Supplies, drugs & other prices at Northern Montana Hospital

Havre, MT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
2019-ncov diagnostic p (U0001) $34.65 $49.50 1.0×
Adm tocilizu covid-19 1st (M0249) $351.05 $501.50 0.8×
Adm tocilizu covid-19 2nd (M0250) $351.05 $501.50 0.8×
Admin influenza virus vac (G0008)
range across 2 matching MRF lines
$9.10–$29.05 $13–$41.50 varies
Admin pneumococcal vaccine (G0009) $29.05 $41.50 0.6×
Ca screen;flexi sigmoidscope (G0104) $61.60 $88 0.1×
Colon ca scrn not hi rsk ind (G0121) $203.70 $291 0.2×
Colorectal scrn; hi risk ind (G0105)
range across 2 matching MRF lines
$203–$219.80 $290–$314 varies
Covid-19 lab test non-cdc (U0002) $48.65 $69.50 0.9×
Diab manage trn per indiv (G0108) $78.23 $111.75 1.4×
Drug test def 1-7 classes (G0480)
range across 5 matching MRF lines
$46.90–$239.75 $67–$342.50 varies
Drug test def 8-14 classes (G0481) $389.20 $556 2.5×
Drug test def simple all cl (G0659) $117.08 $167.25 1.9×
Ekg tracing for initial prev (G0404) $159.08 $227.25 5.4×
Hospital outpt clinic visit (G0463)
range across 11 matching MRF lines
$19.25–$119.88 $27.50–$171.25 varies
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $95.55 $136.50 2.2×
Initial preventive exam (G0402) $185.50 $265 1.4×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $353.50 $505 2.9×
Mnt subs tx for change dx (G0270) $32.20 $46 1.0×
Obtaining screen pap smear (Q0091) $21 $30 0.7×
Ppps, subseq visit (G0439) $144.90 $207 1.1×
Psa screening (G0103) $198.28 $283.25 10.3×
Screen cerv/vag thin layer (G0123) $107.98 $154.25 5.3×
Syphilis tst non-treponemal antibody ia qual rpr (0065U) $45.50 $65 2.5×
Tte w or wo fol wcon,doppler (C8929) $2,626.93 $3,752.75 3.3×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.