Supplies, drugs & other prices at SSM Health St. Mary's Hospital -centralia
Centralia, IL · every code in this section with a posted price and a Medicare benchmark.
67 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $1,207.80 | $2,196 | 3.2× |
| Adm tocilizu covid-19 1st (M0249) | $484.55 | $881 | 1.0× |
| Admin hepatitis b vaccine (G0010) | $76.45 | $139 | 1.5× |
| Admin influenza virus vac (G0008) | $66.55 | $121 | 1.3× |
| Admin pneumococcal vaccine (G0009) | $70.95 | $129 | 1.4× |
| Catheterize for urine spec (P9612) | $7.15 | $13 | 0.8× |
| Chemo extend iv infus w/pump (G0498) | $799.15 | $1,453 | 2.3× |
| Covid-19 lab test non-cdc (U0002) | $162.80 | $296 | 3.2× |
| Diab manage trn per indiv (G0108) | $107.25 | $195 | 1.9× |
| Diab manage trn ind/group (G0109) | $80.30 | $146 | 5.0× |
| Direct refer hospital observ (G0379) | $572 | $1,040 | 0.9× |
| Eia hiv-1/hiv-2 screen (G0432) | $83.60 | $152 | 4.3× |
| Elec stim other than wound (G0283) range across 2 matching MRF lines |
$115.50–$121.55 | $210–$221 | varies |
| Elec stim unattend for press (G0281) | $58.85 | $107 | 5.0× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $12,035.65 | $21,883 | 1.0× |
| Fecal blood scrn immunoassay (G0328) | $45.10 | $82 | 2.5× |
| Fecal microbiota prep instil (G0455) | $553.30 | $1,006 | 0.6× |
| Group train w/o patient (G0543) | $74.25 | $135 | 2.4× |
| Hbot, full body chamber, 30m (G0277) | $449.90 | $818 | 3.1× |
| Home sleep test/type 2 porta (G0398) | $517 | $940 | 2.2× |
| Home sleep test/type 3 porta (G0399) | $1,008.70 | $1,834 | 4.4× |
| Hospital outpt clinic visit (G0463) | $135.30 | $246 | 0.9× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$2,124.10–$4,248.20 | $3,862–$7,724 | varies |
| Mnt subs tx for change dx (G0270) | $35.20 | $64 | 1.1× |
| Mra w/cont, abd (C8900) | $2,846.80 | $5,176 | 7.6× |
| Mra w/cont, chest (C8909) | $2,995.85 | $5,447 | 8.0× |
| Mra w/cont, lwr ext (C8912) | $3,054.15 | $5,553 | 8.2× |
| Mra w/cont, pelvis (C8918) | $1,850.75 | $3,365 | 5.0× |
| Mra w/o cont, abd (C8901) | $2,031.15 | $3,693 | 7.9× |
| Mra w/o cont, chest (C8910) | $2,960.65 | $5,383 | 11.6× |
| Mra w/o cont, lwr ext (C8913) | $2,846.80 | $5,176 | 11.1× |
| Mra w/o cont, pelvis (C8919) | $1,828.20 | $3,324 | 7.2× |
| Mra w/o fol w/cont, abd (C8902) | $4,110.15 | $7,473 | 11.0× |
| Mra w/o fol w/cont, chest (C8911) | $3,335.20 | $6,064 | 8.9× |
| Mra w/o fol w/cont, lwr ext (C8914) | $3,763.65 | $6,843 | 10.1× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,114.75 | $3,845 | 5.7× |
| Mra, w/o&w/dye, upper extr (C8936) | $2,555.85 | $4,647 | 6.8× |
| Mri w/cont, breast, bi (C8906) | $2,526.70 | $4,594 | 6.8× |
| Mri w/cont, breast, uni (C8903) | $3,054.15 | $5,553 | 16.2× |
| Mri w/o fol w/cont, breast, (C8908) | $4,455.55 | $8,101 | 11.9× |
| Mri w/o fol w/cont, brst, un (C8905) | $3,145.45 | $5,719 | 8.4× |
| No pt prsnt train initial 30 (G0541) | $71.50 | $130 | 2.3× |
| Oth resp proc, group (G0239) | $55.55 | $101 | 1.4× |
| Pathogen test for platelets (P9100) | $113.85 | $207 | 1.8× |
| Perc d-e cor revasc chro sin (C9607) | $21,133.20 | $38,424 | 1.1× |
| Perc d-e cor revasc t cabg s (C9604) | $23,588.40 | $42,888 | 1.9× |
| Perc d-e cor stent ather s (C9602) | $25,386.90 | $46,158 | 1.3× |
| Perc drug-el cor stent sing (C9600) | $20,359.35 | $37,017 | 1.6× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $9,806.50 | $17,830 | 0.8× |
| Prostate biopsy, any mthd (G0416) | $409.75 | $745 | 1.1× |
| Psa screening (G0103) | $200.20 | $364 | 10.4× |
| Revasc intra lithotrip-ather (C9766) | $11,050.60 | $20,092 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $11,050.60 | $20,092 | 0.6× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$5,454.35 | $9,917 | 0.4× |
| Revasc lith-sten-ath tib/per (C9775) | $17,675.35 | $32,137 | 0.9× |
| Revasc lithotr-ather tib/per (C9774) | $17,675.35 | $32,137 | 0.9× |
| Revasc lithotr-stent tib/per (C9773) | $17,675.35 | $32,137 | 0.9× |
| Revasc lithotrip tibi/perone (C9772) | $11,050.60 | $20,092 | 0.9× |
| Revasc lithotrip-stent-ather (C9767) | $17,675.35 | $32,137 | 0.9× |
| Scr c/v cyto,thinlayer,rescr (G0143) | $124.30 | $226 | 4.6× |
| Screen pap by tech w md supv (P3000) | $288.20 | $524 | 15.5× |
| Therapeutic procd strg endur (G0237) | $86.35 | $157 | 2.8× |
| Trluml Perip Athrc Iliac Art (0238T) | $18,066.40 | $32,848 | 0.9× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $11,919.60 | $21,672 | 1.0× |
| Tte w or w/o fol w/con,stres (C8928) | $2,322.10 | $4,222 | 2.8× |
| Tte w or wo fol wcon,doppler (C8929) | $2,644.95 | $4,809 | 3.1× |
| Unsched dialysis esrd pt hos (G0257) | $733.15 | $1,333 | 1.0× |
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.