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 →

ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndls w/elec stimj 1st 15 min (97813) $52 $65 1.8×
Airway inhalation treatment (94640) $165.40 $206.75 0.8×
Ambulatory Bp Analysis (93788) $148.20 $185.25 1.1×
Ambulatory Bp Recording (93786) $177.80 $222.25 1.3×
Analyze Neurostim Complex (95972) $491.20 $614 5.2×
Analyze neurostim no prog (95970) $285.60 $357 2.1×
Assessment of aphasia (96105) $265.80 $332.25 2.7×
Assmt & care planning pt w/cognitive impairment (99483) $363.20 $454 3.6×
Behavioral and qualitative analysis of voice and resonance (92524) $326.40 $408 3.0×
Blink reflex test (95933) $124 $155 2.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $468.40 $585.50 1.3×
C motor evoked upr&lwr limbs (95939) $876 $1,095 1.0×
Canalith Repositioning (95992) $99.20 $124 2.4×
Cardiac Stress Tst,Tracing Only (93017) $791.40 $989.25 3.7×
Cardiopulmonary resuscitation (92950) $1,340.70 $1,675.88 6.2×
Cardioversion (92960) $1,620.60 $2,025.75 2.4×
Cardioversion internal (92961) $463.20 $579 0.7×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $7,582.40 $9,478 2.3×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $12,320.80 $15,401 3.8×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $11,069 $13,836.25 3.4×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $11,468.60 $14,335.75 3.5×
Chemo Hormon Antineopl Sq/Im (96402) $135.60 $169.50 1.9×
Chemother, IV infusion, 1 hr (96413) $594 $742.50 1.8×
Chemother, IV infusion, ea add hr (96415) $203 $253.75 2.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $251.60 $314.50 3.5×
Color/duplex Doppler, complete (93975) $1,068.20 $1,335.25 4.5×
Color/duplex Doppler, limited (93976) $500.90 $626.12 4.8×
Comprehensive Hearing Test (92557) $178.80 $223.50 1.4×
Computerized Ophthalmic Imaging Anterior Segment (92132) $50.40 $63 0.9×
Computerized Ophthalmic Imaging Optic Nerve (92133) $50.40 $63 0.9×
Conditioning Play Audiometry (92582) $96.60 $120.75 0.7×
Cont Gluc Monitoring Patient Provided Equipment (95249) $97.20 $121.50 1.6×
Continuous Glucose Monitoring (95250) $188.80 $236 1.4×
Corneal Topography (92025) $50.40 $63 0.9×
Coronary artery angio s&i (93454) $8,623.20 $10,779 2.7×
Cpap initiation and management (94660) $71.20 $89 0.3×
Cpt initial (94667) $104 $130 0.8×
Cptrized oph dx img pst segment uni/bi retina (92134) $50.40 $63 0.9×
Critical care (99291) $1,894.80 $2,368.50 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $167.30 $209.12 0.8×
Demo &/or eval,pt use,aerosol device (94664) $59.80 $74.75 0.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $985.70 $1,232.12 4.1×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $738.70 $923.38 7.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,410.40 $1,763 5.9×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $705.20 $881.50 6.7×
Dup-scan xtr veins unilateral/limited study (93971) $776.80 $971 7.4×
Duplex scan extracranial art compl bi study (93880) $919.50 $1,149.38 3.8×
Ear and throat examination (92502) $160 $200 0.3×
Echo Heart Xthoracic,Limited (93308) $480.60 $600.75 2.0×
Echo transesophageal (93312) $2,657.90 $3,322.38 4.9×
Echo Transthoracic - Congenital Tte Complete (93303) $2,118.60 $2,648.25 3.9×
Echo Transthoracic - Congenital Tte Limited (93304) $241.60 $302 0.4×
EEG awake asleep (95819) $967 $1,208.75 4.5×
EEG awake drowsy (95816) $867.60 $1,084.50 4.0×
EEG cerebral death evaluation (95824) $773.40 $966.75 2.1×
EEG coma or sleep only (95822) $943.40 $1,179.25 4.4×
Eeg Extended Monitoring 61-119 Minutes (95813) $1,981.20 $2,476.50 9.2×
EKG (93005) $58.40 $73 1.0×
EKG rhythm strip (93041) $145.60 $182 2.5×
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×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $1,115.30 $1,394.12 5.2×
EMG cranial nerve bilat (95868) $160.40 $200.50 0.7×
