Visits & medical services prices at Mount Graham Regional Medical Center

Safford, AZ · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $4,967.33
Airway inhalation treatment (94640) $1,302
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $487
Canalith Repositioning (95992) $112.24
Capsule endoscopy (91110) $1,620.89
Cardiac Stress Tst,Tracing Only (93017) $1,886
Cardiopulmonary resuscitation (92950) $1,462
Cardioversion (92960) $1,927
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $24,557
Chemo Hormon Antineopl Sq/Im (96402) $216
Chemo IV push addl drug (96411) $306
Chemo Iv Push Sngl Drug (96409) $419
Chemo prolong 8+ hrs infuse w/pump (96416) $730
Chemother, IV infusion, 1 hr (96413) $698
Chemother, IV infusion, ea add hr (96415) $470
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $263
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $318
Circadian respiratry pattern rec 12-24 hr infant (94772) $517
Color/duplex Doppler, limited (93976) $791.02
Coronary artery angio s&i (93454) $16,200
Cpap initiation and management (94660) $977.25
Cpt initial (94667) $169
Critical care (99291) $7,552.50
Debridement Open Wound 20 Sq Cm< (97597) $688
Demo &/or eval,pt use,aerosol device (94664) $325.50
Dup-scan xtr veins unilateral/limited study (93971) $1,218.30
Duplex scan extracranial art compl bi study (93880) $733.85
Echo Heart Xthoracic,Limited (93308) $1,206
Echo transesophageal (93312) $732
EEG awake asleep (95819) $1,858.50
EEG awake drowsy (95816) $829
EKG (93005) $770
EMG cranial nerve bilat (95868) $655
Er level 1 (99281) $490.49
Er level ii (99282) $1,028.48
Er level iii (99283) $1,744.68
Er level IV (99284) $5,100
Er level v (99285) $5,825.82
Esophageal Capsule Endoscopy (91111) $1,482.61
Evaluation of speech sound production (92522) $330.89
Evaluation of swallowing function (92610) $363
External ECG rec>48hr<7d recording (93242) $99
External ECG rec>7d<15d recording (93246) $98
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $181.50
Gastroesophag reflx test w/telemtry ph eltrd (91035) $728.76
Health Behavior Assessment/Re-Assessment (96156) $208
Health behavior ivntj indiv f2f 1st 30 min (96158) $118
Hemodialysis (90935) $3,388.25
Immuniz admin,intranasal/oral,1 vac/tox (90473) $20
Immunization Admin (90471) $164
Immunotherapy, 2+ Injections (95117) $66
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $297
IV infusion hydration each additional hour (96361) $2,030
IV infusion hydration initial 31 min-1 hour (96360) $794
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $1,020
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $2,442
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $1,824
IV push initial (96374) $762
Manual therapy 15 min (97140) $163.50
Mechanical traction (97012) $93.50
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $290
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $324.50
Mnt Group Ea 30 Min (97804) $220
Motility study esophagus (91010) $310
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $463.99
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $476.75
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $699.25
Nerve conduction studies 13/> studies (95913) $626
Nerve Conduction Studies 3-4 Studies (95908) $221
Nerve Conduction Studies 9-10 Studies (95911) $441
Nerve conduction studies; 1-2 studies (95907) $177
Nerve conduction studies; 11-12 studies (95912) $528
Nerve conduction studies; 5-6 studies (95909) $266
Nerve conduction studies; 7-8 studies (95910) $353
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $423.15
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $687.50
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $114
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $234
Ot eval low complex 30 min (97165) $236
Ot eval mod complex 45 min (97166) $269
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $64
Ot re-eval est plan care (97168) $163
Paraffin bath (97018) $97.50
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,276.48
Prq Card Stent W/Angio 1 Vsl (92928) $17,184
Prq trluml coronary angioplasty one art/branch (92920) $21,113
Pt Aquatic Therapy/Exercises (97113) $171
Pt Electric Current Therapy (97033) $159
Pt Electrical Stimulation (97032) $115
Pt eval high complex 45 min (97163) $309
Pt eval low complex 20 min (97161) $229
Pt Gait Training Therapy (97116) $247.50
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $214
Pt Physical Performance Test (97750) $230
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $497
Pt re-evaluation (97164) $152
Pt Ultrasound Therapy (97035) $90
Pt Whirlpool Therapy (97022) $117
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $27,217
Repet tms tx initial w/map/motr threshld/del&m (90867) $626.49
Rt Chest Wall Manipulation,Subsequent (94668) $230
Sleep study unattended (95806) $594
Speech sound lang comprehen (92523) $414
Spirometry (94010) $430.50
Standardized Cognitive Performance Testing (96125) $331
Ther/Proph/Diag Inj Sc/Im (96372) $829.70
Therap repetitive tms tx subseq delivery & mng (90868) $142.85
Therapeutic Activities (97530) $270
Therapeutic phlebotomy (99195) $225
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $30
Trans Care Mgmt 14 Day Disch (99495) $354
Trans Care Mgmt 7 Day Disch (99496) $479
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,220
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $253
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $261.39
Tx/Pro/Dx Inj New Drug Addon (96375) $1,056
Unlisted pulmonary service/procedure (94799) $308
Vasc Duplex Extrem Venous,Bilat (93970) $1,042.90
Ventilation assist & mgmt inpatient 1st day (94002) $2,308.50
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,139