Visits & medical services prices at Providence Holy Family Hospital

Spokane, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Actigraphy Testing Recording Analysis I&R (95803) $129.50 $185 2.0×
Admn Sarscov2 Vacc 1 Dose (90480) $53.90 $77 1.2×
Aep threshold estimation mlt frequencies i&r (92652) $681.80 $974 2.8×
Airway Inhalation Treatment (94640) $870.80 $1,244 3.6×
Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) $463.40 $662 2.1×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $42.70 $61 3.0×
Assessment of aphasia per hr (96105) $243.60 $348 2.5×
Behavral qualit analys voice (92524) $155.40 $222 1.4×
Biofeedback training any modality (90901) $46.20 $66 1.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $591.50 $845 1.4×
Canalith repositioning proc (95992) $114.10 $163 2.8×
Car seat/bed test 60 min (94780) $104.30 $149 2.5×
Cardiac Stress Tst,Tracing Only (93017) $874.30 $1,249 3.6×
Cardiopulmonary resuscitation (92950) $460.60 $658 1.9×
Cardioversion (92960) $1,681.40 $2,402 2.3×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $6,557.60 $9,368 1.8×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $6,557.60 $9,368 1.8×
Chemo Admin Peritoneal Cavity (96446) $973.70 $1,391 2.6×
Chemo Anti-Neopl Sq/Im (96401) $313.60 $448 3.9×
Chemo Hormon Antineopl Sq/Im (96402) $181.30 $259 2.3×
Chemo IV infusion addl hr (96415) $130.90 $187 1.6×
Chemo IV push addl drug (96411) $164.50 $235 2.1×
Chemother Prolong Infuse W/Pump (96416) $861 $1,230 2.3×
Chemotherapy Into Cns (96450) $884.80 $1,264 2.4×
Chemotherapy Unspecified (96549) $114.80 $164 2.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $170.80 $244 2.1×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $884.80 $1,264 2.4×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $508.90 $727 1.4×
Chest Wall Manipulation (94668) $150.50 $215 1.0×
Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) $621.60 $888 1.5×
Color/duplex Doppler, complete (93975) $362.60 $518 1.4×
Color/duplex Doppler, limited (93976) $362.60 $518 3.1×
Community/Work Reintegration Trainj Ea 15 Min (97537) $32.90 $47 1.0×
Continuous Pulse Ox (94762) $572.60 $818 4.0×
Coronary Art/Grft Angio S&I (93455) $10,809.40 $15,442 3.0×
Coronary Artery Angio S&I (93454) $6,557.60 $9,368 1.8×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $366.10 $523 1.5×
Cpt initial (94667) $299.60 $428 2.0×
Critical care first hour (99291)
range across 2 matching MRF lines		 $6,768.30–$7,242.20 $9,669–$10,346 varies
Debridement Open Wound 20 Sq Cm< (97597) $562.80 $804 2.5×
Dialysis One Evaluation (90945) $2,520 $3,600 5.4×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,015 $1,450 3.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $256.20 $366 2.2×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $362.60 $518 1.4×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $256.20 $366 2.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $362.60 $518 1.4×
Dup-scan xtr veins unilateral/limited study (93971) $256.20 $366 2.2×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $853.30 $1,219 3.2×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $411.60 $588 3.5×
Duplex Scan Hemodialysis Access (93990) $482.30 $689 4.1×
Duplex up extrem art bilat (93930) $1,041.60 $1,488 3.9×
Duplex up extrem art unilat/ltd (93931) $256.20 $366 2.2×
Echo Congenital Complete (93303) $1,771.70 $2,531 2.9×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines		 $621.60–$746.20 $888–$1,066 varies
