Visits & medical services prices at Evanston Regional Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Aep hearing status deter broadband stimuli i&r (92651) $112.84 $188.07 0.5×
Airway inhalation treatment (94640) $210.09 $350.15 0.9×
Application of heat wave therapy (97024) $44.92 $74.86 6.1×
Assessment of aphasia (96105) $210.55 $350.92 2.2×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $62.88 $104.80 1.7×
Behavioral and qualitative analysis of voice and resonance (92524) $215.45 $359.08 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $221.18 $368.64 0.6×
Canalith Repositioning (95992) $162.66 $271.10 4.0×
Car seat/bed test 60 min (94780) $270.12 $450.20 7.1×
Cardiac Stress Tst,Tracing Only (93017) $765.05 $1,275.09 3.5×
Cardiopulmonary resuscitation (92950) $1,024.49 $1,707.49 4.6×
Cardioversion (92960) $1,576.15 $2,626.91 2.3×
Chemother, IV infusion, 1 hr (96413) $2,434.48 $4,057.46 7.2×
Chemother, IV infusion, ea add hr (96415) $1,391.12 $2,318.54 18.9×
Color/duplex Doppler, complete (93975) $525.55 $875.92 2.2×
Color/duplex Doppler, limited (93976) $372.21 $620.35 3.5×
Cpap initiation and management (94660) $643.59 $1,072.65 2.9×
Cpt initial (94667) $91.01 $151.68 0.7×
Critical care (99291) $2,654.96 $4,424.94 3.1×
Debridement Open Wound 20 Sq Cm< (97597) $379.24 $632.06 1.9×
Demo &/or eval,pt use,aerosol device (94664) $75.74 $126.24 0.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $525.55 $875.92 2.2×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $372.21 $620.35 3.5×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $637.93 $1,063.22 2.6×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $465.53 $775.89 4.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $637.93 $1,063.22 2.6×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $465.53 $775.89 4.4×
Dup-scan xtr veins unilateral/limited study (93971) $698.42 $1,164.03 6.5×
Duplex scan extracranial art compl bi study (93880) $824.70 $1,374.50 3.4×
Echo Heart Xthoracic,Limited (93308) $354.95 $591.58 1.5×
EKG (93005) $192 $320 3.2×
Er level 1 (99281) $192.93 $321.55 2.2×
Er level ii (99282) $445.10 $741.84 2.8×
Er level iii (99283) $694.82 $1,158.03 2.5×
Er level IV (99284) $1,223.57 $2,039.28 2.9×
Er level v (99285) $1,891.05 $3,151.75 3.1×
Evaluation of speech fluency (92521) $215.45 $359.08 1.6×
Evaluation of speech sound production (92522) $215.45 $359.08 1.9×
Evaluation of swallowing function (92610) $204.19 $340.32 2.4×
External ECG rec>48hr<7d recording (93242) $502.19 $836.98 13.2×
External ECG rec>7d<15d recording (93246) $502.19 $836.98 13.2×
External Ecg Scanning Analysis Report (93226) $517.28 $862.13 8.6×
Flow volume loop (94375) $139.96 $233.26 0.6×
Gastric motility studies (91020) $870.60 $1,451 2.3×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,016.90 $1,694.84 1.2×
Gi wireless capsule measure (91112) $1,156.42 $1,927.36 1.2×
Holter Monitor Recording (93225) $517.28 $862.13 3.8×
Immunization Admin (90471) $83.60 $139.33 1.1×
Ins swan ganz bedside (93503) $2,223.79 $3,706.32 1.4×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $186.41 $310.68 3.1×
IV infusion hydration each additional hour (96361) $182.81 $304.68 3.8×
IV infusion hydration initial 31 min-1 hour (96360) $296.15 $493.58 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $183.50 $305.84 2.5×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $443.72 $739.53 2.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $237.26 $395.44 5.0×
IV push initial (96374) $284.29 $473.82 1.3×
Manual therapy 15 min (97140) $118.62 $197.71 4.3×
Maximum voluntary ventilation (94200) $55.79 $92.99 0.9×
Mechanical traction (97012) $47 $78.33 3.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $57.31 $95.52 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $89.40 $149 2.4×
Methacholine challenge (94070) $132.87 $221.45 0.3×
Motility study esophagus (91010) $816.35 $1,360.58 2.1×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $247.64 $412.73 2.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $134.71 $224.52 0.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $196.84 $328.07 0.5×
Nerve conduction studies 13/> studies (95913) $480 $800 1.3×
