CMS Shoppable Services
#
Code
Description
Available
1
74177
Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]
YES
2
76700
Abdominal ultrasound (complete) [HCPCS 76700]
YES
3
76805
Abdominal ultrasound of pregnant uterus after first trimester, greater than or equal to 14 weeks 0 days (single or first fetus) [HCPCS 76805]
YES
4
64483
Anesthetic agent and/or steroid injection into lower or sacral spine nerve root with imaging guidance (single level) [HCPCS 64483]
NO
5
19120
Breast cyst removal, male or female (1 or more cysts) [HCPCS 19120]
NO
6
216
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications
NO
7
66984
Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]
NO
8
93452
Catheter insertion into left heart with injection, imaging interpretation, and supervision [HCPCS 93452]
NO
9
473
Cervical spinal fusion without complications
NO
10
45380
Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]
NO
11
45385
Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]
NO
12
45391
Colon (large bowel) examination and ultrasound of large bowel with flexible endoscope [HCPCS 45391]
NO
13
45378
Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]
NO
14
59510
Delivery of infant through incision in abdomen and uterus (cesarean delivery) with obstetric care before and after delivery [HCPCS 59510]
NO
15
59610
Delivery of infant through uterus and vagina after previous delivery of infant through incision in abdomen and uterus (cesarean delivery) with obstetric care before and after delivery [HCPCS 59610]
NO
16
59400
Delivery of infant through uterus and vagina with obstetric care before and after delivery [HCPCS 59400]
NO
17
43239
Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]
NO
18
43235
Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]
NO
19
90847
Family psychotherapy treatment with patient (50 minutes) [HCPCS 90847]
NO
20
90846
Family psychotherapy treatment without patient (50 minutes) [HCPCS 90846]
NO
21
47562
Gallbladder removal with an endoscope [HCPCS 47562]
NO
22
49505
Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]
NO
23
70450
Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]
YES
24
70553
Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]
YES
25
73721
Imaging of leg joint by MRI without contrast [HCPCS 73721]
YES
26
72148
Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]
YES
27
76830
Imaging of pelvis by ultrasound through vagina [HCPCS 76830]
YES
28
99385
Initial new patient well visit (preventive medicine evaluation) to assess overall health and identify potential health problems before they occur (18-39 years of age) [HCPCS 99385]
NO
29
99386
Initial new patient well visit (preventive medicine evaluation) to assess overall health and identify potential health problems before they occur (40-64 years of age) [HCPCS 99386]
NO
30
29881
Knee cartilage removal with endoscope (one knee) [HCPCS 29881]
NO
31
80055
Lab analysis for pregnant woment identify the hepatitis B antigen, rubella anitbody, test for syphilis, and perform ABO and Rh(D) blood typing from blood specimen [HCPCS 80055]
YES
32
81001
Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]
YES
33
81000
Lab analysis of urine specimen by dipstick with microscope (non-automated) [HCPCS 81000]
NO
34
81003
Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]
YES
35
81002
Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]
YES
36
80069
Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]
YES
37
85610
Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]
YES
38
84443
Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]
YES
39
85730
Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]
YES
40
85027
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]
YES
41
85025
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]
YES
42
80076
Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 80076]
YES
43
84154
Lab analysis to measure the amount of free PSA (prostate specific antigen) in serum specimen [HCPCS 84154]
YES
44
80061
Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]
YES
45
80048
Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]
YES
46
84153
Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]
YES
47
80053
Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]
YES
48
77067
Mammography of both breasts (screening exam) [HCPCS 77067]
YES
49
77066
Mammography of both breasts for diagnosis [HCPCS 77066]
YES
50
77065
Mammography of one breast for diagnosis [HCPCS 77065]
YES
51
99203
New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 30-44 minutes) [HCPCS 99203]
YES
52
99204
New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 45-59 minutes) [HCPCS 99204]
YES
53
99205
New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 60-74 minutes) [HCPCS 99205]
YES
54
99243
Patient office consultation visit with consulting physician or other qualified health care professional (typically 40 minutes) [HCPCS 99243]
NO
55
99244
Patient office consultation visit with consulting physician or other qualified health care professional (typically 60 minutes) [HCPCS 99244]
NO
56
72193
Pelvis CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 72193]
YES
57
97110
Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]
YES
58
55700
Prostate gland biopsy [HCPCS 55700]
YES
59
90832
Psychotherapy treatment by physician face-to-face with patient (30 minutes) [HCPCS 90832]
NO
60
90834
Psychotherapy treatment by physician face-to-face with patient (45 minutes) [HCPCS 90834]
NO
61
90837
Psychotherapy treatment by physician face-to-face with patient (60 minutes) [HCPCS 90837]
NO
62
90853
Psychotherapy treatment for multiple patients in one group session [HCPCS 90853]
NO
63
66821
Recurring cataract removal in lens capsule by laser [HCPCS 66821]
NO
64
93000
Routine EKG (electrocardiogram) tracing using at least 12 wires with interpretation and report (complete) [HCPCS 93000]
NO
65
29826
Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]
NO
66
95810
Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]
NO
67
62322
Spinal canal injection of substance into lower back or sacrum [HCPCS 62322]
NO
68
62323
Spinal canal injection of substance into lower back or sacrum with imaging guidance [HCPCS 62323]
NO
69
460
Spinal fusion other than the neck without major complications
NO
70
72110
Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]
YES
71
55866
Surgical prostate removal and surrounding lymph nodes with endoscope [HCPCS 55866]
NO
72
42820
Tonsils and adenoid glands removal (younger than 12 years of age) [HCPCS 42820]
NO
73
470
Total Knee or Hip Replacement
YES
74
743
Uterus or Ovary Surgery Not Related to Cancer without complications
YES
Coming Soon

