Visits & medical services prices at Advocate Good Samaritan Hospital
Downers Grove, IL · every code in this section with a posted price and a Medicare benchmark.
259 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Ablate Heart Dysrhythm Focus (93650) | $8,465 | $16,930 | 1.0× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $45 | $90 | 1.0× |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$187.50–$210 | $375–$420 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $60 | $120 | 4.2× |
| Application on-body injector (96377) | $90 | $180 | 1.8× |
| Arrhythmia Induction (93618) | $1,805 | $3,610 | 1.4× |
| Assessment of aphasia per hr (96105) range across 4 matching MRF lines |
$37.50–$342.50 | $75–$685 | varies |
| Behavral qualit analys voice (92524) range across 4 matching MRF lines |
$25–$405 | $50–$810 | varies |
| Biofeedback training any modality (90901) | $75 | $150 | 1.8× |
| Bioimpedance Cv Analysis (93701) | $185 | $370 | 1.3× |
| Bis Xtracell Fluid Analysis (93702) | $202.50 | $405 | 1.5× |
| Blink reflex test (95933) | $212.50 | $425 | 3.4× |
| Breath hydrogen/methane test (91065) | $420 | $840 | 1.8× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $525 | $1,050 | 1.3× |
| Bundle of his recording (93600) | $8,145 | $16,290 | 1.0× |
| Canalith repositioning proc (95992) | $115 | $230 | 2.8× |
| Cardiac Stress Tst,Tracing Only (93017) | $575 | $1,150 | 2.5× |
| Cardiopulmonary resuscitation (92950) | $975 | $1,950 | 4.2× |
| Cardioversion (92960) | $1,145 | $2,290 | 1.6× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $5,305 | $10,610 | 1.5× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $5,460 | $10,920 | 1.6× |
| Cbt 1st hour (94644) | $185 | $370 | 1.3× |
| Chemo Admin Peritoneal Cavity (96446) | $595 | $1,190 | 1.7× |
| Chemo Anti-Neopl Sq/Im (96401) | $260 | $520 | 3.4× |
| Chemo Hormon Antineopl Sq/Im (96402) | $220 | $440 | 2.9× |
| Chemo Ia Push (96420) | $495 | $990 | 1.4× |
| Chemo IV infusion addl hr (96415) | $332.50 | $665 | 4.3× |
| Chemo IV push addl drug (96411) | $400 | $800 | 5.2× |
| Chemother Prolong Infuse W/Pump (96416) | $665 | $1,330 | 1.9× |
| Chemotherapy Into Cns (96450) | $945 | $1,890 | 2.7× |
| Chemotherapy Unspecified (96549) | $150 | $300 | 3.0× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $332.50 | $665 | 4.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $665 | $1,330 | 1.9× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $535 | $1,070 | 1.5× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $470 | $940 | 1.3× |
| Chest Wall Manipulation (94668) | $115 | $230 | 0.8× |
| Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) | $1,135 | $2,270 | 2.8× |
| Color/duplex Doppler, complete (93975) | $1,000 | $2,000 | 3.9× |
| Color/duplex Doppler, limited (93976) | $670 | $1,340 | 6.0× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $85 | $170 | 2.7× |
| Continuous Pulse Ox (94762) | $282.50 | $565 | 2.0× |
| Coronary Art/Grft Angio S&I (93455) | $5,175 | $10,350 | 1.5× |
| Coronary Artery Angio S&I (93454) | $5,650 | $11,300 | 1.6× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$447.50–$570 | $895–$1,140 | varies |
| Cpt initial (94667) | $115 | $230 | 0.8× |
| Critical care first hour (99291) | $2,380 | $4,760 | 2.7× |
| Debridement Open Wound 20 Sq Cm< (97597) | $307.50 | $615 | 1.4× |
| Developmental tst admin phys/qhp 1st hour (96112) | $87.50 | $175 | 0.6× |
| Dialysis One Evaluation (90945) | $640 | $1,280 | 1.4× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $905 | $1,810 | 3.5× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) | $590 | $1,180 | 5.3× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $990 | $1,980 | 3.9× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $660 | $1,320 | 5.9× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $845 | $1,690 | 3.3× |
