Visits & medical services prices at Holy Cross Hospital-davis

Layton, UT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $6,415.52 $16,038.79 0.8×
Airway Inhalation Treatment (94640) $314.48 $786.19 1.4×
Analyze Neurostim Simple (95971) $384.10 $960.25 4.0×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035)
range across 2 matching MRF lines
$49.09–$59.76 $122.71–$149.38 varies
Arrhythmia Induction (93618) $1,626.74 $4,066.84 1.3×
Assessment of aphasia per hr (96105) $186.16 $465.39 1.9×
Behavral qualit analys voice (92524) $101.93 $254.82 0.9×
Biofeedback training any modality (90901) $38.31 $95.76 0.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $414.13 $1,035.32 1.1×
C motor evoked upr&lwr limbs (95939)
range across 2 matching MRF lines
$771.12–$1,572.33 $1,927.79–$3,930.81 varies
Canalith repositioning proc (95992) $56.18 $140.44 1.4×
Cardiac Stress Tst,Tracing Only (93017) $420.27 $1,050.67 1.9×
Cardiopulmonary exercise testing (94621) $424.56 $1,061.40 1.1×
Cardiopulmonary resuscitation (92950) $1,151.45 $2,878.61 5.3×
Cardioversion (92960)
range across 2 matching MRF lines
$736.63–$751.08 $1,841.57–$1,877.68 varies
Cardioversion elective internal (92961) $844.95 $2,112.37 1.3×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $20.66 $51.64 0.8×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $7,851.32 $19,628.29 2.4×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $7,851.32 $19,628.29 2.4×
Cbt 1st hour (94644) $174.52 $436.28 1.3×
Chemo Anti-Neopl Sq/Im (96401) $190.81 $477.01 2.6×
Chemo Hormon Antineopl Sq/Im (96402) $134.40 $336 1.8×
Chemo IV infusion addl hr (96415) $228.38 $570.93 3.1×
Chemo IV push addl drug (96411) $156.19 $390.46 2.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $161.62 $404.03 2.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $460.81 $1,152.02 1.4×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $301.78 $754.43 0.9×
Chest Wall Manipulation (94668) $78.50 $196.23 0.6×
Color/duplex Doppler, complete (93975) $932.24 $2,330.60 3.9×
Color/duplex Doppler, limited (93976) $356.61 $891.52 3.4×
Community/Work Reintegration Trainj Ea 15 Min (97537)
range across 2 matching MRF lines
$55.63–$56.91 $139.06–$142.26 varies
Continuous Pulse Ox (94762) $206.62 $516.53 1.6×
Coronary Art/Grft Angio S&I (93455) $6,938.54 $17,346.33 2.1×
Coronary Artery Angio S&I (93454) $7,035.46 $17,588.64 2.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $521.80 $1,304.50 2.4×
Cpt initial (94667) $216.80 $542 1.6×
Critical care first hour (99291) $1,362.37 $3,405.92 1.6×
Debridement Open Wound 20 Sq Cm< (97597) $260.56 $651.40 1.3×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $397.51 $993.76 1.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $371.79 $929.46 1.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $327.17 $817.92 3.1×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $604.20 $1,510.50 2.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $344.66 $861.65 3.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $771.55 $1,928.87 3.2×
Dup-scan xtr veins unilateral/limited study (93971) $403.50 $1,008.73 3.8×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $319.85 $799.61 1.3×
Duplex Scan Hemodialysis Access (93990) $211.30 $528.25 2.0×
Duplex up extrem art bilat (93930) $896.22 $2,240.55 3.7×
Duplex up extrem art unilat/ltd (93931) $1,506.07 $3,765.17 14.2×
ECG/monitoring and analysis (93271) $672.19 $1,680.47 7.0×
Echo Congenital Complete (93303) $858.52 $2,146.30 1.6×
Echo Heart Xthoracic,Limited (93308) $1,015.56 $2,538.88 4.2×
Echo r-t 2d w/probe placement only (93313) $722.36 $1,805.90 1.3×
Echo transesophag montr cardiac pump functj (93318) $834.71 $2,086.77 1.5×
Echo transesophageal (93312) $1,152.86 $2,882.14 2.1×
Echo Transesophageal - Congenital Tee Complete (93315) $1,152.86 $2,882.14 2.1×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $843.68 $2,109.20 1.5×
Eeg 41-60 Minutes (95812) $655.85 $1,639.62 3.0×
