Visits & medical services prices at Providence St. Joseph Medical Center
Polson, MT · every code in this section with a posted price and a Medicare benchmark.
264 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) | $48 | $60 | 0.4× |
| Actinotherapy Ultraviolet Light (96900) | $49.60 | $62 | 1.3× |
| Acupunct W/Stimul 15 Min (97813) | $79.20 | $99 | 2.7× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $48 | $60 | 1.2× |
| Advncd Care Plan 30 Min (99497) | $123.20 | $154 | 1.2× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$12–$16.80 | $15–$21 | varies |
| Allg test perq & ic drug/biol immed react w/ i&r (95018) | $29.60 | $37 | 0.8× |
| Allg tstg perq & ic venoms immed react w/i&r (95017) | $12.80 | $16 | 0.4× |
| Analyze Neurostim Simple (95971) | $71.20 | $89 | 0.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $68 | $85 | 4.7× |
| Assessment of aphasia per hr (96105) | $135.20 | $169 | 1.4× |
| Assmt & care planning pt w/cognitive impairment (99483) range across 2 matching MRF lines |
$406.40–$408.80 | $508–$511 | varies |
| Behavral qualit analys voice (92524) | $164 | $205 | 1.5× |
| Blink reflex test (95933) | $119.20 | $149 | 2.0× |
| Brief Emotional/Behav Assmt (96127) | $7.20 | $9 | 0.2× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$57.60–$58.40 | $72–$73 | varies |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$63.20–$64 | $79–$80 | varies |
| Car seat/bed test 60 min (94780) | $73.60 | $92 | 1.9× |
| Cardiac Stress Tst,Tracing Only (93017) | $403.20 | $504 | 1.8× |
| Cardiopulmonary resuscitation (92950) | $587.20 | $734 | 2.7× |
| Cardioversion (92960) range across 2 matching MRF lines |
$227.20–$228.80 | $284–$286 | varies |
| Care mgmt services behavioral hlth cond 20 mins (99484) | $64 | $80 | 1.7× |
| Caregiver hlth risk assmt score doc stnd instrm (96161) range across 2 matching MRF lines |
$4–$4.80 | $5–$6 | varies |
| Cbt 1st hour (94644) | $86.40 | $108 | 0.6× |
| Cervical Vemp Testing W/I&R (92517) | $192 | $240 | 1.5× |
| Chemo Anti-Neopl Sq/Im (96401) | $102.40 | $128 | 1.4× |
| Chemo Hormon Antineopl Sq/Im (96402) range across 2 matching MRF lines |
$48.80–$53.60 | $61–$67 | varies |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$60.80–$128 | $76–$160 | varies |
| Chemo IV push addl drug (96411) | $95.20 | $119 | 1.3× |
| Chemother Prolong Infuse W/Pump (96416) | $216 | $270 | 0.6× |
| Chemotherapy Unspecified (96549) | $86.40 | $108 | 1.8× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $108 | $135 | 1.5× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$309.60–$613.60 | $387–$767 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $216.80 | $271 | 0.6× |
| Chest Wall Manipulation (94668) | $120 | $150 | 0.9× |
| Chiropract manj 3-4 regions (98941) | $59.20 | $74 | 2.7× |
| Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) | $40.80 | $51 | 1.8× |
| Chiropractic manipulative treatment (CMT); spinal, 5 regions Facility (98942) | $76.80 | $96 | 3.5× |
| Chron Care Mgmt Srvc 20 Min (99490) range across 2 matching MRF lines |
$92–$92.80 | $115–$116 | varies |
| Color Vision Xm Extended Anomaloscope/Equiv (92283) | $81.60 | $102 | 1.4× |
| Color/duplex Doppler, complete (93975) | $864 | $1,080 | 3.5× |
| Color/duplex Doppler, limited (93976) | $624.80 | $781 | 5.8× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $84.80 | $106 | 2.6× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $202.40 | $253 | 1.1× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $214.40 | $268 | 1.6× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $98.40 | $123 | 1.6× |
| Continuous Pulse Ox (94762) | $178.40 | $223 | 1.4× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $243.20 | $304 | 1.1× |
| Cpt initial (94667) | $152 | $190 | 1.1× |
| Critical care first hour (99291) | $404.80 | $506 | 0.5× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$148.80–$150.40 | $186–$188 | varies |
| Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) | $401.60 | $502 | 2.0× |
