Visits & medical services prices at Adena Pike Medical Center

Waverly, OH · every code in this section with a posted price and a Medicare benchmark.

235 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $15,439.53 $30,879.05 2.1×
Admn Sarscov2 Vacc 1 Dose (90480) $76.30 $152.59 2.0×
Aep threshold estimation mlt frequencies i&r (92652) $518.85 $1,037.70 2.5×
Airway Inhalation Treatment (94640)
range across 6 matching MRF lines
$113.32–$355.94 $226.63–$711.87 varies
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $397.14 $794.28 3.2×
Analyze neurostim complex (95972) $63.28 $126.55 0.7×
Analyze Neurostim Simple (95971) $168.67 $337.33 1.9×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $44.63 $89.26 3.1×
Application Modality 1/> Areas Infrared (97026) $26.58 $53.15 4.0×
Application on-body injector (96377) $115.83 $231.65 2.6×
Assessment of aphasia per hr (96105) $285.84 $571.68 2.9×
Audiometry Air & Bone (92553) $281.07 $562.14 2.3×
Basic vestibular evaluation (92540) $317.53 $635.05 1.6×
Behavral qualit analys voice (92524) $502.60 $1,005.20 4.6×
Breath hydrogen/methane test (91065) $1,130.61 $2,261.22 5.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $572.20 $1,144.40 1.6×
Caloric vestibular test w/rec bi monothermal (92538) $400.41 $800.81 2.0×
Caloric Vstblr Test W/Rec (92537) $882.88 $1,765.75 7.3×
Canalith repositioning proc (95992) $32.89 $65.78 0.8×
Car seat/bed test 60 min (94780) $153.01 $306.02 4.3×
Cardiac Stress Tst,Tracing Only (93017) $851.14 $1,702.27 4.2×
Cardiopulmonary resuscitation (92950) $790.57 $1,581.13 3.9×
Cardioversion (92960) $1,829.29 $3,658.57 2.9×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $120.08 $240.15 4.6×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $13,283.24 $26,566.47 4.3×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $12,523.50 $25,047 4.1×
Cbt 1st hour (94644) $371.49 $742.98 3.0×
Chemo Anti-Neopl Sq/Im (96401) $178.52 $357.04 2.6×
Chemo Hormon Antineopl Sq/Im (96402) $178.52 $357.04 2.6×
Chemo IV infusion addl hr (96415) $154.35 $308.70 2.3×
Chemo IV push addl drug (96411) $354.91 $709.82 5.2×
Chemother Prolong Infuse W/Pump (96416) $700.29 $1,400.57 2.2×
Chemotherapy Into Cns (96450) $459.71 $919.41 1.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $235.90 $471.79 3.5×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $609.49 $1,218.97 2.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $609.49 $1,218.97 2.0×
Chest Wall Manipulation (94668) $236.86 $473.71 1.9×
Color/duplex Doppler, complete (93975) $1,079.72 $2,159.43 4.8×
Color/duplex Doppler, limited (93976) $1,157.25 $2,314.50 11.7×
Community/Work Reintegration Trainj Ea 15 Min (97537) $97.51 $195.02 3.0×
Comprehensive Hearing Test (92557) $281.07 $562.14 2.3×
Conditioning Play Audiometry (92582) $281.07 $562.14 2.3×
Continuous Pulse Ox (94762) $287.50 $574.99 2.4×
Coronary Art/Grft Angio S&I (93455) $9,715.11 $19,430.21 3.2×
Coronary Artery Angio S&I (93454) $8,073.43 $16,146.86 2.6×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $355.94 $711.87 1.7×
Cpt initial (94667) $236.86 $473.71 1.9×
Critical care first hour (99291) $1,548.30 $3,096.60 2.0×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines
$143.75–$365.11 $287.50–$730.22 varies
Dialysis One Evaluation (90945) $1,378.17 $2,756.33 3.5×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $544.95 $1,089.90 1.5×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $684.52 $1,369.04 3.0×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $238.40 $476.79 2.4×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,079.72 $2,159.43 4.8×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $684.52 $1,369.04 6.9×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,079.72 $2,159.43 4.8×
