Visits & medical services prices at Missouri Baptist Sullivan Hospital

Sullivan, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $274.80 $458 1.3×
Ambulatory Bp Analysis (93788) $297 $495 2.2×
Ambulatory Bp Recording (93786) $148.80 $248 1.1×
Appl on-body injector for timed subq injection (96377) $161.40 $269 3.4×
Behavioral and qualitative analysis of voice and resonance (92524) $261.60 $436 2.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $814.20 $1,357 2.2×
Canalith Repositioning (95992) $74.40 $124 1.8×
Capsule endoscopy (91110) $1,608.60 $2,681 1.8×
Cardiac Stress Tst,Tracing Only (93017) $1,503 $2,505 6.9×
Cbt 1st hour (94644) $148.80 $248 1.1×
Chemo Hormon Antineopl Sq/Im (96402) $364.20 $607 5.0×
Chemo IV push addl drug (96411) $328.80 $548 4.6×
Chemo Iv Push Sngl Drug (96409) $430.80 $718 1.3×
Chemother, IV infusion, 1 hr (96413) $914.40 $1,524 2.8×
Chemother, IV infusion, ea add hr (96415) $364.80 $608 5.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $354.60 $591 4.9×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $387 $645 5.4×
Color/duplex Doppler, complete (93975) $1,395.60 $2,326 5.8×
Cpap initiation and management (94660) $708.60 $1,181 3.2×
Cpt initial (94667) $148.80 $248 1.1×
Critical care (99291) $2,323.80 $3,873 2.8×
Debridement Open Wound 20 Sq Cm< (97597) $1,767.30 $2,945.50 8.8×
Demo &/or eval,pt use,aerosol device (94664) $367.80 $613 1.7×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,579.20 $2,632 6.6×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $567.60 $946 5.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $778.20 $1,297 7.4×
Dup-scan xtr veins unilateral/limited study (93971) $997.20 $1,662 9.5×
Duplex scan extracranial art compl bi study (93880) $1,725 $2,875 7.2×
Echo Heart Xthoracic,Limited (93308) $507.60 $846 2.1×
Echo transesophageal (93312) $2,721.60 $4,536 5.0×
Echo Transthoracic - Congenital Tte Complete (93303) $807.60 $1,346 1.5×
EEG awake asleep (95819) $1,086.60 $1,811 5.0×
EEG awake drowsy (95816) $1,044.60 $1,741 4.8×
EKG (93005) $183.60 $306 3.1×
EKG rhythm strip (93041) $75.60 $126 1.3×
Er level 1 (99281) $258 $430 3.1×
Er level ii (99282) $550.20 $917 3.6×
Er level iii (99283) $907.80 $1,513 3.3×
Er level IV (99284) $1,279.20 $2,132 3.1×
Er level v (99285) $1,792.20 $2,987 3.0×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $123 $205 1.7×
Evaluation of speech fluency (92521) $309.30 $515.50 2.3×
Evaluation of speech sound production (92522) $519.60 $866 4.6×
Evaluation of swallowing function (92610) $230.10 $383.50 2.7×
External ECG rec>48hr<7d recording (93242) $485.40 $809 13.0×
External ECG rec>48hr<7d scanning alys w/report (93243) $581.40 $969 4.4×
External ECG rec>7d<15d recording (93246) $553.80 $923 14.8×
External ECG rec>7d<15d scanning alys w/report (93247) $610.20 $1,017 4.6×
External Ecg Scanning Analysis Report (93226) $1,048.80 $1,748 17.7×
Flow volume loop (94375) $321 $535 1.5×
Holter Monitor Recording (93225) $893.40 $1,489 6.7×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $32.40 $54 0.8×
Immunization Admin (90471) $93.60 $156 1.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $292.80 $488 5.0×
IV infusion hydration each additional hour (96361) $194.40 $324 4.1×
IV infusion hydration initial 31 min-1 hour (96360) $454.20 $757 2.1×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $253.20 $422 3.5×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $648.60 $1,081 3.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $232.20 $387 5.0×
IV push initial (96374) $432 $720 2.0×
Manual therapy 15 min (97140) $118.80 $198 4.3×
Maximum voluntary ventilation (94200) $178.20 $297 3.0×
Mechanical chest wall oscillation (94669) $234 $390 1.1×
