Supplies, drugs & other prices at San Juan Regional Medical Center Inc
Farmington, NM · every code in this section with a posted price and a Medicare benchmark.
71 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $37.50 | $75 | 0.8× |
| Admin pneumococcal vaccine (G0009) | $37.50 | $75 | 0.8× |
| Ca screen;flexi sigmoidscope (G0104) | $783.50 | $1,567 | 0.8× |
| Colon ca scrn not hi rsk ind (G0121) | $1,844 | $3,688 | 2.0× |
| Colorectal scrn; hi risk ind (G0105) | $1,844 | $3,688 | 2.0× |
| Complex simulation w/pet-ct (G0562) | $1,950 | $3,900 | 1.0× |
| Direct refer hospital observ (G0379) | $490 | $980 | 0.8× |
| Drug test def 1-7 classes (G0480) range across 5 matching MRF lines |
$12.50–$151 | $25–$302 | varies |
| Drug test def 15-21 classes (G0482) | $322.50 | $645 | 1.6× |
| Drug test def 22+ classes (G0483) | $363.50 | $727 | 1.5× |
| Drug test def 8-14 classes (G0481) | $246.50 | $493 | 1.6× |
| Egd Flx Trnsorl Vol Adjmt Ntrgstr Bariatric Balo (0813T) | $834 | $1,668 | 0.9× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) | $26,585 | $53,170 | 0.6× |
| Fecal blood scrn immunoassay (G0328) range across 2 matching MRF lines |
$21.50–$24.34 | $43–$48.68 | varies |
| Fecal microbiota prep instil (G0455) | $433.50 | $867 | 0.5× |
| Hbot, full body chamber, 30m (G0277) | $508.50 | $1,017 | 3.7× |
| Hiv combination assay (G0475) range across 2 matching MRF lines |
$31–$63.50 | $62–$127 | varies |
| Hpv combo assay ca screen (G0476) range across 2 matching MRF lines |
$37.50–$70.50 | $75–$141 | varies |
| Mra w/cont, abd (C8900) | $1,382.50 | $2,765 | 4.0× |
| Mra w/cont, chest (C8909) | $1,524 | $3,048 | 4.4× |
| Mra w/cont, lwr ext (C8912) range across 2 matching MRF lines |
$1,517–$2,275.50 | $3,034–$4,551 | varies |
| Mra w/cont, pelvis (C8918) | $1,250 | $2,500 | 3.6× |
| Mra w/o cont, abd (C8901) | $1,020.50 | $2,041 | 4.3× |
| Mra w/o cont, chest (C8910) | $1,400 | $2,800 | 5.9× |
| Mra w/o cont, lwr ext (C8913) range across 2 matching MRF lines |
$1,232.50–$1,849 | $2,465–$3,698 | varies |
| Mra w/o cont, pelvis (C8919) | $1,020.50 | $2,041 | 4.3× |
| Mra w/o fol w/cont, abd (C8902) | $2,107 | $4,214 | 6.1× |
| Mra w/o fol w/cont, chest (C8911) | $1,711 | $3,422 | 4.9× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 2 matching MRF lines |
$1,582.50–$2,374 | $3,165–$4,748 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $1,379.50 | $2,759 | 4.0× |
| Mra, w/dye, upper extremity (C8934) range across 2 matching MRF lines |
$627–$940.50 | $1,254–$1,881 | varies |
| Mra, w/o dye, upper extr (C8935) range across 2 matching MRF lines |
$425–$637.50 | $850–$1,275 | varies |
| Mra, w/o&w/dye, upper extr (C8936) range across 2 matching MRF lines |
$1,362.50–$2,044 | $2,725–$4,088 | varies |
| Mri w/o fol w/cont, breast, (C8908) | $2,295 | $4,590 | 6.6× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,497 | $2,994 | 4.3× |
| Perc d-e cor revasc chro sin (C9607) | $14,812 | $29,624 | 0.8× |
| Perc d-e cor revasc t cabg s (C9604) | $11,362 | $22,724 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $18,900 | $37,800 | 1.0× |
| Perc drug-el cor stent sing (C9600) | $13,698 | $27,396 | 1.2× |
| Perq Sacral Augmt Bilat Inj (0201T) | $8,000 | $16,000 | 1.1× |
| Perq Sacral Augmt Unilat Inj (0200T) | $6,397 | $12,794 | 0.9× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $6,386 | $12,772 | 0.6× |
| Place device/marker, non pro (C9728) | $1,354 | $2,708 | 1.0× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $52.50 | $105 | 1.4× |
| Prolonged iv inf, req pump (C8957) | $256.50 | $513 | 1.2× |
| Prostate biopsy, any mthd (G0416) | $294.50 | $589 | 0.8× |
| Psa screening (G0103) range across 4 matching MRF lines |
$31.47–$89 | $62.94–$178 | varies |
| Revasc intra lithotrip-ather (C9766) | $20,502.50 | $41,005 | 1.1× |
| Revasc intra lithotrip-stent (C9765) | $20,502.50 | $41,005 | 1.1× |
| Revasc intravasc lithotripsy (C9764) | $16,214 | $32,428 | 1.4× |
| Revasc lith-sten-ath tib/per (C9775) | $20,502.50 | $41,005 | 1.1× |
| Revasc lithotr-ather tib/per (C9774) | $20,502.50 | $41,005 | 1.1× |
| Revasc lithotr-stent tib/per (C9773) | $20,502.50 | $41,005 | 1.1× |
| Revasc lithotrip tibi/perone (C9772) | $15,316 | $30,632 | 1.3× |
| Revasc lithotrip-stent-ather (C9767) | $24,690 | $49,380 | 1.4× |
| Sbrt w/positron emission del (G0563) | $3,750 | $7,500 | 1.2× |
| Screen cerv/vag thin layer (G0123) | $65.50 | $131 | 3.2× |
| Screen pap by tech w md supv (P3000) | $36 | $72 | 1.9× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $13,474 | $26,948 | 0.7× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $2,939 | $5,878 | 0.9× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) | $13,474 | $26,948 | 0.7× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $7,475 | $14,950 | 1.3× |
| Tomosynthesis, mammo (G0279) range across 2 matching MRF lines |
$112.50–$185 | $225–$370 | varies |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $7,800 | $15,600 | 1.4× |
| Transcatheter renal sympath denervation unilat (0338T) | $5,450 | $10,900 | 1.0× |
| Trauma respons w/hosp criti (G0390) range across 3 matching MRF lines |
$1,750–$4,860.50 | $3,500–$9,721 | varies |
| Trluml perip athrc abd aorta (0236T) | $19,176 | $38,352 | 1.7× |
| Trluml Perip Athrc Brchiocph (0237T) | $19,176 | $38,352 | 1.7× |
| Trluml Perip Athrc Iliac Art (0238T) | $10,175 | $20,350 | 0.6× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $17,860 | $35,720 | 1.6× |
| Unsched dialysis esrd pt hos (G0257) | $1,522 | $3,044 | 2.2× |
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.