Visits & medical services prices at Pike County Memorial Hospital
Louisiana, MO · every code in this section with a posted price and a Medicare benchmark.
155 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $32 | $40 | 0.8× |
| Airway Inhalation Treatment (94640) range across 8 matching MRF lines |
$30.40–$101.60 | $38–$127 | varies |
| Analyze neurostim no prog (95970) | $240 | $300 | 1.8× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $62.40 | $78 | 4.3× |
| Behavral qualit analys voice (92524) | $220 | $275 | 2.0× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $382.40 | $478 | 1.0× |
| Canalith repositioning proc (95992) | $81.60 | $102 | 2.0× |
| Cardiac Stress Tst,Tracing Only (93017) | $583.20 | $729 | 2.7× |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$185.60–$384 | $232–$480 | varies |
| Cardioversion (92960) | $384 | $480 | 0.6× |
| Cbt 1st hour (94644) | $176 | $220 | 1.3× |
| Chemo Anti-Neopl Sq/Im (96401) | $70.40 | $88 | 1.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $37.60 | $47 | 0.5× |
| Chemo IV infusion addl hr (96415) | $84 | $105 | 1.2× |
| Chemo IV push addl drug (96411) | $53.60 | $67 | 0.7× |
| Chemother Prolong Infuse W/Pump (96416) | $123.20 | $154 | 0.4× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $62.40 | $78 | 0.9× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $434.40 | $543 | 1.3× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $96.80 | $121 | 0.3× |
| Chron Care Mgmt Srvc 20 Min (99490) range across 2 matching MRF lines |
$33.60–$158.59 | $42–$198.24 | varies |
| Color/duplex Doppler, complete (93975) | $457.60 | $572 | 1.9× |
| Color/duplex Doppler, limited (93976) | $326.40 | $408 | 3.1× |
| Comprehensive Hearing Test (92557) | $64 | $80 | 0.5× |
| Continuous Pulse Ox (94762) | $148 | $185 | 1.1× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $659.20 | $824 | 3.0× |
| Cpt initial (94667) | $204.80 | $256 | 1.5× |
| Critical care first hour (99291) | $705.60 | $882 | 0.9× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$50.40–$903.20 | $63–$1,129 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $457.60 | $572 | 1.9× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $247.20 | $309 | 1.0× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $244.80 | $306 | 2.3× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 4 matching MRF lines |
$326.40–$571.20 | $408–$714 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 6 matching MRF lines |
$231.20–$244.80 | $289–$306 | varies |
| Duplex up extrem art bilat (93930) | $572 | $715 | 2.4× |
| Duplex up extrem art unilat/ltd (93931) | $340 | $425 | 3.2× |
| Echo Heart Xthoracic,Limited (93308) | $395.20 | $494 | 1.7× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $1,120 | $1,400 | 2.0× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) | $480 | $600 | 5.0× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $272 | $340 | 7.3× |
| Electrical Stimulation Ea 15 Min (97032) | $95.20 | $119 | 6.5× |
| Electrocardiogram Tracing (93005) range across 6 matching MRF lines |
$40–$164 | $50–$205 | varies |
| Emergency Dept Visit Level 2 (99282) | $240 | $300 | 1.6× |
| Emergency Dept Visit Level 3 (99283) | $360 | $450 | 1.3× |
| Emergency Dept Visit Level 4 (99284) | $520 | $650 | 1.2× |
| Er level 1 (99281) | $140 | $175 | 1.7× |
| Er level v (99285) | $680 | $850 | 1.1× |
| Evaluate pt use of inhaler (94664) | $47.20 | $59 | 0.2× |
| Evaluate Swallowing Function (92610) | $301.60 | $377 | 3.6× |
| External ECG rec>48hr<7d recording (93242) | $351.20 | $439 | 9.4× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $351.20 | $439 | 2.6× |
| External ECG rec>7d<15d recording (93246) | $351.20 | $439 | 9.4× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $351.20 | $439 | 2.6× |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$351.20–$476 | $439–$595 | varies |
