Visits & medical services prices at Intermountain Health Primary Children's Hospital
Salt Lake City, UT · every code in this section with a posted price and a Medicare benchmark.
332 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) | $200.32 | $267.10 | 1.5× |
| Acoustic Reflex Testing (92568) | $84.68 | $112.90 | 2.2× |
| Actigraphy Testing Recording Analysis I&R (95803) | $518.62 | $691.50 | 8.7× |
| Admn Sarscov2 Vacc 1 Dose (90480) range across 2 matching MRF lines |
$15.54–$88.41 | $20.72–$117.88 | varies |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $470.91 | $627.88 | 2.2× |
| Aep neurodiagnostic i&r (92653) | $955.77 | $1,274.36 | 4.4× |
| Aep threshold estimation mlt frequencies i&r (92652) | $955.77 | $1,274.36 | 4.4× |
| Airway Inhalation Treatment (94640) | $56.18 | $74.91 | 0.3× |
| Airway resistance by oscillometry (94728) | $456.89 | $609.19 | 3.5× |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) | $235.79 | $314.39 | 1.8× |
| Analysis Cochlear Implt Pt <7 Yr Prgrmg (92601) | $571.71 | $762.28 | 4.4× |
| Analyze neurostim complex (95972) | $261.92 | $349.23 | 2.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $70.99 | $94.65 | 4.9× |
| Application on-body injector (96377) | $106.14 | $141.52 | 2.2× |
| Arrhythmia Induction (93618) | $2,129.33 | $2,839.11 | 1.7× |
| Assessment of aphasia per hr (96105) | $496.88 | $662.51 | 5.1× |
| Audiometry Air & Bone (92553) | $205.91 | $274.55 | 1.6× |
| Basic vestibular evaluation (92540) | $533.96 | $711.94 | 2.4× |
| Behavral qualit analys voice (92524) | $511.53 | $682.04 | 4.7× |
| Biofeedback training any modality (90901) | $236.47 | $315.29 | 5.8× |
| Brief Emotional/Behav Assmt (96127) | $97.47 | $129.96 | 2.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $449.48 | $599.30 | 1.2× |
| Bundle of his recording (93600) likely a partial charge, not the full procedure |
$724.84 | $966.45 | 0.1× |
| C motor evoked upr&lwr limbs (95939) | $2,217.71 | $2,956.95 | 2.6× |
| Caloric vestibular test w/rec bi monothermal (92538) | $405.12 | $540.16 | 1.9× |
| Caloric Vstblr Test W/Rec (92537) | $430.18 | $573.58 | 3.3× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$111.52–$116.48 | $148.69–$155.31 | varies |
| Car seat/bed test 60 min (94780) | $206.21 | $274.95 | 5.5× |
| Cardiac Stress Tst,Tracing Only (93017) | $210.01 | $280.01 | 1.0× |
| Cardiopulmonary exercise testing (94621) | $672.19 | $896.25 | 1.8× |
| Cardiopulmonary resuscitation (92950) | $873.82 | $1,165.10 | 4.0× |
| Cardioversion (92960) | $708.82 | $945.09 | 1.1× |
| Cardioversion elective internal (92961) | $917.85 | $1,223.80 | 1.4× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) range across 3 matching MRF lines |
$77.28–$81.71 | $103.04–$108.95 | varies |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $7,772.66 | $10,363.55 | 2.4× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $6,878.62 | $9,171.49 | 2.1× |
| Cbt 1st hour (94644) | $2,901.88 | $3,869.17 | 21.5× |
| Cervical Vemp Testing W/I&R (92517) | $295.07 | $393.43 | 2.3× |
| Chemo Anti-Neopl Sq/Im (96401) | $308.38 | $411.17 | 4.2× |
| Chemo Ia Push (96420) | $334.54 | $446.05 | 1.0× |
| Chemo Intralesional Over 7 (96406) | $1,129.66 | $1,506.21 | 5.2× |
| Chemo intralesional up to 7 (96405) | $765.88 | $1,021.18 | 10.5× |
| Chemo IV infusion addl hr (96415) | $361.26 | $481.68 | 5.0× |
| Chemo IV push addl drug (96411) | $274.11 | $365.48 | 3.8× |
| Chemother Prolong Infuse W/Pump (96416) | $562.50 | $750 | 1.7× |
| Chemotherapy Into Cns (96450) | $541.58 | $722.11 | 1.6× |
| Chemotherapy Unspecified (96549) | $435.99 | $581.32 | 9.2× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $366.47 | $488.63 | 5.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $784.28 | $1,045.70 | 2.3× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $616.24 | $821.65 | 1.8× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $353.90 | $471.86 | 1.1× |
