Visits & medical services prices at Caribou Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $60.17 $85.95 0.3×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $70.46 $100.66 1.9×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $55.30 $79 3.9×
Application Modality 1/> Areas Infrared (97026) $22.16 $31.66 3.3×
Bedside Swallowing Eval (92610) $144.20 $206 1.7×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $80.50 $115 1.0×
Brief Emotional/Behavioral Assessment (96127) $12.83 $18.32 0.3×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $512.30 $731.85 1.4×
Canalith Repositioning Procedure (95992) $63 $90 1.5×
Car seat/bed test 60 min (94780) $55.13 $78.75 1.5×
Cardiac Stress Tst,Tracing Only (93017) $52.79 $75.42 0.2×
Cardiopulmonary exercise testing (94621) $1,030.47 $1,472.10 2.8×
Cardiopulmonary resuscitation (92950) $638.16 $911.66 3.0×
Cardioversion (92960) $490.22 $700.32 0.8×
Cbt 1st hour (94644) $242.20 $346 1.8×
Chemo Hormon Antineopl Sq/Im (96402) $197.40 $282 2.8×
Chemo Ia Infuse Each Addl Hr (96423) $55.35 $79.07 1.2×
Chemo IV push addl drug (96411) $246.40 $352 3.5×
Chemo prolong 8+ hrs infuse w/pump (96416) $632.80 $904 1.9×
Chemother, IV infusion, 1 hr (96413) $716.80 $1,024 2.2×
Chemother, IV infusion, ea add hr (96415) $214.90 $307 3.0×
Chemother,ia infusn tech,<1 hr (96422) $519.02 $741.46 1.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $222.60 $318 3.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $280.70 $401 3.9×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $424.90 $607 1.3×
Chronic care management services 1st 20 min (99490) $117.45 $167.78 1.2×
Color/duplex Doppler, complete (93975) $897.35 $1,281.93 3.8×
Color/duplex Doppler, limited (93976) $527.80 $754 5.1×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $158.75 $226.78 0.9×
Cont Gluc Monitoring Patient Provided Equipment (95249) $121.10 $173 2.1×
Continuous Glucose Monitoring (95250) $264.60 $378 2.0×
Cpap/bipap (94660) $644.70 $921 3.0×
Cpt initial (94667) $136.20 $194.57 1.0×
Critical care (99291) $591.93 $845.62 0.7×
Debridement Open Wound 20 Sq Cm< (97597) $109.92 $157.03 0.6×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $709.80 $1,014 3.0×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $770.70 $1,101 3.3×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $552.30 $789 5.3×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $525.70 $751 5.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $834.40 $1,192 3.5×
Dup-scan xtr veins unilateral/limited study (93971) $548.10 $783 5.3×
Duplex scan extracranial art compl bi study (93880) $807.80 $1,154 3.4×
Echo Heart Xthoracic,Limited (93308) $683.20 $976 2.9×
Electrocardiogram Tracing (93005) $33.81 $48.30 0.6×
Er level 1 (99281) $80.89 $115.55 1.0×
Er level ii (99282) $134.44 $192.05 0.9×
Er level iii (99283) $204.22 $291.74 0.8×
Er level IV (99284) $295.29 $421.84 0.7×
Er level v (99285) $450.93 $644.18 0.8×
Eval speech sound production (92522) $141.40 $202 1.3×
Evaluation of speech fluency (92521) $132.47 $189.24 1.0×
Exercise tst brncspsm (94617) $374.12 $534.45 2.8×
External ECG rec>48hr<7d recording (93242) $274.01 $391.44 7.4×
External ECG rec>7d<15d recording (93246) $274.01 $391.44 7.4×
Fluorescein icg angrph w/multiframe i&r uni/bi (92242) $355.50 $507.86 1.7×
Holter Monitor (93225) $349.30 $499 2.7×
Immune Admin Oral/Nasal (90473) $49.82 $71.18 0.7×
Immunization Admin (90471) $48.30 $69 0.7×
Inital newborn e/m (99460) $238.66 $340.94 1.8×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) $267.10 $381.57 2.0×
Intrapulmonary Surfactant Administj Phys/Qhp (94610) $146.30 $209 0.7×
Iontophoresis 15 min (97033) $86.41 $123.44 4.5×
Irrig drug delivery device (96523) $174.30 $249 3.0×
IV infusion hydration each additional hour (96361) $137.90 $197 3.0×
IV infusion hydration initial 31 min-1 hour (96360) $372.40 $532 1.8×
