Visits & medical services prices at Ivinson Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $253 $253 1.9×
Actinotherapy Ultraviolet Light (96900) $94 $94 2.5×
Airway Inhalation Treatment (94640) $196 $196 0.9×
Analyze neurostim no prog (95970) $245 $245 1.8×
Analyze Pacemaker System (93724) $1,164 $1,164 3.7×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $95 $95 6.6×
Application on-body injector (96377) $159 $159 3.3×
Assessment of aphasia per hr (96105) $323 $323 3.3×
Audiometry Air & Bone (92553) $138 $138 1.0×
Basic vestibular evaluation (92540) $516 $516 2.3×
Behavral qualit analys voice (92524) $156 $156 1.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $442 $442 1.2×
Caloric Vstblr Test W/Rec (92537) $429 $429 3.3×
Cardiac Stress Tst,Tracing Only (93017) $814 $814 3.7×
Cardiopulmonary resuscitation (92950) $875 $875 4.0×
Cardioversion (92960) $1,572 $1,572 2.3×
Cbt 1st hour (94644) $347 $347 2.6×
Chemo Anti-Neopl Sq/Im (96401) $307 $307 4.2×
Chemo Hormon Antineopl Sq/Im (96402) $299 $299 4.1×
Chemo IV infusion addl hr (96415) $204 $204 2.8×
Chemo IV push addl drug (96411) $348 $348 4.7×
Chemother Prolong Infuse W/Pump (96416) $735 $735 2.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $240 $240 3.3×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $568 $568 1.7×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $485 $485 1.4×
Chest Wall Manipulation (94668) $110 $110 0.8×
Color/duplex Doppler, complete (93975) $1,262 $1,262 5.2×
Color/duplex Doppler, limited (93976) $670 $670 6.3×
Community/Work Reintegration Trainj Ea 15 Min (97537) $128 $128 4.0×
Comprehensive Hearing Test (92557) $138 $138 1.0×
Conditioning Play Audiometry (92582) $303 $303 2.3×
Cont gluc mntr physician/qhp provided equiptment (95250) $452 $452 3.3×
Continuous Pulse Ox (94762) $193 $193 1.5×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 2 matching MRF lines		 $484–$491 $484–$491 varies
Cpt initial (94667) $121 $121 0.9×
Critical care first hour (99291) $2,602 $2,602 3.1×
Debridement Open Wound 20 Sq Cm< (97597) $283 $283 1.4×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,200 $1,200 4.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $876 $876 8.2×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $982 $982 4.0×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926)
range across 3 matching MRF lines		 $565–$993 $565–$993 varies
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 3 matching MRF lines		 $630–$1,145 $630–$1,145 varies
Dup-scan xtr veins unilateral/limited study (93971) $749 $749 7.0×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $1,003 $1,003 4.1×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $303 $303 2.8×
Duplex up extrem art bilat (93930)
range across 2 matching MRF lines		 $1,000–$1,326 $1,000–$1,326 varies
Duplex up extrem art unilat/ltd (93931)
range across 3 matching MRF lines		 $85–$500 $85–$500 varies
Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) $373 $373 2.8×
Echo Congenital Complete (93303) $1,914 $1,914 3.4×
Echo Heart Xthoracic,Limited (93308)
range across 3 matching MRF lines		 $625–$981 $625–$981 varies
Echo transesophageal (93312) $1,881 $1,881 3.4×
Eeg 41-60 Minutes (95812) $1,430 $1,430 6.5×
EEG awake and asleep (95819) $1,130 $1,130 5.1×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $353 $353 3.6×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $122 $122 3.2×
Electrical Stimulation Ea 15 Min (97032) $65 $65 4.4×
Electrocardiogram Tracing (93005) $329 $329 5.5×
Emergency Dept Visit Level 2 (99282) $356 $356 2.3×
Emergency Dept Visit Level 3 (99283) $630 $630 2.3×
Emergency Dept Visit Level 4 (99284) $1,027 $1,027 2.4×
Er level 1 (99281) $177 $177 2.1×
Er level v (99285) $1,305 $1,305 2.1×
Evaluate pt use of inhaler (94664) $233 $233 1.0×
Evaluate Speech Production (92522) $149 $149 1.3×
Evaluate Swallowing Function (92610) $177 $177 2.1×
Evaluation of speech fluency (92521) $182 $182 1.4×
Evoked Auditory Test,Limited (92587) $110 $110 0.5×
External Ecg Scanning Analysis Report (93226) $589 $589 9.8×
Extracranial Bilat Study (93880) $561 $561 2.3×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $465 $465 0.7×
Holter monitor recording (93225) $647 $647 4.8×
