Visits & medical services prices at Bon Secours St. Mary's Hospital

Richmond, VA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $8,396.40 $13,994 1.1×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $53.40 $89 1.8×
Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the… (97813) $53.40 $89 1.8×
Advance care planning first 30 mins (99497) $88.20 $147 0.9×
Airway inhalation treatment (94640) $157.80 $263 0.7×
Appl modality 1+lllt po pain (97037) $76.20 $127 2.0×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $101.40 $169 7.1×
Assmt & care planning pt w/cognitive impairment (99483) $175.20 $292 1.7×
Bedside Swallowing Eval (92610) $275.40 $459 3.2×
Behavioral and qualitative analysis of voice and resonance (92524) $255.60 $426 2.3×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $819.60 $1,366 2.2×
Canalith Repositioning Procedure (95992) $186.60 $311 4.6×
Car seat/bed test 60 min (94780) $405.60 $676 10.8×
Cardiac Stress Tst,Tracing Only (93017) $1,669.80 $2,783 7.7×
Cardiopulmonary exercise testing (94621) $942 $1,570 2.5×
Cardiopulmonary resuscitation (92950) $234.60 $391 1.1×
Cardioversion (92960) $1,053.30 $1,755.50 1.6×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $45.60 $76 1.8×
Cath Perc Clos,Cong Interatrial Commun W/Impl (93580) $19,265.40 $32,109 1.0×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $18,770.40 $31,284 5.8×
Cbt 1st hour (94644) $235.20 $392 1.8×
Chemo Hormon Antineopl Sq/Im (96402) $454.20 $757 6.3×
Chemo IV push addl drug (96411) $336.60 $561 4.7×
Chemother, IV infusion, 1 hr (96413) $1,512.60 $2,521 4.6×
Chemother, IV infusion, ea add hr (96415) $376.80 $628 5.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $262.20 $437 3.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $476.40 $794 6.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $595.20 $992 1.8×
Color/duplex Doppler, complete (93975) $1,000.20 $1,667 4.2×
Color/duplex Doppler, limited (93976) $595.20 $992 5.7×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $318.60 $531 1.8×
Cont Gluc Monitoring Patient Provided Equipment (95249) $115.80 $193 2.0×
Continuous Glucose Monitoring (95250) $401.40 $669 3.0×
Coronary art/grft angio s&i (93455) $11,905.20 $19,842 3.7×
Coronary artery angio s&i (93454) $7,593 $12,655 2.3×
Cpap/bipap (94660) $813 $1,355 3.7×
Cpt initial (94667) $175.80 $293 1.3×
Critical care (99291) $5,729.40 $9,549 6.9×
Debridement Open Wound 20 Sq Cm< (97597) $537.60 $896 2.7×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $742.20 $1,237 3.1×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,420.20 $2,367 5.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $444 $740 4.2×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $508.20 $847 2.1×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $556.80 $928 5.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $2,194.80 $3,658 9.2×
Dup-scan xtr veins unilateral/limited study (93971) $1,344.60 $2,241 12.8×
Duplex scan extracranial art compl bi study (93880) $792.60 $1,321 3.3×
Duplex Scan Hemodialysis Access (93990) $372.60 $621 3.6×
Echo Heart Xthoracic,Limited (93308) $1,197 $1,995 5.0×
Echo r-t 2d w/probe placement only (93313) $2,446.20 $4,077 4.5×
Echo transesophag montr cardiac pump functj (93318) $1,939.20 $3,232 3.5×
Echo transesophageal (93312) $2,698.20 $4,497 4.9×
Echo Transthoracic - Congenital Tte Complete (93303) $2,373 $3,955 4.3×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $5,617.20 $9,362 10.2×
EEG awake and asleep (95819) $3,283.20 $5,472 15.2×
EEG awake drowsy (95816) $2,401.80 $4,003 11.1×