| Chest Wall Manipulation (94668) | $156.54 | $208.72 | 1.2× |
| Color/duplex Doppler, complete (93975) | $592.41 | $789.88 | 2.5× |
| Color/duplex Doppler, limited (93976) | $354.88 | $473.18 | 3.4× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) range across 2 matching MRF lines |
$150.84–$152.21 | $201.12–$202.94 | varies |
| Comprehensive Hearing Test (92557) | $324.55 | $432.73 | 2.5× |
| Conditioning Play Audiometry (92582) | $313.22 | $417.63 | 2.4× |
| Continuous Pulse Ox (94762) range across 2 matching MRF lines |
$214.94–$241.81 | $286.58–$322.41 | varies |
| Coronary Art/Grft Angio S&I (93455) | $6,639.86 | $8,853.14 | 2.0× |
| Coronary Artery Angio S&I (93454) | $6,133.25 | $8,177.67 | 1.9× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 4 matching MRF lines |
$226.20–$898.48 | $301.60–$1,197.97 | varies |
| Cpt initial (94667) | $156.62 | $208.82 | 1.2× |
| Critical care first hour (99291) | $4,948.75 | $6,598.33 | 5.9× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$496.34–$507.28 | $661.79–$676.37 | varies |
| Developmental tst admin phys/qhp 1st hour (96112) range across 3 matching MRF lines |
$691.82–$705.23 | $922.43–$940.31 | varies |
| Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming Facility (92602) | $288.14 | $384.19 | 2.2× |
| Dialysis One Evaluation (90945) range across 5 matching MRF lines |
$670.58–$1,211.89 | $894.11–$1,615.85 | varies |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) | $158.91 | $211.88 | 0.4× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $559.54 | $746.06 | 2.3× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $245.28 | $327.04 | 2.3× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $416.80 | $555.74 | 1.7× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $375.15 | $500.20 | 3.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $632.91 | $843.88 | 2.6× |
| Dup-scan xtr veins unilateral/limited study (93971) | $428.42 | $571.23 | 4.0× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $572.03 | $762.71 | 2.4× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $412.01 | $549.35 | 3.9× |
| Duplex Scan Hemodialysis Access (93990) range across 2 matching MRF lines |
$448.40–$448.42 | $597.86–$597.89 | varies |
| Duplex up extrem art bilat (93930) | $483.87 | $645.16 | 2.0× |
| Duplex up extrem art unilat/ltd (93931) | $386.48 | $515.30 | 3.7× |
| Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) | $172.64 | $230.19 | 1.3× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) | $296.22 | $394.96 | 2.3× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) | $573.14 | $764.19 | 4.4× |
| ECG/monitoring and analysis (93271) | $127.42 | $169.90 | 1.3× |
| Echo Congenital Complete (93303) range across 2 matching MRF lines |
$859.82–$859.87 | $1,146.43–$1,146.49 | varies |
| Echo Heart Xthoracic,Limited (93308) | $437.45 | $583.27 | 1.8× |
| Echo r-t 2d w/probe placement only (93313) | $534.85 | $713.13 | 1.0× |
| Echo transesophag montr cardiac pump functj (93318) | $2,189.36 | $2,919.14 | 4.0× |
| Echo transesophageal (93312) | $1,198.67 | $1,598.23 | 2.2× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $1,499.01 | $1,998.68 | 2.7× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $906.08 | $1,208.11 | 1.6× |
| Eeg 41-60 Minutes (95812) | $1,126.10 | $1,501.46 | 5.2× |
| EEG awake and asleep (95819) | $613.63 | $818.17 | 2.8× |
| EEG awake drowsy (95816) | $614.54 | $819.39 | 2.8× |
| EEG cont rec w/video by tech min 8 channels (95700) | $631.51 | $842.01 | 2.9× |
| EEG extended monitoring 61-119 minutes (95813) | $848.84 | $1,131.79 | 3.9× |
| Eeg Sleep Only (95822) | $410.86 | $547.81 | 1.9× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $633.26 | $844.35 | 2.9× |
