Supplies, drugs & other prices at Ochsner LSU Health - St. Mary Medical Center
Shreveport, LA · every code in this section with a posted price and a Medicare benchmark.
76 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $931.84 | $3,328 | 1.3× |
| Admin hepatitis b vaccine (G0010) | $22.40 | $80 | 0.5× |
| Admin influenza virus vac (G0008) | $22.40 | $80 | 0.5× |
| Admin pneumococcal vaccine (G0009) | $22.40 | $80 | 0.5× |
| Behavior counsel obesity 15m (G0447) | $32.20 | $115 | 0.4× |
| Ca screen;flexi sigmoidscope (G0104) | $372.40 | $1,330 | 0.4× |
| Ca screen;pelvic/breast exam (G0101) | $32.20 | $115 | 0.4× |
| Catheterize for urine spec (P9612) | $16.94 | $60.50 | 1.8× |
| Colon ca scrn not hi rsk ind (G0121) | $645.68 | $2,306 | 0.8× |
| Colorectal scrn; hi risk ind (G0105) | $645.68 | $2,306 | 0.8× |
| Covid-19 lab test non-cdc (U0002) | $51.80 | $185 | 1.0× |
| Depression screen annual (G0444) | $11.48 | $41 | 0.3× |
| Diab manage trn per indiv (G0108) | $54.60 | $195 | 1.0× |
| Diab manage trn ind/group (G0109) | $31.64 | $113 | 2.0× |
| Direct refer hospital observ (G0379) | $666.68 | $2,381 | 1.2× |
| Elec stim other than wound (G0283) | $18.45 | $65.88 | 1.5× |
| Esd endoscopy or colonoscopy (C9779) | $2,262.40 | $8,080 | 0.6× |
| Extraction erupted tooth/exr (D7140) | $595 | $2,125 | 1.0× |
| Fecal microbiota prep instil (G0455) | $346.92 | $1,239 | 0.4× |
| Fern test (Q0114) | $4.20 | $15 | 0.4× |
| Followup eval of foot pt lop (G0246) | $120.40 | $430 | 1.0× |
| Group mnt 2 or more 30 mins (G0271) | $22.40 | $80 | 1.3× |
| Hospital outpt clinic visit (G0463) | $51.24 | $183 | 0.4× |
| Ig paraprotein qual bld/ur (0077U) | $18.48 | $66 | 0.4× |
| Impact tooth rem bony w/comp (D7241) | $595 | $2,125 | 1.0× |
| Impact tooth remov comp bony (D7240) | $595 | $2,125 | 1.0× |
| Impact tooth remov part bony (D7230) | $595 | $2,125 | 1.0× |
| Impact tooth remov soft tiss (D7220) | $595 | $2,125 | 1.0× |
| Initial foot exam pt lops (G0245) | $120.40 | $430 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) | $918.40 | $3,280 | 1.4× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $51.24 | $183 | 0.4× |
| Liver dis 10 assays w/nash (0003M) | $211.68 | $756 | 0.4× |
| Mnt subs tx for change dx (G0270) | $22.40 | $80 | 0.7× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $227.36 | $812 | 0.4× |
| Nfct ds strn typ whl gen seq (0010U) | $179.48 | $641 | 0.4× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $116.48 | $416 | 0.3× |
| Obtaining screen pap smear (Q0091) | $10.64 | $38 | 0.4× |
| Onc merkel cell carc detcj antb serum reprtd +/- (0059U) | $99.40 | $355 | 0.3× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $99.40 | $355 | 0.3× |
| Pelvic ring fracture uni/bil (G0413) unusually low: confirm this is the full procedure |
$2,686.88 | $9,596 | 0.4× |
| Perc d-e cor revasc chro sin (C9607) | $16,612.68 | $59,331 | 1.0× |
| Perc d-e cor revasc t cabg s (C9604) | $16,612.68 | $59,331 | 1.6× |
| Perc d-e cor stent ather s (C9602) | $16,612.68 | $59,331 | 1.0× |
| Perc drug-el cor stent sing (C9600) | $16,612.68 | $59,331 | 1.6× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) | $10,960.32 | $39,144 | 0.9× |
| Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) unusually low: confirm this is the full procedure |
$6,889.12 | $24,604 | 0.4× |
| Place device/marker, non pro (C9728) | $541.80 | $1,935 | 0.4× |
| Potassium hydroxide preps (Q0112) | $2.52 | $9 | 0.4× |
| Prolonged iv inf, req pump (C8957) | $208.32 | $744 | 1.1× |
| Prostate biopsy, any mthd (G0416) | $125.16 | $447 | 0.4× |
| Psa screening (G0103) | $8.12 | $29 | 0.4× |
| Rem imp tooth w mucoper flp (D7210) | $595 | $2,125 | 0.4× |
| Rem odontogen cyst to 1.25cm (D7450) | $80.64 | $288 | 0.0× |
| Revasc intra lithotrip-ather (C9766) unusually low: confirm this is the full procedure |
$6,678 | $23,850 | 0.4× |
| Revasc intra lithotrip-stent (C9765) | $14,429.18 | $51,532.80 | 0.9× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$4,494.56 | $16,052 | 0.4× |
| Revasc lith-sten-ath tib/per (C9775) | $14,565.88 | $52,021 | 0.9× |
| Revasc lithotr-ather tib/per (C9774) | $14,565.88 | $52,021 | 0.9× |
| Revasc lithotr-stent tib/per (C9773) | $14,565.88 | $52,021 | 0.9× |
| Revasc lithotrip tibi/perone (C9772) | $9,106.44 | $32,523 | 0.9× |
| Routine footcare pt w lops (G0247) | $102.76 | $367 | 0.6× |
| Rx Metab Advrs Trgt Seq Alys (0029U) | $311.92 | $1,114 | 0.4× |
| Therapeutic procd strg endur (G0237) | $53.76 | $192 | 2.1× |
| Tooth reimplantation (D7270) | $64.40 | $230 | 0.1× |
| Tooth root removal (D7250) | $595 | $2,125 | 1.0× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) | $196 | $700 | 0.4× |
| Trauma respons w/hosp criti (G0390) | $3,360 | $12,000 | 2.8× |
| Trim nail(s) (G0127) | $24.08 | $86 | 0.5× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $9,640.68 | $34,431 | 0.9× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $9,640.68 | $34,431 | 0.6× |
| Tte w or w/o fol w/cont, com (C8921) | $931.84 | $3,328 | 1.3× |
| Tte w or wo fol wcon,doppler (C8929) | $975.52 | $3,484 | 1.4× |
| Unsched dialysis esrd pt hos (G0257) | $609.56 | $2,177 | 1.0× |
| Vasc emb/occ w/prs cath (C9797) | $14,034.16 | $50,122 | 0.8× |
| Warfarin response genotype (0030U) | $56.56 | $202 | 0.4× |
| Wet mounts/ w preparations (Q0111) | $6.72 | $24 | 0.4× |