Supplies, drugs & other prices at Sentara Norfolk General Hospital
Norfolk, VA · every code in this section with a posted price and a Medicare benchmark.
107 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) | $2,043 | $4,086 | 2.7× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,190.50 | $2,381 | 3.5× |
| Adm of soc dtr assess 5-15 m (G0136) | $37 | $74 | 1.0× |
| Adm tocilizu covid-19 1st (M0249) | $225 | $450 | 0.5× |
| Adm tocilizu covid-19 2nd (M0250) | $225 | $450 | 0.5× |
| Admin hepatitis b vaccine (G0010) | $48 | $96 | 1.1× |
| Admin influenza virus vac (G0008) | $48 | $96 | 1.1× |
| Admin pneumococcal vaccine (G0009) | $48 | $96 | 1.1× |
| Alcohol/subs interv 15-30mn (G0396) | $37.50 | $75 | 1.0× |
| Annual alcohol screen 15 min (G0442) | $42.50 | $85 | 1.2× |
| Behavior counsel obesity 15m (G0447) | $42.50 | $85 | 0.4× |
| Blind cor sinus reducer impl (C9783) | $14,182 | $28,364 | 1.3× |
| Blind interatrial shunt ide (C9758) | $28,056.50 | $56,113 | 1.7× |
| Ca screen;flexi sigmoidscope (G0104) | $1,110 | $2,220 | 1.2× |
| Ca screen;pelvic/breast exam (G0101) | $129.50 | $259 | 1.3× |
| Catheterize for urine spec (P9612) | $14 | $28 | 1.5× |
| Depression screen annual (G0444) | $25.50 | $51 | 0.7× |
| Diab manage trn per indiv (G0108) | $35 | $70 | 0.6× |
| Diab manage trn ind/group (G0109) | $24 | $48 | 1.5× |
| Direct refer hospital observ (G0379) | $465 | $930 | 0.8× |
| Drug test def 1-7 classes (G0480) | $29.50 | $55.50 | 0.3× |
| Ekg tracing for initial prev (G0404) | $75.50 | $151 | 2.7× |
| Elec stim other than wound (G0283) | $104.50 | $209 | 8.2× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $15,542.50 | $31,085 | 1.4× |
| Extraction erupted tooth/exr (D7140) | $1,006 | $2,012 | 1.6× |
| Fecal blood scrn immunoassay (G0328) | $89 | $178 | 4.9× |
| Fern test (Q0114) | $41 | $82 | 4.2× |
| Followup eval of foot pt lop (G0246) | $182.50 | $365 | 1.4× |
| Group mnt 2 or more 30 mins (G0271) | $27.50 | $55 | 1.6× |
| Hbot, full body chamber, 30m (G0277) | $563.50 | $1,127 | 4.2× |
| High inten beh couns std 30m (G0445) | $103.50 | $207 | 1.0× |
| Hiv combination assay (G0475) | $39.50 | $79 | 1.6× |
| Hospital outpt clinic visit (G0463) | $172 | $344 | 1.3× |
| Iliac Atherectomy (0238T) | $13,233.50 | $26,467 | 0.7× |
| Initial foot exam pt lops (G0245) | $162.50 | $325 | 1.3× |
| Initial preventive exam (G0402) | $243.50 | $487 | 1.9× |
| Inj for sacroiliac jt anesth (G0260) | $765.50 | $1,531 | 1.1× |
| Insertion wrls car stimulator lv pacg compl sys (0515T) | $44,708.50 | $89,417 | 2.1× |
| Insj Wcs Lv Eltrd Only (0516T) | $15,049.50 | $30,099 | 1.5× |
| Intens cardiac rehab no exer (G0423) | $140.50 | $281 | 1.1× |
| Intens cardiac rehab w/exerc (G0422) | $140.50 | $281 | 1.1× |
| Mnt subs tx for change dx (G0270) | $37.75 | $75.50 | 1.2× |
| Mra w/cont, abd (C8900) | $2,438 | $4,876 | 7.2× |
| Mra w/cont, chest (C8909) | $1,859.50 | $3,719 | 5.5× |
| Mra w/cont, lwr ext (C8912) | $2,415 | $4,830 | 7.1× |
| Mra w/cont, pelvis (C8918) | $2,300 | $4,600 | 6.8× |
| Mra w/o cont, abd (C8901) | $2,121.50 | $4,243 | 9.1× |
| Mra w/o cont, chest (C8910) | $1,617 | $3,234 | 6.9× |
| Mra w/o cont, pelvis (C8919) | $2,101 | $4,202 | 9.0× |
| Mra w/o fol w/cont, abd (C8902) | $2,805 | $5,610 | 8.2× |
| Mra w/o fol w/cont, chest (C8911) | $2,138.50 | $4,277 | 6.3× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,777 | $5,554 | 8.2× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,777 | $5,554 | 8.2× |
