Supplies, drugs & other prices at Providence St. Mary Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,fu (C8924) $1,278.20 $1,826 3.3×
Catheterize for urine spec (P9612) $77 $110 8.2×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) $1,197.70 $1,711 1.5×
Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) $1,197.70 $1,711 1.5×
Diab manage trn per indiv (G0108) $124.60 $178 2.2×
Diab manage trn ind/group (G0109) $73.50 $105 4.6×
Direct refer hospital observ (G0379) $145.60 $208 0.2×
Elec stim other than wound (G0283) $37.80 $54 3.0×
Home sleep test/type 3 porta (G0399) $669.90 $957 2.8×
Hospital outpt clinic visit (G0463) $236.60 $338 1.6×
Iliac Atherectomy (0238T) $26,013.40 $37,162 1.3×
Lev 1 hosp type b ed visit (G0380) $283.50 $405 3.4×
Lev 2 hosp type b ed visit (G0381) $410.90 $587 4.0×
Lev 3 hosp type b ed visit (G0382) $538.30 $769 2.8×
Lev 4 hosp type b ed visit (G0383) $775.60 $1,108 2.6×
Lev 5 hosp type b ed visit (G0384) $2,196.60 $3,138 4.8×
Oth resp proc, group (G0239) $144.90 $207 3.5×
Oth resp proc, indiv (G0238) $137.90 $197 4.3×
Perc d-e cor revasc t cabg s (C9604) $15,603 $22,290 1.2×
Perc d-e cor stent ather s (C9602) $16,242.80 $23,204 0.8×
Perc drug-el cor stent sing (C9600) $17,199 $24,570 1.3×
Prolonged iv inf, req pump (C8957) $880.60 $1,258 3.7×
Prostate biopsy, any mthd (G0416) $372.40 $532 0.9×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $26,019 $37,170 1.2×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $31,815 $45,450 1.5×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $25,991 $37,130 1.2×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $30,887.50 $44,125 1.4×
Tee w or w/o fol w/cont, mon (C8927) $4,167.80 $5,954 4.8×
Therapeutic procd strg endur (G0237) $144.90 $207 4.5×
Tomosynthesis, mammo (G0279) $41.30 $59 3.3×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $26,013.40 $37,162 2.0×
Trauma respons w/hosp criti (G0390) $4,092.90 $5,847 2.8×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $26,013.40 $37,162 2.0×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $26,013.40 $37,162 2.0×
Tte w or w/o fol w/con,stres (C8928) $3,306.10 $4,723 3.8×
Tte w or w/o fol w/cont, com (C8921) $1,673.70 $2,391 1.9×
Tte w or wo fol wcon,doppler (C8929) $4,093.60 $5,848 4.7×
Unsched dialysis esrd pt hos (G0257) $1,191.40 $1,702 1.6×
Visit to determ ldct elig (G0296) $200.90 $287 1.8×