Visits & medical services prices at INTEGRIS Grove Hospital

Grove, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Airway Inhalation Treatment (94640) $80.40 $402 0.4×
Analyze neurostim complex (95972) $38.60 $193 0.4×
Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) $76 $380 0.4×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $36.60 $183 2.5×
Application on-body injector (96377) $40 $200 0.9×
Assessment of aphasia per hr (96105) $94.40 $472 1.0×
Behavral qualit analys voice (92524) $77.40 $387 0.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $78.40 $392 0.2×
Canalith repositioning proc (95992) $49.80 $249 1.2×
Cardiac Stress Tst,Tracing Only (93017) $213.80 $1,069 1.0×
Cardiopulmonary resuscitation (92950) $149 $745 0.7×
Cardioversion (92960) $474.20 $2,371 0.7×
Cardioversion elective internal (92961) $675.20 $3,376 1.1×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $3,688.40 $18,442 1.2×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $3,323 $16,615 1.1×
Cbt 1st hour (94644) $33.60 $168 0.3×
Chemo Anti-Neopl Sq/Im (96401) $30.60 $153 0.4×
Chemo Hormon Antineopl Sq/Im (96402) $18.40 $92 0.3×
Chemo IV infusion addl hr (96415) $37.60 $188 0.5×
Chemo IV push addl drug (96411) $55.60 $278 0.8×
Chemother Prolong Infuse W/Pump (96416) $94.40 $472 0.3×
Chemotherapy Into Cns (96450) $92.60 $463 0.3×
Chemotherapy Unspecified (96549) $4 $20 0.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $44.60 $223 0.6×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $92.60 $463 0.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $75.60 $378 0.2×
Chest Wall Manipulation (94668) $40.60 $203 0.3×
Color/duplex Doppler, complete (93975) $359.20 $1,796 1.6×
Color/duplex Doppler, limited (93976) $88.60 $443 0.9×
Community/Work Reintegration Trainj Ea 15 Min (97537) $25.40 $127 0.8×
Continuous Pulse Ox (94762) $74.40 $372 0.6×
Coronary Art/Grft Angio S&I (93455) $3,263.60 $16,318 1.0×
Coronary Artery Angio S&I (93454) $2,785.20 $13,926 0.9×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $159 $795 0.8×
Cpt initial (94667) $50 $250 0.4×
Critical care first hour (99291) $640.40 $3,202 0.8×
Debridement Open Wound 20 Sq Cm< (97597) $65.80 $329 0.3×
Dialysis One Evaluation (90945) $229.20 $1,146 0.6×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $120.40 $602 0.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $78 $390 0.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 2 matching MRF lines		 $431.80–$659 $2,159–$3,295 varies
Dup-scan xtr veins unilateral/limited study (93971) $268.80 $1,344 2.7×
Duplex up extrem art bilat (93930) $139.80 $699 0.6×
Duplex up extrem art unilat/ltd (93931) $106.80 $534 1.1×
ECG/monitoring and analysis (93271) $105 $525 1.1×
Echo Heart Xthoracic,Limited (93308) $197.80 $989 0.9×
Echo transesophageal (93312)
range across 2 matching MRF lines		 $363.80–$820 $1,819–$4,100 varies
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $346.20 $1,731 0.7×
Eeg 41-60 Minutes (95812) $189.20 $946 0.9×
EEG awake and asleep (95819) $224 $1,120 1.1×
EEG awake drowsy (95816) $228 $1,140 1.1×
EEG cerebral death evaluation (95824) $224.40 $1,122 0.6×
Eeg Sleep Only (95822) $198.20 $991 1.0×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $32.40 $162 0.4×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $11.80 $59 0.3×
Electrical Stimulation Ea 15 Min (97032) $30.80 $154 2.1×
Electrocardiogram Tracing (93005) $78.40 $392 1.4×
Emergency Dept Visit Level 2 (99282) $178.20 $891 1.2×
Emergency Dept Visit Level 3 (99283) $272 $1,360 1.0×
Emergency Dept Visit Level 4 (99284) $419.40 $2,097 1.0×
Er level 1 (99281) $125.20 $626 1.5×
Er level v (99285) $626 $3,130 1.1×
Evaluate pt use of inhaler (94664) $72.20 $361 0.3×
Evaluate Speech Production (92522) $38 $190 0.3×