| Dup-scan xtr veins unilateral/limited study (93971) | $565 | $1,130 | 5.0× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $750 | $1,500 | 2.9× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $500 | $1,000 | 4.5× |
| Duplex Scan Hemodialysis Access (93990) | $605 | $1,210 | 5.4× |
| Duplex up extrem art bilat (93930) | $780 | $1,560 | 3.1× |
| Duplex up extrem art unilat/ltd (93931) | $520 | $1,040 | 4.6× |
| Echo Congenital Complete (93303) range across 3 matching MRF lines |
$935–$1,225 | $1,870–$2,450 | varies |
| Echo Heart Xthoracic,Limited (93308) range across 3 matching MRF lines |
$420–$470 | $840–$940 | varies |
| Echo transesophageal (93312) range across 2 matching MRF lines |
$1,215–$1,265 | $2,430–$2,530 | varies |
| Echo Transesophageal - Congenital Tee Complete (93315) | $1,090 | $2,180 | 1.9× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) range across 2 matching MRF lines |
$1,635–$1,685 | $3,270–$3,370 | varies |
| Eeg 41-60 Minutes (95812) | $795 | $1,590 | 3.4× |
| EEG awake and asleep (95819) | $905 | $1,810 | 3.9× |
| EEG awake drowsy (95816) | $835 | $1,670 | 3.6× |
| EEG cerebral death evaluation (95824) | $1,060 | $2,120 | 2.7× |
| EEG cont rec w/video by tech min 8 channels (95700) | $445 | $890 | 1.9× |
| EEG extended monitoring 61-119 minutes (95813) | $1,040 | $2,080 | 4.5× |
| Eeg Sleep Only (95822) | $795 | $1,590 | 3.4× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $442.50 | $885 | 1.9× |
| EEG w/o vid 2-12hr cont mntr (95707) | $442.50 | $885 | 1.9× |
| EEG w/o vid ea 12-26hr intmt (95709) | $885 | $1,770 | 2.2× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $885 | $1,770 | 2.2× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $442.50 | $885 | 1.9× |
| EEG wo vid ea 12-26hr unmntr (95708) | $885 | $1,770 | 2.2× |
| EKG signal averaged (93278) | $280 | $560 | 4.4× |
| Electrical Stimulation Ea 15 Min (97032) | $75 | $150 | 5.1× |
| Electrocardiogram Tracing (93005) | $232.50 | $465 | 3.7× |
| Electroconvulsive Therapy (90870) | $795 | $1,590 | 0.9× |
| Electrophysiology Evaluation (93642) | $2,620 | $5,240 | 2.0× |
| Emergency Dept Visit Level 2 (99282) | $267.50 | $535 | 1.6× |
| Emergency Dept Visit Level 3 (99283) | $580 | $1,160 | 2.0× |
| Emergency Dept Visit Level 4 (99284) | $1,255 | $2,510 | 2.8× |
| Emg 3 Extremities (95863) | $515 | $1,030 | 3.7× |
| Emg 4 Extremities (95864) | $590 | $1,180 | 4.3× |
| Endomyocardial Biopsy (93505) | $3,390 | $6,780 | 1.0× |
| Ep & ablate supravent arrhyt (93653) | $28,635 | $57,270 | 1.0× |
| Ep & ablate ventric tachy (93654) | $31,500 | $63,000 | 1.1× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $10,545 | $21,090 | 1.3× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) unusually low: confirm this is the full procedure |
$3,855 | $7,710 | 0.5× |
| Er level 1 (99281) range across 3 matching MRF lines |
$62.50–$195 | $125–$390 | varies |
| Er level v (99285) | $2,040 | $4,080 | 3.2× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) | $780 | $1,560 | 2.0× |
| Evaluate pt use of inhaler (94664) | $127.50 | $255 | 0.5× |
| Evaluate Speech Production (92522) range across 4 matching MRF lines |
$30–$262.50 | $60–$525 | varies |
| Evaluate Swallowing Function (92610) range across 4 matching MRF lines |
$30–$200 | $60–$400 | varies |
| Evaluation of speech fluency (92521) range across 4 matching MRF lines |
$42.50–$350 | $85–$700 | varies |
| Extracranial Bilat Study (93880) | $905 | $1,810 | 3.5× |
| Extracranial Uni/Ltd Study (93882) | $605 | $1,210 | 5.4× |
| F-up/limited tthrc echo congenital car anomaly (93304) range across 3 matching MRF lines |
$665–$795 | $1,330–$1,590 | varies |
