Visits & medical services prices at Mountains Community Hospital

Lake Arrowhead, CA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $49.82 $124.56 1.0×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines		 $14–$42.40 $35–$106 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $14 $35 1.0×
Behavral qualit analys voice (92524)
range across 3 matching MRF lines		 $96–$192 $240–$480 varies
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $89.60 $224 0.2×
Canalith repositioning proc (95992) $36 $90 0.9×
Cardiac Stress Tst,Tracing Only (93017) $542.80 $1,357 2.0×
Cardiopulmonary resuscitation (92950) $452 $1,130 1.6×
Cardioversion (92960) $456 $1,140 0.5×
Cbt 1st hour (94644) $27.20 $68 0.2×
Chest Wall Manipulation (94668) $27.20 $68 0.2×
Color/duplex Doppler, complete (93975) $440.80 $1,102 1.4×
Community/Work Reintegration Trainj Ea 15 Min (97537) $36 $90 1.1×
Continuous Pulse Ox (94762) $174 $435 1.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $346.40 $866 1.2×
Cpt initial (94667) $36.80 $92 0.2×
Critical care first hour (99291) $2,632.40 $6,581 2.5×
Debridement Open Wound 20 Sq Cm< (97597)
range across 2 matching MRF lines		 $88–$107.60 $220–$269 varies
Dup-scan lxtr art/artl bpgs compl bi study (93925)
range across 2 matching MRF lines		 $581.20–$1,032.80 $1,453–$2,582 varies
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $465.20 $1,163 3.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,032.80 $2,582 3.4×
Dup-scan xtr veins unilateral/limited study (93971) $516 $1,290 3.8×
Duplex up extrem art unilat/ltd (93931) $368 $920 2.7×
Electrical Stimulation Ea 15 Min (97032) $20 $50 1.4×
Electrocardiogram Tracing (93005) $86.80 $217 1.1×
Emergency Dept Visit Level 2 (99282) $452 $1,130 2.3×
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines		 $62.40–$684.40 $156–$1,711 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines		 $105.60–$1,158.80 $264–$2,897 varies
Er level 1 (99281)
range across 2 matching MRF lines		 $22–$211.20 $55–$528 varies
Er level v (99285)
range across 2 matching MRF lines		 $248.40–$1,684.40 $621–$4,211 varies
Evaluate pt use of inhaler (94664) $8 $20 0.0×
Evaluate Speech Production (92522)
range across 3 matching MRF lines		 $96–$192 $240–$480 varies
Evaluate Swallowing Function (92610)
range across 3 matching MRF lines		 $96–$192 $240–$480 varies
Evaluation of speech fluency (92521)
range across 3 matching MRF lines		 $96–$192 $240–$480 varies
Extracranial Bilat Study (93880) $490.80 $1,227 1.6×
Group Therapeutic Procedures (97150) $22 $55 1.2×
Holter monitor recording (93225) $78.80 $197 0.5×
Immunization administration (90471)
range across 2 matching MRF lines		 $28.80–$40 $72–$100 varies
Iontophoresis 15 min (97033) $30 $75 1.6×
IV infusion hydration each additional hour (96361) $51.20 $128 0.9×
IV infusion hydration initial 31 min-1 hour (96360) $101.60 $254 0.4×
IV infusion therapy prophylaxis/dx ea hour (96366) $71.20 $178 1.2×
IV push initial (96374) $124.80 $312 0.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $32 $80 1.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $34 $85 0.9×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $22 $55 1.3×
Multiple Family Group Psychotherapy (90849) $46 $115 0.2×
Neuromuscular Reeducation (97112) $36 $90 1.1×
Nonphysician Telephone Assessment 11-20 Min (98967) $12 $30 0.5×
Nonphysician Telephone Assessment 21-30 Min (98968) $18 $45 0.5×
Nonphysician Telephone Assessment 5-10 Min (98966) $6 $15 0.4×
