23 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) |
$2,377.80 |
$3,963 |
1.3× |
| Behavior counsel obesity 15m (G0447) |
$55.80 |
$93 |
0.6× |
| Ca screen;pelvic/breast exam (G0101) |
$48 |
$80 |
0.5× |
| Catheterize for urine spec (P9612) |
$82.80 |
$138 |
8.9× |
| Diab manage trn per indiv (G0108) |
$42 |
$70 |
0.8× |
| Diab manage trn ind/group (G0109) |
$28.80 |
$48 |
1.8× |
| Direct refer hospital observ (G0379) |
$89.40 |
$149 |
0.2× |
| Ekg tracing for initial prev (G0404) |
$46.80 |
$78 |
1.7× |
| Elec stim other than wound (G0283) |
$46.80 |
$78 |
3.7× |
| Hbot, full body chamber, 30m (G0277) |
$330 |
$550 |
2.5× |
| Home sleep test/type 3 porta (G0399) |
$165 |
$275 |
0.8× |
| Inj for sacroiliac jt anesth (G0260) |
$1,236 |
$2,060 |
1.8× |
| Obtaining screen pap smear (Q0091) |
$13.20 |
$22 |
0.5× |
| Oth resp proc, indiv (G0238) |
$51 |
$85 |
1.8× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) |
$21,951 |
$36,585 |
1.8× |
| Revasc intra lithotrip-stent (C9765) |
$12,533.40 |
$20,889 |
0.7× |
| Revasc intravasc lithotripsy (C9764) |
$6,186.60 |
$10,311 |
0.6× |
| Revasc lithotr-stent tib/per (C9773) |
$20,047.80 |
$33,413 |
1.1× |
| Revasc lithotrip tibi/perone (C9772) |
$12,533.40 |
$20,889 |
1.1× |
| Revasc lithotrip-stent-ather (C9767) |
$20,469.60 |
$34,116 |
1.2× |
| Trluml peripheral atherectomy iliac artery ea (0238T) |
$13,104 |
$21,840 |
0.7× |
| Visit to determ ldct elig (G0296) |
$73.20 |
$122 |
0.8× |
| Wet mounts/ w preparations (Q0111) |
$7.20 |
$12 |
0.4× |