Supplies, drugs & other prices at Swedish Hospital

Chicago, IL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
2d cephalometric image (D0340) $179 $179 1.9×
Admin hepatitis b vaccine (G0010) $74 $74 1.5×
Admin influenza virus vac (G0008) $74 $74 1.5×
Admin pneumococcal vaccine (G0009) $74 $74 1.5×
Alveoloplasty not w/extracts (D7321) $435 $435 0.3×
Alveoloplasty w/extract 1-3 (D7311) $319 $319 0.2×
Alveoplasty w/ extraction (D7310) $401 $401 0.2×
Alveoplasty w/o extraction (D7320) $517 $517 0.3×
Amalgam 4 or > surfaces perm (D2161) $515 $515 0.7×
Amalgam one surface permanen (D2140) $204 $204 0.3×
Amalgam three surfaces perma (D2160) $345 $345 0.5×
Amalgam two surfaces permane (D2150) $256 $256 0.4×
Ant resin-based cmpst crown (D2390) $397 $397 0.6×
Behavior counsel obesity 15m (G0447) $89 $89 0.8×
Bitewings four images (D0274) $90 $90 0.4×
Blind interatrial shunt ide (C9758) $32,901 $32,901 1.8×
Brief alcohol misuse counsel (G0443) $89 $89 0.8×
Ca screen;pelvic/breast exam (G0101)
range across 2 matching MRF lines		 $89–$202 $89–$202 varies
Catheterize for urine spec (P9612) $10 $10 1.1×
Chemo extend iv infus w/pump (G0498) $1,797 $1,797 5.1×
Collagen Cross-Linking Cornea&Pachymetry (0402T) $2,672 $2,672 1.0×
Comp periodontal evaluation (D0180) $216 $216 1.5×
Comprehensve oral evaluation (D0150) $181 $181 1.3×
Core build-up incl any pins (D2950) $506 $506 0.7×
Covid-19 lab test non-cdc (U0002) $116 $116 2.3×
Crown full cast noble metal (D2792) $795 $795 1.1×
Crown lengthen hard tissue (D4249) $1,058 $1,058 1.5×
Crown porcelain fused base m (D2751) $795 $795 1.1×
Crown porcelain w/ h noble m (D2750) $795 $795 1.1×
Crown porcelain w/ noble met (D2752) $795 $795 1.1×
Crown porcelain/ceramic (D2740) $795 $795 1.1×
Cysto impl 4 or more (C9740) $9,216 $9,216 0.9×
Cystoscopy prostatic imp 1-3 (C9739) $5,177 $5,177 0.9×
Demonstrate use home inr mon (G0248) $210 $210 1.5×
Dental bitewings two images (D0272) $63 $63 0.7×
Dental onlay metallic 3 surf (D2543) $552 $552 0.8×
Dental prophylaxis adult (D1110) $166 $166 1.2×
Depression screen annual (G0444) $34 $34 0.8×
Diab manage trn per indiv (G0108)
range across 2 matching MRF lines		 $115–$150 $115–$150 varies
Diab manage trn ind/group (G0109)
range across 2 matching MRF lines		 $41–$97 $41–$97 varies
Direct refer hospital observ (G0379) $2,866 $2,866 4.5×
Drug test def 1-7 classes (G0480)
range across 52 matching MRF lines		 $51–$379 $51–$379 varies
Drug test def 8-14 classes (G0481) $193 $193 1.2×
Ekg tracing for initial prev (G0404) $30 $30 1.0×
Elec stim unattend for press (G0281) $163 $163 13.9×
End thxpy, anterior tooth (D3310) $1,050 $1,050 1.5×
End thxpy, molar tooth (D3330) $1,458 $1,458 2.1×
End thxpy, premolar tooth (D3320) $1,196 $1,196 1.7×
Excision benign lesion>1.25c (D7411) $713 $713 0.4×
Extensv oral eval prob focus (D0160) $188 $188 1.3×
Extraction erupted tooth/exr (D7140) $255 $255 0.4×
Fern test (Q0114) $19 $19 2.0×
