Supplies, drugs & other prices at Summit Medical Center

Casper, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin influenza virus vac (G0008) $32.86 $80.15 0.7×
Covid-19 lab test non-cdc (U0002) $320.62 $782 6.2×
Direct refer hospital observ (G0379) $48.97 $119.45 0.1×
Drug test def 1-7 classes (G0480) $43.46 $106 0.4×
Home sleep test/type 3 porta (G0399) $335.33 $817.90 1.5×
Hospital outpt clinic visit (G0463) $250.92 $612.02 1.8×
Impltj ant sgm io nbiodegradable rx eluting sys (0660T) $1,381.90 $3,370.50 0.3×
Inj for sacroiliac jt anesth (G0260) $512.35 $1,249.65 0.7×
Mri w/o fol w/cont, breast, (C8908) $820.77 $2,001.90 2.3×
Njx pltlt plasma w/img harvest/preparation (0232T) $1,662.56 $4,055.02 3.6×
Opps service,sched team conf (G0175) $53.60 $130.75 0.1×
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) $11,982.25 $29,225 0.9×
Tte w or wo fol wcon,doppler (C8929) $1,650.70 $4,026.10 2.1×