| Extracranial Bilat Study (93880) | $395.20 | $494 | 1.7× |
| Health Behavior Assessment/Re-Assessment (96156) | $128 | $160 | 1.3× |
| Holter monitor recording (93225) | $351.20 | $439 | 2.6× |
| Icd device progr eval dual (93283) | $52 | $65 | 1.4× |
| Icd Device Progr Eval Mult (93284) | $52 | $65 | 1.4× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $24 | $30 | 0.3× |
| Immunization administration (90471) range across 9 matching MRF lines |
$24–$76.80 | $30–$96 | varies |
| Iontophoresis 15 min (97033) | $76 | $95 | 4.0× |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$84.80–$93.60 | $106–$117 | varies |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$40.80–$44 | $51–$55 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 3 matching MRF lines |
$177.60–$182.60 | $222–$228.25 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 3 matching MRF lines |
$28.80–$75.20 | $36–$94 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $40.80 | $51 | 0.9× |
| IV push initial (96374) range across 3 matching MRF lines |
$79.90–$204 | $99.88–$255 | varies |
| Lwr Xtr Vasc Stdy Bilat (93924) | $608 | $760 | 2.8× |
| Motion Fluoroscopy/Swallow (92611) | $216 | $270 | 2.4× |
| Multiple Family Group Psychotherapy (90849) | $42.40 | $53 | 0.2× |
| Muscle Test 2 Limbs (95861) range across 3 matching MRF lines |
$177.60–$576.80 | $222–$721 | varies |
| Muscle Test One Limb (95860) | $104 | $130 | 0.8× |
| Nasopharyngoscopy (92511) | $248.80 | $311 | 1.2× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$48.80–$160 | $61–$200 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $84 | $105 | 0.2× |
| Nerve Conduction Studies 1-2 Studies (95907) | $81.60 | $102 | 0.4× |
| Nerve Conduction Studies 11-12 Studies (95912) range across 3 matching MRF lines |
$224–$2,304 | $280–$2,880 | varies |
| Nerve conduction studies 13 or more studies (95913) range across 3 matching MRF lines |
$260–$2,496 | $325–$3,120 | varies |
| Nerve Conduction Studies 3-4 Studies (95908) range across 3 matching MRF lines |
$100–$864 | $125–$1,080 | varies |
| Nerve conduction studies 5-6 studies (95909) range across 3 matching MRF lines |
$120–$1,296 | $150–$1,620 | varies |
| Nerve conduction studies 7-8 studies (95910) range across 3 matching MRF lines |
$158.40–$1,728 | $198–$2,160 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 3 matching MRF lines |
$191.20–$1,920 | $239–$2,400 | varies |
| Neuromuscular Reeducation (97112) | $85.60 | $107 | 2.6× |
| Oral Function Therapy (92526) | $300.80 | $376 | 3.6× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $41.60 | $52 | 1.9× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $58.40 | $73 | 2.7× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $63.20 | $79 | 2.9× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $76 | $95 | 3.5× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $79.20 | $99 | 3.7× |
| Ot eval high complexity (97167) | $200 | $250 | 2.0× |
| Ot Eval Low Complex (97165) | $172 | $215 | 1.7× |
| Ot Eval Moderate Complexity (97166) | $177.60 | $222 | 1.8× |
| Ot manual therapy 15 min (97140) range across 10 matching MRF lines |
$33.60–$88 | $42–$110 | varies |
| Ot Re-Eval Est Plan Care (97168) | $96 | $120 | 1.4× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $176.80 | $221 | 1.4× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $124 | $155 | 1.0× |
| Percutaneous tests w/allergenic extracts (95004) | $5.60 | $7 | 0.0× |
| Phlebotomy therapeutic (99195) | $668.80 | $836 | 5.0× |
| Physical Performance Test (97750) | $268 | $335 | 7.9× |
| Plethysmography (94726) | $185.60 | $232 | 0.5× |
| Pm device progr eval dual (93280) | $39.20 | $49 | 1.0× |