EEG cerebral death evaluation (95824) $1,007.40 $1,679 2.7×
EEG cont rec w/video by tech min 8 channels (95700) $294.60 $491 1.4×
EEG greater than 1 hour (95813) $1,426.80 $2,378 6.6×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $588.60 $981 2.7×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $1,003.20 $1,672 2.7×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $611.40 $1,019 2.8×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $588.60 $981 2.7×
EKG rhythm strip (93041) $190.80 $318 3.2×
Elec alys implt cplx cn npgt prgrmg (95977) $181.80 $303 1.9×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $74.40 $124 2.0×
Electrocardiogram Tracing (93005) $226.20 $377 3.8×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $336.60 $561 1.6×
Endomyocardial biopsy (93505) $1,784.40 $2,974 0.6×
Ep & ablate supravent arrhyt (93653) $23,817 $39,695 0.9×
Ep & ablate ventric tachy (93654) $30,394.80 $50,658 1.2×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $12,438 $20,730 1.6×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $2,452.80 $4,088 2.0×
Er level 1 (99281) $373.50 $622.50 4.4×
Er level ii (99282) $883.80 $1,473 5.7×
Er level iii (99283) $1,386.60 $2,311 5.1×
Er level IV (99284) $1,929.60 $3,216 4.6×
Er level v (99285) $3,817.64 $6,362.72 6.4×
Esoph balloon distension tst (91040) $10,782.04 $17,970.06 28.8×
Eval speech sound production (92522) $255.60 $426 2.3×
Eval to use/fit voice prosth (92597) $279.60 $466 3.9×
Evaluate Pt Use Of Inhaler (94664) $160.20 $267 0.7×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $321.60 $536 2.6×
Evaluation of speech fluency (92521) $247.20 $412 1.9×
External ECG rec>48hr<7d recording (93242) $78.60 $131 2.1×
External ECG rec>48hr<7d scanning alys w/report (93243) $241.80 $403 1.8×
External ECG rec>7d<15d recording (93246) $128.40 $214 3.4×
External ECG rec>7d<15d scanning alys w/report (93247) $241.80 $403 1.8×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $440.40 $734 2.2×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $8,671.10 $14,451.83 10.1×
Gi tract capsule endoscopy (91110) $6,966.51 $11,610.85 7.7×
Hemodialysis (90935) $1,419.60 $2,366 2.1×
Holter Monitor (93225) $525 $875 3.9×
Ilr Device Eval Progr (93285) $69.60 $116 1.9×
Imm admn sarscov2 vaccine single dose (90480) $27.60 $46 0.7×
Immune Admin Oral/Nasal (90473) $55.20 $92 0.8×
Immunization Admin (90471) $52.80 $88 0.7×
Ins swan ganz bedside (93503) $3,033.60 $5,056 1.9×
Interrog dev eval icpms phys/qhp in person (93290) $69.60 $116 1.9×
Interrog dev eval scrms phys/qhp in person (93291) $18.60 $31 0.6×
Interrog device eval heart (93289) $225.60 $376 6.0×
Intrapulmonary Surfactant Administj Phys/Qhp (94610) $175.80 $293 0.8×
Irrig drug delivery device (96523) $169.50 $282.50 2.9×
IV infusion hydration each additional hour (96361) $147.60 $246 3.1×
IV infusion hydration initial 31 min-1 hour (96360) $642 $1,070 3.0×
IV infusion ther proph addl sequential to 1 hr (96367) $244.80 $408 3.4×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $503.40 $839 2.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $161.40 $269 3.4×
IV push ea addl new drug (96375) $241.80 $403 5.1×
IV push initial (96374) $288 $480 1.3×
L hrt art/grft angio (93459) $19,832.40 $33,054 6.1×
Liver Elastography W/O Imag W/I&R (91200) $98.40 $164 0.8×
Manual therapy 15 min (97140) $105.60 $176 3.8×
Massage 15 min (97124) $93.30 $155.50 3.1×
Mechanical chest wall oscillation (94669) $133.80 $223 0.6×
Mechanical traction (97012) $103.20 $172 7.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $140.40 $234 4.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $126.60 $211 3.4×
