Supplies, drugs & other prices at Trinity Health Livonia Hospital

Livonia, MI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
2019-ncov diagnostic p (U0001) $94.90 $146 2.6×
2d tee w or w/o fol w/con,in (C8925) $1,627.60 $2,504 2.1×
2d tte w or w/o fol w/con,co (C8923) $1,700.40 $2,616 2.2×
2d tte w or w/o fol w/con,fu (C8924) $951.60 $1,464 2.7×
Adm tocilizu covid-19 1st (M0249) $476.45 $733 1.1×
Adm tocilizu covid-19 2nd (M0250) $476.45 $733 1.1×
Admin hepatitis b vaccine (G0010) $14.95 $23 0.3×
Admin influenza virus vac (G0008)
range across 2 matching MRF lines
$14.95–$47.45 $23–$73 varies
Admin pneumococcal vaccine (G0009)
range across 2 matching MRF lines
$26.65–$49.40 $41–$76 varies
Ca screen;flexi sigmoidscope (G0104) $4,115.05 — 4.4×
Catheterize for urine spec (P9612) $8.45 $13 0.9×
Chemo extend iv infus w/pump (G0498) $635.05 $977 1.9×
Colon ca scrn not hi rsk ind (G0121)
range across 2 matching MRF lines
$4,011.05–$4,134.52 — varies
Colorectal scrn; hi risk ind (G0105)
range across 2 matching MRF lines
$4,144.46–$4,469.17 — varies
Covid-19 lab test non-cdc (U0002) $138.45 $213 2.7×
Cysto impl 4 or more (C9740) $24,655.53 — 2.6×
Cysto, litho, vacuum kidney (C9761)
range across 2 matching MRF lines
$24,054.15–$24,191.26 — varies
Diab manage trn per indiv (G0108) $97.50 — 1.7×
Diab manage trn ind/group (G0109) $260 — 16.2×
Direct refer hospital observ (G0379) $267.80 $412 0.5×
Drug test def 1-7 classes (G0480) $564.20 — 4.9×
Eia hiv-1/hiv-2 screen (G0432) $68.25 $105 3.5×
Elec stim other than wound (G0283) $104 $160 8.2×
Electrophysiologic eval ccm-d leads at 1st impl (0930T) $1,183.65 $1,821 1.0×
Electrophysiologic eval ccm-d leads separate (0931T) $1,183.65 $1,821 1.0×
Elisa hiv-1/hiv-2 screen (G0433) $31.85 $49 1.7×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T)
range across 3 matching MRF lines
$13,339.30–$20,008.95 $20,522–$30,783 varies
Fecal blood scrn immunoassay (G0328) $29.25 $45 1.6×
Fern test (Q0114) $14.95 $23 1.5×
Hbot, full body chamber, 30m (G0277) $1,835.60 — 13.4×
Hep c screen high risk/other (G0472)
range across 2 matching MRF lines
$59.15–$65 $91–$100 varies
Hepb screen high risk indiv (G0499)
range across 2 matching MRF lines
$61.10–$63.05 $94–$97 varies
Hiv combination assay (G0475) $615.55 — 25.6×
Home sleep test/type 3 porta (G0399) $657.15 $1,011 3.1×
Hospital outpt clinic visit (G0463) $127.40 — 1.0×
Hpv combo assay ca screen (G0476) $90.35 $139 2.6×
Inj for sacroiliac jt anesth (G0260)
range across 3 matching MRF lines
$1,063.40–$1,595.75 $1,636–$2,455 varies
Insertion perm ccm-d system pulse generator only (0916T) $11,818.30 $18,182 0.5×
Insj perm ccm-d sys 1 transvns lead only (0917T) $4,357.60 $6,704 0.5×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $4,357.60 $6,704 0.5×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) $16,880.50 $25,970 0.5×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $24,822.20 $38,188 0.8×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $5,264.35 $8,099 0.6×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $5,264.35 $8,099 0.6×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $18,850 $29,000 0.9×
Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) $254.47 $391.50 0.5×
Mra w/cont, abd (C8900) $949.65 $1,461 2.7×
Mra w/cont, chest (C8909) $939.25 $1,445 2.7×
Mra w/o cont, abd (C8901) $815.10 $1,254 3.4×
Mra w/o cont, chest (C8910) $968.50 $1,490 4.1×
Mra w/o cont, pelvis (C8919) $1,073.15 $1,651 4.5×
Mra w/o fol w/cont, abd (C8902) $2,494.05 $3,837 7.2×
Mra w/o fol w/cont, chest (C8911) $2,178.15 $3,351 6.3×
Mra w/o fol w/cont, lwr ext (C8914)
range across 3 matching MRF lines
