Visits & medical services prices at Memorial Hospital Los Banos

Los Banos, CA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $95 $95 1.8×
Airway Inhalation Treatment (94640) $685 $685 2.4×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $162 $162 11.3×
Application on-body injector (96377) $318 $318 5.3×
Assessment of aphasia per hr (96105) $630 $630 6.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $1,449 $1,449 3.0×
Canalith repositioning proc (95992) $284 $284 7.0×
Car seat/bed test 60 min (94780) $702 $702 14.6×
Cardiac Stress Tst,Tracing Only (93017) $2,345 $2,345 8.4×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines		 $1,845–$2,739 $1,845–$2,739 varies
Cardioversion (92960)
range across 2 matching MRF lines		 $2,619–$4,095 $2,619–$4,095 varies
Cbt 1st hour (94644) $649 $649 3.8×
Chemo Anti-Neopl Sq/Im (96401) $673 $673 7.3×
Chemo IV infusion addl hr (96415) $645 $645 7.0×
Chemo IV push addl drug (96411) $765 $765 8.3×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $799 $799 8.6×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $1,666 $1,666 3.9×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $1,087 $1,087 2.6×
Chest Wall Manipulation (94668) $330 $330 1.9×
Color/duplex Doppler, complete (93975) $2,942 $2,942 9.6×
Color/duplex Doppler, limited (93976) $1,988 $1,988 14.8×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $2,575 $2,575 9.1×
Cpt initial (94667) $394 $394 2.3×
Critical care first hour (99291) $9,840 $9,840 9.3×
Debridement Open Wound 20 Sq Cm< (97597) $900 $900 3.5×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $2,598 $2,598 8.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,738 $1,738 12.9×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $2,704 $2,704 8.8×
Dup-scan xtr veins unilateral/limited study (93971) $1,927 $1,927 14.3×
Duplex up extrem art bilat (93930) $2,676 $2,676 8.7×
Duplex up extrem art unilat/ltd (93931) $1,829 $1,829 13.6×
Echo Congenital Complete (93303) $1,384 $1,384 2.0×
Echo Heart Xthoracic,Limited (93308) $1,811 $1,811 5.9×
Echo r-t 2d w/probe placement only (93313) $1,641 $1,641 2.3×
Echo transesophag montr cardiac pump functj (93318) $5,280 $5,280 7.5×
Echo transesophageal (93312) $5,134 $5,134 7.3×
Echo Transesophageal - Congenital Tee Complete (93315) $5,160 $5,160 7.3×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $4,006 $4,006 5.7×
EEG awake and asleep (95819) $2,191 $2,191 7.9×
EEG awake drowsy (95816) $2,034 $2,034 7.3×
EEG cerebral death evaluation (95824) $2,417 $2,417 5.0×
Electrical Stimulation Ea 15 Min (97032) $176 $176 12.0×
Electrocardiogram Tracing (93005) $614 $614 8.1×
Emergency Dept Visit Level 2 (99282) $1,527 $1,527 7.7×
Emergency Dept Visit Level 3 (99283) $2,882 $2,882 8.2×
Emergency Dept Visit Level 4 (99284) $4,634 $4,634 8.6×
Er level 1 (99281) $603 $603 5.6×
Er level v (99285) $6,672 $6,672 8.7×
Evaluate pt use of inhaler (94664)
range across 5 matching MRF lines		 $522–$550 $522–$550 varies
Evaluate Speech Production (92522) $572 $572 5.1×
Evaluate Swallowing Function (92610) $778 $778 9.2×
External Ecg Scanning Analysis Report (93226) $890 $890 11.7×
Extracranial Bilat Study (93880) $2,747 $2,747 9.0×
Extracranial Uni/Ltd Study (93882) $1,468 $1,468 10.9×
F-up/limited tthrc echo congenital car anomaly (93304) $923 $923 1.3×
Holter monitor recording (93225) $705 $705 4.1×
Im Adm Intransl/Oral 1 Vaccine (90473) $94 $94 1.0×
Immunization administration (90471) $192 $192 2.1×
Irrig Drug Delivery Device (96523) $358 $358 4.7×
IV infusion hydration each additional hour (96361) $461 $461 7.7×
IV infusion hydration initial 31 min-1 hour (96360) $1,091 $1,091 4.0×
IV infusion ther proph addl sequential to 1 hr (96367) $517 $517 5.6×
IV infusion therapy prophylaxis/dx ea hour (96366) $555 $555 9.2×
IV push initial (96374) $609 $609 2.2×
Lung Function Test (Mbc/Mvv) (94200) $294 $294 3.9×
Neuromuscular Reeducation (97112) $234 $234 7.1×
Oral Function Therapy (92526) $508 $508 6.0×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $210 $210 4.6×
Ot Eval Low Complex (97165) $508 $508 5.1×
Ot manual therapy 15 min (97140) $246 $246 8.9×
Ot Prosthetic Training, Each 15 Min (97761) $180 $180 4.5×
Ot Re-Eval Est Plan Care (97168) $372 $372 5.4×
Plethysmography (94726) $908 $908 1.9×
Pt Eval High Complex (97163) $629 $629 6.4×
Pt eval low complex 20 min (97161) $495 $495 5.1×
Pt Eval Mod Complex (97162) $558 $558 5.7×
Pt gait training 15 min (97116) $225 $225 7.7×
Pt Re-Eval Est Plan Care (97164) $330 $330 4.9×
Pulm function test by gas (94727) $573 $573 2.1×
Pulmonary Stress Testing (94618) $606 $606 3.5×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $807 $807 1.9×
Respiratory flow volume loop (94375) $706 $706 2.5×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $215 $215 2.8×
Self Care Mngment Training (97535) $226 $226 7.0×
Speech sound lang comprehen (92523) $756 $756 3.3×
Spirometry (94010) $653 $653 2.4×
Stress Tte Only (93350) $4,073 $4,073 5.8×
Subcutaneous Infusion Each Additional Hour (96370) $145 $145 2.4×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $492 $492 1.8×
Subq Infusion Additional Pump Infusion Site (96371) $1,128 $1,128 12.2×
Temp transcutaneous pacing (92953)
range across 2 matching MRF lines		 $1,825–$2,432 $1,825–$2,432 varies
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $166 $166 5.6×
Ther/Proph/Diag Inj Sc/Im (96372) $325 $325 3.5×
Ther/Proph/Diag Iv Inf Init (96365) $1,143 $1,143 4.2×
Therapeutic Activities (97530) $238 $238 6.8×
Tobacco Use Cessation Intensive >10 Minutes (99407) $149 $149 3.1×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $125 $125 2.6×
Tte w/doppler, complete (93306) $4,223 $4,223 6.0×
Tte W/O Doppler Complete (93307) $2,614 $2,614 8.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $545 $545 7.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $456 $456 7.6×
Tympanometry (92567) $230 $230 4.8×
Upr/L Xtremity Art 2 Levels (93922) $1,030 $1,030 6.0×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $1,579 $1,579 5.7×
Vent Mgmt Inpat Init Day (94002) $5,633 $5,633 7.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $4,047 $4,047 5.1×
Wheelchair Mgmt Ea 15 Min (97542) $183 $183 5.9×

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.