| Mra, w/o&w/dye, spinal canal (C8933) | $2,242 | $4,484 | 6.6× |
| Mra, w/o&w/dye, upper extr (C8936) | $2,242 | $4,484 | 6.6× |
| Mri w/cont, breast, bi (C8906) | $3,383 | $6,766 | 9.9× |
| Mri w/cont, breast, uni (C8903) | $3,028.50 | $6,057 | 17.7× |
| Mri w/o fol w/cont, breast, (C8908) | $3,552 | $7,104 | 10.4× |
| Mri w/o fol w/cont, brst, un (C8905) | $3,198 | $6,396 | 9.4× |
| Neuro csf prion prtn qual (0035U) | $316 | $632 | 0.6× |
| Obtaining screen pap smear (Q0091) | $36 | $72 | 1.3× |
| Off base opioid tx 70min (G2086) | $167.50 | $335 | 1.0× |
| Off base opioid tx, 60 m (G2087) | $167.50 | $335 | 1.0× |
| Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) | $1,007.50 | $2,015 | 0.3× |
| Oth resp proc, group (G0239) | $58 | $116 | 1.6× |
| Oth resp proc, indiv (G0238) | $58 | $116 | 2.1× |
| Pathogen test for platelets (P9100) | $43.50 | $87 | 0.8× |
| Pelvic ring fracture uni/bil (G0413) | $4,599 | $9,198 | 0.6× |
| Perc d-e cor revasc chro sin (C9607) | $11,044 | $22,088 | 0.6× |
| Perc d-e cor revasc t cabg s (C9604) | $11,044 | $22,088 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $14,416.50 | $28,833 | 0.8× |
| Perc drug-el cor stent sing (C9600) | $16,566 | $33,132 | 1.5× |
| Perq Sacral Augmt Bilat Inj (0201T) | $4,633.50 | $9,267 | 0.7× |
| Perq Sacral Augmt Unilat Inj (0200T) | $4,633.50 | $9,267 | 0.7× |
| Pin service 60m per month (G0023) | $114 | $228 | 1.2× |
| Place device/marker, non pro (C9728) | $3,458 | $6,916 | 2.6× |
| Potassium hydroxide preps (Q0112) | $20 | $40 | 3.4× |
| Ppps, initial visit (G0438) | $476.50 | $953 | 2.7× |
| Ppps, subseq visit (G0439) | $319.50 | $639 | 2.3× |
| Prgrmg Dev Eval Scrms Phys/Qhp Remote (0650T) | $71 | $142 | 2.0× |
| Prolonged iv inf, req pump (C8957) | $486.50 | $973 | 2.3× |
| Prostate biopsy, any mthd (G0416) | $438.25 | $876.50 | 1.3× |
| Psa screening (G0103) | $107.50 | $215 | 5.6× |
| Rem imp tooth w mucoper flp (D7210) | $1,006 | $2,012 | 0.7× |
| Revasc intra lithotrip-ather (C9766) | $14,755 | $29,510 | 0.8× |
| Revasc intra lithotrip-stent (C9765) | $14,755 | $29,510 | 0.8× |
| Revasc intravasc lithotripsy (C9764) | $7,377 | $14,754 | 0.7× |
| Revasc lith-sten-ath tib/per (C9775) | $32,651 | $65,302 | 1.8× |
| Revasc lithotr-ather tib/per (C9774) | $32,651 | $65,302 | 1.8× |
| Revasc lithotr-stent tib/per (C9773) | $32,651 | $65,302 | 1.8× |
| Revasc lithotrip tibi/perone (C9772) | $21,468 | $42,936 | 1.9× |
| Revasc lithotrip-stent-ather (C9767) | $23,736.50 | $47,473 | 1.3× |
| Routine footcare pt w lops (G0247) | $153 | $306 | 0.8× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $49.75 | $99.50 | 1.9× |
| Screen cerv/vag thin layer (G0123) | $82 | $164 | 4.0× |
| Screen pap by tech w md supv (P3000) | $32.50 | $65 | 1.8× |
| Therapeutic procd strg endur (G0237) | $58 | $116 | 2.1× |
| Tomosynthesis, mammo (G0279) | $23.50 | $47 | 1.9× |
| Trauma respons w/hosp criti (G0390) | $3,598.50 | $7,197 | 2.8× |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $1,757.50 | $3,515 | 0.5× |
| Trim nail(s) (G0127) | $103 | $206 | 1.8× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $15,200.50 | $30,401 | 1.3× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $12,008.50 | $24,017 | 1.1× |
| Tte w or w/o fol w/con,stres (C8928) | $1,916 | $3,832 | 2.5× |
| Tte w or wo fol wcon,doppler (C8929) | $1,844 | $3,688 | 2.4× |
| Unsched dialysis esrd pt hos (G0257) | $1,065 | $2,130 | 1.6× |
| Wet mounts/ w preparations (Q0111) | $31 | $62 | 1.7× |