Benefis Community Care

Cash prices

1. Caregiver training, first 30 minutes

   CPT 97550

   Facility fee only
   $106
   US typical $101

   Doctor fees are billed separately.
2. Caregiver training in care strategies, each additional 15 min

   CPT 97551

   Facility fee only
   $48.60
   US typical $52.65

   Doctor fees are billed separately.
3. Tracheostomy speaking valve

   HCPCS L8501

   Facility fee only
   $167
   US typical $165

   Doctor fees are billed separately.
4. Caregiver training in a group

   CPT 97552

   Facility fee only
   $45
   US typical $38.12

   Doctor fees are billed separately.
5. Flexible lower back brace (L1-L5), off-the-shelf

   HCPCS L0625

   Facility fee only
   $96
   US typical $52.20

   Doctor fees are billed separately.
6. Sterile water or saline, per 500 mL

   HCPCS A4217

   Facility fee only
   $3
   US typical $10.78

   Doctor fees are billed separately.
7. Alginate wound dressing, over 16 to 48 sq in, each

   HCPCS A6197

   Facility fee only
   $5.40
   US typical $24.14

   Doctor fees are billed separately.
8. Foam wound dressing with adhesive border, 16 sq in or less, each

   HCPCS A6212

   Facility fee only
   $4.80
   US typical $8.80

   Doctor fees are billed separately.
9. Foam wound dressing, 16 sq in or less, no adhesive border, each

   HCPCS A6209

   Facility fee only
   $2.40
   US typical $12.03

   Doctor fees are billed separately.
10. Bordered foam wound dressing, 16-48 sq in, each

    HCPCS A6213

    Facility fee only
    $5.40
    US typical $17.28

    Doctor fees are billed separately.
11. Collagen wound dressing, 16 sq in or less

    HCPCS A6021

    Facility fee only
    $13.80
    US typical $26

    Doctor fees are billed separately.
12. Foley urinary catheter, two-way latex, coated, each

    HCPCS A4338

    Facility fee only
    $2.40
    US typical $14.76

    Doctor fees are billed separately.
13. Foley urinary catheter, two-way, all silicone, each

    HCPCS A4344

    Facility fee only
    $4.20
    US typical $22.96

    Doctor fees are billed separately.
14. Skin sealant, protectant, or moisturizer

    HCPCS A6250

    Facility fee only
    $16.20
    US typical $16.45

    Doctor fees are billed separately.
15. Specialty indwelling urinary catheter (e.g. coude), each

    HCPCS A4340

    Facility fee only
    $13.80
    US typical $27

    Doctor fees are billed separately.
16. Foley catheter insertion tray with drainage bag, 2-way latex

    HCPCS A4314

    Facility fee only
    $91.20
    US typical $36

    Doctor fees are billed separately.
17. Foam wound dressing, 16-48 sq in, no adhesive border, each

    HCPCS A6210

    Facility fee only
    $4.20
    US typical $23

    Doctor fees are billed separately.
18. Intermittent urinary catheter, straight tip, each

    HCPCS A4351

    Facility fee only
    $1.20
    US typical $5.60

    Doctor fees are billed separately.
19. Urine drainage bag, leg or belly, each

    HCPCS A4358

    Facility fee only
    $2.40
    US typical $10.23

    Doctor fees are billed separately.
20. Light compression bandage, 3 to under 5 inches wide, per yard

    HCPCS A6449

    Facility fee only
    $1.80
    US typical $4.35

    Doctor fees are billed separately.
21. Hydrocolloid wound dressing, no border, up to 16 sq in, each

    HCPCS A6234

    Facility fee only
    $2.40
    US typical $5.70

    Doctor fees are billed separately.
22. Medicated gauze dressing, 16–48 sq in, no adhesive border, each

    HCPCS A6223

    Facility fee only
    $1.20
    US typical $3

    Doctor fees are billed separately.
23. Hydrogel wound gel filler, per fluid ounce

    HCPCS A6248

    Facility fee only
    $2.40
    US typical $21.20

    Doctor fees are billed separately.
24. Collagen wound dressing, 16 to 48 sq in, each

    HCPCS A6022

    Facility fee only
    $11.40
    US typical $36.80

    Doctor fees are billed separately.
25. Zinc paste bandage, 3 to under 5 inches wide, per yard

    HCPCS A6456

    Facility fee only
    $6.60
    US typical $13.10

    Doctor fees are billed separately.
26. Drainable ostomy pouch for flange barrier (2-piece), each