Oral Function Therapy (92526)
range across 3 matching MRF lines		 $76–$152 $190–$380 varies
Orthc/Prostc Mgmt Sbsq Enc (97763) $42 $105 0.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $40 $100 0.9×
Ot Contrast Bath Ea 15 Min (97034) $18 $45 1.3×
Ot eval high complexity (97167) $135.20 $338 1.3×
Ot Eval Low Complex (97165) $45.20 $113 0.4×
Ot Eval Moderate Complexity (97166) $90 $225 0.9×
Ot manual therapy 15 min (97140) $32 $80 1.2×
Ot paraffin bath (97018) $10 $25 1.7×
Ot Prosthetic Training, Each 15 Min (97761) $36 $90 0.9×
Ot Re-Eval Est Plan Care (97168) $54 $135 0.8×
Phlebotomy therapeutic (99195) $105.20 $263 0.6×
Physical Performance Test (97750) $34 $85 1.0×
Psych diag eval w/med srvcs (90792) $100 $250 0.4×
Psychiatric diagnostic evaluation (90791) $100 $250 0.4×
Psychoanalysis (90845) $100 $250 0.4×
Psytx Crisis Initial 60 Min (90839) $67.56 $168.90 0.3×
Pt Eval High Complex (97163) $129.20 $323 1.3×
Pt eval low complex 20 min (97161) $43.20 $108 0.4×
Pt Eval Mod Complex (97162) $86 $215 0.9×
Pt gait training 15 min (97116) $30 $75 1.0×
Pt mechanical traction (97012) $18 $45 1.3×
Pt Re-Eval Est Plan Care (97164) $46 $115 0.7×
Pulm function test by gas (94727) $61.20 $153 0.2×
Qnhp Ol Dig Assmt&Mgmt 11-20 (98971) $36 $90 1.6×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) $56 $140 1.6×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) $20 $50 1.6×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $44 $110 0.9×
Rem ther mntr dev sply resp (98976) $44 $110 0.9×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $20 $50 0.1×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981) $40 $100 1.0×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980) $44 $110 0.8×
Respiratory flow volume loop (94375) $58.80 $147 0.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 2 matching MRF lines		 $72–$88 $180–$220 varies
Self Care Mngment Training (97535) $30 $75 0.9×
Sensory Integration Ea 15 Min (97533) $30 $75 0.5×
Speech sound lang comprehen (92523)
range across 3 matching MRF lines		 $96–$192 $240–$480 varies
Spirometry (94010) $54.40 $136 0.2×
Subcutaneous Infusion Each Additional Hour (96370) $85.20 $213 1.4×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $169.20 $423 0.6×
Subq Infusion Additional Pump Infusion Site (96371) $56.80 $142 0.6×
Temp transcutaneous pacing (92953) $332.80 $832 0.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $26 $65 1.2×
Ther Ivntj Ea Addl 15 Min (97130) $22 $55 1.0×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $28 $70 0.9×
Ther/Proph/Diag Inj Ia (96373) $96.40 $241 0.4×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines		 $74.40–$91.20 $186–$228 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines		 $142–$297.60 $355–$744 varies
Therapeutic Activities (97530) $36 $90 1.0×
Tte w/doppler, complete (93306) $407.60 $1,019 0.6×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507)
range across 3 matching MRF lines		 $76–$152 $190–$380 varies
Tx/Pro/Dx Inj New Drug Addon (96375) $62.40 $156 1.0×
Upr/L Xtremity Art 2 Levels (93922) $129.60 $324 0.8×
Vasopneumatic device (97016) $20 $50 1.7×
Vent Mgmt Inpat Init Day (94002) $1,037.60 $2,594 1.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,037.60 $2,594 1.3×
Vital capacity, total (94150) $23.60 $59 0.1×
Wheelchair Mgmt Ea 15 Min (97542) $32 $80 1.0×
Whirlpool Therapy (97022) $22 $55 1.4×

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.