Visits & medical services prices at Monument Health Custer Hospital
Custer, SD · every code in this section with a posted price and a Medicare benchmark.
346 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 1St psychiatric collab care mgmt 1st 70 mins (99492) | $178.40 | $223 | 1.7× |
| Ablate Heart Dysrhythm Focus (93650) | $13,875.20 | $17,344 | 1.7× |
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) | $306.40 | $383 | 2.3× |
| Acoustic Reflex Testing (92568) | $86.40 | $108 | 2.3× |
| Actinotherapy Ultraviolet Light (96900) | $72.80 | $91 | 1.9× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $72.80 | $91 | 1.8× |
| Advncd Care Plan 30 Min (99497) range across 2 matching MRF lines |
$231.20–$245.60 | $289–$307 | varies |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$260–$695.20 | $325–$869 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) | $260 | $325 | 1.9× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) | $158.40 | $198 | 1.2× |
| Analyze neurostim complex (95972) | $350.40 | $438 | 3.6× |
| Analyze neurostim no prog (95970) | $234.40 | $293 | 1.7× |
| Analyze Neurostim Simple (95971) | $173.60 | $217 | 1.8× |
| Analyze Pacemaker System (93724) | $531.20 | $664 | 1.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $76.80 | $96 | 5.3× |
| Application Modality 1/> Areas Infrared (97026) | $76 | $95 | 11.4× |
| Application on-body injector (96377) | $107.20 | $134 | 2.2× |
| Assessment of aphasia per hr (96105) | $411.20 | $514 | 4.2× |
| Assessment of tinnitus (92625) | $988 | $1,235 | 7.5× |
| Assmt & care planning pt w/cognitive impairment (99483) | $178.40 | $223 | 1.7× |
| Audiometry Air & Bone (92553) | $306.40 | $383 | 2.3× |
| Auditory Function, 60 Min (92620) | $337.60 | $422 | 2.6× |
| Basic vestibular evaluation (92540) | $240 | $300 | 1.1× |
| Behavral qualit analys voice (92524) | $358.40 | $448 | 3.3× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $180.80 | $226 | 2.2× |
| Bfb training ea addl 15 min (90913) | $124 | $155 | 3.8× |
| Brief Emotional/Behav Assmt (96127) | $95.20 | $119 | 2.5× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$197.60–$579.20 | $247–$724 | varies |
| C motor evoked upr&lwr limbs (95939) | $3,287.20 | $4,109 | 3.7× |
| Caloric Vstblr Test W/Rec (92537) | $196 | $245 | 1.5× |
| Canalith repositioning proc (95992) range across 3 matching MRF lines |
$70.40–$172.80 | $88–$216 | varies |
| Car seat/bed test 60 min (94780) | $156.80 | $196 | 4.1× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,412.80 | $1,766 | 6.4× |
| Cardiopulmonary exercise testing (94621) | $771.20 | $964 | 2.0× |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$404–$1,048.80 | $505–$1,311 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$536–$1,465.60 | $670–$1,832 | varies |
| Care mgmt services behavioral hlth cond 20 mins (99484) | $75.20 | $94 | 2.0× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $7,790.40 | $9,738 | 2.4× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $9,688.80 | $12,111 | 2.9× |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$288.80–$756 | $361–$945 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $251.20 | $314 | 3.4× |
| Chemo Hormon Antineopl Sq/Im (96402) | $203.20 | $254 | 2.8× |
| Chemo Ia Push (96420) | $846.40 | $1,058 | 2.5× |
| Chemo intralesional up to 7 (96405) | $191.20 | $239 | 2.6× |
| Chemo IV infusion addl hr (96415) | $341.60 | $427 | 4.6× |
| Chemo IV push addl drug (96411) | $292 | $365 | 4.0× |
| Chemother Prolong Infuse W/Pump (96416) | $892 | $1,115 | 2.6× |
