Visits & medical services prices at Madison Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $284.25 $379 1.3×
Analyze neurostim complex (95972) $361.88 $482.50 3.9×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $45 $60 3.1×
Application Modality 1/> Areas Infrared (97026) $49.50 $66 7.4×
Assessment of aphasia per hr (96105) $147 $196 1.5×
Bedside Swallowing Eval (92610) $260.25 $347 3.1×
Behavioral and qualitative analysis of voice and resonance (92524) $245.25 $327 2.2×
Biofeedback training any modality (90901) $69.75 $93 1.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $463.50 $618 1.3×
C motor evoked upr&lwr limbs (95939) $1,470.75 $1,961 1.7×
Canalith Repositioning Procedure (95992) $61.50 $82 1.5×
Car seat/bed test 60 min (94780) $60 $80 1.6×
Cardiac Stress Tst,Tracing Only (93017) $678 $904 3.2×
Cardiopulmonary resuscitation (92950) $396.75 $529 1.9×
Cardioversion (92960) $1,427.25 $1,903 2.2×
Chemo Hormon Antineopl Sq/Im (96402) $177.75 $237 2.5×
Chemo IV push addl drug (96411) $183.38 $244.50 2.6×
Chemo prolong 8+ hrs infuse w/pump (96416) $879 $1,172 2.7×
Chemother, IV infusion, 1 hr (96413) $459 $612 1.4×
Chemother, IV infusion, ea add hr (96415) $363.38 $484.50 5.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $331.88 $442.50 4.7×
Chemotherapy into cns (96450) $518.25 $691 1.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $258.75 $345 3.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $524.25 $699 1.6×
Color/duplex Doppler, complete (93975) $734.62 $979.50 3.1×
Color/duplex Doppler, limited (93976) $248.62 $331.50 2.4×
Cpap/bipap (94660) $289.88 $386.50 1.3×
Cpt initial (94667) $177 $236 1.3×
Critical care (99291) $1,848 $2,464 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $160.50 $214 0.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $348 $464 3.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $802.50 $1,070 3.4×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $348 $464 3.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,125 $1,500 4.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $253.50 $338 2.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,080.75 $1,441 4.6×
Dup-scan xtr veins unilateral/limited study (93971) $350.25 $467 3.4×
Duplex scan extracranial art compl bi study (93880) $1,046.25 $1,395 4.4×
Ear and throat examination (92502) $424.50 $566 0.8×
Echo Heart Xthoracic,Limited (93308) $738.38 $984.50 3.1×
Echo transesophag montr cardiac pump functj (93318) $683.25 $911 1.3×
Echo transesophageal (93312) $1,653 $2,204 3.1×
Echo Transthoracic - Congenital Tte Complete (93303) $1,569.75 $2,093 2.9×
Echo Transthoracic - Congenital Tte Limited (93304) $856.88 $1,142.50 1.6×
EEG awake drowsy (95816) $396.75 $529 1.9×
EEG greater than 1 hour (95813) $805.50 $1,074 3.8×
Electrocardiogram Tracing (93005) $193.50 $258 3.3×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $679.50 $906 3.2×
EMG two extremities (95861) $445.24 $593.65 3.4×
Er level 1 (99281) $228.75 $305 2.7×
Er level ii (99282) $432.75 $577 2.9×
Er level iii (99283) $762 $1,016 2.8×
Er level IV (99284) $1,199.62 $1,599.50 2.9×
Er level v (99285) $1,721.62 $2,295.50 2.9×
Eval speech sound production (92522) $245.25 $327 2.2×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $249 $332 2.0×
Evaluation of speech fluency (92521) $245.25 $327 1.8×
External ECG rec>48hr<7d recording (93242) $102.38 $136.50 2.8×
External ECG rec>48hr<7d scanning alys w/report (93243) $185.25 $247 1.4×
External ECG rec>7d<15d recording (93246) $102.38 $136.50 2.8×
External Ecg Scanning Analysis Report (93226) $336 $448 5.8×
Eye exam w anesth; complete (92018) $2,885.25 $3,847 1.2×
Eye service or procedure (92499) $19.50 $26 0.7×
Hemodialysis (90935) $1,119.75 $1,493 1.7×
Holter Monitor (93225) $336 $448 2.6×
Imm admn sarscov2 vaccine single dose (90480) $39.75 $53 1.0×
Immunization Admin (90471) $55.50 $74 0.8×
Injection intra arterial (96373) $478.50 $638 2.3×
Intrapulmonary Surfactant Administj Phys/Qhp (94610) $185.25 $247 0.9×
Iontophoresis 15 min (97033) $62.25 $83 3.3×
Irrig drug delivery device (96523) $153 $204 2.6×
IV infusion hydration each additional hour (96361) $105.75 $141 2.3×
IV infusion hydration initial 31 min-1 hour (96360) $290.25 $387 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $136.50 $182 1.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $409.12 $545.50 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $117 $156 2.5×
IV push ea addl new drug (96375) $170.25 $227 3.7×
IV push initial (96374) $473.25 $631 2.3×
Manual therapy 15 min (97140) $67.50 $90 2.4×
Massage 15 min (97124) $48.75 $65 1.6×
