21 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Colon ca scrn not hi rsk ind (G0121) |
$465.80 |
$685 |
0.5× |
| Colorectal scrn; hi risk ind (G0105) |
$1,695.32 |
$2,493.12 |
1.8× |
| Direct refer hospital observ (G0379) |
$541.29 |
$796.02 |
0.9× |
| Drug test def 1-7 classes (G0480) |
$311.25 |
$457.72 |
2.7× |
| Drug test def 15-21 classes (G0482) |
$540.57 |
$794.96 |
2.7× |
| Drug test def 22+ classes (G0483) |
$671.62 |
$987.68 |
2.7× |
| Drug test def 8-14 classes (G0481) |
$425.92 |
$626.36 |
2.7× |
Endo defect closure gi tract (C9901)
likely a partial charge, not the full procedure |
$74.13 |
$109.02 |
0.0× |
| Home sleep test/type 3 porta (G0399) |
$556.92 |
$819 |
2.6× |
| Hospital outpt clinic visit (G0463) |
$342.58 |
$503.80 |
2.6× |
| Inj for sacroiliac jt anesth (G0260) |
$1,677.82 |
$2,467.38 |
2.4× |
| Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) |
$5,900.25 |
$8,676.84 |
1.8× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,071 |
$1,575 |
2.4× |
| Oth resp proc, indiv (G0238) |
$107.44 |
$158 |
3.7× |
| Perc drug-el cor stent sing (C9600) |
$28,510.52 |
$41,927.24 |
2.5× |
| Perq Sacral Augmt Bilat Inj (0201T) |
$14,296.32 |
$21,024 |
2.0× |
| Perq Sacral Augmt Unilat Inj (0200T) |
$9,530.88 |
$14,016 |
1.3× |
| Rbc DNA gnotyp 10 bld groups (0084U) |
$567.12 |
$834 |
0.8× |
| Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and… (0598T) |
$847.01 |
$1,245.60 |
3.9× |
| Trauma respons w/hosp criti (G0390) |
$4,217.36 |
$6,202 |
3.1× |
| Trluml peripheral atherectomy iliac artery ea (0238T) |
$11,899.32 |
$17,499 |
0.6× |