Visits & medical services prices at Monadnock Community Hospital

Peterborough, NH · 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
1St psyc collab care mgmt (99492) $78 $130 0.7×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $36 $60 1.2×
Advance care planning first 30 mins (99497) $83.40 $139 0.8×
Airway inhalation treatment (94640) $67.80 $113 0.3×
Application on-body injector (96377) $106.80 $178 2.1×
Assmt & care planning pt w/cognitive impairment (99483) $117 $195 1.1×
Brief Emotional/Behavioral Assessment (96127) $6 $10 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $332.40 $554 0.8×
C motor evoked upr&lwr limbs (95939) $2,079 $3,465 2.3×
Car seat/bed test 60 min (94780) $139.20 $232 3.5×
Cardiac Stress Tst,Tracing Only (93017) $928.20 $1,547 4.0×
Cardiopulmonary resuscitation (92950) $588.95 $981.59 2.6×
Cardioversion (92960) $383.16 $638.60 0.5×
Care mgmt svc bhvl hlth cond (99484) $28.50 $47.50 0.7×
Cbt 1st hour (94644) $176.40 $294 1.2×
Chemo Hormon Antineopl Sq/Im (96402) $322.20 $537 4.2×
Chemo IV push addl drug (96411) $322.20 $537 4.2×
Chemo prolong 8+ hrs infuse w/pump (96416) $411 $685 1.2×
Chemother, IV infusion, 1 hr (96413) $335.40 $559 1.0×
Chemother, IV infusion, ea add hr (96415) $322.20 $537 4.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $322.20 $537 4.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $372.60 $621 4.8×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $322.20 $537 0.9×
Chronic care management services 1st 20 min (99490) $64.80 $108 0.6×
Color/duplex Doppler, complete (93975) $642.72 $1,071.20 2.5×
Color/duplex Doppler, limited (93976) $302.20 $503.67 2.7×
Cpap/bipap (94660) $142.80 $238 0.6×
Cpt initial (94667) $198.60 $331 1.4×
Critical care (99291) $1,022.94 $1,704.90 1.2×
Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) $1,075.20 $1,792 2.7×
Ctr Motor Ep Std Transcrnl Motor Stimj Upr Limbs (95928) $2,079 $3,465 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $90.60 $151 0.4×
Distort Product Evoked Otoacoustic Emisns Limitd (92587) $194.40 $324 0.8×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $872 $1,453.33 3.4×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $708.85 $1,181.41 6.3×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,062.96 $1,771.60 4.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $651.99 $1,086.65 5.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,183.47 $1,972.45 4.6×
Dup-scan xtr veins unilateral/limited study (93971) $787.95 $1,313.25 7.1×
Duplex scan extracranial art compl bi study (93880) $526.54 $877.56 2.1×
Echo Heart Xthoracic,Limited (93308) $422.71 $704.52 1.7×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,430.67 $2,384.45 2.5×
EEG awake and asleep (95819) $448.80 $748 1.9×
EEG awake drowsy (95816) $448.80 $748 1.9×
EKG rhythm strip (93041) $44.40 $74 0.7×
Electrocardiogram Tracing (93005) $143.40 $239 2.3×
EMG four extremities (95864) $242.40 $404 1.8×
EMG one extremity (95860) $193.80 $323 1.4×
EMG three extremities (95863) $242.40 $404 1.8×
EMG two extremities (95861) $193.80 $323 1.4×
Er level 1 (99281) $192 $320 2.1×
Er level ii (99282) $85.28 $142.14 0.5×
Er level iii (99283) $161.92 $269.86 0.6×
Er level IV (99284) $249.67 $416.12 0.6×
Er level v (99285) $391.81 $653.02 0.6×
Evaluate Pt Use Of Inhaler (94664) $64.80 $108 0.3×
External ECG rec>48hr<7d recording (93242) $670.80 $1,118 16.8×
External ECG rec>48hr<7d scanning alys w/report (93243) $282 $470 2.0×
External ECG rec>7d<15d recording (93246) $670.80 $1,118 16.8×
External Ecg Scanning Analysis Report (93226) $282 $470 4.5×
Gi tract capsule endoscopy (91110) $1,116 $1,860 1.2×
Holter Monitor (93225) $670.80 $1,118 4.7×
Imm admn sarscov2 vaccine single dose (90480) $29.40 $49 0.7×
Immune Admin Oral/Nasal (90473) $13.21 $22.02 0.2×
