22 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Admin hepatitis b vaccine (G0010) |
$78 |
$78 |
1.6× |
| Admin influenza virus vac (G0008) |
$73 |
$73 |
1.5× |
| Admin pneumococcal vaccine (G0009) |
$73 |
$73 |
1.5× |
| Alcohol/sub misuse assess (G2011) |
$48 |
$48 |
1.6× |
| Arthro/shoul surg; w/spacer (C9781) |
$23,895 |
$23,895 |
1.8× |
| Brief alcohol misuse counsel (G0443) |
$239 |
$239 |
2.3× |
| Colon ca scrn not hi rsk ind (G0121) |
$2,672.50 |
$2,672.50 |
2.8× |
| Colorectal scrn; hi risk ind (G0105) |
$3,500 |
$3,500 |
3.6× |
| Direct refer hospital observ (G0379) |
$904.50 |
$904.50 |
1.5× |
| Ekg tracing for initial prev (G0404) |
$108 |
$108 |
3.6× |
| Elec stim other than wound (G0283) |
$46.50 |
$46.50 |
3.7× |
| Fecal blood scrn immunoassay (G0328) |
$69 |
$69 |
3.8× |
| Group mnt 2 or more 30 mins (G0271) |
$26 |
$26 |
1.5× |
| Home sleep test/type 3 porta (G0399) |
$456 |
$456 |
2.0× |
| Hospital outpt clinic visit (G0463) |
$140 |
$140 |
1.0× |
| Inj for sacroiliac jt anesth (G0260) |
$3,072 |
$3,072 |
4.2× |
| Mri w/o fol w/cont, breast, (C8908) |
$2,750 |
$2,750 |
7.6× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$650 |
$650 |
1.4× |
| Obtaining screen pap smear (Q0091) |
$97.50 |
$97.50 |
3.3× |
| Quan MRI alys brain with diagnostic MRI (0866T) |
$525 |
$525 |
2.1× |
| Tomosynthesis, mammo (G0279) |
$110 |
$110 |
8.7× |
| Visit to determ ldct elig (G0296) |
$75 |
$75 |
0.7× |