Visits & medical services prices at Citizens Memorial Hospital
Bolivar, MO · every code in this section with a posted price and a Medicare benchmark.
262 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Actinotherapy Ultraviolet Light (96900) | $28.80 | $36 | 0.8× |
| Acupunct W/Stimul 15 Min (97813) | $52 | $65 | 1.8× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $41.60 | $52 | 1.0× |
| Airway Inhalation Treatment (94640) range across 6 matching MRF lines |
$31.20–$492.40 | $39–$615.50 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) | $177.80 | $222.25 | 1.3× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) | $148.20 | $185.25 | 1.1× |
| Analyze neurostim complex (95972) range across 3 matching MRF lines |
$270.40–$760 | $338–$950 | varies |
| Analyze neurostim no prog (95970) range across 3 matching MRF lines |
$107.20–$392 | $134–$490 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 4 matching MRF lines |
$98.80–$114.40 | $123.50–$143 | varies |
| Application Modality 1/> Areas Infrared (97026) range across 2 matching MRF lines |
$23.20–$28.80 | $29–$36 | varies |
| Assessment of aphasia per hr (96105) | $265.80 | $332.25 | 2.7× |
| Assmt & care planning pt w/cognitive impairment (99483) | $363.20 | $454 | 3.6× |
| Behavral qualit analys voice (92524) range across 2 matching MRF lines |
$318.40–$334.40 | $398–$418 | varies |
| Blink reflex test (95933) range across 2 matching MRF lines |
$90.40–$157.60 | $113–$197 | varies |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 3 matching MRF lines |
$386–$492 | $482.50–$615 | varies |
| C motor evoked upr&lwr limbs (95939) | $876 | $1,095 | 1.0× |
| Canalith repositioning proc (95992) range across 3 matching MRF lines |
$96–$181.60 | $120–$227 | varies |
| Cardiac Stress Tst,Tracing Only (93017) range across 3 matching MRF lines |
$101.60–$831 | $127–$1,038.75 | varies |
| Cardiopulmonary resuscitation (92950) range across 4 matching MRF lines |
$495.20–$1,531.40 | $619–$1,914.25 | varies |
| Cardioversion (92960) range across 4 matching MRF lines |
$512–$1,795.40 | $640–$2,244.25 | varies |
| Cardioversion elective internal (92961) | $463.20 | $579 | 0.7× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) range across 2 matching MRF lines |
$12,688–$13,322.40 | $15,860–$16,653 | varies |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) range across 2 matching MRF lines |
$11,188.80–$11,748.40 | $13,986–$14,685.50 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $251.60 | $314.50 | 3.5× |
| Chemo Hormon Antineopl Sq/Im (96402) range across 4 matching MRF lines |
$58.40–$255.20 | $73–$319 | varies |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$49.60–$356.40 | $62–$445.50 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 3 matching MRF lines |
$103.20–$623.80 | $129–$779.75 | varies |
| Chest Wall Manipulation (94668) | $75.60 | $94.50 | 0.6× |
| Cmptr ophth dx img ant segmt (92132) range across 3 matching MRF lines |
$28–$78.40 | $35–$98 | varies |
| Color/duplex Doppler, complete (93975) | $1,068.20 | $1,335.25 | 4.5× |
| Color/duplex Doppler, limited (93976) range across 4 matching MRF lines |
$403.20–$513.20 | $504–$641.50 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) range across 2 matching MRF lines |
$112.80–$126.60 | $141–$158.25 | varies |
| Comprehensive Hearing Test (92557) | $178.80 | $223.50 | 1.4× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) range across 3 matching MRF lines |
$37.60–$88 | $47–$110 | varies |
| Computerized Ophthalmic Imaging Retina (92134) range across 3 matching MRF lines |
$43.20–$92.80 | $54–$116 | varies |
| Conditioning Play Audiometry (92582) | $96.60 | $120.75 | 0.7× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $188.80 | $236 | 1.4× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $97.20 | $121.50 | 1.6× |