| EEG w/o vid 2-12hr cont mntr (95707) | $638.99 | $851.99 | 2.9× |
| EEG w/o vid ea 12-26hr intmt (95709) | $1,250.86 | $1,667.82 | 3.3× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $3,246.19 | $4,328.25 | 8.6× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $647.42 | $863.22 | 3.0× |
| EEG wo vid ea 12-26hr unmntr (95708) | $1,214.97 | $1,619.96 | 3.2× |
| EKG signal averaged (93278) | $149.76 | $199.68 | 2.5× |
| Electrical Stimulation Ea 15 Min (97032) range across 2 matching MRF lines |
$105.62–$106.55 | $140.82–$142.07 | varies |
| Electrocardiogram Tracing (93005) | $164.02 | $218.70 | 2.7× |
| Electrocochleography (92584) | $373.22 | $497.63 | 2.9× |
| Electroconvulsive Therapy (90870) | $966.17 | $1,288.23 | 1.1× |
| Electrophysiology Evaluation (93642) | $2,019.11 | $2,692.15 | 1.6× |
| Emergency Dept Visit Level 2 (99282) | $829.88 | $1,106.50 | 5.3× |
| Emergency Dept Visit Level 3 (99283) | $1,244.66 | $1,659.54 | 4.5× |
| Emergency Dept Visit Level 4 (99284) | $1,866.87 | $2,489.16 | 4.4× |
| Endomyocardial Biopsy (93505) | $4,963.31 | $6,617.75 | 1.6× |
| Ep & ablate supravent arrhyt (93653) | $49,020.44 | $65,360.58 | 1.9× |
| Ep & ablate ventric tachy (93654) | $54,085.88 | $72,114.51 | 2.0× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $10,724.13 | $14,298.84 | 1.4× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) | $9,644.46 | $12,859.28 | 1.2× |
| Ep Esophageal Recording Atria+Pacing (93616) | $1,656.38 | $2,208.50 | 1.3× |
| Er level 1 (99281) | $553.47 | $737.96 | 6.5× |
| Er level v (99285) | $2,800.27 | $3,733.69 | 4.6× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) | $1,663.67 | $2,218.23 | 4.4× |
| Esophgl funcj g-esop rflx impd eltrd prolng (91038) | $1,882.44 | $2,509.92 | 5.0× |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $178.82 | $238.42 | 1.4× |
| Evaluate pt use of inhaler (94664) | $273.72 | $364.96 | 1.2× |
| Evaluate Speech Production (92522) | $334.65 | $446.20 | 3.0× |
| Evaluate Swallowing Function (92610) range across 3 matching MRF lines |
$517.01–$524.86 | $689.35–$699.81 | varies |
| Evaluation of speech fluency (92521) | $476.20 | $634.93 | 3.6× |
| Evoked Auditory Test,Limited (92587) | $296.61 | $395.48 | 1.4× |
| Exercise test for bronchospasm (94617) | $667.28 | $889.70 | 5.0× |
| External ECG rec>48hr<7d recording (93242) | $348.15 | $464.20 | 9.2× |
| External ECG rec>7d<15d recording (93246) | $130.35 | $173.80 | 3.4× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $260.08 | $346.77 | 1.9× |
| External Ecg Scanning Analysis Report (93226) | $375.61 | $500.81 | 6.3× |
| Extracranial Bilat Study (93880) | $486.87 | $649.16 | 2.0× |
| Extracranial Uni/Ltd Study (93882) | $261.39 | $348.52 | 2.5× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $547.88 | $730.51 | 1.0× |
| Flexible endoscopic eval swallow c/v rec (92612) | $686.80 | $915.74 | 3.4× |
| Flexible ndsc eval swlng&laryn sens c/v rec (92616) | $316.40 | $421.87 | 1.4× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) | $1,760.15 | $2,346.87 | 2.0× |
| Fundus photography (92250) | $654.98 | $873.31 | 4.9× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) | $1,017.64 | $1,356.86 | 2.7× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $1,698.76 | $2,265.02 | 2.0× |
| Gi tract capsule endoscopy (91110) | $3,077.83 | $4,103.77 | 3.4× |
| Gi tract imaging intraluminal colon i&r (91113) | $3,095.95 | $4,127.93 | 3.3× |
| Gi wireless capsule measure (91112) | $3,183.72 | $4,244.96 | 3.5× |
| Group Therapeutic Procedures (97150) range across 2 matching MRF lines |
$141.92–$141.93 | $189.23–$189.24 | varies |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $8,183.19 | $10,910.92 | 2.5× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $2,748.38 | $3,664.51 | 4.0× |
