Supplies, drugs & other prices at UConn John Dempsey Hospital
Farmington, CT · every code in this section with a posted price and a Medicare benchmark.
53 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Ablation, irreversible electroporation; 1 or more tumors per organ, including imaging guidance, when performed,… (0600T) | $24,052.80 | $40,088 | 1.9× |
| Adm tocilizu covid-19 1st (M0249) | $658.80 | $1,098 | 1.2× |
| Ca screen;pelvic/breast exam (G0101) | $197.40 | $329 | 1.6× |
| Covid-19 lab test non-cdc (U0002) | $80.40 | $134 | 1.6× |
| Diab manage trn per indiv (G0108) | $102 | $170 | 1.8× |
| Diab manage trn ind/group (G0109) | $39.60 | $66 | 2.5× |
| Direct refer hospital observ (G0379) | $883.20 | $1,472 | 1.2× |
| Drug test def 1-7 classes (G0480) | $127.50 | $212.50 | 1.1× |
| Fern test (Q0114) | $25.80 | $43 | 2.6× |
| Fractional abl lsr fenestration first 100 sqcm (0479T) | $1,216.20 | $2,027 | 1.4× |
| Group mnt 2 or more 30 mins (G0271) | $43.20 | $72 | 2.5× |
| Hbot, full body chamber, 30m (G0277) | $481.80 | $803 | 2.9× |
| Hepb screen high risk indiv (G0499) | $117 | $195 | 4.1× |
| Hospital outpt clinic visit (G0463) | $213 | $355 | 1.3× |
| Initial foot exam pt lops (G0245) | $307.20 | $512 | 1.9× |
| Lev 2 hosp type b ed visit (G0381) | $690.60 | $1,151 | 6.2× |
| Mnt subs tx for change dx (G0270) | $74.40 | $124 | 2.3× |
| Mra w/cont, abd (C8900) | $1,934.40 | $3,224 | 4.6× |
| Mra w/cont, chest (C8909) | $1,934.40 | $3,224 | 4.6× |
| Mra w/cont, lwr ext (C8912) | $2,215.80 | $3,693 | 5.3× |
| Mra w/cont, pelvis (C8918) | $1,934.40 | $3,224 | 4.6× |
| Mra w/o cont, abd (C8901) | $1,773 | $2,955 | 6.2× |
| Mra w/o cont, chest (C8910) | $1,627.80 | $2,713 | 5.7× |
| Mra w/o cont, lwr ext (C8913) | $1,773 | $2,955 | 6.2× |
| Mra w/o fol w/cont, abd (C8902) | $2,578.20 | $4,297 | 6.2× |
| Mra w/o fol w/cont, chest (C8911) | $2,577.30 | $4,295.50 | 6.2× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,576.40 | $4,294 | 6.2× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,578.20 | $4,297 | 6.2× |
| Mra, w/o dye, upper extr (C8935) | $1,773 | $2,955 | 6.2× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,773 | $2,955 | 4.2× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $414 | $690 | 0.8× |
| Obtaining screen pap smear (Q0091) | $35.40 | $59 | 1.0× |
| Pemivibart infusion (M0224) | $954 | $1,590 | 1.8× |
| Perc d-e cor revasc chro sin (C9607) | $40,038.60 | $66,731 | 1.8× |
| Perc d-e cor revasc t cabg s (C9604) | $24,014.40 | $40,024 | 1.7× |
| Perc d-e cor stent ather s (C9602) | $40,038.60 | $66,731 | 1.8× |
| Perc drug-el cor stent sing (C9600) | $36,809.40 | $61,349 | 2.7× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) | $16,607.40 | $27,679 | 1.2× |
| Place device/marker, non pro (C9728) | $3,352.80 | $5,588 | 2.0× |
| Psa screening (G0103) | $78 | $130 | 4.0× |
| Quan CT tiss charac i&r w/cncrnt CT exam (0722T) | $1,470.60 | $2,451 | 1.9× |
| Quan CT tiss charac w/o CT (0721T) | $1,470.60 | $2,451 | 1.9× |
| Quan MRI alys brain with diagnostic MRI (0866T) | $574.80 | $958 | 2.0× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $990 | $1,650 | 1.4× |
| Routine footcare pt w lops (G0247) | $367.80 | $613 | 1.5× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $13,141.80 | $21,903 | 1.9× |
| Transcatheter renal sympath denervation unilat (0338T) | $13,141.80 | $21,903 | 1.9× |
| Trim nail(s) (G0127) | $154.80 | $258 | 2.2× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $28,237.80 | $47,063 | 1.3× |
| Visit esketamine 56m or less (G2082) | $916.12 | $1,526.87 | 0.7× |
| Visit esketamine, > 56m (G2083) | $916.12 | $1,526.87 | 0.5× |
| Visit to determ ldct elig (G0296) | $131.40 | $219 | 1.1× |
| Wet mounts/ w preparations (Q0111) | $15 | $25 | 0.8× |