EEG awake and asleep (95819) $485.78 $1,214.44 2.2×
EEG awake drowsy (95816) $485.78 $1,214.44 2.2×
EEG cerebral death evaluation (95824) $515.18 $1,287.93 1.4×
EEG cont rec w/video by tech min 8 channels (95700) $380.45 $951.12 1.7×
EEG extended monitoring 61-119 minutes (95813) $711.60 $1,778.99 3.3×
Eeg Sleep Only (95822) $485.78 $1,214.44 2.2×
EEG wo vid ea 12-26hr unmntr (95708) $729.94 $1,824.85 1.9×
Electrical Stimulation Ea 15 Min (97032)
range across 2 matching MRF lines
$58.79–$74.08 $146.96–$185.20 varies
Electrocardiogram Tracing (93005) $174.92 $437.29 2.9×
Electrophysiology Evaluation (93642) $1,518.32 $3,795.79 1.2×
Emergency Dept Visit Level 2 (99282) $308.97 $772.41 2.0×
Emergency Dept Visit Level 3 (99283) $469.86 $1,174.63 1.7×
Emergency Dept Visit Level 4 (99284) $747.11 $1,867.77 1.8×
Emg 3 Extremities (95863) $851.39 $2,128.46 6.5×
Emg 4 Extremities (95864) $982.62 $2,456.54 7.5×
Ep & ablate supravent arrhyt (93653) $13,770.73 $34,426.82 0.5×
Ep & ablate ventric tachy (93654)
unusually low: confirm this is the full procedure
$12,518.85 $31,297.12 0.5×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $5,630.51 $14,076.26 0.7×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $4,948.52 $12,371.29 0.6×
Er level 1 (99281) $143.58 $358.95 1.7×
Er level v (99285) $1,023.84 $2,559.59 1.7×
Evaluate pt use of inhaler (94664) $298.08 $745.20 1.3×
Evaluate Speech Production (92522) $114.59 $286.47 1.0×
Evaluate Swallowing Function (92610) $181.49 $453.71 2.1×
Evaluation of speech fluency (92521) $112.95 $282.37 0.8×
Exercise test for bronchospasm (94617) $165.66 $414.15 1.2×
External ECG rec>48hr<7d recording (93242) $1,449.45 $3,623.61 38.3×
External ECG rec>48hr<7d scanning alys w/report (93243) $327.84 $819.60 2.4×
External ECG rec>7d<15d recording (93246) $1,449.45 $3,623.61 38.3×
External ECG rec>7d<15d scanning alys w/report (93247) $181.86 $454.63 1.4×
External Ecg Scanning Analysis Report (93226) $179.35 $448.36 3.0×
Extracranial Bilat Study (93880) $600.82 $1,502.03 2.5×
Extracranial Uni/Ltd Study (93882) $288.60 $721.49 2.7×
F-up/limited tthrc echo congenital car anomaly (93304) $845.27 $2,113.16 1.5×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,806.25 $4,515.61 2.1×
Gi tract capsule endoscopy (91110) $1,806.48 $4,516.20 2.0×
Group Therapeutic Procedures (97150) $60.59 $151.47 3.4×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $7,008.96 $17,522.40 2.1×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $928.37 $2,320.92 1.3×
Holter monitor recording (93225) $158.87 $397.16 1.2×
Immunization administration (90471) $54.17 $135.42 0.7×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $358.26 $895.63 0.9×
Insert/Place Heart Catheter (93503) $1,903.62 $4,759.05 1.2×
Intracranial Complete Study (93886) $324.52 $811.28 1.3×
Iontophoresis 15 min (97033) $62.32 $155.80 3.3×
Irrig Drug Delivery Device (96523) $98.20 $245.49 1.6×
IV infusion hydration each additional hour (96361)
range across 2 matching MRF lines
$155.83–$160.24 $389.56–$400.58 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 2 matching MRF lines
$299.09–$304.95 $747.71–$762.37 varies
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines
$156.82–$157.40 $392.04–$393.49 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines
$155.83–$164.24 $389.56–$410.60 varies
IV push initial (96374)
range across 2 matching MRF lines
$290.98–$295.52 $727.43–$738.80 varies
L Hrt Art/Grft Angio (93459) $8,419.98 $21,049.93 2.6×
L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) $7,851.32 $19,628.29 2.4×
Low frequency non-thermal us (97610) $245.34 $613.35 1.2×
Lung Function Test (Mbc/Mvv) (94200) $97.62 $244.04 1.6×
Lwr Xtr Vasc Stdy Bilat (93924) $217.48 $543.69 1.0×
Mechanical chest wall oscillation per session (94669) $314.48 $786.19 1.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $43.10 $107.73 1.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $48.84 $122.09 1.3×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $27.06 $67.64 1.6×