Dup-scan xtr veins unilateral/limited study (93971) $684.52 $1,369.04 6.9×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $510.85 $1,021.70 2.3×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $624.25 $1,248.50 6.3×
Duplex Scan Hemodialysis Access (93990) $376.14 $752.27 3.8×
Duplex up extrem art bilat (93930) $1,079.72 $2,159.43 4.8×
Duplex up extrem art unilat/ltd (93931) $684.52 $1,369.04 6.9×
Echo Congenital Complete (93303) $940.39 $1,880.77 1.8×
Echo Heart Xthoracic,Limited (93308) $467.55 $935.09 2.1×
Echo transesophageal (93312) $1,825.51 $3,651.01 3.5×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,172.65 $2,345.30 2.3×
EEG awake and asleep (95819) $572.20 $1,144.40 2.8×
EEG awake drowsy (95816) $806.63 $1,613.25 3.9×
EEG extended monitoring 61-119 minutes (95813) $547.24 $1,094.47 2.7×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $600.73 $1,201.45 2.9×
EEG w/o vid ea 12-26hr intmt (95709) $1,152.56 $2,305.12 3.3×
Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) $1,152.56 $2,305.12 3.3×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $600.73 $1,201.45 2.9×
EEG wo vid ea 12-26hr unmntr (95708) $1,152.56 $2,305.12 3.3×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $202.21 $404.41 2.2×
Electrical Stimulation Ea 15 Min (97032) $68.02 $136.03 4.6×
Electrocardiogram Tracing (93005) $161.53 $323.05 2.9×
Emergency Dept Visit Level 2 (99282) $290.99 $581.97 2.0×
Emergency Dept Visit Level 3 (99283) $570.84 $1,141.67 2.2×
Emergency Dept Visit Level 4 (99284) $930.73 $1,861.45 2.4×
Ep & ablate supravent arrhyt (93653) $19,939.20 $39,878.39 0.8×
Ep & ablate ventric tachy (93654) $17,318.59 $34,637.17 0.7×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $17,738.60 $35,477.20 2.4×
Er level 1 (99281) $178.39 $356.78 2.2×
Er level v (99285) $1,126.57 $2,253.14 2.0×
Esophageal Capsule Endoscopy (91111) $1,813.62 $3,627.23 2.1×
Esophgl Balo Distension Dx Std W/Provocation (91040) $1,333.17 $2,666.34 3.8×
Evaluate Speech Production (92522) $502.60 $1,005.20 4.5×
Evaluate Swallowing Function (92610) $287.96 $575.91 3.4×
Evaluation of speech fluency (92521) $502.60 $1,005.20 3.8×
Exhaled Air Analysis O2 (94680) $92.19 $184.38 0.8×
External Ecg Scanning Analysis Report (93226) $345.34 $690.68 6.2×
Extracranial Bilat Study (93880) $590.32 $1,180.64 2.6×
Extracranial Uni/Ltd Study (93882) $590.32 $1,180.64 6.0×
F-up/limited tthrc echo congenital car anomaly (93304) $277.35 $554.70 0.5×
Flexible endoscopic eval swallow c/v rec (92612) $330.88 $661.76 1.7×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $2,903.81 $5,807.61 8.2×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $621.39 $1,242.78 3.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,596.85 $3,193.69 2.0×
Gi tract capsule endoscopy (91110) $3,073.79 $6,147.58 3.6×
Gi wireless capsule measure (91112) $4,264.40 $8,528.80 5.0×
Group Therapeutic Procedures (97150) $62.76 $125.52 3.5×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $12,864.58 $25,729.16 4.2×
Holter monitor recording (93225) $345.34 $690.68 2.7×
Icd Device Interrogate (93289) $212.28 $424.55 6.0×
Immunization administration (90471) $130.78 $261.56 1.9×
Insert/Place Heart Catheter (93503) $2,854.45 $5,708.89 1.9×
Iontophoresis 15 min (97033) $98.82 $197.64 5.2×
Irrig Drug Delivery Device (96523) $109.15 $218.30 2.0×
IV infusion hydration each additional hour (96361) $96.47 $192.94 2.2×
IV infusion hydration initial 31 min-1 hour (96360) $413.44 $826.88 2.1×
IV infusion ther proph addl sequential to 1 hr (96367) $130.78 $261.56 1.9×
IV infusion therapy prophylaxis/dx ea hour (96366) $99.23 $198.45 2.2×
IV push initial (96374) $387.15 $774.29 1.9×
L Hrt Art/Grft Angio (93459) $13,612.64 $27,225.28 4.4×
Liver Elastography W/O Imag W/I&R (91200) $287.16 $574.31 2.4×