Immunization administration (90471) $110 $110 1.5×
Intra-atrial recording (93602) $8,048 $8,048 1.0×
Iontophoresis 15 min (97033) $98 $98 5.1×
Irrig Drug Delivery Device (96523) $131 $131 2.2×
IV infusion hydration each additional hour (96361) $147 $147 3.1×
IV infusion hydration initial 31 min-1 hour (96360) $490 $490 2.3×
IV infusion ther proph addl sequential to 1 hr (96367) $153 $153 2.1×
IV infusion therapy prophylaxis/dx ea hour (96366) $144 $144 3.0×
IV push initial (96374) $99 $99 0.5×
Lwr Xtr Vasc Stdy Bilat (93924) $1,069 $1,069 4.8×
Mechanical chest wall oscillation per session (94669) $191 $191 0.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $72 $72 2.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $67 $67 1.8×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $57 $57 3.3×
Motion Fluoroscopy/Swallow (92611) $288 $288 3.1×
Nasopharyngoscopy (92511) $360 $360 1.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $257 $257 1.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $317 $317 0.8×
Neuromuscular Reeducation (97112) $74 $74 2.3×
Oral Function Therapy (92526) $191 $191 2.3×
Oral Speech Device Eval (92597) $489 $489 6.9×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $73 $73 1.6×
Ot eval high complexity (97167) $437 $437 4.3×
Ot Eval Low Complex (97165) $263 $263 2.6×
Ot Eval Moderate Complexity (97166) $351 $351 3.5×
Ot manual therapy 15 min (97140) $108 $108 3.9×
Ot paraffin bath (97018) $77 $77 12.8×
Ot Re-Eval Est Plan Care (97168) $210 $210 3.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $213 $213 1.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $190 $190 1.4×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $389 $389 1.7×
Phlebotomy therapeutic (99195) $258 $258 1.9×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $86 $86 1.4×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $86 $86 1.4×
Physical Performance Test (97750) $132 $132 3.9×
Plethysmography (94726) $209 $209 0.5×
Pm device eval in person (93288) $138 $138 3.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,093 $5,093 5.8×
Positional nystagmus test (92542) $279 $279 2.1×
Pt Eval High Complex (97163) $427 $427 4.4×
Pt eval low complex 20 min (97161) $256 $256 2.6×
Pt Eval Mod Complex (97162) $343 $343 3.5×
Pt gait training 15 min (97116) $75 $75 2.6×
Pt mechanical traction (97012) $81 $81 5.6×
Pt Re-Eval Est Plan Care (97164) $202 $202 3.0×
Pulmonary Stress Testing (94618) $148 $148 1.1×
Pure Tone Audiometry Air (92552)
range across 2 matching MRF lines		 $26–$116 $26–$116 varies
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $172 $172 0.8×
Self Care Mngment Training (97535) $74 $74 2.3×
Sleep study unattended (95806) $713 $713 3.2×
Speech Audiometry Complete (92556) $54 $54 0.9×
Speech audiometry threshold (92555) $38 $38 0.6×
Speech sound lang comprehen (92523) $276 $276 1.2×
Spirometry (94010) $169 $169 0.8×
Standardized Cognitive Performance Testing (96125) $311 $311 3.0×
Stress Tte Only (93350) $1,249 $1,249 2.2×
Surfactant Admin Thru Tube (94610) $995 $995 4.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $135 $135 6.0×
Ther Ivntj Ea Addl 15 Min (97130) $110 $110 5.2×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $54 $54 1.8×
Ther/Proph/Diag Inj Sc/Im (96372) $121 $121 1.6×
Ther/Proph/Diag Iv Inf Init (96365) $485 $485 2.2×
Therapeutic Activities (97530) $74 $74 2.1×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $2,024 $2,024 5.3×
Tte w/doppler, complete (93306) $1,958 $1,958 3.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $197 $197 2.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $97 $97 2.0×
Tympanometry (92567) $121 $121 3.2×
Tympanometry and reflex threshold measurements (92550) $158 $158 0.7×
Upr/L Xtremity Art 2 Levels (93922) $374 $374 2.8×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $439 $439 2.0×
Vent Mgmt Inpat Init Day (94002) $1,377 $1,377 2.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,092 $1,092 1.7×
Visual reinforcement audiometry (vra) (92579) $39 $39 0.2×
Vital capacity, total (94150) $186 $186 1.4×
Wheelchair Mgmt Ea 15 Min (97542) $69 $69 2.2×
Whirlpool Therapy (97022) $166 $166 10.6×

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.