Supplies, drugs & other prices at St. Mary's Good Samaritan Hospital
Greensboro, GA · every code in this section with a posted price and a Medicare benchmark.
17 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $772.85 | $1,189 | 2.5× |
| Admin influenza virus vac (G0008) | $50.70 | $78 | 1.2× |
| Catheterize for urine spec (P9612) | $18.20 | $28 | 1.9× |
| Colon ca scrn not hi rsk ind (G0121) | $4,905.10 | — | 6.0× |
| Colorectal scrn; hi risk ind (G0105) | $4,482.01 | — | 5.5× |
| Direct refer hospital observ (G0379) | $1,149.85 | $1,769 | 2.2× |
| Fecal blood scrn immunoassay (G0328) | $58.50 | $90 | 3.2× |
| Hep c screen high risk/other (G0472) | $47.12 | $72.50 | 1.0× |
| Hepb screen high risk indiv (G0499) | $27.95 | $43 | 1.0× |
| Hiv combination assay (G0475) | $80.60 | $124 | 3.3× |
| Hospital outpt clinic visit (G0463) | $81.58 | $125.50 | 0.7× |
| Mri w/o fol w/cont, breast, (C8908) | $829.40 | $1,276 | 2.7× |
| Pathogen test for platelets (P9100) | $114.40 | $176 | 2.2× |
| Prolonged iv inf, req pump (C8957) | $666.25 | $1,025 | 3.6× |
| Psa screening (G0103) | $45.18 | $69.50 | 2.3× |
| Tomosynthesis, mammo (G0279) | $133.90 | $206 | 10.6× |
| Tte w or wo fol wcon,doppler (C8929) | $1,652.95 | $2,543 | 2.4× |