Visits & medical services prices at Jones Memorial Hospital

Wellsville, NY · 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
Admn Sarscov2 Vacc 1 Dose (90480) $43 — 0.8×
Advncd Care Plan 30 Min (99497) $176 — 1.4×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines
$244–$387 — varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $42 — 2.9×
Application on-body injector (96377) $87 — 1.5×
Assessment of aphasia per hr (96105) $144 — 1.5×
Assmt & care planning pt w/cognitive impairment (99483) $260.58 $437 2.1×
Audiometry Air & Bone (92553) $297 — 1.8×
Behavral qualit analys voice (92524) $134 — 1.2×
Breathing response to hypoxia (94450) $82.29 $138 0.5×
Brief Emotional/Behav Assmt (96127)
range across 2 matching MRF lines
$4.17 $7–$9 0.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $592 — 1.3×
Canalith repositioning proc (95992) $54 — 1.3×
Cardiac Stress Tst,Tracing Only (93017) $592 — 2.2×
Cardiopulmonary resuscitation (92950) $592 — 2.2×
Cardioversion (92960) $1,244 — 1.5×
Cardioversion elective internal (92961) $223.02 $374 0.3×
Chemo Admin Peritoneal Cavity (96446) $630 — 1.5×
Chemo Anti-Neopl Sq/Im (96401) $135 — 1.5×
Chemo Hormon Antineopl Sq/Im (96402) $135 — 1.5×
Chemo Ia Push (96420) $630 — 1.5×
Chemo Intralesional Over 7 (96406) $400 — 1.5×
Chemo intralesional up to 7 (96405) $135 — 1.5×
Chemo IV infusion addl hr (96415) $135 — 1.5×
Chemo IV push addl drug (96411) $135 — 1.5×
Chemother Prolong Infuse W/Pump (96416) $630 — 1.5×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $630 — 1.5×
Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) $87 — 1.5×
Chemotherapy Into Cns (96450) $630 — 1.5×
Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) $630 — 1.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $135 — 1.5×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $630 — 1.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $630 — 1.5×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $630 — 1.5×
Chest Wall Manipulation (94668) $244 — 1.5×
Color/duplex Doppler, complete (93975) $459 — 1.5×
Color/duplex Doppler, limited (93976)
range across 2 matching MRF lines
$116–$202 — varies
Community/Work Reintegration Trainj Ea 15 Min (97537) $44 — 1.4×
Comprehensive Hearing Test (92557) $297 — 1.8×
Conditioning Play Audiometry (92582) $297 — 1.8×
Cont gluc mntr physician/qhp provided equiptment (95250) $244 — 1.5×
Cont Gluc Mntr Pt Prov Eqp (95249) $61.42 $103 0.8×
Continuous Pulse Ox (94762) $297 — 1.8×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $244 — 0.9×
Cpt initial (94667) $244 — 1.5×
Critical care first hour (99291)
range across 2 matching MRF lines
$218–$1,602 — varies
Debridement Open Wound 20 Sq Cm< (97597) $378 — 1.5×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $459 — 1.5×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $459 — 1.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $202 — 1.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $459 — 1.5×
Dup-scan xtr veins unilateral/limited study (93971)
range across 2 matching MRF lines
$92–$202 — varies
Duplex up extrem art bilat (93930) $459 — 1.5×
Duplex up extrem art unilat/ltd (93931) $202 — 1.5×
Echo Heart Xthoracic,Limited (93308)
range across 3 matching MRF lines
$76–$459 — varies
Eeg 41-60 Minutes (95812) $592 — 2.2×
EEG awake drowsy (95816) $592 — 2.2×
EEG extended monitoring 61-119 minutes (95813) $592 — 2.2×
Electrical Stimulation Ea 15 Min (97032)
range across 2 matching MRF lines
$27–$28 — varies
Electrocardiogram Tracing (93005) $112 — 1.5×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
$34–$302 — varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines
$56–$526 — varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines
$96–$810 — varies
Er level 1 (99281)
range across 2 matching MRF lines
$9–$168 — varies
Er level v (99285)
range across 2 matching MRF lines
$139–$1,166 — varies
Evaluate pt use of inhaler (94664) $387 — 1.4×
Evaluate Swallowing Function (92610) $94 — 1.1×
Evoked Auditory Test,Limited (92587) $592 — 2.2×
External Ecg Scanning Analysis Report (93226) $112 — 1.5×
Extracranial Bilat Study (93880) $459 — 1.5×
Extracranial Uni/Ltd Study (93882) $202 — 1.5×
Eye Exam With Photos (92230) $227.19 $381 0.5×
Fundus photography (92250) $244 — 1.5×
Gi tract capsule endoscopy (91110) $653.54 $1,096 0.6×
Holter monitor recording (93225) $244 — 1.5×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines
$13–$43 — varies
Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) $28.03 $47 0.6×
Immunization administration (90471)
range across 2 matching MRF lines
$13–$43 — varies
Ingestion challenge test initial 120 minutes (95076) $212.88 $357 0.5×
Inital newborn e/m (99460) $87.66 $147 0.5×
Insert/Place Heart Catheter (93503) $2,954 — 1.5×
Iontophoresis 15 min (97033) $44 — 2.3×
Irrig Drug Delivery Device (96523) $112 — 1.5×
IV infusion hydration each additional hour (96361) $87 — 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $400 — 1.5×
IV infusion ther proph addl sequential to 1 hr (96367) $135 — 1.5×
IV infusion therapy prophylaxis/dx ea hour (96366) $87 — 1.5×
IV push initial (96374) $400 — 1.5×
