Visits & medical services prices at Northeastern Health System

Tahlequah, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $328.50 $438 1.6×
Assessment of aphasia (96105) $114 $152 1.2×
Behavioral and qualitative analysis of voice and resonance (92524) $160.50 $214 1.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $203.62 $271.50 0.6×
Canalith Repositioning (95992) $43.50 $58 1.1×
Capsule endoscopy (91110) $1,362 $1,816 1.6×
Cardiac Stress Tst,Tracing Only (93017) $695.25 $927 3.3×
Cardiopulmonary resuscitation (92950) $537.75 $717 2.6×
Cardioversion (92960) $447 $596 0.7×
Cardioversion internal (92961) $642.75 $857 1.0×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $4,381.50 $5,842 1.4×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $4,419 $5,892 1.4×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $4,381.50 $5,842 1.4×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $4,381.50 $5,842 1.4×
Cbt 1st hour (94644) $83.25 $111 0.7×
Chemo Hormon Antineopl Sq/Im (96402) $90 $120 1.3×
Chemo IV push addl drug (96411) $120.75 $161 1.7×
Chemo Iv Push Sngl Drug (96409) $240.75 $321 0.8×
Chemo prolong 8+ hrs infuse w/pump (96416) $441.75 $589 1.4×
Chemother, IV infusion, 1 hr (96413) $441.75 $589 1.4×
Chemother, IV infusion, ea add hr (96415) $66 $88 1.0×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $144.75 $193 2.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $66 $88 1.0×
Color/duplex Doppler, complete (93975) $367.50 $490 1.6×
Color/duplex Doppler, limited (93976) $268.12 $357.50 2.7×
Coronary artery angio s&i (93454) $4,381.50 $5,842 1.4×
Cpap initiation and management (94660) $183.75 $245 0.9×
Cpt initial (94667) $72 $96 0.6×
Critical care (99291) $1,125 $1,500 1.4×
Debridement Open Wound 20 Sq Cm< (97597) $269.62 $359.50 1.4×
Demo &/or eval,pt use,aerosol device (94664) $124.50 $166 0.6×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $643.50 $858 1.6×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $386.25 $515 1.7×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $201.75 $269 2.0×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $888 $1,184 3.9×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $744.75 $993 7.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $232.88 $310.50 1.0×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $177.38 $236.50 1.8×
Dup-scan xtr veins unilateral/limited study (93971) $742.50 $990 7.4×
Duplex hemodialysis access (93990) $209.25 $279 2.1×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $216.75 $289 0.9×
Duplex scan extracranial art compl bi study (93880) $1,158.75 $1,545 5.0×
Echo Heart Xthoracic,Limited (93308) $896.62 $1,195.50 3.9×
Echo transesophageal (93312) $924 $1,232 1.8×
Echo Transesophageal - Congenital Tee Complete (93315) $1,483.50 $1,978 2.8×
Echo Transthoracic - Congenital Tte Complete (93303) $1,483.50 $1,978 2.8×
Echo Transthoracic - Congenital Tte Limited (93304) $1,483.50 $1,978 2.8×
EEG awake asleep (95819) $519 $692 2.5×
EEG awake drowsy (95816) $354 $472 1.7×
EEG coma or sleep only (95822) $540 $720 2.6×
EEG cont rec w/video by tech min 8 channels (95700) $258 $344 1.2×
Eeg Extended Monitoring 61-119 Minutes (95813) $519 $692 2.5×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $519 $692 2.5×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $885.75 $1,181 2.5×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $885.75 $1,181 2.5×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $885.75 $1,181 2.5×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $519 $692 2.5×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $519 $692 2.5×
EKG (93005) $117.75 $157 2.1×
EKG rhythm strip (93041) $66 $88 1.2×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $519 $692 2.5×
Endomyocardial biopsy (93505) $5,460.10 $7,280.13 1.8×
Er level 1 (99281) $141 $188 1.7×
Er level ii (99282) $225 $300 1.5×
Er level iii (99283) $360 $480 1.4×
Er level IV (99284) $585 $780 1.5×
Er level v (99285) $787.50 $1,050 1.4×