| Holter monitor recording (93225) | $348.14 | $464.18 | 2.6× |
| Icd Device Interrogate (93289) | $70.28 | $93.71 | 1.9× |
| Icd device progr eval dual (93283) | $63.25 | $84.33 | 1.7× |
| Icm Device Eval (93290) | $119.36 | $159.15 | 3.2× |
| Ilr Device Eval Progr (93285) | $184.59 | $246.12 | 4.9× |
| Ilr Device Interrogate (93291) | $77.34 | $103.12 | 2.6× |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 2 matching MRF lines |
$15.54–$88.41 | $20.72–$117.88 | varies |
| Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) | $110.75 | $147.67 | 2.9× |
| Immunization administration (90471) range across 4 matching MRF lines |
$14.04–$28.65 | $18.72–$38.20 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $290.51 | $387.35 | 0.8× |
| Interrogate Subq Defib (93261) | $75.70 | $100.94 | 2.0× |
| Interrogation vad in person (93750) | $265.02 | $353.36 | 2.8× |
| Intra-atrial pacing (93610) | $12,231.22 | $16,308.30 | 1.5× |
| Intracranial Complete Study (93886) | $541.01 | $721.35 | 2.2× |
| Intraventricular pacing (93612) | $10,581.40 | $14,108.53 | 1.3× |
| Iontophoresis 15 min (97033) | $129.16 | $172.22 | 6.8× |
| Irrig Drug Delivery Device (96523) | $175.95 | $234.60 | 2.9× |
| IV infusion hydration each additional hour (96361) | $170.72 | $227.63 | 3.6× |
| IV infusion hydration initial 31 min-1 hour (96360) | $275.59 | $367.45 | 1.3× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $361.69 | $482.25 | 5.0× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $270.26 | $360.35 | 5.7× |
| IV push initial (96374) | $236.48 | $315.30 | 1.1× |
| L Hrt Art/Grft Angio (93459) | $7,339.24 | $9,785.66 | 2.2× |
| L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) | $7,807.87 | $10,410.49 | 2.4× |
| Liver Elastography W/O Imag W/I&R (91200) | $401.10 | $534.80 | 3.1× |
| Lung Function Test (Mbc/Mvv) (94200) | $353.68 | $471.58 | 5.9× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $330.69 | $440.92 | 1.5× |
| Mechanical chest wall oscillation per session (94669) | $276.94 | $369.25 | 1.2× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $32.38 | $43.18 | 1.0× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $38.09 | $50.79 | 1.0× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $27.02 | $36.02 | 1.6× |
| Methacholine challenge (94070) | $819.81 | $1,093.08 | 2.2× |
| Motility study esophagus (91010) | $1,830.18 | $2,440.24 | 4.8× |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$544.52–$583.44 | $726.03–$777.92 | varies |
| Multiple Sleep Latency Test (95805) | $2,569.02 | $3,425.36 | 3.0× |
| Muscle Test 2 Limbs (95861) | $379.80 | $506.40 | 2.8× |
| Nasopharyngoscopy (92511) | $283.84 | $378.45 | 1.4× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $349.01 | $465.35 | 1.6× |
| Needle electromyography larynx (95865) | $607.07 | $809.42 | 4.5× |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) | $595.19 | $793.59 | 2.7× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) range across 3 matching MRF lines |
$541.20–$550.64 | $721.60–$734.18 | varies |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) range across 3 matching MRF lines |
$654.32–$841.91 | $872.42–$1,122.55 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 3 matching MRF lines |
$607.90–$618.48 | $810.54–$824.64 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 3 matching MRF lines |
$842.90–$857.57 | $1,123.86–$1,143.43 | varies |
| Nerve Conduction Studies 11-12 Studies (95912) range across 2 matching MRF lines |
$554.66–$1,604.76 | $739.55–$2,139.68 | varies |
| Nerve conduction studies 13 or more studies (95913) | $1,901.09 | $2,534.79 | 5.0× |
| Nerve Conduction Studies 3-4 Studies (95908) | $498.71 | $664.95 | 2.3× |
| Nerve conduction studies 5-6 studies (95909) range across 2 matching MRF lines |
