Supplies, drugs & other prices at Intermountain Health St. Mary's Regional Hospital

Grand Junction, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Adm tocilizu covid-19 1st (M0249) $1,402.05
Admin hepatitis b vaccine (G0010) $21.17
Catheterize for urine spec (P9612) $26.30
Covid-19 lab test non-cdc (U0002) $176.76
Diab manage trn per indiv (G0108) $277.15
Diab manage trn ind/group (G0109) $210.70
Direct refer hospital observ (G0379) $921.95
Drug test def 1-7 classes (G0480) $321.12
Drug test def 15-21 classes (G0482) $496.85
Drug test def 22+ classes (G0483) $790.16
Drug test def 8-14 classes (G0481) $390.88
Eia hiv-1/hiv-2 screen (G0432) $336.34
Ekg tracing for initial prev (G0404) $162.25
Elisa hiv-1/hiv-2 screen (G0433) $124.30
Fecal microbiota prep instil (G0455) $5,166.10
Group mnt 2 or more 30 mins (G0271) $88.75
Hbot, full body chamber, 30m (G0277) $782.70
Heart symp image plnr (0331T) $4,062.95
Hep c screen high risk/other (G0472) $303.04
Hepb screen high risk indiv (G0499) $163.91
Home sleep test/type 2 porta (G0398) $1,316.85
Home sleep test/type 3 porta (G0399) $1,053.50
Hospital outpt clinic visit (G0463) $322.80
Mnt subs tx for change dx (G0270) $88.75
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $546
Oth resp proc, group (G0239) $254.65
Oth resp proc, indiv (G0238) $130.15
Perc d-e cor revasc chro sin (C9607) $50,137.72
Perq Sacral Augmt Bilat Inj (0201T) $12,829
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) $17,744.25
Prolonged iv inf, req pump (C8957) $2,081.55
Prostate biopsy, any mthd (G0416) $1,575.12
Psa screening (G0103) $131.20
Revasc intra lithotrip-ather (C9766) $51,996.50
Revasc intra lithotrip-stent (C9765) $48,903.50
Revasc intravasc lithotripsy (C9764) $44,084.82
Scr c/v cyto,thinlayer,rescr (G0145) $117.22
Screen cerv/vag thin layer (G0123) $89.65
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $16,948.50
Therapeutic procd strg endur (G0237) $145.90
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $37,971.85
Trauma respons w/hosp criti (G0390) $7,725.28
Trluml Perip Athrc Renal Art (0234T) $37,971.85
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $37,971.85
Trluml peripheral atherectomy iliac artery ea (0238T) $37,971.85
Unsched dialysis esrd pt hos (G0257) $3,288.20