Our patient price estimator tool will be activated by January 1, 2021 or sooner.

This link leads to the downloadable machine-readable file of all items and services provided by this facility as required by CMS. Please be advised the file size may exceed 1.5 gigabytes and therefore may take an extended amount of time to download depending on each individual user’s internet speed, bandwidth, connectivity, available hard drive space, etc.

Patient Price Information List

Disclaimer: Northern Regional Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Northern Regional Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2021. Northern Regional Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Hugh Chatham Memorial Hospital

Elkin

NC

Novant Health Forsyth Medical Center

Winston Salem

NC

Twin County Regional Hospital

Galax

VA

Wake Forest Baptist Medical Center

Winston Salem

NC

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$433
$2,671

84% lower than market

Intensive Care Unit

$1,426
$2,847

50% lower than market

Coronary Care Unit

$1,426
$3,707

62% lower than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$2,950
$4,567

35% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$950
$1,723

45% lower than market

Anesthetic agent and/or steroid injection into lower or sacral spine nerve root with imaging guidance (single level) [HCPCS 64483]

$1,314
$3,980

67% lower than market

Breast cyst removal, male or female (1 or more cysts) [HCPCS 19120]

$2,954
$7,943

63% lower than market

Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]

$3,644
$12,482

71% lower than market

Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]

$3,525
$9,217

62% lower than market

Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]

$3,366
$14,083

76% lower than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$3,130
$7,466

58% lower than market

Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]

$2,555
$8,049

68% lower than market

Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]

$3,173
$8,412

62% lower than market

Gallbladder removal with an endoscope [HCPCS 47562]

$7,704
$30,719

75% lower than market

Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]

$5,847
$17,582

67% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$1,175
$1,819

35% lower than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$2,600
$5,535

53% lower than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$2,200
$3,309

34% lower than market

Imaging of pelvis by ultrasound through vagina [HCPCS 76830]

$615
$1,064

42% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$34
$65

48% lower than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$23
$23

2% lower than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$70
$189

63% lower than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$34
$42

19% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$85
$219

61% lower than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$50
$82

39% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$28
$113

75% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$66
$126

47% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$72
$167

57% lower than market

Lab analysis to measure the amount of free PSA (prostate specific antigen) in serum specimen [HCPCS 84154]

$79
$151

48% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$104
$164

37% lower than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$61
$166

63% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$63
$157

60% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$77
$240

68% lower than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$190
$541

65% lower than market

Mammography of both breasts for diagnosis [HCPCS 77066]

$210
$906

77% lower than market

Mammography of one breast for diagnosis [HCPCS 77065]

$170
$694

76% lower than market

Pelvis CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 72193]

$1,450
$2,558

43% lower than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$36
$100

65% lower than market

Prostate gland biopsy [HCPCS 55700]

$2,942
$9,854

70% lower than market

Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]

$13,464
$33,511

60% lower than market

Spinal canal injection of substance into lower back or sacrum with imaging guidance [HCPCS 62323]

$895
$8,194

89% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$340
$396

14% lower than market

Total Knee or Hip Replacement

$27,188
$65,863

59% lower than market

Uterus or Ovary Surgery Not Related to Cancer without complications

$7,571
$55,973

86% lower than market

OUTPATIENT CLINIC

Description

Our Charge
Market Charge

Variance

Hospital outpt clinic visit [HCPCS G0463]

$192
$253

24% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Emergency department visit for minor problem [HCPCS 99281]

$138
$341

60% lower than market

Emergency department visit for problem of high severity [HCPCS 99284]

$458
$1,764

74% lower than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$186
$559

67% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$261
$933

72% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$596
$2,491

76% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Catheterize for urine spec [HCPCS P9612]

$56
$78

28% lower than market

Drug test def 1-7 classes [HCPCS G0480]

$200
$256

22% lower than market

Lab analysis by immunoassay (ELISA) to identify bacteria toxin (shiga-like toxin) [HCPCS 87427]

$49
$93

47% lower than market

Lab analysis by immunoassay (ELISA) to identify clostridium difficile toxins (stool pathogen) [HCPCS 87324]

