ATRIUM HEALTH FLOYD POLK MEDICAL CENTER Hospital

Legal name: POLK MEDICAL CENTER, INC

CEDARTOWN, GA 301256029 (770) 748-2500 275N00000X

Published Procedure Prices

Procedure	CPT	Cash Price	Insurance Range
HC NASH FIBROSURE PANEL	0003M	$573	N/A
TRGT GEN SEQ DNA 324 GENES	0037U	N/A	N/A
HC CT PERFUSION W/CONTRAST CBF	0042T	$1,842	N/A
Lab	0058T	N/A	N/A
US LEIOMYOMATA ABLATE <200	0071T	N/A	N/A
FCSD US ABLTJ LEIOMYOM>=200	0072T	N/A	N/A
GENOME RAPID SEQUENCE ALYS	0094U	N/A	N/A
Radiology	0126T	N/A	N/A
HC NFCT DS MCRB CLL FR DNA UNTRGT NEXT GENRJ SEQ	0152U	$4,677	N/A
ONC SLD TUM ALYS BRCA1 BRCA2	0172U	N/A	N/A
HC RESPIRATORY PANEL 2 PCR BIO	0202U	$333	N/A
NJX PARAVERT W/US CER/THOR	0213T	N/A	N/A
NJX PARAVERT W/US LUMB/SAC	0216T	N/A	N/A
Radiology	0228T	N/A	N/A
Radiology	0230T	N/A	N/A
TRGT GEN SEQ ALYS PNL 311+	0239U	N/A	N/A
HC INFCT DIS VIR RESP RNA SARS-COV-2, FLU A-B	0240U	$191	N/A
HC SARS-COV-2 FLU AB RSV CEPHEID	0241U	$191	N/A
IM B1 MRW CEL THER CMPL	0263T	N/A	N/A
IM B1 MRW CEL THER XCL HRVST	0264T	N/A	N/A
IM B1 MRW CEL THER HRVST ONL	0265T	N/A	N/A
PRQ LAMOT/LAM DCMPR CRV/THRC	0274T	N/A	N/A
Radiology	0275T	N/A	N/A
HC VERSITI RED CELL GENOTYPING PANEL	0282U	$1,505	N/A
Tear film imaging, unilateral or bilateral, with interpretation and report	0330T	N/A	N/A
TRNSCTH RENAL SYMP DENRV UNL	0338T	N/A	N/A
TRNSCTH RENAL SYMP DENRV BIL	0339T	N/A	N/A
Radiology	0340T	N/A	N/A
ONC PAN CA ALYS MRD PLASMA	0340U	N/A	N/A
PSYC GENOM ALYS PNL 15 GEN	0345U	N/A	N/A

Prices shown are published rates from hospital chargemaster files and insurer rate data. Your actual cost depends on your insurance plan, deductible status, and services rendered.