Echo transesophageal (93312) $1,696.80 $2,424 2.8×
Eeg 41-60 Minutes (95812) $1,122.80 $1,604 4.7×
EEG awake and asleep (95819) $519.40 $742 2.2×
EEG awake drowsy (95816) $519.40 $742 2.2×
EEG cerebral death evaluation (95824) $1,162 $1,660 2.8×
EEG cont rec w/video by tech min 8 channels (95700) $863.10 $1,233 3.6×
EEG extended monitoring 61-119 minutes (95813) $519.40 $742 2.2×
Eeg Sleep Only (95822) $519.40 $742 2.2×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $643.30 $919 2.7×
EEG w/o vid 2-12hr cont mntr (95707) $737.10 $1,053 3.1×
EEG w/o vid ea 12-26hr intmt (95709) $1,186.50 $1,695 2.9×
EEG wo vid ea 12-26hr unmntr (95708) $1,591.10 $2,273 3.8×
Electrical Stimulation Ea 15 Min (97032) $40.60 $58 2.8×
Electrocardiogram Tracing (93005) $98.70 $141 1.5×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines		 $541.10–$578.90 $773–$827 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines		 $800.10–$856.10 $1,143–$1,223 varies
Emergency Dept Visit Level 4 (99284)
range across 3 matching MRF lines		 $1,285.90–$1,376.20 $1,837–$1,966 varies
Er level 1 (99281)
range across 2 matching MRF lines		 $334.60–$357.70 $478–$511 varies
Er level v (99285)
range across 2 matching MRF lines		 $2,849.70–$3,049.20 $4,071–$4,356 varies
Evaluate pt use of inhaler (94664)
range across 2 matching MRF lines		 $475.30–$537.60 $679–$768 varies
Evaluate Speech Production (92522) $149.80 $214 1.3×
Evaluate Swallowing Function (92610) $261.80 $374 3.1×
Evaluation of speech fluency (92521) $185.50 $265 1.4×
Exercise test for bronchospasm (94617) $385 $550 2.6×
Exhaled Air Analysis O2 (94680) $621.60 $888 4.3×
Extracranial Bilat Study (93880) $546 $780 2.1×
Extracranial Uni/Ltd Study (93882) $546 $780 4.7×
F-up/limited tthrc echo congenital car anomaly (93304) $1,401.40 $2,002 2.3×
Flexible endoscopic eval swallow c/v rec (92612) $351.40 $502 1.8×
Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) $440.30 $629 0.5×
Gi tract capsule endoscopy (91110) $2,103.50 $3,005 2.1×
Group Therapeutic Procedures (97150) $55.30 $79 3.1×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $6,557.60 $9,368 1.8×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $2,136.40 $3,052 2.8×
Immunization administration (90471)
range across 4 matching MRF lines		 $16.10–$99.40 $23–$142 varies
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $1,478.40 $2,112 3.6×
Insert/Place Heart Catheter (93503) $4,023.60 $5,748 2.3×
Intracranial Complete Study (93886) $1,074.50 $1,535 4.0×
Iontophoresis 15 min (97033) $46.90 $67 2.5×
Irrig Drug Delivery Device (96523) $241.50 $345 3.7×
IV infusion hydration each additional hour (96361) $102.20 $146 2.0×
IV infusion hydration initial 31 min-1 hour (96360) $355.60 $508 1.5×
IV infusion ther proph addl sequential to 1 hr (96367) $149.10 $213 1.9×
IV infusion therapy prophylaxis/dx ea hour (96366) $102.20 $146 2.0×
IV push initial (96374) $355.60 $508 1.5×
L Hrt Art/Grft Angio (93459) $6,557.60 $9,368 1.8×
Lung Function Test (Mbc/Mvv) (94200) $225.40 $322 3.4×
Lwr Xtr Vasc Stdy Bilat (93924) $572.60 $818 2.4×
Mechanical chest wall oscillation per session (94669) $150.50 $215 0.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $99.40 $142 3.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $99.40 $142 2.7×
Methacholine challenge (94070) $1,059.10 $1,513 2.5×
Motion Fluoroscopy/Swallow (92611) $318.50 $455 3.5×
Multiple Family Group Psychotherapy (90849)
range across 2 matching MRF lines		 $206.50–$310.10 $295–$443 varies