Loudness balance test (92562) $592 — 2.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $37 — 1.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $44 — 1.2×
Motion Fluoroscopy/Swallow (92611) $116 — 1.3×
Multiple Sleep Latency Test (95805) $1,008 — 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $378 — 1.5×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $759 — 1.5×
Neuromuscular Reeducation (97112) $57 — 1.7×
Newborn resuscitation (99465) $133.57 $224 0.2×
Oral Function Therapy (92526) $115 — 1.4×
Orthc/Prostc Mgmt Sbsq Enc (97763) $81 — 1.6×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $52 — 1.1×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $56.05 $94 2.1×
Osteopathic manipulative tx 3-4 body regions (98926) $48 — 1.8×
Osteopathic manipulative tx 5-6 body regions (98927) $48 — 1.8×
Osteopathic manipulative tx 7-8 body regions (98928) $48 — 1.8×
Osteopathic manipulative tx 9-10 body regions (98929) $48 — 1.8×
Ot Contrast Bath Ea 15 Min (97034) $24 — 1.7×
Ot eval high complexity (97167) $122 — 1.2×
Ot Eval Low Complex (97165) $122 — 1.2×
Ot Eval Moderate Complexity (97166) $122 — 1.2×
Ot manual therapy 15 min (97140) $56 — 2.0×
Ot paraffin bath (97018) $25 — 4.2×
Ot Prosthetic Training, Each 15 Min (97761) $46 — 1.1×
Ot Re-Eval Est Plan Care (97168) $106 — 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $240 — 1.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $240 — 1.5×
Patient-initiated spirometric phys/qhp r&i only (94016) $23.26 $39 0.9×
Phlebotomy therapeutic (99195) $244 — 1.5×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $112 — 1.5×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $112 — 1.5×
Plethysmography (94726) $592 — 1.3×
Pm device eval in person (93288) $70 — 1.5×
Pm device progr eval dual (93280) $70 — 1.5×
Pm Device Progr Eval Sngl (93279) $70 — 1.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,934 — 1.8×
Polysom <6 yrs 4/> paramtrs (95782) $1,934 — 1.8×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $1,934 — 1.8×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $87 — 1.5×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $87 — 1.5×
Pt Eval High Complex (97163) $132 — 1.3×
Pt eval low complex 20 min (97161) $132 — 1.3×
Pt Eval Mod Complex (97162) $132 — 1.3×
Pt gait training 15 min (97116) $39 — 1.3×
Pt mechanical traction (97012) $32 — 2.2×
Pt Re-Eval Est Plan Care (97164) $90 — 1.3×
Pulm function test by gas (94727) $297 — 1.1×
Pulmonary service/procedure (94799) $297 — 1.8×
Pure Tone Audiometry Air (92552) $244 — 1.5×
Qnhp Ol Dig Assmt&Mgmt 11-20 (98971) $24 — 1.0×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) $38 — 1.1×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) $14 — 1.1×
Refill/Maint Portable Pump (96521) $400 — 1.5×
Refill/Maint Pump/Resvr Syst (96522) $400 — 1.5×
Remote 30 Day Ecg Rev/Report (93270) $7.16 $12 0.2×
Respiratory flow volume loop (94375) $592 — 2.2×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $112 — 1.5×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $378 — 1.5×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $146 — 1.2×
Same day nb discharge (99463) $102.56 $172 0.6×
Self Care Mngment Training (97535) $54 — 1.7×
Sleep study unattended (95806) $297 — 1.1×
Speech Audiometry Complete (92556) $112 — 1.5×
Speech audiometry threshold (92555) $112 — 1.5×
Speech sound lang comprehen (92523) $256 — 1.1×
Spirometry (94010) $297 — 1.1×
Stenger Test, Pure Tone (92565) $112 — 1.5×
Stress Tte Only (93350) $1,042 — 1.5×
Subcutaneous Infusion Each Additional Hour (96370) $87 — 1.5×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $400 — 1.5×
Subq Infusion Additional Pump Infusion Site (96371) $135 — 1.5×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $26 — 1.2×
Ther Ivntj Ea Addl 15 Min (97130) $26 — 1.2×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $46 — 1.2×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $41 — 1.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $124 — 1.2×
Ther/Proph/Diag Inj Ia (96373) $400 — 1.5×
Ther/Proph/Diag Inj Sc/Im (96372) $135 — 1.5×
Ther/Proph/Diag Iv Inf Init (96365) $400 — 1.5×
Therapeutic Activities (97530) $69 — 2.0×
Tobacco Use Cessation Intensive >10 Minutes (99407) $57 — 1.2×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines
$57–$68 — varies
Trans Care Mgmt 14 Day Disch (99495) $196.78 $330 1.2×
Trans Care Mgmt 7 Day Disch (99496) $267.14 $448 1.6×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $70 — 1.5×
Tte w/doppler, complete (93306) $1,042 — 1.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $106 — 1.4×
Tx/Pro/Dx Inj New Drug Addon (96375) $87 — 1.5×
Tympanometry (92567) $75 — 1.6×
Tympanometry and reflex threshold measurements (92550) $20.87 $35 0.1×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $297 — 1.1×
Vent Mgmt Inpat Init Day (94002) $1,257 — 1.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,257 — 1.6×
Visual reinforcement audiometry (vra) (92579) $297 — 1.1×
Wheelchair Mgmt Ea 15 Min (97542) $43 — 1.4×
Whirlpool Therapy (97022) $46 — 2.9×

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.