Visits & medical services prices at Ascension St. Vincent's Southside

Jacksonville, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Aerosol inhalation pentamidine (94642) $205.35 $555 0.9×
Airway inhalation treatment (94640) $61.05 $165 0.3×
Airway resistance by oscillometry (94728) $332.54 $898.75 2.5×
Analyze neurostim simple (95971) $514.86 $1,391.50 5.2×
Appl on-body injector for timed subq injection (96377) $69.28 $187.25 1.4×
Assessment of aphasia (96105) $164.42 $444.38 1.7×
Behav assmt w/score & docd/stand instrument (96127) $62.81 $169.75 1.6×
Behavior id assessment by phys/qhp ea 15 min (97151) $68.17 $184.25 0.6×
Behavior id support assmt by 1 tech ea 15 min (97152) $68.17 $184.25 0.6×
Behavioral & qualit analysis voice and resonance (92524) $185.46 $501.25 1.7×
Bfb training 1st 15 min (90912) $79.46 $214.75 1.0×
Bfb training ea addl 15 min (90913) $79.46 $214.75 2.4×
Bioimpedance cv analysis (93701) $116.74 $315.50 0.8×
Car seat/bed testing w/interp & report 60 min (94780) $149.02 $402.75 3.8×
Cardiac stress test (93017) $1,382.69 $3,737 6.1×
Cardiopulmonary exercise testing (94621) $817.66 $2,209.88 2.1×
Cardioversion elective external (92960) $1,097.56 $2,966.38 1.6×
Carotid duplex scan; bilat (93880) $1,107.60 $2,993.50 4.4×
Carotid duplex scan; unil/limit (93882) $755.17 $2,041 6.9×
Chemo cns (intrathecal) w lp (96450) $920.93 $2,489 2.7×
Chemo hormon antineopl sq/im (96402) $207.94 $562 2.8×
Chemo inj via sq reservoir (96542) $207.94 $562 0.6×
Chemo intralesional 1-7 lesions (96405) $164.37 $444.25 2.2×
Chemo intralesional over 7 (96406) $499.50 $1,350 2.2×
Chemo IV infus each addl seq (96417) $483.59 $1,307 6.4×
Chemo IV infusion addl hr (96415) $349.19 $943.75 4.6×
Chemother prolong infuse w/pump (96416) $621.23 $1,679 1.8×
Chemother, IV infusion, 1 hr (96413) $977.91 $2,643 2.8×
Chemother, IV push,ea add drug (96411) $419.03 $1,132.50 5.6×
Chemother,non-hormone anti-neopl, sub-q/im (96401) $218.30 $590 2.9×
Chemotherapy admin intra-arterial push tq (96420) $841.57 $2,274.50 2.4×
Chemotherapy administration into pleural cavity, requiring and including thoracentesis UNSCHEDULED (96440) $316.54 $855.50 0.9×
Chemotherapy administration, intra-arterial; infusion technique, each additional hour (List separately in addition to… (96423) $66.42 $179.50 1.4×
Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours),… (96425) $535.76 $1,448 1.6×
Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour UNSCHEDULED (96422) $519.67 $1,404.50 1.5×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $419.03 $1,132.50 1.2×
Chemotherapy Unspecified (96549) $207.11 $559.75 4.2×
Chemotx admn pertl cavity implanted port/cath (96446) $421.43 $1,139 1.2×
Chron care mgmt srvc 20 min (99490) $134.31 $363 1.3×
Color/duplex Doppler, complete (93975) $826.30 $2,233.25 3.3×
Color/duplex Doppler, limited (93976) $902.89 $2,440.25 8.3×
Continuous inhalation tx, 1st hr (94644) $117.01 $316.25 0.8×
Cpap/bipap daily (94660) $340.22 $919.50 1.5×
Cpr (92950) $486 $1,313.50 2.2×
Cpt initial (94667) $95.83 $259 0.7×
Cpt subsequent (94668) $97.59 $263.75 0.7×
Critical care first hour (99291) $1,534.67 $4,147.75 1.8×
Developmental tst admin phys/qhp 1st hour (96112) $277.87 $751 2.1×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $291.75 $788.50 2.7×
Duplex a ivc il/bpg; compl (93978) $525.68 $1,420.75 2.1×
Duplex a ivc il/bpg; unil/lim (93979) $311.27 $841.28 2.9×
Duplex ext veins; bilat (93970) $1,088.26 $2,941.25 4.4×
Duplex hemodialysis access (93990) $663.78 $1,794 6.1×
Duplex le art/bpg; bilat (93925) $856 $2,313.50 3.4×
Duplex le art/bpg; unil/limit (93926) $527.25 $1,425 4.8×
Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study Age Under 21 (93981) $307.84 $832 2.8×
Duplex ue art/bpg; bilat (93930) $852.57 $2,304.25 3.4×
Duplex ue art/bpg; unil/limit (93931) $530.12 $1,432.75 4.9×
Duplex venous ext unilat/lmtd (93971) $691.07 $1,867.75 6.3×
ECG monit/reprt up to 48 hrs (93226) $114.70 $310 1.9×
ECG up to 48 hrs recording (93225) $428.74 $1,158.75 3.1×
Echo transesophageal (93312) $3,200.69 $8,650.50 5.6×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $3,220.20 $8,703.25 5.6×
EEG awake & asleep (95819) $559.72 $1,512.75 2.5×
EEG awake/drowsy (95816) $536.22 $1,449.25 2.4×
EEG cerebral death eval (95824) $289.25 $781.75 0.7×
EEG coma or sleep only (95822) $559.72 $1,512.75 2.5×
EEG cont rec w/video by tech min 8 channels (95700) $498.67 $1,347.75 2.2×
EEG extended monitoring 61-119 minutes (95813) $505.51 $1,366.25 2.2×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $763.31 $2,063 2.0×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $763.31 $2,063 2.0×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $763.31 $2,063 2.0×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $413.94 $1,118.75 1.8×
EEG w/o video by tech 2-12 hr unmonitored (95705) $413.94 $1,118.75 1.8×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $413.94 $1,118.75 1.8×
Eeg,Extended Monitoring,41-60 Minutes - Eeg (95812) $559.44 $1,512 2.5×
EKG rhythm strip (93041) $85.29 $230.50 1.4×
Elec alys implt npgt phys/qhp w/o programming (95970) $332.45 $898.50 2.4×
Electrocardiogram (93005) $112.94 $305.25 1.8×
Electrode stimulation brain (95961) $707.16 $1,911.25 0.8×
Emergency department visit high mdm (99285) $1,395.46 $3,771.50 2.2×
Emergency department visit low mdm (99283) $1,319.05 $3,565 4.6×
Emergency department visit may not req phys/qhp (99281) $211.73 $572.25 2.4×
Emergency department visit moderate mdm (99284) $1,327.56 $3,588 3.0×
Emergency department visit straightforward mdm (99282) $491.18 $1,327.50 3.1×
Endoscopy swallow (fees) vid (92612) $60.22 $162.75 0.3×
Ergonovine provocation test (93024) $623.82 $1,686 1.3×
Evaluate pt use of inhaler (94664) $132.37 $357.75 0.6×
Evaluate speech production (92522) $185.78 $502.12 1.7×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $62.07 $167.75 1.3×
Evaluation of speech fluency (92521) $211.50 $571.62 1.6×
Evoked auditory test limited (92587) $130.98 $354 0.6×
Exercise tst brncspsm (94617) $293.60 $793.50 2.1×
External ECG rec>48hr<7d recording (93242) $305.44 $825.50 7.8×
External ECG rec>7d<15d recording (93246) $280.46 $758 7.2×
Flow volume loop (94375) $174.64 $472 0.8×
Gait training 15 min (97116) $29.69 $80.25 1.0×
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $369.08 $997.50 1.6×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $197.21 $533 0.2×
Hast w/oxygen titrate (94453) $231.16 $624.75 1.7×
Hast w/report (94452) $236.80 $640 1.7×
Hemodialysis procedure w/ phys/qhp evaluation (90935) $181.58 $490.75 0.3×
Icd Ck W Reprog Mult (93284) $129.13 $349 3.3×
Icd device prog eval, 1 single (93282) $129.13 $349 3.3×
Icd device progr eval, dual (93283) $129.13 $349 3.3×
Im adm intransl/oral 1 vaccine (90473) $11.10 $30 0.1×
Immunization Admin (90471) $53.37 $144.25 0.7×
Inhlj brncl challenge tstg w/histam/methachol (95070) $550.01 $1,486.50 1.4×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) $66.60 $180 0.5×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $238 $643.25 4.9×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $257.24 $695.25 1.2×
Injections intra arterial (96373) $333.83 $902.25 1.5×
Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health… (93290) $106.01 $286.50 2.7×
Irrigaj implntd venous access drug delivery syst (96523) $118.86 $321.25 1.9×
