Visits & medical services prices at Bitterroot Health - Daly Hospital
Hamilton, MT · every code in this section with a posted price and a Medicare benchmark.
230 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 1St psychiatric collab care mgmt 1st 70 mins (99492) | $406 | $406 | 3.9× |
| Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) | $138 | $138 | 4.7× |
| Admn Sarscov2 Vacc 1 Dose (90480) range across 3 matching MRF lines |
$21.32–$104 | $21.32–$104 | varies |
| Advncd Care Plan 30 Min (99497) | $246 | $246 | 2.4× |
| Airway Inhalation Treatment (94640) range across 9 matching MRF lines |
$53–$610 | $53–$610 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) range across 2 matching MRF lines |
$57.01–$451 | $57.01–$451 | varies |
| Analyze neurostim complex (95972) | $170 | $170 | 1.8× |
| Analyze neurostim no prog (95970) | $56 | $56 | 0.4× |
| Analyze Neurostim Simple (95971) | $143 | $143 | 1.5× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $14 | $14 | 1.0× |
| Application Modality 1/> Areas Infrared (97026) | $23 | $23 | 3.4× |
| Application on-body injector (96377) | $138 | $138 | 2.9× |
| Assessment of aphasia per hr (96105) | $305 | $305 | 3.1× |
| Behavral qualit analys voice (92524) | $347 | $347 | 3.2× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $126 | $126 | 1.5× |
| Bfb training ea addl 15 min (90913) | $71 | $71 | 2.2× |
| Breath hydrogen/methane test (91065) | $196 | $196 | 0.9× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 6 matching MRF lines |
$117–$996 | $117–$996 | varies |
| Canalith repositioning proc (95992) | $127 | $127 | 3.1× |
| Car seat/bed test 60 min (94780) | $126 | $126 | 3.3× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,090 | $1,090 | 4.9× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$879–$961 | $879–$961 | varies |
| Cardioversion (92960) range across 4 matching MRF lines |
$459–$2,463 | $459–$2,463 | varies |
| Care mgmt services behavioral hlth cond 20 mins (99484) | $148 | $148 | 3.9× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) range across 6 matching MRF lines |
$75–$83 | $75–$83 | varies |
| Cbt 1st hour (94644) | $387 | $387 | 2.8× |
| Chemo Anti-Neopl Sq/Im (96401) | $178 | $178 | 2.4× |
| Chemo Hormon Antineopl Sq/Im (96402) range across 2 matching MRF lines |
$108–$178 | $108–$178 | varies |
| Chemo Ia Push (96420) | $829 | $829 | 2.5× |
| Chemo intralesional up to 7 (96405) | $178 | $178 | 2.4× |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$142–$178 | $142–$178 | varies |
| Chemo IV push addl drug (96411) | $178 | $178 | 2.4× |
| Chemother Prolong Infuse W/Pump (96416) | $829 | $829 | 2.5× |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) | $829 | $829 | 2.5× |
| Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) | $115 | $115 | 2.4× |
| Chemotherapy Unspecified (96549) | $115 | $115 | 2.4× |
| Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) | $829 | $829 | 2.5× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $178 | $178 | 2.4× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$663–$829 | $663–$829 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $829 | $829 | 2.5× |
| Chest Wall Manipulation (94668) | $387 | $387 | 2.8× |
| Chiropract manj 3-4 regions (98941) | $119 | $119 | 5.4× |
| Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) | $82 | $82 | 3.7× |
| Chiropractic manipulative treatment (CMT); spinal, 5 regions Facility (98942) | $154 | $154 | 7.0× |
| Chron Care Mgmt Srvc 20 Min (99490) | $169 | $169 | 1.6× |
| Cmptr ophth dx img ant segmt (92132) | $89 | $89 | 1.5× |
| Color/duplex Doppler, complete (93975) range across 3 matching MRF lines |
$783–$846 | $783–$846 | varies |
| Color/duplex Doppler, limited (93976) | $372 | $372 | 3.5× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $96 | $96 | 3.0× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $368 | $368 | 2.0× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) range across 3 matching MRF lines |
$92–$1,015 | $92–$1,015 | varies |
| Computerized Ophthalmic Imaging Retina (92134) | $97 | $97 | 1.6× |
| Continuous Pulse Ox (94762) range across 4 matching MRF lines |
$74–$508 | $74–$508 | varies |
| Corneal Topography (92025) | $109 | $109 | 1.8× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 4 matching MRF lines |
$190–$610 | $190–$610 | varies |
| Cpt initial (94667) | $387 | $387 | 2.8× |
| Critical care first hour (99291) range across 5 matching MRF lines |
$743–$5,766 | $743–$5,766 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 9 matching MRF lines |