$62
$67

7% lower than market

Lab analysis by immunoassay to identify influenza virus [HCPCS 87804]

$31
$120

74% lower than market

Lab analysis by immunoassay to identify Strep (streptococcus) [HCPCS 87880]

$43
$111

61% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify Staphylococcus aureus, methicillin resistant (MRSA bacteria) by amplified probe technique [HCPCS 87641]

$99
$194

49% lower than market

Lab analysis of any culture (except blood) to identify aerobic isolates (each isolate) [HCPCS 87077]

$36
$110

67% lower than market

Lab analysis of any culture (except urine, blood, or stool) to measure the amount of anaerobic bacteria [HCPCS 87073]

$40
$146

73% lower than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$59
$103

43% lower than market

Lab analysis of complex special stain to identify parasites [HCPCS 87209]

$76
$104

27% lower than market

Lab analysis of smear to identify and measre the amount of parasites in culture [HCPCS 87177]

$38
$51

25% lower than market

Lab analysis of special gram or Giemsa stain to idenitfy microorganisms [HCPCS 87205]

$19
$60

68% lower than market

Lab analysis of stool culture to identify bacteria [HCPCS 87045]

$41
$162

75% lower than market

Lab analysis of stool culture to identify bacteria and additional pathogens [HCPCS 87046]

$21
$94

78% lower than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$45
$62

28% lower than market

Lab analysis of urine specimen by dipstick to detect the hormone found in women in early pregnancy [HCPCS 81025]

$39
$93

58% lower than market

Lab analysis to evaluate an antimicrobial drug (antibiotic, antifungal, antiviral) by microdilution or agar dilution (each multi-antimicrobial, per plate) [HCPCS 87186]

$45
$159

72% lower than market

Lab analysis to evaluate thyroid hormone in serum specimen [HCPCS 84479]

$42
$94

55% lower than market

Lab analysis to identify and measure the amount of hemoglobin in blood specimen by chromatography [HCPCS 83021]

$68
$123

45% lower than market

Lab analysis to identify antibodies to Helicobacter pylori (gastrointestinal bacteria) [HCPCS 86677]

$42
$75

44% lower than market

Lab analysis to identify gonadotropin (reproductive hormone) in serum or urine specimen [HCPCS 84703]

$39
$155

75% lower than market

Lab analysis to identify ketone bodies in blood, serum, or plasma specimen [HCPCS 82009]

$20
$91

78% lower than market

Lab analysis to identify total thyroxine (thyroid chemical) function in serum specimen for screening [HCPCS 84436]

$40
$104

62% lower than market

Lab analysis to measure blood count (hemoglobin) [HCPCS 85018]

$16
$37

57% lower than market

Lab analysis to measure blood glucose (sugar) level with hand-held instrument [HCPCS 82962]

$13
$22

42% lower than market

Lab analysis to measure coagulation function measurement of D-dimer (quantitative) [HCPCS 85379]

$49
$196

75% lower than market

Lab analysis to measure red blood cell concentration [HCPCS 85014]

$16
$36

56% lower than market

Lab analysis to measure the ammonia level [HCPCS 82140]

$62
$145

57% lower than market

Lab analysis to measure the amount of blood gases [HCPCS 82803]

$85
$281

70% lower than market

Lab analysis to measure the amount of C-reactive protein in serum to identify infection or inflammation [HCPCS 86140]

$27
$146

82% lower than market

Lab analysis to measure the amount of tacrolimus in blood specimen [HCPCS 80197]

$212
$275

23% lower than market

Lab analysis to measure the amount of total thyroid hormone, T3 in serum specimen [HCPCS 84480]

$73
$102

28% lower than market

Lab analysis to measure the amount of total valproic acid in blood specimen [HCPCS 80164]

$65
$119

45% lower than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$98
$233

58% lower than market

Lab analysis to measure the amount of vancomycin (antibiotic) in serum specimen [HCPCS 80202]

$100
$179

44% lower than market

Lab analysis to measure the amylase (enzyme) level in serum specimen [HCPCS 82150]

$66
$112

41% lower than market

Lab analysis to measure the c-peptide (protein) level in urine specimen [HCPCS 84681]

$67
$213

69% lower than market

Lab analysis to measure the creatine kinase (cardiac enzyme) level (MB fraction only) [HCPCS 82553]

$108
$264

59% lower than market

Lab analysis to measure the creatinine level in blood specimen to test for kidney function or muscle injury [HCPCS 82565]

$25
$66

62% lower than market

Lab analysis to measure the cyanocobalamin (vitamin b-12) level [HCPCS 82607]

$79
$122

35% lower than market

Lab analysis to measure the direct bilirubin level [HCPCS 82248]

$23
$73

69% lower than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$70
$128

45% lower than market

Lab analysis to measure the folic acid level in serum specimen [HCPCS 82746]

$68
$134

49% lower than market

Lab analysis to measure the iron binding capacity [HCPCS 83550]

