Visits & medical services prices at Keefe Memorial Hospital
Cheyenne Wells, CO · every code in this section with a posted price and a Medicare benchmark.
82 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Advncd Care Plan 30 Min (99497) range across 2 matching MRF lines |
$160–$212 | $160–$212 | varies |
| Airway Inhalation Treatment (94640) | $186 | $186 | 0.8× |
| Behavral qualit analys voice (92524) | $227 | $227 | 2.1× |
| Brief Emotional/Behav Assmt (96127) | $12 | $12 | 0.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $557 | $557 | 1.4× |
| Cardiac Stress Tst,Tracing Only (93017) | $869.60 | $1,087 | 3.8× |
| Cardiopulmonary resuscitation (92950) | $867 | $867 | 3.8× |
| Cardioversion (92960) | $399 | $399 | 0.6× |
| Chest Wall Manipulation (94668) | $139 | $139 | 1.0× |
| Chiropract manj 3-4 regions (98941) | $38 | $38 | 1.7× |
| Color/duplex Doppler, complete (93975) | $641 | $641 | 2.5× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $337 | $337 | 1.8× |
| Continuous Pulse Ox (94762) | $474 | $474 | 3.5× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $869 | $869 | 3.8× |
| Cpt initial (94667) | $200 | $200 | 1.4× |
| Critical care first hour (99291) | $699 | $699 | 0.8× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $983 | $983 | 3.9× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,004 | $1,255 | 4.0× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $803.20 | $1,004 | 7.3× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,185.60 | $1,482 | 4.7× |
| Dup-scan xtr veins unilateral/limited study (93971) | $939 | $939 | 8.5× |
| Duplex Scan Hemodialysis Access (93990) | $352 | $352 | 3.2× |
| Duplex up extrem art bilat (93930) | $952 | $1,190 | 3.8× |
| Duplex up extrem art unilat/ltd (93931) | $856.80 | $1,071 | 7.8× |
| ECG/monitoring and analysis (93271) | $492 | $492 | 4.9× |
| Electrocardiogram Tracing (93005) | $335 | $335 | 5.4× |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$104–$459 | $104–$459 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$177–$830 | $177–$830 | varies |
| Emergency Dept Visit Level 4 (99284) range across 2 matching MRF lines |
$300–$917.60 | $300–$1,147 | varies |
| Er level 1 (99281) range across 2 matching MRF lines |
$55–$355 | $55–$355 | varies |
| Er level v (99285) range across 2 matching MRF lines |
$435–$1,224 | $435–$1,530 | varies |
| Evaluate pt use of inhaler (94664) | $170 | $170 | 0.7× |
| External ECG rec>48hr<7d recording (93242) | $186 | $186 | 4.7× |
| External ECG rec>7d<15d recording (93246) | $224 | $224 | 5.7× |
| External Ecg Scanning Analysis Report (93226) | $492 | $492 | 7.9× |
| Extracranial Bilat Study (93880) | $1,224 | $1,530 | 4.9× |
| Extracranial Uni/Ltd Study (93882) | $904.80 | $1,131 | 8.2× |
| Holter monitor recording (93225) | $421 | $421 | 3.0× |
| Immunization administration (90471) range across 2 matching MRF lines |
$42–$130 | $42–$130 | varies |
| Irrig Drug Delivery Device (96523) | $191 | $191 | 3.1× |
| IV infusion hydration each additional hour (96361) | $170 | $170 | 3.4× |
| IV infusion hydration initial 31 min-1 hour (96360) range across 4 matching MRF lines |
$90–$440 | $90–$440 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) | $193 | $193 | 2.5× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $134 | $134 | 2.7× |
| IV push initial (96374) | $260 | $260 | 1.2× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $75 | $75 | 2.0× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $428 | $428 | 2.0× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $311 | $311 | 0.7× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $109 | $109 | 2.4× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $80 | $80 | 3.5× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $113 | $113 | 5.0× |
| Ot Prosthetic Training, Each 15 Min (97761) | $104 | $104 | 2.6× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $268 | $268 | 2.0× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $249 | $249 | 1.8× |
| Phlebotomy therapeutic (99195) | $304 | $304 | 2.2× |
| Physical Performance Test (97750) | $127 | $127 | 3.8× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $2,722.30 | $3,889 | 3.0× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $25 | $25 | 0.5× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $30 | $30 | 0.6× |
| Psych diag eval w/med srvcs (90792) | $448 | $448 | 2.4× |
| Psychiatric diagnostic evaluation (90791) | $426 | $426 | 2.3× |
| Psytx Crisis Initial 60 Min (90839) | $345 | $345 | 1.8× |
| Pulmonary Stress Testing (94618) | $312 | $312 | 2.2× |
| Pure Tone Audiometry Air (92552) | $243 | $243 | 1.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $492 | $492 | 12.5× |
| Remote 30 Day Ecg Tech Supp (93229) | $271 | $271 | 0.7× |
| Spirometry (94010) range across 3 matching MRF lines |
$274–$503 | $274–$503 | varies |
| Stress Tte Only (93350) | $2,303.70 | $3,291 | 4.0× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $175 | $175 | 4.7× |
| Ther/Proph/Diag Inj Ia (96373) | $216 | $216 | 1.0× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $113 | $113 | 1.5× |
| Ther/Proph/Diag Iv Inf Init (96365) range across 4 matching MRF lines |
$176–$440 | $176–$440 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $26 | $26 | 0.7× |
| Tte w/doppler, complete (93306) | $1,896.80 | $2,371 | 3.3× |
| Tte W/O Doppler Complete (93307) | $1,064.80 | $1,331 | 4.2× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $155 | $155 | 2.0× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $179 | $179 | 3.6× |
| Tympanometry (92567) | $99 | $99 | 2.5× |
| Upr/L Xtremity Art 2 Levels (93922) range across 3 matching MRF lines |
$577–$803.20 | $577–$1,004 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 2 matching MRF lines |
$845–$1,004 | $845–$1,255 | varies |
| Vent Mgmt Inpat Init Day (94002) | $1,281.60 | $1,602 | 2.0× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $932 | $1,165 | 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.