| Continuous Pulse Ox (94762) range across 2 matching MRF lines |
$48.80–$266.80 | $61–$333.50 | varies |
| Corneal Topography (92025) range across 3 matching MRF lines |
$32.80–$83.20 | $41–$104 | varies |
| Coronary Art/Grft Angio S&I (93455) range across 4 matching MRF lines |
$2,140.80–$7,767.40 | $2,676–$9,709.25 | varies |
| Coronary Artery Angio S&I (93454) range across 3 matching MRF lines |
$4,652.20–$9,054.40 | $5,815.25–$11,318 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $71.20 | $89 | 0.3× |
| Cpt initial (94667) range across 2 matching MRF lines |
$101.40–$106.60 | $126.75–$133.25 | varies |
| Critical care first hour (99291) range across 3 matching MRF lines |
$947.40–$1,989.60 | $1,184.25–$2,487 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 6 matching MRF lines |
$93.40–$459 | $116.75–$573.75 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) range across 4 matching MRF lines |
$284.80–$1,009.80 | $356–$1,262.25 | varies |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 4 matching MRF lines |
$594.40–$756.80 | $743–$946 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 4 matching MRF lines |
$420–$1,482.40 | $525–$1,853 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 5 matching MRF lines |
$331.20–$815.80 | $414–$1,019.75 | varies |
| Duplex up extrem art bilat (93930) range across 3 matching MRF lines |
$664–$1,481 | $830–$1,851.25 | varies |
| Duplex up extrem art unilat/ltd (93931) range across 3 matching MRF lines |
$581.60–$740.60 | $727–$925.75 | varies |
| Ear and throat examination (92502) | $160 | $200 | 0.3× |
| ECG/monitoring and analysis (93271) range across 2 matching MRF lines |
$626.40–$657.80 | $783–$822.25 | varies |
| Echo Congenital Complete (93303) range across 3 matching MRF lines |
$400.80–$2,224.60 | $501–$2,780.75 | varies |
| Echo Heart Xthoracic,Limited (93308) range across 3 matching MRF lines |
$109.60–$504.80 | $137–$631 | varies |
| Echo transesophageal (93312) range across 2 matching MRF lines |
$2,593–$2,722.80 | $3,241.25–$3,403.50 | varies |
| Eeg 41-60 Minutes (95812) range across 2 matching MRF lines |
$744.60–$1,486 | $930.75–$1,857.50 | varies |
| EEG awake and asleep (95819) range across 2 matching MRF lines |
$943.40–$990.60 | $1,179.25–$1,238.25 | varies |
| EEG awake drowsy (95816) range across 2 matching MRF lines |
$744.60–$990.60 | $930.75–$1,238.25 | varies |
| EEG cerebral death evaluation (95824) | $773.40 | $966.75 | 2.1× |
| EEG extended monitoring 61-119 minutes (95813) | $1,981.20 | $2,476.50 | 9.2× |
| Eeg Sleep Only (95822) | $943.40 | $1,179.25 | 4.4× |
| Elec alys implt brn npgt prgrmg 1st 15 min (95983) | $84 | $105 | 0.9× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) | $106.40 | $133 | 1.1× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $33.60 | $42 | 0.9× |
| Electrical Stimulation Ea 15 Min (97032) range across 6 matching MRF lines |
$94.80–$1,536 | $118.50–$1,920 | varies |
| Electrocardiogram Tracing (93005) range across 7 matching MRF lines |
$48.80–$317.60 | $61–$397 | varies |
| Electrophysiology Evaluation (93642) | $2,111 | $2,638.75 | 1.7× |
| Emergency Dept Visit Level 2 (99282) range across 3 matching MRF lines |
$352.80–$370.60 | $441–$463.25 | varies |
| Emergency Dept Visit Level 3 (99283) range across 3 matching MRF lines |
$531.40–$558 | $664.25–$697.50 | varies |
| Emergency Dept Visit Level 4 (99284) range across 3 matching MRF lines |
$872.40–$916.20 | $1,090.50–$1,145.25 | varies |
| Emg 3 Extremities (95863) range across 2 matching MRF lines |
$130.40–$313.60 | $163–$392 | varies |
| Emg 4 Extremities (95864) range across 2 matching MRF lines |
