Visits & medical services prices at Montgomery General Hospital

Montgomery, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $461.96 $615.94 2.2×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $49.63 $66.18 3.5×
Bedside Swallowing Eval (92610) $135.96 $181.28 1.6×
Behavioral and qualitative analysis of voice and resonance (92524) $173.81 $231.75 1.6×
Bioimpedance-derived physiologic cardiovascular analysis Facility (93701) $64.50 $86 0.5×
Breath Hydrogen/Methane Test (91065) $187.42 $249.90 0.9×
Brief Emotional/Behavioral Assessment (96127) $11.59 $15.45 0.3×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $409.04 $545.38 1.1×
Cardiac Stress Tst,Tracing Only (93017) $608.34 $811.13 2.9×
Cardiopulmonary resuscitation (92950) $364.62 $486.16 1.8×
Cardioversion (92960) $553.69 $738.25 0.9×
Caregiver hlth risk assmt score doc stnd instrm (96161) $11.59 $15.45 0.3×
Chemother, IV infusion, 1 hr (96413) $324.45 $432.60 1.0×
Color/duplex Doppler, complete (93975) $228.18 $304.24 1.0×
Color/duplex Doppler, limited (93976) $233.68 $311.58 2.3×
Cont Gluc Monitoring Patient Provided Equipment (95249) $121.67 $162.23 2.2×
Continuous Glucose Monitoring (95250) $263.62 $351.49 2.1×
Cpap/bipap (94660) $309 $412 1.5×
Cpt initial (94667) $96.56 $128.75 0.8×
Critical care (99291) $830.44 $1,107.25 1.0×
Debridement Open Wound 20 Sq Cm< (97597) $93.86 $125.15 0.5×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $340.48 $453.97 1.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $233.68 $311.58 2.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $203.26 $271.02 0.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $138.86 $185.14 1.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $190.52 $254.02 0.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $129.88 $173.17 1.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $209.35 $279.13 0.9×
Dup-scan xtr veins unilateral/limited study (93971) $233.68 $311.58 2.3×
Duplex scan extracranial art compl bi study (93880) $267.68 $356.90 1.2×
EEG awake and asleep (95819) $488.03 $650.70 2.4×
EEG awake drowsy (95816) $488.03 $650.70 2.4×
EEG cerebral death evaluation (95824) $488.03 $650.70 1.4×
Ekg Signal Averaging (93278) $216.11 $288.14 3.8×
Electrocardiogram Tracing (93005) $110.85 $147.81 2.0×
Er level 1 (99281) $42.68 $56.91 0.5×
Er level ii (99282) $63.92 $85.23 0.4×
Er level iii (99283) $106.61 $142.14 0.4×
Er level IV (99284) $287.95 $383.94 0.7×
Er level v (99285) $400.06 $533.41 0.7×
Eval speech sound production (92522) $212.44 $283.25 1.9×
Evaluate Pt Use Of Inhaler (94664) $124.28 $165.70 0.6×
Evaluation of speech fluency (92521) $208.58 $278.10 1.6×
External ECG rec>48hr<7d recording (93242) $56.25 $75 1.6×
External ECG rec>7d<15d recording (93246) $90 $120 2.5×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $441.68 $588.90 1.2×
Gi tract capsule endoscopy (91110) $324.45 $432.60 0.4×
Group Therapeutic Procedures (97150) $33.41 $44.55 1.9×
Immune Admin Oral/Nasal (90473) $28.58 $38.11 0.4×
Immunization Admin (90471) $40.17 $53.56 0.6×
Indocyanine-Green Angrph W/Multiframe I&R Uni/Bi (92240) $354.82 $473.10 1.7×
Ins swan ganz bedside (93503) $1,072.04 $1,429.38 0.7×
Iontophoresis 15 min (97033) $49.63 $66.18 2.6×
Irrig drug delivery device (96523) $60.83 $81.11 1.1×
IV infusion hydration each additional hour (96361) $73.39 $97.85 1.6×
IV infusion hydration initial 31 min-1 hour (96360) $238.02 $317.37 1.2×
IV infusion ther proph addl sequential to 1 hr (96367) $63.54 $84.72 0.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $324.45 $432.60 1.6×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $53.30 $71.07 1.2×
IV push ea addl new drug (96375) $55.43 $73.90 1.2×
IV push initial (96374) $108.64 $144.84 0.5×
Liver Elastography W/O Imag W/I&R (91200) $38.63 $51.50 0.3×
Manual therapy 15 min (97140) $50.60 $67.46 1.8×
Massage 15 min (97124) $44.80 $59.74 1.5×
Maximum voluntary ventilation (94200) $63.92 $85.23 1.1×
Mechanical traction (97012) $59.68 $79.57 4.2×
Motility study esophagus (91010) $435.98 $581.30 1.2×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $243.34 $324.45 2.7×
