Visits & medical services prices at Hot Springs County Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $194 $194 1.9×
Airway inhalation treatment (94640) $251 $251 1.1×
Allergy injection single (95115) $26 $26 0.5×
Appl on-body injector for timed subq injection (96377) $228 $228 4.8×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $114 $114
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $117 $117
Application of ultraviolet light to skin (96900) $196 $196 5.1×
Assessment of aphasia (96105) $283 $283
Bipap initial day (94660) $1,012 $1,012 4.5×
Breathing capacity test (94010) $371.50 $371.50 1.7×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $431 $431 1.1×
Cardiovascular stress test (93017) $1,379 $1,379 6.3×
Cardioversion elective external (92960) $455 $455 0.7×
Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a… (99484) $106 $106 2.8×
Chemo anti-neopl sq/im (96401) $435 $435 5.9×
Chemo IV infus each addl seq (96417) $432 $432 5.9×
Chemo IV infusion addl hr (96415) $328 $328 4.5×
Chemo IV push addl drug (96411) $404 $404 5.5×
Chemother prolong infuse w/pump (96416) $973 $973 2.9×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $920 $920 2.7×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $584 $584 1.7×
Chest physiotherapy initial (94667) $225 $225 1.7×
Chron care mgmt srvc 20 min (99490) $88 $88 0.8×
Color/duplex Doppler, complete (93975) $971.50 $971.50 4.0×
Color/duplex Doppler, limited (93976) $510 $510 4.8×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $487 $487 3.6×
Cpr (92950) $775 $775 3.5×
Critical care ill/injured patient init 30-74 min (99291) $877.50 $877.50 1.0×
Debridement open wound 20 sq cm< (97597) $185.50 $185.50 0.9×
Delivery/birthing room resuscitation (99465) $909 $909 1.3×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $629.50 $629.50 2.6×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $451.50 $451.50 4.2×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $675 $675 2.8×
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $410 $410 3.8×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $1,092 $1,092 4.5×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $108 $108 1.0×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $851 $851 3.5×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $488.50 $488.50 4.6×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $1,007.50 $1,007.50 4.1×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $529.50 $529.50 5.0×
ECG monit/reprt up to 48 hrs (93226) $1,031 $1,031 17.1×
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed,… (93307) $234 $234 1.0×
EKG 12 lead tracing only (93005) $333.50 $333.50 5.5×
Emergency department visit high mdm (99285) $710 $710 1.2×
Emergency department visit low mdm (99283) $617 $617 2.2×
Emergency department visit may not req phys/qhp (99281) $253.50 $253.50 2.9×
Emergency department visit moderate mdm (99284) $944 $944 2.2×
Emergency department visit straightforward mdm (99282) $508 $508 3.2×
End tidal co2 mntrng (crbn dxde exp gas dtrmntn by infrared analyzer) (94799) $244 $244 1.9×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $265 $265
Evaluate pt use of inhaler (94664) $261 $261 1.2×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $655 $655
Evaluation of speech fluency (92521) $366 $366
Evaluation of speech sound production articulate (92522) $358 $358
External ECG rec>48hr<7d recording (93242) $519 $519 13.6×
External ECG rec>7d<15d recording (93246) $580.50 $580.50 15.2×
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $755.50 $755.50 5.6×
Fluidotherapy (97022) $122 $122
Im adm intransl/oral 1 vaccine (90473) $22.86 $22.86 0.3×
Immunization administration (90471) $22.86 $22.86 0.3×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) $221 $221 1.6×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) $300 $300 2.2×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $246 $246 5.1×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $336 $336 1.5×