$467.97–$810.27 | $623.96–$1,080.36 | varies |
| Nerve conduction studies 7-8 studies (95910) range across 2 matching MRF lines |
$470.30–$1,073.27 | $627.07–$1,431.02 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 2 matching MRF lines |
$549.74–$1,366.36 | $732.99–$1,821.81 | varies |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $275.08 | $366.78 | 2.1× |
| Neuromuscular Reeducation (97112) range across 3 matching MRF lines |
$87.70–$106.45 | $116.93–$141.93 | varies |
| Newborn resuscitation (99465) | $855.82 | $1,141.10 | 1.3× |
| Nitric oxide expired gas determination (95012) | $149.28 | $199.04 | 3.9× |
| O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) | $467.21 | $622.95 | 1.2× |
| Opscpy extnd rta drawing & scl deprsn i&r uni/bi (92201) | $158.16 | $210.88 | 2.6× |
| Oral Function Therapy (92526) range across 3 matching MRF lines |
$236.47–$357.29 | $315.29–$476.39 | varies |
| Oral Speech Device Eval (92597) | $536.67 | $715.56 | 7.5× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 2 matching MRF lines |
$96.42–$97.28 | $128.56–$129.71 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 2 matching MRF lines |
$101.28–$102.18 | $135.04–$136.24 | varies |
| Ot Contrast Bath Ea 15 Min (97034) | $98.43 | $131.24 | 7.0× |
| Ot eval high complexity (97167) | $490.20 | $653.60 | 4.9× |
| Ot Eval Low Complex (97165) | $292.85 | $390.46 | 2.9× |
| Ot Eval Moderate Complexity (97166) | $395.36 | $527.15 | 3.9× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$104.92–$105.86 | $139.90–$141.15 | varies |
| Ot paraffin bath (97018) | $80.26 | $107.01 | 13.4× |
| Ot Prosthetic Training, Each 15 Min (97761) | $92.09 | $122.79 | 2.3× |
| Ot Re-Eval Est Plan Care (97168) | $224.49 | $299.32 | 3.3× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $201.64 | $268.85 | 1.5× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $193.70 | $258.26 | 1.5× |
| Penile Vascular Study,Ltd or F/U (93981) range across 2 matching MRF lines |
$240.56–$574.30 | $320.74–$765.74 | varies |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) range across 2 matching MRF lines |
$258.84–$285.58 | $345.12–$380.78 | varies |
| Perq transcath closure pda (93582) | $36,080.11 | $48,106.81 | 1.9× |
| Perq Transcath Cls Aortic (93591) | $34,963.46 | $46,617.94 | 1.9× |
| Perq Transcath Cls Mitral (93590) | $34,414.41 | $45,885.88 | 1.9× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $12,644.98 | $16,859.98 | 2.2× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) range across 3 matching MRF lines |
$24,867.35–$26,446.37 | $33,156.47–$35,261.83 | varies |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$218.33–$227.09 | $291.11–$302.79 | varies |
| Physical Performance Test (97750) range across 2 matching MRF lines |
$104.40–$105.32 | $139.20–$140.43 | varies |
| Plethysmography (94726) | $239.42 | $319.23 | 0.6× |
| Pm device eval in person (93288) | $77.11 | $102.82 | 2.0× |
| Pm device progr eval dual (93280) | $66.38 | $88.50 | 1.8× |
| Pm device progr eval multi (93281) | $66.38 | $88.50 | 1.8× |
| Pm Device Progr Eval Sngl (93279) | $265.56 | $354.08 | 7.0× |
| Pm/Icd Remote Tech Serv (93296) | $215.02 | $286.70 | 5.7× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$3,944.20–$4,013.36 | $5,258.93–$5,351.15 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) | $3,671.50 | $4,895.33 | 4.2× |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) | $4,484.05 | $5,978.73 | 5.2× |
| Positional nystagmus test (92542) | $182.65 | $243.53 | 1.4× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $311.44 | $415.25 | 8.2× |
| Prq Card Angio/Athrect 1 Art (92924) | $19,444.68 | $25,926.24 | 1.7× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $20,092.83 | $26,790.44 | 1.7× |
