Visits & medical services prices at Golden Valley Memorial Healthcare

Clinton, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $119.46 $199.10 0.9×
Advance care planning first 30 mins (99497) $106.65 $177.75 1.0×
Airway inhalation treatment (94640) $167.74 $279.57 0.8×
Analyze Neurostim Complex (95972) $103.66 $172.77 1.1×
Analyze neurostim no prog (95970) $109.62 $182.68 0.8×
Appl on-body injector for timed subq injection (96377) $87.04 $145.07 1.9×
Application of allergenic extract skin patch, exposure to ultraviolet light, and reaction analysis (95052) $50.40 $84 0.9×
Basic vestibular evaluation (92540) $152.79 $254.65 0.7×
Behav assmt w/score & docd/stand instrument (96127) $28.62 $47.70 0.8×
Behavioral and qualitative analysis of voice and resonance (92524) $210 $350 1.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $360 $600 1.0×
Caloric vestibular test w/rec bi bithermal (92537) $147.78 $246.30 1.1×
Canalith Repositioning (95992) $55.80 $93 1.4×
Capsule endoscopy (91110) $1,440 $2,400 1.6×
Cardiac Stress Tst,Tracing Only (93017) $638.18 $1,063.62 3.0×
Cardiopulmonary resuscitation (92950) $720 $1,200 3.3×
Cardioversion (92960) $960 $1,600 1.5×
Cbt 1st hour (94644) $94.54 $157.56 0.7×
Chemo Hormon Antineopl Sq/Im (96402) $156 $260 2.2×
Chemo IV push addl drug (96411) $184.50 $307.50 2.6×
Chemo Iv Push Sngl Drug (96409) $523.73 $872.88 1.6×
Chemo prolong 8+ hrs infuse w/pump (96416) $900.74 $1,501.24 2.7×
Chemother, IV infusion, 1 hr (96413) $736.80 $1,228 2.2×
Chemother, IV infusion, ea add hr (96415) $163.50 $272.50 2.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $172.50 $287.50 2.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $279 $465 3.9×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $64.75 $107.91 0.6×
Color vision examination (92283) $94.54 $157.56 1.6×
Color/duplex Doppler, complete (93975) $731.01 $1,218.35 3.1×
Color/duplex Doppler, limited (93976) $660 $1,100 6.3×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $138.10 $230.16 0.8×
Comprehensive Hearing Test (92557) $123.89 $206.48 1.0×
Computerized Ophthalmic Imaging Anterior Segment (92132) $23.35 $38.92 0.4×
Computerized Ophthalmic Imaging Optic Nerve (92133) $50.36 $83.94 0.9×
Continuous Glucose Monitoring (95250) $121.70 $202.84 0.9×
Corneal Topography (92025) $50.36 $83.94 0.9×
Cpap initiation and management (94660) $720 $1,200 3.3×
Cpt initial (94667) $153.75 $256.25 1.2×
Cptrized oph dx img pst segment uni/bi retina (92134) $50.36 $83.94 0.9×
Critical care (99291) $876.20 $1,460.32 1.1×
Dark adaptation exam w int & rep (92284) $297.01 $495.02 0.7×
Debridement Open Wound 20 Sq Cm< (97597) $257.70 $429.50 1.3×
Demo &/or eval,pt use,aerosol device (94664) $172.44 $287.40 0.8×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $319.98 $533.30 0.8×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $603.21 $1,005.35 2.5×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $570 $950 5.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $570 $950 2.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $570 $950 5.4×
Dup-scan xtr veins unilateral/limited study (93971) $636.05 $1,060.09 6.1×
Duplex scan extracranial art compl bi study (93880) $795 $1,325 3.3×
Ear and throat examination (92502) $413.89 $689.81 0.8×
Ear Protector Attenuation Measurements (92596) $59.26 $98.76 1.6×
Echo Heart Xthoracic,Limited (93308) $530.53 $884.22 2.2×
Echo transesophageal (93312) $1,783.20 $2,972 3.3×
Ed special anterior segment photography with interpretation and report; with fluorescein angiography (92287) $94.54 $157.56 0.7×
EEG awake asleep (95819) $717.81 $1,196.35 3.3×
EEG awake drowsy (95816) $643.60 $1,072.66 3.0×
