PROCEDURE PRICING
November 1, 2012
The information provided on this website is an estimate and not a guarantee of what your charge will be. Based on your medical condition and medical needs from your physician, the charges may be lower or higher than the estimate on this website. The actual charges will depend upon several factors such as: length of time spent in surgery or recovery, additional tests required by your physician, and/or any special care or unexpected conditions or complications. During the care you received at our facility, you may incur charges from other providers such as Radiologist, Physicians, or Anesthesiologists. If you have insurance, your benefits will determine the amount you owe based on your specific plan.
The following information reflects charges solely from Atlantic General Hospital
Blood Tests
Radiology Procedures
Surgical Procedures
BLOOD TESTS
| BASIC METABOLIC PANEL |
$ 20.68
|
80048
|
| CBC WITH DIFFERENTIAL |
$ 19.14
|
85025
|
| LIPID PROFILE |
$ 35.67
|
80061
|
| PROTHROMBIN TIME |
$ 15.21
|
85610
|
| CBC |
$ 15.00
|
85027
|
|
HEPATIC FUNCTION
|
$ 20.68
|
80076
|
| COMPREHENSIVE METABOLIC PANEL |
$ 28.17
|
80053
|
| TSH |
$ 28.17
|
84443
|
| MAGNESIUM |
$ 11.28
|
83735
|
| PTT |
$ 15.00
|
85730
|
URINALYSIS
(additional charge for reflex as required)
|
$ 16.89
|
81001
|
URINE CULTURE
(additional charge for reflex as required)
|
$ 56.20
|
87088
|
GLYCOHEMOGLOBIN (HgbA1c)
|
$ 37.54
|
83036
|
| GLUCOSE |
$ 7.52
|
82947
|
| SCREENING PSA |
$ 37.49
|
G0103
|
| CREATININE |
$ 3.79
|
82565
|
| VITAMIN B12 |
$ 28.17
|
82607
|
| PSA TOTAL |
$ 37.49
|
84153
|
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RADIOLOGY PROCEDURES
CHEST X-RAY PA AND LAT
|
$ 83.72
|
71020
|
DIGITAL SCREENING MAMMOGRAM WITH
COMPUTER AIDED DIAGNOSIS
|
$362.70
|
G0202
77052
|
CT HEAD WITHOUT IV CONTRAST INJECTION
|
$113.30
|
70450
|
ELECTROCARDIOGRAM (ECG OR EKG)
|
$ 32.77
|
93005
|
CT SCAN PELVIS WITH ORAL CONTRAST
|
$188.85
|
72193
|
CT SCAN ABDOMEN WITH ORAL CONTRAST
|
$188.85
|
74160
|
X-RAY OF THE FOOT 3 VIEWS
|
$ 83.72
|
73630
|
COMPLETE ULTRASOUND OF ABDOMEN
|
$334.78
|
76700
|
X-RAY OF THE KNEE 4 VIEWS
|
$167.40
|
73564
|
X-RAY OF THE ANKLE 3 VIEWS
|
$ 83.72
|
73610
|
LUMBAR SPINE X-RAY WITH OBLIQUE VIEWS
|
$167.40
|
72110
|
TRANSTHORACIC ECHOCARDIOGRAM
|
$163.71
|
93306
|
SHOULDER X-RAY AT LEAST 2 VIEWS
|
$ 83.72
|
73030
|
X-RAY OF THE HAND 3 VIEWS
|
$ 83.72
|
73130
|
CT SCAN OF THE CHEST WITH IV CONTRAST
|
$188.85
|
71260
|
HIP X-RAY 2 VIEWS
|
$111.60
|
73510
|
MRI OF THE KNEE
|
$614.83
|
73721
|
MRI OF THE BRAIN
WITHOUT CONTRAST
|
$409.86
|
70551
|
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SURGICAL PROCEDURES
UPPER GI ENDOSCOPY BIOPSY: Examines
the interior liningof your esophagus, your
stomach and the first part of your small intestine
(duodenum) through a thin, flexible viewing
instrument called an endoscope.
|
$1,353.64
|
43239
|
DIAGNOSTIC COLONOSCOPY: Performed
when other symptoms or tests indicate the
presence of dangerous colon changes.
|
$ 1,188.61
|
45378
|
COLONOSCOPY & BIOPSY: During colonoscopy,
tissue samples are collected (biopsy) and abnormal
growths can be taken out.
|
$ 1,592.08
|
45380
|
COLONOSCOPY: Allows your doctor to look at the
interior lining of your large intestine (rectum and colon)
|
$ 1,692.55
|
45384
|
LESION REMOVAL COLONOSCOPY: Colonoscopy,
flexible, proximal to splenic flexure; with removal of
tumor(s), polyp(s), or other lesion(s) by hot biopsy
forceps or bipolar cautery.
|
$ 1,785.85
|
45385
|
CATARACT REMOVAL WITH INTRAOCULAR LENS:
Surgery to remove a clouded lens (cataract) from the
eye with insertion of intraocular lens.
|
$ 2,417.12
|
66984
|
REPAIR OF WOUND OR LESION: Repair, complex,
scalp, arms, and/or legs; 2.6 cm to 7.5 cm.
|
$ 1,145.33
|
13121
|
EXCISION, MALIGNANT LESION: including
margins, face, ears, eyelids, nose, lips; excised
diameter 1.1 to 2.0 cm.
|
$ 1,130.72
|
11642
|
LAPAROSCOPY, CHOLECYSTECTOMY:
Surgical removal of the gallbladder.
|
$ 6,729.27
|
47562
|
REPAIR, INTERMEDIATE, WOUNDS OF SCALP,
AXILLAE, TRUNK AND/OR EXTREMITIES
(excluding hands and feet); 2.6 cm to 7.5 cm.
|
$ 1,595.35
|
12032
|
REPAIR OF WOUND OR LESION: Repair, complex,
trunk; 2.6 cm. to 7.5 cm.
|
$ 1,388.91
|
13101
|
LAPAROSCOPY, APPENDECTOMY: Minimally
invasive surgical technique to remove the appendix.
|
$7,782.43
|
44970
|
BIOPSY SKIN LESION: Biopsy of skin, subcutaneous
tissue and/or mucous membrane
(including simple closure), unless otherwise
listed; single lesion.
|
$ 1,293.49
|
11100
|
HYSTEROSCOPY, BIOPSY: Inspection of the
uterine cavity by endoscopy with access through the cervix.
|
$ 3,550.57
|
58558
|
BLOOD TRANSFUSION: Process of receiving
blood products into one’s circulation intravenously.
|
$ 3,343.21
|
36430
|
SHOULDER ARTHROSCOPY/SURGERY: Surgery
that uses a tiny camera called an arthroscope to
examine or repair the tissues inside or around
your shoulder joint.
|
$ 7,083.78
|
29826
|
ARTHROSCOPY ROTATOR CUFF REPAIR:
Arthroscopy, shoulder, surgical; with rotator
cuff repair.
|
$ 7,673.40
|
29827
|
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