Evaluate Swallowing Function (92610) $75 $375 0.9×
Evaluation of speech fluency (92521) $45.60 $228 0.3×
External Ecg Scanning Analysis Report (93226) $293.20 $1,466 5.2×
Extracranial Bilat Study (93880) $193.20 $966 0.8×
Extracranial Uni/Ltd Study (93882) $114.80 $574 1.1×
Flexible endoscopic eval swallow c/v rec (92612) $32 $160 0.2×
Gi tract capsule endoscopy (91110) $1,392.80 $6,964 1.6×
Group Therapeutic Procedures (97150) $22.40 $112 1.2×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $3,543.40 $17,717 1.1×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $344.20 $1,721 0.5×
Holter monitor recording (93225) $285 $1,425 2.2×
Immunization administration (90471) $33 $165 0.5×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $205.60 $1,028 0.6×
Insert/Place Heart Catheter (93503) $516 $2,580 0.3×
Intracranial Complete Study (93886) $237.40 $1,187 1.0×
Iontophoresis 15 min (97033) $68.20 $341 3.6×
Irrig Drug Delivery Device (96523) $32.20 $161 0.6×
IV infusion hydration each additional hour (96361) $65.60 $328 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $105.60 $528 0.5×
IV infusion ther proph addl sequential to 1 hr (96367) $38.20 $191 0.6×
IV infusion therapy prophylaxis/dx ea hour (96366) $31 $155 0.7×
IV push initial (96374) $88.60 $443 0.4×
L Hrt Art/Grft Angio (93459) $3,646.40 $18,232 1.2×
Lwr Xtr Vasc Stdy Bilat (93924) $121.40 $607 0.6×
Mechanical chest wall oscillation per session (94669) $72.20 $361 0.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $44.40 $222 1.2×
Methacholine challenge (94070) $81.40 $407 0.2×
Motility study esophagus (91010) $183.60 $918 0.5×
Motion Fluoroscopy/Swallow (92611) $119 $595 1.3×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $44.20 $221 0.1×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $41.80 $209 0.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $65.80 $329 0.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $120.80 $604 0.3×
Neuromuscular Reeducation (97112) $54 $270 1.6×
Oral Function Therapy (92526) $63.60 $318 0.8×
Oral Speech Device Eval (92597) $59.60 $298 0.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $40.20 $201 0.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $52 $260 1.1×
Ot Contrast Bath Ea 15 Min (97034) $22 $110 1.6×
Ot eval high complexity (97167) $117 $585 1.2×
Ot Eval Low Complex (97165) $90.20 $451 0.9×
Ot Eval Moderate Complexity (97166) $103.60 $518 1.0×
Ot manual therapy 15 min (97140) $52 $260 1.9×
Ot paraffin bath (97018) $32 $160 5.3×
Ot Prosthetic Training, Each 15 Min (97761) $35.20 $176 0.9×
Ot Re-Eval Est Plan Care (97168) $55 $275 0.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $69.20 $346 0.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $63 $315 0.5×
Oxygen Uptake Rest Indirect (94690) $86.60 $433 1.5×
Peripheral arterial disease rehab per session (93668) $87 $435 1.5×
Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930)
likely a partial charge, not the full procedure		 $3,382.80 $16,914 0.2×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920)
unusually low: confirm this is the full procedure		 $2,316.80 $11,584 0.4×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943)
likely a partial charge, not the full procedure		 $2,578.60 $12,893 0.2×
Phlebotomy therapeutic (99195) $52.40 $262 0.4×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $39.20 $196 0.7×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $39.20 $196 0.7×
Physical Performance Test (97750) $38.80 $194 1.2×
Plethysmography (94726) $78.40 $392 0.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,734.60 $8,673 2.1×
Polysom <6 yrs 4/> paramtrs (95782) $1,431.20 $7,156 1.7×
Prq Card Angio/Athrect 1 Art (92924)
likely a partial charge, not the full procedure		 $3,110.60 $15,553 0.3×