$150.40–$347.20 | $188–$434 | varies |
| Er level 1 (99281) | $253 | $316.25 | 3.0× |
| Er level v (99285) range across 2 matching MRF lines |
$1,001–$1,051.20 | $1,251.25–$1,314 | varies |
| Evaluate pt use of inhaler (94664) | $59.80 | $74.75 | 0.3× |
| Evaluate Speech Production (92522) range across 2 matching MRF lines |
$297.40–$312.40 | $371.75–$390.50 | varies |
| Evaluate Swallowing Function (92610) range across 2 matching MRF lines |
$326.40–$342.80 | $408–$428.50 | varies |
| Evaluation of speech fluency (92521) | $295.60 | $369.50 | 2.2× |
| Excimer laser tx psoriasis tot area <250 sq cm (96920) | $500 | $625 | 2.5× |
| External ECG rec>48hr<7d recording (93242) range across 2 matching MRF lines |
$315.80–$331.60 | $394.75–$414.50 | varies |
| External ECG rec>7d<15d recording (93246) range across 2 matching MRF lines |
$300.60–$315.80 | $375.75–$394.75 | varies |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$423.80–$445 | $529.75–$556.25 | varies |
| Extracranial Bilat Study (93880) range across 4 matching MRF lines |
$250.40–$942 | $313–$1,177.50 | varies |
| Extracranial Uni/Ltd Study (93882) range across 2 matching MRF lines |
$289.60–$515.60 | $362–$644.50 | varies |
| Eye exam w anesth; complete (92018) | $236.80 | $296 | 0.1× |
| Eye exam w anesth; limited (92019) | $118.40 | $148 | 0.0× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $241.60 | $302 | 0.4× |
| Facial nerve function studies (92516) | $144.80 | $181 | 0.7× |
| Flexible endoscopic eval swallow c/v rec (92612) | $311.60 | $389.50 | 1.6× |
| Fluorescein angiography (92235) range across 3 matching MRF lines |
$71.20–$294.40 | $89–$368 | varies |
| Fundus photography (92250) range across 3 matching MRF lines |
$36–$130.40 | $45–$163 | varies |
| Gonioscopy (92020) range across 3 matching MRF lines |
$35.20–$129.60 | $44–$162 | varies |
| Group Therapeutic Procedures (97150) | $100 | $125 | 5.5× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) range across 2 matching MRF lines |
$902.40–$14,601.40 | $1,128–$18,251.75 | varies |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$601.20–$631.40 | $751.50–$789.25 | varies |
| Icd Device Interrogate (93289) | $48.80 | $61 | 1.3× |
| Icd device progr eval dual (93283) range across 2 matching MRF lines |
$60–$74 | $75–$92.50 | varies |
| Icd Device Progr Eval Mult (93284) | $65.60 | $82 | 1.8× |
| Icm Device Eval (93290) | $15.20 | $19 | 0.4× |
| Ilr Device Eval Progr (93285) range across 2 matching MRF lines |
$28–$86 | $35–$107.50 | varies |
| Ilr Device Interrogate (93291) range across 2 matching MRF lines |
$36.80–$86 | $46–$107.50 | varies |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 2 matching MRF lines |
$18.40–$20.40 | $23–$25.50 | varies |
| Immunization administration (90471) range across 4 matching MRF lines |
$27.20–$57.40 | $34–$71.75 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $606.80 | $758.50 | 1.6× |
| Inital newborn e/m (99460) | $153.60 | $192 | 1.2× |
| Insert/Place Heart Catheter (93503) range across 2 matching MRF lines |
$212.80–$2,788.40 | $266–$3,485.50 | varies |
| Interrogate Subq Defib (93261) | $29.60 | $37 | 0.8× |
| Interrogation eval in person wr defibrillator (93292) | $32.80 | $41 | 0.9× |
| Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens,… (95027) | $14.40 | $18 | 0.5× |
| Intracutaneous tests w/allergenic extracts (95024) range across 3 matching MRF lines |
$13.60–$544 | $17–$680 | varies |
| Iontophoresis 15 min (97033) range across 5 matching MRF lines |
$153.80–$172.60 | $192.25–$215.75 | varies |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$40–$164.20 | $50–$205.25 | varies |
| IV infusion hydration each additional hour (96361) range across 8 matching MRF lines |