Multiple Sleep Latency Test (95805) $1,132.97 $1,510.62 1.4×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $366.94 $489.25 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $270.38 $360.50 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $482.82 $643.75 1.2×
Neurobehavioral Status Exam (96116) $106.61 $142.14 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $22.40 $29.87 0.2×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $80.92 $107.89 0.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $47.42 $63.22 1.0×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $60.83 $81.11 2.9×
Osteopathic manipulative tx 3-4 body regions (98926) $81.11 $108.15 3.9×
Osteopathic manipulative tx 5-6 body regions (98927) $101.39 $135.19 4.9×
Osteopathic manipulative tx 7-8 body regions (98928) $121.67 $162.23 5.9×
Osteopathic manipulative tx 9-10 body regions (98929) $141.95 $189.26 6.9×
Ot Contrast Bath Ea 15 Min (97034) $21.05 $28.07 1.5×
Ot eval high complex 60 min (97167) $182.50 $243.34 1.8×
Ot eval low complex 30 min (97165) $119.74 $159.65 1.2×
Ot eval mod complex 45 min (97166) $111.82 $149.10 1.1×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $72.23 $96.30 1.4×
Ot Prosthetic Training, Each 15 Min (97761) $51.18 $68.24 1.3×
Ot Range Motion Measure,Each Extrem (95851) $51.08 $68.11 2.0×
Ot therapeutic activity 15 min (97530) $45.58 $60.77 1.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $73.39 $97.85 0.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $48.67 $64.89 0.4×
Paraffin bath pt (97018) $51.08 $68.11 8.5×
Phlebotomy therapeutic (99195) $89.61 $119.48 0.7×
Plethysmography (94726) $182.32 $243.08 0.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,292.97 $1,723.96 1.6×
Polysom <6 yrs 4/> paramtrs (95782) $945.34 $1,260.46 1.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $29.93 $39.91 0.7×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $38.43 $51.24 0.9×
Psych diag eval w/med srvcs (90792) $212.44 $283.25 1.2×
Psychiatric diagnostic evaluation (90791) $193.13 $257.50 1.1×
Psytx crisis initial 60 min (90839) $231.75 $309 1.4×
Pt Aquatic Therapy/Exercises (97113) $77.25 $103 2.1×
Pt Electrical Stimulation (97032) $75.61 $100.82 5.1×
Pt eval high complex 45 min (97163) $182.50 $243.34 1.9×
Pt eval low complex 20 min (97161) $119.74 $159.65 1.2×
Pt eval mod complex 30 min (97162) $162.23 $216.30 1.7×
Pt gait training 15 min (97116) $54.08 $72.10 1.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $24.72 $32.96 0.8×
Pt re-evaluation (97164) $75.13 $100.17 1.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $47.51 $63.35 1.5×
Pt Whirlpool Therapy (97022) $47.32 $63.09 3.0×
Pt-focused hlth risk assmt (96160) $11.59 $15.45 0.3×
Pure Tone Audiometry Air Only (92552) $36.50 $48.67 0.3×
Respiratory flow volume loop (94375) $193.13 $257.50 0.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $106.80 $142.40 0.6×
Rom meas&reprt hand w/wo comparison normal sid (95852) $59.10 $78.80 2.8×
Rt Chest Wall Manipulation,Subsequent (94668) $135.19 $180.25 1.1×
Sleep study unattended (95806) $251.06 $334.75 1.2×
Slp caregiver training 1st 30 min (97550) $100.43 $133.90 1.9×
Smoking cessation > 10 min (99407) $35.34 $47.12 1.0×
Speech sound lang comprehen (92523) $328.31 $437.75 1.4×
Spirometry (94010) $157.68 $210.25 0.8×
Standardized Cognitive Performance Testing (96125) $270.38 $360.50 2.6×
Temp transcutaneous pacing (92953) $209.34 $279.13 0.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $57.94 $77.25 2.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $42.49 $56.65 2.0×
Therapeutic prophylactic/dx injection subq/im (96372) $29.93 $39.91 0.4×
Tilt table evaluation (93660) $348.20 $464.27 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $18.25 $24.34 0.5×
Tte w/doppler, complete (93306) $1,462.92 $1,950.56 2.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $89.32 $119.10 1.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $164.16 $218.88 2.0×
Tympanometry (92567) $38.63 $51.50 1.1×
Vasc Duplex Scan Extracranial,Limited (93882) $140.40 $187.20 1.4×
Vasopneumatic device (97016) $19.31 $25.75 1.6×
Vent mgmt inpat init day (94002) $200.46 $267.28 0.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $204.33 $272.44 0.3×
Wheelchair Mgmt Ea 15 Min (97542) $46.93 $62.57 1.5×
Xtrnl mobile cv telemetry w/technical support (93229) $750 $1,000 2.1×