Visits & medical services prices at Faith Community Hospital

Jacksboro, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $250.91 $358.44 1.1×
Application of heat wave therapy (97024) $15.04 $21.48 2.0×
Assessment of aphasia (96105) $217.70 $311 2.2×
Behavioral and qualitative analysis of voice and resonance (92524) $189.34 $270.48 1.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $469 $670 1.3×
C motor evoked upr&lwr limbs (95939) $12.21 $17.44 0.0×
Cardiac Stress Tst,Tracing Only (93017) $354.30 $506.14 1.6×
Cardiopulmonary resuscitation (92950) $454.23 $648.90 2.1×
Cardioversion (92960) $1,008.35 $1,440.50 1.5×
Cbt 1st hour (94644) $532 $760 4.0×
Color/duplex Doppler, complete (93975) $15.60 $22.28 0.1×
Cpap initiation and management (94660) $868 $1,240 3.9×
Cpt initial (94667) $52.23 $74.62 0.4×
Critical care (99291) $3,850 $5,500 4.6×
Ctr motor ep std transcrnl motor stimj lwr limbs (95929) $13.12 $18.74 0.0×
Debridement Open Wound 20 Sq Cm< (97597) $279.60 $399.43 1.4×
Demo &/or eval,pt use,aerosol device (94664) $366.95 $524.22 1.7×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $14.50 $20.72 0.1×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $14.46 $20.66 0.1×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $15.44 $22.05 0.1×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $15.32 $21.88 0.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $684.95 $978.50 2.9×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $630.15 $900.22 6.0×
Dup-scan xtr veins unilateral/limited study (93971) $15.38 $21.96 0.1×
Duplex scan extracranial art compl bi study (93880) $15.09 $21.55 0.1×
EKG (93005) $3.50 $5 0.1×
EMG two extremities (95861) $12.62 $18.03 0.1×
Er level 1 (99281) $371 $530 4.4×
Er level ii (99282) $679 $970 4.4×
Er level iii (99283) $1,085 $1,550 4.0×
Er level IV (99284) $2,170 $3,100 5.2×
Er level v (99285) $3,167.50 $4,525 5.3×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $155.36 $221.94 2.2×
Evaluation of speech fluency (92521) $242.40 $346.29 1.8×
Evaluation of speech sound production (92522) $196.06 $280.08 1.8×
Evaluation of swallowing function (92610) $180.60 $258 2.1×
Evaluation with prescription of speech-generating alternative (92607) $278.63 $398.04 2.3×
Exercise tst brncspsm (94617) $216.52 $309.31 1.6×
External ECG rec>48hr<7d recording (93242) $3.50 $5 0.1×
External ECG rec>7d<15d recording (93246) $3.50 $5 0.1×
Flow volume loop (94375) $889 $1,270 4.1×
Group Therapeutic Procedures (97150) $38.56 $55.09 2.1×
Hydrotherapy (97036) $74.84 $106.92 2.2×
Immunization Admin (90471) $11.56 $16.52 0.2×
Inital newborn e/m (99460) $33.47 $47.81 0.3×
Initial normal newborn care, same day discharge (99463) $37.18 $53.11 0.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $3.50 $5 0.1×
IV infusion hydration each additional hour (96361) $55.27 $78.95 1.2×
IV infusion hydration initial 31 min-1 hour (96360) $175 $250 0.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $97.79 $139.70 1.4×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $212.06 $302.94 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $71.84 $102.63 1.5×
IV push initial (96374) $124.78 $178.26 0.6×
Low frequency non-thermal us (97610) $280 $400 1.4×
Manual therapy 15 min (97140) $57.10 $81.58 2.1×
Massage 15 min (97124) $53.70 $76.71 1.8×
Mechanical traction (97012) $42.10 $60.14 2.9×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $186.90 $267 2.0×
Nasopharyngoscopy (92511) $350 $500 1.7×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $12.71 $18.16 0.1×
Neg press wnd tx </=50 sq cm (97607) $6.55 $9.36 0.0×
Neg press wound tx >50 cm (97608) $6.60 $9.43 0.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $6.30 $9 0.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $6.43 $9.18 0.0×
Nerve conduction studies 13/> studies (95913) $13.92 $19.88 0.0×
Nerve Conduction Studies 3-4 Studies (95908) $13.61 $19.44 0.1×
Nerve Conduction Studies 9-10 Studies (95911) $14.33 $20.47 0.0×
Nerve conduction studies; 1-2 studies (95907) $14.06 $20.09 0.1×
Nerve conduction studies; 11-12 studies (95912) $13.38 $19.12 0.0×