Mechanical traction (97012) $72 $120 5.0×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $241.80 $403 2.6×
Multiple sleep latency test (95805) $1,612.20 $2,687 1.9×
Nasopharyngoscopy (92511) $223.80 $373 1.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $448.80 $748 2.2×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $648.60 $1,081 1.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $573.60 $956 4.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $1,036.80 $1,728 4.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $180 $300 1.4×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $84 $140 1.8×
Osteopathic manipulative tx 1-2 body regions (98925) $33 $55 1.5×
Osteopathic manipulative tx 3-4 body regions (98926) $47.40 $79 2.2×
Osteopathic manipulative tx 5-6 body regions (98927) $66.60 $111 3.1×
Osteopathic manipulative tx 7-8 body regions (98928) $85.20 $142 3.9×
Osteopathic manipulative tx 9-10 body regions (98929) $101.40 $169 4.7×
Ot eval high complex 60 min (97167) $217.80 $363 2.2×
Ot eval low complex 30 min (97165) $153.60 $256 1.5×
Ot eval mod complex 45 min (97166) $181.80 $303 1.8×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $91.80 $153 1.8×
Ot Prosthetic Training, Each 15 Min (97761) $57.60 $96 1.4×
Ot re-eval est plan care (97168) $120.60 $201 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $271.20 $452 2.1×
Phy/qhp op pulm rhb w/mntr (94626) $256.20 $427 4.3×
Phy/qhp op pulm rhb w/o mntr (94625) $170.40 $284 2.9×
Plethysmography (94726) $697.80 $1,163 1.9×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,253 $8,755 6.1×
Psych diag eval w/med srvcs (90792) $232.20 $387 1.3×
Pt Aquatic Therapy/Exercises (97113) $125.40 $209 3.4×
Pt Electric Current Therapy (97033) $105 $175 5.5×
Pt Electrical Stimulation (97032) $74.40 $124 5.1×
Pt eval high complex 45 min (97163) $217.80 $363 2.2×
Pt eval low complex 20 min (97161) $153.60 $256 1.6×
Pt Gait Training Therapy (97116) $100.20 $167 3.4×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $133.20 $222 4.1×
Pt Physical Performance Test (97750) $49.20 $82 1.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $181.80 $303 1.9×
Pt re-evaluation (97164) $120.60 $201 1.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $82.80 $138 2.6×
Pt Ultrasound Therapy (97035) $100.80 $168 7.0×
Pt Whirlpool Therapy (97022) $66 $110 4.2×
Pulmonary stress testing (94618) $324 $540 2.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $574.20 $957 15.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $180 $300 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $100.20 $167 0.8×
Sensory Integration Ea 15 Min (97533) $103.20 $172 1.7×
Sleep study unattended (95806) $870 $1,450 4.0×
Speech sound lang comprehen (92523) $432 $720 1.9×
Spirometry (94010) $346.20 $577 1.6×
Stress echo (93350) $3,397.80 $5,663 6.2×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $58.20 $97 2.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $31.20 $52 1.5×
Ther/Proph/Diag Inj Sc/Im (96372) $193.20 $322 2.7×
Therapeutic Activities (97530) $99.60 $166 2.8×
Therapeutic phlebotomy (99195) $258.60 $431 1.9×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $3,993 $6,655 7.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $292.80 $488 3.8×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $160.80 $268 1.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $241.80 $403 5.2×
Unlisted pulmonary service/procedure (94799) $99 $165 0.8×
Vasc Duplex Extrem Venous,Bilat (93970) $1,958.40 $3,264 8.2×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $867.60 $1,446 4.0×
Ventilation assist & mgmt inpatient 1st day (94002) $748.20 $1,247 1.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $505.20 $842 0.8×
Wheelchair Mgmt Ea 15 Min (97542) $46.20 $77 1.5×