Supplies, drugs & other prices at Providence Holy Family Hospital

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

43 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) $1,624.70 $2,321 1.9×
2d tte w or w/o fol w/con,co (C8923) $1,243.20 $1,776 1.4×
2d tte w or w/o fol w/con,fu (C8924) $1,243.20 $1,776 3.2×
Adm tocilizu covid-19 1st (M0249) $471.80 $674 1.0×
Catheterize for urine spec (P9612) $116.90 $167 12.5×
Demonstrate use home inr mon (G0248) $281.40 $402 1.9×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) $1,347.50 $1,925 1.6×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) $1,347.50 $1,925 1.6×
Direct refer hospital observ (G0379) $1,332.80 $1,904 2.0×
Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) $7,991.90 $11,417 2.3×
Home sleep test/type 3 porta (G0399) $794.50 $1,135 3.3×
Hospital outpt clinic visit (G0463) $329 $470 2.2×
Iliac Atherectomy (0238T) $24,614.80 $35,164 1.2×
Interrog dev eval wcs ip (0521T) $44.80 $64 1.4×
Lev 1 hosp type b ed visit (G0380) $151.20 $216 1.8×
Lev 2 hosp type b ed visit (G0381) $276.50 $395 2.7×
Lev 3 hosp type b ed visit (G0382) $483 $690 2.5×
Lev 4 hosp type b ed visit (G0383) $694.40 $992 2.4×
Lev 5 hosp type b ed visit (G0384) $856.80 $1,224 1.9×
Perc d-e cor revasc chro sin (C9607) $18,281.20 $26,116 0.9×
Perc d-e cor revasc t cabg s (C9604) $18,281.20 $26,116 1.4×
Perc d-e cor stent ather s (C9602) $18,281.20 $26,116 0.9×
Perc drug-el cor stent sing (C9600) $8,988 $12,840 0.7×
Perq Sacral Augmt Bilat Inj (0201T) $7,772.80 $11,104 1.0×
Prgrmg dev eval wcs ip (0522T) $95.90 $137 2.3×
Prostate biopsy, any mthd (G0416) $322.70 $461 0.8×
Provide inr test mater/equip (G0249) $345.10 $493 2.3×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $679.70 $971 0.7×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $600.60 $858 0.6×
Quan us tiss charac i&r w/o dx us same anat (0689T) $240.10 $343 2.5×
Scr c/v cyto,thinlayer,rescr (G0145) $119 $170 4.5×
Screen cerv/vag thin layer (G0123) $91.70 $131 4.5×
Screen pap by tech w md supv (P3000) $49.70 $71 2.7×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $24,614.80 $35,164 1.9×
Trauma respons w/hosp criti (G0390) $11,227.30 $16,039 7.6×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $24,614.80 $35,164 1.9×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $24,614.80 $35,164 1.9×
Tte w or w/o contr, cont ecg (C8930) $1,624.70 $2,321 1.9×
Tte w or w/o fol w/con,stres (C8928) $1,624.70 $2,321 1.9×
Tte w or w/o fol w/cont, com (C8921) $1,624.70 $2,321 1.9×
Tte w or w/o fol w/cont, f/u (C8922) $1,243.20 $1,776 1.4×
Tte w or wo fol wcon,doppler (C8929) $1,624.70 $2,321 1.9×
Unsched dialysis esrd pt hos (G0257) $2,286.20 $3,266 3.0×