Visits & medical services prices at Melissa Memorial Hospital
Holyoke, CO · every code in this section with a posted price and a Medicare benchmark.
122 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) range across 2 matching MRF lines |
$13.60–$23.20 | $17–$29 | varies |
| Advncd Care Plan 30 Min (99497) | $161.60 | $202 | 1.5× |
| Airway Inhalation Treatment (94640) | $167.20 | $209 | 0.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $114.40 | $143 | 8.0× |
| Application on-body injector (96377) | $92.80 | $116 | 1.9× |
| Assessment of aphasia per hr (96105) | $280.80 | $351 | 2.9× |
| Behavral qualit analys voice (92524) | $235.20 | $294 | 2.1× |
| Brief Emotional/Behav Assmt (96127) | $48 | $60 | 1.2× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $510.40 | $638 | 1.3× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$76.80–$90.40 | $96–$113 | varies |
| Cardiac Stress Tst,Tracing Only (93017) | $517.60 | $647 | 2.3× |
| Cardiopulmonary exercise testing (94621) | $420 | $525 | 1.1× |
| Cardiopulmonary resuscitation (92950) | $388 | $485 | 1.7× |
| Cardioversion (92960) | $198.40 | $248 | 0.3× |
| Chemo Anti-Neopl Sq/Im (96401) | $244 | $305 | 3.2× |
| Chemo Hormon Antineopl Sq/Im (96402) | $194.40 | $243 | 2.6× |
| Chemo IV infusion addl hr (96415) | $165.60 | $207 | 2.2× |
| Chemo IV push addl drug (96411) | $212.80 | $266 | 2.8× |
| Chemother Prolong Infuse W/Pump (96416) | $645.60 | $807 | 1.9× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $224.80 | $281 | 3.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $716.80 | $896 | 2.1× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $461.60 | $577 | 1.3× |
| Color/duplex Doppler, complete (93975) | $1,085.60 | $1,357 | 4.3× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $92 | $115 | 2.9× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $229.60 | $287 | 1.6× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $75.20 | $94 | 1.2× |
| Continuous Pulse Ox (94762) | $236 | $295 | 1.7× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $539.20 | $674 | 2.3× |
| Critical care first hour (99291) range across 3 matching MRF lines |
$711.20–$4,254.40 | $889–$5,318 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$52–$344 | $65–$430 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $479.20 | $599 | 1.9× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $554.40 | $693 | 5.0× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $828 | $1,035 | 3.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $587.20 | $734 | 5.3× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$1,130.40–$1,188.80 | $1,413–$1,486 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) | $764 | $955 | 6.9× |
| Duplex up extrem art bilat (93930) | $849.60 | $1,062 | 3.4× |
| Duplex up extrem art unilat/ltd (93931) | $566.40 | $708 | 5.1× |
| Echo Congenital Complete (93303) | $1,038.40 | $1,298 | 1.8× |
| Echo Heart Xthoracic,Limited (93308) | $598.40 | $748 | 2.4× |
| Electrical Stimulation Ea 15 Min (97032) | $32 | $40 | 2.2× |
| Electrocardiogram Tracing (93005) | $224 | $280 | 3.6× |
| Emergency Dept Visit Level 2 (99282) | $181.60 | $227 | 1.1× |
| Emergency Dept Visit Level 3 (99283) | $297.60 | $372 | 1.0× |
| Emergency Dept Visit Level 4 (99284) | $449.60 | $562 | 1.0× |
| Er level 1 (99281) | $112 | $140 | 1.3× |
| Er level v (99285) | $666.40 | $833 | 1.1× |
| Evaluate pt use of inhaler (94664) | $101.60 | $127 | 0.4× |
| Evaluate Speech Production (92522) | $280.80 | $351 | 2.5× |
| Exercise test for bronchospasm (94617) | $248 | $310 | 1.8× |
| External Ecg Scanning Analysis Report (93226) | $441.60 | $552 | 7.1× |
| Extracranial Bilat Study (93880) | $963.20 | $1,204 | 3.8× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $717.60 | $897 | 1.2× |
| Flexible endoscopic eval swallow c/v rec (92612) | $141.60 | $177 | 0.7× |
| Holter monitor recording (93225) | $344.80 | $431 | 2.5× |
| Immunization administration (90471) range across 2 matching MRF lines |
$92.80–$160.80 | $116–$201 | varies |
| Iontophoresis 15 min (97033) | $76.80 | $96 | 4.0× |
| Irrig Drug Delivery Device (96523) | $135.20 | $169 | 2.2× |
| IV infusion hydration each additional hour (96361) | $132.80 | $166 | 2.7× |
