Visits & medical services prices at Lost Rivers Medical Center

Arco, ID · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
1St psyc collab care mgmt (99492) $230.40 $288 2.3×
Advance care planning first 30 mins (99497) $120.80 $151 1.2×
Airway inhalation treatment (94640) $160 $200 0.7×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $49.60 $62 3.5×
Assmt & care planning pt w/cognitive impairment (99483) $466.40 $583 4.6×
Basic vestibular evaluation (92540) $204 $255 1.0×
Bedside Swallowing Eval (92610) $148 $185 1.7×
Behavioral and qualitative analysis of voice and resonance (92524) $179.20 $224 1.6×
Breath Hydrogen/Methane Test (91065) $712.80 $891 3.3×
Brief Emotional/Behavioral Assessment (96127) $8 $10 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $80.80 $101 0.2×
Caloric vestibular test w/rec bi bithermal (92537) $80 $100 0.6×
Caloric vestibular test w/rec bi monothermal (92538) $40.80 $51 0.2×
Canalith Repositioning Procedure (95992) $74.40 $93 1.8×
Cardiac Stress Tst,Tracing Only (93017) $1,120 $1,400 5.3×
Cardiopulmonary resuscitation (92950) $360.80 $451 1.7×
Cardioversion (92960) $284 $355 0.4×
Care mgmt svc bhvl hlth cond (99484) $80 $100 2.2×
Chemother, IV infusion, 1 hr (96413) $740 $925 2.3×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) $43.20 $54 2.0×
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions Facility (98941) $63.20 $79 3.0×
Chiropractic manipulative treatment (CMT); spinal, 5 regions Facility (98942) $81.60 $102 3.8×
Chronic care management services 1st 20 min (99490) $83.20 $104 0.8×
Color/duplex Doppler, complete (93975) $1,000 $1,250 4.2×
Color/duplex Doppler, limited (93976) $560 $700 5.4×
Computerized dynamic posturography (92548) $192 $240 1.5×
Cpt initial (94667) $138.40 $173 1.1×
Critical care (99291) $1,217.20 $1,521.50 1.5×
Debridement Open Wound 20 Sq Cm< (97597) $203.20 $254 1.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $940 $1,175 4.0×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $520 $650 5.0×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $920 $1,150 3.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $540 $675 5.2×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $860 $1,075 3.6×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $500 $625 4.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $960 $1,200 4.1×
Dup-scan xtr veins unilateral/limited study (93971) $580 $725 5.6×
Duplex scan extracranial art compl bi study (93880) $1,000 $1,250 4.2×
Echo Heart Xthoracic,Limited (93308) $752 $940 3.2×
EKG rhythm strip (93041) $318.40 $398 5.5×
Electrocardiogram Tracing (93005) $165.60 $207 2.8×
Electrogastrography, diagnostic, transcutaneous; Non-Facility (91132) $642.40 $803 3.0×
Er level 1 (99281) $92.80 $116 1.1×
Er level ii (99282) $187.20 $234 1.2×
Er level iii (99283) $275.20 $344 1.0×
Er level IV (99284) $466.40 $583 1.1×
Er level v (99285) $660 $825 1.1×
Eval speech sound production (92522) $184.80 $231 1.7×
Evaluate Pt Use Of Inhaler (94664) $26.40 $33 0.1×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $255.20 $319 2.1×
Evaluation of speech fluency (92521) $222.40 $278 1.7×
External ECG rec>48hr<7d recording (93242) $166.80 $208.50 4.5×
External ECG rec>7d<15d recording (93246) $166.80 $208.50 4.5×
External Ecg Scanning Analysis Report (93226) $160.80 $201 2.8×
Health behavior ivntj indiv f2f 1st 30 min (96158) $104 $130 0.6×
Holter Monitor (93225) $224.80 $281 1.7×
Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) $48 $60 1.3×
Imm admn sarscov2 vaccine single dose (90480) $32.80 $41 0.8×
Immune Admin Oral/Nasal (90473) $24 $30 0.3×
Immunization Admin (90471) $29.60 $37 0.4×
Inital newborn e/m (99460) $135.20 $169 1.0×
Injection intra arterial (96373) $300 $375 1.4×
Interrog dev eval scrms phys/qhp in person (93291) $80.80 $101 2.8×
Interrog device eval heart (93289) $106.40 $133 2.9×
Interrogate subq defib (93261) $116.80 $146 3.2×
Iontophoresis 15 min (97033) $56 $70 2.9×
Irrig drug delivery device (96523) $125.60 $157 2.2×
IV infusion hydration each additional hour (96361) $84.40 $105.50 1.8×
IV infusion hydration initial 31 min-1 hour (96360) $188.80 $236 0.9×
IV infusion ther proph addl sequential to 1 hr (96367) $208 $260 2.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $248.80 $311 1.2×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $151.20 $189 3.3×
IV push ea addl new drug (96375) $146.40 $183 3.2×
