Supplies, drugs & other prices at St. Michael Medical Center
Silverdale, WA · every code in this section with a posted price and a Medicare benchmark.
87 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,430.03 | $3,240.12 | 1.6× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,608.83 | $3,645.25 | 1.8× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,027.63 | $2,328.38 | 2.6× |
| Adm tocilizu covid-19 1st (M0249) | $348.44 | $789.47 | 0.7× |
| Adm tocilizu covid-19 2nd (M0250) | $348.44 | $789.47 | 0.7× |
| Admin hepatitis b vaccine (G0010) | $35.05 | $79.40 | 0.7× |
| Admin influenza virus vac (G0008) | $58.56 | $132.68 | 1.1× |
| Admin pneumococcal vaccine (G0009) | $58.56 | $132.68 | 1.1× |
| Alcohol/subs interv 15-30mn (G0396) | $68.44 | $155.05 | 1.6× |
| Alcohol/subs interv >30 min (G0397) | $136.86 | $310.08 | 0.7× |
| Catheterize for urine spec (P9612) | $95.27 | $215.86 | 10.2× |
| Diab manage trn per indiv (G0108) | $106.82 | $242.01 | 1.9× |
| Diab manage trn ind/group (G0109) | $68.23 | $154.58 | 4.3× |
| Direct refer hospital observ (G0379) | $378.06 | $856.59 | 0.6× |
| Drug test def 1-7 classes (G0480) | $172.92 | $391.80 | 1.5× |
| Drug test def 22+ classes (G0483) | $344.52 | $780.59 | 1.4× |
| Drug test def 8-14 classes (G0481) | $165.32 | $374.56 | 1.1× |
| Ekg tracing for initial prev (G0404) | $59.44 | $134.66 | 1.8× |
| Group mnt 2 or more 30 mins (G0271) | $29.37 | $66.53 | 1.7× |
| Hbot, full body chamber, 30m (G0277) | $417.41 | $945.75 | 2.6× |
| Home sleep test/type 3 porta (G0399) | $435.52 | $986.79 | 1.8× |
| Iliac Atherectomy (0238T) unusually low: confirm this is the full procedure |
$8,892.91 | $20,149.41 | 0.4× |
| Inj for sacroiliac jt anesth (G0260) | $1,168.79 | $2,648.21 | 1.4× |
| Insertion of substernal implantable defibrillator electrode (0572T) unusually low: confirm this is the full procedure |
$4,678.65 | $10,600.80 | 0.5× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) likely a partial charge, not the full procedure |
$8,562.90 | $19,401.69 | 0.2× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) unusually low: confirm this is the full procedure |
$11,305.02 | $25,614.75 | 0.3× |
| Lev 1 hosp type b ed visit (G0380) | $254.68 | $577.04 | 3.0× |
| Lev 2 hosp type b ed visit (G0381) | $416.74 | $944.24 | 3.9× |
| Lev 3 hosp type b ed visit (G0382) | $856.63 | $1,940.94 | 4.3× |
| Lev 4 hosp type b ed visit (G0383) | $1,319.68 | $2,990.10 | 4.3× |
| Lev 5 hosp type b ed visit (G0384) | $2,309.97 | $5,233.89 | 4.9× |
| Mnt subs tx for change dx (G0270) | $51.56 | $116.81 | 1.6× |
| Mra w/cont, abd (C8900) | $2,026.23 | $4,591 | 5.0× |
| Mra w/cont, chest (C8909) | $2,057.07 | $4,660.86 | 5.1× |
| Mra w/cont, pelvis (C8918) | $2,218.71 | $5,027.12 | 5.5× |
| Mra w/o cont, abd (C8901) | $1,833.32 | $4,153.89 | 6.7× |
| Mra w/o cont, chest (C8910) | $2,013.30 | $4,561.69 | 7.3× |
| Mra w/o cont, pelvis (C8919) | $2,017.01 | $4,570.10 | 7.3× |
| Mra w/o fol w/cont, abd (C8902) | $2,597.44 | $5,885.23 | 6.5× |
| Mra w/o fol w/cont, chest (C8911) | $2,626.04 | $5,950.03 | 6.5× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,319.57 | $5,255.63 | 5.8× |
| Mra, w/dye, spinal canal (C8931) | $1,902.93 | $4,311.62 | 4.7× |
| Mra, w/dye, upper extremity (C8934) | $2,169.66 | $4,915.98 | 5.4× |
| Mra, w/o dye, spinal canal (C8932) | $1,810.67 | $4,102.58 | 6.6× |
