Visits & medical services prices at Crook County Medical Services District

Sundance, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $18.75 $25 0.5×
Advncd Care Plan 30 Min (99497) $202.72 $270.30 2.0×
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines
$43.12–$163.05 $57.50–$217.40 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $45.75 $61 3.2×
Application Modality 1/> Areas Infrared (97026) $32.25 $43 4.8×
Assessment of aphasia per hr (96105) $126 $168 1.3×
Behavral qualit analys voice (92524) $105 $140 1.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $526.50 $702 1.4×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines
$544.28–$597.75 $725.70–$797 varies
Cardioversion (92960) $1,154.92 $1,539.90 1.7×
Care mgmt services behavioral hlth cond 20 mins (99484) $118.42 $157.90 3.1×
Chron Care Mgmt Srvc 20 Min (99490) $134.92 $179.90 1.3×
Color/duplex Doppler, complete (93975) $672.75 $897 2.8×
Color/duplex Doppler, limited (93976) $432.15 $576.20 4.0×
Community/Work Reintegration Trainj Ea 15 Min (97537) $35.25 $47 1.1×
Complex chronic care mgmt svc 1st 60 min cal mo (99487)
range across 2 matching MRF lines
$106.12–$289.28 $141.50–$385.70 varies
Cpap Ventilation Cpap Initiation&Mgmt (94660) $633.98 $845.30 2.8×
Critical care first hour (99291) $1,737.08 $2,316.10 2.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $815.92 $1,087.90 3.3×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $922.88 $1,230.50 3.8×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $584.78 $779.70 5.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 3 matching MRF lines
$1,355.02–$1,967.40 $1,806.70–$2,623.20 varies
Dup-scan xtr veins unilateral/limited study (93971) $552.90 $737.20 5.2×
Duplex up extrem art bilat (93930) $922.88 $1,230.50 3.8×
Duplex up extrem art unilat/ltd (93931) $584.78 $779.70 5.5×
Echo Heart Xthoracic,Limited (93308) $911.70 $1,215.60 3.7×
Electrical Stimulation Ea 15 Min (97032) $22.50 $30 1.5×
Electrocardiogram Tracing (93005) $207 $276 3.4×
Emergency Dept Visit Level 2 (99282) $322.14 $429.52 2.1×
Emergency Dept Visit Level 3 (99283) $558.90 $745.20 2.0×
Emergency Dept Visit Level 4 (99284) $893.55 $1,191.40 2.1×
Er level 1 (99281) $219.08 $292.10 2.5×
Er level v (99285) $1,286.85 $1,715.80 2.1×
Evaluate Speech Production (92522) $108 $144 1.0×
Evaluate Swallowing Function (92610) $85.50 $114 1.0×
Evaluation of speech fluency (92521) $129.75 $173 1.0×
External Ecg Scanning Analysis Report (93226) $499.42 $665.90 8.3×
Extracranial Bilat Study (93880) $1,036.72 $1,382.30 4.3×
Holter monitor recording (93225) $394.20 $525.60 2.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $18.75 $25 0.3×
Immunization administration (90471) $19.88 $26.50 0.3×
Iontophoresis 15 min (97033) $57.75 $77 3.0×
Irrig Drug Delivery Device (96523) $133.72 $178.30 2.2×
IV infusion hydration each additional hour (96361) $78.52 $104.70 1.6×
IV infusion hydration initial 31 min-1 hour (96360) $263.92 $351.90 1.2×
IV infusion ther proph addl sequential to 1 hr (96367) $104.40 $139.20 1.4×
IV infusion therapy prophylaxis/dx ea hour (96366) $118.20 $157.60 2.5×
IV push initial (96374) $227.70 $303.60 1.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $44.02 $58.70 1.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $51.75 $69 1.4×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $29.32 $39.10 1.7×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $651.22 $868.30 1.6×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $651.22 $868.30 1.6×
Neuromuscular Reeducation (97112) $60 $80 1.8×
Oral Function Therapy (92526) $100.50 $134 1.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $44.25 $59 1.0×
Ot eval high complexity (97167) $258.75 $345 2.6×
Ot Eval Low Complex (97165) $130.50 $174 1.3×
Ot Eval Moderate Complexity (97166) $195 $260 1.9×
Ot manual therapy 15 min (97140)
range across 6 matching MRF lines
$57.75–$66.45 $77–$88.60 varies
Ot paraffin bath (97018)
range across 3 matching MRF lines
$12.75–$14.70 $17–$19.60 varies
Ot Prosthetic Training, Each 15 Min (97761) $38.25 $51 0.9×
Phlebotomy therapeutic (99195) $87.15 $116.20 0.6×
Physical Performance Test (97750) $38.25 $51 1.1×
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $133.50 $178 1.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $21.60 $28.80 0.5×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $28.50 $38 0.6×
Pt Eval High Complex (97163) $120.75 $161 1.2×
Pt eval low complex 20 min (97161) $95.25 $127 1.0×
Pt Eval Mod Complex (97162) $168 $224 1.7×
Pt gait training 15 min (97116) $69.75 $93 2.4×
Pt mechanical traction (97012) $18.75 $25 1.3×
Pt Re-Eval Est Plan Care (97164) $48.75 $65 0.7×
Pulmonary Stress Testing (94618) $228.21 $304.28 1.7×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $101.92 $135.90 2.7×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $101.92 $135.90 2.7×
Rem ther mntr dev sply resp (98976) $101.92 $135.90 2.7×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $43.05 $57.40 0.3×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981) $86.18 $114.90 2.1×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980) $109.12 $145.50 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $155.25 $207 0.8×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $9 $12 0.3×
Self Care Mngment Training (97535) $41.25 $55 1.3×
Speech sound lang comprehen (92523) $227.25 $303 1.0×
Spirometry (94010) $283.50 $378 1.3×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $21 $28 0.9×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $30.75 $41 1.0×
Ther/Proph/Diag Inj Sc/Im (96372) $40.58 $54.10 0.6×
Ther/Proph/Diag Iv Inf Init (96365) $427.80 $570.40 2.0×
Therapeutic Activities (97530) $40.50 $54 1.2×
Tobacco Use Cessation Intensive >10 Minutes (99407) $28.50 $38 0.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $24.15 $32.20 0.6×
Trans Care Mgmt 14 Day Disch (99495) $144.08 $192.10 1.1×
Tte w/doppler, complete (93306) $2,042.40 $2,723.20 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $164.25 $219 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $104.40 $139.20 2.2×
Upr/L Xtremity Art 2 Levels (93922) $298.42 $397.90 2.2×
Vent Mgmt Inpat Init Day (94002) $1,105.72 $1,474.30 1.8×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,105.72 $1,474.30 1.8×
Wheelchair Mgmt Ea 15 Min (97542) $79.50 $106 2.6×
Whirlpool Therapy (97022) $27 $36 1.7×

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.