Visits & medical services prices at Molokai General Hospital

Kaunakakai, HI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $544.95 $778.50 2.1×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $84 $120 5.8×
Bioimpedance-derived physiologic cardiovascular analysis Facility (93701) $320.60 $458 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $258.30 $369 0.6×
Canalith Repositioning Procedure (95992) $129.50 $185 3.2×
Cardiac Stress Tst,Tracing Only (93017) $1,140.30 $1,629 4.5×
Cardiopulmonary resuscitation (92950) $986.30 $1,409 3.9×
Cardioversion (92960) $914.90 $1,307 1.2×
Caregiver hlth risk assmt score doc stnd instrm (96161) $53.55 $76.50 1.2×
Chemo Hormon Antineopl Sq/Im (96402) $271.95 $388.50 3.2×
Chemo IV push addl drug (96411) $350 $500 4.1×
Chemo prolong 8+ hrs infuse w/pump (96416) $753.20 $1,076 1.9×
Chemother, IV infusion, 1 hr (96413) $1,305.85 $1,865.50 3.3×
Chemother, IV infusion, ea add hr (96415) $265.65 $379.50 3.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $410.55 $586.50 4.8×
Chemotherapy, unspecified procedure (96549) $38.50 $55 0.7×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $368.20 $526 4.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $826 $1,180 2.1×
Color/duplex Doppler, complete (93975) $986.30 $1,409 3.5×
Color/duplex Doppler, limited (93976) $403.20 $576 3.3×
Cpap/bipap (94660) $763 $1,090 2.9×
Cpt initial (94667) $517.30 $739 3.3×
Critical care (99291) $4,480 $6,400 4.6×
Debridement Open Wound 20 Sq Cm< (97597) $763 $1,090 3.2×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $490.70 $701 1.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $417.90 $597 3.4×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $998.90 $1,427 8.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $576.80 $824 2.0×
Dup-scan xtr veins unilateral/limited study (93971) $443.80 $634 3.6×
EKG rhythm strip (93041) $98.70 $141 1.4×
Electrocardiogram Tracing (93005) $277.90 $397 4.0×
Er level 1 (99281) $471.10 $673 4.7×
Er level ii (99282) $859.60 $1,228 4.7×
Er level iii (99283) $1,654.10 $2,363 5.1×
Er level IV (99284) $2,407.30 $3,439 4.9×
Er level v (99285) $2,782.85 $3,975.50 4.0×
Evaluate Pt Use Of Inhaler (94664) $168.70 $241 0.7×
External ECG rec>7d<15d recording (93246) $276.15 $394.50 6.3×
Group Therapeutic Procedures (97150) $209.30 $299 11.6×
Holter Monitor (93225) $534.80 $764 3.4×
Imm admn sarscov2 vaccine single dose (90480) $103.60 $148 2.2×
Immunization Admin (90471) $177.10 $253 2.1×
Iontophoresis 15 min (97033) $137.90 $197 7.2×
Irrig drug delivery device (96523) $231.70 $331 3.3×
IV infusion hydration each additional hour (96361) $721 $1,030 13.0×
IV infusion hydration initial 31 min-1 hour (96360) $623 $890 2.5×
IV infusion ther proph addl sequential to 1 hr (96367) $392.35 $560.50 4.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $802.90 $1,147 3.2×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $280 $400 5.1×
IV push ea addl new drug (96375) $215.60 $308 3.9×
IV push initial (96374) $802.90 $1,147 3.2×
Manual therapy 15 min (97140) $150.50 $215 5.4×
Massage 15 min (97124) $107.80 $154 3.6×
Mechanical traction (97012) $86.10 $123 6.0×
Neg press wound tx >50 cm (97608) $567.70 $811 1.2×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $851.20 $1,216 1.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $583.80 $834 2.5×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,725.50 $2,465 3.6×
Newborn resuscitation (99465) $1,300.60 $1,858 1.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $460.60 $658 2.9×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $129.50 $185 0.9×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $156.80 $224 3.4×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $123.20 $176 3.8×
Ot Contrast Bath Ea 15 Min (97034) $74.90 $107 5.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $100.80 $144 2.0×
Ot Prosthetic Training, Each 15 Min (97761) $136.50 $195 3.4×
Ot therapeutic activity 15 min (97530) $141.40 $202 4.0×
Paraffin bath pt (97018) $46.20 $66 7.7×
Phlebotomy therapeutic (99195) $898.80 $1,284 5.7×
Pt Aquatic Therapy/Exercises (97113) $443.45 $633.50 12.0×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $144.20 $206 3.8×
Pt Electrical Stimulation (97032) $88.20 $126 6.0×
Pt eval high complex 45 min (97163) $306.60 $438 3.1×
Pt eval low complex 20 min (97161) $253.05 $361.50 2.6×
Pt eval mod complex 30 min (97162) $267.40 $382 2.7×
Pt gait training 15 min (97116) $111.65 $159.50 3.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $261.80 $374 8.0×
Pt Physical Performance Test (97750) $136.50 $195 4.0×
Pt re-evaluation (97164) $211.05 $301.50 3.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $151.20 $216 4.7×
Pt-focused hlth risk assmt (96160) $104.65 $149.50 2.4×
Pulmonary Service/Procedure (94799) $129.50 $185 0.9×
Pure Tone Audiometry Air Only (92552) $490 $700 3.1×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $73.50 $105 1.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $728.35 $1,040.50 3.1×
Sensory Integration Ea 15 Min (97533) $118.30 $169 1.9×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $329.70 $471 1.3×
Spirometry (94010) $408.80 $584 1.6×
Temp transcutaneous pacing (92953) $1,436.40 $2,052 1.8×
Ther/prop/diag inj/inf proc (96379) $161.70 $231 2.9×
Therapeutic prophylactic/dx injection subq/im (96372) $200.20 $286 2.4×
Vasopneumatic device (97016) $82.60 $118 6.9×
Vital capacity, total (94150) $129.50 $185 0.9×
Wheelchair Mgmt Ea 15 Min (97542) $231 $330 7.4×