Supplies, drugs & other prices at UH Rainbow Babies & Children's Hospital

Cleveland, OH · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
2d tee w or w/o fol w/con,in (C8925) $2,472.75 $3,297 3.3×
2d tte w or w/o fol w/con,co (C8923) $1,305 $1,740 1.8×
2d tte w or w/o fol w/con,fu (C8924) $900 $1,200 2.7×
3D contour simulaj trgt lvr les&mrgn micrwv ablt (0944T) $283.50 $378 1.3×
Ablation b9 thyroid nodule perq laser w/img gdn (0673T) $1,253.25 $1,671 0.8×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $2,244.75 $2,993 1.2×
Admin hepatitis b vaccine (G0010) $38.25 $51 0.9×
Admin influenza virus vac (G0008) $38.25 $51 0.9×
Admin pneumococcal vaccine (G0009) $38.25 $51 0.9×
Alcohol/subs interv 15-30mn (G0396) $54 $72 1.5×
Alcohol/subs interv >30 min (G0397) $100.50 $134 0.6×
Ca screen;flexi sigmoidscope (G0104) $1,296 $1,728 1.5×
Ca screen;pelvic/breast exam (G0101) $123.75 $165 1.3×
Catheterize for urine spec (P9612) $58.50 $78 6.3×
Colon ca scrn not hi rsk ind (G0121) $2,602.50 $3,470 3.0×
Colorectal scrn; hi risk ind (G0105) $2,602.50 $3,470 3.0×
Demonstrate use home inr mon (G0248) $153.75 $205 1.2×
Diab manage trn per indiv (G0108) $101.25 $135 1.8×
Diab manage trn ind/group (G0109) $57.75 $77 3.6×
Direct refer hospital observ (G0379) $529.50 $706 0.9×
Egd flexible transnasal dx w/collj spec br/wa (0652T) $2,205 $2,940 1.2×
Egd flexible transnasal w/biopsy single/multiple (0653T) $1,742.25 $2,323 1.0×
Egd flexible transnasal w/insj intral tube/cath (0654T) $4,440.75 $5,921 1.2×
Electrophysiologic eval ccm-d leads at 1st impl (0930T) $1,477.50 $1,970 1.3×
Electrophysiologic eval ccm-d leads separate (0931T) $1,477.50 $1,970 1.3×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $33,462.75 $44,617 0.8×
Esd endoscopy or colonoscopy (C9779) $4,440.75 $5,921 1.2×
Fecal microbiota prep instil (G0455) $1,059 $1,412 1.2×
Gi myoelectrical activity study stmch-colon i&r (0779T) $404.25 $539 1.1×
Glyca nuc mr spectroscopy quantitative (0024U) $34.50 $46 1.0×
Hbot, full body chamber, 30m (G0277) $738.75 $985 5.7×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U)
range across 2 matching MRF lines		 $129–$223.50 $172–$298 varies
Initial preventive exam (G0402) $130.50 $174 1.0×
Insertion perm ccm-d system pulse generator only (0916T) $27,312.75 $36,417 1.3×
Insj perm ccm-d sys 1 transvns lead only (0917T) $10,070.25 $13,427 1.3×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $10,070.25 $13,427 1.3×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) $39,012.75 $52,017 1.3×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $58,312.50 $77,750 2.0×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $20,633.25 $27,511 2.6×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $20,633.25 $27,511 2.6×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $58,312.50 $77,750 2.8×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $38,142 $50,856 1.3×
Instill pharm renal pelvis (C9789) $2,632.50 $3,510 2.3×
Instlj fecal microbiota ssp (0780T) $1,476.75 $1,969 11.7×
Interro Device Evaluation Cardiac Modulj System (0418T) $42.75 $57 1.2×
Interrog dev eval impl ccm-d system in person (0927T) $43.50 $58 1.2×
Ire Abltj 1+Tum Organ Perq (0600T) $11,934 $15,912 1.2×
Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) $576.75 $769 1.1×
Mra, w/dye, upper extremity (C8934) $2,075.25 $2,767 6.3×
Mra, w/o dye, spinal canal (C8932) $1,923.75 $2,565 8.5×
Mra, w/o dye, upper extr (C8935) $1,925.25 $2,567 8.5×
Mra, w/o&w/dye, spinal canal (C8933) $417.75 $557 1.3×
N-invas assmt car rsk augmnt sw alys fat w/CT (0993T) $101.25 $135 0.4×
N-invas assmt car rsk augmnt sw alys fat w/o CT (0992T) $101.25 $135 0.4×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) $351 $468 1.2×
Njx platelet plasma (0232T)
range across 3 matching MRF lines		 $131.25–$525 $175–$700 varies
Obtaining screen pap smear (Q0091) $21.75 $29 0.8×
Onc merkel cell carc detcj antb serum reprtd +/- (0059U) $671.25 $895 2.1×
Onc Merkel Cll Carc Srm Quan (0058U) $691.50 $922 2.1×
Ortho impl mvmt alys pair CT (0946T) $123.75 $165 1.3×
Oth resp proc, group (G0239) $187.50 $250 5.3×
