Visits & medical services prices at Manchester Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $30 $30 0.9×
Airway inhalation treatment (94640) $684.56 $684.56 2.6×
Assessment of aphasia (96105) $389.70 $389.70 4.0×
Behavioral and qualitative analysis of voice and resonance (92524) $195.91 $195.91 1.8×
Breath Hydrogen/Methane Test (91065) $519.89 $519.89 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $1,001.17 $1,001.17 2.2×
Canalith Repositioning (95992) $382.03 $382.03 9.4×
Capsule endoscopy (91110) $7,007.50 $7,007.50 6.4×
Car seat/bed test 60 min (94780) $121.40 $121.40 2.7×
Cardiac Stress Tst,Tracing Only (93017) $1,001.17 $1,001.17 3.9×
Cardiopulmonary resuscitation (92950) $2,669.33 $2,669.33 10.3×
Cardioversion (92960) $2,815.05 $2,815.05 3.6×
Cbt 1st hour (94644) $415.05 $415.05 2.6×
Chemother, IV infusion, 1 hr (96413) $1,671.03 $1,671.03 4.2×
Chemother, IV infusion, ea add hr (96415) $326.85 $326.85 3.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $241.20 $241.20 2.8×
Chemotx Admn Cns Req Spinal Puncture (96450) $1,189.05 $1,189.05 3.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $264.99 $264.99 3.1×
Color/duplex Doppler, complete (93975) $1,104.21 $1,104.21 3.9×
Color/duplex Doppler, limited (93976) $886.14 $886.14 7.1×
Cont Gluc Monitoring Patient Provided Equipment (95249) $205.47 $205.47 2.9×
Continuous Glucose Monitoring (95250) $432.03 $432.03 2.7×
Cpap initiation and management (94660) $684.56 $684.56 2.6×
Cpt initial (94667) $415.05 $415.05 2.6×
Critical care (99291) $3,959 $3,959 4.0×
Debridement Open Wound 20 Sq Cm< (97597) $812.13 $812.13 3.4×
Demo &/or eval,pt use,aerosol device (94664) $684.56 $684.56 2.6×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $1,076.61 $1,076.61 3.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $797.98 $797.98 6.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,332.20 $1,332.20 4.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $1,089.22 $1,089.22 8.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,332.20 $1,332.20 4.7×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,089.22 $1,089.22 8.7×
Dup-scan xtr veins unilateral/limited study (93971) $1,035.17 $1,035.17 8.3×
Duplex hemodialysis access (93990) $828.18 $828.18 6.6×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $1,072.25 $1,072.25 3.7×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $515.73 $515.73 4.1×
Duplex scan extracranial art compl bi study (93880) $1,674.05 $1,674.05 5.9×
Echo Heart Xthoracic,Limited (93308) $1,061.69 $1,061.69 3.7×
Echo r-t 2d w/probe placement only (93313) $1,879.01 $1,879.01 2.9×
Echo transesophageal (93312) $2,233.89 $2,233.89 3.4×
EEG awake asleep (95819) $1,001.17 $1,001.17 3.9×
EEG awake drowsy (95816) $1,001.17 $1,001.17 3.9×
EEG cerebral death evaluation (95824) $1,729.80 $1,729.80 3.9×
EEG coma or sleep only (95822) $1,001.17 $1,001.17 3.9×
EKG (93005) $252.23 $252.23 3.6×
Er level 1 (99281) $268.42 $268.42 2.7×
Er level ii (99282) $561.75 $561.75 3.1×
Er level iii (99283) $1,337.50 $1,337.50 4.1×
Er level IV (99284) $2,140 $2,140 4.3×
Er level v (99285) $3,745 $3,745 5.2×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $750.04 $750.04 4.9×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $389.70 $389.70 5.5×
Evaluation of speech fluency (92521) $230.34 $230.34 1.7×
Evaluation of speech sound production (92522) $183.67 $183.67 1.6×
Evaluation of swallowing function (92610) $389.70 $389.70 4.6×
Evaluation with prescription of speech-generating alternative (92607) $555.62 $555.62 4.5×
External Ecg Scanning Analysis Report (93226) $980.47 $980.47 13.9×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $385.84 $385.84 1.9×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $5,193.42 $5,193.42 5.0×
Group Therapeutic Procedures (97150) $77.71 $77.71 4.3×
Hemodialysis (90935) $2,320.99 $2,320.99 2.8×
Holter Monitor Recording (93225) $460.83 $460.83 2.9×
Immunization Admin (90471) $241.20 $241.20 2.8×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $257.46 $257.46 3.6×
IV infusion hydration each additional hour (96361) $226.52 $226.52 4.0×
IV infusion hydration initial 31 min-1 hour (96360) $766.06 $766.06 3.0×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $328.81 $328.81 3.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $793.70 $793.70 3.1×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $268.40 $268.40 4.8×
IV push initial (96374) $738.43 $738.43 2.9×
Manual therapy 15 min (97140) $120.90 $120.90 4.4×