$27.20–$4,467.20 | $34–$5,584 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 5 matching MRF lines |
$92.80–$488.20 | $116–$610.25 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 3 matching MRF lines |
$464.80–$488.20 | $581–$610.25 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 6 matching MRF lines |
$43.20–$1,839.60 | $54–$2,299.50 | varies |
| IV push initial (96374) range across 5 matching MRF lines |
$97.60–$281.20 | $122–$351.50 | varies |
| L Hrt Art/Grft Angio (93459) range across 4 matching MRF lines |
$476–$11,339 | $595–$14,173.75 | varies |
| Lung Function Test (Mbc/Mvv) (94200) range across 4 matching MRF lines |
$40–$142.20 | $50–$177.75 | varies |
| Lwr Xtr Vasc Stdy Bilat (93924) range across 2 matching MRF lines |
$540–$623.80 | $675–$779.75 | varies |
| Mechanical chest wall oscillation per session (94669) | $224.80 | $281 | 1.0× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $44.80 | $56 | 1.4× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$49.40–$52 | $61.75–$65 | varies |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $26.20 | $32.75 | 1.5× |
| Methacholine challenge (94070) | $510 | $637.50 | 1.4× |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$345.80–$363.20 | $432.25–$454 | varies |
| Motor &/sens nrv cndj preconf eltrd array limb (95905) range across 2 matching MRF lines |
$135.20–$142.40 | $169–$178 | varies |
| Multiple Sleep Latency Test (95805) | $1,479.60 | $1,849.50 | 1.7× |
| Muscle Test 2 Limbs (95861) range across 3 matching MRF lines |
$108–$261.60 | $135–$327 | varies |
| Muscle Test Nonparaspinal (95870) | $96.80 | $121 | 0.7× |
| Muscle Test One Limb (95860) range across 2 matching MRF lines |
$96.80–$181.60 | $121–$227 | varies |
| Nasopharyngoscopy (92511) range across 3 matching MRF lines |
$145.60–$315.20 | $182–$394 | varies |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) range across 2 matching MRF lines |
$101.60–$219.20 | $127–$274 | varies |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) range across 2 matching MRF lines |
$71.20–$148 | $89–$185 | varies |
| Needle electromyography larynx (95865) | $228 | $285 | 1.7× |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) | $351.20 | $439 | 1.6× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 3 matching MRF lines |
$90.40–$574 | $113–$717.50 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 3 matching MRF lines |
$96.80–$308.80 | $121–$386 | varies |
| Nerve Conduction Studies 1-2 Studies (95907) range across 2 matching MRF lines |
$98.40–$166.40 | $123–$208 | varies |
| Nerve Conduction Studies 11-12 Studies (95912) range across 2 matching MRF lines |
$179.20–$448.80 | $224–$561 | varies |
| Nerve conduction studies 13 or more studies (95913) range across 2 matching MRF lines |
$200–$520 | $250–$650 | varies |
| Nerve Conduction Studies 3-4 Studies (95908) range across 2 matching MRF lines |
$119.20–$200.80 | $149–$251 | varies |
| Nerve conduction studies 5-6 studies (95909) range across 3 matching MRF lines |
$105.60–$240.80 | $132–$301 | varies |
| Nerve conduction studies 7-8 studies (95910) range across 2 matching MRF lines |
$136–$316 | $170–$395 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 2 matching MRF lines |
$158.40–$383.20 | $198–$479 | varies |
| Neurobehavioral Status Exam (96116) range across 2 matching MRF lines |
$43.20–$202.40 | $54–$253 | varies |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $118.40 | $148 | 0.9× |
| Neuromuscular Reeducation (97112) range across 6 matching MRF lines |
$133.40–$533.60 | $166.75–$667 | varies |
| Newborn resuscitation (99465) | $271.20 | $339 | 0.4× |
| Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) range across 3 matching MRF lines |
