Supplies, drugs & other prices at Witham Health Services
Lebanon, IN · every code in this section with a posted price and a Medicare benchmark.
47 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Adm of soc dtr assess 5-15 m (G0136) range across 2 matching MRF lines |
$19.85–$36.02 | $28.35–$51.45 | varies |
| Admin hepatitis b vaccine (G0010) range across 2 matching MRF lines |
$49.98–$70.70 | $71.40–$101 | varies |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$49.98–$70.70 | $71.40–$101 | varies |
| Admin pneumococcal vaccine (G0009) range across 3 matching MRF lines |
$49.98–$110.99 | $71.40–$158.55 | varies |
| Adv prim care mgmt lvl 1 (G0556) | $69.09 | $98.70 | 1.7× |
| Adv prim care mgmt lvl 2 (G0557) | $69.09 | $98.70 | 1.7× |
| Adv prim care mgmt lvl 3 (G0558) | $213.89 | $305.55 | 2.0× |
| Ascvd rsk mng clin stf pr mo (G0538) range across 3 matching MRF lines |
$14.70–$218.40 | $21–$312 | varies |
| Ca screen;pelvic/breast exam (G0101) range across 2 matching MRF lines |
$93.35–$134.40 | $133.35–$192 | varies |
| Catheterize for urine spec (P9612) | $42.63 | $60.90 | 4.6× |
| Comm hlth intg svs sdoh 60mn (G0019) range across 2 matching MRF lines |
$84.53–$112.46 | $120.75–$160.65 | varies |
| Covid-19 lab test non-cdc (U0002) | $152.88 | $218.40 | 3.0× |
| Diab manage trn per indiv (G0108) | $102.17 | $145.95 | 1.8× |
| Direct refer hospital observ (G0379) range across 3 matching MRF lines |
$264.60–$271.22 | $378–$387.45 | varies |
| Drug test def 1-7 classes (G0480) | $252.11 | $360.15 | 2.2× |
| Fecal blood scrn immunoassay (G0328) | $39.69 | $56.70 | 2.2× |
| Group mnt 2 or more 30 mins (G0271) | $58.07 | $82.95 | 3.4× |
| Hbot, full body chamber, 30m (G0277) | $406.46 | $580.65 | 2.8× |
| Hospital outpt clinic visit (G0463) | $138.18 | $197.40 | 1.0× |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $1,110.59 | $1,586.55 | 2.2× |
| Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0002M) | $1,275.23 | $1,821.75 | 2.5× |
| Mnt subs tx for change dx (G0270) | $102.90 | $147 | 3.2× |
| Mra w/cont, chest (C8909) | $2,648.94 | $3,784.20 | 7.2× |
| Neuro csf prion prtn qual (0035U) | $1,192.91 | $1,704.15 | 2.2× |
| Non-ophthalmic fva (C9733) | $951.09 | $1,358.70 | 2.6× |
| Oth resp proc, group (G0239) | $125.69 | $179.55 | 3.2× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,502.48 | $12,146.40 | 0.4× |
| Perc d-e cor revasc t cabg s (C9604) | $22,580.67 | $32,258.10 | 1.8× |
| Perc d-e cor stent ather s (C9602) | $35,773.92 | $51,105.60 | 1.8× |
| Perc drug-el cor stent sing (C9600) range across 2 matching MRF lines |
$10,496.54–$20,985.72 | $14,995.05–$29,979.60 | varies |
| Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) likely a partial charge, not the full procedure |
$400.58 | $572.25 | 0.0× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $12,572.91 | $17,961.30 | 1.0× |
| Post d/c phone follow up (G0544) | $213.89 | $305.55 | 2.0× |
| Psa screening (G0103) | $210.95 | $301.35 | 10.9× |
| Risk ascvd tst once pr 12 mo (G0537) range across 3 matching MRF lines |
$18.20–$84 | $26–$120 | varies |
| Scr c/v cyto,thinlayer,rescr (G0145) | $133.77 | $191.10 | 5.0× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $39,438.63 | $56,340.90 | 1.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $39,438.63 | $56,340.90 | 1.9× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $39,438.63 | $56,340.90 | 1.9× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $39,438.63 | $56,340.90 | 1.9× |
| Trim nail(s) (G0127) | $109.52 | $156.45 | 1.8× |
| Trluml perip athrc abd aorta (0236T) | $27,830.04 | $39,757.20 | 2.3× |
| Trluml Perip Athrc Brchiocph (0237T) | $27,830.04 | $39,757.20 | 2.3× |
| Trluml Perip Athrc Iliac Art (0238T) | $27,830.04 | $39,757.20 | 1.4× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $27,830.04 | $39,757.20 | 2.3× |
| Unsched dialysis esrd pt hos (G0257) range across 2 matching MRF lines |
$1,829.42–$1,830.15 | $2,613.45–$2,614.50 | varies |
| Visit to determ ldct elig (G0296) | $28 | $40 | 0.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.