| Flexible endoscopic eval swallow c/v rec (92612) | $457.50 | $915 | 2.3× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $780 | $1,560 | 0.8× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $6,920 | $13,840 | 2.0× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) range across 2 matching MRF lines |
$1,025–$1,590 | $2,050–$3,180 | varies |
| High altitude simulation test (94452) | $225 | $450 | 1.6× |
| High Altitude Simulatj W/Phys I&R W/O2 Titration (94453) | $262.50 | $525 | 1.8× |
| Icd Device Interrogate (93289) | $242.50 | $485 | 6.1× |
| Icd device progr eval dual (93283) | $315 | $630 | 7.9× |
| Icd Device Progr Eval Mult (93284) | $370 | $740 | 9.3× |
| Icm Device Eval (93290) | $120 | $240 | 3.0× |
| Ilr Device Interrogate (93291) | $152.50 | $305 | 4.9× |
| Immunization administration (90471) | $50 | $100 | 0.6× |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $560 | $1,120 | 1.4× |
| Insert/Place Heart Catheter (93503) | $1,390 | $2,780 | 0.8× |
| Interrogation vad in person (93750) | $185 | $370 | 1.8× |
| Intra-atrial pacing (93610) | $7,985 | $15,970 | 1.0× |
| Intra-atrial recording (93602) | $7,985 | $15,970 | 1.0× |
| Intracranial Complete Study (93886) | $950 | $1,900 | 3.7× |
| Intraventricular pacing (93612) | $7,985 | $15,970 | 1.0× |
| Iontophoresis 15 min (97033) | $72.50 | $145 | 3.8× |
| Irrig Drug Delivery Device (96523) | $125 | $250 | 2.0× |
| IV infusion hydration each additional hour (96361) | $117.50 | $235 | 2.3× |
| IV infusion hydration initial 31 min-1 hour (96360) | $355 | $710 | 1.6× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $157.50 | $315 | 2.0× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $157.50 | $315 | 3.1× |
| IV push initial (96374) | $320 | $640 | 1.4× |
| L Hrt Art/Grft Angio (93459) | $4,970 | $9,940 | 1.4× |
| Liver Elastography W/O Imag W/I&R (91200) | $427.50 | $855 | 3.1× |
| Low frequency non-thermal us (97610) | $137.50 | $275 | 0.6× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $740 | $1,480 | 3.2× |
| Mechanical chest wall oscillation per session (94669) | $187.50 | $375 | 0.8× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $47.50 | $95 | 1.5× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $55 | $110 | 1.5× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $20 | $40 | 1.2× |
| Methacholine challenge (94070) | $645 | $1,290 | 1.6× |
| Motion Fluoroscopy/Swallow (92611) range across 4 matching MRF lines |
$105–$327.50 | $210–$655 | varies |
| Multiple Sleep Latency Test (95805) | $2,430 | $4,860 | 2.6× |
| Muscle Test 2 Limbs (95861) | $447.50 | $895 | 3.1× |
| Muscle Test One Limb (95860) | $297.50 | $595 | 2.1× |
| Nasopharyngoscopy (92511) | $525 | $1,050 | 2.5× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $280 | $560 | 1.2× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $307.50 | $615 | 1.4× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $370 | $740 | 0.8× |
| Nerve Conduction Studies 1-2 Studies (95907) | $455 | $910 | 2.0× |
| Nerve Conduction Studies 11-12 Studies (95912) | $1,415 | $2,830 | 3.5× |
| Nerve conduction studies 13 or more studies (95913) | $1,630 | $3,260 | 4.1× |
| Nerve Conduction Studies 3-4 Studies (95908) | $680 | $1,360 | 2.9× |
| Nerve conduction studies 5-6 studies (95909) | $855 | $1,710 | 3.7× |
| Nerve conduction studies 7-8 studies (95910) | $1,030 | $2,060 | 2.6× |
| Nerve Conduction Studies 9-10 Studies (95911) | $1,230 | $2,460 | 3.1× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $287.50 | $575 | 2.1× |
| Neuromuscular Reeducation (97112) | $85 | $170 | 2.6× |
| Nitric oxide expired gas determination (95012) | $92.50 | $185 | 2.3× |
| Nonphysician Telephone Assessment 11-20 Min (98967) | $82.50 | $165 | 3.3× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $110 | $220 | 3.2× |
| Nonphysician Telephone Assessment 5-10 Min (98966) | $50 | $100 | 3.7× |
| Oral Function Therapy (92526) range across 4 matching MRF lines |