| Dialysis One Evaluation (90945) | $1,357.60 | $1,697 | 3.2× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $824.80 | $1,031 | 3.4× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $636.80 | $796 | 6.0× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $716.80 | $896 | 2.9× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $747.20 | $934 | 7.0× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $932 | $1,165 | 3.8× |
| Dup-scan xtr veins unilateral/limited study (93971) | $432.80 | $541 | 4.1× |
| Duplex Scan Hemodialysis Access (93990) | $434.40 | $543 | 4.1× |
| Duplex up extrem art bilat (93930) | $761.60 | $952 | 3.1× |
| Duplex up extrem art unilat/ltd (93931) | $795.20 | $994 | 7.4× |
| Echo Congenital Complete (93303) | $508.80 | $636 | 0.9× |
| Echo Heart Xthoracic,Limited (93308) | $145.60 | $182 | 0.6× |
| Echo transesophageal (93312) | $346.40 | $433 | 0.6× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $341.60 | $427 | 0.6× |
| Elec alys implt brn npgt prgrmg 1st 15 min (95983) | $73.60 | $92 | 0.8× |
| Electrical Stimulation Ea 15 Min (97032) | $32.80 | $41 | 2.2× |
| Electrocardiogram Tracing (93005) | $9.60 | $12 | 0.2× |
| Emergency Dept Visit Level 2 (99282) | $61.60 | $77 | 0.4× |
| Emergency Dept Visit Level 3 (99283) | $104.80 | $131 | 0.4× |
| Emergency Dept Visit Level 4 (99284) | $176.80 | $221 | 0.4× |
| Emg 3 Extremities (95863) | $312 | $390 | 2.4× |
| Emg 4 Extremities (95864) | $329.60 | $412 | 2.5× |
| Er level 1 (99281) | $32 | $40 | 0.4× |
| Er level v (99285) | $256.80 | $321 | 0.4× |
| Evaluate pt use of inhaler (94664) range across 2 matching MRF lines |
$24.80–$27.20 | $31–$34 | varies |
| Evaluate Speech Production (92522) | $167.20 | $209 | 1.5× |
| Evaluate Swallowing Function (92610) | $128 | $160 | 1.5× |
| Evaluation of speech fluency (92521) | $200.80 | $251 | 1.5× |
| Evoked Auditory Test,Limited (92587) | $32.80 | $41 | 0.1× |
| Exercise test for bronchospasm (94617) | $182.40 | $228 | 1.3× |
| External ECG rec>48hr<7d recording (93242) | $17.60 | $22 | 0.5× |
| External ECG rec>7d<15d recording (93246) | $17.60 | $22 | 0.5× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $204.80 | $256 | 1.5× |
| External Ecg Scanning Analysis Report (93226) | $51.20 | $64 | 0.8× |
| Extracranial Bilat Study (93880) | $279.20 | $349 | 1.1× |
| Extracranial Uni/Ltd Study (93882) | $376 | $470 | 3.5× |
| Fundus photography (92250) | $55.20 | $69 | 0.4× |
| Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) | $299.20 | $374 | 1.4× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $650.40 | $813 | 0.7× |
| Group Therapeutic Procedures (97150) | $52.80 | $66 | 2.9× |
| Holter monitor recording (93225) | $27.20 | $34 | 0.2× |
| Ic Tsts W/Allgic Xtrcs Dlyd Typ Rxn W/Reading (95028) | $18.40 | $23 | 0.5× |
| Icd Device Interrogate (93289) | $105.60 | $132 | 2.8× |
| Icd device progr eval dual (93283) range across 2 matching MRF lines |
$144–$148 | $180–$185 | varies |
| Icd Device Progr Eval Mult (93284) range across 2 matching MRF lines |
$155.20–$160 | $194–$200 | varies |
| Icm Device Eval (93290) | $77.60 | $97 | 2.0× |
| Ilr Device Eval Progr (93285) | $88 | $110 | 2.3× |
| Ilr Device Interrogate (93291) | $72 | $90 | 2.4× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $16.80 | $21 | 0.2× |
| Img retina detcj/mntr ds rem clin staff uni/bi (92227) | $26.40 | $33 | 0.4× |
| Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) | $44.80 | $56 | 1.2× |
| Immunization administration (90471) range across 5 matching MRF lines |
$16.80–$35.20 | $21–$44 | varies |
| Ingestion challenge test initial 120 minutes (95076) | $185.60 | $232 | 0.5× |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $52.80 | $66 | 0.1× |
| Inital newborn e/m (99460) | $136.80 | $171 | 1.0× |
| Interrogate Subq Defib (93261) | $106.40 | $133 | 2.8× |
| Intracutaneous tests w/allergenic extracts (95024) | $12 | $15 | 0.2× |
| Iontophoresis 15 min (97033) | $37.60 | $47 | 2.0× |
| Irrig Drug Delivery Device (96523) range across 2 matching MRF lines |