Evaluation of speech fluency (92521) $184.50 $246 1.4×
Evaluation of speech sound production (92522) $148.50 $198 1.3×
Evaluation of swallowing function (92610) $133.50 $178 1.6×
Evaluation with prescription of speech-generating alternative (92607) $195 $260 1.6×
Evoked auditory test,limited (92587) $71.25 $95 0.3×
External ECG rec>48hr<7d recording (93242) $67.50 $90 1.9×
External ECG rec>48hr<7d scanning alys w/report (93243) $140.25 $187 1.1×
External Ecg Scanning Analysis Report (93226) $140.25 $187 2.5×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $96.75 $129 0.5×
Flexible ndsc eval swlng&laryn sens c/v rec (92616) $178.50 $238 0.8×
Fluorescein angiography (92235) $75 $100 0.4×
Group Therapeutic Procedures (97150) $32.25 $43 1.8×
Hemodialysis (90935) $597 $796 0.9×
Holter Monitor Recording (93225) $259.50 $346 2.0×
Icd Device Interrogate (93289) $463.50 $618 12.9×
Immunization Admin (90471) $106.50 $142 1.5×
Ins swan ganz bedside (93503) $1,526.25 $2,035 1.0×
Interrog dev eval scrms phys/qhp in person (93291) $463.50 $618 16.7×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $80.25 $107 1.4×
IV infusion hydration each additional hour (96361) $56.25 $75 1.2×
IV infusion hydration initial 31 min-1 hour (96360) $153 $204 0.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $60 $80 0.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $201 $268 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $56.25 $75 1.2×
IV push initial (96374) $193.50 $258 0.9×
Laryngeal Function Studies (92520) $71.25 $95 0.6×
Laryngoscopic Sensory Test (92614) $118.50 $158 0.8×
Manual therapy 15 min (97140) $48.75 $65 1.8×
Massage 15 min (97124) $56.25 $75 1.9×
Mechanical traction (97012) $45.75 $61 3.2×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $162.38 $216.50 1.8×
Multiple sleep latency test (95805) $4,369.50 $5,826 5.3×
Neg press wnd tx </=50 sq cm (97607) $400.88 $534.50 1.0×
Neg press wound tx >50 cm (97608) $431.25 $575 1.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $241.50 $322 1.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $271.88 $362.50 0.7×
Nerve conduction studies 13/> studies (95913) $459 $612 1.3×
Nerve Conduction Studies 3-4 Studies (95908) $292.12 $389.50 1.4×
Nerve Conduction Studies 9-10 Studies (95911) $459.38 $612.50 1.3×
Nerve conduction studies; 1-2 studies (95907) $292.50 $390 1.4×
Nerve conduction studies; 11-12 studies (95912) $459.38 $612.50 1.3×
Nerve conduction studies; 5-6 studies (95909) $451.50 $602 2.2×
Nerve conduction studies; 7-8 studies (95910) $459.38 $612.50 1.3×
Newborn resuscitation (99465) $702.75 $937 1.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $814.50 $1,086 6.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $146.25 $195 0.7×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $276 $368 2.2×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $69.38 $92.50 1.5×
Osteopathic manipulative tx 1-2 body regions (98925) $47.25 $63 2.3×
Ot eval high complex 60 min (97167) $128.25 $171 1.3×
Ot eval low complex 30 min (97165) $93 $124 0.9×
Ot eval mod complex 45 min (97166) $112.50 $150 1.1×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $75 $100 1.5×
Ot Prosthetic Training, Each 15 Min (97761) $48 $64 1.2×
Ot re-eval est plan care (97168) $87.75 $117 1.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $122.25 $163 1.0×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $187.50 $250 1.5×
Paraffin bath (97018) $26.25 $35 4.4×
Peripheral arterial disease rehab per session (93668) $99 $132 1.7×
Plethysmography (94726) $444.75 $593 1.2×
Pm device eval in person (93288) $405.75 $541 11.3×
Pm device progr eval dual (93280) $264.75 $353 7.4×
Pm device progr eval multi (93281) $463.50 $618 12.9×
Pm device progr eval sngl (93279) $405.75 $541 11.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,767.75 $6,357 5.8×
Polysom <6 yrs 4/> paramtrs (95782) $4,369.50 $5,826 5.3×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $4,369.50 $5,826 5.3×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $463.50 $618 12.9×
