Supplies, drugs & other prices at Sentara RMH Medical Center
Harrisonburg, VA · every code in this section with a posted price and a Medicare benchmark.
108 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) | $763.50 | $1,527 | 1.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $732 | $1,464 | 2.2× |
| 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) | $49 | $98 | 1.1× |
| Admin influenza virus vac (G0008) | $20.50 | $41 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $20.50 | $41 | 0.4× |
| Alcohol/subs interv 15-30mn (G0396) | $36 | $72 | 1.0× |
| Annual alcohol screen 15 min (G0442) | $52.50 | $105 | 1.4× |
| Behavior counsel obesity 15m (G0447) | $52.50 | $105 | 0.5× |
| Blind cor sinus reducer impl (C9783) | $12,930 | $25,860 | 1.1× |
| Blind interatrial shunt ide (C9758) | $25,036.50 | $50,073 | 1.5× |
| Ca screen;flexi sigmoidscope (G0104) | $965 | $1,930 | 1.1× |
| Ca screen;pelvic/breast exam (G0101) | $36.50 | $73 | 0.4× |
| Catheterize for urine spec (P9612) | $68 | $136 | 7.3× |
| Chemo extend iv infus w/pump (G0498) | $820.50 | $1,641 | 2.5× |
| Depression screen annual (G0444) | $34 | $68 | 0.9× |
| Diab manage trn per indiv (G0108) | $69.50 | $139 | 1.2× |
| Diab manage trn ind/group (G0109) | $29.50 | $59 | 1.8× |
| Direct refer hospital observ (G0379) | $374.50 | $749 | 0.6× |
| Drug test def 1-7 classes (G0480) | $29.50 | $55.50 | 0.3× |
| Ekg tracing for initial prev (G0404) | $19 | $38 | 0.7× |
| Elec stim other than wound (G0283) | $49 | $98 | 3.9× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $13,869 | $27,738 | 1.2× |
| Extraction erupted tooth/exr (D7140) | $1,157 | $2,314 | 1.8× |
| Fecal blood scrn immunoassay (G0328) | $49 | $98 | 2.7× |
| Fern test (Q0114) | $30.50 | $61 | 3.1× |
| Followup eval of foot pt lop (G0246) | $58 | $116 | 0.4× |
| Group mnt 2 or more 30 mins (G0271) | $48.50 | $97 | 2.8× |
| Hbot, full body chamber, 30m (G0277) | $286 | $572 | 2.1× |
| High inten beh couns std 30m (G0445) | $103.50 | $207 | 1.0× |
| Hiv combination assay (G0475) | $96.50 | $193 | 4.0× |
| Hospital outpt clinic visit (G0463) | $209 | $418 | 1.6× |
| Iliac Atherectomy (0238T) | $12,369 | $24,738 | 0.7× |
| Initial foot exam pt lops (G0245) | $155.50 | $311 | 1.2× |
| Initial preventive exam (G0402) | $319.50 | $639 | 2.5× |
| Inj for sacroiliac jt anesth (G0260) | $1,231 | $2,462 | 1.8× |
| Insertion wrls car stimulator lv pacg compl sys (0515T) | $40,762.50 | $81,525 | 1.9× |
| Insj Wcs Lv Eltrd Only (0516T) | $13,721 | $27,442 | 1.3× |
| Intens cardiac rehab no exer (G0423) | $134.50 | $269 | 1.1× |
| Intens cardiac rehab w/exerc (G0422) | $134.50 | $269 | 1.1× |
| Mnt subs tx for change dx (G0270) | $48.50 | $97 | 1.5× |
| Mra w/cont, abd (C8900) | $1,781.50 | $3,563 | 5.2× |
| Mra w/cont, chest (C8909) | $1,781.50 | $3,563 | 5.2× |
| Mra w/cont, lwr ext (C8912) | $1,781.50 | $3,563 | 5.2× |
| Mra w/cont, pelvis (C8918) | $1,781.50 | $3,563 | 5.2× |
| Mra w/o cont, abd (C8901) | $1,713.50 | $3,427 | 7.4× |
| Mra w/o cont, chest (C8910) | $1,713.50 | $3,427 | 7.4× |
| Mra w/o cont, lwr ext (C8913) | $1,713.50 | $3,427 | 7.4× |
| Mra w/o cont, pelvis (C8919) | $1,713.50 | $3,427 | 7.4× |
| Mra w/o fol w/cont, abd (C8902) | $1,885 | $3,770 | 5.5× |
| Mra w/o fol w/cont, chest (C8911) | $1,885 | $3,770 | 5.5× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,885 | $3,770 | 5.5× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,885 | $3,770 | 5.5× |
