Visits & medical services prices at Cimarron Memorial Hospital

Boise City, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) $152 $304 1.6×
Airway inhalation treatment (94640) $91 $181 0.4×
Assmt & care planning pt w/cognitive impairment (99483) $125 $250 1.3×
Behav assmt w/score & docd/stand instrument (96127) $14 $27 0.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $162 $324 0.5×
Cardiac Stress Tst,Tracing Only (93017) $223 $446 1.1×
Cardiopulmonary resuscitation (92950) $364 $728 1.8×
Cardioversion (92960) $1,070 $2,140 1.7×
Care mgmt svc bhvl hlth cond (99484) $49 $98 1.4×
Cpap initiation and management (94660) $144.50 $289 0.7×
Cpt initial (94667) $61 $121 0.5×
Critical care (99291) $821 $1,642 1.0×
Debridement Open Wound 20 Sq Cm< (97597) $211.50 $422 1.1×
Demo &/or eval,pt use,aerosol device (94664) $61 $121 0.3×
EKG (93005) $83 $85 1.5×
EKG rhythm strip (93041) $34 $68 0.6×
Er level 1 (99281) $97 $194 1.2×
Er level ii (99282) $173 $345 1.2×
Er level iii (99283) $331 $661 1.3×
Er level IV (99284) $481 $961.50 1.2×
Er level v (99285) $693 $1,386 1.2×
Evaluation of swallowing function (92610) $63 $125 0.7×
Health Behavior Assessment/Re-Assessment (96156) $25 $50 0.3×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $48 $95 1.3×
Health behavior ivntj group f2f 1st 30 min (96164) $15 $30 0.4×
Health behavior ivntj indiv f2f 1st 30 min (96158) $44.50 $89 0.3×
Holter Monitor Recording (93225) $237 $473 1.9×
Hypoxia Response Curve (94450) $144 $287 1.2×
Immunization Admin (90471) $38 $75 0.5×
Immunotherapy, 2+ Injections (95117) $6 $11 0.1×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $135 $270 2.4×
IV infusion hydration each additional hour (96361) $99 $198 2.2×
IV infusion hydration initial 31 min-1 hour (96360) $200 $400 1.0×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $181 $361 2.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $220 $439 1.1×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $99 $198 2.2×
IV push initial (96374) $114 $227.50 0.6×
Manual therapy 15 min (97140) $66 $131 2.4×
Massage 15 min (97124) $66 $131 2.2×
Maximum voluntary ventilation (94200) $144 $287 2.5×
Mechanical traction (97012) $66 $131 4.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $22 $44 0.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $24 $47 0.7×
Multiple Family Group Psychotherapy (90849) $34 $67 0.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $113.50 $226.50 0.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $132 $263 0.3×
Neurobehavioral Status Exam (96116) $38 $76 0.2×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $184 $368 1.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $66 $131 1.4×
Osteopathic manipulative tx 3-4 body regions (98926) $46 $92 2.2×
Osteopathic manipulative tx 5-6 body regions (98927) $64.50 $128 3.1×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $105 $210 3.3×
Ot eval high complex 60 min (97167) $101 $201 1.0×
Ot eval low complex 30 min (97165) $101 $201 1.0×
Ot eval mod complex 45 min (97166) $101 $201 1.0×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $131 $262 2.6×
Ot Prosthetic Training, Each 15 Min (97761) $66 $131 1.6×
Ot re-eval est plan care (97168) $101 $201 1.5×
Percutaneous tests w/allergenic extracts (95004) $4 $8 0.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $823 $1,645 1.0×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $41 $81 0.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $4 $8 0.1×
Psychiatric diagnostic evaluation (90791) $188 $376 1.1×
Psychoanalysis (90845) $103 $205 0.6×
Psytx crisis initial 60 min (90839) $152 $303 0.9×
Pt Aquatic Therapy/Exercises (97113) $66 $131 1.8×
Pt Electric Current Therapy (97033) $66 $131 3.5×
Pt Electrical Stimulation (97032) $66 $131 4.5×
Pt eval high complex 45 min (97163) $101 $201 1.0×
Pt eval low complex 20 min (97161) $101 $201 1.0×
Pt Gait Training Therapy (97116) $66 $131 2.3×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $66 $131 2.0×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $101 $201 1.0×
Pt re-evaluation (97164) $68 $136 1.0×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $105 $210 3.2×
Pt Ultrasound Therapy (97035) $66 $131 4.6×
Pt Whirlpool Therapy (97022) $66 $131 4.2×
Pt-focused hlth risk assmt (96160) $26 $52 0.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $135 $269 0.7×
Rt Chest Wall Manipulation,Subsequent (94668) $61 $121 0.5×
Sbsq psychiatric collab care mgmt 1st 60 mins (99493) $143 $286 1.5×
Sensory Integration Ea 15 Min (97533) $105 $210 1.7×
Smoking cessation > 10 min (99407) $31 $61 0.9×
Speech sound lang comprehen (92523) $98 $196 0.4×
Spirometry (94010) $144 $287 0.7×
Temp transcutaneous pacing (92953) $307 $614 0.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $85 $169 3.8×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $21.50 $42.50 1.0×
Ther/Proph/Diag Inj Sc/Im (96372) $20.50 $40.50 0.3×
Therapeutic Activities (97530) $66 $131 1.9×
Therapeutic phlebotomy (99195) $167 $333 1.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $56 $112 0.7×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $63 $125 0.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $63 $126 1.4×
Unlisted pulmonary service/procedure (94799) $152 $303 1.2×
Vital capacity total (94150) $144 $287 1.2×
Wheelchair Mgmt Ea 15 Min (97542) $105 $210 3.4×