Prq Card Stent W/Angio 1 Vsl (92928)
likely a partial charge, not the full procedure		 $2,578.60 $12,893 0.2×
Prq Card Stent/Ath/Angio (92933)
likely a partial charge, not the full procedure		 $3,212.40 $16,062 0.2×
Prq Revasc Byp Graft 1 Vsl (92937)
likely a partial charge, not the full procedure		 $2,476.40 $12,382 0.2×
Prq trl rvs ch occ ant&rtrgr (92945)
unusually low: confirm this is the full procedure		 $4,834.80 $24,174 0.4×
Pt Eval High Complex (97163) $117 $585 1.2×
Pt eval low complex 20 min (97161) $90.20 $451 0.9×
Pt Eval Mod Complex (97162) $103.60 $518 1.1×
Pt gait training 15 min (97116) $47 $235 1.6×
Pt mechanical traction (97012) $53.60 $268 3.7×
Pt Re-Eval Est Plan Care (97164) $55 $275 0.8×
Pulm function test by gas (94727) $45 $225 0.2×
Pulmonary service/procedure (94799)
range across 2 matching MRF lines		 $280.80–$285.60 $1,404–$1,428 varies
Pulmonary Stress Testing (94618) $47.80 $239 0.4×
R Hrt Art/Grft Angio (93457) $3,799.80 $18,999 1.2×
R hrt coronary artery angio (93456) $3,484.80 $17,424 1.1×
R&L Hrt Cath W/Ventriclgrphy (93453) $2,823.80 $14,119 0.9×
Refill/Maint Portable Pump (96521) $62 $310 0.3×
Refill/Maint Pump/Resvr Syst (96522) $69.40 $347 0.3×
Remote 30 Day Ecg Rev/Report (93270) $69.40 $347 1.9×
Right Heart Cath (93451) $2,788.40 $13,942 0.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $65.80 $329 0.3×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $77 $385 0.6×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $26.80 $134 0.6×
Self Care Mngment Training (97535) $41.40 $207 1.3×
Sensory Integration Ea 15 Min (97533) $64.40 $322 1.1×
Sleep study unattended (95806) $179.60 $898 0.9×
Slp Stdy Unatnd W/Anal (95801) $46.80 $234 0.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $261.80 $1,309 1.3×
Speech sound lang comprehen (92523) $92.40 $462 0.4×
Spirometry (94010) $43.20 $216 0.2×
Standardized Cognitive Performance Testing (96125) $58.40 $292 0.6×
Stress Tte Only (93350) $250.80 $1,254 0.5×
Surfactant Admin Thru Tube (94610) $120.80 $604 0.6×
Temp transcutaneous pacing (92953) $199.40 $997 0.3×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $37.80 $189 1.7×
Ther Ivntj Ea Addl 15 Min (97130) $37.80 $189 1.8×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $42.60 $213 1.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $47.80 $239 1.6×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $41.80 $209 0.4×
Ther/Prop/Diag Inj/Inf Proc (96379) $18.80 $94 0.4×
Ther/Proph/Diag Inj Sc/Im (96372) $71.80 $359 1.0×
Ther/Proph/Diag Iv Inf Init (96365) $108.20 $541 0.5×
Therapeutic Activities (97530) $36.80 $184 1.0×
Tobacco Use Cessation Intensive >10 Minutes (99407) $41.40 $207 1.1×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $41.40 $207 1.1×
Tte w/doppler, complete (93306) $309.20 $1,546 0.6×
Tte W/O Doppler Complete (93307)
range across 2 matching MRF lines		 $239.80–$2,554 $1,199–$12,770 varies
Tx atrial fib pulm vein isol (93656)
unusually low: confirm this is the full procedure		 $8,970.40 $44,852 0.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $91.80 $459 1.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $65.20 $326 1.4×
Unlisted noninvasive vascular diagnostic study (93998) $49 $245 1.8×
Upr/L Xtremity Art 2 Levels (93922) $51.80 $259 0.4×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $70 $350 0.3×
Vasopneumatic device (97016) $57.80 $289 4.8×
Vent Mgmt Inpat Init Day (94002)
range across 2 matching MRF lines		 $74.20–$536 $371–$2,680 varies
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $482.40 $2,412 0.8×
Vital capacity, total (94150) $43.20 $216 0.3×
Wheelchair Mgmt Ea 15 Min (97542) $20.40 $102 0.7×
Whirlpool Therapy (97022) $66.20 $331 4.2×

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.