Multiple Sleep Latency Test (95805) $1,698.20 $2,426 1.8×
Nasopharyngoscopy (92511) $473.20 $676 2.1×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines		 $553–$913.50 $790–$1,305 varies
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608)
range across 2 matching MRF lines		 $516.60–$898.10 $738–$1,283 varies
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $319.90 $457 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $562.80 $804 1.2×
Neurobehavioral Status Exam (96116) $429.80 $614 1.8×
Neuromuscular Reeducation (97112) $63 $90 1.9×
Newborn resuscitation (99465) $384.30 $549 0.5×
Ophth Medical Xm&Eval Intermediate New Pt (92002) $280 $400 1.9×
Oral Function Therapy (92526) $90.30 $129 1.1×
Oral Speech Device Eval (92597) $264.60 $378 3.7×
Orthc/Prostc Mgmt Sbsq Enc (97763) $58.10 $83 1.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $58.10 $83 1.3×
Ot Contrast Bath Ea 15 Min (97034) $31.50 $45 2.2×
Ot eval high complexity (97167) $244.30 $349 2.4×
Ot Eval Low Complex (97165) $182 $260 1.8×
Ot Eval Moderate Complexity (97166) $212.80 $304 2.1×
Ot manual therapy 15 min (97140) $53.20 $76 1.9×
Ot paraffin bath (97018) $42 $60 7.0×
Ot Re-Eval Est Plan Care (97168) $72.10 $103 1.1×
Oxygen Uptake Rest Indirect (94690) $253.40 $362 3.9×
Penile Vascular Study,Ltd or F/U (93981) $362.60 $518 3.1×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $308 $440 1.3×
Perq Transcath Cls Aortic (93591) $41,885.90 $59,837 2.1×
Perq Transcath Cls Mitral (93590) $41,885.90 $59,837 2.1×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $11,757.20 $16,796 1.9×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $14,389.20 $20,556 1.1×
Phlebotomy therapeutic (99195) $311.50 $445 2.1×
Physical Performance Test (97750) $50.40 $72 1.5×
Plethysmography (94726) $389.20 $556 0.9×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,698.20 $2,426 1.8×
Polysom <6 yrs 4/> paramtrs (95782) $866.60 $1,238 0.9×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $866.60 $1,238 0.9×
Prq Card Angio/Athrect 1 Art (92924) $18,063.50 $25,805 1.4×
Prq Card Stent W/Angio 1 Vsl (92928) $14,389.20 $20,556 1.1×
Prq Card Stent/Ath/Angio (92933) $14,389.20 $20,556 0.7×
Prq Revasc Byp Graft 1 Vsl (92937) $14,389.20 $20,556 1.1×
Psychiatric diagnostic evaluation (90791)
range across 2 matching MRF lines		 $384.30–$410.90 $549–$587 varies
Psytx Crisis Initial 60 Min (90839)
range across 2 matching MRF lines		 $314.30–$336 $449–$480 varies
Pt Eval High Complex (97163) $244.30 $349 2.5×
Pt eval low complex 20 min (97161) $182 $260 1.9×
Pt Eval Mod Complex (97162) $212.80 $304 2.2×
Pt gait training 15 min (97116) $47.60 $68 1.6×
Pt mechanical traction (97012) $69.30 $99 4.8×
Pt Re-Eval Est Plan Care (97164) $72.10 $103 1.1×
Pulmonary service/procedure (94799) $78.40 $112 0.5×
Pulmonary Stress Testing (94618) $385 $550 2.6×
R Hrt Art/Grft Angio (93457) $17,875.20 $25,536 4.9×
R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) $8,584.80 $12,264 2.4×
R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) $8,584.80 $12,264 2.4×
R hrt coronary artery angio (93456) $15,922.90 $22,747 4.4×
R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) $8,584.80 $12,264 2.4×
R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) $8,584.80 $12,264 2.4×
R&L Hrt Cath W/Ventriclgrphy (93453) $13,256.60 $18,938 3.7×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $529.90 $757 1.4×
Refill/Maint Portable Pump (96521) $517.30 $739 2.2×