Motility study esophagus (91010) $7,827.44 $13,045.73 20.9×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $558 $930 6.1×
Multiple Sleep Latency Test (95805) $3,824.40 $6,374 4.4×
Nasopharyngoscopy (92511) $149.40 $249 0.7×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $23,933.84 $39,889.74 110.5×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $271.80 $453 2.0×
Neg press wound tx >50 cm (97608) $379.80 $633 0.9×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $649.20 $1,082 1.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $264 $440 1.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $307.80 $513 0.8×
Newborn resuscitation (99465) $447.60 $746 0.7×
Nitric oxide expired gas determination (95012) $150 $250 4.0×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $510.60 $851 3.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $393.60 $656 3.0×
Nrpsyc tst eval phys/qhp 1st (96132) $1,003.20 $1,672 2.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $138.90 $231.50 3.0×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $39.30 $65.50 1.8×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $61.20 $102 1.9×
Ot eval high complex 60 min (97167) $351 $585 3.5×
Ot eval low complex 30 min (97165) $356.40 $594 3.5×
Ot eval mod complex 45 min (97166) $349.80 $583 3.5×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $96 $160 1.9×
Ot re-evaluation (97168) $160.80 $268 2.3×
Ot therapeutic activity 15 min (97530) $165.60 $276 4.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $311.40 $519 2.4×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $262.20 $437 2.0×
Paraffin bath pt (97018) $89.40 $149 14.9×
Peripheral arterial disease rehab per session (93668) $144 $240 2.4×
Peritoneal Dialysis (90945) $2,635.20 $4,392 6.3×
Perq transcath closure pda (93582) $32,624.40 $54,374 1.8×
Perq Transcath Cls Mitral (93590) $33,938.40 $56,564 1.8×
Perq transcath cls paravalvr leak 1 aortic valve (93591) $33,938.40 $56,564 1.8×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $11,401.80 $19,003 2.0×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $21,685.80 $36,143 1.9×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $126.60 $211 2.1×
Plethysmography (94726) $267 $445 0.7×
Pm device eval in person (93288) $96 $160 2.6×
Pm device progr eval dual (93280) $82.20 $137 2.2×
Pm device progr eval multi (93281) $84 $140 2.2×
Pm device progr eval sngl (93279) $186.60 $311 5.0×
Pm/Icd Remote Tech Serv (93296) $24 $40 0.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,884.80 $9,808 6.8×
Polysom <6 yrs 4/> paramtrs (95782) $2,275.80 $3,793 2.6×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $24 $40 0.6×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $357 $595 9.5×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) $244.80 $408 6.5×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) $300.60 $501 8.0×
Prq balloon valvuloplasty aortic valve (92986) $3,626.40 $6,044 0.6×
Prq Balloon Valvuloplasty Mitral Valve (92987) $22,119.60 $36,866 1.9×
Prq Card Stent W/Angio 1 Vsl (92928) $21,378.60 $35,631 1.8×
Prq Card Stent/Ath/Angio (92933) $21,355.20 $35,592 1.2×
Prq Revasc Byp Graft 1 Vsl (92937) $21,519 $35,865 1.9×
Prq trluml coronary angio/atherect one art/brnch (92924) $20,912.40 $34,854 1.8×
Psych diag eval w/med srvcs (90792) $197.40 $329 1.1×
Psychiatric diagnostic evaluation (90791) $660.60 $1,101 3.7×
Psycl tst eval phys/qhp 1st (96130) $197.40 $329 0.9×
Psycl/nrpsyc tech 1st (96138) $754.20 $1,257 1.7×