$38
$75

49% lower than market

Lab analysis to measure the iron level [HCPCS 83540]

$29
$66

56% lower than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$46
$163

72% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$66
$141

53% lower than market

Lab analysis to measure the microalbumin (protein) level in urine specimen [HCPCS 82043]

$22
$44

51% lower than market

Lab analysis to measure the natriuretic peptide (heart and blood vessel protein) level in plasma specimen [HCPCS 83880]

$165
$361

54% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$39
$92

58% lower than market

Lab analysis to measure the total creatine kinase (cardiac enzyme) level in blood specimen [HCPCS 82550]

$48
$115

58% lower than market

Lab analysis to measure the uric acid level in blood specimen [HCPCS 84550]

$24
$83

71% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$111
$258

57% lower than market

Lab analysis to measure total testosterone (hormone) level in serum specimen [HCPCS 84403]

$108
$254

57% lower than market

Lab blood analysis to confirm blood unit compatibility by antiglobulin technique [HCPCS 86922]

$59
$204

71% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$40
$88

55% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]

$37
$70

47% lower than market

Lab blood analysis to screen for antibodies to red blood cell antigens (each serum technique) [HCPCS 86850]

$74
$172

57% lower than market

Lab genetic analysis of tumor (manual) [HCPCS 88360]

$171
$449

62% lower than market

Pathology lab analysis of special stained specimen slides to examine tissue (each additional procedure) [HCPCS 88341]

$78
$266

71% lower than market

Pathology lab analysis of special stained specimen slides to examine tissue (each multiplex stain) [HCPCS 88344]

$257
$887

71% lower than market

Pathology lab analysis of tissue with microscope (intermediate complexity) [HCPCS 88305]

$164
$294

44% lower than market

Psa screening [HCPCS G0103]

$63
$149

58% lower than market

Rbc leukocytes reduced [HCPCS P9016]

$249
$528

53% lower than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Blood vessel compression or decompression device application to 1 or more areas [HCPCS 97016]

$46
$188

75% lower than market

Drug administration beneath the skin or into muscle by injection for therapy, diagnosis, or prevention [HCPCS 96372]

$71
$140

49% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (each additional hour) [HCPCS 96366]

$100
$159

37% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$240
$527

54% lower than market

Drug administration into vein by infusion of additional sequential infusion of new drug for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96367]

$25
$193

87% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$90
$178

50% lower than market

Hydration administration into vein by infusion (31 minutes to 1 hour) [HCPCS 96360]

$240
$370

35% lower than market

Hydration administration into vein by infusion (each additional hour) [HCPCS 96361]

$33
$133

75% lower than market

Immunization administration of vaccine into, between, or beneath the skin or into muscle (single vaccine) [HCPCS 90471]

$50
$114

56% lower than market

Influenza vaccine for injection into muscle (0.5 ml dosage, quadrivalent, preservation free) [HCPCS 90686]

$35
$78

55% lower than market

Influenza vaccine for injection into muscle (preservation free) [HCPCS 90662]

$83
$164

49% lower than market

Medication application by electic current through skin (each 15 minutes) [HCPCS 97033]

$87
$173

50% lower than market

Physician services for outpatient heart rehab with continuous EKG monitoring (per session) [HCPCS 93798]

$240
$312

23% lower than market

Pneumococcal conjugate, 13 valent vaccine for injection into muscle [HCPCS 90670]

$245
$749

67% lower than market

Pneumococcal polysaccharide vaccine for injection beneath the skin or into muscle (2 years of age or older) [HCPCS 90732]

$105
$415

75% lower than market

Tissue removal from wounds per session (each additional 20 sq cm) [HCPCS 97598]

$145
$227

36% lower than market

Wireless, single, dual, or multiple wire pacemaker system evaluation of parameters with qualified health care professional analysis, review, and report [HCPCS 93288]

$59
$1,822

97% lower than market

OUTPATIENT OTHER

Description

Our Charge
Market Charge

Variance

Oth resp proc, indiv [HCPCS G0238]

$66
$55

20% higher than market

Telehealth facility fee [HCPCS Q3014]

$95
$152

37% lower than market

Tomosynthesis, mammo [HCPCS G0279]

$60
$77

22% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Admin influenza virus vac [HCPCS G0008]

$50
$60

16% lower than market

Admin pneumococcal vaccine [HCPCS G0009]

$50
$61

18% lower than market

Alteplase recombinant [HCPCS J2997]

$4
$151

98% lower than market

Amiodarone hcl [HCPCS J0282]

$27
$5

415% higher than market

Cefazolin sodium injection [HCPCS J0690]

$4
$15

75% lower than market

Diphenhydramine hcl injectio [HCPCS J1200]

$22
$55

59% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of new drug) [HCPCS 96375]

$100
$212

53% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (initial drug) [HCPCS 96374]