$271–$646 | $271–$646 | varies |
| Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) | $811 | $811 | 4.0× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $372 | $372 | 3.5× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) | $351 | $351 | 3.3× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $846 | $846 | 3.5× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 4 matching MRF lines |
$372–$546 | $372–$546 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 4 matching MRF lines |
$846–$1,632 | $846–$1,632 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 5 matching MRF lines |
$71–$792 | $71–$792 | varies |
| Duplex up extrem art bilat (93930) | $1,632 | $1,632 | 6.7× |
| Duplex up extrem art unilat/ltd (93931) range across 2 matching MRF lines |
$372–$718 | $372–$718 | varies |
| ECG/monitoring and analysis (93271) | $321 | $321 | 3.3× |
| Echo Heart Xthoracic,Limited (93308) range across 6 matching MRF lines |
$74–$846 | $74–$846 | varies |
| Eeg 41-60 Minutes (95812) | $1,012 | $1,012 | 4.6× |
| EEG awake and asleep (95819) | $1,012 | $1,012 | 4.6× |
| EEG awake drowsy (95816) range across 2 matching MRF lines |
$1,012–$1,165 | $1,012–$1,165 | varies |
| EEG extended monitoring 61-119 minutes (95813) | $1,012 | $1,012 | 4.6× |
| Elec alys implt brn npgt prgrmg 1st 15 min (95983) | $144 | $144 | 1.5× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $113 | $113 | 3.0× |
| Electrical Stimulation Ea 15 Min (97032) | $48 | $48 | 3.3× |
| Electrocardiogram Tracing (93005) | $216 | $216 | 3.6× |
| Emergency Dept Visit Level 2 (99282) range across 5 matching MRF lines |
$113–$461 | $113–$461 | varies |
| Emergency Dept Visit Level 3 (99283) range across 4 matching MRF lines |
$191–$632 | $191–$632 | varies |
| Emergency Dept Visit Level 4 (99284) range across 4 matching MRF lines |
$325–$1,444 | $325–$1,444 | varies |
| Er level 1 (99281) range across 4 matching MRF lines |
$31–$308 | $31–$308 | varies |
| Er level v (99285) range across 4 matching MRF lines |
$472–$3,256 | $472–$3,256 | varies |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $352 | $352 | 2.7× |
| Evaluate pt use of inhaler (94664) range across 3 matching MRF lines |
$46–$610 | $46–$610 | varies |
| Evaluate Speech Production (92522) | $353 | $353 | 3.2× |
| Evaluate Swallowing Function (92610) | $271 | $271 | 3.2× |
| Evaluation of speech fluency (92521) | $425 | $425 | 3.2× |
| Excimer laser tx psoriasis 250-500 sq cm (96921) | $227 | $227 | 1.1× |
| Excimer laser tx psoriasis >500 sq cm (96922) | $363 | $363 | 0.9× |
| Excimer laser tx psoriasis tot area <250 sq cm (96920) | $202 | $202 | 1.0× |
| External ECG rec>48hr<7d recording (93242) range across 3 matching MRF lines |
$137–$143 | $137–$143 | varies |
| External ECG rec>7d<15d recording (93246) | $137 | $137 | 3.6× |
| External Ecg Scanning Analysis Report (93226) | $208 | $208 | 3.5× |
| Extracranial Bilat Study (93880) | $846 | $846 | 3.5× |
| Extracranial Uni/Ltd Study (93882) | $372 | $372 | 3.5× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) | $985 | $985 | 1.1× |
| Fundus photography (92250) | $110 | $110 | 0.8× |
| Gi tract capsule endoscopy (91110) | $2,095 | $2,095 | 2.3× |
| Gonioscopy (92020) | $81 | $81 | 0.6× |
| Group Therapeutic Procedures (97150) range across 10 matching MRF lines |
$53–$54.97 | $53–$54.97 | varies |
| Holter monitor recording (93225) | $451 | $451 | 3.3× |
| Ic Tsts W/Allgic Xtrcs Dlyd Typ Rxn W/Reading (95028) | $37 | $37 | 1.0× |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 4 matching MRF lines |
$21.32–$178 | $21.32–$178 | varies |
| Immunization administration (90471) range across 12 matching MRF lines |
$21.32–$178 | $21.32–$178 | varies |
| Inital newborn e/m (99460) | $248 | $248 | 1.8× |
| Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens,… (95027) | $14 | $14 | 0.5× |
| Intracutaneous tests w/allergenic extracts (95024) | $23 | $23 | 0.4× |
| Iontophoresis 15 min (97033) | $42 | $42 | 2.2× |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$72–$119 | $72–$119 | varies |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$69–$140 | $69–$140 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) | $316 | $316 | 1.5× |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 3 matching MRF lines |
$107–$142 | $107–$142 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 4 matching MRF lines |
$69–$92 | $69–$92 | varies |
| IV push initial (96374) range across 6 matching MRF lines |
$105–$421 | $105–$421 | varies |
| Lwr Xtr Vasc Stdy Bilat (93924) range across 2 matching MRF lines |