| Mra, w/o dye, upper extr (C8935) | $1,969.20 | $4,461.78 | 7.2× |
| Mra, w/o&w/dye, spinal canal (C8933) | $2,062.30 | $4,672.73 | 5.1× |
| Mra, w/o&w/dye, upper extr (C8936) | $2,391.10 | $5,417.71 | 6.0× |
| Mri w/cont, breast, bi (C8906) | $2,350.46 | $5,325.62 | 5.9× |
| Mri w/o fol w/cont, breast, (C8908) | $2,738.39 | $6,204.60 | 6.8× |
| Neuro csf prion prtn qual (0035U) | $301.22 | $682.50 | 0.6× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $472.76 | $1,071.17 | 0.9× |
| Onc brst ca erbb2 amp/nonamp (0009U) | $59.19 | $134.11 | 0.6× |
| Onc hmtlmf neo jak2 mut DNA (0017U) | $133.97 | $303.54 | 1.5× |
| Onc hmtlmf neo RNA bcr/abl1 bld/bne marrow (0016U) | $239.61 | $542.89 | 1.5× |
| Oth resp proc, group (G0239) | $84.56 | $191.58 | 2.0× |
| Oth resp proc, indiv (G0238) | $72.27 | $163.74 | 2.2× |
| Perc d-e cor revasc chro sin (C9607) | $14,418.99 | $32,670.33 | 0.7× |
| Perc d-e cor revasc t cabg s (C9604) | $13,475.69 | $30,533.02 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $14,418.99 | $32,670.33 | 0.7× |
| Perc drug-el cor stent sing (C9600) | $13,475.69 | $30,533.02 | 1.0× |
| Perq Sacral Augmt Bilat Inj (0201T) | $5,821.56 | $13,190.39 | 0.7× |
| Perq Sacral Augmt Unilat Inj (0200T) | $5,444.93 | $12,337.03 | 0.7× |
| Place device/marker, non pro (C9728) | $2,648.59 | $6,001.13 | 1.7× |
| Prostate biopsy, any mthd (G0416) | $481.77 | $1,091.57 | 1.2× |
| Removal of substernal implantable defibrillator electrode (0573T) | $4,334.81 | $9,821.75 | 1.0× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $4,334.81 | $9,821.75 | 1.0× |
| Revasc lith-sten-ath tib/per (C9775) unusually low: confirm this is the full procedure |
$10,119.70 | $22,929.06 | 0.5× |
| Revasc lithotr-ather tib/per (C9774) unusually low: confirm this is the full procedure |
$10,119.70 | $22,929.06 | 0.5× |
| Revasc lithotr-stent tib/per (C9773) unusually low: confirm this is the full procedure |
$10,119.70 | $22,929.06 | 0.5× |
| Revasc lithotrip tibi/perone (C9772) | $7,831.33 | $17,744.11 | 0.6× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $4,334.81 | $9,821.75 | 1.0× |
| Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) unusually low: confirm this is the full procedure |
$7,826.58 | $17,733.35 | 0.3× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $11,984.10 | $27,153.39 | 0.5× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $11,648.06 | $26,392 | 0.5× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,681.18 | $3,809.18 | 1.9× |
| Therapeutic procd strg endur (G0237) | $72.27 | $163.74 | 2.2× |
| Tomosynthesis, mammo (G0279) | $116.47 | $263.89 | 9.2× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) | $7,371.59 | $16,702.43 | 0.6× |
| Trauma respons w/hosp criti (G0390) | $5,277.20 | $11,957 | 3.4× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $8,054.46 | $18,249.68 | 0.6× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $7,077.68 | $16,036.50 | 0.5× |
| Tte w or w/o contr, cont ecg (C8930) | $1,114.06 | $2,524.20 | 1.2× |
| Tte w or w/o fol w/con,stres (C8928) | $937.67 | $2,124.54 | 1.0× |
| Tte w or w/o fol w/cont, com (C8921) | $1,267.01 | $2,870.77 | 1.4× |
| Tte w or w/o fol w/cont, f/u (C8922) | $941.04 | $2,132.18 | 1.0× |
| Tte w or wo fol wcon,doppler (C8929) | $2,723.74 | $6,171.39 | 3.0× |
| Unsched dialysis esrd pt hos (G0257) | $1,406.87 | $3,187.65 | 1.8× |