| Chemotherapy Into Cns (96450) | $842.40 | $1,053 | 2.5× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $481.60 | $602 | 6.5× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $753.60 | $942 | 2.2× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $511.20 | $639 | 1.5× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $519.20 | $649 | 1.5× |
| Chest Wall Manipulation (94668) | $244 | $305 | 1.8× |
| Chron Care Mgmt Srvc 20 Min (99490) range across 2 matching MRF lines |
$108–$144.80 | $135–$181 | varies |
| Color/duplex Doppler, complete (93975) | $1,171.20 | $1,464 | 4.8× |
| Color/duplex Doppler, limited (93976) | $880 | $1,100 | 8.2× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $111.20 | $139 | 3.5× |
| Comprehensive Hearing Test (92557) | $335.20 | $419 | 2.5× |
| Conditioning Play Audiometry (92582) | $337.60 | $422 | 2.6× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $324.80 | $406 | 2.4× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $152.80 | $191 | 2.5× |
| Continuous Pulse Ox (94762) | $452.80 | $566 | 3.4× |
| Coronary Art/Grft Angio S&I (93455) | $9,999.20 | $12,499 | 3.0× |
| Coronary Artery Angio S&I (93454) | $9,836 | $12,295 | 3.0× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $841.60 | $1,052 | 3.8× |
| Cpt initial (94667) | $296 | $370 | 2.2× |
| Critical care first hour (99291) | $920 | $1,150 | 1.1× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$285.60–$463.20 | $357–$579 | varies |
| Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) | $447.20 | $559 | 2.2× |
| Dialysis One Evaluation (90945) range across 2 matching MRF lines |
$1,453.60–$1,454.40 | $1,817–$1,818 | varies |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) | $584.80 | $731 | 1.5× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $1,032 | $1,290 | 4.2× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $292 | $365 | 2.7× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,251.20 | $1,564 | 5.1× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $965.60 | $1,207 | 9.0× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,251.20 | $1,564 | 5.1× |
| Dup-scan xtr veins unilateral/limited study (93971) | $973.60 | $1,217 | 9.1× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $858.40 | $1,073 | 3.5× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $355.20 | $444 | 3.3× |
| Duplex Scan Hemodialysis Access (93990) | $610.40 | $763 | 5.7× |
| Duplex up extrem art bilat (93930) | $1,251.20 | $1,564 | 5.1× |
| Duplex up extrem art unilat/ltd (93931) | $834.40 | $1,043 | 7.8× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) | $356 | $445 | 2.7× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) | $316 | $395 | 2.4× |
| ECG/monitoring and analysis (93271) | $568.80 | $711 | 5.9× |
| Echo Congenital Complete (93303) | $1,549.60 | $1,937 | 2.8× |
| Echo Heart Xthoracic,Limited (93308) range across 3 matching MRF lines |
$423.20–$877.60 | $529–$1,097 | varies |
| Echo transesophageal (93312) | $2,679.20 | $3,349 | 4.8× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $2,314.40 | $2,893 | 4.1× |
| Eeg 41-60 Minutes (95812) | $1,374.40 | $1,718 | 6.2× |
| EEG awake and asleep (95819) | $1,148 | $1,435 | 5.2× |
| EEG awake drowsy (95816) | $1,009.60 | $1,262 | 4.6× |
| EEG cerebral death evaluation (95824) | $1,132 | $1,415 | 3.0× |
| EEG cont rec w/video by tech min 8 channels (95700) | $723.20 | $904 | 3.3× |
| EEG extended monitoring 61-119 minutes (95813) | $1,916 | $2,395 | 8.7× |
| Eeg Sleep Only (95822) | $736.80 | $921 | 3.3× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $392.80 | $491 | 1.8× |
| EEG w/o vid 2-12hr cont mntr (95707) | $761.60 | $952 | 3.5× |
| EEG w/o vid ea 12-26hr intmt (95709) | $1,605.60 | $2,007 | 4.2× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $1,316 | $1,645 | 3.5× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $392.80 | $491 | 1.8× |
