Supplies, drugs & other prices at Saint Joseph Regional Medical Center - Plymouth
Plymouth, IN · every code in this section with a posted price and a Medicare benchmark.
54 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $1,116.05 | $1,717 | 3.0× |
| Adm tocilizu covid-19 1st (M0249) | $417.95 | $643 | 0.9× |
| Adm tocilizu covid-19 2nd (M0250) | $417.95 | $643 | 0.9× |
| Admin hepatitis b vaccine (G0010) | $87.75 | $135 | 1.8× |
| Admin influenza virus vac (G0008) | $57.20 | $88 | 1.2× |
| Admin pneumococcal vaccine (G0009) | $54.60 | $84 | 1.1× |
| Autolog prp not diab ulcer (G0460) | $1,882.40 | $2,896 | 0.9× |
| Catheterize for urine spec (P9612) | $7.80 | $12 | 0.8× |
| Colon ca scrn not hi rsk ind (G0121) | $4,991.02 | — | 5.1× |
| Colorectal scrn; hi risk ind (G0105) | $4,976.98 | — | 5.1× |
| Covid-19 lab test non-cdc (U0002) | $145.60 | $224 | 2.8× |
| Diab manage trn per indiv (G0108) | $93.60 | $144 | 1.7× |
| Diab manage trn ind/group (G0109) | $54.60 | $84 | 3.4× |
| Direct refer hospital observ (G0379) | $406.90 | $626 | 0.6× |
| Ekg tracing for initial prev (G0404) | $39 | $60 | 1.3× |
| Elec stim other than wound (G0283) | $144.30 | $222 | 11.4× |
| Fecal blood scrn immunoassay (G0328) | $167.70 | $258 | 9.3× |
| Hbot, full body chamber, 30m (G0277) | $32,392.10 | — | 222.5× |
| Hep c screen high risk/other (G0472) | $66.30 | $102 | 1.4× |
| Hiv combination assay (G0475) | $51.35 | $79 | 2.1× |
| Home sleep test/type 3 porta (G0399) | $787.15 | $1,211 | 3.4× |
| Hospital outpt clinic visit (G0463) | $985.40 | — | 7.0× |
| Inj for sacroiliac jt anesth (G0260) range across 6 matching MRF lines |
$1,758.90–$2,637.70 | $2,706–$4,058 | varies |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $742.95 | $1,143 | 1.5× |
| Mnt subs tx for change dx (G0270) | $59.80 | $92 | 1.9× |
| Mra w/o cont, abd (C8901) | $2,214.55 | $3,407 | 8.8× |
| Mra w/o cont, chest (C8910) | $2,214.55 | $3,407 | 8.8× |
| Mra w/o cont, lwr ext (C8913) range across 3 matching MRF lines |
$2,349.10–$3,523 | $3,614–$5,420 | varies |
| Mra w/o fol w/cont, abd (C8902) | $3,476.20 | $5,348 | 9.4× |
| Mra w/o fol w/cont, chest (C8911) | $3,476.20 | $5,348 | 9.4× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 3 matching MRF lines |
$3,447.60–$5,170.75 | $5,304–$7,955 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $3,476.20 | $5,348 | 9.4× |
| Mri w/o fol w/cont, breast, (C8908) | $5,619.90 | $8,646 | 15.2× |
| Mri w/o fol w/cont, brst, un (C8905) | $3,745.95 | $5,763 | 10.1× |
| Onc aml DNA gntyp int tandem dup detcj/nondetcj (0023U) | $445.25 | $685 | 1.8× |
| Oth resp proc, group (G0239) | $139.10 | $214 | 3.5× |
| Oth resp proc, indiv (G0238) | $66.95 | $103 | 2.2× |
| Pathogen test for platelets (P9100) | $81.90 | $126 | 1.3× |
| Perc d-e cor revasc chro sin (C9607) | $14,647.75 | $22,535 | 0.8× |
| Perc d-e cor stent ather s (C9602) | $14,647.75 | $22,535 | 0.8× |
| Perc drug-el cor stent sing (C9600) | $16,009.50 | $24,630 | 1.3× |
| Perq Sacral Augmt Unilat Inj (0200T) unusually low: confirm this is the full procedure |
$3,554.85 | $5,469 | 0.5× |
| Prostate biopsy, any mthd (G0416) | $432.90 | $666 | 1.1× |
| Psa screening (G0103) | $168.35 | $259 | 8.7× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $1,083.55 | $1,667 | 1.5× |
| Revasc intravasc lithotripsy (C9764) | $11,700.65 | $18,001 | 1.0× |
| Therapeutic procd strg endur (G0237) | $66.95 | $103 | 2.2× |
| Tomosynthesis, mammo (G0279) | $100.10 | $154 | 7.9× |
| Trim nail(s) (G0127) | $86.45 | $133 | 1.4× |
| Tte w or w/o contr, cont ecg (C8930) | $1,959.75 | $3,015 | 2.4× |
| Tte w or w/o fol w/con,stres (C8928) | $1,587.30 | $2,442 | 1.9× |
| Tte w or wo fol wcon,doppler (C8929) | $2,222.35 | $3,419 | 2.7× |
| Unsched dialysis esrd pt hos (G0257) | $951.60 | $1,464 | 1.3× |
| Ven blood coll snf/hha (G0471) | $7.80 | $12 | 0.7× |
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.