Supplies, drugs & other prices at Plumas District Hospital
Quincy, CA · every code in this section with a posted price and a Medicare benchmark.
113 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Adm of soc dtr assess 5-15 m (G0136) | $47.20 | $59 | 1.0× |
| Admin hepatitis b vaccine (G0010) | $62.40 | $78 | 1.0× |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$75.20–$78.40 | $94–$98 | varies |
| Admin pneumococcal vaccine (G0009) range across 2 matching MRF lines |
$75.20–$78.40 | $94–$98 | varies |
| Alveoloplasty not w/extracts (D7321) | $80.80 | $101 | 0.0× |
| Alveoplasty w/ extraction (D7310) | $257.60 | $322 | 0.1× |
| Alveoplasty w/o extraction (D7320) | $416 | $520 | 0.2× |
| Amalgam 4 or > surfaces perm (D2161) | $216.80 | $271 | 0.3× |
| Amalgam one surface permanen (D2140) | $129.60 | $162 | 0.2× |
| Amalgam three surfaces perma (D2160) | $192 | $240 | 0.2× |
| Amalgam two surfaces permane (D2150) | $156.80 | $196 | 0.2× |
| Annual alcohol screen 15 min (G0442) | $32.80 | $41 | 0.7× |
| Ant resin-based cmpst crown (D2390) | $376.80 | $471 | 0.5× |
| Bitewings - three images (D0273) | $39.20 | $49 | 0.1× |
| Bitewings four images (D0274) | $65.60 | $82 | 0.2× |
| Ca screen;pelvic/breast exam (G0101) | $44.80 | $56 | 0.3× |
| Catheterize for urine spec (P9612) | $152.80 | $191 | 16.4× |
| Colorectal scrn; hi risk ind (G0105) | $2,095.20 | $2,619 | 1.8× |
| Comprehensve oral evaluation (D0150) | $78.40 | $98 | 0.5× |
| Cone beam ct capt & interp (D0364) | $100.80 | $126 | 0.7× |
| Cone beam ct interp both jaw (D0367) | $164 | $205 | 1.2× |
| Cone beam ct interprete man (D0365) | $122.40 | $153 | 0.9× |
| Cone beam ct interprete max (D0366) | $122.40 | $153 | 0.9× |
| Core build-up incl any pins (D2950) | $228.80 | $286 | 0.3× |
| Crown full cast high noble m (D2790) | $981.60 | $1,227 | 1.2× |
| Crown full cast noble metal (D2792) | $936.80 | $1,171 | 1.1× |
| Crown porcelain fused base m (D2751) | $929.60 | $1,162 | 1.1× |
| Crown porcelain w/ h noble m (D2750) | $936.80 | $1,171 | 1.1× |
| Crown porcelain w/ noble met (D2752) | $954.40 | $1,193 | 1.1× |
| Crown porcelain/ceramic (D2740) | $826.40 | $1,033 | 1.0× |
| Dental bitewing single image (D0270) | $23.20 | $29 | 0.2× |
| Dental bitewings two images (D0272) | $46.40 | $58 | 0.4× |
| Dental prophylaxis adult (D1110) range across 2 matching MRF lines |
$66.40–$96 | $83–$120 | varies |
| Depression screen annual (G0444) | $32 | $40 | 0.7× |
| Diab manage trn per indiv (G0108) | $116.80 | $146 | 2.1× |
| Direct refer hospital observ (G0379) | $328 | $410 | 0.4× |
| Drug test def 1-7 classes (G0480) | $120 | $150 | 1.0× |
| Ekg tracing for initial prev (G0404) | $264.80 | $331 | 7.1× |
| End thxpy, anterior tooth (D3310) | $682.40 | $853 | 0.8× |
| End thxpy, molar tooth (D3330) | $936.80 | $1,171 | 1.1× |
| End thxpy, premolar tooth (D3320) | $770.40 | $963 | 0.9× |
| Extraction coronal remnants (D7111) | $108 | $135 | 0.1× |
| Extraction erupted tooth/exr (D7140) | $156.80 | $196 | 0.2× |
| Fixed bilat space maint, man (D1517) | $244.80 | $306 | 0.3× |
| Fixed bilat space maint, max (D1516) | $244.80 | $306 | 0.3× |
| Full mouth debridement (D4355) | $103.20 | $129 | 0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) | $391.20 | $489 | 0.1× |
| Gingivectomy/plasty 4 or mor (D4210) | $528 | $660 | 0.1× |
| Gross pulpal debridement (D3221) | $99.20 | $124 | 0.1× |
| Hopd mntl hlt, 15-29 min (C7900) | $539.20 | $674 | 11.2× |
| Hopd mntl hlt, 30-60 min (C7901) | $666.40 | $833 | 5.1× |
| Hopd mntl hlt, grp (C7903) | $648.80 | $811 | 13.5× |
| Hospital outpt clinic visit (G0463) | $84 | $105 | 0.5× |
