Visits & medical services prices at Cheyenne County Hospital

St. Francis, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $116.40 $116.40 1.2×
Airway inhalation treatment (94640) $114 $114 0.6×
Application of heat wave therapy (97024) $33 $33 4.5×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $63.50 $63.50 1.7×
Behavioral and qualitative analysis of voice and resonance (92524) $182.75 $215 1.7×
Bfb training 1st 15 min (90912) $90 $90 1.1×
Bfb training ea addl 15 min (90913) $90 $90 2.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $75 $75 0.2×
Cardiac Stress Tst,Tracing Only (93017) $487.99 $574.11 2.5×
Cardiopulmonary resuscitation (92950) $312.80 $368 1.6×
Cardioversion (92960) $573.02 $674.14 0.9×
Cbt 1st hour (94644) $247.39 $281.25 2.0×
Chemo Hormon Antineopl Sq/Im (96402) $49.40 $49.40 0.7×
Chemo IV push addl drug (96411) $171.28 $201.50 2.6×
Chemo Iv Push Sngl Drug (96409) $171.28 $201.50 0.6×
Chemother, IV infusion, 1 hr (96413) $297.50 $350 1.0×
Chemother, IV infusion, ea add hr (96415) $215.48 $253.50 3.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $42 $42 0.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $215.48 $253.50 3.3×
Color/duplex Doppler, complete (93975) $627.30 $738 2.9×
Color/duplex Doppler, limited (93976) $688.50 $810 7.2×
Cpap initiation and management (94660) $798.79 $939.75 4.0×
Cpt initial (94667) $134 $134 1.1×
Critical care (99291) $423.73 $498.50 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $223.26 $248.10 1.2×
Demo &/or eval,pt use,aerosol device (94664) $206.38 $233 1.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $752.25 $885 3.4×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $667.25 $785 6.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $752.25 $885 3.4×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $667.25 $785 6.9×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $752.25 $885 3.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $667.25 $785 6.9×
Dup-scan xtr veins unilateral/limited study (93971) $667.25 $785 6.9×
Duplex scan extracranial art compl bi study (93880) $752.25 $885 3.4×
Echo Heart Xthoracic,Limited (93308) $822.80 $968 3.7×
EKG (93005) $225.23 $264.98 4.2×
EKG rhythm strip (93041) $86.85 $86.85 1.6×
Er level 1 (99281) $318.75 $375 4.1×
Er level ii (99282) $361.25 $425 2.6×
Er level iii (99283) $510 $600 2.0×
Er level IV (99284) $786.25 $925 2.0×
Er level v (99285) $1,173 $1,380 2.1×
Evaluation of speech fluency (92521) $182.75 $215 1.4×
Evaluation of speech sound production (92522) $182.75 $215 1.6×
Evaluation of swallowing function (92610) $180 $180 2.1×
Evoked auditory test,limited (92587) $93.45 $93.45 0.5×
External ECG rec>48hr<7d recording (93242) $269.33 $316.86 7.8×
External ECG rec>7d<15d recording (93246) $269.33 $316.86 7.8×
External Ecg Scanning Analysis Report (93226) $265.68 $312.57 4.9×
Group Therapeutic Procedures (97150) $40.80 $40.80 2.3×
Holter Monitor Recording (93225) $186.41 $186.41 1.5×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $28.39 $28.39 0.8×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $20 $20 0.3×
Immunization Admin (90471) $20 $20 0.3×
Immunotherapy, 2+ Injections (95117) $23 $23 0.5×
Injection intra arterial (96373) $52 $52 0.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $143 $143 2.6×
IV infusion hydration each additional hour (96361) $159 $159 3.7×
IV infusion hydration initial 31 min-1 hour (96360) $176.20 $176.20 0.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $171.28 $201.50 2.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $201.03 $236.50 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $104.38 $120.50 2.4×
IV push initial (96374) $109.70 $109.70 0.6×
Low frequency non-thermal us (97610) $187 $220 1.0×
Manual therapy 15 min (97140) $83 $83 3.0×
Massage 15 min (97124) $69 $69 2.3×
Mechanical chest wall oscillation (94669) $195.84 $230.40 1.0×
Mechanical traction (97012) $62 $62 4.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $25 $25 0.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $25 $25 0.7×
Methacholine challenge (94070) $273.57 $315.23 0.8×
Mnt Group Ea 30 Min (97804) $7 $7 0.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $199.75 $235 2.2×
Neg press wnd tx </=50 sq cm (97607) $531.42 $625.20 1.4×
Neg press wound tx >50 cm (97608) $556.92 $655.20 1.5×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $311.95 $367 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $444.92 $523.44 1.2×
