Supplies, drugs & other prices at Saint Alphonsus Medical Center Ontario
Ontario, OR · every code in this section with a posted price and a Medicare benchmark.
41 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $1,122.55 | $1,727 | 2.9× |
| Adm tocilizu covid-19 1st (M0249) | $694.85 | $1,069 | 1.4× |
| Adm tocilizu covid-19 2nd (M0250) | $694.85 | $1,069 | 1.4× |
| Admin hepatitis b vaccine (G0010) | $52 | $80 | 1.0× |
| Admin influenza virus vac (G0008) | $36.40 | $56 | 0.7× |
| Admin pneumococcal vaccine (G0009) | $35.10 | $54 | 0.7× |
| Catheterize for urine spec (P9612) | $20.80 | $32 | 2.2× |
| Chemo extend iv infus w/pump (G0498) | $692.90 | $1,066 | 1.9× |
| Direct refer hospital observ (G0379) | $271.05 | $417 | 0.4× |
| Elec stim other than wound (G0283) | $58.50 | $90 | 4.6× |
| Fecal blood scrn immunoassay (G0328) | $111.15 | $171 | 6.2× |
| Fecal microbiota prep instil (G0455) | $4,238 | $6,520 | 4.1× |
| Hep c screen high risk/other (G0472) range across 2 matching MRF lines |
$62.40–$76.05 | $96–$117 | varies |
| Hepb screen high risk indiv (G0499) | $91 | $140 | 3.2× |
| Hiv combination assay (G0475) range across 2 matching MRF lines |
$79.95–$96.85 | $123–$149 | varies |
| Home sleep test/type 3 porta (G0399) | $504.40 | $776 | 2.1× |
| Hospital outpt clinic visit (G0463) range across 33 matching MRF lines |
$17.55–$271.05 | $27–$417 | varies |
| Init/sub psych care m 1st 30 (G2214) | $70.20 | $108 | 0.6× |
| Initial preventive exam (G0402) | $98.15 | $151 | 0.7× |
| Inj for sacroiliac jt anesth (G0260) range across 6 matching MRF lines |
$1,577.55–$2,366.65 | $2,427–$3,641 | varies |
| Intens cardiac rehab no exer (G0423) | $239.20 | $368 | 1.7× |
| Intens cardiac rehab w/exerc (G0422) | $250.90 | $386 | 1.8× |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $462.80 | $712 | 0.9× |
| Mnt subs tx for change dx (G0270) | $46.80 | $72 | 1.5× |
| Mra w/o fol w/cont, abd (C8902) | $2,262 | $3,480 | 5.8× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,883.70 | $2,898 | 4.9× |
| Njx platelet plasma (0232T) | $326.30 | $502 | 0.7× |
| Obtaining screen pap smear (Q0091) | $61.75 | $95 | 1.9× |
| Oth resp proc, group (G0239) | $76.70 | $118 | 1.8× |
| Prolonged iv inf, req pump (C8957) | $657.15 | $1,011 | 2.8× |
| Psa screening (G0103) | $49.40 | $76 | 2.6× |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) | $1,334.45 | $2,053 | 1.3× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $309.40 | $476 | 0.4× |
| Revasc lithotrip-stent-ather (C9767) likely a partial charge, not the full procedure |
$5,677.75 | $8,735 | 0.3× |
| Tomosynthesis, mammo (G0279) range across 3 matching MRF lines |
$39–$58.50 | $60–$90 | varies |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$2,459.60–$3,074.50 | $3,784–$4,730 | varies |
| Trim nail(s) (G0127) | $55.25 | $85 | 0.8× |
| Tte w or w/o contr, cont ecg (C8930) | $2,603.90 | $4,006 | 3.0× |
| Tte w or w/o fol w/con,stres (C8928) | $1,673.10 | $2,574 | 1.9× |
| Tte w or w/o fol w/cont, com (C8921) | $1,539.85 | $2,369 | 1.8× |
| Tte w or wo fol wcon,doppler (C8929) | $2,157.35 | $3,319 | 2.5× |
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.