Visits & medical services prices at Medicine Lodge Memorial Hospital

Medicine Lodge, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $55.20 $55.20 0.3×
Analyze Neurostim Complex (95972) $102.66 $102.66 1.2×
Application of heat wave therapy (97024) $47.65 $47.65 6.5×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $67 $67 1.8×
Behav assmt w/score & docd/stand instrument (96127) $7.09 $7.09 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $507 $507 1.5×
Canalith Repositioning (95992) $77 $77 1.9×
Capsule endoscopy (91110) $43.50 $43.50 0.1×
Cardiopulmonary resuscitation (92950) $435.50 $435.50 2.2×
Cardioversion (92960) $375 $375 0.6×
Color/duplex Doppler, complete (93975) $664.65 $664.65 3.0×
Cpap initiation and management (94660) $1,232 $1,232 6.1×
Critical care (99291) $358 $358 0.5×
Debridement Open Wound 20 Sq Cm< (97597) $155 $155 0.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $664.65 $664.65 3.0×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $664.65 $664.65 3.0×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $664.65 $664.65 6.9×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $664.65 $664.65 3.0×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $664.65 $664.65 6.9×
Dup-scan xtr veins unilateral/limited study (93971) $664.65 $664.65 6.9×
Duplex scan extracranial art compl bi study (93880) $664.65 $664.65 3.0×
EKG (93005) $64.70 $64.70 1.2×
Er level 1 (99281) $100 $100 1.3×
Er level ii (99282) $100 $100 0.7×
Er level iii (99283) $150 $150 0.6×
Er level IV (99284) $200 $200 0.5×
Er level v (99285) $250 $250 0.5×
Evaluation of speech sound production (92522) $152 $152 1.4×
Evaluation of swallowing function (92610) $170 $170 2.0×
External Ecg Scanning Analysis Report (93226) $346.20 $346.20 6.4×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $228.80 $228.80 1.1×
Group Therapeutic Procedures (97150) $37 $37 2.1×
Holter Monitor Recording (93225) $346 $346 2.8×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $31.63 $31.63 0.8×
Immunization Admin (90471) $55 $55 0.8×
Immunotherapy, 2+ Injections (95117) $28 $28 0.7×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $63 $63 1.2×
IV infusion hydration each additional hour (96361) $237.90 $237.90 5.5×
IV infusion hydration initial 31 min-1 hour (96360) $290.83 $290.83 1.5×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $201 $201 3.0×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $290.83 $290.83 1.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $150 $150 3.5×
IV push initial (96374) $217.93 $217.93 1.1×
Manual therapy 15 min (97140) $67.30 $67.30 2.4×
Massage 15 min (97124) $55.44 $55.44 1.9×
Mechanical traction (97012) $80.20 $80.20 5.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $20.22 $20.22 0.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $20.22 $20.22 0.6×
Neg press wnd tx </=50 sq cm (97607) $204.28 $204.28 0.5×
Neg press wound tx >50 cm (97608) $206.02 $206.02 0.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $296 $296 1.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $334.10 $334.10 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $664.65 $664.65 5.4×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $70 $70 1.5×
Osteopathic manipulative tx 1-2 body regions (98925) $55 $55 2.8×
Osteopathic manipulative tx 3-4 body regions (98926) $65 $65 3.3×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $52 $52 1.6×
Ot Contrast Bath Ea 15 Min (97034) $47.50 $47.50 3.4×
Ot eval high complex 60 min (97167) $154 $154 1.5×
Ot eval low complex 30 min (97165) $145 $145 1.4×
Ot eval mod complex 45 min (97166) $154 $154 1.5×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $35 $35 0.7×
Ot Range Motion Measure,Each Extrem (95851) $32 $32 1.2×
Ot re-eval est plan care (97168) $102 $102 1.5×
Paraffin bath (97018) $55.90 $55.90 9.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,352.50 $2,352.50 3.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $19 $19 0.4×
Pt Aquatic Therapy/Exercises (97113) $70 $70 1.9×
Pt Electric Current Therapy (97033) $55.90 $55.90 2.9×
Pt Electrical Stimulation (97032) $50.45 $50.45 3.4×
Pt eval high complex 45 min (97163) $285.70 $285.70 2.9×
Pt eval low complex 20 min (97161) $157.62 $157.62 1.6×
Pt Gait Training Therapy (97116) $60.72 $60.72 2.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $66 $66 2.0×
Pt Physical Performance Test (97750) $83.12 $83.12 2.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $214.28 $214.28 2.2×
Pt re-evaluation (97164) $106.30 $106.30 1.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $67.30 $67.30 2.1×
Pt Ultrasound Therapy (97035) $66.60 $66.60 4.6×
Pt Whirlpool Therapy (97022) $89.02 $89.02 5.7×
Pulm function test by gas (94727) $186 $186 0.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $38.90 $38.90 0.2×
Sensory Integration Ea 15 Min (97533) $70 $70 1.2×
Smoking cessation > 10 min (99407) $44.79 $44.79 1.3×
Speech sound lang comprehen (92523) $149.50 $149.50 0.7×
Spirometry (94010) $358 $358 1.8×
Standardized Cognitive Performance Testing (96125) $149 $149 1.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $73 $73 3.3×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $56 $56 2.7×
Ther/Proph/Diag Inj Sc/Im (96372) $60 $60 0.9×
Therapeutic Activities (97530) $67.30 $67.30 1.9×
Therapeutic phlebotomy (99195) $123.60 $123.60 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $24.16 $24.16 0.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,060.34 $2,060.34 4.1×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $752.40 $752.40 3.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $100.10 $100.10 1.3×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $84.23 $84.23 1.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $67 $67 1.6×
Unlisted Cardiovascular Service/Procedure (93799) $800 $800 6.8×
Vasc Duplex Extrem Venous,Bilat (93970) $664.65 $664.65 3.0×
Vasopneumatic device (97016) $50.20 $50.20 4.2×
Wheelchair Mgmt Ea 15 Min (97542) $65 $65 2.1×