Visits & medical services prices at INTEGRIS Health Ponca City

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

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

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ProcedurePosted cashPosted gross× Medicare
Airway Inhalation Treatment (94640) $168.60 $843 0.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $73.60 $368 0.6×
Analyze neurostim complex (95972) $262.60 $1,313 2.9×
Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) $157 $785 0.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $50 $250 3.5×
Application on-body injector (96377) $97 $485 2.2×
Assessment of aphasia per hr (96105) $178 $890 1.8×
Behavral qualit analys voice (92524) $208.20 $1,041 1.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $371.80 $1,859 1.0×
Canalith repositioning proc (95992) $93.80 $469 2.3×
Cardiac Stress Tst,Tracing Only (93017) $639 $3,195 3.1×
Cardiopulmonary exercise testing (94621) $640 $3,200 1.8×
Cardiopulmonary resuscitation (92950) $576 $2,880 2.8×
Cardioversion (92960) $935 $4,675 1.5×
Cardioversion elective internal (92961) $909.60 $4,548 1.4×
Cbt 1st hour (94644) $205.40 $1,027 1.6×
Chemo Anti-Neopl Sq/Im (96401) $80.40 $402 1.2×
Chemo Hormon Antineopl Sq/Im (96402) $80.40 $402 1.2×
Chemo IV infusion addl hr (96415) $65.40 $327 0.9×
Chemotherapy Into Cns (96450) $256.20 $1,281 0.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $216.20 $1,081 3.1×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $353 $1,765 1.1×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $288.20 $1,441 0.9×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $264.20 $1,321 0.8×
Chest Wall Manipulation (94668) $96.40 $482 0.8×
Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) $639.60 $3,198 1.8×
Color/duplex Doppler, complete (93975) $430 $2,150 1.9×
Color/duplex Doppler, limited (93976) $405 $2,025 4.0×
Community/Work Reintegration Trainj Ea 15 Min (97537) $48 $240 1.5×
Continuous Pulse Ox (94762) $130.80 $654 1.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $399.40 $1,997 1.9×
Cpt initial (94667) $151.20 $756 1.2×
Critical care first hour (99291) $1,570.40 $7,852 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $181.80 $909 0.9×
Dialysis One Evaluation (90945) $431.80 $2,159 1.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $398.80 $1,994 1.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $427.20 $2,136 4.2×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $471.80 $2,359 2.1×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $297.40 $1,487 3.0×
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 2 matching MRF lines		 $471.80–$492 $2,359–$2,460 varies
Dup-scan xtr veins unilateral/limited study (93971) $473.20 $2,366 4.7×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $854.80 $4,274 3.7×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $580 $2,900 5.8×
Duplex Scan Hemodialysis Access (93990) $186.60 $933 1.9×
Duplex up extrem art bilat (93930) $409.60 $2,048 1.8×
Duplex up extrem art unilat/ltd (93931) $278 $1,390 2.8×
ECG/monitoring and analysis (93271) $180.20 $901 2.0×
Echo Congenital Complete (93303) $1,653.60 $8,268 3.1×
Echo Heart Xthoracic,Limited (93308) $419.20 $2,096 1.8×
Echo r-t 2d w/probe placement only (93313) $497.60 $2,488 0.9×
Echo transesophag montr cardiac pump functj (93318) $2,306.60 $11,533 4.4×
Echo transesophageal (93312)
range across 2 matching MRF lines		 $615.20–$668.20 $3,076–$3,341 varies
Echo Transesophageal - Congenital Tee Complete (93315) $941 $4,705 1.8×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,198.20 $5,991 2.3×
Eeg 41-60 Minutes (95812)
range across 2 matching MRF lines		 $395.80–$788.60 $1,979–$3,943 varies
EEG awake and asleep (95819)
range across 2 matching MRF lines		 $635.20–$933.40 $3,176–$4,667 varies
EEG awake drowsy (95816) $783 $3,915 3.8×
EEG cerebral death evaluation (95824) $430.20 $2,151 1.2×
EEG cont rec w/video by tech min 8 channels (95700) $315.80 $1,579 1.5×
EEG extended monitoring 61-119 minutes (95813)
range across 2 matching MRF lines		 $736–$1,018.80 $3,680–$5,094 varies
Eeg Sleep Only (95822) $826.60 $4,133 4.0×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $325.60 $1,628 1.6×
EEG w/o vid 2-12hr cont mntr (95707) $325.60 $1,628 1.6×
Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) $1,790.40 $8,952 5.0×
EEG wo vid ea 12-26hr unmntr (95708) $2,775.80 $13,879 7.7×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $177.60 $888 1.9×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $65.80 $329 1.8×
