South Georgia Specialty Hospital
Shoppable Services
Prices Effective March 1st, 2021
South Georgia Specialty Hospital Shoppable Services | Chargemaster Price | |
| Basic metobolic panel | $ 263.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Blood culture | $ 247.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Blood culture AFB | $ 38.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Kidney imaging with FLO | $ 720.00 | Insurances pay DRG or per diems and not specific pricing for items |
| PSA (prostate specific antigen) | $ 103.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Blood test, thyroid stimulating hormone (TSH) | $ 107.57 | Insurances pay DRG or per diems and not specific pricing for items |
| Urinalysis routine | $ 45.98 | Insurances pay DRG or per diems and not specific pricing for items |
| Urinalysis with culture | $ 43.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Urinalysis with microscopic | $ 93.31 | Insurances pay DRG or per diems and not specific pricing for items |
| Urine potassium | $ 31.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Urine sodium random | $ 96.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Urine amino acid | $ 764.00 | Insurances pay DRG or per diems and not specific pricing for items |
| CT scan, head or brain, without contrast | $ 1,600.80 | Insurances pay DRG or per diems and not specific pricing for items |
| MRI scan of brain before and after contrast | $ 3,067.00 | Insurances pay DRG or per diems and not specific pricing for items |
| MRI scan of lower spinal canal | $ 3,985.00 | Insurances pay DRG or per diems and not specific pricing for items |
| CT scan, pelvis, with contrast | $ 2,292.00 | Insurances pay DRG or per diems and not specific pricing for items |
| MRI scan of leg joint | $ 2,366.00 | Insurances pay DRG or per diems and not specific pricing for items |
| CT scan of abdomen and pelvis with contrast | $ 2,585.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Ultrasound of abdomen | $ 192.00 | Insurances pay DRG or per diems and not specific pricing for items |
| CT scan thorax chest w/o contrast | $ 2,111.00 | Insurances pay DRG or per diems and not specific pricing for items |
| CT scan upper extremity w contrast | $ 2,054.00 | Insurances pay DRG or per diems and not specific pricing for items |
| MRI cervical spine w/wo contrast | $ 3,795.00 | Insurances pay DRG or per diems and not specific pricing for items |
| X-ray chest 2 views | $ 277.20 | Insurances pay DRG or per diems and not specific pricing for items |
| Ultrasound renal | $ 188.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Bipap management 4 hours | $ 116.00 | Insurances pay DRG or per diems and not specific pricing for items |
| Vent management 1 hour | $ 47.00 | Insurances pay DRG or per diems and not specific pricing for items |
| PT evaluation 15 minutes | $ 55.00 | Insurances pay DRG or per diems and not specific pricing for items |
| PT evaluation 60 minutes | $ 217.00 | Insurances pay DRG or per diems and not specific pricing for items |
| PT exercise 15 minutes | $ 55.00 | Insurances pay DRG or per diems and not specific pricing for items |
| PT gait 15 minutes | $ 65.00 | Insurances pay DRG or per diems and not specific pricing for items |
| OT evaluation 15 minutes | $ 55.00 | Insurances pay DRG or per diems and not specific pricing for items |
| OT evaluation 60 minutes | $ 217.00 | Insurances pay DRG or per diems and not specific pricing for items |
| OT exercise 15 minutes | $ 55.00 | Insurances pay DRG or per diems and not specific pricing for items |