Nerve conduction studies; 5-6 studies (95909) $14.36 $20.52 0.1×
Nerve conduction studies; 7-8 studies (95910) $13.23 $18.90 0.0×
Neuromuscular junction test (95937) $12.39 $17.70 0.1×
Newborn resuscitation (99465) $1,417.17 $2,024.52 2.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $14.01 $20.01 0.1×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $700 $1,000 5.4×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $64.35 $91.93 1.4×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $70.20 $100.29 2.2×
Ot Contrast Bath Ea 15 Min (97034) $35.16 $50.22 2.5×
Ot eval high complex 60 min (97167) $194.80 $278.28 1.9×
Ot eval low complex 30 min (97165) $194.80 $278.28 1.9×
Ot eval mod complex 45 min (97166) $194.80 $278.28 1.9×
Ot Range Motion Measure,Each Extrem (95851) $52.50 $75 2.0×
Ot re-eval est plan care (97168) $133.69 $190.98 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $16.29 $23.27 0.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $26.26 $37.52 0.2×
Paraffin bath (97018) $24.56 $35.08 4.1×
Phy/qhp op pulm rhb w/mntr (94626) $16.78 $23.97 0.3×
Phy/qhp op pulm rhb w/o mntr (94625) $16.70 $23.86 0.3×
Plethysmography (94726) $889 $1,270 2.4×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $17.94 $25.63 0.4×
Pt Aquatic Therapy/Exercises (97113) $76.54 $109.34 2.1×
Pt Electric Current Therapy (97033) $44.24 $63.20 2.3×
Pt Electrical Stimulation (97032) $32.50 $46.43 2.2×
Pt eval high complex 45 min (97163) $152.92 $218.46 1.6×
Pt eval low complex 20 min (97161) $152.92 $218.46 1.6×
Pt Gait Training Therapy (97116) $57.82 $82.60 2.0×
Pt Infrared Therapy (97026) $13.52 $19.32 2.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $67.28 $96.10 2.1×
Pt Physical Performance Test (97750) $49.21 $70.30 1.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $152.92 $218.46 1.6×
Pt re-evaluation (97164) $81 $115.72 1.2×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $68.12 $97.30 2.1×
Pt Ultrasound Therapy (97035) $33.64 $48.06 2.3×
Pt Whirlpool Therapy (97022) $55.30 $79.01 3.5×
Pulm function test by gas (94727) $469 $670 2.2×
Pulmonary stress testing (94618) $297.26 $424.66 2.2×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $3.50 $5 0.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $16.77 $23.95 0.1×
Rom meas&reprt hand w/wo comparison normal sid (95852) $41.64 $59.48 1.9×
Rt Chest Wall Manipulation,Subsequent (94668) $52.23 $74.62 0.4×
Sensory Integration Ea 15 Min (97533) $91.39 $130.56 1.5×
Smoking cessation > 10 min (99407) $33.26 $47.52 0.9×
Somatosensory testing (95938) $12.17 $17.39 0.0×
Speech group therapy (92508) $50.61 $72.30 2.1×
Speech sound lang comprehen (92523) $418.28 $597.54 1.8×
Spirometry (94010) $469 $670 2.2×
Standardized Cognitive Performance Testing (96125) $170.24 $243.21 1.7×
Temp transcutaneous pacing (92953) $261.18 $373.12 0.4×
Testing of autonomic (sympathetic) nervous system function (95923) $16.01 $22.87 0.1×
Testing of autonomic nervous system function heart rate (95921) $15.88 $22.69 0.1×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $70 $100 3.1×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $70 $100 3.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $232.64 $332.34 2.3×
Ther/Proph/Diag Inj Sc/Im (96372) $3.50 $5 0.0×
Therapeutic Activities (97530) $65.38 $93.40 1.9×
Therapeutic phlebotomy (99195) $3.50 $5 0.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $33.21 $47.44 0.9×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,090.15 $1,557.36 2.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $168.32 $240.45 2.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $184.21 $263.16 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $52.44 $74.91 1.1×
Ultraviolet Therapy (97028) $17.33 $24.75 2.1×
Unlisted pulmonary service/procedure (94799) $700 $1,000 5.4×
Vasc Duplex Extrem Venous,Bilat (93970) $422.50 $603.56 1.8×
Vasopneumatic device (97016) $27.15 $38.79 2.3×
Ventilation assist & mgmt inpatient 1st day (94002) $2,450 $3,500 3.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $2,450 $3,500 3.9×
Vital capacity total (94150) $490 $700 3.8×
Wheelchair Mgmt Ea 15 Min (97542) $81.68 $116.68 2.6×