Supplies, drugs & other prices at West Carroll Memorial Hospital

Oak Grove, LA · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedureCash priceGross charge× Medicare
Amalgam one surface permanen (D2140) — $135 —
Amalgam three surfaces perma (D2160) — $200 —
Amalgam two surfaces permane (D2150) — $172 —
Colon ca scrn not hi rsk ind (G0121) — $1,815 —
Colorectal scrn; hi risk ind (G0105) — $1,815 —
Comprehensve oral evaluation (D0150) — $68 —
Core build-up incl any pins (D2950) — $195 —
Dental bitewings two images (D0272) — $32 —
Dental prophylaxis adult (D1110) — $67 —
Extracorporeal shock wave muscskel sys nos (0101T) — $200 —
Extraction erupted tooth/exr (D7140) — $115 —
Hospital outpt clinic visit (G0463) — $189 —
Intraoral periapical first (D0220) — $40 —
Panoramic image (D0330) — $78 —
Periodic oral evaluation (D0120) — $52 —
Ppps, initial visit (G0438) — $525 —
Ppps, subseq visit (G0439) — $275 —
Prefab stnlss steel crwn pri (D2930) — $210 —
Psa screening (G0103) — $73 —
Re-cement or re-bond crown (D2920) — $100 —
Rem imp tooth w mucoper flp (D7210) — $200 —
Resin 4/> surf or w incis an (D2335) — $216 —
Resin one surface-anterior (D2330) — $115 —
Resin three surfaces-anterio (D2332) — $175 —
Resin two surfaces-anterior (D2331) — $143 —
Tomosynthesis, mammo (G0279) — $294 —
Trim nail(s) (G0127) — $188 —