Supplies, drugs & other prices at Roper St. Francis Berkeley Hospital

Summerville, SC · every code in this section with a posted price and a Medicare benchmark.

66 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) $1,975.35 $3,039 2.7×
2d tte w or w/o fol w/con,co (C8923) $698.75 $1,075 1.0×
2d tte w or w/o fol w/con,fu (C8924) $612.30 $942 1.9×
Admin hepatitis b vaccine (G0010) $75.40 $116 1.7×
Admin influenza virus vac (G0008) $55.25 $85 1.3×
Admin pneumococcal vaccine (G0009) $55.25 $85 1.3×
Autolog prp not diab ulcer (G0460) $3,121.30 $4,802 1.6×
Ca screen;flexi sigmoidscope (G0104) $5,870.90 $9,784.82 6.8×
Catheterize for urine spec (P9612) $49.40 $76 5.3×
Colon ca scrn not hi rsk ind (G0121) $5,936.45 $9,894.08 6.9×
Colorectal scrn; hi risk ind (G0105) $5,920.39 $9,867.32 6.8×
Cysto impl 4 or more (C9740) $22,658.15 $37,763.58 2.6×
Direct refer hospital observ (G0379) $299 $460 0.5×
Drug test def 1-7 classes (G0480) $218.72 $336.50 1.9×
Elec stim other than wound (G0283) $133.90 $206 10.6×
Elec stim unattend for press (G0281) $169 $260 14.5×
Hbot, full body chamber, 30m (G0277) $1,215.50 $1,870 9.5×
Inj for sacroiliac jt anesth (G0260) $2,409.55 $3,707 3.7×
Mra w/cont, abd (C8900) $2,837.25 $4,365 8.7×
Mra w/cont, chest (C8909) $2,694.90 $4,146 8.3×
Mra w/cont, lwr ext (C8912) $2,837.25 $4,365 8.7×
Mra w/cont, pelvis (C8918) $2,837.25 $4,365 8.7×
Mra w/o cont, abd (C8901) $2,837.25 $4,365 12.8×
Mra w/o cont, chest (C8910) $2,694.90 $4,146 12.1×
Mra w/o cont, lwr ext (C8913) $2,837.25 $4,365 12.8×
Mra w/o cont, pelvis (C8919) $2,837.25 $4,365 12.8×
Mra w/o fol w/cont, abd (C8902) $1,836.90 $2,826 5.7×
Mra w/o fol w/cont, chest (C8911) $2,694.90 $4,146 8.3×
Mra w/o fol w/cont, lwr ext (C8914) $1,836.90 $2,826 5.7×
Mra w/o fol w/cont, pelvis (C8920) $3,180.45 $4,893 9.8×
Mra, w/dye, upper extremity (C8934) $2,837.25 $4,365 8.7×
Mri w/o fol w/cont, breast, (C8908) $3,657.55 $5,627 11.3×
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $409.50 $630 0.8×
Oth resp proc, group (G0239) $81.25 $125 2.3×
Oth resp proc, indiv (G0238) $62.40 $96 2.3×
Pathogen test for platelets (P9100) $91 $140 1.7×
Perq Sacral Augmt Bilat Inj (0201T) $10,047.05 $15,457 1.5×
Perq Sacral Augmt Unilat Inj (0200T) $4,772.30 $7,342 0.7×
Prostate biopsy, any mthd (G0416) $1,833.65 $2,821 5.5×
Psa screening (G0103) $222.95 $343 11.5×
Quan MRI alys brain with diagnostic MRI (0866T) $873.60 $1,344 3.9×
Quan MRI alys brn w/o dx MRI (0865T) $873.60 $1,344 3.9×
Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and… (0598T) $656.50 $1,010 3.3×
Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0863T) $6,540.95 $10,063 3.4×
Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0862T) $6,540.95 $10,063 3.4×
Removal Pg Wcs Lv Pacing Both Components (0861T) $6,540.95 $10,063 1.9×
Revasc intra lithotrip-ather (C9766) $37,313.25 $57,405 2.2×
Revasc intravasc lithotripsy (C9764) $37,313.25 $57,405 3.5×
Revasc lithotr-ather tib/per (C9774) $37,313.25 $57,405 2.2×
Revasc lithotrip tibi/perone (C9772) $23,058.10 $35,474 2.1×
Rpr intst excl anrect fist (C9796) $5,647.85 $8,689 2.2×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $36,697.05 $56,457 2.0×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $6,540.95 $10,063 2.2×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $36,697.05 $56,457 2.0×
Therapeutic procd strg endur (G0237) $62.40 $96 2.3×
Tomosynthesis, mammo (G0279) $81.90 $126 6.5×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $6,588.40 $10,136 0.6×
Trluml Perip Athrc Renal Art (0234T) $6,588.40 $10,136 0.6×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $6,588.40 $10,136 0.6×
Trluml peripheral atherectomy iliac artery ea (0238T)
unusually low: confirm this is the full procedure
$6,588.40 $10,136 0.4×
Tte w or w/o fol w/con,stres (C8928) $1,263.60 $1,944 1.7×
Tte w or w/o fol w/cont, com (C8921) $1,120.60 $1,724 1.5×
Tte w or w/o fol w/cont, f/u (C8922) $565.50 $870 0.8×
Tte w or wo fol wcon,doppler (C8929) $2,144.35 $3,299 2.9×
Unsched dialysis esrd pt hos (G0257) $526.50 $810 0.8×
Vasc emb/occ w/prs cath (C9797) $35,234.55 $54,207 2.1×