$100
$282

65% lower than market

Ertapenem injection [HCPCS J1335]

$130
$213

39% lower than market

F18 fdg [HCPCS A9552]

$650
$900

28% lower than market

Fentanyl citrate injection [HCPCS J3010]

$21
$42

51% lower than market

Hyalgan or supartz inj dose [HCPCS J7321]

$65
$215

70% lower than market

Hydromorphone injection [HCPCS J1170]

$26
$57

55% lower than market

Inj enoxaparin sodium [HCPCS J1650]

$3
$8

69% lower than market

Inj magnesium sulfate [HCPCS J3475]

$4
$22

80% lower than market

Inj midazolam hydrochloride [HCPCS J2250]

$9
$24

61% lower than market

Inj pantoprazole sodium, via [HCPCS C9113]

$31
$88

65% lower than market

Injection,onabotulinumtoxina [HCPCS J0585]

$23
$23

1% higher than market

Kcentra, per i.u. [HCPCS C9132]

$4
$7

33% lower than market

Leuprolide acetate suspnsion [HCPCS J9217]

$62
$266

77% lower than market

Levofloxacin injection [HCPCS J1956]

$4
$24

82% lower than market

Lorazepam injection [HCPCS J2060]

$19
$57

66% lower than market

Methylprednisolone 40 mg inj [HCPCS J1030]

$24
$84

71% lower than market

Methylprednisolone 80 mg inj [HCPCS J1040]

$15
$57

73% lower than market

Methylprednisolone injection [HCPCS J2930]

$49
$68

27% lower than market

Mitomycin injection [HCPCS J9280]

$18
$480

96% lower than market

Monovisc inj per dose [HCPCS J7327]

$1,100
$2,836

61% lower than market

Morphine sulfate injection [HCPCS J2270]

$23
$58

61% lower than market

Normal saline solution infus [HCPCS J7050]

$40
$43

7% lower than market

Ondansetron hcl injection [HCPCS J2405]

$1
$6

84% lower than market

Orphenadrine injection [HCPCS J2360]

$98
$117

17% lower than market

Piperacillin/tazobactam [HCPCS J2543]

$6
$12

49% lower than market

Tc99m sestamibi [HCPCS A9500]

$57
$217

74% lower than market

Tetanus, diphtheria toxoids and acellular pertussis (whooping cough) vaccine for injection into muscle (7 years of age or older) [HCPCS 90715]

$43
$152

72% lower than market

Triptorelin pamoate [HCPCS J3315]

$125
$1,228

90% lower than market

Vancomycin hcl injection [HCPCS J3370]

$19
$57

67% lower than market

Vitamin b12 injection [HCPCS J3420]

$9
$20

56% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Electrical stimulation application to 1 or more areas (each 15 minutes) [HCPCS 97032]

$73
$131

44% lower than market

Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]

$71
$124

43% lower than market

Hot wax bath application to 1 or more areas [HCPCS 97018]

$60
$130

54% lower than market

Occupational therapy evaluation (typically 30 minutes) [HCPCS 97165]

$156
$255

39% lower than market

Occupational therapy evaluation (typically 45 minutes) [HCPCS 97166]

$156
$312

50% lower than market

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$34
$115

71% lower than market

Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]

$150
$257

42% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$150
$305

51% lower than market

Physical therapy procedure to re-educate brain-to-nerve-to-muscle function (each 15 minutes) [HCPCS 97112]

$76
$165

54% lower than market

Physical therapy re-evaluation (typically 20 minutes) [HCPCS 97164]

$108
$188

43% lower than market

Physical therapy techniques to 1 or more regions (each 15 minutes) [HCPCS 97140]

$76
$182

58% lower than market

Speech, language, voice, communication, and/or hearing processing disorder treatment [HCPCS 92507]

$157
$243

35% lower than market

Swallowing and/or oral feeding function treatment [HCPCS 92526]

$140
$327

57% lower than market

Swallowing function evaluation [HCPCS 92610]

$175
$338

48% lower than market

Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]

$71
$88

19% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

CPAP (continuous positive airway pressure) mask or breathing tube initiation and management for night time respiratory muscle rest [HCPCS 94660]

$463
$776

40% lower than market

Pulmonary rehab w exer [HCPCS G0424]

$155
$183

15% lower than market

Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]

$104
$207

50% lower than market

Total and timed exhaled air capacity measurement and graphic recording [HCPCS 94010]

$220
$330

33% lower than market

OUTPATIENT RESPIRATORY THERAPY

Description

Our Charge
Market Charge

Variance

Airway inhalation treatment to relieve airway obstruction or for sputum collection (inhaled pressure or nonpressure treatment) [HCPCS 94640]

$81
$169

52% lower than market

Oxygen saturation measurement in blood by ear or finger device (single determination) [HCPCS 94760]

$35
$89

60% lower than market

OUTPATIENT SUPPLIES

Description

Our Charge
Market Charge

Variance

Anchor/screw bn/bn,tis/bn [HCPCS C1713]