Massage 15 min (97124) $89.80 $89.80 3.0×
Mechanical chest wall oscillation (94669) $684.56 $684.56 2.6×
Mechanical traction (97012) $131.27 $131.27 9.1×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $40.13 $40.13 1.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $53.50 $53.50 1.5×
Methacholine challenge (94070) $1,801.09 $1,801.09 4.0×
Mnt Group Ea 30 Min (97804) $51.77 $51.77 3.0×
Motility study esophagus (91010) $6,135.92 $6,135.92 13.7×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $428.67 $428.67 4.7×
Multiple sleep latency test (95805) $5,178.80 $5,178.80 5.0×
Nasopharyngoscopy (92511) $694 $694 2.9×
Neg press wound tx >50 cm (97608) $1,333.66 $1,333.66 2.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $645.53 $645.53 2.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,333.66 $1,333.66 2.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $1,023.05 $1,023.05 6.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $1,920.44 $1,920.44 7.4×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $1,096.32 $1,096.32 7.1×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $120.90 $120.90 2.6×
Ot eval high complex 60 min (97167) $385.84 $385.84 3.8×
Ot eval low complex 30 min (97165) $385.84 $385.84 3.8×
Ot eval mod complex 45 min (97166) $385.84 $385.84 3.8×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $193.50 $193.50 3.9×
Ot Prosthetic Training, Each 15 Min (97761) $108.04 $108.04 2.7×
Ot re-eval est plan care (97168) $308.68 $308.68 4.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $429.21 $429.21 2.8×
Paraffin bath (97018) $51.81 $51.81 8.6×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $684.56 $684.56 2.6×
Peripheral arterial disease rehab per session (93668) $272.09 $272.09 3.8×
Phy/qhp op pulm rhb w/mntr (94626) $205.47 $205.47 2.9×
Phy/qhp op pulm rhb w/o mntr (94625) $205.47 $205.47 2.9×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,708.45 $5,708.45 5.5×
Psych diag eval w/med srvcs (90792) $636.83 $636.83 3.0×
Psychiatric diagnostic evaluation (90791) $605.35 $605.35 2.8×
Psychoanalysis (90845) $800.29 $800.29 3.8×
Pt Aquatic Therapy/Exercises (97113) $130.82 $130.82 3.5×
Pt Electric Current Therapy (97033) $86.35 $86.35 4.5×
Pt Electrical Stimulation (97032) $77.71 $77.71 5.3×
Pt eval high complex 45 min (97163) $385.84 $385.84 3.9×
Pt eval low complex 20 min (97161) $385.84 $385.84 3.9×
Pt Gait Training Therapy (97116) $112.25 $112.25 3.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $120.90 $120.90 3.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $385.84 $385.84 3.9×
Pt re-evaluation (97164) $308.68 $308.68 4.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $120.90 $120.90 3.7×
Pt Ultrasound Therapy (97035) $56.14 $56.14 3.9×
Pt Whirlpool Therapy (97022) $64.91 $64.91 4.1×
Pulm function test by gas (94727) $1,091.16 $1,091.16 4.2×
Pulmonary stress testing (94618) $460.80 $460.80 2.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $668.10 $668.10 2.8×
Rt Chest Wall Manipulation,Subsequent (94668) $415.05 $415.05 2.6×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $123.48 $123.48 2.6×
Sensory Integration Ea 15 Min (97533) $88.74 $88.74 1.5×
Sleep study unattended (95806) $5,708.45 $5,708.45 22.1×
Speech sound lang comprehen (92523) $382.03 $382.03 1.7×
Spirometry (94010) $548.16 $548.16 2.1×
Standardized Cognitive Performance Testing (96125) $389.70 $389.70 3.8×
Stress Tte Complete (93351) $3,508.88 $3,508.88 5.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $88.50 $88.50 4.0×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $86.83 $86.83 4.1×
Ther/Proph/Diag Inj Sc/Im (96372) $241.20 $241.20 2.8×
Therapeutic Activities (97530) $116.58 $116.58 3.3×
Therapeutic phlebotomy (99195) $580.98 $580.98 3.6×
Tilt Table Eval (93660) $2,375.61 $2,375.61 5.3×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,853.42 $1,853.42 2.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $302.23 $302.23 4.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $181.33 $181.33 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $240.13 $240.13 4.3×
Ultraviolet Light Therapy (96900) $182.50 $182.50 4.1×
Vasc Duplex Extrem Venous,Bilat (93970) $1,380.28 $1,380.28 4.8×
Vasc Duplex Scan Extracranial,Limited (93882) $1,025.55 $1,025.55 8.2×
Ventilation assist & mgmt inpatient 1st day (94002) $1,990.17 $1,990.17 2.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,990.17 $1,990.17 2.7×
Wheelchair Mgmt Ea 15 Min (97542) $102.87 $102.87 3.3×