Full mouth debridement (D4355) $554 $554 0.8×
Gingival flap proc w/ planin (D4240) $1,102 $1,102 0.3×
Gingivectomy/plasty 4 or mor (D4210) $372 $372 0.1×
Gngvl flap w rootplan 1-3 th (D4241) $870 $870 0.5×
Gross pulpal debridement (D3221) $422 $422 0.6×
Hbot, full body chamber, 30m (G0277) $829 $829 5.6×
Hep c screen high risk/other (G0472) $221 $221 4.8×
I&d absc intraoral soft tiss (D7510) $450 $450 0.6×
I&d abscess extraoral (D7520) $626 $626 0.8×
Incision/drain abscess extra (D7521) $805 $805 1.1×
Incision/drain abscess intra (D7511) $509 $509 0.7×
Initial care training 30 m (G0539) $138 $138 2.6×
Inj for sacroiliac jt anesth (G0260) $2,011 $2,011 2.7×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $58,332 $58,332 1.7×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $60,845 $60,845 1.8×
Intraor comprehensive series (D0210) $200 $200 0.8×
Limit oral eval problm focus (D0140) $270 $270 1.9×
Limited occlusal adjustment (D9951) $445 $445 0.6×
Localized delivery antimicro (D4381) $162 $162 0.2×
Mesial/distal wedge proc (D4274) $464 $464 0.7×
Mri w/cont, breast, bi (C8906) $2,020 $2,020 5.4×
Mri w/cont, breast, uni (C8903) $1,896 $1,896 10.1×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) $1,313 $1,313 4.0×
Neuro csf prion prtn qual (0035U) $1,668 $1,668 3.1×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $2,566 $2,566 2.7×
Obtaining screen pap smear (Q0091) $30 $30 1.0×
Osseous surg 1 to 3 teeth (D4261) $1,044 $1,044 0.3×
Osseous surgery 4 or more (D4260)
likely a partial charge, not the full procedure		 $1,392 $1,392 0.2×
Oth resp proc, group (G0239) $155 $155 3.9×
Oth resp proc, indiv (G0238) $132 $132 4.3×
Panoramic image (D0330) $162 $162 0.6×
Perc d-e cor revasc chro sin (C9607) $26,782 $26,782 1.4×
Perc d-e cor revasc t cabg s (C9604) $27,124 $27,124 2.2×
Perc d-e cor stent ather s (C9602) $32,370 $32,370 1.6×
Perc drug-el cor stent sing (C9600) $29,891 $29,891 2.4×
Periodic oral evaluation (D0120) $74 $74 0.5×
Periodontal maint procedures (D4910) $210 $210 0.3×
Periodontal scaling & root (D4341) $360 $360 0.5×
Periodontal scaling 1-3teeth (D4342) $267 $267 0.4×
Perq Sacral Augmt Bilat Inj (0201T) $7,202 $7,202 0.9×
Perq Sacral Augmt Unilat Inj (0200T) $7,202 $7,202 0.9×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $10,719 $10,719 0.9×
Pet not otherwise specified (G0235) $4,870 $4,870 11.4×
Place direct restoration (D2940) $202 $202 0.3×
Post 1 srfc resinbased cmpst (D2391) $260 $260 0.4×
Post 2 srfc resinbased cmpst (D2392) $374 $374 0.5×
Post 3 srfc resinbased cmpst (D2393) $458 $458 0.7×
Post >=4srfc resinbase cmpst (D2394) $515 $515 0.7×
Post and core cast + crown (D2952) $372 $372 0.5×
Post-coital mucous exam (Q0115) $41 $41 1.6×
Potassium hydroxide preps (Q0112) $44 $44 7.5×
Pre 3d mdl w/ccta and/or mri (C9793) $4,224 $4,224 4.6×
Prefab post/core + crown (D2954) $466 $466 0.7×
