Supplies, drugs & other prices at Portsmouth Regional Hospital
Portsmouth, NH · every code in this section with a posted price and a Medicare benchmark.
61 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) | $5,884 | $5,884 | 7.0× |
| 2d tte w or w/o fol w/con,co (C8923) | $5,884 | $5,884 | 7.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $5,884 | $5,884 | 15.7× |
| Adm tocilizu covid-19 1st (M0249) | $798 | $798 | 1.7× |
| Admin hepatitis b vaccine (G0010) | $185 | $185 | 3.7× |
| Admin influenza virus vac (G0008) | $105 | $105 | 2.1× |
| Admin pneumococcal vaccine (G0009) | $105 | $105 | 2.1× |
| Diab manage trn per indiv (G0108) | $265 | $265 | 4.8× |
| Direct refer hospital observ (G0379) | $686 | $686 | 1.1× |
| Drug test def 1-7 classes (G0480) | $743 | $743 | 6.5× |
| Drug test def 15-21 classes (G0482) | $1,226 | $1,226 | 6.2× |
| Drug test def 22+ classes (G0483) | $1,471 | $1,471 | 6.0× |
| Drug test def 8-14 classes (G0481) | $1,766 | $1,766 | 11.3× |
| Elec stim other than wound (G0283) | $100 | $100 | 7.9× |
| Group mnt 2 or more 30 mins (G0271) | $130 | $130 | 7.6× |
| Hbot, full body chamber, 30m (G0277) | $1,945 | $1,945 | 13.1× |
| Hdr electronic brachytherapy ntrstl/intrcav (0395T) | $2,628 | $2,628 | 3.5× |
| Hiv combination assay (G0475) | $744 | $744 | 30.9× |
| Home sleep test/type 3 porta (G0399) | $1,244 | $1,244 | 5.3× |
| Lev 1 hosp type b ed visit (G0380) | $629 | $629 | 7.9× |
| Lev 2 hosp type b ed visit (G0381) | $832 | $832 | 8.3× |
| Lev 3 hosp type b ed visit (G0382) | $1,178 | $1,178 | 6.4× |
| Lev 4 hosp type b ed visit (G0383) | $2,109 | $2,109 | 7.4× |
| Lev 5 hosp type b ed visit (G0384) | $3,871 | $3,871 | 8.7× |
| Mnt subs tx for change dx (G0270) | $128.50 | $128.50 | 4.0× |
| Mra w/cont, abd (C8900) | $7,613 | $7,613 | 20.3× |
| Mra w/cont, chest (C8909) | $9,146 | $9,146 | 24.3× |
| Mra w/cont, lwr ext (C8912) | $7,975 | $7,975 | 21.2× |
| Mra w/cont, pelvis (C8918) | $7,975 | $7,975 | 21.2× |
| Mra w/o cont, abd (C8901) | $6,769 | $6,769 | 26.3× |
| Mra w/o cont, chest (C8910) | $9,146 | $9,146 | 35.6× |
| Mra w/o cont, lwr ext (C8913) | $7,975 | $7,975 | 31.0× |
| Mra w/o cont, pelvis (C8919) | $7,975 | $7,975 | 31.0× |
| Mra w/o fol w/cont, abd (C8902) | $9,146 | $9,146 | 24.3× |
| Mra w/o fol w/cont, chest (C8911) | $9,146 | $9,146 | 24.3× |
| Mra w/o fol w/cont, lwr ext (C8914) | $7,975 | $7,975 | 21.2× |
| Mra w/o fol w/cont, pelvis (C8920) | $7,975 | $7,975 | 21.2× |
| Mra, w/dye, upper extremity (C8934) | $7,975 | $7,975 | 21.2× |
| Mra, w/o dye, spinal canal (C8932) | $9,146 | $9,146 | 35.6× |
| Mra, w/o dye, upper extr (C8935) | $7,975 | $7,975 | 31.0× |
| Mra, w/o&w/dye, spinal canal (C8933) | $9,146 | $9,146 | 24.3× |
| Mra, w/o&w/dye, upper extr (C8936) | $7,975 | $7,975 | 21.2× |
| Mri w/cont, breast, bi (C8906) | $4,083 | $4,083 | 10.9× |
| Mri w/cont, breast, uni (C8903) | $7,613 | $7,613 | 40.3× |
| Mri w/o fol w/cont, breast, (C8908) | $9,978 | $9,978 | 26.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $7,255 | $7,255 | 19.3× |
| Oth resp proc, group (G0239) | $625 | $625 | 15.5× |
| Oth resp proc, indiv (G0238) | $325 | $325 | 10.4× |
| Pathogen test for platelets (P9100) | $571 | $571 | 9.0× |
| Psa screening (G0103) | $309 | $309 | 16.0× |
| Tee w or w/o fol w/cont,cong (C8926) | $5,884 | $5,884 | 7.0× |
| Therapeutic procd strg endur (G0237) | $325 | $325 | 10.4× |
| Tomosynthesis, mammo (G0279) | $52 | $52 | 4.1× |
| Trauma respons w/hosp criti (G0390) | $23,128 | $23,128 | 16.1× |
| Tte w or w/o contr, cont ecg (C8930) | $6,875 | $6,875 | 8.1× |
| Tte w or w/o fol w/con,stres (C8928) | $6,875 | $6,875 | 8.1× |
| Tte w or w/o fol w/cont, com (C8921) | $5,884 | $5,884 | 7.0× |
| Tte w or w/o fol w/cont, f/u (C8922) | $5,884 | $5,884 | 7.0× |
| Tte w or wo fol wcon,doppler (C8929) | $6,263 | $6,263 | 7.4× |
| Unsched dialysis esrd pt hos (G0257) | $3,454 | $3,454 | 4.7× |
| Visit to determ ldct elig (G0296) | $200 | $200 | 1.8× |