IV infusion ther proph addl sequential to 1 hr (96367) $180.60 $258 2.5×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $304.34 $434.78 1.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $147 $210 3.2×
IV push ea addl new drug (96375) $159.60 $228 3.5×
IV push initial (96374) $211.40 $302 1.0×
Manual therapy 15 min (97140) $77 $110 2.8×
Maximum voluntary ventilation (94200) $176.40 $252 3.0×
Mechanical traction (97012) $60.20 $86 4.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $72.80 $104 2.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $64.17 $91.67 1.7×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $70.71 $101.01 4.2×
Multiple Sleep Latency Test (95805) $2,935.80 $4,194 3.5×
Nasopharyngoscopy (92511) $396.20 $566 2.0×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $558.89 $798.42 1.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $244.30 $349 1.2×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $505.42 $722.02 1.3×
Newborn resuscitation (99465) $421.36 $601.95 0.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $354.20 $506 2.7×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $211.40 $302 1.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $93.05 $132.93 2.0×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $74.31 $106.16 2.3×
Ot Contrast Bath Ea 15 Min (97034) $47.60 $68 3.4×
Ot eval high complex 60 min (97167) $240.10 $343 2.4×
Ot eval low complex 30 min (97165) $158.20 $226 1.6×
Ot eval mod complex 45 min (97166) $199.50 $285 2.0×
Ot re-evaluation (97168) $112 $160 1.6×
Ot therapeutic activity 15 min (97530) $89.29 $127.55 2.5×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $326.90 $467 1.5×
Phlebotomy therapeutic (99195) $227.50 $325 1.7×
Plethysmography (94726) $224.70 $321 0.6×
Pm device eval in person (93288) $105 $150 2.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,756.12 $5,365.88 4.4×
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $60.27 $86.10 0.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $25.10 $35.86 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $33.81 $48.30 0.7×
Psych diag eval w/med srvcs (90792) $295.64 $422.34 1.7×
Psychiatric diagnostic evaluation (90791) $222.12 $317.31 1.3×
Pt Electrical Stimulation (97032) $68.60 $98 4.7×
Pt eval high complex 45 min (97163) $214.20 $306 2.2×
Pt eval low complex 20 min (97161) $141.40 $202 1.4×
Pt eval mod complex 30 min (97162) $178.50 $255 1.8×
Pt gait training 15 min (97116) $77.70 $111 2.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $87.50 $125 2.7×
Pt re-evaluation (97164) $105.70 $151 1.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $85.40 $122 2.6×
Pulmonary Service/Procedure (94799) $154 $220 1.2×
Pulmonary stress test simple (94618) $284.20 $406 2.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $175 $250 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $119.70 $171 0.9×
Sleep study attended (95807) $1,381.35 $1,973.35 3.7×
Sleep study unattended (95806) $606.90 $867 2.8×
Speech sound lang comprehen (92523) $220.50 $315 1.0×
Spirometry (94010) $152.52 $217.88 0.7×
Standardized Cognitive Performance Testing (96125) $298.20 $426 2.9×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $114.56 $163.66 5.1×
Therapeutic prophylactic/dx injection subq/im (96372) $81.54 $116.48 1.1×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $27.24 $38.91 0.7×
Trans Care Mgmt 14 Day Disch (99495) $271.47 $387.82 2.1×
Trans Care Mgmt 7 Day Disch (99496) $398.22 $568.88 3.0×
Tte w/doppler, complete (93306) $1,486.54 $2,123.63 2.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $121.80 $174 1.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $145.60 $208 1.7×
Tympanometry (92567) $30.10 $43 0.8×
Tympanometry And Reflex Threshold Measurements (92550) $42 $60 0.2×
Unlisted otorhinolaryngological service (92700) $14.70 $21 0.5×
Upr/lxtr art stdy 3+ lvls (93923) $580.30 $829 2.7×
Vent mgmt inpat init day (94002) $1,620.50 $2,315 2.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $980.36 $1,400.52 1.6×
Vital capacity, total (94150) $195.30 $279 1.5×