Methacholine challenge (94070) $261.46 $653.64 0.7×
Motion Fluoroscopy/Swallow (92611) $295.40 $738.48 3.2×
Multiple Sleep Latency Test (95805) $1,324.53 $3,311.31 1.5×
Muscle Test 2 Limbs (95861) $283.53 $708.82 2.1×
Muscle Test Nonparaspinal (95870) $162.88 $407.20 1.2×
Muscle Test One Limb (95860) $168.05 $420.12 1.2×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $346.75 $866.86 1.6×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $231.16 $577.90 1.1×
Needle electromyography larynx (95865) $737.12 $1,842.78 5.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $424.72 $1,061.80 1.0×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $418.03 $1,045.07 1.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $130.14 $325.33 0.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $515.51 $1,288.77 1.3×
Nerve Conduction Studies 1-2 Studies (95907) $476.26 $1,190.63 2.2×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $218.54 $546.35 1.7×
Neuromuscular Reeducation (97112) $64.16 $160.38 2.0×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $185.62 $464.03 0.5×
Opscpy extnd rta drawing & scl deprsn i&r uni/bi (92201) $82.17 $205.42 1.4×
Oral Function Therapy (92526) $137.82 $344.55 1.6×
Oral Speech Device Eval (92597) $278.18 $695.44 3.9×
Orthc/Prostc Mgmt Sbsq Enc (97763) $78.37 $195.91 1.6×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $70.88 $177.20 1.5×
Ot Contrast Bath Ea 15 Min (97034) $64.99 $162.47 4.6×
Ot eval high complexity (97167) $111.28 $278.19 1.1×
Ot Eval Low Complex (97165) $111.28 $278.19 1.1×
Ot Eval Moderate Complexity (97166) $111.28 $278.19 1.1×
Ot manual therapy 15 min (97140) $63.68 $159.19 2.3×
Ot paraffin bath (97018)
range across 2 matching MRF lines
$23.46–$37.16 $58.65–$92.90 varies
Ot Prosthetic Training, Each 15 Min (97761) $55.16 $137.90 1.4×
Ot Re-Eval Est Plan Care (97168) $104.41 $261.01 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $100.57 $251.42 0.8×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $89.81 $224.51 0.7×
Oxygen Uptake Rest Indirect (94690) $56.64 $141.60 0.9×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $789.44 $1,973.59 3.6×
Peripheral arterial disease rehab per session (93668) $89.17 $222.91 1.5×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $9,374.32 $23,435.78 1.6×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $24,234.11 $60,585.27 2.1×
Phlebotomy therapeutic (99195) $108.75 $271.87 0.8×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $80.41 $201.02 1.3×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $80.41 $201.02 1.3×
Physical Performance Test (97750)
range across 2 matching MRF lines
$58.87–$79.09 $147.17–$197.72 varies
Plethysmography (94726) $216.94 $542.35 0.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,113.61 $5,284.01 2.4×
Polysom <6 yrs 4/> paramtrs (95782) $1,731.38 $4,328.43 2.0×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $1,723.05 $4,307.62 2.0×
Prq Card Angio/Athrect 1 Art (92924) $16,943.60 $42,358.99 1.4×
Prq Card Stent W/Angio 1 Vsl (92928) $17,146.48 $42,866.19 1.5×
Prq Card Stent/Ath/Angio (92933) $24,234.11 $60,585.27 1.3×
Prq Revasc Byp Graft 1 Vsl (92937) $13,496.30 $33,740.73 1.2×
Psychiatric diagnostic evaluation (90791) $310.60 $776.48 1.7×
Pt Eval High Complex (97163) $166.62 $416.55 1.7×
Pt eval low complex 20 min (97161) $111.28 $278.19 1.1×
Pt Eval Mod Complex (97162) $153.16 $382.89 1.6×
Pt gait training 15 min (97116) $75.04 $187.59 2.6×
Pt mechanical traction (97012) $39.21 $98.02 2.7×
Pt Re-Eval Est Plan Care (97164) $57.07 $142.67 0.8×
Pulm function test by gas (94727) $243.79 $609.47 1.1×
Pulmonary service/procedure (94799) $243.30 $608.24 1.9×
Pulmonary Stress Testing (94618) $176.90 $442.25 1.3×
R Hrt Art/Grft Angio (93457) $6,482.86 $16,207.15 2.0×
R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) $7,851.32 $19,628.29 2.4×