Maximum voluntary ventilation (94200) $98.25 $131 1.7×
Mechanical traction (97012) $39 $52 2.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $42.75 $57 1.2×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $67.50 $90 4.0×
Methacholine challenge (94070) $461.25 $615 1.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $260.62 $347.50 2.8×
Multiple Sleep Latency Test (95805) $1,656.75 $2,209 2.0×
Nasopharyngoscopy (92511) $173.25 $231 0.9×
Neg press wound tx >50 cm (97608) $996.75 $1,329 2.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $440.62 $587.50 1.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $273.75 $365 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $295.50 $394 0.7×
Nerve Conduction Studies 3-4 Studies (95908) $531.75 $709 2.5×
Newborn resuscitation (99465) $296.25 $395 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $357.38 $476.50 2.7×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $222.75 $297 1.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $61.12 $81.50 1.3×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $116.25 $155 5.5×
Osteopathic manipulative tx 3-4 body regions (98926) $168.75 $225 7.9×
Ot eval high complex 60 min (97167) $129.38 $172.50 1.3×
Ot eval low complex 30 min (97165) $156 $208 1.6×
Ot eval mod complex 45 min (97166) $164.25 $219 1.6×
Ot re-evaluation (97168) $73.50 $98 1.1×
Ot therapeutic activity 15 min (97530) $120 $160 3.4×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $190.50 $254 1.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $183 $244 1.4×
Peritoneal Dialysis (90945) $467.25 $623 1.1×
Phlebotomy therapeutic (99195) $154.50 $206 1.2×
Plethysmography (94726) $452.25 $603 1.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,112.50 $4,150 3.7×
Polysom <6 yrs 4/> paramtrs (95782) $2,967.75 $3,957 3.5×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $2,967.75 $3,957 3.5×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $3,174.75 $4,233 3.7×
Pt Aquatic Therapy/Exercises (97113) $84 $112 2.3×
Pt Electrical Stimulation (97032) $57.38 $76.50 3.9×
Pt eval high complex 45 min (97163) $175.88 $234.50 1.8×
Pt eval low complex 20 min (97161) $159 $212 1.6×
Pt eval mod complex 30 min (97162) $164.25 $219 1.7×
Pt gait training 15 min (97116) $62.25 $83 2.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $76.12 $101.50 2.3×
Pt re-evaluation (97164) $98.25 $131 1.5×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $62.25 $83 1.9×
Pt ultraviolet (97028) $59.62 $79.50 7.1×
Pt Whirlpool Therapy (97022) $47.25 $63 3.0×
Pulmonary Service/Procedure (94799) $247.88 $330.50 1.9×
Pulmonary stress test simple (94618) $183.38 $244.50 1.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $126.75 $169 3.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $108 $144 0.5×
Rt Chest Wall Manipulation,Subsequent (94668) $116.62 $155.50 0.9×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $53.25 $71 1.1×
Sensory Integration Ea 15 Min (97533) $61.50 $82 1.0×
Sleep study attended (95807) $1,609.50 $2,146 4.4×
Sleep study unattended (95806) $471.38 $628.50 2.2×
Somatosensory testing (95938) $963.38 $1,284.50 1.1×
Speech sound lang comprehen (92523) $240.75 $321 1.1×
Spirometry (94010) $238.12 $317.50 1.1×
Standardized Cognitive Performance Testing (96125) $204 $272 2.0×
Stress echo (93350) $1,240.50 $1,654 2.3×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $153.38 $204.50 0.7×
Subcutaneous Infusion Each Additional Hour (96370) $59.25 $79 1.3×
Subq Infusion Additional Pump Infusion Site (96371) $51 $68 0.7×
Temp transcutaneous pacing (92953) $879.75 $1,173 1.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $58.12 $77.50 2.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $87.75 $117 4.2×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $245.25 $327 2.4×
Ther/prop/diag inj/inf proc (96379) $66.75 $89 1.4×
Therapeutic prophylactic/dx injection subq/im (96372) $150.38 $200.50 2.1×
Tte w/doppler, complete (93306) $1,607.25 $2,143 3.0×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $998.62 $1,331.50 4.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $247.12 $329.50 3.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $254.62 $339.50 3.0×
Upr/lxtr art stdy 3+ lvls (93923) $177.75 $237 0.8×
Vasc Duplex Scan Extracranial,Limited (93882) $354.75 $473 3.4×
Vasopneumatic device (97016) $58.50 $78 4.9×
Vent mgmt inpat init day (94002) $741 $988 1.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $702.75 $937 1.2×
Wheelchair Mgmt Ea 15 Min (97542) $43.88 $58.50 1.4×
Xtrnl mobile cv telemetry w/technical support (93229) $247.12 $329.50 0.7×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $309 $412 3.3×