IV hydration each add'l hr (96361) $78.44 $212 1.6×
IV infusion hydration initial 31 min-1 hour (96360) $602.18 $1,627.50 2.7×
IV infusion ther proph addl sequential to 1 hr (96367) $76.41 $206.50 1.0×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $754.71 $2,039.75 3.4×
IV tx, each additional hour (96366) $119.70 $323.50 2.4×
Low frequency non-thermal us (97610) $352.89 $953.75 1.7×
Lwr xtr vasc stdy bilat (93924) $436.74 $1,180.38 1.9×
Manual therapy ea 15 min (97140) $36.26 $98 1.3×
Massage therapy ea 15 mins (97124) $54.30 $146.75 1.8×
Maximum voluntary ventilation (94200) $93.98 $254 1.5×
Mechanical chest wall oscillation lung function (94669) $135.88 $367.25 0.6×
Methacholine challenge (94070) $946.55 $2,558.25 2.4×
Microvolt T-wave alternans for assessment of ventricular arrhythmias UNSCHEDULED (93025) $458.06 $1,238 3.4×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $132.18 $357.25 1.4×
Multiple sleep latency test (95805) $5,676.08 $15,340.75 6.3×
Neg pressure wound therapy non dme </= 50 sq cm (97607) $447.33 $1,209 1.1×
Neg pressure wound therapy non dme >50 sq cm (97608) $447.33 $1,209 1.1×
Negative pressure wound therapy dme </= 50 sq cm (97605) $283.33 $765.75 1.4×
Negative pressure wound therapy dme >50 sq cm (97606) $559.02 $1,510.88 1.3×
Neuromuscular junction test (95937) $482.39 $1,303.75 3.6×
Nitric oxide expired gas determination (95012) $62.90 $170 1.6×
Non-invasive physiologic study extremity 3 levels (93923) $515.50 $1,393.25 2.3×
Oral speech device eval (92597) $108.60 $293.50 1.5×
Osteopathic manip,3-4 body regn (98926) $22.20 $60 1.0×
Osteopathic manip,9-10 body regn (98929) $28.49 $77 1.3×
Osteopathic manipulative tx 1-2 body regions (98925) $19.98 $54 0.9×
Osteopathic manipulative tx 5-6 body regions (98927) $24.42 $66 1.1×
Osteopathic manipulative tx 7-8 body regions (98928) $26.27 $71 1.2×
Ot group therapy procedures (97150) $24.79 $67 1.4×
Ot mechanical traction (97012) $40.24 $108.75 2.8×
Ot Prosthetic Training, Each 15 Min (97761) $52.08 $140.75 1.3×
Ot wheelchair management (97542) $40.15 $108.50 1.3×
Oxygen uptake, expired gas analysis; rest, indirect (separate procedure) UNSCHEDULED (94690) $228.20 $616.75 3.7×
Paraffin bath therapy (97018) $7.31 $19.75 1.2×
Percutaneous tests w/allergenic extracts (95004) $127.19 $343.75 0.1×
Peritoneal Dialysis-Outpatient (90945) $670.63 $1,812.50 1.5×
Pharmacological or physical activation requiring physician or other qualified health care professional attendance… (95954) $1,303.05 $3,521.75 3.3×
Phlebotomy therapeutic (99195) $217.01 $586.50 1.6×
Pm device eval in person (93288) $129.13 $349 3.3×
Pm device progr eval multi (93281) $129.13 $349 3.3×
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $5,143 $13,900 5.7×
Polysom <6 yrs 4/> paramtrs (95782) $2,547.54 $6,885.25 2.8×
Polysom <6 yrs cpap/bilvl (95783) $2,739.48 $7,404 3.1×
Prgrmg dev eval pm/ldls pm (93279) $129.13 $349 3.3×
Program eval implantable in persn dual ld pacer (93280) $129.13 $349 3.3×
Psychiatric Diagnostic Evaluation (90791) $224.83 $607.65 1.2×
Pt Aquatic Therapy/Exercises (97113) $61.24 $165.50 1.7×
Pt Community/Work Reintegration Trainj Ea 15 Min (97537) $40.15 $108.50 1.3×
Pt Debridement Open Wound 20 Sq Cm< (97597) $153.09 $413.75 0.7×
Pt Electric Current Therapy (97033) $56.33 $152.25 3.0×
Pt Electrical Stimulation (97032) $46.62 $126 3.2×
Pt eval high complex 45 min (97163) $100.92 $272.75 1.0×
Pt eval low complex 20 min (97161) $100.92 $272.75 1.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $39.59 $107 1.2×
Pt Physical Performance Test (97750) $35.24 $95.25 1.0×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $100.92 $272.75 1.0×