Immunization Admin (90471) $40.80 $68 0.5×
Irrig drug delivery device (96523) $112.20 $187 1.8×
IV infusion hydration each additional hour (96361) $119.40 $199 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $247.20 $412 1.1×
IV infusion ther proph addl sequential to 1 hr (96367) $297.60 $496 3.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $297 $495 1.3×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $119.40 $199 2.4×
IV push ea addl new drug (96375) $53.40 $89 1.1×
IV push initial (96374) $119.40 $199 0.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $33.60 $56 1.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $39 $65 1.1×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $47.40 $79 2.8×
Needle electromyography larynx (95865) $258 $430 1.8×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $193.80 $323 1.4×
Neg press wound tx >50 cm (97608) $394.80 $658 0.9×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $394.80 $658 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $46.20 $77 0.2×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $394.80 $658 0.9×
Neurobehavioral Status Exam (96116) $330 $550 1.4×
Newborn resuscitation (99465) $928.80 $1,548 1.3×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $462 $770 3.3×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $150 $250 1.1×
Nonphysician Telephone Assessment 11-20 Min (98967) $44.40 $74 1.8×
Nonphysician Telephone Assessment 5-10 Min (98966) $22.20 $37 1.6×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $15.60 $26 0.7×
Osteopathic manipulative tx 3-4 body regions (98926) $22.50 $37.50 1.0×
Osteopathic manipulative tx 5-6 body regions (98927) $29.70 $49.50 1.3×
Osteopathic manipulative tx 7-8 body regions (98928) $35.70 $59.50 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $147 $245 1.1×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $147 $245 1.1×
Phlebotomy therapeutic (99195) $427.80 $713 3.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $16.20 $27 0.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $19.80 $33 0.4×
Psych diag eval w/med srvcs (90792) $73.80 $123 0.4×
Psychiatric diagnostic evaluation (90791) $76.80 $128 0.4×
Psytx crisis initial 60 min (90839) $222 $370 1.2×
Pulm function test by gas (94727) $297.60 $496 1.3×
Pulmonary Service/Procedure (94799) $324 $540 2.4×
Pulmonary stress test simple (94618) $270 $450 1.9×
Refill/Maint Portable Pump (96521) $699.60 $1,166 3.1×
Refill/Maint Pump/Resvr Syst (96522) $478.20 $797 2.1×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $527.40 $879 13.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $10.20 $17 0.0×
Rt Chest Wall Manipulation,Subsequent (94668) $157.20 $262 1.1×
Sbsq psyc collab care mgmt (99493) $71.70 $119.50 0.7×
Short-latency somatosens ep std upr limbs (95925) $622.80 $1,038 2.7×
Smoking cessation > 10 min (99407) $51 $85 1.3×
Somatosensory testing (95938) $1,075.20 $1,792 1.2×
Spirometry (94010) $194.40 $324 0.8×
Ssep lower limbs (95926) $622.80 $1,038 2.7×
Stress echo (93350) $587.10 $978.50 1.0×
Temp transcutaneous pacing (92953) $275.10 $458.50 0.4×
Therapeutic prophylactic/dx injection subq/im (96372) $44.40 $74 0.6×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $33.60 $56 0.8×
Trans Care Mgmt 14 Day Disch (99495) $167.40 $279 1.2×
Trans Care Mgmt 7 Day Disch (99496) $118.20 $197 0.8×
Tte w/doppler, complete (93306) $1,536.35 $2,560.58 2.6×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $543.22 $905.37 2.1×
Tympanometry (92567) $14.40 $24 0.4×
Unlisted Diagnostic Gastroenterology Procedure (91299) $195.88 $326.46 1.4×
Vasc Duplex Scan Extracranial,Limited (93882) $526.54 $877.56 4.7×
Vent mgmt inpat init day (94002) $482.40 $804 0.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $244.20 $407 0.4×