DORMINY MEDICAL CENTER

Legal name: HOSPITAL AUTHORITY OF BEN HILL

FITZGERALD, GA 317508857 (229) 424-7100 273R00000X

Published Procedure Prices

Procedure	CPT	Cash Price	Insurance Range
FINE NEEDLE ASPIRATION W/IMAGI	10005	$668	N/A
CT GUIDE ST DRAINAGE	10030	$703	N/A
I&D ABSCESS SIMPLE/SINGLE	10060	$83	N/A
I&D ABSCESS MULTI/COMPLIC	10061	$110	N/A
DRAIN PILONIDAL CYST SIMPLE	10080	$127	N/A
DRAIN PILONIDAL CYST COMPLEX	10081	$724	N/A
F.B. REM SUBCU SMP	10120	$168	N/A
F.B. REMOVAL SUBCUT CMPLX	10121	$150	N/A
HEMATOMA I&D	10140	$242	N/A
ASPIRATION/PUNC HEMATOMA/ABSCE	10160	$77	N/A
INCISION & DRAIN POSTOP WOUND	10180	$1,318	N/A
DEBRIDE INFECTED SKIN 10% BSA	11000	$210	N/A
DEBRIDE SKIN & SUBQ TISSU	11042	$128	N/A
DEBRIDE SKIN;SUBQ;MUSCLE	11043	$228	N/A
DEBRIDE SKIN;SUBQ;MUS;BON	11044	$331	N/A
DEBRIDE SUBQ EACH ADDT 20SQ CM	11045	$216	N/A
DEBRIDE MUSCLE/FASCIA ADD 20CM	11046	$228	N/A
DEBRIDE BONE EACH ADDT 20SQ CM	11047	$585	N/A
PARING SINGLE LESION	11055	$76	N/A
PARING 2-4 LESIONS	11056	$90	N/A
BX SKIN/SUBQ/MUCOUS 1 LES	11102	$66	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.