| EEG wo vid ea 12-26hr unmntr (95708) | $1,379.20 | $1,724 | 3.6× |
| EKG signal averaged (93278) | $463.20 | $579 | 7.7× |
| Elec alys implt brn npgt prgrmg 1st 15 min (95983) | $105.60 | $132 | 1.1× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) | $300 | $375 | 3.1× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $92 | $115 | 2.4× |
| Electrical Stimulation Ea 15 Min (97032) | $76.80 | $96 | 5.2× |
| Electrocardiogram Tracing (93005) | $241.60 | $302 | 4.0× |
| Electrophysiology Evaluation (93642) | $2,248 | $2,810 | 1.8× |
| Emergency Dept Visit Level 2 (99282) | $176 | $220 | 1.1× |
| Emergency Dept Visit Level 3 (99283) | $266.40 | $333 | 1.0× |
| Emergency Dept Visit Level 4 (99284) | $397.60 | $497 | 0.9× |
| Emg 3 Extremities (95863) | $457.60 | $572 | 3.5× |
| Emg 4 Extremities (95864) | $568.80 | $711 | 4.3× |
| Endomyocardial Biopsy (93505) | $6,162.40 | $7,703 | 1.9× |
| Ep & ablate supravent arrhyt (93653) | $43,484 | $54,355 | 1.6× |
| Ep & ablate ventric tachy (93654) | $43,484 | $54,355 | 1.6× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $13,137.60 | $16,422 | 1.6× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) | $13,137.60 | $16,422 | 1.6× |
| Er level 1 (99281) | $60 | $75 | 0.7× |
| Er level v (99285) | $595.20 | $744 | 1.0× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) range across 2 matching MRF lines |
$1,301.60–$2,741.60 | $1,627–$3,427 | varies |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $213.60 | $267 | 1.6× |
| Evaluate pt use of inhaler (94664) range across 2 matching MRF lines |
$44.80–$428.80 | $56–$536 | varies |
| Evaluate Speech Production (92522) | $350.40 | $438 | 3.1× |
| Evaluate Swallowing Function (92610) | $299.20 | $374 | 3.5× |
| Evaluation of speech fluency (92521) | $323.20 | $404 | 2.4× |
| Evoked Auditory Test,Limited (92587) | $584.80 | $731 | 2.7× |
| Exercise test for bronchospasm (94617) | $260 | $325 | 1.9× |
| External ECG rec>48hr<7d recording (93242) | $170.40 | $213 | 4.5× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $543.20 | $679 | 4.0× |
| External ECG rec>7d<15d recording (93246) | $170.40 | $213 | 4.5× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $569.60 | $712 | 4.2× |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$100–$1,076 | $125–$1,345 | varies |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$914.40–$1,251.20 | $1,143–$1,564 | varies |
| Extracranial Uni/Ltd Study (93882) range across 2 matching MRF lines |
$558.40–$837.60 | $698–$1,047 | varies |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,302.40 | $1,628 | 2.3× |
| Flexible ndsc eval swlng&laryn sens c/v rec (92616) | $413.60 | $517 | 1.8× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) | $2,232.80 | $2,791 | 2.5× |
| Fundus photography (92250) | $315.20 | $394 | 2.3× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) range across 2 matching MRF lines |
$728–$838.40 | $910–$1,048 | varies |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $2,196 | $2,745 | 2.5× |
| Gi tract capsule endoscopy (91110) | $2,252 | $2,815 | 2.4× |
| Group Therapeutic Procedures (97150) range across 2 matching MRF lines |
$87.20–$97.60 | $109–$122 | varies |
| Health Behavior Assessment/Re-Assessment (96156) | $195.20 | $244 | 1.9× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $8,743.20 | $10,929 | 2.6× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $1,766.40 | $2,208 | 2.5× |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$67.20–$452.80 | $84–$566 | varies |
| Icd Device Interrogate (93289) | $106.40 | $133 | 2.8× |
