Supplies, drugs & other prices at Summit Pacific Medical Center

Elma, WA · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedureCash priceGross charge× Medicare
Alcohol/subs interv 15-30mn (G0396) — $92 —
Alcohol/subs interv >30 min (G0397) — $183 —
Annual alcohol screen 15 min (G0442) — $55 —
Brief alcohol misuse counsel (G0443) — $63 —
Ca screen;pelvic/breast exam (G0101) — $56 —
Colon ca scrn not hi rsk ind (G0121) — $1,366 —
Colorectal scrn; hi risk ind (G0105) — $1,362 —
Comm hlth intg svs sdoh 60mn (G0019) — $141 —
Depression screen annual (G0444) — $55 —
Diab manage trn per indiv (G0108) — $127 —
Diab manage trn ind/group (G0109) — $37 —
Direct refer hospital observ (G0379) — $868 —
Hospital outpt clinic visit (G0463) — $934 —
Init/sub psych care m 1st 30 (G2214) — $111 —
Initial preventive exam (G0402) — $177 —
Liver Dis 10 Assays W/Nash (0003M) — $938 —
Obtaining screen pap smear (Q0091) — $61 —
Periodic oral evaluation (D0120) — $41 —
Pin service 60m per month (G0023) — $141 —
Ppps, initial visit (G0438) — $414 —
Ppps, subseq visit (G0439) — $162 —
Routine footcare pt w lops (G0247) — $103 —
Tomosynthesis, mammo (G0279) — $565 —
Trim nail(s) (G0127) — $147.50 —
Tte w or wo fol wcon,doppler (C8929) — $6,275.50 —
Visit to determ ldct elig (G0296) — $81 —
Wet mounts/ w preparations (Q0111) — $42 —