Supplies, drugs & other prices at Phelps Memorial Health Center

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

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $28.80 $32 0.6×
Admin influenza virus vac (G0008) $41.40 $46 0.9×
Admin pneumococcal vaccine (G0009) $41.40 $46 0.9×
Colon ca scrn not hi rsk ind (G0121) $852.30 $947 0.9×
Colorectal scrn; hi risk ind (G0105) $1,042.20 $1,158 1.1×
Covid-19 lab test non-cdc (U0002) $248.40 $276 4.8×
Diab manage trn per indiv (G0108) $132.75 $147.50 2.4×
Direct refer hospital observ (G0379) $674.10 $749 1.1×
Ekg tracing for initial prev (G0404) $16.20 $18 0.5×
Elec stim other than wound (G0283) $96.30 $107 7.6×
Fecal blood scrn immunoassay (G0328) $69.30 $77 3.8×
Initial preventive exam (G0402) $318.60 $354 2.3×
Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) $2,271.15 $2,523.50 0.7×
Insertion of sinus tarsi implant (0335T)
likely a partial charge, not the full procedure
$1,696.50 $1,885 0.2×
Liver dis 10 assays w/nash (0003M) $981 $1,090 1.9×
Oth resp proc, group (G0239) $260.10 $289 6.7×
Oth resp proc, indiv (G0238) $95.40 $106 3.2×
Perc drug-el cor stent sing (C9600) $37,902.60 $42,114 3.2×
Perq Sacral Augmt Bilat Inj (0201T) $6,887.70 $7,653 0.9×
Perq Sacral Augmt Unilat Inj (0200T)
unusually low: confirm this is the full procedure
$2,820.60 $3,134 0.4×
Ppps, initial visit (G0438) $201.60 $224 1.2×
Ppps, subseq visit (G0439) $158.40 $176 1.2×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $647.10 $719 0.9×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $5,132.70 $5,703 1.3×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $8,089.65 $8,988.50 2.1×
Revasc intra lithotrip-stent (C9765) $25,430.40 $28,256 1.3×
Revasc lithotrip tibi/perone (C9772) $15,953.40 $17,726 1.3×
Therapeutic procd strg endur (G0237) $145.80 $162 4.9×
Trauma respons w/hosp criti (G0390) $1,669.50 $1,855 1.2×