Supplies, drugs & other prices at Fairview Range Hospital

Hibbing, MN · every code in this section with a posted price and a Medicare benchmark.

40 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) $566.53 $1,333 1.6×
Admin hepatitis b vaccine (G0010) $13.01 $30.61 0.3×
Admin influenza virus vac (G0008) $17 $40 0.4×
Admin pneumococcal vaccine (G0009) $17 $40 0.4×
Ca screen;pelvic/breast exam (G0101) $52.28 $123 0.5×
Colon ca scrn not hi rsk ind (G0121) $870.74 $2,048.78 0.9×
Colorectal scrn; hi risk ind (G0105) $926.38 $2,179.71 1.0×
Diab manage trn per indiv (G0108) $130.90 $307.98 2.3×
Diab manage trn ind/group (G0109) $88.40 $208 5.5×
Drug test def 1-7 classes (G0480) $3.40 $8 0.0×
Drug test def 15-21 classes (G0482) $3.40 $8 0.0×
Ekg tracing for initial prev (G0404) $14.03 $33 0.5×
Fern test (Q0114) $41.23 $97 4.2×
Hep c screen high risk/other (G0472) $56.10 $132 1.2×
Hiv combination assay (G0475) $57.80 $136 2.4×
Home sleep test/type 3 porta (G0399) $329.80 $776 1.5×
Hospital outpt clinic visit (G0463) $59.90 $140.94 0.4×
Hpv combo assay ca screen (G0476) $46.75 $110 1.3×
Ig paraprotein qual bld/ur (0077U) $171.07 $402.50 3.9×
Initial preventive exam (G0402) $137.65 $11 1.0×
Inj for sacroiliac jt anesth (G0260) $794.12 $1,868.50 1.1×
Mri w/o fol w/cont, breast, (C8908) $1,033.80 $2,432.46 2.9×
Obtaining screen pap smear (Q0091) $83.30 $196 2.8×
Oth resp proc, group (G0239) $99.03 $233 2.6×
Oth resp proc, indiv (G0238) $65.03 $153 2.2×
Pemivibart infusion (M0224) $375.28 $883 0.8×
Prostate biopsy, any mthd (G0416) $120.84 $284.32 0.3×
Psa screening (G0103) $26.35 $62 1.4×
Quan mr alys tiss composition w/MRI 1orgn (0649T) $93.50 $220 0.1×
Rbc DNA gnotyp 10 bld groups (0084U) $320.88 $755 0.4×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $264.78 $623 0.4×
Scr c/v cyto,thinlayer,rescr (G0145) $37.83 $89 1.4×
Screen cerv/vag thin layer (G0123) $29.04 $68.33 1.4×
Therapeutic procd strg endur (G0237) $73.86 $173.78 2.5×
Tomosynthesis, mammo (G0279) $33.15 $78 2.6×
Trauma respons w/hosp criti (G0390) $2,271.49 $5,344.67 1.7×
Trim nail(s) (G0127) $32.30 $76 0.5×
Tte w or w/o fol w/con,stres (C8928) $813.45 $1,914 1.0×
Tte w or wo fol wcon,doppler (C8929) $814.36 $1,916.15 1.0×
Visit to determ ldct elig (G0296) $41.23 $97 0.4×