Prefab stnlss steel crwn pri (D2930) $231 $231 0.3×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $288 $288 7.2×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $289 $289 7.2×
Programming dev eval icds w/ss eltrd in person (0575T) $517 $517 12.9×
Prolonged iv inf, req pump (C8957) $737 $737 3.2×
Prostate biopsy, any mthd (G0416) $3,163 $3,163 8.2×
Provide inr test mater/equip (G0249) $137 $137 1.0×
Pulp cap direct (D3110) $41 $41 0.1×
Pulp cap indirect (D3120) $41 $41 0.1×
Pulp vitality test (D0460) $102 $102 0.1×
Rad exc lesion up to 1.25 cm (D7410) $574 $574 0.3×
Re-cement or re-bond crown (D2920) $166 $166 0.2×
Re-eval,est pt,problem focus (D0170) $100 $100 0.7×
Rem imp tooth w mucoper flp (D7210) $608 $608 0.4×
Rem interrog dev eval ss ld icds < 90d tech (0579T) $103 $103 2.6×
Removal of torus palatinus (D7472) $812 $812 1.2×
Remove torus mandibularis (D7473) $812 $812 1.2×
Resin 4/> surf or w incis an (D2335) $626 $626 0.9×
Resin one surface-anterior (D2330) $278 $278 0.4×
Resin three surfaces-anterio (D2332) $430 $430 0.6×
Resin two surfaces-anterior (D2331) $345 $345 0.5×
Revasc intra lithotrip-ather (C9766) $40,158 $40,158 2.0×
Revasc intra lithotrip-stent (C9765) $34,363 $34,363 1.7×
Revasc intravasc lithotripsy (C9764) $18,580 $18,580 1.5×
Revasc lith-sten-ath tib/per (C9775) $35,225 $35,225 1.8×
Revasc lithotr-ather tib/per (C9774) $35,225 $35,225 1.8×
Revasc lithotr-stent tib/per (C9773) $35,225 $35,225 1.8×
Revasc lithotrip tibi/perone (C9772) $17,630 $17,630 1.4×
Revasc lithotrip-stent-ather (C9767) $45,613 $45,613 2.3×
Space maintainer fxd unilat (D1510) $224 $224 0.3×
Surgical revision procedure (D4268) $1,322 $1,322 1.9×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $36,037 $36,037 1.7×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $37,905 $37,905 1.8×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $37,905 $37,905 1.8×
Therapeutic procd strg endur (G0237) $132 $132 4.3×
Therapeutic pulpotomy (D3220) $422 $422 0.6×
Tooth reimplantation (D7270) $766 $766 1.1×
Tooth root removal (D7250) $683 $683 1.0×
Train for caregiver add 15 (G0540) $74 $74 2.8×
Transcatheter Renal Sympath Denervation Bilat (0339T) $6,864 $6,864 1.1×
Transcatheter renal sympath denervation unilat (0338T) $6,864 $6,864 1.1×
Trauma respons w/hosp criti (G0390)
range across 2 matching MRF lines		 $6,342–$8,883 $6,342–$8,883 varies
Treatment of complications (D9930) $103 $103 0.1×
Trim nail(s) (G0127) $61 $61 1.0×
Trluml perip athrc abd aorta (0236T) $17,009 $17,009 1.4×
Trluml Perip Athrc Brchiocph (0237T) $17,009 $17,009 1.4×
Trluml Perip Athrc Iliac Art (0238T) $19,138 $19,138 1.0×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $17,009 $17,009 1.4×
Unspecified periodontal proc (D4999) $165 $165 0.7×
Vasc emb/occ w/prs cath (C9797) $32,431 $32,431 1.7×
Visit to determ ldct elig (G0296) $89 $89 0.8×
Wet mounts/ w preparations (Q0111) $18 $18 1.0×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.