$1,163.50–$1,745.25 $1,790–$2,685 varies
Mra w/o fol w/cont, pelvis (C8920) $1,574.95 $2,423 4.5×
Mra, w/o&w/dye, spinal canal (C8933) $1,821.30 $2,802 5.2×
Mri w/o fol w/cont, breast, (C8908) $3,116.75 $4,795 9.0×
Mri w/o fol w/cont, brst, un (C8905) $2,077.40 $3,196 6.0×
Neuro csf prion prtn qual (0035U) $333.39 $512.91 0.6×
Njx platelet plasma (0232T) $21,974.42 — 49.3×
Onc aml DNA gntyp int tandem dup detcj/nondetcj (0023U) $248.62 $382.50 1.0×
Oth resp proc, group (G0239) $70.85 $109 1.9×
Oth resp proc, indiv (G0238) $61.75 $95 2.1×
Pathogen test for platelets (P9100)
range across 2 matching MRF lines
$53.95–$63.05 $83–$97 varies
Perc d-e cor revasc chro sin (C9607) $19,456.45 $29,933 1.1×
Perc d-e cor revasc t cabg s (C9604) $15,158 $23,320 1.3×
Perc drug-el cor stent sing (C9600) $14,753.05 $22,697 1.3×
Perq Sacral Augmt Bilat Inj (0201T) $8,179.60 $12,584 1.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)
likely a partial charge, not the full procedure
$2,918.50 $4,490 0.3×
Ppps, initial visit (G0438) $279.50 $430 1.6×
Ppps, subseq visit (G0439) $185.25 $285 1.3×
Prolonged iv inf, req pump (C8957) $557.70 $858 2.6×
Prostate biopsy, any mthd (G0416) $466.70 $718 1.3×
Psa screening (G0103)
range across 2 matching MRF lines
$59.15–$65.65 $91–$101 varies
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $1,842.10 $2,834 0.9×
Relocation skin pocket implanted ccm-d pg (0925T) $1,926.60 $2,964 0.9×
Removal perm ccm-d system pulse generator only (0919T) $3,832.40 $5,896 1.0×
Repos Cardiac Modulj Transvenous Electrode (0415T) $581.10 $894 0.9×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $650.65 $1,001 1.0×
Revasc intra lithotrip-ather (C9766) $9,880.65 $15,201 0.5×
Revasc intra lithotrip-stent (C9765) $103,790.19 — 5.7×
Revasc intravasc lithotripsy (C9764)
unusually low: confirm this is the full procedure
$5,197.40 $7,996 0.5×
Revasc lithotrip tibi/perone (C9772) $7,192.25 $11,065 0.6×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $20,358 $31,320 0.9×
Rmvl Car Modulj Tranvns Elt (0413T) $3,703.05 $5,697 1.0×
Rmvl Cardiac Modulj Pls Gen (0412T) $3,703.05 $5,697 1.0×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) $3,832.40 $5,896 1.0×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $3,832.40 $5,896 1.0×
Rmvl perm ccm-d sys dual transvns leads only (0922T) $3,832.40 $5,896 1.0×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $11,818.30 $18,182 0.5×
Screen cerv/vag thin layer (G0123) $79.30 $122 3.9×
Screen pap by tech w md supv (P3000) $46.80 $72 2.5×
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) $1,693.25 $2,605 0.5×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $19,007.30 $29,242 1.0×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $3,331.90 $5,126 1.1×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $19,007.30 $29,242 1.0×
Tee w or w/o fol w/cont,cong (C8926) $1,664 $2,560 2.1×
Therapeutic procd strg endur (G0237) $61.75 $95 2.1×
Tomosynthesis, mammo (G0279) $82.55 $127 6.5×
Trauma respons w/hosp criti (G0390)
range across 3 matching MRF lines
$2,395.25–$11,636.95 $3,685–$17,903 varies
Trim nail(s) (G0127) $57.85 $89 1.0×
Trluml Perip Athrc Iliac Art (0238T) $14,411.80 $22,172 0.8×
Tte w or w/o contr, cont ecg (C8930) $1,736.15 $2,671 2.2×
Tte w or w/o fol w/con,stres (C8928) $1,718.60 $2,644 2.2×
Tte w or w/o fol w/cont, com (C8921) $1,736.15 $2,671 2.2×
Tte w or w/o fol w/cont, f/u (C8922) $1,682.20 $2,588 2.2×
Tte w or wo fol wcon,doppler (C8929) $1,755 $2,700 2.2×
Unsched dialysis esrd pt hos (G0257) $817.05 $1,257 1.2×
Visit to determ ldct elig (G0296) $72.80 $112 0.7×

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.