte w or wo fol wcon,doppler (C8929) $3,101.50