$52–$145.60 | $65–$182 | varies |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) range across 3 matching MRF lines |
$103.20–$264.80 | $129–$331 | varies |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) range across 3 matching MRF lines |
$103.20–$232.80 | $129–$291 | varies |
| Ophth medical xm&eval intermediate estab pt (92012) range across 3 matching MRF lines |
$87.20–$188.80 | $109–$236 | varies |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) range across 3 matching MRF lines |
$79.20–$181.60 | $99–$227 | varies |
| Oral Function Therapy (92526) range across 2 matching MRF lines |
$270–$283.60 | $337.50–$354.50 | varies |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 5 matching MRF lines |
$95–$291 | $118.75–$363.75 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 7 matching MRF lines |
$123–$512 | $153.75–$640 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $43 | $53.75 | 2.0× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $57 | $71.25 | 2.6× |
| Ot Contrast Bath Ea 15 Min (97034) range across 2 matching MRF lines |
$64.60–$67.80 | $80.75–$84.75 | varies |
| Ot eval high complexity (97167) range across 3 matching MRF lines |
$347–$364.40 | $433.75–$455.50 | varies |
| Ot Eval Low Complex (97165) range across 3 matching MRF lines |
$237.20–$249.20 | $296.50–$311.50 | varies |
| Ot Eval Moderate Complexity (97166) range across 3 matching MRF lines |
$292–$306.60 | $365–$383.25 | varies |
| Ot manual therapy 15 min (97140) range across 9 matching MRF lines |
$47.20–$424.80 | $59–$531 | varies |
| Ot paraffin bath (97018) range across 3 matching MRF lines |
$88.80–$93.40 | $111–$116.75 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) range across 2 matching MRF lines |
$94–$98.80 | $117.50–$123.50 | varies |
| Ot Re-Eval Est Plan Care (97168) | $163.60 | $204.50 | 2.4× |
| Ot rom hand (95852) range across 2 matching MRF lines |
$74–$83 | $92.50–$103.75 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 4 matching MRF lines |
$309.20–$328.80 | $386.50–$411 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) range across 2 matching MRF lines |
$6.40–$6.80 | $8–$8.50 | varies |
| Percutaneous tests w/allergenic extracts (95004) | $384 | $480 | 0.4× |
| Peripheral arterial disease rehab per session (93668) range across 2 matching MRF lines |
$121.60–$127.80 | $152–$159.75 | varies |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) range across 7 matching MRF lines |
$525.60–$9,304.40 | $657–$11,630.50 | varies |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) range across 4 matching MRF lines |
$5,977.60–$17,078.40 | $7,472–$21,348 | varies |
| Phlebotomy therapeutic (99195) range across 3 matching MRF lines |
$332.40–$349.20 | $415.50–$436.50 | varies |
| Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) | $48 | $60 | 0.8× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) range across 3 matching MRF lines |
$255.20–$281.40 | $319–$351.75 | varies |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) range across 3 matching MRF lines |
$255.20–$281.40 | $319–$351.75 | varies |
| Physical Performance Test (97750) range across 5 matching MRF lines |
$44–$119 | $55–$148.75 | varies |
| Plethysmography (94726) range across 3 matching MRF lines |
$395.40–$503.80 | $494.25–$629.75 | varies |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$40.80–$110 | $51–$137.50 | varies |
| Pm device progr eval dual (93280) range across 2 matching MRF lines |
$45.60–$56.60 | $57–$70.75 | varies |
| Pm device progr eval multi (93281) | $57.60 | $72 | 1.5× |
| Pm Device Progr Eval Sngl (93279) range across 2 matching MRF lines |
$40–$56.60 | $50–$70.75 | varies |
