Supplies, drugs & other prices at Salem Memorial District Hospital
Salem, MO · every code in this section with a posted price and a Medicare benchmark.
9 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin hepatitis b vaccine (G0010) | $45 | $60 | 1.0× |
| Admin influenza virus vac (G0008) | $61.50 | $82 | 1.3× |
| Colon ca scrn not hi rsk ind (G0121) | $1,959 | $2,612 | 2.1× |
| Colorectal scrn; hi risk ind (G0105) | $1,959 | $2,612 | 2.1× |
| Ekg tracing for initial prev (G0404) | $37.50 | $50 | 1.3× |
| Elec stim other than wound (G0283) | $47.25 | $63 | 3.7× |
| Hospital outpt clinic visit (G0463) | $38.63 | $51.50 | 0.3× |
| Mnt subs tx for change dx (G0270) | $23.63 | $31.50 | 0.7× |
| Psa screening (G0103) | $145.69 | $194.25 | 7.5× |