Supplies, drugs & other prices at Norwalk Hospital

Norwalk, CT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $3,426 $3,426 3.6×
2d tte w or w/o fol w/con,co (C8923) $3,426 $3,426 3.6×
2d tte w or w/o fol w/con,fu (C8924) $1,645 $1,645 3.9×
Adm tocilizu covid-19 1st (M0249) $1,408 $1,408 2.7×
Adm tocilizu covid-19 2nd (M0250) $1,408 $1,408 2.7×
Amalgam 4 or > surfaces perm (D2161) $727 $727 0.9×
Amalgam one surface permanen (D2140) $346 $346 0.4×
Amalgam three surfaces perma (D2160) $528 $528 0.7×
Amalgam two surfaces permane (D2150) $414 $414 0.5×
Autolog prp not diab ulcer (G0460) $6,530 $6,530 2.6×
Bitewings four images (D0274) $174 $174 0.6×
Covid-19 lab test non-cdc (U0002) $122 $122 2.4×
Crown porcelain fused base m (D2751) $2,930 $2,930 3.8×
Demonstrate use home inr mon (G0248) $395 $395 2.5×
Dental bitewings two images (D0272) $116 $116 1.1×
Dental prophylaxis adult (D1110) $232 $232 1.5×
Diab manage trn per indiv (G0108) $203 $203 3.6×
Diab manage trn ind/group (G0109) $108 $108 6.7×
Direct refer hospital observ (G0379) $427 $427 0.6×
Drug test def 1-7 classes (G0480) $479 $479 4.2×
Drug test def 8-14 classes (G0481) $656 $656 4.2×
End thxpy, anterior tooth (D3310) $2,143 $2,143 2.8×
End thxpy, molar tooth (D3330) $3,185 $3,185 4.1×
End thxpy, premolar tooth (D3320) $2,756 $2,756 3.6×
Extraction erupted tooth/exr (D7140) $418 $418 0.5×
Group mnt 2 or more 30 mins (G0271) $157 $157 9.2×
Hbot, full body chamber, 30m (G0277) $1,008 $1,008 6.1×
Impact tooth remov comp bony (D7240) $1,367 $1,367 1.8×
Impact tooth remov part bony (D7230) $1,046 $1,046 1.3×
Impact tooth remov soft tiss (D7220) $828 $828 1.1×
Inj for sacroiliac jt anesth (G0260) $2,368 $2,368 2.8×
Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed,… (0744T) $21,093 $21,093 3.2×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $61,518 $61,518 1.6×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $20,874 $20,874 2.1×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $20,874 $20,874 2.1×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $43,763 $43,763 1.6×
Interro Device Evaluation Cardiac Modulj System (0418T) $128 $128 2.9×
Intraor comprehensive series (D0210) $368 $368 1.3×
Intraoral occlusal film (D0240) $69 $69 0.7×
Intraoral periapical first (D0220) $69 $69 0.7×
Limit oral eval problm focus (D0140) $174 $174 1.1×
Mnt subs tx for change dx (G0270) $64 $64 2.0×
Panoramic image (D0330) $317 $317 1.1×
Pemivibart infusion (M0224) $1,325 $1,325 2.5×
Perc d-e cor revasc chro sin (C9607) $24,361 $24,361 1.1×
Perc d-e cor revasc t cabg s (C9604) $33,784 $33,784 2.4×
Perc d-e cor stent ather s (C9602) $33,784 $33,784 1.5×
Perc drug-el cor stent sing (C9600) $17,758 $17,758 1.3×
Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) $87,696 $87,696 4.0×
Periodic oral evaluation (D0120) $128 $128 0.8×
Periodontal scaling & root (D4341) $177 $177 0.2×
Perq Sacral Augmt Bilat Inj (0201T) $10,175 $10,175 1.2×
Perq Sacral Augmt Unilat Inj (0200T) $8,426 $8,426 1.0×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) $21,338 $21,338 1.5×
Place direct restoration (D2940) $182 $182 0.2×
Post 1 srfc resinbased cmpst (D2391) $474 $474 0.6×
Post 2 srfc resinbased cmpst (D2392) $582 $582 0.8×
Post 3 srfc resinbased cmpst (D2393) $727 $727 0.9×
Post >=4srfc resinbase cmpst (D2394) $911 $911 1.2×
Prefab post/core + crown (D2954) $838 $838 1.1×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $128 $128 2.9×
Prostate biopsy, any mthd (G0416) $1,476 $1,476 3.4×
Quan MRI alys brain with diagnostic MRI (0866T) $368 $368 1.3×
Rad exc lesion up to 1.25 cm (D7410) $323 $323 0.2×
Re-cement or re-bond crown (D2920) $153 $153 0.2×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $6,620 $6,620 2.7×
Rem exostosis any site (D7471) $361 $361 0.1×
Rem odontogen cyst to 1.25cm (D7450) $1,593 $1,593 0.4×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $12,853 $12,853 2.9×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $12,853 $12,853 2.9×
Removal fb skin/areolar tiss (D7530) $304 $304 0.4×
Repos Cardiac Modulj Transvenous Electrode (0415T) $2,218 $2,218 2.9×
Resin 4/> surf or w incis an (D2335) $862 $862 1.1×
Resin one surface-anterior (D2330) $363 $363 0.5×
Resin three surfaces-anterio (D2332) $617 $617 0.8×
Resin two surfaces-anterior (D2331) $497 $497 0.6×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $43,763 $43,763 1.6×
Therapeutic pulpotomy (D3220) $483 $483 0.6×
Trauma respons w/hosp criti (G0390) $9,958 $9,958 6.2×
Trim nail(s) (G0127) $212 $212 3.0×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $33,168 $33,168 2.4×
Trluml peripheral atherectomy iliac artery ea (0238T) $31,826 $31,826 1.4×
Tte w or w/o contr, cont ecg (C8930) $3,426 $3,426 3.6×
Tte w or w/o fol w/con,stres (C8928) $3,426 $3,426 3.6×
Tte w or w/o fol w/cont, com (C8921) $3,426 $3,426 3.6×
Tte w or w/o fol w/cont, f/u (C8922) $3,426 $3,426 3.6×
Tte w or wo fol wcon,doppler (C8929) $3,426 $3,426 3.6×
Unsched dialysis esrd pt hos (G0257) $2,350 $2,350 2.9×