Refill/Maint Pump/Resvr Syst (96522) $361.90 $517 1.5×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $377.30 $539 2.5×
Respiratory flow volume loop (94375) $159.60 $228 0.7×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $192.50 $275 2.9×
Right Heart Cath (93451) $7,152.60 $10,218 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $319.90 $457 1.4×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $229.60 $328 1.9×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $98 $140 2.1×
Self Care Mngment Training (97535) $69.30 $99 2.1×
Sensory Integration Ea 15 Min (97533) $39.20 $56 0.6×
Short-latency somatosens ep std upr limbs (95925) $836.50 $1,195 3.5×
Sleep study unattended (95806) $340.90 $487 1.4×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $359.80 $514 1.5×
Somatosensory Testing (95938) $658.70 $941 0.7×
Speech sound lang comprehen (92523) $310.80 $444 1.4×
Spin/Brain Pump Refil & Main (95991) $529.90 $757 1.5×
Spirometry (94010) $389.20 $556 1.6×
Ssep lower limbs (95926) $836.50 $1,195 3.5×
Standardized Cognitive Performance Testing (96125) $305.90 $437 3.0×
Subcutaneous Infusion Each Additional Hour (96370) $117.60 $168 2.3×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $575.40 $822 2.4×
Subq Infusion Additional Pump Infusion Site (96371) $188.30 $269 2.3×
Surfactant Admin Thru Tube (94610) $70 $100 0.3×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $247.10 $353 2.1×
Temp transcutaneous pacing (92953) $609 $870 0.8×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $133 $190 5.9×
Ther Ivntj Ea Addl 15 Min (97130) $133 $190 6.3×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $48.30 $69 1.6×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $352.80 $504 3.4×
Ther/Prop/Diag Inj/Inf Proc (96379) $100.10 $143 1.9×
Ther/Proph/Diag Inj Ia (96373) $575.40 $822 2.4×
Ther/Proph/Diag Inj Sc/Im (96372) $149.10 $213 1.9×
Ther/Proph/Diag Iv Inf Init (96365) $578.20 $826 2.4×
Therapeutic Activities (97530) $72.10 $103 2.1×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $787.50 $1,125 1.9×
Tobacco Use Cessation Intensive >10 Minutes (99407) $67.20 $96 1.6×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $59.50 $85 1.4×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $385.70 $551 3.3×
Tte w/doppler, complete (93306) $1,219.40 $1,742 2.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $74.20 $106 1.0×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $56.70 $81 2.4×
Tx/Pro/Dx Inj New Drug Addon (96375) $149.10 $213 2.9×
Unlisted otorhinolaryngological service (92700) $45.50 $65 1.4×
Upr/L Xtremity Art 2 Levels (93922) $308 $440 2.1×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $1,498 $2,140 6.2×
Vasopneumatic device (97016) $30.80 $44 2.6×
Veeg 2-12 Hr Cont Mntr (95713) $1,591.10 $2,273 3.8×
Veeg 2-12 hr intmt mntr (95712) $863.10 $1,233 2.1×
Veeg 2-12 hr unmonitored (95711) $863.10 $1,233 3.6×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $1,591.10 $2,273 3.8×
Veeg Ea 12-26 Hr Unmntr (95714) $1,505.70 $2,151 3.6×
Vent Mgmt Inpat Init Day (94002) $1,623.30 $2,319 2.4×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,623.30 $2,319 2.4×
Visual Evoked Potential Test (95930) $558.60 $798 2.3×
Vital capacity, total (94150) $250.60 $358 1.7×
Wada Activation Test Hemispheric Function W/Eeg (95958) $421.40 $602 0.4×
Wheelchair Mgmt Ea 15 Min (97542) $45.50 $65 1.5×
Whirlpool Therapy (97022) $79.80 $114 5.1×

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.