| Icd device progr eval dual (93283) | $140 | $175 | 3.7× |
| Icd Device Progr Eval Mult (93284) | $149.60 | $187 | 3.9× |
| Ilr Device Eval Progr (93285) | $112.80 | $141 | 3.0× |
| Ilr Device Interrogate (93291) | $85.60 | $107 | 2.9× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $161.60 | $202 | 2.2× |
| Img retina detcj/mntr ds poc auton a/r uni/bi (92229) | $142.40 | $178 | 2.4× |
| Immunization administration (90471) range across 2 matching MRF lines |
$24–$72.80 | $30–$91 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $1,172.80 | $1,466 | 3.1× |
| Insert/Place Heart Catheter (93503) | $2,576.80 | $3,221 | 1.6× |
| Interrogate Subq Defib (93261) | $90.40 | $113 | 2.4× |
| Interrogation vad in person (93750) range across 2 matching MRF lines |
$133.60–$236 | $167–$295 | varies |
| Intracranial Complete Study (93886) | $414.40 | $518 | 1.7× |
| Intracutaneous tests w/allergenic extracts (95024) range across 2 matching MRF lines |
$24–$149.60 | $30–$187 | varies |
| Iontophoresis 15 min (97033) range across 2 matching MRF lines |
$76–$76.80 | $95–$96 | varies |
| Irrig Drug Delivery Device (96523) range across 2 matching MRF lines |
$76.80–$169.60 | $96–$212 | varies |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$38.40–$116 | $48–$145 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) | $432 | $540 | 2.0× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $159.20 | $199 | 2.2× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $172 | $215 | 3.6× |
| IV push initial (96374) | $349.60 | $437 | 1.6× |
| L Hrt Art/Grft Angio (93459) | $12,025.60 | $15,032 | 3.6× |
| Liver Elastography W/O Imag W/I&R (91200) | $368.80 | $461 | 2.8× |
| Lung Function Test (Mbc/Mvv) (94200) range across 2 matching MRF lines |
$53.60–$158.40 | $67–$198 | varies |
| Lwr Xtr Vasc Stdy Bilat (93924) | $628 | $785 | 2.8× |
| Mechanical chest wall oscillation per session (94669) | $484.80 | $606 | 2.2× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $51.20 | $64 | 1.6× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$68–$101.60 | $85–$127 | varies |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $28.80 | $36 | 1.7× |
| Methacholine challenge (94070) | $723.20 | $904 | 1.9× |
| Motility study esophagus (91010) | $1,488.80 | $1,861 | 3.9× |
| Motion Fluoroscopy/Swallow (92611) | $506.40 | $633 | 5.5× |
| Multiple Sleep Latency Test (95805) | $3,200.80 | $4,001 | 3.6× |
| Muscle Test 2 Limbs (95861) | $321.60 | $402 | 2.4× |
| Muscle Test Hemidiaphragm (95866) | $337.60 | $422 | 2.6× |
| Muscle Test Nonparaspinal (95870) | $829.60 | $1,037 | 6.1× |
| Muscle Test One Limb (95860) | $202.40 | $253 | 1.5× |
| Nasopharyngoscopy (92511) | $415.20 | $519 | 2.0× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $263.20 | $329 | 1.2× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) | $530.40 | $663 | 2.4× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $205.60 | $257 | 0.9× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $813.60 | $1,017 | 2.0× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $886.40 | $1,108 | 2.1× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $452 | $565 | 2.2× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $830.40 | $1,038 | 2.0× |
| Nerve Conduction Studies 1-2 Studies (95907) | $335.20 | $419 | 1.5× |
| Nerve Conduction Studies 11-12 Studies (95912) | $792.80 | $991 | 2.1× |
| Nerve conduction studies 13 or more studies (95913) | $944 | $1,180 | 2.5× |
| Nerve Conduction Studies 3-4 Studies (95908) | $366.40 | $458 | 1.7× |
| Nerve conduction studies 5-6 studies (95909) | $428.80 | $536 | 1.9× |
| Nerve conduction studies 7-8 studies (95910) | $568.80 | $711 | 1.5× |