$40–$245 | $80–$490 | varies |
| Oral Speech Device Eval (92597) range across 3 matching MRF lines |
$45–$315 | $90–$630 | varies |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $90 | $180 | 1.8× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $100 | $200 | 2.2× |
| Ot eval high complexity (97167) range across 4 matching MRF lines |
$42.50–$230 | $85–$460 | varies |
| Ot Eval Low Complex (97165) range across 4 matching MRF lines |
$37.50–$222.50 | $75–$445 | varies |
| Ot Eval Moderate Complexity (97166) range across 4 matching MRF lines |
$40–$225 | $80–$450 | varies |
| Ot manual therapy 15 min (97140) | $85 | $170 | 3.1× |
| Ot paraffin bath (97018) | $65 | $130 | 10.8× |
| Ot Prosthetic Training, Each 15 Min (97761) | $85 | $170 | 2.1× |
| Ot Re-Eval Est Plan Care (97168) range across 4 matching MRF lines |
$30–$130 | $60–$260 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $240 | $480 | 1.7× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $220 | $440 | 1.6× |
| Oxygen Uptake Rest Indirect (94690) | $200 | $400 | 3.2× |
| Peripheral arterial disease rehab per session (93668) | $67.50 | $135 | 1.1× |
| Perq transcath closure pda (93582) | $17,610 | $35,220 | 0.9× |
| Perq Transcath Cls Aortic (93591) | $18,420 | $36,840 | 0.9× |
| Perq Transcath Cls Mitral (93590) | $18,420 | $36,840 | 0.9× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) range across 5 matching MRF lines |
$9,310–$9,465 | $18,620–$18,930 | varies |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) range across 10 matching MRF lines |
$10,410–$17,190 | $20,820–$34,380 | varies |
| Phlebotomy therapeutic (99195) | $207.50 | $415 | 1.5× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $150 | $300 | 2.4× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $137.50 | $275 | 2.2× |
| Plethysmography (94726) | $505 | $1,010 | 1.3× |
| Pm device eval in person (93288) | $160 | $320 | 4.0× |
| Pm device progr eval dual (93280) | $240 | $480 | 6.0× |
| Pm device progr eval multi (93281) | $280 | $560 | 7.0× |
| Pm Device Progr Eval Sngl (93279) | $205 | $410 | 5.1× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$2,105–$3,235 | $4,210–$6,470 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) range across 2 matching MRF lines |
$2,105–$3,235 | $4,210–$6,470 | varies |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) range across 2 matching MRF lines |
$2,105–$3,235 | $4,210–$6,470 | varies |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $260 | $520 | 6.5× |
| Prq Card Angio/Athrect 1 Art (92924) | $14,010 | $28,020 | 1.1× |
| Prq Card Stent W/Angio 1 Vsl (92928) range across 10 matching MRF lines |
$12,105–$16,805 | $24,210–$33,610 | varies |
| Prq Card Stent/Ath/Angio (92933) range across 10 matching MRF lines |
$13,410–$20,060 | $26,820–$40,120 | varies |
| Prq Revasc Byp Graft 1 Vsl (92937) range across 10 matching MRF lines |
$12,105–$14,010 | $24,210–$28,020 | varies |
| Psych diag eval w/med srvcs (90792) | $262.50 | $525 | 1.4× |
| Psychiatric diagnostic evaluation (90791) | $397.50 | $795 | 2.1× |
| Psytx Crisis Initial 60 Min (90839) | $295 | $590 | 1.6× |
| Pt Eval High Complex (97163) range across 4 matching MRF lines |
$42.50–$212.50 | $85–$425 | varies |
| Pt eval low complex 20 min (97161) range across 4 matching MRF lines |
$37.50–$207.50 | $75–$415 | varies |
| Pt Eval Mod Complex (97162) range across 4 matching MRF lines |
$40–$210 | $80–$420 | varies |
| Pt gait training 15 min (97116) | $85 | $170 | 2.9× |
| Pt mechanical traction (97012) | $60 | $120 | 4.2× |
| Pt Re-Eval Est Plan Care (97164) range across 4 matching MRF lines |
$30–$120 | $60–$240 | varies |
| Pulm function test by gas (94727) | $275 | $550 | 1.2× |
| Pulmonary Stress Testing (94618) | $247.50 | $495 | 1.7× |