$548–$1,056 | $548–$1,056 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $116 | $116 | 3.7× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $118 | $118 | 3.2× |
| Motion Fluoroscopy/Swallow (92611) | $289 | $289 | 3.2× |
| Motor &/sens nrv cndj preconf eltrd array limb (95905) | $98 | $98 | 0.2× |
| Multiple Sleep Latency Test (95805) | $1,724 | $1,724 | 2.0× |
| Nasopharyngoscopy (92511) | $347 | $347 | 1.7× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $799 | $799 | 1.9× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $799 | $799 | 1.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$130–$397 | $130–$397 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 2 matching MRF lines |
$155–$799 | $155–$799 | varies |
| Nerve Conduction Studies 1-2 Studies (95907) | $266 | $266 | 1.2× |
| Nerve Conduction Studies 11-12 Studies (95912) | $728 | $728 | 1.9× |
| Nerve conduction studies 13 or more studies (95913) | $852 | $852 | 2.2× |
| Nerve Conduction Studies 3-4 Studies (95908) | $331 | $331 | 1.5× |
| Nerve conduction studies 5-6 studies (95909) | $398 | $398 | 1.8× |
| Nerve conduction studies 7-8 studies (95910) | $520 | $520 | 1.4× |
| Nerve Conduction Studies 9-10 Studies (95911) | $624 | $624 | 1.6× |
| Neuromuscular Reeducation (97112) range across 7 matching MRF lines |
$97–$104 | $97–$104 | varies |
| Newborn resuscitation (99465) | $379 | $379 | 0.6× |
| Nonphysician Telephone Assessment 11-20 Min (98967) range across 3 matching MRF lines |
$63–$78.65 | $63–$78.65 | varies |
| Nonphysician Telephone Assessment 21-30 Min (98968) range across 3 matching MRF lines |
$89–$117.98 | $89–$117.98 | varies |
| Nonphysician Telephone Assessment 5-10 Min (98966) range across 3 matching MRF lines |
$32–$39.33 | $32–$39.33 | varies |
| Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) range across 3 matching MRF lines |
$128–$141 | $128–$141 | varies |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) | $400 | $400 | 2.9× |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) | $339 | $339 | 2.5× |
| Ophth medical xm&eval intermediate estab pt (92012) | $239 | $239 | 1.8× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) | $227 | $227 | 1.7× |
| Oral Function Therapy (92526) | $269 | $269 | 3.2× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 5 matching MRF lines |
$137–$148 | $137–$148 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 9 matching MRF lines |
$126–$149 | $126–$149 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $94 | $94 | 4.3× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $136 | $136 | 6.2× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $177 | $177 | 8.0× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $215 | $215 | 9.7× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $254 | $254 | 11.5× |
| Ot Contrast Bath Ea 15 Min (97034) | $46 | $46 | 3.3× |
| Ot eval high complexity (97167) | $279 | $279 | 2.8× |
| Ot Eval Low Complex (97165) | $279 | $279 | 2.8× |
| Ot Eval Moderate Complexity (97166) | $279 | $279 | 2.8× |
| Ot manual therapy 15 min (97140) | $82 | $82 | 3.0× |
| Ot paraffin bath (97018) | $14 | $14 | 2.3× |
| Ot Prosthetic Training, Each 15 Min (97761) range across 7 matching MRF lines |
$111–$121 | $111–$121 | varies |
| Ot Re-Eval Est Plan Care (97168) range across 3 matching MRF lines |
$193–$209 | $193–$209 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $441 | $441 | 3.3× |
| Patch/Application Test Specify Number Tests (95044) | $12 | $12 | 0.0× |
| Pdt dstr prmlg les phys/qhp (96573) | $660 | $660 | 3.2× |
| Pdt dstr prmlg les skn illum/activj per day (96567) | $490 | $490 | 2.4× |
| Peripheral arterial disease rehab per session (93668) | $44 | $44 | 0.7× |
| Phlebotomy therapeutic (99195) | $387 | $387 | 2.8× |
| Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) | $508 | $508 | 8.4× |
| Physical Performance Test (97750) range across 9 matching MRF lines |
$81–$100 | $81–$100 | varies |
| Pm device eval in person (93288) | $150 | $150 | 3.9× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $3,307 | $3,307 | 3.8× |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) | $3,307 | $3,307 | 3.8× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $43 | $43 | 0.9× |
| Prepj& Antigen Allergen Immunotherapy 1 Insect (95145) | $95 | $95 | 2.0× |
| Prepj& antigen allergen immunotherapy 2 insect (95146) | $175 | $175 | 3.7× |
| Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of… (92311) | $306 | $306 | 0.7× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $32 | $32 | 0.7× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $37 | $37 | 0.8× |
