Supplies, drugs & other prices at St. Bernards Medical Center

Jonesboro, AR · every code in this section with a posted price and a Medicare benchmark.

80 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $139.75 $215 0.1×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T)
likely a partial charge, not the full procedure
$139.75 $215 0.0×
Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) $139.75 $215 0.1×
Admin hepatitis b vaccine (G0010) $24.05 $37 0.5×
Admin influenza virus vac (G0008) $24.05 $37 0.5×
Admin pneumococcal vaccine (G0009) $36.40 $56 0.8×
Annual alcohol screen 15 min (G0442) $16.25 $25 0.5×
Behavior counsel obesity 15m (G0447) $27.30 $42 0.3×
Blind interatrial shunt ide (C9758) $22,750.32 $35,000.50 1.4×
Brief alcohol misuse counsel (G0443) $26 $40 0.3×
Ca screen;flexi sigmoidscope (G0104) $113.75 $175 0.1×
Ca screen;pelvic/breast exam (G0101) $34.45 $53 0.4×
Catheterize for urine spec (P9612) $48.75 $75 5.2×
Colon ca scrn not hi rsk ind (G0121) $325 $500 0.4×
Colorectal scrn; hi risk ind (G0105) $455 $700 0.5×
Depression screen annual (G0444) $16.25 $25 0.5×
Dermal filler injection(s) (G0429) $507 $780 0.3×
Diab manage trn per indiv (G0108) $65 $100 1.2×
Diab manage trn ind/group (G0109) $19.50 $30 1.2×
Direct refer hospital observ (G0379) $667.88 $1,027.50 1.2×
Drug test def 1-7 classes (G0480) $149.50 $230 1.3×
Drug test def 8-14 classes (G0481) $94.25 $145 0.6×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $14,742 $22,680 1.4×
Fecal blood scrn immunoassay (G0328) $25.35 $39 1.4×
Fecal microbiota prep instil (G0455) $97.50 $150 0.1×
Followup eval of foot pt lop (G0246) $26 $40 0.2×
Group mnt 2 or more 30 mins (G0271) $19.50 $30 1.1×
Hep c screen high risk/other (G0472) $24.05 $37 0.5×
Initial foot exam pt lops (G0245) $42.25 $65 0.3×
Initial preventive exam (G0402) $165.75 $255 1.3×
Insertion of substernal implantable defibrillator electrode (0572T) $10,757.50 $16,550 1.4×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0516T) $13,604.50 $20,930 1.4×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $13,604.50 $20,930 1.4×
Insertion wrls car stimulator lv pacg compl sys (0515T) $29,181.75 $44,895 1.4×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $41,681.25 $64,125 1.4×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $41,681.25 $64,125 1.4×
Intens behave ther cardio dx (G0446) $39 $60 1.1×
Mnt subs tx for change dx (G0270) $35.75 $55 1.1×
Obtaining screen pap smear (Q0091) $32.50 $50 1.2×
Perc drug-el cor stent sing (C9600)
unusually low: confirm this is the full procedure
$3,685.50 $5,670 0.3×
Perq Sacral Augmt Bilat Inj (0201T) $8,862.75 $13,635 1.3×
Perq Sacral Augmt Unilat Inj (0200T) $8,862.75 $13,635 1.3×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) $7,410 $11,400 0.7×
Ppps, initial visit (G0438) $177.12 $272.50 1.0×
Ppps, subseq visit (G0439) $113.75 $175 0.8×
Pre 3d mdl w/ccta and/or mri (C9793) $1,308.12 $2,012.50 1.6×
Prolonged iv inf, req pump (C8957) $364 $560 1.8×
Psa screening (G0103) $42.25 $65 2.2×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s)… (0519T) $13,604.50 $20,930 1.4×
Repos prev impl ss impltbl dfb pacing eltrd (0574T) $4,732 $7,280 1.4×
Revasc intra lithotrip-ather (C9766) $23,344.75 $35,915 1.4×
Revasc intra lithotrip-stent (C9765) $23,344.75 $35,915 1.4×
Revasc intravasc lithotripsy (C9764) $14,742 $22,680 1.4×
Revasc lith-sten-ath tib/per (C9775) $23,344.75 $35,915 1.4×
Revasc lithotr-ather tib/per (C9774) $23,344.75 $35,915 1.4×
Revasc lithotr-stent tib/per (C9773) $23,344.75 $35,915 1.4×
Revasc lithotrip tibi/perone (C9772) $14,742 $22,680 1.4×
Revasc lithotrip-stent-ather (C9767) $23,344.75 $35,915 1.4×
Rmvl substernal implantable defibrillator eltrd (0573T) $4,732 $7,280 1.4×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $24,791 $38,140 1.4×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $24,791 $38,140 1.4×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $24,791 $38,140 1.4×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $24,791 $38,140 1.4×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $2,478.12 $3,812.50 0.8×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $12,941.50 $19,910 0.7×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T)
likely a partial charge, not the full procedure
$1,092 $1,680 0.1×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $24,794.25 $38,145 1.4×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $24,794.25 $38,145 1.4×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $7,413.25 $5,857.50 1.4×
Transcatheter Renal Sympath Denervation Bilat (0339T) $7,413.25 $11,405 1.4×
Transcatheter renal sympath denervation unilat (0338T) $7,413.25 $11,405 1.4×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $14,742 $22,680 1.4×
Trauma respons w/hosp criti (G0390) $1,244.75 $1,915 1.0×
Trim nail(s) (G0127) $22.75 $35 0.4×
Trluml Perip Athrc Renal Art (0234T) $14,742 $22,680 1.4×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $14,742 $22,680 1.4×
Trluml peripheral atherectomy iliac artery ea (0238T) $23,344.75 $35,915 1.4×
Visit esketamine 56m or less (G2082) $890.50 $1,370 0.9×
Visit esketamine, > 56m (G2083) $1,264.25 $1,945 0.8×
Visit to determ ldct elig (G0296) $60.78 $93.50 0.6×