Supplies, drugs & other prices at Riverside Smithfield Hospital
Smithfield, VA · every code in this section with a posted price and a Medicare benchmark.
72 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $638.88 | $1,277.76 | 0.8× |
| 2d tte w or w/o fol w/con,co (C8923) | $706.13 | $1,412.25 | 0.9× |
| 2d tte w or w/o fol w/con,fu (C8924) | $706.13 | $1,412.25 | 2.1× |
| Adm tocilizu covid-19 1st (M0249) | $236.65 | $473.29 | 0.6× |
| Adm tocilizu covid-19 2nd (M0250) | $236.65 | $473.29 | 0.6× |
| Admin hepatitis b vaccine (G0010) | $33.75 | $67.50 | 0.7× |
| Admin influenza virus vac (G0008) | $22.38 | $44.75 | 0.5× |
| Admin pneumococcal vaccine (G0009) | $22.38 | $44.75 | 0.5× |
| Ca screen;flexi sigmoidscope (G0104) | $1,081.38 | $2,162.75 | 1.2× |
| Ca screen;pelvic/breast exam (G0101) | $47.70 | $95.39 | 0.5× |
| Catheterize for urine spec (P9612) | $27.50 | $55 | 2.9× |
| Covid-19 lab test non-cdc (U0002) | $28.62 | $57.24 | 0.6× |
| Cysto impl 4 or more (C9740) | $4,767.86 | $9,535.71 | 0.5× |
| Cysto, litho, vacuum kidney (C9761) | $4,767.86 | $9,535.71 | 0.5× |
| Cystoscopy prostatic imp 1-3 (C9739) | $3,536.39 | $7,072.77 | 0.7× |
| Diab manage trn per indiv (G0108) | $60 | $120 | 1.1× |
| Diab manage trn ind/group (G0109) | $42.50 | $85 | 2.7× |
| Direct refer hospital observ (G0379) | $316.12 | $632.23 | 0.5× |
| Drug test def 1-7 classes (G0480) | $96.73 | $193.45 | 0.8× |
| Ekg tracing for initial prev (G0404) | $62.96 | $125.91 | 2.2× |
| Elec stim other than wound (G0283) | $45.13 | $90.25 | 3.6× |
| Elisa hiv-1/hiv-2 screen (G0433) | $32.14 | $64.28 | 1.8× |
| Hbot, full body chamber, 30m (G0277) | $218.13 | $436.25 | 1.6× |
| Home sleep test/type 3 porta (G0399) | $372 | $744 | 1.8× |
| Hospital outpt clinic visit (G0463) | $162.61 | $325.22 | 1.3× |
| Iliac Atherectomy (0238T) | $11,872.97 | $23,745.94 | 0.7× |
| Liver Dis 10 Assays W/Nash (0003M) | $530.18 | $1,060.35 | 1.1× |
| Mra w/cont, abd (C8900) | $1,430.88 | $2,861.75 | 4.2× |
| Mra w/cont, chest (C8909) | $1,430.88 | $2,861.75 | 4.2× |
| Mra w/cont, lwr ext (C8912) | $1,430.88 | $2,861.75 | 4.2× |
| Mra w/o cont, abd (C8901) | $925 | $1,850 | 4.0× |
| Mra w/o cont, chest (C8910) | $925 | $1,850 | 4.0× |
| Mra w/o fol w/cont, abd (C8902) | $1,293.50 | $2,587 | 3.8× |
| Mra w/o fol w/cont, chest (C8911) | $1,293.50 | $2,587 | 3.8× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,744.13 | $3,488.25 | 5.1× |
| Mri w/o fol w/cont, breast, (C8908) | $3,582.88 | $7,165.75 | 10.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,430.63 | $2,861.25 | 4.2× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $239.04 | $478.06 | 0.5× |
| Obtaining screen pap smear (Q0091) | $19.25 | $38.50 | 0.7× |
| Oth resp proc, group (G0239) | $42.50 | $85 | 1.2× |
| Oth resp proc, indiv (G0238) | $42.50 | $85 | 1.5× |
| Pathogen test for platelets (P9100) | $35.50 | $70.99 | 0.6× |
| Perc d-e cor revasc chro sin (C9607) | $14,203.50 | $28,407 | 0.8× |
| Perc d-e cor revasc t cabg s (C9604) | $14,203.50 | $28,407 | 1.3× |
| Perc d-e cor stent ather s (C9602) | $14,203.50 | $28,407 | 0.8× |
| Perc drug-el cor stent sing (C9600) | $13,699.02 | $27,398.03 | 1.2× |
| Pne flu hepb cov home admin (M0201) | $49.08 | $98.16 | 1.4× |
| Ppps, initial visit (G0438) | $539.66 | $1,079.32 | 3.1× |
| Ppps, subseq visit (G0439) | $359.37 | $718.74 | 2.6× |
| Prostate biopsy, any mthd (G0416) | $1,369.78 | $2,739.56 | 3.9× |
| Psa screening (G0103) | $63.38 | $126.75 | 3.3× |
| Quan us tiss charac i&r w/o dx us same anat (0689T) | $492.58 | $985.15 | 5.8× |
| Revasc intra lithotrip-ather (C9766) | $9,258.54 | $18,517.07 | 0.5× |
| Revasc intra lithotrip-stent (C9765) | $11,222 | $22,444 | 0.6× |
| Revasc intravasc lithotripsy (C9764) | $10,798 | $21,596 | 1.0× |
| Revasc lith-sten-ath tib/per (C9775) | $9,258.54 | $18,517.07 | 0.5× |
| Revasc lithotr-ather tib/per (C9774) | $9,258.54 | $18,517.07 | 0.5× |
| Revasc lithotr-stent tib/per (C9773) | $9,258.54 | $18,517.07 | 0.5× |
| Revasc lithotrip tibi/perone (C9772) | $11,769.60 | $23,539.20 | 1.0× |
| Revasc lithotrip-stent-ather (C9767) | $9,258.54 | $18,517.07 | 0.5× |
| Scr c/v cyto,thinlayer,rescr (G0144) | $60.38 | $120.75 | 1.4× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $67.76 | $135.52 | 2.6× |
| Scr c/v cyto,thinlayer,rescr (G0143) | $65.63 | $131.25 | 2.4× |
| Screen cerv/vag thin layer (G0123) | $64.38 | $128.75 | 3.2× |
| Therapeutic procd strg endur (G0237) | $48.88 | $97.75 | 1.7× |
| Tomosynthesis, mammo (G0279) | $67.96 | $135.91 | 5.4× |
| Trauma respons w/hosp criti (G0390) | $1,828.75 | $3,657.50 | 1.4× |
| Trim nail(s) (G0127) | $38.82 | $77.64 | 0.7× |
| Tte w or w/o contr, cont ecg (C8930) | $1,145 | $2,290 | 1.5× |
| Tte w or w/o fol w/con,stres (C8928) | $642.25 | $1,284.50 | 0.8× |
| Tte w or wo fol wcon,doppler (C8929) | $682.88 | $1,365.75 | 0.9× |
| Unsched dialysis esrd pt hos (G0257) | $360.78 | $721.56 | 0.5× |