| Prq Card Stent/Ath/Angio (92933) | $24,826.95 | $33,102.60 | 1.3× |
| Prq Revasc Byp Graft 1 Vsl (92937) range across 3 matching MRF lines |
$18,083.54–$18,472.46 | $24,111.39–$24,629.94 | varies |
| Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) unusually low: confirm this is the full procedure |
$8,919.41 | $11,892.54 | 0.5× |
| Prq trluml pulmonary art balloon angiop 1 vsl (92997) | $29,167.01 | $38,889.35 | 2.5× |
| Psycl/Nrpsyc Tst Auto Result (96146) | $74.51 | $99.35 | 2.5× |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) | $87.90 | $117.20 | 2.3× |
| Pt Eval High Complex (97163) | $361.68 | $482.24 | 3.7× |
| Pt eval low complex 20 min (97161) | $239.54 | $319.39 | 2.4× |
| Pt Eval Mod Complex (97162) | $299.78 | $399.71 | 3.1× |
| Pt gait training 15 min (97116) | $110.38 | $147.18 | 3.8× |
| Pt group caregiver training (97552) | $33.83 | $45.10 | 1.5× |
| Pt mechanical traction (97012) | $81.24 | $108.32 | 5.7× |
| Pt Re-Eval Est Plan Care (97164) | $185.80 | $247.74 | 2.8× |
| Pulm function test by gas (94727) | $213.76 | $285.01 | 1.0× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$55.22–$198.22 | $73.63–$264.30 | varies |
| Pulmonary Stress Testing (94618) | $485.62 | $647.49 | 3.6× |
| Pure Tone Audiometry Air (92552) | $104.45 | $139.27 | 0.8× |
| R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) | $6,185.50 | $8,247.34 | 1.9× |
| R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) | $6,185.50 | $8,247.34 | 1.9× |
| R hrt coronary artery angio (93456) | $7,022.67 | $9,363.56 | 2.1× |
| R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) | $6,185.50 | $8,247.34 | 1.9× |
| R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) | $6,185.50 | $8,247.34 | 1.9× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $6,977.80 | $9,303.74 | 2.1× |
| Remote 30 Day Ecg Rev/Report (93270) | $123.79 | $165.05 | 3.3× |
| Remote 30 Day Ecg Tech Supp (93229) | $1,299.60 | $1,732.80 | 3.4× |
| Respiratory flow volume loop (94375) | $334.66 | $446.21 | 1.5× |
| Right Heart Cath (93451) | $4,636.35 | $6,181.80 | 1.4× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 4 matching MRF lines |
$304.44–$389.82 | $405.92–$519.76 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $385.91 | $514.55 | 3.2× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $191.98 | $255.97 | 4.0× |
| Self Care Mngment Training (97535) range across 3 matching MRF lines |
$110.64–$123.40 | $147.52–$164.54 | varies |
| Sensory Integration Ea 15 Min (97533) range across 3 matching MRF lines |
$106.57–$107.58 | $142.09–$143.44 | varies |
| Short-latency somatosens ep std upr limbs (95925) | $1,144.72 | $1,526.30 | 5.2× |
| Sinusoidal Vertical Axis Rotational Testing (92546) | $443.82 | $591.76 | 3.4× |
| Sleep study unattended (95806) range across 2 matching MRF lines |
$587.92 | $783.89–$783.90 | 2.7× |
| Slp caregiver training 1st 30 min (97550) range across 3 matching MRF lines |
$150.44–$152.15 | $200.59–$202.87 | varies |
| Somatosensory Testing (95938) | $1,232.49 | $1,643.32 | 1.4× |
| Speech Audiometry Complete (92556) | $160.73 | $214.31 | 2.7× |
| Speech audiometry threshold (92555) | $114.88 | $153.17 | 1.9× |
| Speech sound lang comprehen (92523) | $583.24 | $777.65 | 2.6× |
| Spirometry (94010) | $206.82 | $275.76 | 0.9× |
| Spontaneous Nystagmus Test (92541) | $158.28 | $211.04 | 1.2× |
| Ssep lower limbs (95926) | $1,132.10 | $1,509.47 | 5.2× |
| Standardized Cognitive Performance Testing (96125) range across 2 matching MRF lines |
$109.04–$505.31 | $145.39–$673.75 | varies |
| Stenger Test Speech (92577) | $104.45 | $139.27 | 0.3× |
| Stenger Test, Pure Tone (92565) | $103.85 | $138.47 | 1.7× |
| Subcutaneous Infusion Each Additional Hour (96370) | $259.78 | $346.37 | 5.5× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $487.41 | $649.88 | 2.3× |
