Visits & medical services prices at Aspen Mountain Medical Center

Rock Springs, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Aerosol inhalation pentamidine (94642) $475.85
Airway inhalation treatment (94640) $182.90
Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) $77.10
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $77.10
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $77.10
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $77.10
Bipap initial day (94660) $274.80
Breath hydrogen/methane test (91065) $503.10
Breathing capacity test (94010) $311.90
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $409.80
Canalith repositioning (95992) $409.50
Chest physiotherapy initial (94667) $274.80
Color/duplex Doppler, complete (93975) $1,482.90
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $347.30
Debridement open wound 20 sq cm< (97597) $538.85
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $1,026.80
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $801.10
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $1,412.30
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $1,026.80
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $1,620.65
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $877.50
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $1,676.20
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $904.10
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $904.10
Echo transesophageal (93312) $3,085.08
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed,… (93307) $2,134.65
EKG 12 lead tracing only (93005) $275.50
Emergency department visit high mdm (99285) $2,136.95
Emergency department visit low mdm (99283) $780.25
Emergency department visit may not req phys/qhp (99281) $434.10
Emergency department visit moderate mdm (99284) $1,376.40
Emergency department visit straightforward mdm (99282) $578.80
Evaluate pt use of inhaler (94664) $137.40
Fluidotherapy (97022) $66.20
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $272.05
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $321.80
Interrog dev eval pm/ldls pm phys/qhp in person (93288) $358.85
IV infusion hydration each additional hour (96361) $142.40
IV infusion hydration initial 31 min-1 hour (96360) $140
IV infusion ther proph addl sequential to 1 hr (96367) $195.60
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $802.25
IV tx, each additional hour (96366) $142.40
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $138.30
Maximum voluntary ventilation (94200) $208.35
Mechanical traction therapy (97012) $66.20
Methacholine challenge (94070) $657.50
Multiple sleep latency (95805) $3,970.60
Needle measurement of electrical activity in muscles on both sides of body (95868) $684.10
Neg pressure wound therapy non dme >50 sq cm (97608) $699.20
Negative pressure wound therapy dme </= 50 sq cm (97605) $425.70
Negative pressure wound therapy dme >50 sq cm (97606) $538.85
Nerve conduction studies 11-12 studies (95912) $14.42
Nerve conduction studies 13/> studies (95913) $1,564.50
Nerve conduction studies 5-6 studies (95909) $822
Nerve conduction studies 7-8 studies (95910) $956.25
Nerve conduction studies 9-10 studies (95911) $1,192.50
Non-invasive physiologic study extremity 3 levels (93923) $772.85
Occupational therapy eval high complex 60 mins (97167) $277
Occupational therapy eval low complex 30 mins (97165) $277
Occupational therapy eval mod complex 45 mins (97166) $277
Orthc/prostc mgmt sbsq enc (97763) $66.35
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $99.65
Ot manual therapy ea 15 min (97140) $77.10
Ot neuromuscular re-education (97112) $99.95
Ot paraffin bath (97018) $66.20
Ot re-evaluation (97168) $216.75
OT Therapeutic Activities Charges (97530) $99.95
Ot wheelchair management (97542) $66.20
Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen extracted (94681) $874
Phlebotomy therapeutic (99195) $333.35
Physical therapy evaluation high complex 45 mins (97163) $277
Physical therapy evaluation low complex 20 mins (97161) $277
Physical therapy evaluation mod complex 30 mins (97162) $277
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $6,010.40
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $99.65
Pt gait training 15 min (97116) $89.15
Pt physical performance test (97750) $141.50
Pt re-evaluation (97164) $216.75
Pt Work Hardening/conditioningwork Reconditioning Initial Charge (97545) $277
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section… (95851) $81.90
Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side Other… (95852) $81.90
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $99.95
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95925) $1,019.85
Sleep study unattended (95806) $1,033.75
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $802.25
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $77.10
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $77.10
Therapeutic prophylactic/dx injection subq/im (96372) $210.70
Upr/l xtremity art 2 levels (93922) $850.25
Ventilation ip/obs initial day (94002) $1,227.30
Ventilator subsequent day (94003) $1,227.30
Vital capacity total (94150) $208.35
Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) (97546) $110.75
Wound(s) care non-selective (97602) $306.20