31 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Airway inhalation treatment (94640) |
$113.40 |
$162 |
0.5× |
| Critical care (99291) |
$1,042.30 |
$1,489 |
1.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) |
$407.40 |
$582 |
1.7× |
| EKG (93005) |
$135.10 |
$193 |
2.3× |
| Er level 1 (99281) |
$112 |
$160 |
1.3× |
| Er level ii (99282) |
$223.30 |
$319 |
1.4× |
| Er level iii (99283) |
$445.90 |
$637 |
1.6× |
| Er level IV (99284) |
$594.30 |
$849 |
1.4× |
| Er level v (99285) |
$891.80 |
$1,274 |
1.5× |
| Immunization Admin (90471) |
$46.20 |
$66 |
0.6× |
| Irrigaj Implntd Venous Access Drug Delivery Syst (96523) |
$77.70 |
$111 |
1.3× |
| IV infusion hydration each additional hour (96361) |
$46.20 |
$66 |
1.0× |
| IV infusion hydration initial 31 min-1 hour (96360) |
$245.70 |
$351 |
1.1× |
| IV infusion, therap/proph/diagnost,initial,1st hour (96365) |
$275.10 |
$393 |
1.3× |
| IV infusion, therap/proph/diagnost,initial,ea add hour (96366) |
$46.20 |
$66 |
1.0× |
| IV push initial (96374) |
$135.80 |
$194 |
0.6× |
| Manual therapy 15 min (97140) |
$65.10 |
$93 |
2.3× |
| Ot eval low complex 30 min (97165) |
$175 |
$250 |
1.7× |
| Ot re-eval est plan care (97168) |
$93.80 |
$134 |
1.4× |
| Pt Aquatic Therapy/Exercises (97113) |
$55.30 |
$79 |
1.5× |
| Pt eval high complex 45 min (97163) |
$175 |
$250 |
1.8× |
| Pt eval low complex 20 min (97161) |
$175 |
$250 |
1.8× |
| Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) |
$52.50 |
$75 |
1.6× |
| Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) |
$175 |
$250 |
1.8× |
| Pt re-evaluation (97164) |
$93.80 |
$134 |
1.4× |
| Pt Ultrasound Therapy (97035) |
$44.80 |
$64 |
3.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) |
$154 |
$220 |
0.8× |
| Ther/Proph/Diag Inj Sc/Im (96372) |
$30.10 |
$43 |
0.4× |
| Therapeutic Activities (97530) |
$53.20 |
$76 |
1.5× |
| Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) |
$854 |
$1,220 |
1.6× |
| Tx/Pro/Dx Inj New Drug Addon (96375) |
$99.40 |
$142 |
2.1× |