Supplies, drugs & other prices at North Okaloosa Medical Center

Crestview, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,318.60 $7,325.55 1.6×
Adm tocilizu covid-19 1st (M0249) $212.86 $1,182.56 0.5×
Adm tocilizu covid-19 2nd (M0250) $212.86 $1,182.56 0.5×
Admin hepatitis b vaccine (G0010) $47.30 $262.76 1.0×
Admin influenza virus vac (G0008) $47.30 $262.76 1.0×
Admin pneumococcal vaccine (G0009) $47.30 $262.76 1.0×
Ca screen;flexi sigmoidscope (G0104) $3,269.86 $18,165.88 3.4×
Colon ca scrn not hi rsk ind (G0121) $3,800.98 $21,116.58 3.9×
Colorectal scrn; hi risk ind (G0105) $3,276.14 $18,200.77 3.4×
Covid-19 lab test non-cdc (U0002) $29.09 $161.63 0.6×
Direct refer hospital observ (G0379) $289.69 $1,609.39 0.5×
Elec stim other than wound (G0283) $37.80 $210 3.0×
Elisa hiv-1/hiv-2 screen (G0433) $54.73 $304.07 3.0×
Hbot, full body chamber, 30m (G0277) $148.09 $822.72 1.0×
Hiv combination assay (G0475) $11.38 $63.21 0.5×
Hospital outpt clinic visit (G0463) $216.77 $1,204.29 1.6×
Inj for sacroiliac jt anesth (G0260) $627.47 $3,485.93 0.9×
Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and… (0671T) $5,968 $33,155.58 1.1×
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space;… (0449T) $7,403.91 $41,132.81 1.3×
Mra w/cont, chest (C8909) $1,794.83 $9,971.25 4.9×
Mra w/cont, pelvis (C8918) $1,794.83 $9,971.25 4.9×
Mra w/o cont, abd (C8901) $1,462.09 $8,122.73 5.9×
Mra w/o fol w/cont, abd (C8902) $2,262.02 $12,566.77 6.2×
Mra w/o fol w/cont, chest (C8911) $2,262.02 $12,566.77 6.2×
Mra w/o fol w/cont, lwr ext (C8914) $2,262.02 $12,566.77 6.2×
Mra w/o fol w/cont, pelvis (C8920) $2,262.02 $12,566.77 6.2×
Mra, w/dye, upper extremity (C8934) $2,262.02 $12,566.77 6.2×
Mri w/cont, breast, bi (C8906) $1,794.83 $9,971.25 4.9×
Mri w/cont, breast, uni (C8903) $1,794.83 $9,971.25 9.8×
Mri w/o fol w/cont, breast, (C8908) $2,262.02 $12,566.77 6.2×
Mri w/o fol w/cont, brst, un (C8905) $2,262.02 $12,566.77 6.2×
Oral hiv-1/hiv-2 screen (G0435) $73.94 $410.78 6.2×
Perc d-e cor revasc t cabg s (C9604) $7,588.04 $42,155.80 0.6×
Perc drug-el cor stent sing (C9600) $7,588.04 $42,155.80 0.6×
Prostate biopsy, any mthd (G0416) $277.14 $1,539.66 0.7×
Psa screening (G0103) $113.80 $632.24 5.9×
Tomosynthesis, mammo (G0279) $244.24 $1,356.85 19.2×
Trluml perip athrc iliac art (0238T) $20,238.36 $112,435.35 1.1×
Unsched dialysis esrd pt hos (G0257) $311.85 $1,732.50 0.4×