| Pm/Icd Remote Tech Serv (93296) | $127.20 | $159 | 3.4× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$4,237.40–$4,449.40 | $5,296.75–$5,561.75 | varies |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) | $1,338.40 | $1,673 | 1.6× |
| Positional nystagmus test (92542) | $109.60 | $137 | 0.8× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) range across 2 matching MRF lines |
$31.20–$35.20 | $39–$44 | varies |
| Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) | $29.60 | $37 | 0.8× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) range across 2 matching MRF lines |
$50.40–$86.40 | $63–$108 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $31.20 | $39 | 0.7× |
| Prq Card Angio/Athrect 1 Art (92924) | $16,291.80 | $20,364.75 | 1.4× |
| Prq Card Stent W/Angio 1 Vsl (92928) range across 2 matching MRF lines |
$14,283.20–$15,290.20 | $17,854–$19,112.75 | varies |
| Prq Card Stent/Ath/Angio (92933) range across 3 matching MRF lines |
$26,049–$27,351.60 | $32,561.25–$34,189.50 | varies |
| Prq Revasc Byp Graft 1 Vsl (92937) | $15,520.60 | $19,400.75 | 1.3× |
| Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) | $210.40 | $263 | 0.5× |
| Pt Eval High Complex (97163) range across 2 matching MRF lines |
$357.80–$375.80 | $447.25–$469.75 | varies |
| Pt eval low complex 20 min (97161) range across 3 matching MRF lines |
$244.40–$256.80 | $305.50–$321 | varies |
| Pt Eval Mod Complex (97162) range across 3 matching MRF lines |
$256–$301 | $320–$376.25 | varies |
| Pt gait training 15 min (97116) range across 4 matching MRF lines |
$110.40–$119 | $138–$148.75 | varies |
| Pt mechanical traction (97012) range across 2 matching MRF lines |
$117.40–$123.40 | $146.75–$154.25 | varies |
| Pt Re-Eval Est Plan Care (97164) range across 2 matching MRF lines |
$176–$184.80 | $220–$231 | varies |
| Pulmonary Stress Testing (94618) range across 4 matching MRF lines |
$100–$159.20 | $125–$199 | varies |
| Pure Tone Audiometry Air (92552) | $59.80 | $74.75 | 0.4× |
| R Hrt Art/Grft Angio (93457) range across 2 matching MRF lines |
$11,296–$11,860.80 | $14,120–$14,826 | varies |
| R hrt coronary artery angio (93456) range across 2 matching MRF lines |
$12,020.20–$12,621.40 | $15,025.25–$15,776.75 | varies |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $8,777.20 | $10,971.50 | 2.7× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) | $178.40 | $223 | 0.5× |
| Remote 30 Day Ecg Rev/Report (93270) range across 2 matching MRF lines |
$253.80–$266.60 | $317.25–$333.25 | varies |
| Replacement of contact lens (92326) range across 3 matching MRF lines |
$54.40–$148.80 | $68–$186 | varies |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $145.60 | $182 | 2.5× |
| Right Heart Cath (93451) range across 2 matching MRF lines |
$5,050.80–$5,303.40 | $6,313.50–$6,629.25 | varies |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$140.80–$281.60 | $176–$352 | varies |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) range across 2 matching MRF lines |
$97–$108.80 | $121.25–$136 | varies |
| Self Care Mngment Training (97535) range across 5 matching MRF lines |
$12–$342.60 | $15–$428.25 | varies |
| Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) range across 3 matching MRF lines |
$50.40–$113.60 | $63–$142 | varies |
| Sensory Integration Ea 15 Min (97533) range across 2 matching MRF lines |
$95.60–$100.40 | $119.50–$125.50 | varies |
| Sleep study unattended (95806) | $691.40 | $864.25 | 3.2× |
| Speech Audiometry Complete (92556) | $78.20 | $97.75 | 1.3× |
| Speech audiometry threshold (92555) | $52 | $65 | 0.9× |
| Speech sound lang comprehen (92523) range across 2 matching MRF lines |
$376.40–$395.40 | $470.50–$494.25 | varies |
| Spirometry (94010) range across 6 matching MRF lines |
