Visits & medical services prices at Potomac Valley Hospital

Keyser, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Acupunct W/Stimul 15 Min (97813) $35.50 $71 1.3×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $35.50 $71 1.3×
Advncd Care Plan 30 Min (99497) $97.50 $195 1.0×
Airway Inhalation Treatment (94640) $122 $244 0.6×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $64 $128 1.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $128 $256 1.0×
Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) $168 $336 1.3×
Analyze neurostim complex (95972)
range across 2 matching MRF lines		 $91.50–$140 $183–$280 varies
Analyze neurostim no prog (95970) $127.50 $255 1.0×
Analyze Neurostim Simple (95971)
range across 2 matching MRF lines		 $91–$140 $182–$280 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $65 $130 4.5×
Application on-body injector (96377) $97 $194 2.2×
Brief Emotional/Behav Assmt (96127) $61 $122 1.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $407 $814 1.1×
Cardiac Stress Tst,Tracing Only (93017) $485.50 $971 2.3×
Cardiopulmonary resuscitation (92950) $568 $1,136 2.7×
Cardioversion (92960) $950.50 $1,901 1.5×
Caregiver hlth risk assmt score doc stnd instrm (96161) $36 $72 1.0×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $20.50 $41 0.8×
Cbt 1st hour (94644) $268.50 $537 2.1×
Chemo Anti-Neopl Sq/Im (96401) $133 $266 1.9×
Chemo Hormon Antineopl Sq/Im (96402) $195 $390 2.8×
Chemo IV infusion addl hr (96415) $133 $266 1.9×
Chemo IV push addl drug (96411) $71.50 $143 1.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $119 $238 1.7×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $680.50 $1,361 2.1×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $343 $686 1.1×
Chest Wall Manipulation (94668) $88 $176 0.7×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) $31 $62 1.5×
Chron Care Mgmt Srvc 20 Min (99490) $97.50 $195 1.0×
Color/duplex Doppler, complete (93975) $582.50 $1,165 2.5×
Color/duplex Doppler, limited (93976) $289.50 $579 2.9×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $170.50 $341 1.0×
Comprehensive Hearing Test (92557)
range across 2 matching MRF lines		 $66–$259 $132–$518 varies
Continuous Pulse Ox (94762) $262.50 $525 2.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $295.50 $591 1.4×
Cpt initial (94667) $88.50 $177 0.7×
Critical care first hour (99291) $839.50 $1,679 1.1×
Debridement Open Wound 20 Sq Cm< (97597) $122.50 $245 0.6×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $448.50 $897 2.0×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $438.50 $877 1.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $307 $614 3.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $458 $916 2.0×
Dup-scan xtr veins unilateral/limited study (93971) $375.50 $751 3.7×
Duplex up extrem art bilat (93930) $417.50 $835 1.8×
Duplex up extrem art unilat/ltd (93931) $238 $476 2.4×
Echo Heart Xthoracic,Limited (93308) $457.50 $915 2.0×
EEG awake and asleep (95819) $426.50 $853 2.1×
EEG extended monitoring 61-119 minutes (95813) $632.50 $1,265 3.1×
Electrical Stimulation Ea 15 Min (97032) $71.50 $143 4.9×
Electrocardiogram Tracing (93005) $133 $266 2.4×
Emergency Dept Visit Level 2 (99282) $189 $378 1.3×
Emergency Dept Visit Level 3 (99283) $266.50 $533 1.0×
Emergency Dept Visit Level 4 (99284) $406.50 $813 1.0×
Er level 1 (99281) $170 $340 2.1×
Er level v (99285) $611.50 $1,223 1.1×
Evaluate pt use of inhaler (94664) $113.50 $227 0.5×
Evaluate Speech Production (92522) $182 $364 1.6×
Evaluate Swallowing Function (92610) $149.50 $299 1.8×
External ECG rec>48hr<7d recording (93242) $77.50 $155 2.2×
External ECG rec>7d<15d recording (93246) $114 $228 3.2×
Extracranial Bilat Study (93880) $315 $630 1.4×
Extracranial Uni/Ltd Study (93882) $352.50 $705 3.5×
Group Therapeutic Procedures (97150) $32 $64 1.8×
Icd Device Progr Eval Mult (93284) $36 $72 1.0×
Im Adm Intransl/Oral 1 Vaccine (90473) $37.50 $75 0.5×
Img retina detcj/mntr ds poc auton a/r uni/bi (92229) $57 $114 1.0×
Img retina detcj/mntr ds rem clin staff uni/bi (92227) $29.50 $59 0.5×
Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) $19.50 $39 0.5×
Immunization administration (90471)
range across 2 matching MRF lines		 $9.50–$39 $19–$78 varies
Interrog eval crtd sins bat modulj sys ip w/ (93146) $123.50 $247 1.0×
Interrog eval crtd sins bat modulj sys ip wo (93145) $123.50 $247 1.0×
Interrogate Subq Defib (93261) $36 $72 1.0×
Iontophoresis 15 min (97033) $49.50 $99 2.6×
Irrig Drug Delivery Device (96523) $57 $114 1.0×
