Visits & medical services prices at Grisell Memorial Hospital

Ransom, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $65.84 $69.30 0.3×
Application of heat wave therapy (97024) $139.90 $147.26 19.0×
Behav assmt w/score & docd/stand instrument (96127) $23.71 $24.96 0.7×
Canalith Repositioning (95992) $170.72 $179.71 4.2×
Cardiac Stress Tst,Tracing Only (93017) $734.16 $772.80 3.7×
Cardiopulmonary resuscitation (92950) $507.28 $533.98 2.6×
Cardioversion (92960) $166.62 $175.39 0.3×
Chemo Hormon Antineopl Sq/Im (96402) $67.26 $70.80 1.0×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $72.90 $76.74 1.1×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $136.34 $143.52 1.5×
Color/duplex Doppler, complete (93975) $993.51 $1,045.80 4.5×
Color/duplex Doppler, limited (93976) $575.20 $605.47 6.0×
Critical care (99291) $598.50 $630 0.8×
Debridement Open Wound 20 Sq Cm< (97597) $148.20 $156 0.8×
Demo &/or eval,pt use,aerosol device (94664) $346.12 $364.34 1.7×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $993.51 $1,045.80 4.5×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $897.75 $945 4.1×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $718.20 $756 7.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $795.58 $837.45 8.3×
Dup-scan xtr veins unilateral/limited study (93971) $795.58 $837.45 8.3×
Duplex scan extracranial art compl bi study (93880) $795.58 $837.45 3.6×
Echo Heart Xthoracic,Limited (93308) $952.70 $1,002.84 4.3×
EKG (93005) $270.88 $285.14 5.0×
EKG rhythm strip (93041) $119.81 $126.12 2.2×
Er level 1 (99281) $136.80 $144 1.8×
Er level ii (99282) $193.80 $204 1.4×
Er level iii (99283) $262.20 $276 1.0×
Er level IV (99284) $319.20 $336 0.8×
Er level v (99285) $456 $480 0.8×
Holter Monitor Recording (93225) $308.59 $324.83 2.5×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $21.85 $23 0.6×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $22.46 $23.64 0.3×
Immunization Admin (90471) $32.60 $34.32 0.5×
Immunotherapy, 2+ Injections (95117) $52.16 $54.91 1.2×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $108.30 $114 2.0×
IV infusion hydration each additional hour (96361) $218.53 $230.03 5.1×
IV infusion hydration initial 31 min-1 hour (96360) $369.45 $388.90 1.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $262.02 $275.82 4.0×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $369.45 $388.90 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $214.32 $225.60 5.0×
IV push initial (96374) $362.21 $381.27 1.9×
Manual therapy 15 min (97140) $87.73 $92.35 3.2×
Massage 15 min (97124) $96.03 $101.08 3.2×
Mechanical traction (97012) $96.03 $101.08 6.7×
Neg press wnd tx </=50 sq cm (97607) $615.47 $647.86 1.6×
Neg press wound tx >50 cm (97608) $617.71 $650.22 1.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $310.10 $326.43 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $611.82 $644.02 1.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $993.51 $1,045.80 8.1×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $897.75 $945 4.5×
Osteopathic manipulative tx 1-2 body regions (98925) $91.30 $96.10 4.6×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $87.73 $92.35 2.7×
Ot Contrast Bath Ea 15 Min (97034) $87.73 $92.35 6.3×
Paraffin bath (97018) $139.90 $147.26 23.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $42.68 $44.93 1.0×
Psychiatric diagnostic evaluation (90791) $336.76 $354.48 2.1×
Psytx crisis initial 60 min (90839) $293.34 $308.78 1.8×
Pt Electric Current Therapy (97033) $96.03 $101.08 5.0×
Pt Electrical Stimulation (97032) $87.73 $92.35 6.0×
Pt eval high complex 45 min (97163) $234.75 $247.10 2.4×
Pt eval low complex 20 min (97161) $197.68 $208.08 2.0×
Pt Gait Training Therapy (97116) $136.34 $143.52 4.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $87.73 $92.35 2.7×
Pt Physical Performance Test (97750) $87.74 $92.36 2.6×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $208.66 $219.64 2.1×
Pt re-evaluation (97164) $133.31 $140.33 2.0×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $136.34 $143.52 4.2×
Pt Ultrasound Therapy (97035) $65.30 $68.74 4.5×
Pt Whirlpool Therapy (97022) $139.90 $147.26 8.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $307.80 $324 1.7×
Rt Chest Wall Manipulation,Subsequent (94668) $45.05 $47.42 0.4×
Smoking cessation > 10 min (99407) $71.14 $74.88 2.1×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $42.82 $45.07 1.9×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $40.90 $43.05 1.9×
Ther/Proph/Diag Inj Sc/Im (96372) $109.77 $115.55 1.7×
Therapeutic Activities (97530) $96.03 $101.08 2.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $29.64 $31.20 0.9×
Trans Care Mgmt 7 Day Disch (99496) $129.22 $136.02 1.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,523.44 $2,656.25 5.0×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $952.70 $1,002.84 4.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $70.36 $74.06 1.6×
Vasc Duplex Extrem Venous,Bilat (93970) $897.75 $945 4.1×
Vasc Duplex Scan Extracranial,Limited (93882) $788.01 $829.48 8.2×
Vasopneumatic device (97016) $128.04 $134.78 10.7×
Wheelchair Mgmt Ea 15 Min (97542) $87.73 $92.35 2.8×