| R Hrt Art/Grft Angio (93457) | $7,255 | $14,510 | 2.1× |
| R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) | $3,860 | $7,720 | 1.1× |
| R hrt coronary artery angio (93456) | $7,150 | $14,300 | 2.1× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $4,065 | $8,130 | 1.2× |
| Repet tms tx initial w/map/motr threshld/del&m (90867) | $595 | $1,190 | 2.6× |
| Repet Tms Tx Subseq Motr Threshld W/Deliv & Mngt (90869) | $595 | $1,190 | 2.6× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $177.50 | $355 | 2.8× |
| Right Heart Cath (93451) | $4,065 | $8,130 | 1.2× |
| Right ventricular recording (93603) | $1,385 | $2,770 | 1.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $235 | $470 | 1.1× |
| Self Care Mngment Training (97535) | $85 | $170 | 2.6× |
| Sensory Integration Ea 15 Min (97533) | $85 | $170 | 1.4× |
| Sleep study unattended (95806) | $495 | $990 | 2.1× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $495 | $990 | 2.1× |
| Somatosensory Testing (95938) | $1,255 | $2,510 | 1.4× |
| Speech sound lang comprehen (92523) range across 8 matching MRF lines |
$70–$525 | $140–$1,050 | varies |
| Spirometry (94010) | $307.50 | $615 | 1.3× |
| Standardized Cognitive Performance Testing (96125) range across 4 matching MRF lines |
$42.50–$332.50 | $85–$665 | varies |
| Surfactant Admin Thru Tube (94610) | $275 | $550 | 1.2× |
| Temp transcutaneous pacing (92953) | $960 | $1,920 | 1.4× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $90 | $180 | 4.0× |
| Ther Ivntj Ea Addl 15 Min (97130) | $90 | $180 | 4.3× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $100 | $200 | 2.7× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $30 | $60 | 1.0× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $155 | $310 | 2.0× |
| Ther/Proph/Diag Iv Inf Init (96365) | $395 | $790 | 1.7× |
| Therap repetitive tms tx subseq delivery & mng (90868) | $425 | $850 | 1.8× |
| Therapeutic Activities (97530) | $85 | $170 | 2.4× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,320 | $2,640 | 3.3× |
| Transcath Closure of Asd (93580) | $21,415 | $42,830 | 1.1× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $635 | $1,270 | 5.7× |
| Tte w/doppler, complete (93306) range across 3 matching MRF lines |
$1,075–$1,170 | $2,150–$2,340 | varies |
| Tte W/O Doppler Complete (93307) range across 3 matching MRF lines |
$665–$890 | $1,330–$1,780 | varies |
| Tx atrial fib pulm vein isol (93656) | $29,925 | $59,850 | 1.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 4 matching MRF lines |
$37.50–$220 | $75–$440 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $240 | $480 | 4.8× |
| Unlisted cardiovascular service/procedure (93799) range across 2 matching MRF lines |
$210–$620 | $420–$1,240 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $400 | $800 | 2.8× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $600 | $1,200 | 2.6× |
| Valvuloplasty aortic valve (92986) | $6,925 | $13,850 | 1.1× |
| Valvuloplasty mitral valve (92987) | $11,775 | $23,550 | 1.0× |
| Veeg 2-12 Hr Cont Mntr (95713) | $885 | $1,770 | 2.2× |
| Veeg 2-12 hr intmt mntr (95712) | $442.50 | $885 | 1.1× |
| Veeg 2-12 hr unmonitored (95711) | $442.50 | $885 | 1.9× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $885 | $1,770 | 2.2× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $885 | $1,770 | 2.2× |
| Veeg ea 12-26hr cont mntr (95716) | $1,545 | $3,090 | 1.7× |
| Vent Mgmt Inpat Init Day (94002) | $995 | $1,990 | 1.5× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $750 | $1,500 | 1.1× |
| Visual Evoked Potential Test (95930) | $497.50 | $995 | 2.2× |
| Vital capacity, total (94150) | $165 | $330 | 1.2× |
| Wheelchair Mgmt Ea 15 Min (97542) | $85 | $170 | 2.7× |
| Whirlpool Therapy (97022) | $70 | $140 | 4.5× |
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.