$320
$1,878

83% lower than market

Catheter, ureteral [HCPCS C1758]

$38
$153

75% lower than market

Guide wire [HCPCS C1769]

$44
$344

87% lower than market

Slings [HCPCS A4565]

$9
$33

73% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Abscess incision and drainage (simple procedure or single abscess) [HCPCS 10060]

$1,500
$9,429

84% lower than market

Bladder and urethra (bladder canal) examination with endoscope for diagnosis [HCPCS 52000]

$955
$10,041

90% lower than market

Breathing tube insertion into windpipe cartilage with endoscope (emergent) [HCPCS 31500]

$5,997
$16,440

64% lower than market

Catheter placement into bladder with irrigation and/or instillation [HCPCS 51700]

$443
$11,956

96% lower than market

Colon (large bowel) examination and tissue abnormalities, tumors, or polyps removal by hot biopsy forceps with flexible endoscope [HCPCS 45384]

$2,747
$6,713

59% lower than market

Colorectal cancer screening; colonoscopy on invididual not meeting high risk [HCPCS G0121]

$2,198
$7,139

69% lower than market

Colorectal scrn; hi risk ind [HCPCS G0105]

$2,194
$10,497

79% lower than market

Complex cataract removal with lens insertion [HCPCS 66982]

$4,332
$17,119

75% lower than market

Destruction of non-cancerous skin lesions/growths other than skin tags (up to 14 lesions/growths) [HCPCS 17110]

$769
$367

110% higher than market

Destruction of pre-cancerous skin lesion/growth (first lesion/growth) [HCPCS 17000]

$381
$433

12% lower than market

Esophagus, stomach, and/or upper small bowel examination and widening by balloon with endoscope (less than 30 mm) [HCPCS 43249]

$3,800
$9,474

60% lower than market

Foreign body, stone, or stent removal from urethra (bladder canal) or bladder with endoscope (simple) [HCPCS 52310]

$1,864
$10,896

83% lower than market

Impacted ear wax removal (one ear) [HCPCS 69210]

$973
$261

273% higher than market

Indwelling bladder catheter insertion (simple) [HCPCS 51702]

$3,687
$21,556

83% lower than market

Inj for sacroiliac jt anesth [HCPCS G0260]

$487
$930

48% lower than market

Knee joint repair at lower or upper part of joint (inside and outside compartments [HCPCS 27447]

$20,538
$63,568

68% lower than market

Leg cast application (rigid, total contact) [HCPCS 29445]

$455
$664

31% lower than market

Long arm splint application (shoulder to hand) [HCPCS 29105]

$2,902
$1,647

76% higher than market

Lower or sacral spine facet joint injections with imaging guidance (first level) [HCPCS 64493]

$2,240
$3,599

38% lower than market

Lower or sacral spine facet joint injections with imaging guidance (second level) [HCPCS 64494]

$2,411
$3,678

34% lower than market

Measurement of bladder capacity after voiding by ultrasound [HCPCS 51798]

$404
$2,498

84% lower than market

Median nerve of hand release and/or relocation [HCPCS 64721]

$4,592
$11,533

60% lower than market

Medium joint or joint capsule fluid removal and/or injection with needle [HCPCS 20605]

$1,482
$659

125% higher than market

Needle insertion into vein for collection of blood sample [HCPCS 36415]

$11
$22

50% lower than market

Non-tunneled central venous catheter insertion for infusion (5 years of age or older) [HCPCS 36556]

$6,815
$18,613

63% lower than market

Prostate removal through urethra (bladder canal) by electrosurgery including control of bleeding with endoscope [HCPCS 52601]

$9,483
$27,080

65% lower than market

Short arm splint application forearm to hand (non-moveable) [HCPCS 29125]

$2,056
$3,254

37% lower than market

Short leg splint application (calf to foot) [HCPCS 29515]

$1,630
$3,662

55% lower than market

Shoulder examination and removal of abnormal shoulder joint tissue with endoscope (limitied) [HCPCS 29822]

$11,810
$27,863

58% lower than market

Shoulder examination and removal of collar bone at shoulder with endoscope (partial) [HCPCS 29824]

$13,311
$19,573

32% lower than market

Simple control of nose bleed (limited cautery and/or packing) [HCPCS 30901]

$663
$3,819

83% lower than market

Simple repair of wound of face, ears, eyelids, nose, lips and/or mouth (2.5 cm or less) [HCPCS 12011]

$2,979
$6,548

54% lower than market

Simple repair of wound of face, ears, eyelids, nose, lips and/or mouth (2.6 to 5.0 cm) [HCPCS 12013]

$4,518
$7,428

39% lower than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.5 cm or less) [HCPCS 12001]

$943
$4,489

79% lower than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.6 to 7.5 cm) [HCPCS 12002]