EEG coma or sleep only (95822) $270.20 $450.33 1.2×
EEG cont rec w/video by tech min 8 channels (95700) $253.24 $422.07 1.2×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $1,158.64 $1,931.08 3.1×
EKG (93005) $162 $270 2.7×
EKG rhythm strip (93041) $81 $135 1.4×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $62.94 $104.89 1.7×
Elec alys nstim pls gen smpl sc/perph w/prgrmg (95971) $103.66 $172.77 1.1×
Electro-oculography w/i&r (92270) $94.54 $157.56 0.7×
EMG four extremities (95864) $175.96 $293.27 1.4×
EMG one extremity (95860) $94.54 $157.56 0.7×
EMG three extremities (95863) $170.38 $283.96 1.3×
EMG two extremities (95861) $156.76 $261.26 1.2×
Er level 1 (99281) $95.84 $159.74 1.1×
Er level ii (99282) $178.63 $297.71 1.2×
Er level iii (99283) $630 $1,050 2.3×
Er level IV (99284) $414.48 $690.81 1.0×
Er level v (99285) $1,003.74 $1,672.91 1.7×
Evaluation of speech fluency (92521) $210 $350 1.6×
Evaluation of speech sound production (92522) $189 $315 1.7×
Evaluation of swallowing function (92610) $222 $370 2.6×
Evaluation with prescription of speech-generating alternative (92607) $180 $300 1.5×
Evoked Auditory Test,Comprehsv (92588) $262.87 $438.12 0.7×
Evoked auditory test,limited (92587) $218.46 $364.10 1.0×
Exam of visual field with extended testing (92083) $94.54 $157.56 0.7×
Exam of visual field with intermediate testing (92082) $50.36 $83.94 0.9×
Exam of visual field with limited testing (92081) $50.36 $83.94 0.9×
External ECG rec>48hr<7d recording (93242) $111 $185 3.0×
External ECG rec>7d<15d recording (93246) $105 $175 2.8×
External Ecg Scanning Analysis Report (93226) $120.46 $200.76 2.0×
External ocular photography (92285) $50.36 $83.94 1.3×
Eye exam w anesth; complete (92018) $1,744.38 $2,907.31 0.7×
Eye exam w anesth; limited (92019) $1,630.22 $2,717.03 0.7×
Eye exam, new patient,comprehesv (92004) $229.15 $381.91 1.7×
Filtered Speech Test (92571) $59.26 $98.76 1.6×
Flow volume loop (94375) $107.83 $179.71 0.5×
Fluorescein angiography (92235) $223.95 $373.25 1.0×
Fluorescein angioscopy (92230) $399.95 $666.59 1.1×
Fundus photography w/interpretation & report (92250) $94.54 $157.56 0.7×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,990.51 $3,317.52 2.3×
Gonioscopy (92020) $94.54 $157.56 0.7×
Group Therapeutic Procedures (97150) $40.50 $67.50 2.2×
Hemodialysis (90935) $538.23 $897.05 0.8×
Holter Monitor Recording (93225) $112.92 $188.20 0.8×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $24.32 $40.53 0.6×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $52.38 $87.30 0.7×
Immunization Admin (90471) $92.32 $153.88 1.3×
Immunotherapy, 2+ Injections (95117) $34.09 $56.82 0.7×
Indocyanine-green angiography (92240) $223.95 $373.25 1.0×
Inhlj Brncl Challenge Tstg W/Histamine/Methachol (95070) $629.16 $1,048.60 1.7×
Inital newborn e/m (99460) $152.42 $254.04 1.1×
Initial normal newborn care, same day discharge (99463) $175.36 $292.26 1.3×
Internal eye photography (92286) $94.54 $157.56 0.7×
Interrog dev eval scrms phys/qhp in person (93291) $120 $200 4.1×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $242.88 $404.79 4.1×
IV infusion hydration each additional hour (96361) $133.20 $222 2.8×
IV infusion hydration initial 31 min-1 hour (96360) $302.89 $504.82 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $145.50 $242.50 2.0×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $426.30 $710.50 2.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $105 $175 2.2×
IV push initial (96374) $261 $435 1.2×
Manual therapy 15 min (97140) $81.60 $136 2.9×
Massage 15 min (97124) $84.60 $141 2.8×