| Pm Device Progr Eval Sngl (93279) | $39.20 | $49 | 1.0× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $2,099.20 | $2,624 | 2.4× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $52 | $65 | 1.4× |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $162 | $202.50 | 1.6× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $20 | $25 | 0.4× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $28.80 | $36 | 0.6× |
| Psych diag eval w/med srvcs (90792) | $158.40 | $198 | 0.9× |
| Psychiatric diagnostic evaluation (90791) | $264 | $330 | 1.5× |
| Psychological tst eval svc phys/qhp first hour (96130) | $200 | $250 | 0.9× |
| Psytx Crisis Initial 60 Min (90839) | $140 | $175 | 0.8× |
| Pt Eval High Complex (97163) | $191.20 | $239 | 2.0× |
| Pt eval low complex 20 min (97161) | $163.20 | $204 | 1.7× |
| Pt Eval Mod Complex (97162) | $172 | $215 | 1.8× |
| Pt gait training 15 min (97116) | $87.20 | $109 | 3.0× |
| Pt mechanical traction (97012) | $60 | $75 | 4.2× |
| Pt Re-Eval Est Plan Care (97164) | $96 | $120 | 1.4× |
| Pulmonary service/procedure (94799) range across 5 matching MRF lines |
$64–$97.60 | $80–$122 | varies |
| Pulmonary Stress Testing (94618) | $132 | $165 | 1.0× |
| Pure Tone Audiometry Air (92552) | $32 | $40 | 0.2× |
| Refill/Maint Portable Pump (96521) | $120 | $150 | 0.6× |
| Rem mntr physiol param 1st dev supply ea 30 d (99454) | $112.80 | $141 | 3.0× |
| Rem mntr physiol param 1st set up pt educaj eqp (99453) | $51.74 | $64.68 | 0.4× |
| Remote 30 Day Ecg Rev/Report (93270) | $387.20 | $484 | 10.4× |
| Respiratory flow volume loop (94375) | $140.80 | $176 | 0.7× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $53.60 | $67 | 0.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $840 | $1,050 | 4.2× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $320 | $400 | 2.6× |
| Self Care Mngment Training (97535) | $88 | $110 | 2.7× |
| Sensory Integration Ea 15 Min (97533) | $81.60 | $102 | 1.3× |
| Sleep study unattended (95806) | $741.60 | $927 | 3.4× |
| Speech sound lang comprehen (92523) | $480 | $600 | 2.1× |
| Spirometry (94010) | $207.20 | $259 | 1.0× |
| Standardized Cognitive Performance Testing (96125) | $304 | $380 | 3.0× |
| Stress Tte Only (93350) | $1,469.60 | $1,837 | 2.7× |
| Subcutaneous Infusion Each Additional Hour (96370) | $16.80 | $21 | 0.4× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $140 | $175 | 0.7× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $128.80 | $161 | 3.5× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 7 matching MRF lines |
$58.40–$81.60 | $73–$102 | varies |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $280 | $350 | 2.7× |
| Ther/Prop/Diag Inj/Inf Proc (96379) range across 2 matching MRF lines |
$87.60–$90.40 | $109.50–$113 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 5 matching MRF lines |
$24–$96.80 | $30–$121 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 3 matching MRF lines |
$188.80–$204 | $236–$255 | varies |
| Therapeutic Activities (97530) | $88 | $110 | 2.5× |
| Trans Care Mgmt 14 Day Disch (99495) | $108 | $135 | 0.8× |
| Trans Care Mgmt 7 Day Disch (99496) | $132 | $165 | 1.0× |
| Tte w/doppler, complete (93306) range across 4 matching MRF lines |
$134.40–$1,920 | $168–$2,400 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $300.80 | $376 | 4.0× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 4 matching MRF lines |
$24–$88.80 | $30–$111 | varies |
| Tympanometry (92567) | $37.60 | $47 | 1.0× |
| Upr/L Xtremity Art 2 Levels (93922) range across 4 matching MRF lines |
$340–$600.80 | $425–$751 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $370.40 | $463 | 1.7× |
| Vasopneumatic device (97016) | $50.40 | $63 | 4.2× |
| Vent Mgmt Inpat Init Day (94002) | $744.80 | $931 | 1.2× |
| Wheelchair Mgmt Ea 15 Min (97542) | $60 | $75 | 1.9× |
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.