| Nerve Conduction Studies 9-10 Studies (95911) | $676 | $845 | 1.8× |
| Neurobehavioral Status Exam (96116) | $567.20 | $709 | 2.6× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $316 | $395 | 2.4× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$22.40–$91.20 | $28–$114 | varies |
| Newborn resuscitation (99465) | $688.80 | $861 | 1.0× |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) | $321.60 | $402 | 2.4× |
| Optokinetic Nystagmus Test (92544) | $316 | $395 | 2.4× |
| Oral Function Therapy (92526) | $252 | $315 | 3.0× |
| Oral Speech Device Eval (92597) | $367.20 | $459 | 5.2× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $111.20 | $139 | 2.2× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $111.20 | $139 | 2.4× |
| Oscillating Tracking Test (92545) | $529.60 | $662 | 2.4× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$51.20–$80.80 | $64–$101 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$77.60–$115.20 | $97–$144 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) | $102.40 | $128 | 4.6× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $128 | $160 | 5.8× |
| Ot Contrast Bath Ea 15 Min (97034) | $73.60 | $92 | 5.2× |
| Ot eval high complexity (97167) | $262.40 | $328 | 2.6× |
| Ot Eval Low Complex (97165) | $262.40 | $328 | 2.6× |
| Ot Eval Moderate Complexity (97166) | $262.40 | $328 | 2.6× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$17.60–$98.40 | $22–$123 | varies |
| Ot paraffin bath (97018) range across 2 matching MRF lines |
$73.60–$76.80 | $92–$96 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) | $108.80 | $136 | 2.7× |
| Ot Re-Eval Est Plan Care (97168) | $191.20 | $239 | 2.8× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $326.40 | $408 | 2.5× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) range across 2 matching MRF lines |
$37.60–$292 | $47–$365 | varies |
| Oxygen Uptake Rest Indirect (94690) | $144.80 | $181 | 2.4× |
| Patch/Application Test Specify Number Tests (95044) | $24.80 | $31 | 0.0× |
| Pdt dstr prmlg les phys/qhp (96573) | $418.40 | $523 | 2.0× |
| Pdt dstr prmlg les skn illum/activj per day (96567) | $418.40 | $523 | 2.0× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $432.80 | $541 | 1.9× |
| Peripheral arterial disease rehab per session (93668) | $200.80 | $251 | 3.3× |
| Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930) | $10,794.40 | $13,493 | 0.6× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) range across 2 matching MRF lines |
$6,446.40–$13,073.60 | $8,058–$16,342 | varies |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $219.20 | $274 | 3.6× |
| Physical Performance Test (97750) | $105.60 | $132 | 3.1× |
| Plethysmography (94726) | $580.80 | $726 | 1.5× |
| Pm device eval in person (93288) | $97.60 | $122 | 2.6× |
| Pm device progr eval dual (93280) | $106.40 | $133 | 2.8× |
| Pm device progr eval multi (93281) | $130.40 | $163 | 3.4× |
| Pm Device Progr Eval Sngl (93279) | $95.20 | $119 | 2.5× |
| Pm/Icd Remote Tech Serv (93296) | $112.80 | $141 | 3.0× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $4,762.40 | $5,953 | 5.4× |
| Polysom <6 yrs 4/> paramtrs (95782) range across 2 matching MRF lines |
$4,637.60–$5,761.60 | $5,797–$7,202 | varies |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) range across 2 matching MRF lines |
$3,488.80–$5,761.60 | $4,361–$7,202 | varies |
| Positional nystagmus test (92542) | $326.40 | $408 | 2.4× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $92 | $115 | 1.9× |
| Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) | $132 | $165 | 3.5× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $118.40 | $148 | 3.1× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 2 matching MRF lines |