Electrical Stimulation Ea 15 Min (97032) $58.20 $291 4.0×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines		 $143–$244 $715–$1,220 varies
Emergency Dept Visit Level 2 (99282) $162.80 $814 1.1×
Emergency Dept Visit Level 3 (99283) $216.40 $1,082 0.8×
Emergency Dept Visit Level 4 (99284) $361.20 $1,806 0.9×
Emg 3 Extremities (95863) $288.20 $1,441 2.3×
Emg 4 Extremities (95864) $404.60 $2,023 3.3×
Er level 1 (99281) $116.20 $581 1.4×
Er level v (99285) $559.40 $2,797 1.0×
Evaluate pt use of inhaler (94664) $168.60 $843 0.8×
Evaluate Speech Production (92522) $208.20 $1,041 1.9×
Evaluate Swallowing Function (92610) $185.20 $926 2.2×
Evaluation of speech fluency (92521) $174 $870 1.3×
External ECG rec>48hr<7d recording (93242) $116.60 $583 3.2×
External ECG rec>7d<15d recording (93246) $116.60 $583 3.2×
External Ecg Scanning Analysis Report (93226) $165.20 $826 2.9×
Extracranial Bilat Study (93880) $471.80 $2,359 2.1×
Extracranial Uni/Ltd Study (93882) $409.60 $2,048 4.1×
F-up/limited tthrc echo congenital car anomaly (93304) $795.60 $3,978 1.5×
Flexible endoscopic eval swallow c/v rec (92612) $60 $300 0.3×
Fluorescein angiography (92235) $201.20 $1,006 1.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035)
range across 2 matching MRF lines		 $867.40–$1,395.20 $4,337–$6,976 varies
Gi tract capsule endoscopy (91110) $2,316.20 $11,581 2.7×
Group Therapeutic Procedures (97150) $42.20 $211 2.3×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $648.40 $3,242 1.0×
Holter monitor recording (93225) $511.20 $2,556 4.0×
Immunization administration (90471)
range across 5 matching MRF lines		 $56.60–$69.20 $283–$346 varies
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $807.60 $4,038 2.3×
Intracranial Complete Study (93886) $391.40 $1,957 1.7×
Iontophoresis 15 min (97033) $50 $250 2.6×
Irrig Drug Delivery Device (96523) $126.40 $632 2.2×
IV infusion hydration each additional hour (96361) $104.20 $521 2.3×
IV infusion hydration initial 31 min-1 hour (96360) $173 $865 0.8×
IV infusion ther proph addl sequential to 1 hr (96367) $101.60 $508 1.5×
IV infusion therapy prophylaxis/dx ea hour (96366) $101.60 $508 2.3×
IV push initial (96374) $142.20 $711 0.7×
Lwr Xtr Vasc Stdy Bilat (93924) $189.20 $946 0.9×
Mechanical chest wall oscillation per session (94669) $186.20 $931 0.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $58 $290 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $11.40 $57 0.3×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $38.80 $194 2.3×
Methacholine challenge (94070) $333.60 $1,668 0.9×
Motility study esophagus (91010) $844 $4,220 2.4×
Motion Fluoroscopy/Swallow (92611) $185.20 $926 2.0×
Multiple Sleep Latency Test (95805) $1,809.60 $9,048 2.2×
Muscle Test 2 Limbs (95861) $248.20 $1,241 1.9×
Muscle Test One Limb (95860) $160.20 $801 1.3×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $464.80 $2,324 1.2×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $464.80 $2,324 1.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $141.80 $709 0.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $464.80 $2,324 1.2×
Nerve Conduction Studies 1-2 Studies (95907) $212.60 $1,063 1.0×
Nerve Conduction Studies 11-12 Studies (95912) $497.80 $2,489 1.4×
Nerve conduction studies 13 or more studies (95913) $550.40 $2,752 1.5×
Nerve Conduction Studies 3-4 Studies (95908) $284.20 $1,421 1.4×
Nerve conduction studies 5-6 studies (95909) $339 $1,695 1.6×
Nerve conduction studies 7-8 studies (95910) $438.80 $2,194 1.2×
Nerve Conduction Studies 9-10 Studies (95911) $494.60 $2,473 1.4×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $152.40 $762 1.2×
Neuromuscular Reeducation (97112) $94.40 $472 2.9×
Oral Function Therapy (92526) $100.60 $503 1.2×
Oral Speech Device Eval (92597) $112.40 $562 1.6×
Orthc/Prostc Mgmt Sbsq Enc (97763) $73.80 $369 1.5×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $82.40 $412 1.8×
Ot Contrast Bath Ea 15 Min (97034) $41.40 $207 3.0×
Ot eval high complexity (97167) $138.60 $693 1.4×
Ot Eval Low Complex (97165) $106 $530 1.1×
Ot Eval Moderate Complexity (97166) $138.60 $693 1.4×
Ot manual therapy 15 min (97140) $80.40 $402 2.9×
Ot paraffin bath (97018) $38 $190 6.3×
Ot Prosthetic Training, Each 15 Min (97761) $69.20 $346 1.7×
Ot Re-Eval Est Plan Care (97168) $94.20 $471 1.4×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $182.20 $911 1.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $151 $755 1.2×
Oxygen Uptake Rest Indirect (94690) $91.20 $456 1.6×
Peripheral arterial disease rehab per session (93668) $163.80 $819 2.9×
