Supplies, drugs & other prices at Northwestern Medicine Valley West Hospital

Sandwich, IL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,848.70 $2,641 2.2×
2d tte w or w/o fol w/con,co (C8923) $1,997.10 $2,853 2.4×
2d tte w or w/o fol w/con,fu (C8924) $1,383.90 $1,977 3.7×
Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) $10,148.60 $14,498 1.1×
Adm tocilizu covid-19 1st (M0249) $1,575 $2,250 3.3×
Admin influenza virus vac (G0008) $72.10 $103 1.4×
Admin pneumococcal vaccine (G0009) $62.30 $89 1.2×
Asstv alg ECG rsk asmt prev (0765T) $282.10 $403 2.0×
B burgdorferi antb 12 prtn grp immunoblot igg (0042U) $32.90 $47 1.9×
B burgdorferi antb 5 prtn grp immunoblot igm (0041U) $32.90 $47 1.9×
Behavior counsel obesity 15m (G0447) $105 $150 1.0×
Colon ca scrn not hi rsk ind (G0121) $2,146.20 $3,066 2.2×
Colorectal scrn; hi risk ind (G0105) $2,927.40 $4,182 2.9×
Comt gene analysis c.472g>a variant (0032U) $856.10 $1,223 4.9×
Cyp2d6 gen com&slct rar vrnt (0070U) $1,420.30 $2,029 2.1×
Direct refer hospital observ (G0379) $358.40 $512 0.6×
Drug test def 1-7 classes (G0480)
range across 18 matching MRF lines
$68.60–$257.60 $98–$368 varies
Drug test def 22+ classes (G0483) $405.30 $579 1.6×
Drug test def 8-14 classes (G0481) $289.80 $414 1.9×
Egd flexible transnasal dx w/collj spec br/wa (0652T) $1,959.30 $2,799 1.0×
Egd flexible transnasal w/insj intral tube/cath (0654T) $3,878.70 $5,541 0.9×
Endo defect closure gi tract (C9901) $22,791.30 $32,559 2.0×
Endo outlet restrict w/tube (C9785) $17,566.50 $25,095 1.5×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $76,619.20 $109,456 1.6×
Esd endoscopy or colonoscopy (C9779) $6,483.40 $9,262 1.6×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $23,851.10 $34,073 1.9×
Extraction erupted tooth/exr (D7140) $328.30 $469 0.5×
Fern test (Q0114) $32.90 $47 3.4×
Hbot, full body chamber, 30m (G0277) $747.60 $1,068 5.1×
High-resolution gastric electrophysiology mapg (0868T) $1,161.30 $1,659 2.9×
Home sleep test/type 4 porta (G0400) $692.30 $989 3.0×
Hospital outpt clinic visit (G0463) $201.60 $288 1.4×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $120.40 $172 2.8×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $18,116.70 $25,881 2.0×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $60,389.70 $86,271 1.8×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $70,185.50 $100,265 2.1×
Instlj fecal microbiota ssp (0780T) $266.70 $381 1.9×
Intens behave ther cardio dx (G0446) $47.60 $68 1.2×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $357 $510 2.9×
Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) $2,890.30 $4,129 2.1×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) $716.10 $1,023 2.2×
Neuro csf prion prtn qual (0035U) $447.30 $639 0.8×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $1,663.90 $2,377 1.8×
Njx platelet plasma (0232T) $5,433.40 $7,762 11.3×
Non-blind interatrial shunt (C9760) $60,200.70 $86,001 2.1×
Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) $6,304.20 $9,006 2.1×
Oth resp proc, group (G0239) $226.10 $323 5.6×
Oth resp proc, indiv (G0238) $86.80 $124 2.8×
Pathogen test for platelets (P9100) $1,036.70 $1,481 16.4×
Pef bronch ablt 3d nav ebus (C8005) $38,548.30 $55,069 2.1×
Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) $39,308.50 $56,155 2.0×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $12,481 $17,830 1.0×
Place device/marker, non pro (C9728) $3,132.50 $4,475 2.1×
Pre 3d mdl w/ccta and/or mri (C9793) $2,227.40 $3,182 2.4×
Prolonged iv inf, req pump (C8957) $922.60 $1,318 4.0×
Psa screening (G0103) $191.80 $274 9.9×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $2,093.70 $2,991 2.1×
Quan us tiss charac i&r w/o dx us same anat (0689T) $192.50 $275 2.1×
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee,… (0350T) $134.40 $192 1.4×
Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow, and wrist,… (0349T) $564.20 $806 5.0×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $613.20 $876 0.9×
Re-cement or re-bond crown (D2920) $3,639.30 $5,199 5.3×
Revasc intra lithotrip-ather (C9766) $20,512.80 $29,304 1.0×
Revasc intra lithotrip-stent (C9765) $13,102.60 $18,718 0.7×
Revasc intravasc lithotripsy (C9764) $12,307.40 $17,582 1.0×
Revasc lith-sten-ath tib/per (C9775)
likely a partial charge, not the full procedure
$1,314.60 $1,878 0.1×
Revasc lithotr-ather tib/per (C9774) $16,375.80 $23,394 0.8×
Revasc lithotr-stent tib/per (C9773) $16,375.80 $23,394 0.8×
Revasc lithotrip tibi/perone (C9772) $15,291.50 $21,845 1.2×
Revasc lithotrip-stent-ather (C9767) $16,375.80 $23,394 0.8×
Rx Metab Advrs Trgt Seq Alys (0029U) $1,558.90 $2,227 2.1×
Sim ang w/prs cath rad emb (C8004) $24,825.50 $35,465 2.0×
Tbrf b grp antb detcj 4 recomb prtn imunoblt igg (0044U) $28 $40 1.9×
Tbrf b grp antb detcj 4 recomb prtn imunoblt igm (0043U) $28 $40 1.9×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $39,480.70 $56,401 1.9×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $42,288.40 $60,412 2.0×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $41,748 $59,640 2.0×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $42,288.40 $60,412 2.0×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $12,825.40 $18,322 2.1×
Therapeutic procd strg endur (G0237) $102.20 $146 3.3×
Tomosynthesis, mammo (G0279) $95.90 $137 7.6×
Tpmt and Nudt15 Genotype (0034U) $420 $600 0.9×
Transcatheter Renal Sympath Denervation Bilat (0339T) $10,423 $14,890 1.7×
Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) $8,452.50 $12,075 2.4×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $24,825.50 $35,465 2.0×
Tte w or w/o contr, cont ecg (C8930) $4,760 $6,800 5.7×
Twin zygosity, genomic targeted sequence analysis of cromosome 2, using circulating cell-free fetal DNA in maternal… (0060U) $1,593.90 $2,277 2.1×
Unsched dialysis esrd pt hos (G0257) $1,647.10 $2,353 2.2×
Vasc emb/occ w/prs cath (C9797) $31,976 $45,680 1.6×

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.