Low frequency non-thermal us (97610) $350.51 $701.01 1.8×
Mechanical chest wall oscillation per session (94669) $373.73 $747.46 1.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $76.11 $152.21 2.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $93.12 $186.24 2.5×
Methacholine challenge (94070) $1,070.44 $2,140.87 3.0×
Motility study esophagus (91010) $1,455.41 $2,910.81 4.1×
Motion Fluoroscopy/Swallow (92611) $301.78 $603.55 3.3×
Multiple Sleep Latency Test (95805) $2,697.88 $5,395.76 3.3×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $734.14 $1,468.28 1.9×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $1,018.90 $2,037.79 2.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $365.11 $730.22 1.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $734.14 $1,468.28 1.9×
Neuromuscular Reeducation (97112) $121.14 $242.28 3.7×
Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) $118.83 $237.65 0.9×
Oral Function Therapy (92526) $314.54 $629.07 3.7×
Oral Speech Device Eval (92597) $353.85 $707.70 5.0×
Orthc/Prostc Mgmt Sbsq Enc (97763) $72.99 $145.97 1.5×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $121.14 $242.28 2.6×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $44.28 $88.55 2.2×
Osteopathic manipulative tx 3-4 body regions (98926) $52.90 $105.80 2.6×
Osteopathic manipulative tx 5-6 body regions (98927) $69.58 $139.15 3.4×
Osteopathic manipulative tx 7-8 body regions (98928) $88.75 $177.50 4.3×
Osteopathic manipulative tx 9-10 body regions (98929) $106.87 $213.73 5.2×
Ot Contrast Bath Ea 15 Min (97034) $52.61 $105.22 3.7×
Ot eval high complexity (97167) $261.85 $523.69 2.6×
Ot Eval Low Complex (97165) $234.28 $468.56 2.3×
Ot Eval Moderate Complexity (97166) $248.07 $496.13 2.5×
Ot manual therapy 15 min (97140) $107.32 $214.64 3.9×
Ot paraffin bath (97018) $31.89 $63.78 5.3×
Ot Prosthetic Training, Each 15 Min (97761) $119.01 $238.01 2.9×
Ot Re-Eval Est Plan Care (97168) $155.86 $311.71 2.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $231.36 $462.72 1.9×
Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930) $32,775.21 $65,550.42 1.9×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $11,556.54 $23,113.08 2.1×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $42,991.73 $85,983.45 3.9×
Phlebotomy therapeutic (99195) $236.86 $473.71 1.9×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $109.15 $218.30 2.0×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $109.15 $218.30 2.0×
Physical Performance Test (97750) $108.39 $216.78 3.2×
Plethysmography (94726) $870.05 $1,740.09 2.5×
Pm device eval in person (93288) $171.07 $342.14 4.8×
Pm Device Progr Eval Sngl (93279) $87.14 $174.27 2.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,697.88 $5,395.76 3.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $84.78 $169.56 1.9×
Prq Card Stent W/Angio 1 Vsl (92928) $31,434.12 $62,868.24 2.9×
Prq Card Stent/Ath/Angio (92933) $42,991.73 $85,983.45 2.5×
Prq Revasc Byp Graft 1 Vsl (92937) $42,991.73 $85,983.45 3.9×
Prq trl rvs ch occ ant&rtrgr (92945) $20,639.91 $41,279.81 1.9×
Pt Eval High Complex (97163) $261.85 $523.69 2.7×
Pt eval low complex 20 min (97161) $220.50 $441 2.3×
Pt Eval Mod Complex (97162) $234.28 $468.56 2.4×
Pt gait training 15 min (97116) $102.02 $204.03 3.5×
Pt group caregiver training (97552) $62.76 $125.52 2.8×
Pt mechanical traction (97012) $62.70 $125.40 4.4×
Pt Re-Eval Est Plan Care (97164) $116.67 $233.33 1.7×
Pulm function test by gas (94727) $408.15 $816.29 2.0×
Pulmonary service/procedure (94799)
range across 2 matching MRF lines
$152.40–$287.50 $304.79–$574.99 varies
Pulmonary Stress Testing (94618) $365.37 $730.73 2.9×
Pure Tone Audiometry Air (92552) $225.58 $451.15 1.8×
R Hrt Art/Grft Angio (93457) $13,186.55 $26,373.09 4.3×