| IV infusion hydration initial 31 min-1 hour (96360) | $351.20 | $439 | 1.6× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $147.20 | $184 | 1.9× |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$128.80–$137.60 | $161–$172 | varies |
| IV push initial (96374) | $206.40 | $258 | 0.9× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $46.40 | $58 | 1.5× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $41.60 | $52 | 1.1× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $28 | $35 | 1.6× |
| Nasopharyngoscopy (92511) | $271.20 | $339 | 1.3× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $364.80 | $456 | 0.9× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $532.80 | $666 | 1.2× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $328 | $410 | 1.5× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $364 | $455 | 0.8× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$98.40–$100.80 | $123–$126 | varies |
| Oral Function Therapy (92526) | $225.60 | $282 | 2.7× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $110.40 | $138 | 2.4× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$49.60–$69.60 | $62–$87 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) | $83.20 | $104 | 3.7× |
| Ot Contrast Bath Ea 15 Min (97034) | $72 | $90 | 5.1× |
| Ot eval high complexity (97167) | $255.20 | $319 | 2.5× |
| Ot Eval Low Complex (97165) | $273.60 | $342 | 2.7× |
| Ot Eval Moderate Complexity (97166) | $273.60 | $342 | 2.7× |
| Ot manual therapy 15 min (97140) | $144.80 | $181 | 5.2× |
| Ot paraffin bath (97018) | $52 | $65 | 8.7× |
| Ot Re-Eval Est Plan Care (97168) | $189.60 | $237 | 2.8× |
| Ot rom hand (95852) | $144.80 | $181 | 6.8× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $212 | $265 | 1.6× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $92 | $115 | 0.7× |
| Phlebotomy therapeutic (99195) | $179.20 | $224 | 1.3× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $40 | $50 | 0.6× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $28 | $35 | 0.4× |
| Physical Performance Test (97750) range across 2 matching MRF lines |
$61.60–$72.80 | $77–$91 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $3,422.40 | $4,278 | 3.8× |
| Pt Eval High Complex (97163) | $268 | $335 | 2.7× |
| Pt eval low complex 20 min (97161) | $271.20 | $339 | 2.8× |
| Pt Eval Mod Complex (97162) | $271.20 | $339 | 2.8× |
| Pt gait training 15 min (97116) range across 2 matching MRF lines |
$82.40–$88.80 | $103–$111 | varies |
| Pt Re-Eval Est Plan Care (97164) | $189.60 | $237 | 2.8× |
| Pulmonary Stress Testing (94618) | $96 | $120 | 0.7× |
| Refill/Maint Portable Pump (96521) | $340 | $425 | 1.5× |
| Remote 30 Day Ecg Rev/Report (93270) | $112 | $140 | 2.8× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $96.80 | $121 | 1.6× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$249.60–$252 | $312–$315 | varies |
| Self Care Mngment Training (97535) | $110.40 | $138 | 3.4× |
| Speech sound lang comprehen (92523) | $372.80 | $466 | 1.6× |
| Spirometry (94010) | $128.80 | $161 | 0.6× |
| Standardized Cognitive Performance Testing (96125) | $216.80 | $271 | 2.1× |
| Stress Tte Only (93350) | $492 | $615 | 0.9× |
| Temp transcutaneous pacing (92953) | $899.20 | $1,124 | 1.3× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 3 matching MRF lines |
$48.80–$84 | $61–$105 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) | $80 | $100 | 3.8× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $84 | $105 | 2.8× |
| Ther/Proph/Diag Inj Ia (96373) | $369.60 | $462 | 1.6× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $102.40 | $128 | 1.3× |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$325.60–$469.60 | $407–$587 | varies |
| Therapeutic Activities (97530) | $100.80 | $126 | 2.9× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $28 | $35 | 0.7× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$1,864–$1,973.60 | $2,330–$2,467 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $253.60 | $317 | 3.3× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $111.20 | $139 | 2.3× |
| Upr/L Xtremity Art 2 Levels (93922) | $417.60 | $522 | 3.0× |
| Vasopneumatic device (97016) | $76 | $95 | 6.3× |
| Wheelchair Mgmt Ea 15 Min (97542) | $137.60 | $172 | 4.4× |
| Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) | $184 | $230 | 3.0× |
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.