Supplies, drugs & other prices at Summit Medical Center, LLC
Edmond, OK · every code in this section with a posted price and a Medicare benchmark.
20 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Amalgam 4 or > surfaces perm (D2161) | $1,019.18 | — | 1.6× |
| Behavior counsel obesity 15m (G0447) | $103.18 | — | 1.1× |
| Ca screen;pelvic/breast exam (G0101) | $103.18 | — | 1.1× |
| Colon ca scrn not hi rsk ind (G0121) | $1,057.95 | — | 1.2× |
| Colorectal scrn; hi risk ind (G0105) | $1,057.95 | — | 1.2× |
| Direct refer hospital observ (G0379) | $743.51 | — | 1.3× |
| Group behave couns 2-10 (G0473) | $33.22 | — | 0.9× |
| Hbot, full body chamber, 30m (G0277) | $160.62 | — | 1.2× |
| Hospital outpt clinic visit (G0463) | $153.02 | — | 1.2× |
| Impact tooth rem bony w/comp (D7241) | $1,019.18 | — | 1.6× |
| Impact tooth remov comp bony (D7240) | $1,019.18 | — | 1.6× |
| Initial preventive exam (G0402) | $153.02 | — | 1.2× |
| Inj for sacroiliac jt anesth (G0260) | $800.50 | — | 1.2× |
| Obtaining screen pap smear (Q0091) | $34.47 | — | 1.2× |
| Prefab stainless steel crown (D2933) | $1,019.18 | — | 1.6× |
| Prolonged iv inf, req pump (C8957) | $392.02 | — | 1.9× |
| Psa screening (G0103) | $25.10 | — | 1.3× |
| Resin 4/> surf or w incis an (D2335) | $1,019.18 | — | 1.6× |
| Surgical splint (D5988) | $1,019.18 | — | 1.6× |
| Therapeutic pulpotomy (D3220) | $1,019.18 | — | 1.6× |