    HCPCS A5063

    Facility fee only
    $28.20
    US typical $4.27

    Doctor fees are billed separately.
27. Tracheostomy inner cannula

    HCPCS A4623

    Facility fee only
    $13.80
    US typical $10

    Doctor fees are billed separately.
28. Self-adhesive elastic bandage, 3 to under 5 inches wide, per yard

    HCPCS A6454

    Facility fee only
    $2.40
    US typical $5.20

    Doctor fees are billed separately.
29. Ostomy belt, each

    HCPCS A4367

    Facility fee only
    $3.60
    US typical $7.80

    Doctor fees are billed separately.
30. Bedside urine drainage bag, each

    HCPCS A4357

    Facility fee only
    $24
    US typical $11.05

    Doctor fees are billed separately.
31. Transparent film dressing, 16 sq in or less, each

    HCPCS A6257

    Facility fee only
    $1.20
    US typical $2.89

    Doctor fees are billed separately.
32. Transparent film dressing, 16 to 48 sq in, each

    HCPCS A6258

    Facility fee only
    $2.40
    US typical $3

    Doctor fees are billed separately.
33. Ostomy skin barrier, solid, extended wear, without convexity, each

    HCPCS A4385

    Facility fee only
    $10.20
    US typical $7.26

    Doctor fees are billed separately.
34. Ostomy supply, miscellaneous

    HCPCS A4421

    Facility fee only
    $20.40
    US typical $6.73

    Doctor fees are billed separately.
35. Medicated gauze dressing, sterile, per yard

    HCPCS A6266

    Facility fee only
    $3
    US typical $6.60

    Doctor fees are billed separately.
36. Ostomy paste, pectin-based, per ounce

    HCPCS A4406

    Facility fee only
    $24
    US typical $6

    Doctor fees are billed separately.
37. Absorbent wound dressing, 16-48 sq in, no adhesive border, each

    HCPCS A6252

    Facility fee only
    $3.60
    US typical $7

    Doctor fees are billed separately.
38. Sterile gauze pad, 16 sq in or smaller, each

    HCPCS A6402

    Facility fee only
    $1.20
    US typical $1.35

    Doctor fees are billed separately.
39. Ostomy skin barrier, flat, extended wear, 4x4 in or smaller, each

    HCPCS A4409

    Facility fee only
    $68.40
    US typical $3

    Doctor fees are billed separately.
40. Male external catheter, disposable, each

    HCPCS A4349

    Facility fee only
    $3
    US typical $2.81

    Doctor fees are billed separately.
41. Two-piece urostomy pouch with flange and drain tap

    HCPCS A4432

    Facility fee only
    $75.60
    US typical $4

    Doctor fees are billed separately.
42. Waterproof tape, per 18 sq in

    HCPCS A4452

    Facility fee only
    $14.40
    US typical $3.04

    Doctor fees are billed separately.
43. Absorbent wound dressing, over 48 sq in, no adhesive border, each

    HCPCS A6253

    Facility fee only
    $1.20
    US typical $7.50

    Doctor fees are billed separately.
44. Ostomy skin barrier, extended wear, built-in convexity, 4x4 in or smaller

    HCPCS A4407

    Facility fee only
    $18.60
    US typical $5.85

    Doctor fees are billed separately.
45. Sterile wound packing strip, up to 2 in wide, per yard

    HCPCS A6407

    Facility fee only
    $3
    US typical $7

    Doctor fees are billed separately.
46. Ostomy skin barrier with flange, flat, 4x4 in or smaller

    HCPCS A4414

    Facility fee only
    $51.60
    US typical $4.39

    Doctor fees are billed separately.
47. Liquid adhesive, any type, per oz

    HCPCS A4364

    Facility fee only
    $4.80
    US typical $18.63

    Doctor fees are billed separately.
48. Hydrocolloid wound dressing, 16-48 sq in, no adhesive border

    HCPCS A6235

    Facility fee only
    $6.60
    US typical $17.66

    Doctor fees are billed separately.
49. Coude (curved) tip intermittent urinary catheter, each

    HCPCS A4352

    Facility fee only
    $18
    US typical $8.65

    Doctor fees are billed separately.
50. Ostomy skin barrier powder, per ounce

    HCPCS A4371

    Facility fee only
    $3.60
    US typical $4.28

    Doctor fees are billed separately.

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.