EMG cranial nerve unilat (95867) $109.60 $137 0.5×
EMG four extremities (95864) $248.80 $311 1.9×
EMG one extremity (95860) $139.20 $174 1.0×
EMG three extremities (95863) $222 $277.50 1.7×
EMG two extremities (95861) $108 $135 0.8×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $2,111 $2,638.75 1.7×
Er level 1 (99281) $253 $316.25 3.0×
Er level ii (99282) $370.60 $463.25 2.4×
Er level iii (99283) $558 $697.50 2.0×
Er level IV (99284) $916.20 $1,145.25 2.2×
Er level v (99285) $1,026.10 $1,282.62 1.7×
Evaluation of speech fluency (92521) $295.60 $369.50 2.2×
Evaluation of speech sound production (92522) $304.90 $381.12 2.7×
Evaluation of swallowing function (92610) $334.60 $418.25 3.9×
Exam of visual field with extended testing (92083) $95.20 $119 0.7×
Exam of visual field with intermediate testing (92082) $50.40 $63 0.9×
Exam of visual field with limited testing (92081) $50.40 $63 0.9×
Excimer laser tx psoriasis tot area <250 sq cm (96920) $500 $625 2.5×
External ECG rec>48hr<7d recording (93242) $323.70 $404.62 8.7×
External ECG rec>7d<15d recording (93246) $308.20 $385.25 8.2×
External Ecg Scanning Analysis Report (93226) $434.40 $543 7.4×
External ocular photography (92285) $50.40 $63 1.3×
Eye exam w anesth; complete (92018) $236.80 $296 0.1×
Eye exam w anesth; limited (92019) $118.40 $148 0.0×
Eye exam, new patient,comprehesv (92004) $162.40 $203 1.2×
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) $224 $280 1.0×
Fundus photography w/interpretation & report (92250) $95.20 $119 0.7×
Gonioscopy (92020) $95.20 $119 0.7×
Group Therapeutic Procedures (97150) $100 $125 5.5×
Holter Monitor Recording (93225) $616.30 $770.38 4.6×
Icd Device Interrogate (93289) $48.80 $61 1.3×
Ilr Device Eval Progr (93285) $57 $71.25 1.5×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $41.60 $52 1.0×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $19.40 $24.25 0.3×
Immunization Admin (90471) $56 $70 0.8×
Immunotherapy, 2+ Injections (95117) $31.20 $39 0.7×
Inhlj Brncl Challenge Tstg W/Histamine/Methachol (95070) $606.80 $758.50 1.6×
Inital newborn e/m (99460) $153.60 $192 1.2×
Injection intra arterial (96373) $40 $50 0.2×
Ins swan ganz bedside (93503) $1,500.60 $1,875.75 1.0×
Interrog dev eval icpms phys/qhp in person (93290) $15.20 $19 0.4×
Interrog dev eval scrms phys/qhp in person (93291) $61.40 $76.75 2.1×
Interrogate subq defib (93261) $29.60 $37 0.8×
Interrogation eval in person wr defibrillator (93292) $32.80 $41 0.9×
Intracutaneous tests w/allergenic xtrcs airborne (95027) $14.40 $18 0.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $156.20 $195.25 2.6×
IV infusion hydration each additional hour (96361) $407.60 $509.50 8.7×
IV infusion hydration initial 31 min-1 hour (96360) $395.60 $494.50 1.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $488.20 $610.25 6.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $512.80 $641 2.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $286.20 $357.75 6.1×
IV push initial (96374) $267.80 $334.75 1.3×
Maintenance of spinal canal or brain drug infusion pump (95990) $178.40 $223 0.5×
Manual therapy 15 min (97140) $269.60 $337 9.7×
Massage 15 min (97124) $106.50 $133.12 3.6×
Maximum voluntary ventilation (94200) $88.70 $110.88 1.5×
Mechanical chest wall oscillation (94669) $224.80 $281 1.0×
Mechanical traction (97012) $120.40 $150.50 8.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $44.80 $56 1.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $50.70 $63.38 1.4×
Methacholine challenge (94070) $510 $637.50 1.4×
Mnt Group Ea 30 Min (97804) $26.20 $32.75 1.5×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $354.50 $443.12 3.9×
Motor &/sens nrv cndj preconf eltrd array limb (95905) $138.80 $173.50 0.3×
Multiple sleep latency test (95805) $1,479.60 $1,849.50 1.7×
Nasopharyngoscopy (92511) $212 $265 1.1×
