Supplies, drugs & other prices at Northeastern Health System

Tahlequah, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $69.75 $93 1.9×
2d tee w or w/o fol w/con,in (C8925) $1,483.50 $1,978 2.0×
2d tte w or w/o fol w/con,co (C8923) $1,483.50 $1,978 2.0×
2d tte w or w/o fol w/con,fu (C8924) $551.50 $1,103 1.6×
Admin influenza virus vac (G0008) $17 $34 0.4×
Admin pneumococcal vaccine (G0009) $25.50 $34 0.6×
Colon ca scrn not hi rsk ind (G0121) $888.50 $1,777 1.0×
Covid-19 lab test non-cdc (U0002) $193.50 $258 3.8×
Direct refer hospital observ (G0379) $31 $62 0.1×
Drug test def 1-7 classes (G0480) $50.50 $101 0.4×
Drug test def 15-21 classes (G0482) $1,046.25 $1,395 5.3×
Drug test def 22+ classes (G0483) $1,638.75 $2,185 6.6×
Drug test def 8-14 classes (G0481) $465 $930 3.0×
Elec stim other than wound (G0283) $36.38 $48.50 2.9×
Hbot, full body chamber, 30m (G0277) $134 $268 1.0×
Home sleep test/type 3 porta (G0399) $579.75 $773 2.8×
Hospital outpt clinic visit (G0463) $77.75 $155.50 0.6×
Hpv combo assay ca screen (G0476) $65.80 $87.73 1.9×
Mra w/cont, chest (C8909) $681.75 $909 2.0×
Mra w/cont, lwr ext (C8912) $1,050 $1,400 3.1×
Mra w/o cont, chest (C8910) $500.25 $667 2.2×
Mra w/o cont, lwr ext (C8913) $959.25 $1,279 4.2×
Mra w/o fol w/cont, chest (C8911) $681.75 $909 2.0×
Mra w/o fol w/cont, lwr ext (C8914) $681.75 $909 2.0×
Non-ophthalmic fva (C9733) $29,797.50 $39,730 88.8×
Oral hiv-1/hiv-2 screen (G0435) $33 $66 2.8×
Perc d-e cor revasc chro sin (C9607) $12,453 $16,604 0.7×
Perc d-e cor revasc t cabg s (C9604) $5,624 $11,248 0.5×
Perc d-e cor stent ather s (C9602)
unusually low: confirm this is the full procedure
$8,551 $17,102 0.5×
Perc drug-el cor stent sing (C9600) $5,624 $11,248 0.5×
Prostate biopsy, any mthd (G0416) $440.25 $587 1.3×
Psa screening (G0103) $33 $66 1.7×
Revasc intra lithotrip-ather (C9766) $19,865 $39,730 1.1×
Revasc intra lithotrip-stent (C9765) $19,865 $39,730 1.1×
Revasc intravasc lithotripsy (C9764) $12,276.50 $24,553 1.1×
Revasc lith-sten-ath tib/per (C9775) $29,797.50 $39,730 1.7×
Revasc lithotr-ather tib/per (C9774) $29,797.50 $39,730 1.7×
Revasc lithotrip tibi/perone (C9772) $12,276.50 $24,553 1.1×
Revasc lithotrip-stent-ather (C9767) $19,865 $39,730 1.1×
Scr c/v cyto,thinlayer,rescr (G0145) $49.67 $66.23 1.9×
Tee w or w/o fol w/cont, mon (C8927) $1,483.50 $1,978 2.0×
Tee w or w/o fol w/cont,cong (C8926) $1,483.50 $1,978 2.0×
Tomosynthesis, mammo (G0279) $93 $186 7.3×
Trim nail(s) (G0127) $97.50 $130 1.7×
Tte w or w/o contr, cont ecg (C8930) $989 $1,978 1.3×
Tte w or w/o fol w/con,stres (C8928) $1,483.50 $1,978 2.0×
Tte w or w/o fol w/cont, com (C8921) $1,483.50 $1,978 2.0×
Tte w or w/o fol w/cont, f/u (C8922) $1,483.50 $1,978 2.0×
Tte w or wo fol wcon,doppler (C8929) $1,273 $2,546 1.7×