Perc d-e cor revasc chro sin (C9607) $32,979.75 $43,973 1.9×
Perc d-e cor revasc t cabg s (C9604) $32,979.75 $43,973 3.0×
Perc d-e cor stent ather s (C9602) $32,979.75 $43,973 1.9×
Perc drug-el cor stent sing (C9600) $16,359.75 $21,813 1.5×
Perq Sacral Augmt Bilat Inj (0201T) $8,340 $11,120 1.2×
Perq Sacral Augmt Unilat Inj (0200T) $8,293.50 $11,058 1.2×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $6,937.50 $9,250 0.6×
Ppps, initial visit (G0438) $243 $324 1.4×
Ppps, subseq visit (G0439) $243 $324 1.8×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $27 $36 0.8×
Programming device eval impl ccm-d sys in person (0926T) $43.50 $58 1.2×
Prostate biopsy, any mthd (G0416) $729 $972 2.1×
Quan MRI alys brain with diagnostic MRI (0866T) $284.25 $379 1.3×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $4,174.50 $5,566 2.1×
Relocation skin pocket implanted ccm-d pg (0925T) $2,226 $2,968 1.1×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $43.50 $58 1.2×
Removal perm ccm-d system pulse generator only (0919T) $4,428 $5,904 1.3×
Repos Cardiac Modulj Transvenous Electrode (0415T) $1,318.50 $1,758 2.2×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $752.25 $1,003 1.3×
Revasc intra lithotrip-ather (C9766) $20,329.50 $27,106 1.2×
Revasc intra lithotrip-stent (C9765) $20,329.50 $27,106 1.2×
Revasc intravasc lithotripsy (C9764) $12,754.50 $17,006 1.2×
Revasc lith-sten-ath tib/per (C9775) $20,329.50 $27,106 1.2×
Revasc lithotr-ather tib/per (C9774) $20,329.50 $27,106 1.2×
Revasc lithotr-stent tib/per (C9773) $20,329.50 $27,106 1.2×
Revasc lithotrip tibi/perone (C9772) $12,754.50 $17,006 1.2×
Revasc lithotrip-stent-ather (C9767) $20,329.50 $27,106 1.2×
Rmvl Car Modulj Tranvns Elt (0413T) $8,707.50 $11,610 2.5×
Rmvl Cardiac Modulj Pls Gen (0412T) $8,707.50 $11,610 2.5×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) $4,428 $5,904 1.3×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $4,428 $5,904 1.3×
Rmvl perm ccm-d sys dual transvns leads only (0922T) $4,428 $5,904 1.3×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $27,312.75 $36,417 1.3×
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) $3,914.25 $5,219 1.3×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $22,590 $30,120 1.2×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $22,590 $30,120 1.2×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $22,590 $30,120 1.2×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $22,590 $30,120 1.2×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $3,696 $4,928 1.2×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $3,696 $4,928 1.2×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $3,696 $4,928 1.2×
Tcat Rmvl Perm Dual Chamber Ldls Pm Compl Sys (0798T) $3,696 $4,928 1.2×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $22,590 $30,120 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) $22,590 $30,120 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $22,590 $30,120 1.2×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $22,590 $30,120 1.2×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $6,627 $8,836 1.2×
Tee w or w/o fol w/cont, mon (C8927) $1,165.50 $1,554 1.6×
Tee w or w/o fol w/cont,cong (C8926) $2,101.50 $2,802 2.8×
Therapeutic ultrafiltration (0692T) $527.25 $703 0.4×
Tpmt and Nudt15 Genotype (0034U) $741.75 $989 1.6×
Transcatheter Renal Sympath Denervation Bilat (0339T) $6,670.50 $8,894 1.2×
Transcatheter renal sympath denervation unilat (0338T) $6,670.50 $8,894 1.2×
Trauma respons w/hosp criti (G0390)
range across 3 matching MRF lines		 $2,854.50–$7,410 $3,806–$9,880 varies
Trluml Perip Athrc Brchiocph (0237T) $12,754.50 $17,006 1.2×
Trluml Perip Athrc Iliac Art (0238T) $20,329.50 $27,106 1.2×
Tte w or w/o fol w/con,stres (C8928) $1,949.25 $2,599 2.6×
Tte w or w/o fol w/cont, com (C8921) $1,475.25 $1,967 2.0×
Tte w or w/o fol w/cont, f/u (C8922) $1,250.25 $1,667 1.7×
Tte w or wo fol wcon,doppler (C8929) $1,899 $2,532 2.6×
Vasc emb/occ w/prs cath (C9797) $21,009 $28,012 1.2×
Visit esketamine 56m or less (G2082) $1,646.25 $2,195 1.7×
Visit esketamine, > 56m (G2083) $2,406 $3,208 1.6×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.