Visits & medical services prices at Memorial Hospital of Converse County
Douglas, WY · every code in this section with a posted price and a Medicare benchmark.
127 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) range across 5 matching MRF lines |
$44.46–$161.88 | $78–$284 | varies |
| Analyze neurostim complex (95972) range across 2 matching MRF lines |
$360.24–$2,161.82 | $632–$3,792.66 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $41.61 | $73 | 2.9× |
| Application Modality 1/> Areas Infrared (97026) | $29.07 | $51 | 4.4× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$315.78–$338.01 | $554–$593 | varies |
| C motor evoked uppr limbs (95928) | $538.08 | $944 | 0.6× |
| C motor evoked upr&lwr limbs (95939) | $2,789.58 | $4,894 | 3.2× |
| Canalith repositioning proc (95992) range across 3 matching MRF lines |
$32.49–$73.53 | $57–$129 | varies |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$748.41–$800.85 | $1,313–$1,405 | varies |
| Cardiopulmonary resuscitation (92950) | $1,059.06 | $1,858 | 4.8× |
| Cardioversion (92960) range across 2 matching MRF lines |
$1,131.45–$1,210.68 | $1,985–$2,124 | varies |
| Cbt 1st hour (94644) | $141.93 | $249 | 1.0× |
| Chemo IV infusion addl hr (96415) range across 3 matching MRF lines |
$107.73–$137.94 | $189–$242 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 3 matching MRF lines |
$347.70–$554.61 | $610–$973 | varies |
| Chest Wall Manipulation (94668) range across 2 matching MRF lines |
$90.63–$168.72 | $159–$296 | varies |
| Color/duplex Doppler, complete (93975) | $656.64 | $1,152 | 2.7× |
| Cont gluc mntr physician/qhp provided equiptment (95250) range across 2 matching MRF lines |
$198.93–$391.59 | $349–$687 | varies |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $197.22 | $346 | 3.3× |
| Continuous Pulse Ox (94762) range across 2 matching MRF lines |
$19.95–$62.13 | $35–$109 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$367.65–$577.41 | $645–$1,013 | varies |
| Cpt initial (94667) | $121.98 | $214 | 0.9× |
| Critical care first hour (99291) range across 2 matching MRF lines |
$1,523.61–$1,630.77 | $2,673–$2,861 | varies |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) | $538.08 | $944 | 1.4× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$70.68–$404.70 | $124–$710 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $885.21 | $1,553 | 3.6× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $663.48 | $1,164 | 6.2× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$977.55–$1,046.52 | $1,715–$1,836 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$703.95–$753.54 | $1,235–$1,322 | varies |
| Duplex up extrem art bilat (93930) | $891.48 | $1,564 | 3.7× |
| Duplex up extrem art unilat/ltd (93931) | $649.80 | $1,140 | 6.1× |
| Echo Heart Xthoracic,Limited (93308) | $491.91 | $863 | 2.0× |
| Eeg 41-60 Minutes (95812) | $567.15 | $995 | 2.6× |
| EEG extended monitoring 61-119 minutes (95813) | $636.69 | $1,117 | 2.9× |
| Elec alys implt brn npgt prgrmg 1st 15 min (95983) | $33.06 | $58 | 0.3× |
| Electrical Stimulation Ea 15 Min (97032) | $53.58 | $94 | 3.6× |
| Electrocardiogram Tracing (93005) range across 4 matching MRF lines |
$167.01–$334.02 | $293–$586 | varies |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$310.65–$332.88 | $545–$584 | varies |
| Emergency Dept Visit Level 3 (99283) range across 3 matching MRF lines |
$457.71–$915.42 | $803–$1,606 | varies |
| Emergency Dept Visit Level 4 (99284) range across 2 matching MRF lines |
$682.86–$730.74 | $1,198–$1,282 | varies |
| Emg 3 Extremities (95863) | $265.62 | $466 | 2.0× |
| Emg 4 Extremities (95864) | $1,181.04 | $2,072 | 9.0× |
| Er level 1 (99281) | $201.21 | $353 | 2.3× |
| Er level v (99285) range across 2 matching MRF lines |
$995.22–$1,065.33 | $1,746–$1,869 | varies |
| Evaluate pt use of inhaler (94664) | $149.34 | $262 | 0.7× |
| Evaluate Swallowing Function (92610) range across 2 matching MRF lines |
$135.09–$144.78 | $237–$254 | varies |
| External ECG rec>48hr<7d recording (93242) | $49.02 | $86 | 1.3× |
| External ECG rec>7d<15d recording (93246) | $49.02 | $86 | 1.3× |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$420.09–$449.73 | $737–$789 | varies |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$760.38–$813.96 | $1,334–$1,428 | varies |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$348.84–$373.35 | $612–$655 | varies |
| Img retina detcj/mntr ds rem clin staff uni/bi (92227) | $10.83 | $19 | 0.2× |
| Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) | $20.52 | $36 | 0.5× |
| Immunization administration (90471) range across 5 matching MRF lines |
$10.26–$66.12 | $18–$116 | varies |
| Intracutaneous tests w/allergenic extracts (95024) | $7.41 | $13 | 0.1× |
| Iontophoresis 15 min (97033) | $79.23 | $139 | 4.2× |
| IV infusion hydration each additional hour (96361) range across 5 matching MRF lines |
$74.10–$340.29 | $130–$597 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 6 matching MRF lines |
$42.75–$286.71 | $75–$503 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 5 matching MRF lines |
$118.56–$272.46 | $208–$478 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 6 matching MRF lines |
$17.10–$515.28 | $30–$904 | varies |
| IV push initial (96374) range across 5 matching MRF lines |
$108.30–$198.36 | $190–$348 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 3 matching MRF lines |
$22.23–$44.46 | $39–$78 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 3 matching MRF lines |