Irrigaj implntd venous access drug delivery syst (96523) $254 $254 4.2×
IV infusion hydration each additional hour (96361) $151 $151 3.2×
IV infusion hydration initial 31 min-1 hour (96360) $351 $351 1.6×
IV infusion ther proph addl sequential to 1 hr (96367) $362 $362 4.9×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $345.50 $345.50 1.6×
IV tx, each additional hour (96366) $190 $190 4.0×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $176 $176 1.3×
Maximum voluntary ventilation (94200) $265 $265 4.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $78 $78
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) $75 $75
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $478 $478
Negative pressure wound therapy dme </= 50 sq cm (97605) $471 $471 2.3×
Negative pressure wound therapy dme >50 sq cm (97606) $791.50 $791.50 1.9×
Noninvasive ear/pulse oximetry overnight monitor (94762) $656 $656 5.0×
Occupational therapy eval high complex 60 mins (97167) $512 $512
Occupational therapy eval low complex 30 mins (97165) $406 $406
Occupational therapy eval mod complex 45 mins (97166) $458 $458
Oral function therapy (92526) $400 $400
Orthc/prostc mgmt sbsq enc (97763) $204 $204
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $188 $188
Osteopath manj 1-2 regions (98925) $103 $103 4.7×
Osteopath manj 3-4 regions (98926) $131 $131 5.9×
Osteopathic manipulative tx 5-6 body regions (98927) $152 $152 6.9×
Osteopathic manipulative tx 7-8 body regions (98928) $168 $168 7.6×
Ot manual therapy ea 15 min (97140) $135 $135
Ot neuromuscular re-education (97112) $140 $140
Ot re-evaluation (97168) $394 $394
OT Therapeutic Activities Charges (97530) $135 $135
Ot wheelchair management (97542) $121 $121
Outpatient cardiac rehab w/cont ECG monitoring (93798) $288 $288 2.2×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $245 $245 1.9×
Phlebotomy therapeutic (99195) $300 $300 2.2×
Physical therapy evaluation high complex 45 mins (97163) $486 $486
Physical therapy evaluation low complex 20 mins (97161) $396 $396
Physical therapy evaluation mod complex 30 mins (97162) $433 $433
Professional services for allergen immunotherapy; 2 or more injections (95117) $30 $30 0.6×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $136.50 $136.50
Psychiatric diagnostic evaluation (90791) $415 $415 2.3×
Psytx crisis initial 60 min (90839) $468 $468 2.6×
Pt gait training 15 min (97116) $131 $131
Pt physical performance test (97750) $157 $157
Pt re-evaluation (97164) $368 $368
Pulm funct tst plethysmograp (94726) $385 $385 1.0×
Pulmonary stress testing (94618) $417 $417 3.1×
Refill/maint pump/resvr syst (96522) $110 $110 0.5×
Remote 30 day ECG rev/report (93270) $557 $557 14.6×
Respiratory flow volume loop (94375) $399 $399 1.8×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $134 $134
Sleep study unattended (95806) $370 $370 1.7×
Speech sound lang comprehen (92523) $635 $635
Standardized cognitive performance testing (96125) $488 $488
Stress tte only (93350) $962 $962 1.7×
Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Other Outpatient (97113) $176 $176
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $109 $109
Therapeutic prophylactic/dx injection subq/im (96372) $121 $121 1.6×
Tobacco use cessation intermediate 3-10 minutes (99406) $94 $94 2.5×
Trans care mgmt 14 day disch (99495) $229 $229 1.7×
Trans care mgmt 7 day disch (99496) $310 $310 2.3×
Transcranial doppler stdy intracranial art compl (93886) $639 $639 2.6×
Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study Age Under 21 (93304) $115 $115 0.2×
Tte congenital complete (93303) $115 $115 0.2×
Tte f-up or lmtd (93308) $617.50 $617.50 2.5×
Tte w/doppler complete (93306) $3,112 $3,112 5.6×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $287 $287
Upr/l xtremity art 2 levels (93922) $133 $133 1.0×
Ventilation ip/obs initial day (94002) $2,836 $2,836 4.5×
Ventilator subsequent day (94003) $1,561 $1,561 2.5×
Vital capacity total (94150) $266 $266 2.0×
Wound(s) care non-selective (97602) $415 $415 2.0×