Supplies, drugs & other prices at Sanford Bemidji Medical Center
Bemidji, MN · every code in this section with a posted price and a Medicare benchmark.
48 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,073.60 | $1,342 | 1.3× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,239.20 | $1,549 | 1.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,224 | $1,530 | 3.4× |
| Admin influenza virus vac (G0008) | $40.80 | $51 | 0.8× |
| Behavior counsel obesity 15m (G0447) | $56.80 | $71 | 0.5× |
| Chemo extend iv infus w/pump (G0498) | $676 | $845 | 2.0× |
| Diab manage trn per indiv (G0108) | $113.60 | $142 | 2.0× |
| Diab manage trn ind/group (G0109) | $72 | $90 | 4.5× |
| Direct refer hospital observ (G0379) | $200 | $250 | 0.3× |
| Ekg tracing for initial prev (G0404) | $65.60 | $82 | 2.2× |
| Group train w/o patient (G0543) | $59.20 | $74 | 2.0× |
| Hbot, full body chamber, 30m (G0277) | $370.40 | $463 | 2.6× |
| Home sleep test/type 3 porta (G0399) | $378.40 | $473 | 1.7× |
| Hospital outpt clinic visit (G0463) | $208.80 | $261 | 1.5× |
| Iliac Atherectomy (0238T) | $18,628 | $23,285 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) | $1,776 | $2,220 | 2.4× |
| No pt prsnt train initial 30 (G0541) | $140.80 | $176 | 4.7× |
| Oth resp proc, group (G0239) | $136.80 | $171 | 3.5× |
| Oth resp proc, indiv (G0238) | $121.60 | $152 | 4.1× |
| Pemivibart infusion (M0224) | $798.40 | $998 | 1.8× |
| Perc d-e cor revasc chro sin (C9607) | $27,648 | $34,560 | 1.5× |
| Perc d-e cor revasc t cabg s (C9604) | $20,732.80 | $25,916 | 1.7× |
| Perc d-e cor stent ather s (C9602) | $26,204 | $32,755 | 1.4× |
| Perc drug-el cor stent sing (C9600) | $21,376 | $26,720 | 1.8× |
| Perq Sacral Augmt Bilat Inj (0201T) | $8,165.60 | $10,207 | 1.1× |
| Perq Sacral Augmt Unilat Inj (0200T) | $5,965.60 | $7,457 | 0.8× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $16,176.80 | $20,221 | 1.4× |
| Prostate biopsy, any mthd (G0416) | $1,006.40 | $1,258 | 2.7× |
| Revasc intra lithotrip-ather (C9766) | $15,120 | $18,900 | 0.8× |
| Revasc intra lithotrip-stent (C9765) | $15,120 | $18,900 | 0.8× |
| Revasc intravasc lithotripsy (C9764) | $7,176 | $8,970 | 0.6× |
| Revasc lith-sten-ath tib/per (C9775) | $29,917.60 | $37,397 | 1.6× |
| Revasc lithotr-ather tib/per (C9774) | $28,418.40 | $35,523 | 1.5× |
| Revasc lithotr-stent tib/per (C9773) | $31,056.80 | $38,821 | 1.6× |
| Revasc lithotrip tibi/perone (C9772) | $13,518.40 | $16,898 | 1.1× |
| Revasc lithotrip-stent-ather (C9767) | $19,843.20 | $24,804 | 1.0× |
| Therapeutic procd strg endur (G0237) | $123.20 | $154 | 4.1× |
| Tomosynthesis, mammo (G0279) | $96.80 | $121 | 7.6× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) | $13,573.60 | $16,967 | 1.1× |
| Trauma respons w/hosp criti (G0390) | $1,941.60 | $2,427 | 1.4× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $18,296 | $22,870 | 1.5× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $15,406.40 | $19,258 | 1.3× |
| Tte w or w/o contr, cont ecg (C8930) | $2,739.20 | $3,424 | 3.4× |
| Tte w or w/o fol w/con,stres (C8928) | $2,399.20 | $2,999 | 3.0× |
| Tte w or w/o fol w/cont, com (C8921) | $1,175.20 | $1,469 | 1.5× |
| Tte w or w/o fol w/cont, f/u (C8922) | $567.20 | $709 | 0.7× |
| Tte w or wo fol wcon,doppler (C8929) | $2,629.60 | $3,287 | 3.3× |
| Unsched dialysis esrd pt hos (G0257) | $1,620 | $2,025 | 2.3× |