Nerve Conduction Studies 3-4 Studies (95908) $480 $800 2.2×
Nerve Conduction Studies 9-10 Studies (95911) $480 $800 1.3×
Nerve conduction studies; 1-2 studies (95907) $480 $800 2.2×
Nerve conduction studies; 11-12 studies (95912) $480 $800 1.3×
Nerve conduction studies; 5-6 studies (95909) $480 $800 2.2×
Nerve conduction studies; 7-8 studies (95910) $480 $800 1.3×
Newborn resuscitation (99465) $632 $1,053.33 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $177.59 $295.98 1.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $293.72 $489.53 1.3×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $342.14 $570.23 2.6×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98972) $31.30 $52.17 0.9×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98970) $10.43 $17.39 0.8×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98971) $20.86 $34.77 0.9×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $63.78 $106.30 2.0×
Ot Contrast Bath Ea 15 Min (97034) $53.58 $89.31 3.8×
Ot eval high complex 60 min (97167) $98.35 $163.92 1.0×
Ot eval low complex 30 min (97165) $210.55 $350.92 2.1×
Ot eval mod complex 45 min (97166) $210.55 $350.92 2.1×
Ot re-eval est plan care (97168) $98.35 $163.92 1.4×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $148.69 $247.82 1.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $148.69 $247.82 1.1×
Paraffin bath (97018) $47 $78.33 7.8×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $242.10 $403.50 1.1×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,531.40 $5,885.67 4.0×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $1,809.98 $3,016.63 2.1×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $3,531.40 $5,885.67 4.0×
Pt Aquatic Therapy/Exercises (97113) $112.14 $186.89 3.0×
Pt Electric Current Therapy (97033) $53.58 $89.31 2.8×
Pt Electrical Stimulation (97032) $53.58 $89.31 3.6×
Pt eval high complex 45 min (97163) $210.55 $350.92 2.2×
Pt eval low complex 20 min (97161) $210.55 $350.92 2.2×
Pt Gait Training Therapy (97116) $63.50 $105.83 2.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $71.75 $119.59 2.2×
Pt Physical Performance Test (97750) $62.88 $104.80 1.9×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $210.55 $350.92 2.2×
Pt re-evaluation (97164) $98.35 $163.92 1.5×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $61.66 $102.76 1.9×
Pt Ultrasound Therapy (97035) $53.58 $89.31 3.7×
Pt Whirlpool Therapy (97022) $47 $78.33 3.0×
Pulm function test by gas (94727) $88.99 $148.32 0.4×
Pulmonary stress testing (94618) $64.89 $108.15 0.5×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $117.77 $196.28 3.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $104.78 $174.63 0.5×
Rt Chest Wall Manipulation,Subsequent (94668) $76.36 $127.27 0.6×
Sensory Integration Ea 15 Min (97533) $70.12 $116.86 1.2×
Sleep study unattended (95806) $529.64 $882.73 2.4×
Speech sound lang comprehen (92523) $215.45 $359.08 1.0×
Spirometry (94010) $185.40 $309 0.8×
Stress Tte Complete (93351) $2,121.80 $3,536.34 3.8×
Temp transcutaneous pacing (92953) $582.36 $970.60 0.9×
Ther/Proph/Diag Inj Sc/Im (96372) $113.29 $188.81 1.5×
Therapeutic Activities (97530) $56.96 $94.94 1.6×
Therapeutic phlebotomy (99195) $92.91 $154.85 0.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $37.08 $61.80 1.0×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,712.53 $2,854.21 3.1×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $611.31 $1,018.85 2.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $209.92 $349.87 2.8×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $106.78 $177.97 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $195.59 $325.98 4.1×
Unlisted Diagnostic Gastroenterology Procedure (91299) $593.69 $989.49 4.5×
Vasc Duplex Extrem Venous,Bilat (93970) $1,044.15 $1,740.25 4.3×
Vasc Duplex Scan Extracranial,Limited (93882) $254.66 $424.44 2.4×
Vasopneumatic device (97016) $47 $78.33 3.9×
Ventilation assist & mgmt inpatient 1st day (94002) $412.10 $686.83 0.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $343.42 $572.37 0.5×
Vital capacity total (94150) $55.79 $92.99 0.4×
Wheelchair Mgmt Ea 15 Min (97542) $68.31 $113.85 2.2×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $312.02 $520.04 3.2×