IV infusion hydration each additional hour (96361) $190 $380 4.2×
IV infusion hydration initial 31 min-1 hour (96360)
range across 2 matching MRF lines		 $237.50–$238 $475–$476 varies
IV infusion ther proph addl sequential to 1 hr (96367) $228 $456 3.3×
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines		 $231.50–$232 $463–$464 varies
IV push initial (96374)
range across 2 matching MRF lines		 $147.50–$148 $295–$296 varies
Liver Elastography W/O Imag W/I&R (91200) $123 $246 1.0×
Lwr Xtr Vasc Stdy Bilat (93924) $295 $590 1.4×
Mchnl sclp cool cap sply head meas fitg&educaj (97007) $1,360 $2,720 1.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $41.50 $83 1.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $41.50 $83 1.1×
Methacholine challenge (94070) $358 $716 1.0×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $389.50 $779 1.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 3 matching MRF lines		 $191–$196 $382–$392 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $389.50 $779 1.0×
Nerve Conduction Studies 1-2 Studies (95907) $241 $482 1.2×
Nerve Conduction Studies 3-4 Studies (95908) $207 $414 1.0×
Nerve conduction studies 5-6 studies (95909) $207 $414 1.0×
Nerve conduction studies 7-8 studies (95910) $357.50 $715 1.0×
Nerve Conduction Studies 9-10 Studies (95911) $357.50 $715 1.0×
Neuromuscular Reeducation (97112) $49.50 $99 1.5×
Nitric oxide expired gas determination (95012) $72.50 $145 2.0×
Optokinetic Nystagmus Test (92544) $214 $428 1.7×
Oral Function Therapy (92526) $109 $218 1.3×
Oscillating Tracking Test (92545) $430 $860 2.1×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $25 $50 1.2×
Ot eval high complexity (97167) $183 $366 1.8×
Ot Eval Low Complex (97165) $183 $366 1.8×
Ot Eval Moderate Complexity (97166) $183 $366 1.8×
Ot manual therapy 15 min (97140) $49.50 $99 1.8×
Ot paraffin bath (97018) $30 $60 5.0×
Ot Re-Eval Est Plan Care (97168) $115 $230 1.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $125 $250 1.0×
Phlebotomy therapeutic (99195)
range across 2 matching MRF lines		 $129.50–$130 $259–$260 varies
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $76 $152 1.3×
Plethysmography (94726) $312.50 $625 0.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $45 $90 1.0×
Psych diag eval w/med srvcs (90792) $187 $374 1.1×
Psytx Crisis Initial 60 Min (90839) $170.50 $341 1.0×
Pt Eval High Complex (97163) $219.50 $439 2.2×
Pt eval low complex 20 min (97161) $208 $416 2.1×
Pt Eval Mod Complex (97162) $219.50 $439 2.2×
Pt gait training 15 min (97116) $49.50 $99 1.7×
Pt group caregiver training (97552) $20.50 $41 0.9×
Pt mechanical traction (97012) $51 $102 3.6×
Pt Re-Eval Est Plan Care (97164) $109 $218 1.6×
Pulm function test by gas (94727) $207.50 $415 1.0×
Pulmonary Stress Testing (94618) $228 $456 1.8×
Pure Tone Audiometry Air (92552) $121 $242 0.9×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $316.50 $633 1.0×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $35.50 $71 1.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $192.50 $385 1.0×
Self Care Mngment Training (97535) $74.50 $149 2.3×
Sleep study unattended (95806) $493.50 $987 2.4×
Slp caregiver training 1st 30 min (97550) $41.50 $83 0.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $207 $414 1.0×
Speech Audiometry Complete (92556) $57 $114 1.0×
Speech sound lang comprehen (92523) $373.50 $747 1.6×
Spin/Brain Pump Refil & Main (95991) $294 $588 1.0×
Spirometry (94010) $387 $774 1.9×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 2 matching MRF lines		 $69–$70 $138–$140 varies
Ther/Proph/Diag Iv Inf Init (96365) $278.50 $557 1.4×
Therapeutic Activities (97530) $49.50 $99 1.4×
Tobacco Use Cessation Intensive >10 Minutes (99407) $36 $72 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $36 $72 1.0×
Trans Care Mgmt 14 Day Disch (99495) $128 $256 1.0×
Trans Care Mgmt 7 Day Disch (99496) $128 $256 1.0×
Tte w/doppler, complete (93306) $722 $1,444 1.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $154 $308 2.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $58.50 $117 1.3×
Tympanometry (92567)
range across 2 matching MRF lines		 $37.50–$40.50 $75–$81 varies
Tympanometry and reflex threshold measurements (92550) $158.50 $317 0.8×
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines		 $134–$268 $268–$536 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923) $272 $544 1.3×
Vent Mgmt Inpat Init Day (94002) $772 $1,544 1.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $764.50 $1,529 1.3×

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.