Supplies, drugs & other prices at Pawnee County Memorial Hospital

Pawnee City, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin influenza virus vac (G0008) $46 $58 0.9×
Admin pneumococcal vaccine (G0009) $46 $58 0.9×
Adv prim care mgmt lvl 1 (G0556) $24 $30 0.6×
Adv prim care mgmt lvl 2 (G0557) $78 $98 2.0×
Adv prim care mgmt lvl 3 (G0558) $171 $214 1.6×
Annual alcohol screen 15 min (G0442) $32 $40 0.8×
Behavior counsel obesity 15m (G0447) $44 $55 0.4×
Brief alcohol misuse counsel (G0443) $44 $55 0.4×
Ca screen;pelvic/breast exam (G0101) $66 $83 0.6×
Colon ca scrn not hi rsk ind (G0121) $1,601 $2,001 1.7×
Colorectal scrn; hi risk ind (G0105) $1,730 $2,163 1.8×
Depression screen annual (G0444) $32 $40 0.8×
Direct refer hospital observ (G0379) $303 $379 0.5×
Eia hiv-1/hiv-2 screen (G0432) $85 $106 4.3×
Ekg tracing for initial prev (G0404) $229 $286 7.6×
Elec stim other than wound (G0283) $61 $76 4.8×
Hep c screen high risk/other (G0472) $82 $103 1.8×
Hepb screen high risk indiv (G0499) $95 $119 3.4×
Hiv combination assay (G0475) $82 $103 3.4×
Home sleep test/type 3 porta (G0399) $433 $541 1.9×
Hpv combo assay ca screen (G0476) $112 $140 3.2×
Initial preventive exam (G0402) $265 $331 1.9×
Obtaining screen pap smear (Q0091) $75 $94 2.5×
Ppps, initial visit (G0438) $264 $330 1.5×
Ppps, subseq visit (G0439) $207 $259 1.5×
Psa screening (G0103) $104 $130 5.4×
Tomosynthesis, mammo (G0279) $69 $86 5.4×
Trauma respons w/hosp criti (G0390) $1,440 $1,800 1.0×
Trim nail(s) (G0127) $65 $81 1.1×
Visit to determ ldct elig (G0296) $50 $62 0.5×