Pt Whirlpool Therapy (97022) $49.21 $133 3.1×
Pt-focused hlth risk assmt score doc stnd instrm (96160) $15.54 $42 0.4×
Pulm funct tst plethysmograp (94726) $616.98 $1,667.50 1.6×
Pulmonary stress testing (94618) $335.50 $906.75 2.4×
Pulse oximetry continuous (94762) $118.22 $319.50 0.9×
Pure tone audiometry, air only (92552) $214.79 $580.50 1.5×
Refill/maint pump/resvr syst (96522) $499.50 $1,350 2.2×
Refill/maint, portable pump (96521) $499.50 $1,350 2.2×
Rem interrog pm/ldls pm/ids <90 d tech review (93296) $119.79 $323.75 3.1×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $66.23 $179 1.7×
Remote ther mntr tx mgmt phys/qhp 1st 20 min (98980) $9.62 $26 0.2×
Remote ther mntr tx mgmt phys/qhp ea addl 20 min (98981) $14.06 $38 0.3×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $228.85 $618.50 1.6×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95927) $971.44 $2,625.50 4.3×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95926) $947.48 $2,560.75 4.2×
Signal average EKG (93278) $91.58 $247.50 1.5×
Sleep study unattended (95806) $619.94 $1,675.50 2.7×
Slp evaloral pharyngeal swallow function (92610) $114.79 $310.25 1.4×
Speech sound lang comprehen (92523) $247.90 $670 1.1×
Spirometry (94010) $218.34 $590.12 1.0×
Spirometry with bronchodilator (94060) $473.83 $1,280.62 1.2×
Ssep upper limbs (95925) $940.63 $2,542.25 4.2×
St eval speech comm device 1st hr (92607) $156.23 $422.25 1.3×
Standardized cognitive performance testing (96125) $230.79 $623.75 2.2×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $69.28 $187.25 1.4×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $333.83 $902.25 1.5×
Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment… (96371) $109.89 $297 1.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $24.88 $67.25 1.1×
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $24.88 $67.25 1.2×
Therapeutic prophylactic/dx injection subq/im (96372) $130.24 $352 1.7×
Therapeutic sp device service (92609) $130.98 $354 1.3×
Tobacco use cessation intensive >10 minutes (99407) $56.98 $154 1.5×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $50.04 $135.25 1.3×
Treat swallowing dysfunction (92526) $73.45 $198.50 0.9×
Tstg ans funcj parasymp&symp w/5 min pasive tilt (95924) $158.82 $429.25 0.7×
Tte f-up or lmtd (93308) $404.46 $1,093.12 1.6×
Tte W/Doppler Complete - Tte Complete (93306) $2,144.15 $5,795 3.8×
Tte w/o doppler complete (93307) $1,194.18 $3,227.50 4.8×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $255.30 $690 3.4×
Tx speech language voice commj auditry 2/>indiv (92508) $23.77 $64.25 1.0×
Tympanometry (92567) $57.72 $156 1.5×
Ultrasound therapy ea 15 mins (97035) $44.68 $120.75 3.1×
Unlisted Ther Proph Dx Inj (96379) $69.28 $187.25 1.4×
Upr/l xtremity art 2 levels (93922) $437.99 $1,183.75 3.2×
Valvuloplasty pulmonary valve (92990) $31,082.78 $84,007.50 2.6×
Veeg by tech 2-12 hours unmonitored (95711) $413.94 $1,118.75 1.8×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $763.87 $2,064.50 2.0×
Veeg by tech 2-12 hr intermittent monitoring (95712) $1,511.45 $4,085 3.9×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $1,429.77 $3,864.25 1.6×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $1,511.45 $4,085 3.9×
Veeg by tech ea incr 12-26 hr unmonitored (95714) $763.31 $2,063 2.0×
Ventilator initial day (94002) $688.85 $1,861.75 1.1×
Ventilator subsequent day (94003) $461.21 $1,246.50 0.7×
Visual ep testing cns except glaucoma w/i&r (95930) $272.41 $736.25 1.2×
Vital capacity total (94150) $91.95 $248.50 0.7×
Wound care non-selective (97602) $230.70 $623.50 1.1×
Xtrnl pt activated ECG rec dwnld 30 days (93271) $55.59 $150.25 0.6×