Supplies, drugs & other prices at Dignity Health - St. Rose Dominican, San Martín Campus
Las Vegas, NV · every code in this section with a posted price and a Medicare benchmark.
45 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) | $1,247.22 | $6,084 | 0.3× |
| Adm tocilizu covid-19 1st (M0249) | $193.73 | $945 | 0.4× |
| Adm tocilizu covid-19 2nd (M0250) | $193.73 | $945 | 0.4× |
| Catheterize for urine spec (P9612) | $14.76 | $72 | 1.6× |
| Covid-19 lab test non-cdc (U0002) | $20.50 | $100 | 0.4× |
| Cysto, litho, vacuum kidney (C9761) | $6,166.40 | $30,080 | 0.6× |
| Direct refer hospital observ (G0379) | $371.26 | $1,811 | 0.6× |
| Drug test def 1-7 classes (G0480) | $39.36 | $192 | 0.3× |
| Drug test def 15-21 classes (G0482) | $96.35 | $470 | 0.5× |
| Drug test def 22+ classes (G0483) | $55.97 | $273 | 0.2× |
| Electrophysiological eval icds w/ss electrode (0577T) | $1,183.47 | $5,773 | 0.9× |
| Hbot, full body chamber, 30m (G0277) | $352.60 | $1,720 | 2.3× |
| Iliac Atherectomy (0238T) likely a partial charge, not the full procedure |
$5,363.42 | $26,163 | 0.3× |
| Inj for sacroiliac jt anesth (G0260) | $404.26 | $1,972 | 0.5× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) unusually low: confirm this is the full procedure |
$13,544.86 | $66,072.50 | 0.4× |
| Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode,… (0576T) | $1,183.47 | $5,773 | 29.0× |
| Mri w/cont, breast, bi (C8906) | $886.01 | $4,322 | 2.3× |
| Mri w/o fol w/cont, breast, (C8908) | $886.01 | $4,322 | 2.3× |
| Neuro csf prion prtn qual (0035U) | $132.64 | $647 | 0.2× |
| Non-ophthalmic fva (C9733) | $201.31 | $982 | 0.5× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,387.99 | $40,917 | 0.4× |
| Perc d-e cor revasc t cabg s (C9604) | $8,387.99 | $40,917 | 0.7× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$8,387.99 | $40,917 | 0.4× |
| Perc drug-el cor stent sing (C9600) | $8,387.99 | $40,917 | 0.7× |
| Perq Sacral Augmt Bilat Inj (0201T) likely a partial charge, not the full procedure |
$1,437.87 | $7,014 | 0.2× |
| Perq Sacral Augmt Unilat Inj (0200T) likely a partial charge, not the full procedure |
$1,437.87 | $7,014 | 0.2× |
| Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode,… (0575T) | $1,183.47 | $5,773 | 29.0× |
| Prolonged iv inf, req pump (C8957) | $192.09 | $937 | 0.8× |
| Prostate biopsy, any mthd (G0416) | $597.78 | $2,916 | 1.5× |
| Revasc intra lithotrip-ather (C9766) unusually low: confirm this is the full procedure |
$8,450.51 | $41,222 | 0.4× |
| Revasc intra lithotrip-stent (C9765) unusually low: confirm this is the full procedure |
$7,847.71 | $38,281.50 | 0.4× |
| Revasc intravasc lithotripsy (C9764) likely a partial charge, not the full procedure |
$3,549.17 | $17,313 | 0.3× |
| Revasc lith-sten-ath tib/per (C9775) | $13,767.19 | $67,157 | 0.7× |
| Revasc lithotr-ather tib/per (C9774) | $11,322.15 | $55,230 | 0.6× |
| Revasc lithotrip tibi/perone (C9772) | $8,610.41 | $42,002 | 0.7× |
| Revasc lithotrip-stent-ather (C9767) | $13,774.36 | $67,192 | 0.7× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $1,183.47 | $5,773 | 0.3× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) likely a partial charge, not the full procedure |
$1,424.14 | $6,947 | 0.2× |
| Transcatheter renal sympath denervation unilat (0338T) likely a partial charge, not the full procedure |
$1,424.14 | $6,947 | 0.2× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) unusually low: confirm this is the full procedure |
$5,124.59 | $24,998 | 0.4× |
| Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative… (0582T) likely a partial charge, not the full procedure |
$1,247.22 | $6,084 | 0.1× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) unusually low: confirm this is the full procedure |
$5,124.59 | $24,998 | 0.4× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) unusually low: confirm this is the full procedure |
$5,124.59 | $24,998 | 0.4× |
| Unsched dialysis esrd pt hos (G0257) | $677.12 | $3,303 | 0.9× |
| Vasc emb/occ w/prs cath (C9797) | $10,800.02 | $52,683 | 0.5× |