$22.23–$69.54 | $39–$122 | varies |
| Multiple Sleep Latency Test (95805) | $2,191.08 | $3,844 | 2.5× |
| Muscle Test 2 Limbs (95861) | $240.54 | $422 | 1.8× |
| Muscle Test Hemidiaphragm (95866) | $195.51 | $343 | 1.5× |
| Muscle Test Nonparaspinal (95870) | $163.59 | $287 | 1.2× |
| Muscle Test One Limb (95860) | $166.44 | $292 | 1.2× |
| Nasopharyngoscopy (92511) range across 3 matching MRF lines |
$34.20–$791.35 | $60–$1,388.33 | varies |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $274.17 | $481 | 1.2× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) | $189.81 | $333 | 0.9× |
| Needle electromyography larynx (95865) | $242.82 | $426 | 1.8× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $142.50 | $250 | 0.6× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $579.69 | $1,017 | 1.4× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $27.93 | $49 | 0.1× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $408.69 | $717 | 1.0× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$54.72–$58.71 | $96–$103 | varies |
| Oculoelectromyography (92265) | $107.73 | $189 | 1.8× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 2 matching MRF lines |
$57–$60.99 | $100–$107 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$21.09–$22.80 | $37–$40 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$31.92–$34.20 | $56–$60 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) range across 2 matching MRF lines |
$41.61–$45.03 | $73–$79 | varies |
| Osteopathic manipulative tx 7-8 body regions (98928) range across 2 matching MRF lines |
$52.44–$56.43 | $92–$99 | varies |
| Osteopathic manipulative tx 9-10 body regions (98929) | $67.83 | $119 | 3.1× |
| Ot eval high complexity (97167) | $189.81 | $333 | 1.9× |
| Ot Eval Low Complex (97165) range across 2 matching MRF lines |
$117.99–$126.54 | $207–$222 | varies |
| Ot Eval Moderate Complexity (97166) range across 2 matching MRF lines |
$147.63–$158.46 | $259–$278 | varies |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$42.18–$60.42 | $74–$106 | varies |
| Ot Re-Eval Est Plan Care (97168) | $145.35 | $255 | 2.1× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$153.90–$198.36 | $270–$348 | varies |
| Percutaneous tests w/allergenic extracts (95004) | $6.27 | $11 | 0.0× |
| Phlebotomy therapeutic (99195) range across 3 matching MRF lines |
$17.10–$130.53 | $30–$229 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $156.18 | $274 | 2.6× |
| Physical Performance Test (97750) | $144.78 | $254 | 4.3× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 3 matching MRF lines |
$2,848.29–$3,217.65 | $4,997–$5,645 | varies |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 3 matching MRF lines |
$19.95–$22.80 | $35–$40 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 3 matching MRF lines |
$27.93–$31.92 | $49–$56 | varies |
| Pt Eval High Complex (97163) range across 2 matching MRF lines |
$164.73–$176.70 | $289–$310 | varies |
| Pt eval low complex 20 min (97161) range across 2 matching MRF lines |
$115.14–$123.69 | $202–$217 | varies |
| Pt Eval Mod Complex (97162) range across 2 matching MRF lines |
$144.78–$155.04 | $254–$272 | varies |
| Pt gait training 15 min (97116) range across 3 matching MRF lines |
$54.72–$109.44 | $96–$192 | varies |
| Pt Re-Eval Est Plan Care (97164) | $123.69 | $217 | 1.8× |
| Pulmonary Stress Testing (94618) | $26.79 | $47 | 0.2× |
| Respiratory flow volume loop (94375) range across 2 matching MRF lines |
$203.49–$217.74 | $357–$382 | varies |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$58.14–$62.70 | $102–$110 | varies |
| Short-latency somatosens ep std upr limbs (95925) | $372.78 | $654 | 1.7× |
| Sleep study unattended (95806) | $419.52 | $736 | 1.9× |
| Somatosensory Testing (95938) | $1,182.18 | $2,074 | 1.3× |
| Spin/Brain Pump Refil & Main (95991) range across 2 matching MRF lines |
$191.52–$205.20 | $336–$360 | varies |
| Ssep lower limbs (95926) | $372.78 | $654 | 1.7× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $75.24 | $132 | 2.0× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $53.58 | $94 | 1.8× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 9 matching MRF lines |
$35.91–$103.74 | $63–$182 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 5 matching MRF lines |
$55.86–$329.46 | $98–$578 | varies |
| Therapeutic Activities (97530) range across 3 matching MRF lines |
$54.72–$109.44 | $96–$192 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $25.65 | $45 | 0.7× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$1,697.46–$1,816.59 | $2,978–$3,187 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 5 matching MRF lines |
$121.41–$364.23 | $213–$639 | varies |
| Tympanometry (92567) | $53.01 | $93 | 1.4× |
| Unlisted cardiovascular service/procedure (93799) | $503.88 | $884 | 3.8× |
| Upr/L Xtremity Art 2 Levels (93922) | $419.52 | $736 | 3.1× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $84.36 | $148 | 0.4× |
| Vasopneumatic device (97016) | $41.61 | $73 | 3.5× |
| Vent Mgmt Inpat Init Day (94002) | $972.99 | $1,707 | 1.5× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) range across 2 matching MRF lines |
$909.15–$972.99 | $1,595–$1,707 | varies |
| Vital capacity, total (94150) | $63.84 | $112 | 0.5× |
| Wheelchair Mgmt Ea 15 Min (97542) | $59.85 | $105 | 1.9× |
| Whirlpool Therapy (97022) | $103.74 | $182 | 6.6× |
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.