Supplies, drugs & other prices at Providence Sacred Heart Medical Center & Children's Hospital

Spokane, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,885.80 $2,694 2.2×
2d tte w or w/o fol w/con,co (C8923) $1,443.40 $2,062 1.7×
2d tte w or w/o fol w/con,fu (C8924) $1,527.40 $2,182 3.9×
Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) $22,171.80 $31,674 1.9×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $5,089.70 $7,271 2.3×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) $17,405.50 $24,865 1.8×
Adm tocilizu covid-19 1st (M0249) $349.30 $499 0.7×
Catheterize for urine spec (P9612) $11.20 $16 1.2×
Demonstrate use home inr mon (G0248) $266 $380 1.8×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) $1,266.30 $1,809 1.5×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) $1,266.30 $1,809 1.5×
Direct refer hospital observ (G0379) $938 $1,340 1.4×
Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) $7,907.20 $11,296 2.2×
Hospital outpt clinic visit (G0463) $344.40 $492 2.3×
Iliac Atherectomy (0238T) $18,809 $26,870 0.9×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $22,163.40 $31,662 1.9×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0526T) $22,163.40 $31,662 2.4×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0525T) $29,572.20 $42,246 1.4×
Insertion wrls car stimulator lv pacg compl sys (0515T)
likely a partial charge, not the full procedure
$53.90 $77 0.0×
Insertion/replacement iims implantable mntr only (0527T) $22,163.40 $31,662 2.4×
Insj Wcs Lv Eltrd Only (0516T) $22,163.40 $31,662 1.9×
Interrog dev eval wcs ip (0521T) $50.40 $72 1.6×
Ire Ablation 1+Tumors per Organ W/Img Gdn Perq (0600T) $22,171.80 $31,674 1.9×
Lev 1 hosp type b ed visit (G0380) $139.30 $199 1.7×
Lev 2 hosp type b ed visit (G0381) $254.10 $363 2.5×
Lev 3 hosp type b ed visit (G0382) $444.50 $635 2.3×
Lev 4 hosp type b ed visit (G0383) $638.40 $912 2.2×
Lev 5 hosp type b ed visit (G0384) $787.50 $1,125 1.7×
No pt prsnt train initial 30 (G0541) $201.60 $288 6.3×
Perc d-e cor revasc chro sin (C9607) $22,636.60 $32,338 1.1×
Perc d-e cor revasc t cabg s (C9604) $22,636.60 $32,338 1.8×
Perc d-e cor stent ather s (C9602) $22,636.60 $32,338 1.1×
Perc drug-el cor stent sing (C9600) $22,871.80 $32,674 1.8×
Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array… (0587T)
unusually low: confirm this is the full procedure
$2,996.70 $4,281 0.4×
Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) $52,983 $75,690 2.6×
Perq Sacral Augmt Bilat Inj (0201T) $15,763.30 $22,519 1.9×
Perq Sacral Augmt Unilat Inj (0200T) $6,747.30 $9,639 0.8×
Prgrmg dev eval wcs ip (0522T) $107.80 $154 2.6×
Prostate biopsy, any mthd (G0416) $284.20 $406 0.7×
Provide inr test mater/equip (G0249) $406.70 $581 2.7×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $723.10 $1,033 0.7×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $723.10 $1,033 0.7×
Quan MRI alys brain with diagnostic MRI (0866T) $602.70 $861 2.3×
Quan us tiss charac i&r w/o dx us same anat (0689T) $255.50 $365 2.6×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing pulse generator component(s)… (0520T) $65,839.90 $94,057 5.7×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s)… (0519T) $9,370.90 $13,387 0.8×
Removal complete iims (0530T) $9,370.90 $13,387 2.3×
Removal iims electrode only (0531T) $9,370.90 $13,387 2.3×
Removal iims implt mntr only (0532T) $9,370.90 $13,387 2.3×
Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left… (0518T) $9,370.90 $13,387 2.3×
Revasc intra lithotrip-stent (C9765) $51,067.10 $72,953 2.5×
Revasc intravasc lithotripsy (C9764) $33,468.40 $47,812 2.6×
Revasc lithotrip tibi/perone (C9772) $33,468.40 $47,812 2.6×
Revision or removal of integrated single device neurostimulation system including electrode array and receiver or pulse… (0588T) $1,298.50 $1,855 0.3×
Scr c/v cyto, autosys, rescr (G0148) $75.60 $108 2.4×
Scr c/v cyto,thinlayer,rescr (G0145) $147 $210 5.5×
Screen cerv/vag thin layer (G0123) $101.50 $145 5.0×
Screen pap by tech w md supv (P3000) $53.90 $77 2.9×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $16,443.70 $23,491 2.6×
Tee w or w/o fol w/cont,cong (C8926) $1,885.80 $2,694 2.2×
Therapeutic ultrafiltration (0692T) $1,246.70 $1,781 0.7×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $18,809 $26,870 1.5×
Trauma respons w/hosp criti (G0390) $12,497.45 $17,853.50 8.4×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $18,809 $26,870 1.5×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $18,809 $26,870 1.5×
Tte w or w/o contr, cont ecg (C8930) $1,885.80 $2,694 2.2×
Tte w or w/o fol w/con,stres (C8928) $1,885.80 $2,694 2.2×
Tte w or w/o fol w/cont, com (C8921) $1,885.80 $2,694 2.2×
Tte w or w/o fol w/cont, f/u (C8922) $1,443.40 $2,062 1.7×
Tte w or wo fol wcon,doppler (C8929) $1,905.40 $2,722 2.2×
Unsched dialysis esrd pt hos (G0257) $1,697.50 $2,425 2.2×