$1,865
$5,585

67% lower than market

Strapping application of unna boot [HCPCS 29580]

$856
$345

148% higher than market

Strapping application to knee [HCPCS 29530]

$117
$943

88% lower than market

Tendon covering incision [HCPCS 26055]

$5,743
$6,550

12% lower than market

Tendon sheath, ligament, or muscle membrane injections [HCPCS 20550]

$711
$566

26% higher than market

Trigger points injection into 1 or 2 muscles [HCPCS 20552]

$1,867
$3,719

50% lower than market

Trigger points injection into 3 or more muscles [HCPCS 20553]

$580
$857

32% lower than market

Ureter (urinary duct) stent insertion with endoscope [HCPCS 52332]

$7,991
$18,910

58% lower than market

Ureter (urinary duct) stone crushing with stent with endoscope [HCPCS 52356]

$9,843
$17,159

43% lower than market

OUTPATIENT VISION SERVICES

Description

Our Charge
Market Charge

Variance

Post chmbr intraocular lens [HCPCS V2632]

$369
$807

54% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

3D radiographic procedure with computerized image post-processing [HCPCS 76377]

$400
$1,724

77% lower than market

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$2,750
$3,104

11% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$3,200
$5,445

41% lower than market

Abdominal and pelvic vessels CTA scan with contrast [HCPCS 74174]

$3,250
$3,151

3% higher than market

Abdominal CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74160]

$1,500
$2,751

45% lower than market

Abdominal CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74170]

$1,600
$3,318

52% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$500
$1,047

52% lower than market

Abdominal x-ray (single view) [HCPCS 74018]

$165
$253

35% lower than market

Abdominal x-ray, complete study including 2 or more views of abdomen and single view of chest [HCPCS 74022]

$320
$517

38% lower than market

Abdominal, pelvic, and/or scrotal arterial inflow and venous outflow ultrasound (complete study) [HCPCS 93975]

$550
$980

44% lower than market

Ankle x-ray (2 views) [HCPCS 73600]

$130
$327

60% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$145
$344

58% lower than market

Arm or leg ultrasound (complete) [HCPCS 76881]

$425
$1,257

66% lower than market

Arm x-ray of forearm (2 views) [HCPCS 73090]

$130
$334

61% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$180
$352

49% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (complete, both arms or legs) [HCPCS 93970]

$995
$1,208

18% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$565
$878

36% lower than market

Arteries of both arms and legs ultrasound (limited) [HCPCS 93922]

$435
$517

16% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$799
$1,186

33% lower than market

Bone density measurement of the axial skeleton (hips, pelvis, spine) [HCPCS 77080]

$255
$658

61% lower than market

Breast ultrasound (one breast, limited) [HCPCS 76642]

$330
$485

32% lower than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$1,500
$2,614

43% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$1,400
$1,530

8% lower than market

Chest x-ray (2 views) [HCPCS 71046]

$199
$347

43% lower than market

Chest x-ray (single view) [HCPCS 71045]

$155
$276

44% lower than market

Collar bone x-ray, complete study [HCPCS 73000]

$130
$301

57% lower than market

Color-directed heart blood flow doppler ultrasound to evaluate heart rate and valve function [HCPCS 93325]

$400
$729

45% lower than market

CTA scan of chest blood vessels with contrast to examine injury, foreign bodies, or tumors [HCPCS 71275]

$1,900
$3,632

48% lower than market

CTA scan of head blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70496]

$1,575
$3,280

52% lower than market

CTA scan of neck blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70498]

$1,575
$3,293

52% lower than market

Digital tomography of both breasts (screening exam) [HCPCS 77063]

$60
$93

35% lower than market

Elbow x-ray (2 views) [HCPCS 73070]

$130
$300

57% lower than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$140
$365

62% lower than market

Esophagus x-ray with barium swallow (single contrast material swallowed) [HCPCS 74220]

$340
$517

34% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$1,275
$1,954

35% lower than market

Fluoroscopic guidance for needle placement [HCPCS 77002]

$340
$487

30% lower than market

Fluoroscopy imaging guidance for procedure (up to 1 hour) [HCPCS 76000]

$220
$534

59% lower than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$140
$241

42% lower than market

Hand x-ray (2 views) [HCPCS 73120]

$130
$132

2% lower than market

Head and neck ultrasound [HCPCS 76536]

$490
$965

49% lower than market

Head or brain CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 70470]

$1,375
$2,611

47% lower than market

Heart blood flow doppler ultrasound to evaluate blood flow, valves, and chambers [HCPCS 93320]

$445
$939

53% lower than market

Heart ultrasound including color-depicted blood flow rate, direction, and valve function [HCPCS 93306]

$1,575
$2,317

32% lower than market

Heart ultrasound performed during rest, exercise, and/or drug-induced stress with interpretation and report [HCPCS 93350]

$1,725
$2,158

20% lower than market

Hip x-ray of both hips with pelvis (2 views) [HCPCS 73521]