| Pt Eval High Complex (97163) | $274 | $274 | 2.8× |
| Pt eval low complex 20 min (97161) | $274 | $274 | 2.8× |
| Pt Eval Mod Complex (97162) | $274 | $274 | 2.8× |
| Pt gait training 15 min (97116) | $87 | $87 | 3.0× |
| Pt group caregiver training (97552) range across 6 matching MRF lines |
$32–$72 | $32–$72 | varies |
| Pt mechanical traction (97012) | $32 | $32 | 2.2× |
| Pt Re-Eval Est Plan Care (97164) | $204 | $204 | 3.0× |
| Pulm function test by gas (94727) range across 4 matching MRF lines |
$135–$501 | $135–$501 | varies |
| Pure Tone Audiometry Air (92552) | $120 | $120 | 0.9× |
| Remote 30 Day Ecg Rev/Report (93270) | $131 | $131 | 3.4× |
| Remote 30 Day Ecg Tech Supp (93229) | $1,090 | $1,090 | 2.9× |
| Replacement of contact lens (92326) | $115 | $115 | 1.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 3 matching MRF lines |
$397–$481 | $397–$481 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $393 | $393 | 3.2× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $155 | $155 | 3.2× |
| Same day nb discharge (99463) | $290 | $290 | 2.1× |
| Sbsq Psyc Collab Care Mgmt (99493) | $374 | $374 | 3.6× |
| Self Care Mngment Training (97535) range across 9 matching MRF lines |
$96–$104 | $96–$104 | varies |
| Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) | $173 | $173 | 2.9× |
| Sensory Integration Ea 15 Min (97533) range across 8 matching MRF lines |
$177–$197 | $177–$197 | varies |
| Sleep study attended (95807) | $1,724 | $1,724 | 4.5× |
| Sleep study unattended (95806) | $508 | $508 | 2.3× |
| Slp caregiver training 1st 30 min (97550) range across 6 matching MRF lines |
$139–$169 | $139–$169 | varies |
| Speech sound lang comprehen (92523) | $726 | $726 | 3.2× |
| Spin/Brain Pump Refil & Main (95991) | $328 | $328 | 1.0× |
| Spirometry (94010) range across 3 matching MRF lines |
$82–$501 | $82–$501 | varies |
| Standardized Cognitive Performance Testing (96125) | $324 | $324 | 3.1× |
| Stress Tte Only (93350) range across 4 matching MRF lines |
$548–$1,919 | $548–$1,919 | varies |
| Temp transcutaneous pacing (92953) | $36 | $36 | 0.1× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 4 matching MRF lines |
$67–$70 | $67–$70 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) range across 4 matching MRF lines |
$65–$67 | $65–$67 | varies |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $110 | $110 | 3.0× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $92 | $92 | 3.1× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $328 | $328 | 3.2× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 6 matching MRF lines |
$135–$178 | $135–$178 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 3 matching MRF lines |
$316–$421 | $316–$421 | varies |
| Therapeutic Activities (97530) range across 17 matching MRF lines |
$104–$112 | $104–$112 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$74–$83 | $74–$83 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $43 | $43 | 1.1× |
| Trans Care Mgmt 14 Day Disch (99495) | $563 | $563 | 4.1× |
| Trans Care Mgmt 7 Day Disch (99496) | $763 | $763 | 5.6× |
| Tte w/doppler, complete (93306) range across 7 matching MRF lines |
$216–$1,919 | $216–$1,919 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $244 | $244 | 3.2× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) range across 3 matching MRF lines |
$77–$425 | $77–$425 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 3 matching MRF lines |
$69–$137 | $69–$137 | varies |
| Tympanometry (92567) | $48 | $48 | 1.3× |
| Upr/L Xtremity Art 2 Levels (93922) range across 2 matching MRF lines |
$456–$870 | $456–$870 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 3 matching MRF lines |
$390–$1,056 | $390–$1,056 | varies |
| Vent Mgmt Inpat Init Day (94002) range across 3 matching MRF lines |
$264–$1,983 | $264–$1,983 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) range across 3 matching MRF lines |
$185–$1,983 | $185–$1,983 | varies |
| Visual Field Exam Extended (92083) range across 4 matching MRF lines |
$138–$451 | $138–$451 | varies |
| Vital capacity, total (94150) range across 3 matching MRF lines |
$65–$501 | $65–$501 | varies |
| Wheelchair Mgmt Ea 15 Min (97542) | $93 | $93 | 3.0× |
| Whirlpool Therapy (97022) range across 6 matching MRF lines |
$50–$54 | $50–$54 | varies |
| Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) | $69 | $69 | 1.8× |
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.