Mechanical traction (97012) $88.54 $147.56 6.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $64.80 $108 2.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $111.10 $185.18 3.0×
Methacholine challenge (94070) $317.70 $529.50 0.9×
Mnt Group Ea 30 Min (97804) $22.20 $37 1.3×
Motility study esophagus (91010) $864.96 $1,441.60 2.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $336 $560 3.7×
Multiple sleep latency test (95805) $1,236 $2,060 1.4×
Nasopharyngoscopy (92511) $165.62 $276.04 0.8×
Needle oculography 1/ xoc musc 1/both eye w/i&r (92265) $73.39 $122.31 1.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $194.68 $324.46 1.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $331.12 $551.86 0.8×
Nerve conduction studies 13/> studies (95913) $1,140 $1,900 3.1×
Nerve Conduction Studies 3-4 Studies (95908) $360 $600 1.7×
Nerve Conduction Studies 9-10 Studies (95911) $810 $1,350 2.2×
Nerve conduction studies; 1-2 studies (95907) $181.50 $302.50 0.8×
Nerve conduction studies; 11-12 studies (95912) $870 $1,450 2.3×
Nerve conduction studies; 5-6 studies (95909) $535.80 $893 2.5×
Nerve conduction studies; 7-8 studies (95910) $720 $1,200 1.9×
Neurobehavioral Status Exam (96116) $223.95 $373.25 1.0×
Neuromuscular junction test (95937) $150.02 $250.04 1.2×
New patient problem focused exam of visual system (92002) $126.36 $210.60 0.9×
Newborn resuscitation (99465) $461.39 $768.99 0.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $331.52 $552.52 2.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $334.82 $558.04 1.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $171.78 $286.30 1.3×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $191.21 $318.69 1.4×
Ophth medical xm&eval intermediate estab pt (92012) $132.77 $221.28 1.0×
Ophthalmic biometry (92136) $94.54 $157.56 0.7×
Ophthalmoscopy/dynamometry (92260) $29.31 $48.85 0.8×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $81.60 $136 1.8×
Oscillating Tracking Test (92545) $133.28 $222.12 0.6×
Osteopathic manipulative tx 1-2 body regions (98925) $48.62 $81.04 2.2×
Osteopathic manipulative tx 3-4 body regions (98926) $70.29 $117.15 3.2×
Osteopathic manipulative tx 5-6 body regions (98927) $92.48 $154.14 4.3×
Osteopathic manipulative tx 7-8 body regions (98928) $112.63 $187.71 5.2×
Osteopathic manipulative tx 9-10 body regions (98929) $134.80 $224.67 6.2×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $45 $75 1.4×
Ot eval high complex 60 min (97167) $195 $325 1.9×
Ot eval low complex 30 min (97165) $187.35 $312.25 1.9×
Ot eval mod complex 45 min (97166) $177 $295 1.8×
Ot re-eval est plan care (97168) $102 $170 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $143.87 $239.78 1.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $107.56 $179.26 0.8×
Paraffin bath (97018) $60 $100 10.0×
Patch/Application Test Specify Number Tests (95044) $298.28 $497.14 0.3×
Pdt dstr prmlg les skn illum/activj per day (96567) $198 $330 1.0×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $213.84 $356.40 1.0×
Percutaneous tests w/allergenic extracts (95004) $827.98 $1,379.96 1.0×
Peripheral arterial disease rehab per session (93668) $102.29 $170.49 1.7×
Photochemotx psoralens&ultraviolet puva (96912) $93.60 $156 1.6×
Photochemotx tar&uvb/petrolatum/uvb (96910) $93.60 $156 1.6×
Phy/qhp op pulm rhb w/o mntr (94625) $173.04 $288.40 2.9×
Plethysmography (94726) $381.47 $635.78 1.0×
Pm device eval in person (93288) $51.22 $85.38 1.4×
Pm device progr eval dual (93280) $61.15 $101.92 1.6×
Pm/Icd Remote Tech Serv (93296) $36.26 $60.43 1.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,052.20 $5,087 3.5×
Positional Nystagmus Test (92542) $94.54 $157.56 0.7×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $37.18 $61.98 0.8×