$24.80–$92 | $31–$115 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 2 matching MRF lines |
$31.20–$92 | $39–$115 | varies |
| Prq Card Angio/Athrect 1 Art (92924) | $22,215.20 | $27,769 | 1.9× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $25,981.60 | $32,477 | 2.2× |
| Prq Card Stent/Ath/Angio (92933) | $39,602.40 | $49,503 | 2.1× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $24,683.20 | $30,854 | 2.1× |
| Psych diag eval w/med srvcs (90792) | $307.20 | $384 | 1.7× |
| Psychiatric diagnostic evaluation (90791) range across 2 matching MRF lines |
$307.20–$454.40 | $384–$568 | varies |
| Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) | $933.60 | $1,167 | 2.0× |
| Psytx Crisis Initial 60 Min (90839) | $388 | $485 | 2.1× |
| Pt Eval High Complex (97163) | $262.40 | $328 | 2.7× |
| Pt eval low complex 20 min (97161) range across 2 matching MRF lines |
$206.40–$262.40 | $258–$328 | varies |
| Pt Eval Mod Complex (97162) | $262.40 | $328 | 2.7× |
| Pt gait training 15 min (97116) range across 2 matching MRF lines |
$19.20–$91.20 | $24–$114 | varies |
| Pt mechanical traction (97012) | $76.80 | $96 | 5.3× |
| Pt Re-Eval Est Plan Care (97164) | $191.20 | $239 | 2.8× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) | $143.20 | $179 | 3.7× |
| Pulm function test by gas (94727) | $353.60 | $442 | 1.6× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$318.40–$454.40 | $398–$568 | varies |
| Pulmonary Stress Testing (94618) | $282.40 | $353 | 2.1× |
| Pure Tone Audiometry Air (92552) | $167.20 | $209 | 1.2× |
| R Hrt Art/Grft Angio (93457) | $9,944.80 | $12,431 | 3.0× |
| R hrt coronary artery angio (93456) | $9,944.80 | $12,431 | 3.0× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $8,880 | $11,100 | 2.7× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) | $736 | $920 | 2.2× |
| Refill/Maint Portable Pump (96521) | $615.20 | $769 | 2.8× |
| Rem interrog icpms <30 d phys/qhp (93297) | $152 | $190 | 4.0× |
| Remote 30 Day Ecg Rev/Report (93270) | $260 | $325 | 6.8× |
| Remote 30 Day Ecg Tech Supp (93229) | $735.20 | $919 | 1.9× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $144 | $180 | 2.4× |
| Right Heart Cath (93451) | $9,481.60 | $11,852 | 2.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $452 | $565 | 2.2× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $308 | $385 | 2.5× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $103.20 | $129 | 2.2× |
| Sbsq Psyc Collab Care Mgmt (99493) | $178.40 | $223 | 1.7× |
| Self Care Mngment Training (97535) | $91.20 | $114 | 2.8× |
| Sensory Integration Ea 15 Min (97533) range across 2 matching MRF lines |
$87.20–$90.40 | $109–$113 | varies |
| Short-latency somatosens ep std upr limbs (95925) | $1,372 | $1,715 | 6.2× |
| Sleep study attended (95807) | $1,397.60 | $1,747 | 3.7× |
| Sleep study unattended (95806) | $838.40 | $1,048 | 3.8× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $838.40 | $1,048 | 3.8× |
| Somatosensory Testing (95938) | $1,700 | $2,125 | 1.9× |
| Speech Audiometry Complete (92556) | $98.40 | $123 | 1.6× |
| Speech audiometry threshold (92555) | $84 | $105 | 1.4× |
| Speech sound lang comprehen (92523) | $423.20 | $529 | 1.9× |
| Spirometry (94010) range across 2 matching MRF lines |
$109.60–$318.40 | $137–$398 | varies |
| Spontaneous Nystagmus Test (92541) | $326.40 | $408 | 2.4× |
| Ssep lower limbs (95926) | $931.20 | $1,164 | 4.2× |
| Standardized Cognitive Performance Testing (96125) | $305.60 | $382 | 3.0× |
| Stenger Test, Pure Tone (92565) | $149.60 | $187 | 2.5× |
| Subcutaneous Infusion Each Additional Hour (96370) | $115.20 | $144 | 2.4× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $521.60 | $652 | 2.4× |