IV push initial (96374) $123.60 $154.50 0.6×
Manual therapy 15 min (97140) $49.20 $61.50 1.8×
Massage 15 min (97124) $44.80 $56 1.5×
Mechanical traction (97012) $23.20 $29 1.6×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $174.40 $218 1.9×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $296.40 $370.50 0.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $81.60 $102 0.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $416.80 $521 1.0×
Neurobehavioral Status Exam (96116) $149.60 $187 0.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $420 $525 3.2×
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording Non-Facility (92544) $33.60 $42 0.3×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $51.20 $64 1.1×
Oscillating Tracking Test (92545) $30.40 $38 0.1×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $56 $70 2.6×
Osteopathic manipulative tx 3-4 body regions (98926) $70.40 $88 3.3×
Osteopathic manipulative tx 5-6 body regions (98927) $91.20 $114 4.3×
Osteopathic manipulative tx 7-8 body regions (98928) $121.60 $152 5.7×
Osteopathic manipulative tx 9-10 body regions (98929) $132 $165 6.2×
Ot Range Motion Measure,Each Extrem (95851) $40.80 $51 1.6×
Ot therapeutic activity 15 min (97530) $55.20 $69 1.6×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $233.60 $292 1.8×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $184 $230 1.4×
Phlebotomy therapeutic (99195) $200 $250 1.5×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $84 $105 1.4×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $72.80 $91 1.2×
Pm device eval in person (93288) $93.60 $117 2.5×
Pm device progr eval dual (93280) $122.40 $153 3.3×
Positional Nystagmus Test (92542) $56.80 $71 0.4×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $16 $20 0.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $17.60 $22 0.4×
Psych diag eval w/med srvcs (90792) $312 $390 1.8×
Psychiatric diagnostic evaluation (90791) $279.20 $349 1.6×
Psychoanalysis (90845) $151.20 $189 0.9×
Psytx crisis initial 60 min (90839) $229.60 $287 1.3×
Pt eval high complex 45 min (97163) $208 $260 2.1×
Pt eval low complex 20 min (97161) $128 $160 1.3×
Pt eval mod complex 30 min (97162) $168 $210 1.7×
Pt gait training 15 min (97116) $64 $80 2.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $51.20 $64 1.6×
Pt re-evaluation (97164) $120 $150 1.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $56 $70 1.7×
Pt Whirlpool Therapy (97022) $51.20 $64 3.3×
Pt-focused hlth risk assmt (96160) $4 $5 0.1×
Pulm function test by gas (94727) $100 $125 0.5×
Pulmonary stress test simple (94618) $96 $120 0.7×
Pure Tone Audiometry Air & Bone (92553) $68 $85 0.5×
Pure Tone Audiometry Air Only (92552) $58.40 $73 0.4×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $85.60 $107 2.3×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $31.20 $39 0.2×
Rem mntr physiol param dev (99454) $80.80 $101 2.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $151.20 $189 0.8×
Rt Chest Wall Manipulation,Subsequent (94668) $104.80 $131 0.8×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $105.60 $132 2.2×
Sbsq psyc collab care mgmt (99493) $232 $290 2.3×
Sinusoidal Vertical Axis Rotational Testing (92546) $196.80 $246 1.5×
Smoking cessation > 10 min (99407) $45.20 $56.50 1.2×
Speech sound lang comprehen (92523) $392.80 $491 1.7×
Spirometry (94010) $130 $162.50 0.6×
Spontaneous nystagmus test (92541) $50.40 $63 0.4×
Stress echo (93350) $336 $420 0.6×
Synthetic Sentence Identification Test (92576) $64 $80 1.7×
Temp transcutaneous pacing (92953) $1,160.80 $1,451 1.8×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $220.80 $276 2.2×
Therapeutic prophylactic/dx injection subq/im (96372) $62.80 $78.50 0.9×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $24 $30 0.6×
Trans Care Mgmt 14 Day Disch (99495) $319.20 $399 2.4×
Trans Care Mgmt 7 Day Disch (99496) $432 $540 3.3×
Tte w/doppler, complete (93306) $2,000 $2,500 3.7×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,120 $1,400 4.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $158.40 $198 2.1×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $173.60 $217 2.1×
Tympanometry (92567) $24 $30 0.7×
Tympanometry And Reflex Threshold Measurements (92550) $44 $55 0.2×
Unlisted Cardiovascular Service/Procedure (93799) $957.60 $1,197 7.5×
Vasc Duplex Scan Extracranial,Limited (93882) $540 $675 5.2×
Vent mgmt inpat init day (94002) $140.80 $176 0.2×