$63.20–$317.40 | $79–$396.75 | varies |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$2,647.80–$2,780.20 | $3,309.75–$3,475.25 | varies |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$580.80–$602.40 | $726–$753 | varies |
| Tensilon Test (95857) | $68.80 | $86 | 0.3× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 3 matching MRF lines |
$67.60–$80.80 | $84.50–$101 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) range across 3 matching MRF lines |
$67.60–$80.80 | $84.50–$101 | varies |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) range across 2 matching MRF lines |
$127.20–$150.60 | $159–$188.25 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 2 matching MRF lines |
$100.40–$112.60 | $125.50–$140.75 | varies |
| Ther/Proph/Diag Inj Ia (96373) | $40 | $50 | 0.2× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 9 matching MRF lines |
$45.60–$160.80 | $57–$201 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 5 matching MRF lines |
$124.80–$520 | $156–$650 | varies |
| Therapeutic Activities (97530) range across 7 matching MRF lines |
$124.20–$621 | $155.25–$776.25 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$39.20–$80.40 | $49–$100.50 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $22.40 | $28 | 0.6× |
| Trans Care Mgmt 14 Day Disch (99495) | $201.60 | $252 | 1.5× |
| Trans Care Mgmt 7 Day Disch (99496) | $289.60 | $362 | 2.2× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) range across 3 matching MRF lines |
$40–$117 | $50–$146.25 | varies |
| Tte w/doppler, complete (93306) range across 3 matching MRF lines |
$240–$2,224.60 | $300–$2,780.75 | varies |
| Tte W/O Doppler Complete (93307) range across 2 matching MRF lines |
$290.40–$1,412.20 | $363–$1,765.25 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 2 matching MRF lines |
$259.80–$272.80 | $324.75–$341 | varies |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $43 | $53.75 | 1.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 6 matching MRF lines |
$141.80–$904.80 | $177.25–$1,131 | varies |
| Tympanometry (92567) | $34.40 | $43 | 0.9× |
| Tympanometry and reflex threshold measurements (92550) range across 2 matching MRF lines |
$120.80–$126.40 | $151–$158 | varies |
| Unlisted allergy/clinical immunologic srvc/px (95199) range across 2 matching MRF lines |
$178.40–$235.20 | $223–$294 | varies |
| Unlisted cardiovascular service/procedure (93799) range across 3 matching MRF lines |
$1,106.60–$1,608 | $1,383.25–$2,010 | varies |
| Upr/L Xtremity Art 2 Levels (93922) range across 4 matching MRF lines |
$202.40–$341.80 | $253–$427.25 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 2 matching MRF lines |
$306.40–$703.20 | $383–$879 | varies |
| Vasopneumatic device (97016) range across 5 matching MRF lines |
$61.20–$70.60 | $76.50–$88.25 | varies |
| Vent Mgmt Inpat Init Day (94002) | $156.80 | $196 | 0.3× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) range across 2 matching MRF lines |
$1,831.60–$1,923.20 | $2,289.50–$2,404 | varies |
| Visual Field Exam Extended (92083) range across 3 matching MRF lines |
$45.60–$140 | $57–$175 | varies |
| Visual field xm uni/bi w/interp intermed exam (92082) range across 3 matching MRF lines |
$36–$86.40 | $45–$108 | varies |
| Visual field xm uni/bi w/interpretj limited exam (92081) range across 3 matching MRF lines |
$28–$78.40 | $35–$98 | varies |
| Vital capacity, total (94150) | $83.80 | $104.75 | 0.7× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$103–$108.20 | $128.75–$135.25 | varies |
| Whirlpool Therapy (97022) range across 4 matching MRF lines |
$139.60–$193 | $174.50–$241.25 | varies |
| Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) range across 3 matching MRF lines |
$5.60–$56 | $7–$70 | varies |
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.