Supplies, drugs & other prices at CHI St. Francis Health
Breckenridge, MN · every code in this section with a posted price and a Medicare benchmark.
24 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Adm tocilizu covid-19 1st (M0249) | $410.40 | $684 | 0.9× |
| Adm tocilizu covid-19 2nd (M0250) | $410.40 | $684 | 0.9× |
| Colon ca scrn not hi rsk ind (G0121) | $574.20 | $957 | 0.6× |
| Colorectal scrn; hi risk ind (G0105) | $573.60 | $956 | 0.6× |
| Diab manage trn per indiv (G0108) | $86.40 | $144 | 1.5× |
| Diab manage trn ind/group (G0109) | $39.60 | $66 | 2.5× |
| Extraction coronal remnants (D7111) | $51 | $85 | 0.1× |
| Extraction erupted tooth/exr (D7140) | $93.60 | $156 | 0.1× |
| Group mnt 2 or more 30 mins (G0271) | $26.40 | $44 | 1.6× |
| Hopd mntl hlt, 15-29 min (C7900) | $534 | $890 | 13.8× |
| Hopd mntl hlt, 30-60 min (C7901) | $669 | $1,115 | 6.4× |
| Hopd mntl hlt, grp (C7903) | $798 | $1,330 | 20.6× |
| Hospital outpt clinic visit (G0463) | $84 | $140 | 0.6× |
| Impact tooth remov comp bony (D7240) | $345.60 | $576 | 0.5× |
| Impact tooth remov part bony (D7230) | $310.80 | $518 | 0.5× |
| Impact tooth remov soft tiss (D7220) | $243 | $405 | 0.4× |
| Mnt subs tx for change dx (G0270) | $39.60 | $66 | 1.2× |
| Ppps, initial visit (G0438) | $281.40 | $469 | 1.6× |
| Ppps, subseq visit (G0439) | $221.40 | $369 | 1.6× |
| Rem imp tooth w mucoper flp (D7210) | $160.80 | $268 | 0.1× |
| Tooth root removal (D7250) | $135.60 | $226 | 0.2× |
| Trauma respons w/hosp criti (G0390) | $1,261.80 | $2,103 | 0.9× |
| Trim nail(s) (G0127) | $64.20 | $107 | 1.1× |
| Tte w or wo fol wcon,doppler (C8929) | $1,055.40 | $1,759 | 1.3× |