R hrt coronary artery angio (93456) $8,984.07 $17,968.13 2.9×
R&L Hrt Cath W/Ventriclgrphy (93453) $7,455.35 $14,910.70 2.4×
Remote 30 Day Ecg Rev/Report (93270) $345.34 $690.68 9.8×
Remote 30 Day Ecg Tech Supp (93229) $165.50 $330.99 0.5×
Respiratory flow volume loop (94375) $572.20 $1,144.40 2.8×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $31.69 $63.37 0.6×
Right Heart Cath (93451) $6,721.85 $13,443.69 2.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 3 matching MRF lines
$158.49–$365.11 $316.97–$730.22 varies
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $307.34 $614.67 2.5×
Select picture audiometry (92583) $103.95 $207.90 1.9×
Self Care Mngment Training (97535) $120.08 $240.15 3.7×
Sensory Integration Ea 15 Min (97533) $102.02 $204.03 1.7×
Sleep study attended (95807) $1,650.19 $3,300.37 4.7×
Sleep study unattended (95806) $1,497.17 $2,994.33 7.3×
Slp caregiver training 1st 30 min (97550) $120.08 $240.15 2.3×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $287.50 $574.99 1.4×
Speech Audiometry Complete (92556) $103.95 $207.90 1.9×
Speech audiometry threshold (92555) $103.95 $207.90 1.9×
Speech sound lang comprehen (92523) $502.60 $1,005.20 2.2×
Spirometry (94010) $365.37 $730.73 1.8×
Standardized Cognitive Performance Testing (96125) $310.28 $620.55 3.0×
Stenger Test Speech (92577) $928.55 $1,857.10 2.6×
Stenger Test, Pure Tone (92565) $103.95 $207.90 1.9×
Stress Tte Only (93350) $1,080.65 $2,161.29 2.1×
Surfactant Admin Thru Tube (94610) $113.32 $226.63 0.5×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $96.70 $193.40 4.3×
Ther Ivntj Ea Addl 15 Min (97130) $98.99 $197.97 4.7×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $79.16 $158.31 2.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $92.46 $184.91 3.1×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $155.97 $311.94 1.5×
Ther/Prop/Diag Inj/Inf Proc (96379) $81.76 $163.51 1.8×
Ther/Proph/Diag Inj Ia (96373) $200.28 $400.55 1.0×
Ther/Proph/Diag Inj Sc/Im (96372) $130.78 $261.56 1.9×
Ther/Proph/Diag Iv Inf Init (96365) $421.71 $843.41 2.1×
Therapeutic Activities (97530) $122.20 $244.40 3.5×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $1,714.98 $3,429.96 4.9×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $54.74 $109.48 1.5×
Transcath Closure of Asd (93580) $39,519.92 $79,039.84 2.3×
Tte w/doppler, complete (93306) $1,911.58 $3,823.16 3.7×
Tte W/O Doppler Complete (93307) $410.74 $821.48 1.8×
Tx atrial fib pulm vein isol (93656) $19,939.20 $39,878.39 0.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $218.89 $437.78 2.9×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $102.02 $204.03 4.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $166.96 $333.92 3.8×
Tympanometry (92567) $100.74 $201.47 2.9×
Unlisted cardiovascular service/procedure (93799)
range across 9 matching MRF lines
$5,715.05–$30,699.69 $11,430.10–$61,399.37 varies
Unlisted Diagnostic Gastroenterology Procedure (91299) $426.98 $853.95 3.5×
Upr/L Xtremity Art 2 Levels (93922) $485.63 $971.25 3.9×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $485.63 $971.25 2.4×
Vasopneumatic device (97016) $62.70 $125.40 5.2×
Veeg Ea 12-26 Hr Unmntr (95714) $1,152.56 $2,305.12 3.3×
Vent Mgmt Inpat Init Day (94002) $1,214.77 $2,429.54 2.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,214.77 $2,429.54 2.1×
Visual Field Exam Extended (92083) $236.86 $473.71 1.9×
Visual reinforcement audiometry (vra) (92579) $281.07 $562.14 1.4×
Vital capacity, total (94150) $287.50 $574.99 2.4×
Wheelchair Mgmt Ea 15 Min (97542) $73.32 $146.64 2.4×
Whirlpool Therapy (97022) $70.14 $140.27 4.5×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $131.68 $263.36 2.4×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.