Phlebotomy therapeutic (99195) $142.20 $711 1.1×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $120.60 $603 2.1×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $120.60 $603 2.1×
Physical Performance Test (97750) $66.40 $332 2.0×
Plethysmography (94726) $353 $1,765 1.0×
Pm/Icd Remote Tech Serv (93296) $41.40 $207 1.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,221 $11,105 2.7×
Polysom <6 yrs 4/> paramtrs (95782) $1,064 $5,320 1.3×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $1,064 $5,320 1.3×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $119.80 $599 3.2×
Pt Eval High Complex (97163) $78.80 $394 0.8×
Pt eval low complex 20 min (97161) $78.80 $394 0.8×
Pt Eval Mod Complex (97162) $78.80 $394 0.8×
Pt gait training 15 min (97116) $60.40 $302 2.1×
Pt mechanical traction (97012) $56 $280 3.9×
Pt Re-Eval Est Plan Care (97164) $44 $220 0.7×
Pulm function test by gas (94727) $371.80 $1,859 1.8×
Pulmonary service/procedure (94799)
range across 2 matching MRF lines		 $488–$488.40 $2,440–$2,442 varies
Pulmonary Stress Testing (94618) $123 $615 1.0×
Refill/Maint Portable Pump (96521) $209.80 $1,049 1.0×
Refill/Maint Pump/Resvr Syst (96522) $210.20 $1,051 1.0×
Remote 30 Day Ecg Rev/Report (93270) $108.40 $542 3.0×
Respiratory flow volume loop (94375) $248.20 $1,241 1.2×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $67.80 $339 1.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $110 $550 0.6×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $145 $725 1.2×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $50.20 $251 1.1×
Self Care Mngment Training (97535) $80.40 $402 2.5×
Sensory Integration Ea 15 Min (97533) $121.40 $607 2.0×
Short-latency somatosens ep std upr limbs (95925) $486 $2,430 2.3×
Sleep study attended (95807) $849.40 $4,247 2.4×
Sleep study unattended (95806) $199.80 $999 1.0×
Slp Stdy Unatnd W/Anal (95801) $94.20 $471 1.7×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $566.60 $2,833 2.7×
Speech sound lang comprehen (92523) $238 $1,190 1.1×
Spirometry (94010) $174.60 $873 0.8×
Ssep lower limbs (95926) $475.40 $2,377 2.3×
Standardized Cognitive Performance Testing (96125) $180.80 $904 1.8×
Stress Tte Only (93350) $514 $2,570 1.0×
Subcutaneous Infusion Each Additional Hour (96370) $54.60 $273 1.2×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $233.40 $1,167 1.1×
Subq Infusion Additional Pump Infusion Site (96371) $193 $965 2.8×
Surfactant Admin Thru Tube (94610) $232.80 $1,164 1.1×
Temp transcutaneous pacing (92953) $279.40 $1,397 0.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $43.60 $218 1.9×
Ther Ivntj Ea Addl 15 Min (97130) $43.60 $218 2.1×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $80.20 $401 2.2×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $68.20 $341 2.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $160.60 $803 1.6×
Ther/Prop/Diag Inj/Inf Proc (96379) $39.60 $198 0.9×
Ther/Proph/Diag Inj Ia (96373) $275.60 $1,378 1.3×
Ther/Proph/Diag Inj Sc/Im (96372) $77 $385 1.1×
Ther/Proph/Diag Iv Inf Init (96365) $233.60 $1,168 1.1×
Therapeutic Activities (97530) $73 $365 2.1×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $2,634.60 $13,173 7.3×
Tobacco Use Cessation Intensive >10 Minutes (99407) $109.60 $548 3.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $29 $145 0.8×
Tte w/doppler, complete (93306) $663.40 $3,317 1.3×
Tte W/O Doppler Complete (93307)
range across 2 matching MRF lines		 $1,823–$2,554 $9,115–$12,770 varies
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $100.20 $501 1.3×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $45.40 $227 1.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $129 $645 2.9×
Unlisted noninvasive vascular diagnostic study (93998) $193.80 $969 7.0×
Upr/L Xtremity Art 2 Levels (93922) $310.20 $1,551 2.4×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $191.40 $957 0.9×
Vasopneumatic device (97016) $108.80 $544 9.1×
Veeg 2-12 Hr Cont Mntr (95713) $2,775.80 $13,879 7.7×
Veeg 2-12 hr intmt mntr (95712) $315.80 $1,579 0.9×
Veeg 2-12 hr unmonitored (95711) $325.60 $1,628 1.6×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $2,775.80 $13,879 7.7×
Veeg Ea 12-26 Hr Unmntr (95714) $2,775.80 $13,879 7.7×
Vent Mgmt Inpat Init Day (94002) $1,104.40 $5,522 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,104.40 $5,522 1.9×
Visual Evoked Potential Test (95930) $423.20 $2,116 2.0×
Vital capacity, total (94150) $242.80 $1,214 2.0×
Wheelchair Mgmt Ea 15 Min (97542) $51.20 $256 1.6×
Whirlpool Therapy (97022) $21.60 $108 1.4×

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.