| Mra, w/o&w/dye, spinal canal (C8933) | $2,246 | $4,492 | 6.6× |
| Mra, w/o&w/dye, upper extr (C8936) | $2,246 | $4,492 | 6.6× |
| Mri w/cont, breast, bi (C8906) | $3,388 | $6,776 | 10.0× |
| Mri w/cont, breast, uni (C8903) | $3,033.50 | $6,067 | 17.7× |
| Mri w/o fol w/cont, breast, (C8908) | $3,558 | $7,116 | 10.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $3,203.50 | $6,407 | 9.4× |
| Neuro csf prion prtn qual (0035U) | $316 | $632 | 0.6× |
| Obtaining screen pap smear (Q0091) | $34 | $68 | 1.2× |
| Off base opioid tx 70min (G2086) | $160.50 | $321 | 0.9× |
| Off base opioid tx, 60 m (G2087) | $160.50 | $321 | 0.9× |
| Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) | $1,007.50 | $2,015 | 0.3× |
| Oth resp proc, group (G0239) | $139 | $278 | 3.8× |
| Oth resp proc, indiv (G0238) | $61.50 | $123 | 2.2× |
| Pathogen test for platelets (P9100) | $44.50 | $89 | 0.8× |
| Pelvic ring fracture uni/bil (G0413) | $4,761 | $9,522 | 0.7× |
| Perc d-e cor revasc chro sin (C9607) | $15,784.50 | $31,569 | 0.9× |
| Perc d-e cor revasc t cabg s (C9604) | $15,784.50 | $31,569 | 1.4× |
| Perc d-e cor stent ather s (C9602) | $15,784.50 | $31,569 | 0.9× |
| Perc drug-el cor stent sing (C9600) | $15,784.50 | $31,569 | 1.4× |
| Perq Sacral Augmt Bilat Inj (0201T) | $5,411 | $10,822 | 0.8× |
| Perq Sacral Augmt Unilat Inj (0200T) | $6,894 | $13,788 | 1.0× |
| Pin service 60m per month (G0023) | $114 | $228 | 1.2× |
| Place device/marker, non pro (C9728) | $3,232 | $6,464 | 2.4× |
| Potassium hydroxide preps (Q0112) | $15 | $30 | 2.6× |
| Ppps, initial visit (G0438) | $218.50 | $437 | 1.3× |
| Ppps, subseq visit (G0439) | $149 | $298 | 1.1× |
| Prolonged iv inf, req pump (C8957) | $454.50 | $909 | 2.2× |
| Prostate biopsy, any mthd (G0416) | $438.25 | $876.50 | 1.3× |
| Psa screening (G0103) | $84.50 | $169 | 4.4× |
| Rem imp tooth w mucoper flp (D7210) | $1,157 | $2,314 | 0.8× |
| Revasc intra lithotrip-ather (C9766) | $13,166.50 | $26,333 | 0.7× |
| Revasc intra lithotrip-stent (C9765) | $13,166.50 | $26,333 | 0.7× |
| Revasc intravasc lithotripsy (C9764) | $6,583.50 | $13,167 | 0.6× |
| Revasc lith-sten-ath tib/per (C9775) | $29,768.50 | $59,537 | 1.7× |
| Revasc lithotr-ather tib/per (C9774) | $29,768.50 | $59,537 | 1.7× |
| Revasc lithotr-stent tib/per (C9773) | $29,768.50 | $59,537 | 1.7× |
| Revasc lithotrip tibi/perone (C9772) | $19,156.50 | $38,313 | 1.7× |
| Revasc lithotrip-stent-ather (C9767) | $21,180.50 | $42,361 | 1.2× |
| Routine footcare pt w lops (G0247) | $94 | $188 | 0.5× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $41.25 | $82.50 | 1.6× |
| Screen cerv/vag thin layer (G0123) | $62.50 | $125 | 3.1× |
| Screen pap by tech w md supv (P3000) | $62.50 | $125 | 3.4× |
| Therapeutic procd strg endur (G0237) | $81 | $162 | 2.9× |
| Tomosynthesis, mammo (G0279) | $82.50 | $165 | 6.5× |
| Trauma respons w/hosp criti (G0390) | $2,366 | $4,732 | 1.8× |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $1,757.50 | $3,515 | 0.5× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $14,207.50 | $28,415 | 1.3× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $11,223.50 | $22,447 | 1.0× |
| Tte w or w/o contr, cont ecg (C8930) | $1,064 | $2,128 | 1.4× |
| Tte w or w/o fol w/con,stres (C8928) | $1,482.50 | $2,965 | 1.9× |
| Tte w or wo fol wcon,doppler (C8929) | $1,427 | $2,854 | 1.9× |
| Unsched dialysis esrd pt hos (G0257) | $605 | $1,210 | 0.9× |
| Wet mounts/ w preparations (Q0111) | $26 | $52 | 1.4× |