Supplies, drugs & other prices at Northeast Regional Medical Center

Kirksville, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $38.35 $159.80 1.1×
Adm tocilizu covid-19 1st (M0249) $293.93 $1,224.72 0.7×
Adm tocilizu covid-19 2nd (M0250) $293.93 $1,224.72 0.7×
Admin hepatitis b vaccine (G0010) $12.60 $52.49 0.3×
Admin influenza virus vac (G0008) $19.18 $79.90 0.4×
Admin pneumococcal vaccine (G0009) $82.44 $343.50 1.8×
Ant resin-based cmpst crown (D2390) $7,860.51 $32,752.13 12.1×
Catheterize for urine spec (P9612) $68.58 $285.77 7.3×
Colon ca scrn not hi rsk ind (G0121) $5,625.61 $23,440.04 6.0×
Colorectal scrn; hi risk ind (G0105) $4,564.20 $19,017.49 4.9×
Crown 3/4 resin-based compos (D2712) $6,690.22 $27,875.93 10.3×
Dental bitewings two images (D0272) $7,460.06 $31,083.60 85.6×
Direct refer hospital observ (G0379) $424.94 $1,770.60 0.7×
Extraction erupted tooth/exr (D7140) $7,657.88 $31,907.85 11.8×
Hepb screen high risk indiv (G0499) $27.71 $115.47 1.0×
Hiv combination assay (G0475) $481.21 $2,005.04 20.0×
Hospital outpt clinic visit (G0463) $132.97 $554.04 1.0×
Inj for sacroiliac jt anesth (G0260) $857.44 $3,572.68 1.2×
Intraoral periapical first (D0220) $7,460.06 $31,083.60 85.6×
Mra w/cont, abd (C8900) $2,564.49 $10,685.39 7.3×
Mra w/cont, chest (C8909) $1,943.32 $8,097.15 5.6×
Mra w/cont, lwr ext (C8912) $1,803.63 $7,515.12 5.2×
Mra w/cont, pelvis (C8918) $2,252.93 $9,387.19 6.4×
Mra w/o cont, lwr ext (C8913) $1,943.32 $8,097.15 8.1×
Mra w/o fol w/cont, abd (C8902) $2,564.49 $10,685.39 7.3×
Mra w/o fol w/cont, lwr ext (C8914) $2,353.98 $9,808.26 6.7×
Mra w/o fol w/cont, pelvis (C8920) $2,419.21 $10,080.03 6.9×
Mri w/o fol w/cont, breast, (C8908) $2,288.76 $9,536.49 6.5×
Mri w/o fol w/cont, brst, un (C8905) $1,943.32 $8,097.15 5.6×
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $374.55 $1,560.64 0.7×
Oral hiv-1/hiv-2 screen (G0435) $259.78 $1,082.42 21.7×
Oth resp proc, group (G0239) $81.18 $338.26 2.2×
Perc d-e cor revasc t cabg s (C9604) $10,368.27 $43,201.12 0.9×
Perc drug-el cor stent sing (C9600) $12,581.72 $52,423.85 1.1×
Post 1 srfc resinbased cmpst (D2391) $7,727.32 $32,197.17 11.9×
Post 2 srfc resinbased cmpst (D2392) $8,255.84 $34,399.32 12.7×
Post 3 srfc resinbased cmpst (D2393) $9,206.83 $38,361.80 14.2×
Post >=4srfc resinbase cmpst (D2394) $9,169.70 $38,207.10 14.2×
Prefab stnlss steel crown pe (D2931) $7,614.95 $31,728.96 11.8×
Prefab stnlss steel crwn pri (D2930) $7,337.92 $30,574.66 11.3×
Psa screening (G0103) $143.89 $599.53 7.5×
Resin 4/> surf or w incis an (D2335) $8,245.96 $34,358.15 12.7×
Resin one surface-anterior (D2330) $8,742.62 $36,427.57 13.5×
Resin three surfaces-anterio (D2332) $8,002.21 $33,342.55 12.4×
Resin two surfaces-anterior (D2331) $7,592.87 $31,636.95 11.7×
Therapeutic pulpotomy (D3220) $8,432.82 $35,136.77 13.0×
Tomosynthesis, mammo (G0279) $24.24 $100.99 1.9×
Trauma respons w/hosp criti (G0390) $1,726.08 $7,192.02 1.3×
Tte w or w/o contr, cont ecg (C8930) $629.02 $2,620.90 0.8×
Tte w or w/o fol w/con,stres (C8928) $835.89 $3,482.87 1.1×
Tte w or wo fol wcon,doppler (C8929) $1,374.21 $5,725.86 1.8×
Ven blood coll snf/hha (G0471) $1.85 $7.70 0.2×