Supplies, drugs & other prices at Poplar Bluff Regional Medical Center

Poplar Bluff, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $31.75 $151.17 0.9×
Admin hepatitis b vaccine (G0010) $51.59 $245.65 1.1×
Admin influenza virus vac (G0008) $47.09 $224.23 1.0×
Admin pneumococcal vaccine (G0009) $48.94 $233.04 1.0×
Amalgam one surface permanen (D2140) $20,884.45 $99,449.74 32.3×
Amalgam three surfaces perma (D2160) $25,199.49 $119,997.55 38.9×
Ant resin-based cmpst crown (D2390) $19,515.81 $92,932.41 30.1×
Autolog prp not diab ulcer (G0460) $726.95 $3,461.69 0.4×
Catheterize for urine spec (P9612) $119.31 $568.13 12.8×
Colon ca scrn not hi rsk ind (G0121) $4,897.70 $23,322.39 5.3×
Colorectal scrn; hi risk ind (G0105) $4,960.61 $23,621.97 5.3×
Comprehensve oral evaluation (D0150) $17,025.07 $81,071.77 127.7×
Dental bitewings two images (D0272) $16,719.71 $79,617.67 191.8×
Direct refer hospital observ (G0379) $495.22 $2,358.18 0.8×
Eia hiv-1/hiv-2 screen (G0432) $25.92 $123.45 1.3×
Elec stim other than wound (G0283) $102.11 $486.25 8.0×
Elisa hiv-1/hiv-2 screen (G0433) $19.31 $91.96 1.1×
Extraction erupted tooth/exr (D7140) $20,166.48 $96,030.85 31.1×
Hbot, full body chamber, 30m (G0277) $611.09 $2,909.93 4.4×
Hiv combination assay (G0475) $35.98 $171.32 1.5×
Hospital outpt clinic visit (G0463) $189.28 $901.32 1.4×
Inj for sacroiliac jt anesth (G0260) $420 $2,000 0.6×
Mra w/o cont, abd (C8901) $330.67 $1,574.64 1.4×
Mra w/o fol w/cont, abd (C8902) $716.97 $3,414.14 2.1×
Mri w/o fol w/cont, breast, (C8908) $3,531.07 $16,814.64 10.1×
Oral hiv-1/hiv-2 screen (G0435) $18.78 $89.43 1.6×
Oral/facial photo images (D0350) $16,541.95 $78,771.18 189.8×
Oth resp proc, group (G0239) $105.81 $503.88 2.8×
Oth resp proc, indiv (G0238) $88.62 $422 3.1×
Pathogen test for platelets (P9100) $72.48 $345.16 1.2×
Perc d-e cor revasc chro sin (C9607) $19,356.36 $92,173.13 1.1×
Perc d-e cor revasc t cabg s (C9604) $13,221.95 $62,961.67 1.1×
Perc d-e cor stent ather s (C9602) $19,356.36 $92,173.13 1.1×
Perc drug-el cor stent sing (C9600) $13,397.61 $63,798.12 1.2×
Perq Sacral Augmt Bilat Inj (0201T)
likely a partial charge, not the full procedure
$1,928.80 $9,184.78 0.3×
Perq Sacral Augmt Unilat Inj (0200T)
likely a partial charge, not the full procedure
$1,928.94 $9,185.42 0.3×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T)
likely a partial charge, not the full procedure
$1,686.85 $8,032.60 0.1×
Post 1 srfc resinbased cmpst (D2391) $18,430.52 $87,764.38 28.5×
Post 2 srfc resinbased cmpst (D2392) $18,935.54 $90,169.26 29.2×
Post 3 srfc resinbased cmpst (D2393) $21,201.48 $100,959.43 32.7×
Post >=4srfc resinbase cmpst (D2394) $21,761.86 $103,627.89 33.6×
Prefab stnlss steel crown pe (D2931) $16,801.62 $80,007.71 25.9×
Prefab stnlss steel crwn pri (D2930) $19,103.78 $90,970.37 29.5×
Prolonged iv inf, req pump (C8957) $391.52 $1,864.37 1.8×
Psa screening (G0103) $140.34 $668.28 7.3×
Rem imp tooth w mucoper flp (D7210) $10,241.24 $48,767.81 6.6×
Resin 4/> surf or w incis an (D2335) $21,845.51 $104,026.26 33.7×
Resin one surface-anterior (D2330) $21,080.54 $100,383.53 32.6×
Resin three surfaces-anterio (D2332) $21,048.71 $100,231.95 32.5×
Resin two surfaces-anterior (D2331) $18,924.20 $90,115.25 29.2×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $22,701.59 $108,102.80 1.2×
Therapeutic procd strg endur (G0237) $92.85 $442.16 3.2×
Therapeutic pulpotomy (D3220) $22,456.46 $106,935.50 34.7×
Tomosynthesis, mammo (G0279) $137.82 $656.31 10.9×
Trauma respons w/hosp criti (G0390) $1,500.48 $7,145.12 1.1×
Trluml peripheral atherectomy iliac artery ea (0238T) $18,959.55 $90,283.56 1.0×
Tte w or w/o contr, cont ecg (C8930) $864.44 $4,116.36 1.1×
Tte w or wo fol wcon,doppler (C8929) $1,258.68 $5,993.71 1.6×
Unsched dialysis esrd pt hos (G0257) $783.57 $3,731.27 1.1×