18 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
| Admin hepatitis b vaccine (G0010) |
$44.93 |
$108 |
0.9× |
| Admin influenza virus vac (G0008) |
$44.93 |
$108 |
0.9× |
| Admin pneumococcal vaccine (G0009) |
$44.93 |
$108 |
0.9× |
| Catheterize for urine spec (P9612) |
$48.32 |
$74 |
5.2× |
| Direct refer hospital observ (G0379) |
$378.01 |
$654 |
0.6× |
| Fern test (Q0114) |
$43.89 |
$66 |
4.5× |
| FLT3 (fms-related tyrosine kinase 3) (eg, acute lyeloid leukemia) internal tandem duplication (ITD) variants,… (0046U) |
$1,085.40 |
$1,800 |
2.7× |
| Instlj fecal microbiota ssp rct nma lwr gi trc (0780T) |
$481.80 |
$584 |
3.5× |
| Neuro csf prion prtn qual (0035U) |
$978.67 |
$1,623 |
1.8× |
| NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative Other Outpatient (0049U) |
$1,371.83 |
$2,275 |
3.4× |
| Oth resp proc, group (G0239) |
$126.26 |
$214 |
3.3× |
| Oth resp proc, indiv (G0238) |
$40.71 |
$69 |
1.4× |
| Prostate biopsy, any mthd (G0416) |
$739.08 |
$925 |
2.0× |
| Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups,… (0001U) |
$1,632.96 |
$2,160 |
2.3× |
| Therapeutic procd strg endur (G0237) |
$74.93 |
$127 |
2.5× |
| Trauma respons w/hosp criti (G0390) |
$1,981.50 |
$3,302.50 |
1.5× |
| Tte w or w/o contr, cont ecg (C8930) |
$1,363.21 |
$1,993 |
1.7× |
| Tte w or wo fol wcon,doppler (C8929) |
$2,530.80 |
$3,700 |
3.2× |