| Surfactant Admin Thru Tube (94610) | $480.80 | $601 | 2.1× |
| Temp transcutaneous pacing (92953) | $1,268 | $1,585 | 1.9× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $91.20 | $114 | 4.1× |
| Ther Ivntj Ea Addl 15 Min (97130) | $91.20 | $114 | 4.3× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) range across 2 matching MRF lines |
$143.20–$144 | $179–$180 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $29.60 | $37 | 1.0× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $204.80 | $256 | 2.0× |
| Ther/Proph/Diag Inj Ia (96373) | $199.20 | $249 | 0.9× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $100 | $125 | 1.4× |
| Ther/Proph/Diag Iv Inf Init (96365) | $444 | $555 | 2.0× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$24.80–$91.20 | $31–$114 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,098.40 | $1,373 | 2.9× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$54.40–$72 | $68–$90 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$39.20–$69.60 | $49–$87 | varies |
| Trans Care Mgmt 14 Day Disch (99495) range across 2 matching MRF lines |
$263.20–$536.80 | $329–$671 | varies |
| Trans Care Mgmt 7 Day Disch (99496) range across 2 matching MRF lines |
$345.60–$711.20 | $432–$889 | varies |
| Transcath Closure of Asd (93580) | $33,860 | $42,325 | 1.8× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $341.60 | $427 | 3.2× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) | $89.60 | $112 | 2.3× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$745.60–$2,399.20 | $932–$2,999 | varies |
| Tte W/O Doppler Complete (93307) range across 2 matching MRF lines |
$488.80–$1,203.20 | $611–$1,504 | varies |
| Tx atrial fib pulm vein isol (93656) | $43,484 | $54,355 | 1.6× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $200.80 | $251 | 2.6× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $94.40 | $118 | 3.9× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $207.20 | $259 | 4.3× |
| Tympanometry (92567) range across 2 matching MRF lines |
$43.20–$77.60 | $54–$97 | varies |
| Tympanometry and reflex threshold measurements (92550) | $368.80 | $461 | 1.7× |
| Unlis neurological/neuromuscular dx px (95999) | $336.80 | $421 | 2.6× |
| Unlisted otorhinolaryngological service (92700) | $63.20 | $79 | 2.1× |
| Upr/L Xtremity Art 2 Levels (93922) | $512.80 | $641 | 3.8× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $848.80 | $1,061 | 3.8× |
| Valvuloplasty aortic valve (92986) | $12,570.40 | $15,713 | 2.2× |
| Valvuloplasty mitral valve (92987) | $25,981.60 | $32,477 | 2.2× |
| Veeg 2-12 Hr Cont Mntr (95713) | $1,256 | $1,570 | 3.3× |
| Veeg 2-12 hr intmt mntr (95712) | $740 | $925 | 1.9× |
| Veeg 2-12 hr unmonitored (95711) | $916 | $1,145 | 4.2× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $1,262.40 | $1,578 | 3.3× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $1,756 | $2,195 | 4.6× |
| Veeg ea 12-26hr cont mntr (95716) | $2,097.60 | $2,622 | 2.4× |
| Vent Mgmt Inpat Init Day (94002) range across 3 matching MRF lines |
$2,123.20–$3,340.80 | $2,654–$4,176 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) range across 3 matching MRF lines |
$1,536.80–$2,767.20 | $1,921–$3,459 | varies |
| Visual Evoked Potential Test (95930) | $234.40 | $293 | 1.1× |
| Visual reinforcement audiometry (vra) (92579) | $337.60 | $422 | 1.5× |
| Vital capacity, total (94150) | $351.20 | $439 | 2.7× |
| Wada Activation Test Hemispheric Function W/Eeg (95958) | $2,515.20 | $3,144 | 2.9× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$90.40–$91.20 | $113–$114 | varies |
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.