Psycl/nrpsyc tst phy/qhp 1st (96136) $243.60 $406 1.8×
Psytx crisis initial 60 min (90839) $301.80 $503 1.7×
Pt Aquatic Therapy/Exercises (97113) $45 $75 1.2×
Pt Electrical Stimulation (97032) $130.80 $218 8.9×
Pt eval high complex 45 min (97163) $364.80 $608 3.7×
Pt eval low complex 20 min (97161) $303.60 $506 3.1×
Pt eval mod complex 30 min (97162) $366 $610 3.7×
Pt gait training 15 min (97116) $142.80 $238 4.9×
Pt group caregiver training (97552) $40.80 $68 1.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $204.90 $341.50 6.3×
Pt re-evaluation (97164) $249.60 $416 3.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $235.80 $393 7.3×
Pulm function test by gas (94727) $103.20 $172 0.5×
Pulmonary Service/Procedure (94799) $294.60 $491 2.3×
Pulmonary stress test simple (94618) $272.40 $454 2.0×
R & l hrt cath w/njx l ventriculog img s&i (93453) $10,198.80 $16,998 3.1×
R hrt art/grft angio (93457) $15,666.60 $26,111 4.8×
R hrt coronary artery angio (93456) $11,367 $18,945 3.5×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $23,495.40 $39,159 7.2×
R&l hrt art/ventricle angio (93460) $17,530.80 $29,218 5.4×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $70.80 $118 1.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $893.40 $1,489 23.9×
Respiratory flow volume loop (94375) $893.40 $1,489 4.1×
Right heart cath (93451) $8,512.80 $14,188 2.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $412.80 $688 2.1×
Rt Chest Wall Manipulation,Subsequent (94668) $133.20 $222 1.0×
Sleep study unattended (95806) $718.80 $1,198 3.3×
Slp caregiver training 1st 30 min (97550) $99.60 $166 1.9×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $783 $1,305 3.6×
Smoking cessation > 10 min (99407) $58.80 $98 1.6×
Speech sound lang comprehen (92523) $275.40 $459 1.2×
Spirometry (94010) $536.40 $894 2.5×
Stress echo (93350) $1,653.60 $2,756 3.0×
Temp transcutaneous pacing (92953) $490.20 $817 0.7×
Ther/prop/diag inj/inf proc (96379) $88.20 $147 1.9×
Therapeutic prophylactic/dx injection subq/im (96372) $148.20 $247 2.1×
Tilt table evaluation (93660) $2,149.20 $3,582 5.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $58.80 $98 1.6×
Trans Care Mgmt 14 Day Disch (99495) $240 $400 1.8×
Trans Care Mgmt 7 Day Disch (99496) $240 $400 1.8×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $1,594.20 $2,657 6.7×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $632.40 $1,054 6.0×
Transtelephonic rhythm strip pacemaker eval (93293) $94.80 $158 2.5×
Tte w/doppler, complete (93306) $3,630.60 $6,051 6.6×
Tx atrial fib pulm vein isol (93656) $24,316.20 $40,527 0.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $174 $290 2.3×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $175.80 $293 2.1×
Upr/lxtr art stdy 3+ lvls (93923) $428.40 $714 2.0×
Vasc Duplex Scan Extracranial,Limited (93882) $325.80 $543 3.1×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,314 $2,190 6.1×
Vasopneumatic device (97016) $136.80 $228 11.4×
Veeg 2-12 hr unmonitored (95711) $1,054.80 $1,758 4.9×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $1,171.80 $1,953 3.1×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $2,193.60 $3,656 2.5×
Veeg Ea 12-26 Hr Unmntr (95714) $4,210.20 $7,017 11.2×
Vent mgmt inpat init day (94002) $1,798.20 $2,997 2.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,419.60 $2,366 2.3×
Visual Evoked Potential Test (95930) $197.40 $329 0.9×
Vital capacity, total (94150) $98.40 $164 0.8×
Xtrnl mobile cv telemetry w/technical support (93229) $288.60 $481 0.8×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $393.60 $656 4.1×