Needle electromyography larynx (95865) $228 $285 1.7×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $96.80 $121 0.7×
Needle EMG w/1 fiber electrode quan meas jitter (95872) $351.20 $439 1.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $180 $225 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $212.80 $266 0.5×
Nerve conduction studies 13/> studies (95913) $360 $450 1.0×
Nerve Conduction Studies 3-4 Studies (95908) $160 $200 0.7×
Nerve Conduction Studies 9-10 Studies (95911) $270.80 $338.50 0.7×
Nerve conduction studies; 1-2 studies (95907) $132.40 $165.50 0.6×
Nerve conduction studies; 11-12 studies (95912) $314 $392.50 0.8×
Nerve conduction studies; 5-6 studies (95909) $135.20 $169 0.6×
Nerve conduction studies; 7-8 studies (95910) $226 $282.50 0.6×
Neurobehavioral Status Exam (96116) $122.80 $153.50 0.6×
Neuromuscular junction test (95937) $118.40 $148 0.9×
New patient problem focused exam of visual system (92002) $103.20 $129 0.8×
Newborn resuscitation (99465) $271.20 $339 0.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $333.60 $417 2.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $504.80 $631 2.3×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $157.80 $197.25 1.2×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $130.40 $163 1.0×
Ophth medical xm&eval intermediate estab pt (92012) $103.20 $129 0.8×
Ophthalmic biometry (92136) $95.20 $119 0.7×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $128 $160 2.8×
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 Community/Work Reintegration Trainj Ea 15 Min (97537) $119.70 $149.62 3.7×
Ot Contrast Bath Ea 15 Min (97034) $66.20 $82.75 4.7×
Ot eval high complex 60 min (97167) $364.40 $455.50 3.6×
Ot eval low complex 30 min (97165) $249.20 $311.50 2.5×
Ot eval mod complex 45 min (97166) $306.60 $383.25 3.0×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $180.80 $226 3.6×
Ot Prosthetic Training, Each 15 Min (97761) $96.40 $120.50 2.4×
Ot Range Motion Measure,Each Extrem (95851) $102.90 $128.62 4.0×
Ot re-eval est plan care (97168) $163.60 $204.50 2.4×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $320.90 $401.12 2.5×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $6.60 $8.25 0.1×
Paraffin bath (97018) $93.40 $116.75 15.5×
Percutaneous tests w/allergenic extracts (95004) $384 $480 0.4×
Peripheral arterial disease rehab per session (93668) $124.70 $155.88 2.1×
Photochemotx tar&uvb/petrolatum/uvb (96910) $48 $60 0.8×
Phy/qhp op pulm rhb w/mntr (94626) $268 $335 4.5×
Phy/qhp op pulm rhb w/o mntr (94625) $268 $335 4.5×
Plethysmography (94726) $479.80 $599.75 1.3×
Pm device eval in person (93288) $75.40 $94.25 2.0×
Pm device progr eval dual (93280) $51.10 $63.88 1.4×
Pm device progr eval multi (93281) $57.60 $72 1.5×
Pm device progr eval sngl (93279) $48.30 $60.38 1.3×
Pm/Icd Remote Tech Serv (93296) $127.20 $159 3.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,343.40 $5,429.25 5.0×
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) $33.20 $41.50 0.7×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $29.60 $37 0.8×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $65.60 $82 1.8×
Programming of dual lead implantable defibrillator system (93283) $67 $83.75 1.8×
Programming of single lead implantable defibrillator system (93282) $68.40 $85.50 1.8×
Prq card revasc chronic 1vsl (92943) $12,171.20 $15,214 1.1×
Prq Card Stent W/Angio 1 Vsl (92928) $14,786.70 $18,483.38 1.3×
Prq Card Stent/Ath/Angio (92933) $27,351.60 $34,189.50 1.5×
Prq revasc byp graft 1 vsl (92937) $15,520.60 $19,400.75 1.3×
Prq trluml coronary angio/atherect one art/brnch (92924) $16,291.80 $20,364.75 1.4×
Prq trluml coronary angioplasty one art/branch (92920) $5,874.20 $7,342.75 1.0×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $210.40 $263 0.5×
Pt Aquatic Therapy/Exercises (97113) $138.90 $173.62 3.7×
