Supplies, drugs & other prices at Summit Healthcare Regional Medical Center

Show Low, AZ · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $239.09
Admin influenza virus vac (G0008) $112.57
Admin pneumococcal vaccine (G0009) $112.57
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative Other Outpatient (0064U) $293.99
Behavior counsel obesity 15m (G0447) $165.80
Catheterize for urine spec (P9612) $42.56
Direct refer hospital observ (G0379) $709.99
Group behave couns 2-10 (G0473) $269.84
Hbot, full body chamber, 30m (G0277) $669.59
Home sleep test/type 3 porta (G0399) $840.78
Ig paraprotein qual bld/ur (0077U) $93.80
Mri w/cont, breast, bi (C8906) $3,723.32
Mri w/o fol w/cont, breast, (C8908) $4,723.06
Mri w/o fol w/cont, brst, un (C8905) $3,122.37
Oth resp proc, group (G0239) $214.94
Oth resp proc, indiv (G0238) $227.56
Perc d-e cor revasc chro sin (C9607) $21,953.88
Perc d-e cor revasc t cabg s (C9604) $21,953.88
Perc d-e cor stent ather s (C9602) $21,953.88
Perc drug-el cor stent sing (C9600) $21,953.88
Psa screening (G0103) $188.62
Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR) Other Outpatient (0065U) $190.90
Therapeutic procd strg endur (G0237) $214.94
Tomosynthesis, mammo (G0279) $79.04
Trauma respons w/hosp criti (G0390) $4,272.11
Trim nail(s) (G0127) $20.36
Tte w or wo fol wcon,doppler (C8929) $2,336.04
Unsched dialysis esrd pt hos (G0257) $2,289.31