Visits & medical services prices at Johnson Memorial Hospital

Stafford Springs, CT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $1,892 7.2×
Appl on-body injector for timed subq injection (96377) $223.30 $406 4.0×
Assessment of aphasia (96105) $190.85 $347 2.0×
Behavioral and qualitative analysis of voice and resonance (92524) $229.90 $418 2.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $381.15 $693 0.9×
Cardiac Stress Tst,Tracing Only (93017) $915.20 $1,664 3.5×
Cardiopulmonary resuscitation (92950) $548.35 $997 2.1×
Cardioversion (92960) $1,028.50 $1,870 1.3×
Cbt 1st hour (94644) $59.40 $108 0.4×
Chemo Hormon Antineopl Sq/Im (96402) $226.60 $412 2.6×
Chemo IV push addl drug (96411) $199.65 $363 2.3×
Chemo Iv Push Sngl Drug (96409) $330 $600 0.8×
Chemo prolong 8+ hrs infuse w/pump (96416) $680.90 $1,238 1.7×
Chemother, IV infusion, 1 hr (96413) $745.80 $1,356 1.9×
Chemother, IV infusion, ea add hr (96415) $194.70 $354 2.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $226.60 $412 2.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $234.85 $427 2.7×
Color/duplex Doppler, complete (93975) $832.15 $1,513 2.9×
Color/duplex Doppler, limited (93976) $283.25 $515 2.3×
Cpap initiation and management (94660) $448.25 $815 1.7×
Cpt initial (94667) $255.75 $465 1.6×
Critical care (99291) $1,299.10 $2,362 1.3×
Debridement Open Wound 20 Sq Cm< (97597) $366.85 $667 1.5×
Demo &/or eval,pt use,aerosol device (94664) $72.60 $132 0.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $725.45 $1,319 2.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $1,169.85 $2,127 9.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $747.45 $1,359 2.6×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $474.65 $863 3.8×
Dup-scan xtr veins unilateral/limited study (93971) $603.90 4.8×
Duplex scan extracranial art compl bi study (93880) $1,169.85 $2,127 4.1×
Echo Heart Xthoracic,Limited (93308) $554.40 $1,008 1.9×
Echo Transthoracic - Congenital Tte Complete (93303) $963.05 $1,751 1.5×
EEG awake drowsy (95816) $705.10 $1,282 2.7×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $629.20 $1,144 2.4×
EKG (93005) $150.70 2.1×
EKG rhythm strip (93041) $352 $640 5.0×
Er level 1 (99281) $155.10 1.5×
Er level ii (99282) $278.30 1.5×
Er level iii (99283) $1,035.10 3.2×
Er level IV (99284) $1,841.84 3.7×
Er level v (99285) $2,381.54 3.3×
Evaluation of speech sound production (92522) $194.70 $354 1.7×
Evaluation of swallowing function (92610) $298.65 $543 3.5×
External Ecg Scanning Analysis Report (93226) $473.55 $861 6.7×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $343.75 $625 1.7×
Flow volume loop (94375) $183.15 $333 0.7×
Hemodialysis (90935) $790.35 $1,437 1.0×
High altitude simulation test (94453) $248.05 $451 1.6×
Holter Monitor Recording (93225) $346.50 $630 2.2×
Imaging of colon using capsule endoscope, with interpretation and report (91113) $1,204.50 $2,190 1.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $51.70 $94 1.1×
Immunization Admin (90471) $64.90 $118 0.8×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $108.90 $198 1.5×
IV infusion hydration each additional hour (96361) $6,473.25 115.3×
IV infusion hydration initial 31 min-1 hour (96360) $4,893.29 19.2×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $221.10 $402 2.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $4,514.62 17.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $8,458.45 150.7×
IV push initial (96374) $4,697.60 18.4×
Liver elastography w/o imag w/i&r (91200) $300.30 $546 1.9×
Manual therapy 15 min (97140) $130.35 $237 4.7×
Maximum voluntary ventilation (94200) $1,283.70 18.2×
Mechanical chest wall oscillation (94669) $130.35 $237 0.5×
Mechanical traction (97012) $73.70 $134 5.1×
Mnt Group Ea 30 Min (97804) $22 $40 1.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $394.90 $718 4.3×
Nasopharyngoscopy (92511) $397.10 $722 1.7×
Neg press wnd tx </=50 sq cm (97607) $811.80 $1,476 1.7×
Neg press wound tx >50 cm (97608) $811.80 $1,476 1.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $196.35 $357 0.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $251.90 $458 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $232.10 $422 1.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $756.25 $1,375 2.9×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $628.65 $1,143 1.4×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $65.45 $119 1.4×
Ot eval low complex 30 min (97165) $181.50 $330 1.8×
Ot eval mod complex 45 min (97166) $194.70 $354 1.9×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $209.55 $381 1.4×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $3.85 $7 0.0×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $400.95 $729 1.5×
Peripheral arterial disease rehab per session (93668) $105.05 $191 1.5×
Phy/qhp op pulm rhb w/mntr (94626) $114.95 $209 1.6×
Phy/qhp op pulm rhb w/o mntr (94625) $114.95 $209 1.6×
Plethysmography (94726) $639.10 $1,162 1.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,666.85 $6,667 3.6×
Psychiatric diagnostic evaluation (90791) $350.90 $638 1.6×
Pt Aquatic Therapy/Exercises (97113) $174.35 $317 4.7×
Pt Electric Current Therapy (97033) $53.90 $98 2.8×
Pt Electrical Stimulation (97032) $46.20 $84 3.1×
Pt eval high complex 45 min (97163) $215.60 $392 2.2×
Pt eval low complex 20 min (97161) $188.10 $342 1.9×
Pt Gait Training Therapy (97116) $86.35 $157 3.0×
Pt Infrared Therapy (97026) $37.40 $68 5.6×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $87.45 $159 2.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $201.30 $366 2.1×
Pt re-evaluation (97164) $116.60 $212 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $65.45 $119 2.0×
Pt Ultrasound Therapy (97035) $61.05 $111 4.3×
Pulm function test by gas (94727) $1,800.15 7.0×
Pulmonary stress testing (94618) $263.45 $479 1.7×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $296.45 $539 6.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $146.85 $267 0.6×
Rt Chest Wall Manipulation,Subsequent (94668) $70.40 $128 0.4×
Sleep study unattended (95806) $512.60 $932 2.0×
Speech group therapy (92508) $185.35 $337 7.7×
Speech sound lang comprehen (92523) $326.42 $593.50 1.4×
Spirometry (94010) $286.55 $521 1.1×
Ther/Proph/Diag Inj Sc/Im (96372) $2,313.16 26.8×
Therapeutic Activities (97530) $108.90 $198 3.1×
Therapeutic phlebotomy (99195) $188.65 $343 1.2×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $57.20 $104 1.3×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,299.65 $2,363 2.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $223.30 $406 2.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $174.08 $316.50 2.1×
Tx/Pro/Dx Inj New Drug Addon (96375) $12,339.96 219.8×
Vasc Duplex Extrem Venous,Bilat (93970) $736.45 $1,339 2.6×
Veeg Ea 12-26 Hr Unmntr (95714) $1,074.15 $1,953 2.4×
Ventilation assist & mgmt inpatient 1st day (94002) $413.05 $751 0.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $259.05 $471 0.3×
Vital capacity total (94150) $312.95 $569 2.0×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $122.65 $223 1.7×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $496.10 $902 4.4×