28 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Abd paracentesis w/imaging (49083) |
$727.05 |
$1,310 |
0.8× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$183.15 |
$330 |
0.2× |
| Appl Mltlayr Compres Leg Below Knee W/Ankle Foot (29581) |
$178.16 |
$321 |
1.0× |
| Application finger splint static (29130) |
$104.90 |
$189 |
0.7× |
| Application short arm splint forearm-hand static (29125) |
$96.57 |
$174 |
0.7× |
| Apply short leg splint (29515) |
$107.12 |
$193 |
0.6× |
| Blood transfusion service (36430) |
$764.79 |
$1,378 |
1.6× |
| Bx breast 1st lesion us imag (19083) |
$1,280.39 |
$2,307 |
0.7× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$400.71 |
$722 |
1.5× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$606.06 |
$1,092 |
0.4× |
| Cltx post hip arthrp dislc w/o anes (27265) |
$565.55 |
$1,019 |
2.1× |
| Cystourethroscopy (52000) |
$2,000.22 |
$3,604 |
2.7× |
| Cystourethroscopy inj chemodenervation bladder (52287) |
$3,069.71 |
$5,531 |
1.4× |
| Egd dilate stricture (43245) |
$4,160.84 |
$7,497 |
2.0× |
| I&d abscess simple (10060) |
$156.51 |
$282 |
0.7× |
| Injection Aa&/Strd Other Peripheral Nerve/Branch (64450) |
$334.67 |
$603 |
0.4× |
| Insert Temp Bladder Cath (51702) |
$130.98 |
$236 |
0.9× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$98.24 |
$177 |
0.7× |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
$1,072.26 |
$1,932 |
1.1× |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) |
$870.24 |
$1,568 |
1.2× |
| Picc line placement (36569) |
$2,483.62 |
$4,475 |
1.5× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$63.27 |
$114 |
1.0× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$311.91 |
$562 |
1.5× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$320.79 |
$578 |
1.5× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$480.63 |
$866 |
2.2× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$315.80 |
$569 |
1.5× |
| Trurl dstrj prst8 tiss rf wv thermotherapy (53854) |
$1,207.68 |
$2,176 |
0.3× |
| Venipuncture (36415) |
$14.43 |
$26 |
1.5× |