| Surfactant Admin Thru Tube (94610) | $272.29 | $363.05 | 1.2× |
| Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) | $402.84 | $537.12 | 3.8× |
| Temp transcutaneous pacing (92953) | $501.55 | $668.73 | 0.7× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 3 matching MRF lines |
$108.92–$113.32 | $145.23–$151.09 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) range across 3 matching MRF lines |
$108.92–$113.32 | $145.23–$151.09 | varies |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) range across 2 matching MRF lines |
$105.76–$105.93 | $141.01–$141.24 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 4 matching MRF lines |
$91.48–$100.34 | $121.97–$133.79 | varies |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $289.94 | $386.59 | 2.8× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $86.67 | $115.56 | 1.2× |
| Ther/Proph/Diag Iv Inf Init (96365) | $260.92 | $347.90 | 1.2× |
| Therapeutic Activities (97530) range across 3 matching MRF lines |
$100.88–$108.18 | $134.51–$144.24 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $810 | $1,080 | 2.1× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $44.27 | $59.03 | 1.2× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $50.49 | $67.32 | 1.3× |
| Transcath Closure of Asd (93580) | $32,044.31 | $42,725.75 | 1.7× |
| Transcranial Doppler Intracran Art Emboli Detect (93892) | $359.24 | $478.99 | 3.4× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $349.66 | $466.21 | 3.3× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$825.43–$860.15 | $1,100.57–$1,146.87 | varies |
| Tte W/O Doppler Complete (93307) | $437.72 | $583.63 | 1.8× |
| Tx atrial fib pulm vein isol (93656) | $52,442.38 | $69,923.18 | 2.0× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $360.71 | $480.95 | 4.7× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $191.90 | $255.86 | 8.0× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $124.64 | $166.19 | 2.6× |
| Tympanometry (92567) | $71.75 | $95.67 | 1.9× |
| Tympanometry and reflex threshold measurements (92550) | $176.66 | $235.55 | 0.8× |
| Unlisted cardiovascular service/procedure (93799) range across 11 matching MRF lines |
$230.88–$13,976.19 | $307.84–$18,634.92 | varies |
| Unlisted otorhinolaryngological service (92700) | $107.75 | $143.67 | 3.7× |
| Upr/L Xtremity Art 2 Levels (93922) range across 3 matching MRF lines |
$260.64–$521.28 | $347.52–$695.04 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 2 matching MRF lines |
$311.68–$623.35 | $415.57–$831.13 | varies |
| Valvuloplasty aortic valve (92986) | $10,061.12 | $13,414.83 | 1.7× |
| Valvuloplasty mitral valve (92987) | $21,300.17 | $28,400.23 | 1.8× |
| Valvuloplasty pulmonary valve (92990) | $29,167.01 | $38,889.35 | 2.5× |
| Veeg 2-12 Hr Cont Mntr (95713) | $3,246.19 | $4,328.25 | 8.6× |
| Veeg 2-12 hr intmt mntr (95712) | $2,217.84 | $2,957.12 | 5.9× |
| Veeg 2-12 hr unmonitored (95711) | $759.90 | $1,013.20 | 3.5× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $2,913.03 | $3,884.04 | 7.7× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $1,457.97 | $1,943.96 | 3.9× |
| Veeg ea 12-26hr cont mntr (95716) | $4,039.82 | $5,386.43 | 4.6× |
| Vent Mgmt Inpat Init Day (94002) | $1,827.10 | $2,436.14 | 2.9× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,862.87 | $2,483.83 | 3.0× |
| Visual reinforcement audiometry (vra) (92579) | $361.81 | $482.41 | 1.7× |
| Vital capacity, total (94150) | $183.33 | $244.44 | 1.4× |
| Wada Activation Test Hemispheric Function W/Eeg (95958) | $892.99 | $1,190.65 | 1.0× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$105.22–$106.18 | $140.30–$141.57 | varies |
| Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) | $667.28 | $889.70 | 11.2× |
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.