Supplies, drugs & other prices at Tops Surgical Specialty Hospital

Houston, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Ca screen;flexi sigmoidscope (G0104) $473.90 $1,354 0.5×
Colon ca scrn not hi rsk ind (G0121) $473.90 $1,354 0.5×
Colorectal scrn; hi risk ind (G0105) $473.90 $1,354 0.5×
Cysto impl 4 or more (C9740)
unusually low: confirm this is the full procedure
$3,069.85 $8,771 0.3×
Cysto, litho, vacuum kidney (C9761)
likely a partial charge, not the full procedure
$2,666.65 $7,619 0.3×
Cystoscopy prostatic imp 1-3 (C9739)
likely a partial charge, not the full procedure
$1,236.90 $3,534 0.2×
Dermal filler injection(s) (G0429) $407.40 $1,164 0.2×
Direct refer hospital observ (G0379) $405.30 $1,158 0.7×
Drug test def 1-7 classes (G0480) $114.45 $327 1.0×
Esophag muc integ w/eso egd (C9777) $2,903.25 $8,295 0.7×
Fecal microbiota prep instil (G0455) $405.30 $1,158 0.4×
Home sleep test/type 3 porta (G0399) $437.85 $1,251 2.0×
Inj for sacroiliac jt anesth (G0260) $473.90 $1,354 0.7×
Mri w/cont, breast, bi (C8906) $2,764.30 $7,898 7.9×
Mri w/o fol w/cont, breast, (C8908) $2,764.30 $7,898 7.9×
Pild/placebo control clin tr (G0276)
likely a partial charge, not the full procedure
$1,923.25 $5,495 0.3×
Revasc intravasc lithotripsy (C9764)
unusually low: confirm this is the full procedure
$3,549.35 $10,141 0.3×
Spine device implant surgery (C9757)
likely a partial charge, not the full procedure
$2,497.25 $7,135 0.2×