R hrt coronary artery angio (93456) $6,938.54 $17,346.33 2.1×
R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) $7,851.32 $19,628.29 2.4×
R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) $12,160.98 $30,402.45 3.7×
R&L Hrt Cath W/Ventriclgrphy (93453) $6,939.52 $17,348.80 2.1×
Rem interrog icpms <30 d phys/qhp (93297) $83.25 $208.11 2.2×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $83.25 $208.11 2.2×
Remote 30 Day Ecg Rev/Report (93270) $312.34 $780.84 8.3×
Right Heart Cath (93451) $6,938.54 $17,346.33 2.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $274.52 $686.28 1.4×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $20.75 $51.87 0.8×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $357.55 $893.86 2.9×
Self Care Mngment Training (97535) $73.71 $184.26 2.3×
Sensory Integration Ea 15 Min (97533)
range across 3 matching MRF lines
$41.86–$70.34 $104.63–$175.84 varies
Sleep study unattended (95806) $372.16 $930.40 1.7×
Slp caregiver training 1st 30 min (97550) $45.16 $112.90 0.9×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $351.36 $878.39 1.6×
Somatosensory Testing (95938) $385.44 $963.59 0.4×
Speech sound lang comprehen (92523) $352.75 $881.87 1.6×
Spirometry (94010) $122.56 $306.38 0.6×
Standardized Cognitive Performance Testing (96125)
range across 2 matching MRF lines
$167.09–$255.30 $417.71–$638.25 varies
Surfactant Admin Thru Tube (94610) $318.15 $795.36 1.4×
Temp transcutaneous pacing (92953) $380.23 $950.57 0.6×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $108.37 $270.92 4.8×
Ther Ivntj Ea Addl 15 Min (97130)
range across 3 matching MRF lines
$24.02–$55.65 $60.03–$139.12 varies
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $53.48 $133.70 1.4×
Ther Px 1/> Areas Each 15 Minutes Massage (97124)
range across 2 matching MRF lines
$54.20–$54.72 $135.48–$136.79 varies
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $216.92 $542.28 2.1×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines
$75.88–$80.85 $189.69–$202.11 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines
$247.56–$252.41 $618.90–$631.01 varies
Therapeutic Activities (97530) $76.01 $190.01 2.2×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $722.76 $1,806.90 1.9×
Tobacco Use Cessation Intensive >10 Minutes (99407) $66.54 $166.33 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $49.22 $123.04 1.3×
Transcath Closure of Asd (93580) $13,932.89 $34,832.21 0.8×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $205.22 $513.04 1.9×
Tte w/doppler, complete (93306) $1,038.78 $2,596.95 1.9×
Tte W/O Doppler Complete (93307) $958.06 $2,395.15 4.0×
Tx atrial fib pulm vein isol (93656) $24,650.02 $61,625.05 0.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $160.47 $401.16 2.1×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines
$75.21–$88.43 $188.01–$221.07 varies
Unlisted cardiovascular service/procedure (93799)
range across 7 matching MRF lines
$190.75–$8,387.94 $476.86–$20,969.84 varies
Unlisted Psychiatric Service/Procedure (90899) $67.22 $168.04 1.8×
Upr/L Xtremity Art 2 Levels (93922) $211.01 $527.51 1.6×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $263.30 $658.24 1.2×
Vasopneumatic device (97016)
range across 2 matching MRF lines
$42.13–$51.64 $105.31–$129.09 varies
Veeg 2-12 hr intmt mntr (95712) $397.51 $993.76 1.1×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $733.21 $1,833.01 1.9×
Veeg Ea 12-26 Hr Unmntr (95714) $733.21 $1,833.01 1.9×
Vent Mgmt Inpat Init Day (94002) $672.60 $1,681.49 1.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $566.36 $1,415.89 0.9×
Vital capacity, total (94150) $106.43 $266.07 0.8×
Wheelchair Mgmt Ea 15 Min (97542) $57.12 $142.80 1.8×
Whirlpool Therapy (97022)
range across 2 matching MRF lines
$63.75–$73.94 $159.36–$184.84 varies
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $87.34 $218.34 1.5×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.