Pt Electric Current Therapy (97033) $161.60 $202 8.5×
Pt Electrical Stimulation (97032) $102.40 $128 7.0×
Pt eval high complex 45 min (97163) $366.80 $458.50 3.7×
Pt eval low complex 20 min (97161) $256.80 $321 2.6×
Pt Gait Training Therapy (97116) $116 $145 4.0×
Pt Infrared Therapy (97026) $26 $32.50 3.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $144.80 $181 4.4×
Pt Physical Performance Test (97750) $88 $110 2.6×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $256 $320 2.6×
Pt re-evaluation (97164) $180.40 $225.50 2.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $114.20 $142.75 3.5×
Pt Ultrasound Therapy (97035) $103.80 $129.75 7.2×
Pt Whirlpool Therapy (97022) $165.20 $206.50 10.5×
Pulmonary stress testing (94618) $122.40 $153 0.9×
Pure Tone Audiometry, Air (92552) $59.80 $74.75 0.4×
R & l hrt cath w/njx l ventriculog img s&i (93453) $8,777.20 $10,971.50 2.7×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $13,005.20 $16,256.50 4.0×
R hrt art/grft angio (93457) $11,578.40 $14,473 3.6×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $7,751.90 $9,689.88 2.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $260.20 $325.25 7.0×
Replace contact lens (92326) $95.20 $119 1.6×
Right heart cath (93451) $5,177.10 $6,471.38 1.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $211.20 $264 1.1×
Rom meas&reprt hand w/wo comparison normal sid (95852) $78.50 $98.12 3.7×
Rt Chest Wall Manipulation,Subsequent (94668) $75.60 $94.50 0.6×
Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) $63.20 $79 1.1×
Sensory Integration Ea 15 Min (97533) $98 $122.50 1.6×
Sleep study unattended (95806) $691.40 $864.25 3.2×
Smoking cessation > 10 min (99407) $59.80 $74.75 1.6×
Speech Audiometry Threshold (92555) $52 $65 0.9×
Speech Audiometry, Complete (92556) $78.20 $97.75 1.3×
Speech group therapy (92508) $43 $53.75 1.8×
Speech sound lang comprehen (92523) $385.90 $482.38 1.7×
Spirometry (94010) $255.30 $319.12 1.2×
Stress echo (93350) $2,714 $3,392.50 5.0×
Temp transcutaneous pacing (92953) $591.60 $739.50 0.9×
Tensilon test (95857) $68.80 $86 0.3×
Test for allergy using allergenic extract injected into skin (95024) $530.40 $663 9.0×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $76.80 $96 3.4×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $76.80 $96 3.7×
Ther/Proph/Diag Inj Sc/Im (96372) $64.20 $80.25 0.9×
Therapeutic Activities (97530) $248.40 $310.50 7.1×
Therapeutic phlebotomy (99195) $349.20 $436.50 2.6×
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) $101.60 $127 2.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,118.60 $2,648.25 3.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $851.30 $1,064.12 3.6×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $266.30 $332.88 3.5×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $276.80 $346 3.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $158.40 $198 3.4×
Tympanometry (92567) $34.40 $43 0.9×
Tympanometry And Reflex Threshold Measurements (92550) $123.60 $154.50 0.6×
Ultraviolet Light Therapy (96900) $28.80 $36 0.8×
Unlisted allergy/clinical immunologic service or procedure Cardiac Catheterization (95199) $206.80 $258.50 7.1×
Unlisted Cardiovascular Service/Procedure (93799) $1,162 $1,452.50 9.0×
Vasc Duplex Extrem Venous,Bilat (93970) $915.90 $1,144.88 3.8×
Vasc Duplex Scan Extracranial,Limited (93882) $402.60 $503.25 3.8×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $581.90 $727.38 2.7×
Vasopneumatic device (97016) $67.20 $84 5.6×
Ventilation assist & mgmt inpatient 1st day (94002) $156.80 $196 0.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,877.40 $2,346.75 3.0×
Vital capacity total (94150) $83.80 $104.75 0.7×
Wheelchair Mgmt Ea 15 Min (97542) $105.60 $132 3.4×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $642.10 $802.62 6.7×