| I&d absc intraoral soft tiss (D7510) | $160.80 | $201 | 0.2× |
| Impact tooth remov part bony (D7230) | $159.20 | $199 | 0.2× |
| Impact tooth remov soft tiss (D7220) | $166.40 | $208 | 0.2× |
| Initial foot exam pt lops (G0245) | $142.40 | $178 | 0.8× |
| Initial preventive exam (G0402) | $180.80 | $226 | 1.1× |
| Interim crown (D2799) | $257.60 | $322 | 0.3× |
| Intraor comprehensive series (D0210) | $128.80 | $161 | 0.4× |
| Intraoral periapical first (D0220) | $30.40 | $38 | 0.3× |
| Labial veneer porc indirect (D2962) | $844.80 | $1,056 | 1.0× |
| Labial veneer resin indirect (D2961) | $178.40 | $223 | 0.2× |
| Limit oral eval problm focus (D0140) | $60 | $75 | 0.4× |
| Limited occlusal adjustment (D9951) | $152.80 | $191 | 0.2× |
| Localized delivery antimicro (D4381) | $161.60 | $202 | 0.2× |
| Obtaining screen pap smear (Q0091) | $36 | $45 | 1.0× |
| Occ guard, soft, full arch (D9945) | $64.80 | $81 | 0.1× |
| Panoramic image (D0330) | $121.60 | $152 | 0.4× |
| Periodic oral evaluation (D0120) | $60 | $75 | 0.4× |
| Periodontal maint procedures (D4910) | $141.60 | $177 | 0.2× |
| Periodontal scaling & root (D4341) | $240.80 | $301 | 0.3× |
| Periodontal scaling 1-3teeth (D4342) | $156.80 | $196 | 0.2× |
| Place direct restoration (D2940) | $96 | $120 | 0.1× |
| Post 1 srfc resinbased cmpst (D2391) | $180 | $225 | 0.2× |
| Post 2 srfc resinbased cmpst (D2392) | $229.60 | $287 | 0.3× |
| Post 3 srfc resinbased cmpst (D2393) | $271.20 | $339 | 0.3× |
| Post >=4srfc resinbase cmpst (D2394) | $285.60 | $357 | 0.3× |
| Post and core cast + crown (D2952) | $324.80 | $406 | 0.4× |
| Ppps, initial visit (G0438) | $119.20 | $149 | 0.7× |
| Ppps, subseq visit (G0439) | $119.20 | $149 | 0.9× |
| Prefab porc/cer crown perm (D2928) | $122.40 | $153 | 0.1× |
| Prefab post/core + crown (D2954) | $283.20 | $354 | 0.3× |
| Prefab stnlss steel crown pe (D2931) | $577.60 | $722 | 0.7× |
| Prefab stnlss steel crwn pri (D2930) | $244.80 | $306 | 0.3× |
| Pulp cap direct (D3110) | $92.80 | $116 | 0.1× |
| Pulp cap indirect (D3120) | $92.80 | $116 | 0.1× |
| Pulp vitality test (D0460) | $25.60 | $32 | 0.0× |
| Rad exc lesion up to 1.25 cm (D7410) | $108 | $135 | 0.1× |
| Re-cement or re-bond crown (D2920) | $92.80 | $116 | 0.1× |
| Re-eval,est pt,problem focus (D0170) | $86.40 | $108 | 0.5× |
| Recement inlay onlay or part (D2910) | $53.60 | $67 | 0.1× |
| Recement space maint - man (D1552) | $67.20 | $84 | 0.1× |
| Recement space maint - max (D1551) | $67.20 | $84 | 0.1× |
| Recement unilat space maint (D1553) | $67.20 | $84 | 0.1× |
| Rem exostosis any site (D7471) | $192.80 | $241 | 0.0× |
| Rem imp tooth w mucoper flp (D7210) | $246.40 | $308 | 0.1× |
| Remove torus mandibularis (D7473) | $458.40 | $573 | 0.6× |
| Resin 4/> surf or w incis an (D2335) | $271.20 | $339 | 0.3× |
| Resin one surface-anterior (D2330) | $157.60 | $197 | 0.2× |
| Resin three surfaces-anterio (D2332) | $228 | $285 | 0.3× |
| Resin two surfaces-anterior (D2331) | $192 | $240 | 0.2× |
| Routine footcare pt w lops (G0247) | $56 | $70 | 0.2× |
| Space maintainer fxd unilat (D1510) | $293.60 | $367 | 0.4× |
| Splint extra-coronal (D4323) | $140.80 | $176 | 0.2× |
| Therapeutic pulpotomy (D3220) | $194.40 | $243 | 0.2× |
| Tooth reimplantation (D7270) | $618.40 | $773 | 0.7× |
| Tooth root removal (D7250) | $261.60 | $327 | 0.3× |
| Tooth splitting (D3920) | $395.20 | $494 | 0.5× |
| Treatment of complications (D9930) | $74.40 | $93 | 0.1× |
| Veneer repair (D2983) | $92.80 | $116 | 0.1× |
| Vert bitewings 7 to 8 images (D0277) | $65.60 | $82 | 0.2× |
| Visit to determ ldct elig (G0296) | $136 | $170 | 1.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.