Newborn resuscitation (99465) $199.50
Nitric oxide expired gas determination (95012) $130 $130 3.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $688.50 $810 5.6×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $688.50 $810 3.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $562.32 $661.55 4.8×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $61 $61 1.3×
Osteopathic manipulative tx 1-2 body regions (98925) $47.40 $47.40 2.4×
Osteopathic manipulative tx 3-4 body regions (98926) $68.50 $68.50 3.4×
Osteopathic manipulative tx 5-6 body regions (98927) $85 $85 4.3×
Osteopathic manipulative tx 7-8 body regions (98928) $100 $100 5.0×
Osteopathic manipulative tx 9-10 body regions (98929) $120 $120 6.0×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $60.20 $60.20 1.9×
Ot Contrast Bath Ea 15 Min (97034) $46.70 $46.70 3.3×
Ot eval high complex 60 min (97167) $180 $180 1.8×
Ot eval low complex 30 min (97165) $180 $180 1.8×
Ot eval mod complex 45 min (97166) $168.29 $168.29 1.7×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $44.80 $44.80 0.9×
Ot Prosthetic Training, Each 15 Min (97761) $78 $78 1.9×
Ot Range Motion Measure,Each Extrem (95851) $37 $37 1.4×
Ot re-eval est plan care (97168) $118 $118 1.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $160 $160 1.3×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $116.05 $116.05 1.0×
Paraffin bath (97018) $35.70 $35.70 5.9×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $191.63 $225.45 1.0×
Phy/qhp op pulm rhb w/mntr (94626) $255 $300 4.7×
Plethysmography (94726) $139.84 $159.93 0.4×
Pm device eval in person (93288) $60 $60 1.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,655.44 $1,947.58 2.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $18 $18 0.4×
Pt Aquatic Therapy/Exercises (97113) $89 $89 2.4×
Pt Electric Current Therapy (97033) $60 $60 3.2×
Pt Electrical Stimulation (97032) $65.50 $65.50 4.5×
Pt eval high complex 45 min (97163) $180 $180 1.8×
Pt eval low complex 20 min (97161) $180 $180 1.8×
Pt Gait Training Therapy (97116) $76 $76 2.6×
Pt Infrared Therapy (97026) $26.40 $26.40 4.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $83 $83 2.5×
Pt Physical Performance Test (97750) $109.10 $109.10 3.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $180 $180 1.8×
Pt re-evaluation (97164) $118 $118 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $59 $59 1.8×
Pt Ultrasound Therapy (97035) $81 $81 5.6×
Pt Whirlpool Therapy (97022) $15.20 $15.20 1.0×
Pulm function test by gas (94727) $150.61 $150.61 0.8×
Pulmonary stress testing (94618) $170 $200 1.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $171.56 $201.83 5.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $265.20 $312 1.4×
Rt Chest Wall Manipulation,Subsequent (94668) $123 $123 1.0×
Sensory Integration Ea 15 Min (97533) $82.20 $82.20 1.4×
Sleep study unattended (95806) $223.62 $255.50 1.1×
Smoking cessation > 10 min (99407) $120 $120 3.5×
Speech sound lang comprehen (92523) $182.75 $215 0.8×
Spirometry (94010) $392.87 $462.20 2.0×
Standardized Cognitive Performance Testing (96125) $150 $150 1.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $78 $78 3.5×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $78 $78 3.7×
Ther/Proph/Diag Inj Sc/Im (96372) $54.20 $54.20 0.8×
Therapeutic Activities (97530) $81 $81 2.3×
Therapeutic phlebotomy (99195) $134.34 $134.34 1.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,191.30 $2,578 4.4×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $822.80 $968 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $101.65 $101.65 1.3×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $110 $110 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $70.75 $70.75 1.6×
Ultraviolet Light Therapy (96900) $40.11 $40.11 1.2×
Unlisted Cardiovascular Service/Procedure (93799) $749.70 $882 6.3×
Vasc Duplex Extrem Venous,Bilat (93970) $752.25 $885 3.4×
Vasc Duplex Scan Extracranial,Limited (93882) $667.25 $785 6.9×
Vasopneumatic device (97016) $67 $67 5.6×
Ventilation assist & mgmt inpatient 1st day (94002) $1,348.10 $1,586 2.4×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $955.40 $1,124 1.7×
Vital capacity total (94150) $90.18 $90.18 0.8×
Wheelchair Mgmt Ea 15 Min (97542) $40 $40 1.3×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $403.75 $475 4.6×