Programming of dual lead implantable defibrillator system (93283) $540.75 $721 15.1×
Programming of single lead implantable defibrillator system (93282) $494.25 $659 13.8×
Prq balloon valvuloplasty aortic valve (92986) $8,781 $11,708 1.6×
Prq card revasc chronic 1vsl (92943) $9,882 $13,176 0.9×
Prq Card Stent W/Angio 1 Vsl (92928) $9,882 $13,176 0.9×
Prq Card Stent/Ath/Angio (92933) $12,453 $16,604 0.7×
Prq revasc byp graft 1 vsl (92937) $9,882 $13,176 0.9×
Prq trluml coronary angio/atherect one art/brnch (92924) $12,291.75 $16,389 1.1×
Prq trluml coronary angioplasty one art/branch (92920) $6,588 $8,784 1.2×
Pt Electric Current Therapy (97033) $35.62 $47.50 1.9×
Pt Electrical Stimulation (97032) $40.12 $53.50 2.7×
Pt eval high complex 45 min (97163) $154.12 $205.50 1.6×
Pt eval low complex 20 min (97161) $87.75 $117 0.9×
Pt Gait Training Therapy (97116) $54.75 $73 1.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $62.25 $83 1.9×
Pt Physical Performance Test (97750) $75.38 $100.50 2.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $143.25 $191 1.5×
Pt re-evaluation (97164) $87.75 $117 1.3×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $71.62 $95.50 2.2×
Pt Ultrasound Therapy (97035) $34.50 $46 2.4×
Pt Whirlpool Therapy (97022) $61.50 $82 3.9×
Pulm Funct Test Oscillometry (94728) $444.75 $593 3.6×
Pulm function test by gas (94727) $250.50 $334 1.2×
R & l hrt cath w/njx l ventriculog img s&i (93453) $4,720.12 $6,293.50 1.5×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $4,419 $5,892 1.4×
R hrt art/grft angio (93457) $4,419 $5,892 1.4×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $4,419 $5,892 1.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $60 $80 1.7×
Right heart cath (93451) $5,021.25 $6,695 1.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $271.88 $362.50 1.4×
Rt Chest Wall Manipulation,Subsequent (94668) $52.88 $70.50 0.4×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $25.50 $34 0.5×
Sensory Integration Ea 15 Min (97533) $80.25 $107 1.3×
Sleep study unattended (95806) $571.12 $761.50 2.8×
Smoking cessation > 10 min (99407) $53.62 $71.50 1.5×
Speech group therapy (92508) $40.50 $54 1.7×
Speech sound lang comprehen (92523) $301.50 $402 1.3×
Spirometry (94010) $172.88 $230.50 0.8×
Standardized Cognitive Performance Testing (96125) $112.50 $150 1.1×
Stress echo (93350) $942.75 $1,257 1.8×
Stress Tte Complete (93351) $1,483.50 $1,978 2.8×
Temp transcutaneous pacing (92953) $176.25 $235 0.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $103.50 $138 4.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $37.88 $50.50 1.8×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $135.75 $181 1.3×
Ther/Proph/Diag Inj Sc/Im (96372) $52.88 $70.50 0.8×
Therapeutic Activities (97530) $69.75 $93 2.0×
Therapeutic phlebotomy (99195) $63.75 $85 0.5×
Tilt Table Eval (93660) $888.75 $1,185 2.5×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $44.25 $59 1.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,668.75 $2,225 3.2×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,483.50 $1,978 6.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $149.25 $199 2.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $104.25 $139 1.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $72.38 $96.50 1.6×
Ultrasound of heart with probe in esophagus to assess heart pump function (93318) $1,483.50 $1,978 2.8×
Unlisted pulmonary service/procedure (94799) $34.50 $46 0.3×
Vasc Duplex Extrem Venous,Bilat (93970) $888 $1,184 3.9×
Vasc Duplex Scan Extracranial,Limited (93882) $387 $516 3.8×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $291.75 $389 1.4×
Vasopneumatic device (97016) $22.50 $30 1.9×
Ventilation assist & mgmt inpatient 1st day (94002) $374.25 $499 0.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $374.25 $499 0.6×
Wheelchair Mgmt Ea 15 Min (97542) $58.50 $78 1.9×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $172.50 $230 1.9×