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of… (92313) $99.68 $166.14 0.7×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $23.23 $38.72 0.5×
Pt Aquatic Therapy/Exercises (97113) $190.20 $317 5.1×
Pt Electric Current Therapy (97033) $109.50 $182.50 5.8×
Pt Electrical Stimulation (97032) $99 $165 6.7×
Pt eval high complex 45 min (97163) $254.62 $424.36 2.6×
Pt eval low complex 20 min (97161) $191.42 $319.04 2.0×
Pt Gait Training Therapy (97116) $95.10 $158.50 3.3×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $95.10 $158.50 2.9×
Pt Physical Performance Test (97750) $450 $750 13.3×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $214.96 $358.26 2.2×
Pt re-evaluation (97164) $105 $175 1.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $95.10 $158.50 2.9×
Pt Ultrasound Therapy (97035) $81.59 $135.99 5.7×
Pt Whirlpool Therapy (97022) $116.14 $193.57 7.4×
Pulm function test by gas (94727) $213.76 $356.27 1.0×
Pulmonary stress testing (94618) $180 $300 1.4×
Pure Tone Audiometry Air & Bone (92553) $199.32 $332.20 1.5×
Pure Tone Audiometry, Air (92552) $94.89 $158.15 0.7×
Refill/maint, portable pump (96521) $358.05 $596.75 1.7×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $33.97 $56.61 0.9×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $142.88 $238.14 1.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $182.05 $303.42 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $87 $145 0.7×
Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) $59.86 $99.76 1.0×
Sensory Integration Ea 15 Min (97533) $80.40 $134 1.3×
Sinusoidal Rotational Test (92546) $134.69 $224.48 1.0×
Sleep study unattended (95806) $635.24 $1,058.73 2.9×
Smoking cessation > 10 min (99407) $35.55 $59.25 0.9×
Speech Audiometry Threshold (92555) $44.88 $74.80 0.8×
Speech Audiometry, Complete (92556) $66.84 $111.40 1.1×
Speech sound lang comprehen (92523) $294 $490 1.3×
Spirometry (94010) $110.54 $184.24 0.5×
Spontaneous Nystagmus Test (92541) $94.54 $157.56 0.7×
Stenger Test, Pure Tone (92565) $90 $150 1.5×
Stenger Test, Speech (92577) $240 $400 0.6×
Tensilon test (95857) $223.95 $373.25 1.0×
Test for abnormal eye movement using a moving target with recording (92544) $122.69 $204.48 1.0×
Test for allergy using allergenic extract injected into skin (95024) $50.36 $83.94 0.9×
Test photosensitivity (95056) $93.60 $156 0.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $33 $55 1.5×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $36 $60 1.7×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $150 $250 1.5×
Ther/Proph/Diag Inj Sc/Im (96372) $111 $185 1.5×
Therapeutic Activities (97530) $96.53 $160.88 2.8×
Therapeutic phlebotomy (99195) $176.40 $294 1.3×
Trans Care Mgmt 14 Day Disch (99495) $201.01 $335.02 1.5×
Trans Care Mgmt 7 Day Disch (99496) $285.04 $324.42 2.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,602.20 $2,670.34 2.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $180 $300 2.4×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $195 $325 2.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $276 $460 5.9×
Tympanometry (92567) $28.62 $47.70 0.8×
Tympanometry And Reflex Threshold Measurements (92550) $120.51 $200.85 0.6×
Unlisted pulmonary service/procedure (94799) $203.17 $338.62 1.6×
Vasc Duplex Extrem Venous,Bilat (93970) $795 $1,325 3.3×
Vasc Duplex Scan Extracranial,Limited (93882) $270 $450 2.6×
Vasopneumatic device (97016) $48 $80 4.0×
Ventilation assist & mgmt inpatient 1st day (94002) $720 $1,200 1.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $592.85 $988.08 1.0×
Visual Evoked Potential Test (95930) $137.70 $229.49 0.6×
Wheelchair Mgmt Ea 15 Min (97542) $88.40 $147.34 2.8×