JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
-	"PIN STEINMANN COMPRESSION NANO 7",#####""	$810	$810	—	—	2
-	"GRAFT HEMASHIELD 24 X 30",#####""	$615	$615	—	—	40
-	"CABLE CERCLAGE WITH CLAMP 1.8MM DIA 25",#####""	$463	$463	—	—	40
-	"MESH VENTRALIGHT ELLIPSE 4 X 6",#####""	$450	$450	—	—	40
-	"SYSTEM CABLE GRIP 1.8MM DIA X 22",#####""	$426	$426	—	—	40
90791	PSYCH DIAG EVAL 90791 MHC	$159	$159	—	—	61
90792	PSYCH DIAG EVAL MED SVC 90792 MHC	$159	$159	—	—	61
90839	Psytx crisis initial 60 min	$151	$151	—	—	61
-	"GUIDEWIRE GLADIUS PTA STRAIGHT 300CM X .018",#####""	$145	$145	—	—	40
-	"FIBERTAPE BLUE TAPERED 2MM 36",#####""	$133	$133	—	—	40
90837	Psytx w pt 60 minutes	$127	$127	—	—	61
90834	Psytx w pt 45 minutes	$119	$119	—	—	61
90846	Family psytx w/o pt 50 min	$119	$119	—	—	61
90847	Family psytx w/pt 50 min	$119	$119	—	—	61
90838	Psytx w pt w e/m 60 min	$116	$116	—	—	33
-	"KIT EXPANSION CATHETER ON-Q SOAKER 1",#####""	$101	$101	—	—	40
90832	Psytx w pt 30 minutes	$95.63	$95.63	—	—	60
90836	Psytx w pt w e/m 45 min	$91.37	$91.37	—	—	33
-	"CATHETER BREVI-XL 19 GAUGE 14",#####""	$87.94	$87.94	—	—	40
90853	Group psychotherapy	$71.98	$71.98	—	—	61
90849	Multiple family group psytx	$71.64	$71.64	—	—	61
-	"CATHETER QUINTON 16.5",#####""	$69.64	$69.64	—	—	40
-	"MESH PRE SHAPED LARGE WITH KEYHOLE 2.4 X 5.4",#####""	$24.04	$24.04	—	—	40
90840	Psytx crisis ea addl 30 min	$7.56	$7.56	—	—	32
77280	Set radiation therapy field	—	—	—	—	57
77295	3-d radiotherapy plan	—	—	—	—	19
77300	Radiation therapy dose plan	—	—	—	—	69
77336	Radiation physics consult	—	—	—	—	69
77370	Radiation physics consult	—	—	—	—	61
77373	Sbrt delivery	—	—	—	—	9
77387	Guidance for radj tx dlvr	—	—	—	—	59
99281	ER VISIT E/M 1	—	—	—	—	28
99282	ER VISIT E/M 2	—	—	—	—	27
99283	ER VISIT E/M 3	—	—	—	—	23
99284	ER VISIT E/M 4	—	—	—	—	23
99285	ER VISIT E/M 5	—	—	—	—	23
99291	Critical care first hour	—	—	—	—	23
G0277	HYPERBARIC OXYGN THERAPY-30MIN	—	—	—	—	32
70030	X-ray eye for foreign body	—	—	—	—	82
70110	X-ray exam of jaw 4/> views	—	—	—	—	82
70140	X-ray exam of facial bones	—	—	—	—	82
70150	X-ray exam of facial bones	—	—	—	—	82
70160	X-ray exam of nasal bones	—	—	—	—	82
70200	X-ray exam of eye sockets	—	—	—	—	82
70220	X-ray exam of sinuses	—	—	—	—	82
70250	X-ray exam of skull	—	—	—	—	82
70260	X-ray exam of skull	—	—	—	—	82
70330	X-ray exam of jaw joints	—	—	—	—	82
70336	Magnetic image jaw joint	—	—	—	—	70
70360	X-ray exam of neck	—	—	—	—	82

Showing top 50 of 2,413 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.