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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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $202.72 $270.30 2.0×
Airway inhalation treatment (94640) $103.08 $137.45 0.5×
Allergy injection single (95115) $21.60 $28.80 0.5×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $22.50 $30
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $57.75 $77
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $45.75 $61
Assessment of aphasia (96105) $126 $168
Behavioral & qualit analysis voice and resonance (92524) $105 $140
Bipap initial day (94660) $633.98 $845.30 2.8×
Breathing capacity test (94010) $283.50 $378 1.3×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $526.50 $702 1.4×
Cardioversion elective external (92960) $1,154.92 $1,539.90 1.7×
Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a… (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 training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $35.25 $47
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) $197.70 $263.60 1.1×
Cpr (92950) $571.02 $761.35 2.6×
Critical care ill/injured patient init 30-74 min (99291) $1,737.08 $2,316.10 2.1×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $815.92 $1,087.90 3.3×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $1,036.72 $1,382.30 4.3×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $1,355.02 $1,806.70 5.6×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $552.90 $737.20 5.2×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $922.88 $1,230.50 3.8×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $584.78 $779.70 5.5×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $922.88 $1,230.50 3.8×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $584.78 $779.70 5.5×
ECG monit/reprt up to 48 hrs (93226) $499.42 $665.90 8.3×
EKG 12 lead tracing only (93005) $207 $276 3.4×
Emergency department visit high mdm (99285) $1,286.85 $1,715.80 2.1×
Emergency department visit low mdm (99283) $558.90 $745.20 2.0×
Emergency department visit may not req phys/qhp (99281) $219.08 $292.10 2.5×
Emergency department visit moderate mdm (99284) $893.55 $1,191.40 2.1×
Emergency department visit straightforward mdm (99282) $322.14 $429.52 2.1×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $85.50 $114
Evaluation of speech fluency (92521) $129.75 $173
Evaluation of speech sound production articulate (92522) $108 $144
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $394.20 $525.60 2.9×
Fluidotherapy (97022) $27 $36
Im adm intransl/oral 1 vaccine (90473) $18.75 $25 0.3×
Imm admn sarscov2 vaccine single dose (90480) $18.75 $25 0.5×
Immunization administration (90471) $19.88 $26.50 0.3×
Infrared therapy (97026) $32.25 $43
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $104.40 $139.20 2.2×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $227.70 $303.60 1.0×
Irrigaj implntd venous access drug delivery syst (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 1st to 1 hr (96365) $427.80 $570.40 2.0×
IV tx, each additional hour (96366) $118.20 $157.60 2.5×
Mechanical traction therapy (97012) $18.75 $25
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $51.75 $69
Medical nutrition group (97804) $29.32 $39.10
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) $44.02 $58.70
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×
Occupational therapy eval high complex 60 mins (97167) $258.75 $345
Occupational therapy eval low complex 30 mins (97165) $130.50 $174
Occupational therapy eval mod complex 45 mins (97166) $195 $260
Oral function therapy (92526) $100.50 $134
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $44.25 $59
Ot manual therapy ea 15 min (97140) $57.75 $77
Ot neuromuscular re-education (97112) $60 $80
Ot paraffin bath (97018) $12.75 $17
OT Therapeutic Activities Charges (97530) $40.50 $54
Ot wheelchair management (97542) $79.50 $106
Phlebotomy therapeutic (99195) $87.15 $116.20 0.6×
Physical therapy evaluation high complex 45 mins (97163) $120.75 $161
Physical therapy evaluation low complex 20 mins (97161) $95.25 $127
Physical therapy evaluation mod complex 30 mins (97162) $168 $224
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $133.50 $178 1.3×
Professional services for allergen immunotherapy; 2 or more injections (95117) $28.50 $38 0.6×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $38.25 $51
Pt gait training 15 min (97116) $69.75 $93
Pt physical performance test (97750) $38.25 $51
Pt re-evaluation (97164) $48.75 $65
Pulmonary stress testing (94618) $228.21 $304.28 1.7×
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section… (95851) $9 $12
Rem mntr physiol param 1st dev supply ea 30 d (99454) $101.92 $135.90 2.7×
Remote ther mntr tx mgmt phys/qhp 1st 20 min (98980) $109.12 $145.50
Remote ther mntr tx mgmt phys/qhp ea addl 20 min (98981) $86.18 $114.90
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $43.05 $57.40 0.3×
Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s)… (98977) $101.92 $135.90 2.7×
Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s)… (98976) $101.92 $135.90 2.7×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $41.25 $55
Speech sound lang comprehen (92523) $227.25 $303
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $21 $28
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $30.75 $41
Therapeutic prophylactic/dx injection subq/im (96372) $40.58 $54.10 0.6×
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 f-up or lmtd (93308) $911.70 $1,215.60 3.7×
Tte w/doppler complete (93306) $2,042.40 $2,723.20 3.7×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $164.25 $219
Upr/l xtremity art 2 levels (93922) $298.42 $397.90 2.2×
Ventilation ip/obs initial day (94002) $1,105.72 $1,474.30 1.8×
Ventilator subsequent day (94003) $1,105.72 $1,474.30 1.8×
Wound(s) care non-selective (97602) $155.25 $207 0.8×