Visits & medical services prices at Community Memorial Hospital

Cloquet, MN · every code in this section with a posted price and a Medicare benchmark.

104 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) $112 $175 1.1×
Airway inhalation treatment (94640) $89.92 $140.50 0.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $221.44 $346 0.6×
Canalith Repositioning Procedure (95992) $86.40 $135 2.1×
Cardiac Stress Tst,Tracing Only (93017) $518.72 $810.50 2.3×
Cardiopulmonary resuscitation (92950) $438.40 $685 2.0×
Cardioversion (92960) $412.48 $644.50 0.6×
Caregiver hlth risk assmt score doc stnd instrm (96161) $12.80 $20 0.3×
Chemo Hormon Antineopl Sq/Im (96402) $133.76 $209 1.8×
Chemo IV push addl drug (96411) $106.88 $167 1.4×
Chemo prolong 8+ hrs infuse w/pump (96416) $654.72 $1,023 1.9×
Chemother, IV infusion, 1 hr (96413) $641.92 $1,003 1.9×
Chemother, IV infusion, ea add hr (96415) $356.48 $557 4.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $133.76 $209 1.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $356.48 $557 4.8×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $344.32 $538 1.0×
Chronic care management services 1st 20 min (99490) $72.96 $114 0.7×
Color/duplex Doppler, complete (93975) $929.92 $1,453 3.8×
Color/duplex Doppler, limited (93976) $650.88 $1,017 6.0×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $131.84 $206 0.7×
Comprehensive Hearing Test (92557) $23.04 $36 0.2×
Cont Gluc Monitoring Patient Provided Equipment (95249) $117.76 $184 1.9×
Continuous Glucose Monitoring (95250) $632.96 $989 4.6×
Cpap/bipap (94660) $139.84 $218.50 0.6×
Cpt initial (94667) $111.36 $174 0.8×
Critical care (99291) $485.12 $758 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $89.60 $140 0.4×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $254.72 $398 0.7×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $383.04 $598.50 3.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $341.76 $534 3.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,073.92 $1,678 4.4×
Dup-scan xtr veins unilateral/limited study (93971) $795.52 $1,243 7.4×
Duplex scan extracranial art compl bi study (93880) $1,073.92 $1,678 4.4×
EKG rhythm strip (93041) $93.44 $146 1.5×
Electrocardiogram Tracing (93005) $332.80 $520 5.5×
EMG one extremity (95860) $28.80 $45 0.2×
EMG two extremities (95861) $48 $75 0.3×
Er level 1 (99281) $104.48 $163.25 1.2×
Er level ii (99282) $190.56 $297.75 1.2×
Er level iii (99283) $279.68 $437 1.0×
Er level IV (99284) $439.68 $687 1.0×
Er level v (99285) $660.32 $1,031.75 1.1×
Evaluate Pt Use Of Inhaler (94664) $116.48 $182 0.5×
External ECG rec>48hr<7d recording (93242) $1,377.92 $2,153 35.7×
External ECG rec>7d<15d recording (93246) $1,377.92 $2,153 35.7×
External Ecg Scanning Analysis Report (93226) $187.52 $293 3.1×
Fluorescein angioscopy with interpretation and report Facility (92230) $64 $100 0.2×
Holter Monitor (93225) $701.12 $1,095.50 5.1×
Imm admn sarscov2 vaccine single dose (90480) $42.88 $67 1.0×
Immunization Admin (90471) $71.36 $111.50 1.0×
Inhalation bronchial challenge testing (95070) $817.92 $1,278 2.1×
Inital newborn e/m (99460) $160 $250 1.2×
Injection intra arterial (96373) $100.48 $157 0.5×
Ins swan ganz bedside (93503) $741.92 $1,159.25 0.5×
Irrig drug delivery device (96523) $74.88 $117 1.2×
IV infusion hydration each additional hour (96361) $60.80 $95 1.3×
IV infusion hydration initial 31 min-1 hour (96360) $161.60 $252.50 0.7×
IV infusion ther proph addl sequential to 1 hr (96367) $84.48 $132 1.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $117.12 $183 0.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $97.28 $152 2.0×
IV push ea addl new drug (96375) $62.72 $98 1.3×
IV push initial (96374) $90.24 $141 0.4×
Maximum voluntary ventilation (94200) $68.48 $107 1.1×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $68.48 $107 2.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $83.84 $131 2.3×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $78.72 $123 4.6×
Methacholine challenge (94070) $681.60 $1,065 1.8×
Neg press wound tx >50 cm (97608) $340.16 $531.50 0.8×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $76.16 $119 0.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $351.36 $549 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $115.20 $180 0.3×
Newborn resuscitation (99465) $315.20 $492.50 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $161.28 $252 1.2×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $225.28 $352 1.7×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $40 $62.50 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $239.36 $374 1.8×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $357.76 $559 2.7×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $229.76 $359 1.0×
Peripheral arterial disease rehab per session (93668) $234.24 $366 3.8×
Phlebotomy therapeutic (99195) $197.12 $308 1.4×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $186.88 $292 3.1×
Positional Nystagmus Test (92542) $28.80 $45 0.2×
Pulm function test by gas (94727) $136.32 $213 0.6×
Pulmonary Service/Procedure (94799) $181.76 $284 1.4×
Pulmonary stress test simple (94618) $136.32 $213 1.0×
Pure Tone Audiometry Air Only (92552) $53.76 $84 0.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $765.44 $1,196 19.9×
Respiratory flow volume loop (94375) $165.76 $259 0.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $85.12 $133 0.4×
Rt Chest Wall Manipulation,Subsequent (94668) $88.32 $138 0.6×
Spirometry (94010) $41.60 $65 0.2×
Stress echo (93350) $1,228.80 $1,920 2.2×
Therapeutic prophylactic/dx injection subq/im (96372) $40 $62.50 0.5×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $25.60 $40 0.7×
Trans Care Mgmt 14 Day Disch (99495) $175.20 $273.75 1.3×
Trans Care Mgmt 7 Day Disch (99496) $240 $375 1.7×
Tte w/doppler, complete (93306) $3,907.20 $6,105 6.9×
Tympanometry (92567) $13.92 $21.75 0.4×
Tympanometry And Reflex Threshold Measurements (92550) $35.20 $55 0.2×
Upr/lxtr art stdy 3+ lvls (93923) $307.84 $481 1.4×
Vent mgmt inpat init day (94002) $447.36 $699 0.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $444.80 $695 0.7×
Visual reinforcement audiometry (vra) (92579) $57.60 $90 0.3×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $238.08 $372 2.4×