Supplies, drugs & other prices at Wentworth-Douglass Hospital

Dover, NH · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $5,891.40 $9,819 7.0×
2d tte w or w/o fol w/con,fu (C8924) $1,842.60 $3,071 4.9×
Admin influenza virus vac (G0008) $28.80 $48 0.6×
Colon ca scrn not hi rsk ind (G0121) $1,847.40 $3,079 1.9×
Colorectal scrn; hi risk ind (G0105) $2,055 $3,425 2.1×
Diab manage trn per indiv (G0108) $133.20 $222 2.4×
Direct refer hospital observ (G0379) $42 $70 0.1×
Elec stim other than wound (G0283) $51 $85 4.0×
Hbot, full body chamber, 30m (G0277) $700.20 $1,167 4.8×
Home sleep test/type 3 porta (G0399) $567.60 $946 2.5×
Mra w/o fol w/cont, abd (C8902) $5,641.20 $9,402 15.1×
Mra w/o fol w/cont, chest (C8911) $5,574.60 $9,291 15.0×
Mri w/o fol w/cont, breast, (C8908) $7,282.20 $12,137 19.5×
Obtaining screen pap smear (Q0091) $99.60 $166 3.2×
Oth resp proc, group (G0239) $45.60 $76 1.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $25,198.80 $41,998 2.0×
Prostate biopsy, any mthd (G0416) $657 $1,095 1.7×
Psa screening (G0103) $156.60 $261 8.1×
Trim nail(s) (G0127) $47.40 $79 0.8×
Tte w or w/o fol w/con,stres (C8928) $3,748.20 $6,247 4.5×
Tte w or wo fol wcon,doppler (C8929) $4,159.20 $6,932 5.0×
Unsched dialysis esrd pt hos (G0257) $1,537.80 $2,563 2.1×