$320
$364

12% lower than market

Imaging for swallowing function evaluation with contrast [HCPCS 74230]

$435
$563

23% lower than market

Imaging of bone and/or joint (whole body) [HCPCS 78306]

$1,195
$2,556

53% lower than market

Imaging of brain by MRI without contrast [HCPCS 70551]

$2,400
$2,874

16% lower than market

Imaging of head blood vessels by MRA without contrast [HCPCS 70544]

$2,000
$2,929

32% lower than market

Imaging of heart vessels with SPECT tomography and drugs or exercise (multiple studies) [HCPCS 78452]

$1,975
$3,705

47% lower than market

Imaging of lower spinal canal by MRI without contrast, followed by contrast [HCPCS 72158]

$2,400
$5,146

53% lower than market

Imaging of middle spinal canal by MRI without contrast [HCPCS 72146]

$2,200
$3,234

32% lower than market

Imaging of pelvis through rectum by ultrasound [HCPCS 76872]

$182
$686

73% lower than market

Imaging of scrotum by ultrasound [HCPCS 76870]

$495
$1,143

57% lower than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$2,200
$3,142

30% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$175
$400

56% lower than market

Knee x-ray (4 or more views) [HCPCS 73564]

$152
$395

61% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$140
$371

62% lower than market

Neck CT scan of the soft tissue of the neck with contrast to examine injury, foreign bodies, or tumors [HCPCS 70491]

$1,375
$2,316

41% lower than market

Pelvis ultrasound, not pregrnancy related (complete) [HCPCS 76856]

$515
$1,204

57% lower than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$195
$356

45% lower than market

PET (positron emission tomography) imaging with CT imaging (skull base to mid-thigh) [HCPCS 78815]

$2,975
$7,089

58% lower than market

Rib cage x-ray of ribs on one side of body including chest (minimum of 3 views) [HCPCS 71101]

$290
$423

31% lower than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$1,400
$2,177

36% lower than market

Spinal CT scan of middle spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72128]

$1,400
$2,468

43% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$1,500
$2,485

40% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$275
$414

34% lower than market

Spinal x-ray of middle spine (2 views) [HCPCS 72070]

$195
$316

38% lower than market

Spinal x-ray of upper spine (2 or 3 views) [HCPCS 72040]

$215
$291

26% lower than market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$270
$563

52% lower than market

Thighbone x-ray (minimum of 2 views) [HCPCS 73552]

$170
$456

63% lower than market

Tte w or wo fol wcon,doppler [HCPCS C8929]

$1,595
$2,792

43% lower than market

Ultrasound application to 1 or more areas (each 15 minutes) [HCPCS 97035]

$71
$169

58% lower than market

Ultrasound guidance for needle placement including imaging supervision of procedure and interpretation of results [HCPCS 76942]

$360
$1,074

66% lower than market

Ultrasound of area behind abdominal cavity (complete) [HCPCS 76770]

$680
$990

31% lower than market

Ultrasound of area behind abdominal cavity (limited) [HCPCS 76775]

$485
$617

21% lower than market

Urinary tract imaging [HCPCS 74420]

$970
$971

Approximately equal to market

Wrist x-ray (2 views) [HCPCS 73100]

$145
$296

51% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$145
$325

55% lower than market

X-ray of eye to locate foreign body with physician supervision of procedure and interpretation of results [HCPCS 70030]

$120
$223

46% lower than market

X-ray of sacrum and tailbone (minimum of 2 views) [HCPCS 72220]

$185
$379

51% lower than market

X-ray of various bones in the body (limited to specific areas of concern) [HCPCS 77074]

$355
$901

61% lower than market

INPATIENT CARDIOLOGY

Description

Our Charge
Market Charge

Variance

Heart Failure with complications

$14,569
$22,634

36% lower than market

Heart Failure with major complications

$17,109
$32,409

47% lower than market

INPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Blood Infection with major complications

$21,751
$53,399

59% lower than market

Blood infection without major complications

$15,802
$29,575

47% lower than market

Digestive System Bleeding with complications

$16,566
$33,914

51% lower than market

Stomach Disorder without complications

$11,769
$23,388

50% lower than market

INPATIENT PULMONOLOGY

Description

Our Charge
Market Charge

Variance

Pneumonia with complications

$14,080
$23,601

40% lower than market

Pneumonia with major complications

$15,386
$35,526

57% lower than market

Respiratory Failure

$12,085
$37,373

68% lower than market

INPATIENT UROLOGY

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection without complications

$12,959
$21,570

40% lower than market

Kidney failure with complications

$12,895
$22,625

43% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Northern Regional Hospital for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Northern Regional Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Northern Regional Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Northern Regional Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 336-719-7458 or toll-free 888-626-0113.

If you need more information about the price of a future service, please contact our Customer Service at 336-719-7458 or toll-free 888-626-0113. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.