Supplies, drugs & other prices at PeaceHealth Southwest Medical Center
Vancouver, WA · every code in this section with a posted price and a Medicare benchmark.
66 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) | $4,649.45 | $7,153 | 5.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $2,632.50 | $4,050 | 6.8× |
| Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) | $17,905.55 | $27,547 | 1.8× |
| Admin hepatitis b vaccine (G0010) | $76.05 | $117 | 1.5× |
| Admin influenza virus vac (G0008) | $77.35 | $119 | 1.5× |
| Admin pneumococcal vaccine (G0009) | $54.60 | $84 | 1.0× |
| Ca screen;flexi sigmoidscope (G0104) | $1,437.90 | $2,212.16 | 1.4× |
| Catheterize for urine spec (P9612) | $49.72 | $76.50 | 5.3× |
| Chemo extend iv infus w/pump (G0498) | $1,050.40 | $1,616 | 2.9× |
| Colon ca scrn not hi rsk ind (G0121) | $1,937.32 | $2,980.50 | 1.9× |
| Colorectal scrn; hi risk ind (G0105) | $1,794.65 | $2,761 | 1.7× |
| Covid-19 lab test non-cdc (U0002) | $66.95 | $103 | 1.3× |
| Direct refer hospital observ (G0379) | $1,593.15 | $2,451 | 2.4× |
| Drug test def 1-7 classes (G0480) | $117 | $180 | 1.0× |
| Drug test def 22+ classes (G0483) | $2,029.30 | $3,122 | 8.2× |
| Elec stim other than wound (G0283) | $81.90 | $126 | 6.5× |
| Esd endoscopy or colonoscopy (C9779) | $5,269.55 | $8,107 | 1.2× |
| Facility svs dental rehab (G0330) | $4,731.68 | $7,279.50 | 1.3× |
| Fecal blood scrn immunoassay (G0328) | $110.50 | $170 | 6.1× |
| Hbot, full body chamber, 30m (G0277) | $3,075.80 | $4,732 | 20.1× |
| Hospital outpt clinic visit (G0463) | $192.40 | $296 | 1.3× |
| Impact tooth remov comp bony (D7240) | $5,232.01 | $8,049.25 | 7.3× |
| Inj for sacroiliac jt anesth (G0260) | $2,388.10 | $3,674 | 3.0× |
| Insj ant sgm drg dev trab mw w/o res&ctrc rmvl1+ (0671T) | $9,367.15 | $14,411 | 1.6× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) | $65,915.20 | $101,408 | 1.9× |
| Mra w/cont, abd (C8900) | $1,931.80 | $2,972 | 5.0× |
| Mra w/cont, chest (C8909) | $2,845.70 | $4,378 | 7.3× |
| Mra w/cont, lwr ext (C8912) | $3,108.95 | $4,783 | 8.0× |
| Mra w/o cont, abd (C8901) | $1,718.92 | $2,644.50 | 6.5× |
| Mra w/o cont, chest (C8910) | $1,574.30 | $2,422 | 5.9× |
| Mra w/o cont, lwr ext (C8913) | $1,174.55 | $1,807 | 4.4× |
| Mra w/o fol w/cont, abd (C8902) | $1,772.22 | $2,726.50 | 4.6× |
| Mra w/o fol w/cont, chest (C8911) | $2,609.42 | $4,014.50 | 6.7× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,625.68 | $4,039.50 | 6.8× |
| Mra, w/dye, upper extremity (C8934) | $1,214.85 | $1,869 | 3.1× |
| Mra, w/o&w/dye, spinal canal (C8933) | $1,760.85 | $2,709 | 4.5× |
| Mri w/cont, breast, bi (C8906) | $3,495.05 | $5,377 | 9.0× |
| Mri w/o fol w/cont, breast, (C8908) | $3,166.80 | $4,872 | 8.1× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,916.85 | $2,949 | 4.9× |
| Oth resp proc, group (G0239) | $208.32 | $320.50 | 5.0× |
| Perc d-e cor revasc chro sin (C9607) | $106,301 | $163,540 | 5.2× |
| Perc d-e cor revasc t cabg s (C9604) | $73,438.30 | $112,982 | 5.7× |
| Perc d-e cor stent ather s (C9602) | $116,126.40 | $178,656 | 5.7× |
| Perc drug-el cor stent sing (C9600) | $65,964.60 | $101,484 | 5.1× |
| Place device/marker, non pro (C9728) | $9,605.05 | $14,777 | 6.2× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $74.10 | $114 | 1.8× |
| Prolonged iv inf, req pump (C8957) | $3,293.88 | $5,067.50 | 13.9× |
| Psa screening (G0103) | $200.85 | $309 | 10.4× |
| Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0863T) | $3,570.45 | $5,493 | 1.6× |
| Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0862T) | $3,570.45 | $5,493 | 1.6× |
| Removal Pg Wcs Lv Pacing Both Components (0861T) | $7,689.50 | $11,830 | 1.8× |
| Revasc intra lithotrip-stent (C9765) | $31,511.35 | $48,479 | 1.5× |
| Revasc intravasc lithotripsy (C9764) | $18,524.35 | $28,499 | 1.4× |
| Revasc lithotrip tibi/perone (C9772) | $14,938.62 | $22,982.50 | 1.2× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $34,776.30 | $53,502 | 1.6× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $29,118.70 | $44,798 | 1.4× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $6,241.30 | $9,602 | 1.8× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) | $38,153.05 | $58,697 | 1.8× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $9,593.35 | $14,759 | 1.5× |
| Therapeutic procd strg endur (G0237) | $94.25 | $145 | 2.9× |
| Tomosynthesis, mammo (G0279) | $115.70 | $178 | 9.1× |
| Trauma respons w/hosp criti (G0390) | $15,624.05 | $24,037 | 10.5× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $31,822.70 | $48,958 | 2.5× |
| Tte w or w/o contr, cont ecg (C8930) | $4,789.20 | $7,368 | 5.5× |
| Tte w or wo fol wcon,doppler (C8929) | $4,719.32 | $7,260.50 | 5.4× |
| Unsched dialysis esrd pt hos (G0257) | $4,173.65 | $6,421 | 5.5× |