Supplies, drugs & other prices at White River Medical Center

Batesville, AR · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,fu (C8924) $472.50 $630 1.5×
Admin hepatitis b vaccine (G0010) $75 $100 1.8×
Admin influenza virus vac (G0008) $68.25 $91 1.6×
Admin pneumococcal vaccine (G0009) $111 $148 2.6×
Alcohol/subs interv 15-30mn (G0396) $93.75 $125 2.7×
Alcohol/subs interv >30 min (G0397) $243 $324 1.5×
Catheterize for urine spec (P9612) $6.75 $9 0.7×
Chemo extend iv infus w/pump (G0498) $430.50 $574 1.4×
Colon ca scrn not hi rsk ind (G0121) $780 $1,040 0.9×
Colorectal scrn; hi risk ind (G0105) $532.50 $710 0.6×
Cysto impl 4 or more (C9740) $9,709.50 $12,946 1.1×
Cystoscopy prostatic imp 1-3 (C9739) $5,337.75 $7,117 1.1×
Direct refer hospital observ (G0379) $869.25 $1,159 1.6×
Drug test def 1-7 classes (G0480) $66 $88 0.6×
Drug test def 8-14 classes (G0481) $301.86 $402.48 1.9×
Elec stim other than wound (G0283) $79.50 $106 6.3×
Fecal blood scrn immunoassay (G0328) $54.75 $73 3.0×
Group mnt 2 or more 30 mins (G0271) $26.25 $35 1.5×
Hep c screen high risk/other (G0472) $40.50 $54 0.9×
Hospital outpt clinic visit (G0463) $112.50 $150 0.9×
Inj for sacroiliac jt anesth (G0260) $1,295.62 $1,727.50 2.0×
Mnt subs tx for change dx (G0270) $54 $72 1.7×
Mra w/o fol w/cont, abd (C8902) $735 $980 2.3×
Mra w/o fol w/cont, chest (C8911) $735 $980 2.3×
Mra w/o fol w/cont, pelvis (C8920) $735 $980 2.3×
Mra, w/o&w/dye, upper extr (C8936) $735 $980 2.3×
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $405.74 $540.99 0.7×
Njx pltlt plasma w/img harvest/preparation (0232T) $409.50 $546 1.0×
Perc d-e cor revasc t cabg s (C9604) $23,883.75 $31,845 2.3×
Perc d-e cor stent ather s (C9602) $37,926 $50,568 2.3×
Perc drug-el cor stent sing (C9600) $23,883.75 $31,845 2.3×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) $9,835.50 $13,114 0.9×
Ppps, initial visit (G0438) $156 $208 0.9×
Psa screening (G0103) $46.50 $62 2.4×
Revasc intra lithotrip-ather (C9766) $31,773.75 $42,365 1.9×
Revasc intra lithotrip-stent (C9765) $31,773.75 $42,365 1.9×
Revasc intravasc lithotripsy (C9764) $19,871.25 $26,495 1.9×
Revasc lith-sten-ath tib/per (C9775) $31,773.75 $42,365 1.9×
Revasc lithotr-ather tib/per (C9774) $31,773.75 $42,365 1.9×
Revasc lithotr-stent tib/per (C9773) $31,773.75 $42,365 1.9×
Revasc lithotrip tibi/perone (C9772) $19,871.25 $26,495 1.9×
Revasc lithotrip-stent-ather (C9767) $31,773.75 $42,365 1.9×
Semen analysis (G0027) $35.25 $47 5.4×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $36,880.50 $49,174 2.1×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $37,595.25 $50,127 2.1×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $37,595.25 $50,127 2.1×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $26,305.50 $35,074 1.5×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $6,241.50 $8,322 2.2×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $37,817.25 $50,423 2.2×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $31,773.75 $42,365 6.1×
Therapeutic procd strg endur (G0237) $63.75 $85 2.4×
Transcatheter Renal Sympath Denervation Bilat (0339T) $16,959 $22,612 3.3×
Transcatheter renal sympath denervation unilat (0338T) $11,306.25 $15,075 2.2×
Trauma respons w/hosp criti (G0390) $1,508.25 $2,011 1.2×
Trluml peripheral atherectomy iliac artery ea (0238T) $31,773.75 $42,365 1.9×
Tte w or wo fol wcon,doppler (C8929) $975 $1,300 1.4×
Unsched dialysis esrd pt hos (G0257) $626.25 $835 1.0×
Visit to determ ldct elig (G0296) $150 $200 1.6×