$36–$39.20 | $45–$49 | varies |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$18.40–$19.20 | $23–$24 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$46.40–$50.40 | $58–$63 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) | $131.20 | $164 | 1.8× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $30.40 | $38 | 0.6× |
| IV push initial (96374) range across 2 matching MRF lines |
$52.80–$57.60 | $66–$72 | varies |
| Lung Function Test (Mbc/Mvv) (94200) | $148.80 | $186 | 2.5× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $464 | $580 | 2.1× |
| Mechanical chest wall oscillation per session (94669) | $249.60 | $312 | 1.1× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 2 matching MRF lines |
$47.20–$48 | $59–$60 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$53.60–$55.20 | $67–$69 | varies |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $25.60 | $32 | 1.5× |
| Methacholine challenge (94070) | $296 | $370 | 0.8× |
| Motility study esophagus (91010) | $321.60 | $402 | 0.8× |
| Motion Fluoroscopy/Swallow (92611) | $136.80 | $171 | 1.5× |
| Multiple Sleep Latency Test (95805) | $1,591.20 | $1,989 | 1.8× |
| Muscle Test 2 Limbs (95861) | $229.60 | $287 | 1.7× |
| Muscle Test One Limb (95860) | $164.80 | $206 | 1.2× |
| Nasopharyngoscopy (92511) range across 2 matching MRF lines |
$172–$175.20 | $215–$219 | varies |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) | $272 | $340 | 1.2× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) range across 2 matching MRF lines |
$244–$524 | $305–$655 | varies |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) range across 2 matching MRF lines |
$244–$479.20 | $305–$599 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$62.40–$64.80 | $78–$81 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 2 matching MRF lines |
$69.60–$73.60 | $87–$92 | varies |
| Nerve Conduction Studies 1-2 Studies (95907) | $132 | $165 | 0.6× |
| Nerve Conduction Studies 11-12 Studies (95912) | $360.80 | $451 | 0.9× |
| Nerve conduction studies 13 or more studies (95913) | $421.60 | $527 | 1.1× |
| Nerve Conduction Studies 3-4 Studies (95908) | $164 | $205 | 0.7× |
| Nerve conduction studies 5-6 studies (95909) | $197.60 | $247 | 0.9× |
| Nerve conduction studies 7-8 studies (95910) | $257.60 | $322 | 0.7× |
| Nerve Conduction Studies 9-10 Studies (95911) | $309.60 | $387 | 0.8× |
| Neurobehavioral Status Exam (96116) | $136.80 | $171 | 0.6× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $151.20 | $189 | 1.2× |
| Neuromuscular Reeducation (97112) | $55.20 | $69 | 1.7× |
| Newborn resuscitation (99465) | $209.60 | $262 | 0.3× |
| Nitric oxide expired gas determination (95012) | $28 | $35 | 0.7× |
| Nonphysician Telephone Assessment 11-20 Min (98967) range across 2 matching MRF lines |
$35.20–$36.80 | $44–$46 | varies |
| Nonphysician Telephone Assessment 21-30 Min (98968) range across 2 matching MRF lines |
$49.60–$51.20 | $62–$64 | varies |
| Nonphysician Telephone Assessment 5-10 Min (98966) range across 2 matching MRF lines |
$19.20–$20 | $24–$25 | varies |
| Nose Allergy Test (95065) | $44 | $55 | 1.2× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $191.20 | $239 | 0.5× |
| Oral Function Therapy (92526) range across 2 matching MRF lines |
$103.20–$115.20 | $129–$144 | varies |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $46.40 | $58 | 0.9× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $71.20 | $89 | 1.5× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$46.40–$47.20 | $58–$59 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$65.60–$68 | $82–$85 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) | $85.60 | $107 | 3.9× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $104.80 | $131 | 4.8× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $125.60 | $157 | 5.7× |
| Ot eval high complexity (97167) | $153.60 | $192 | 1.5× |
| Ot Eval Low Complex (97165) range across 3 matching MRF lines |
$92.80–$154.40 | $116–$193 | varies |
| Ot Eval Moderate Complexity (97166) | $123.20 | $154 | 1.2× |
| Ot manual therapy 15 min (97140) | $66.40 | $83 | 2.4× |
| Ot paraffin bath (97018) | $9.60 | $12 | 1.6× |
| Ot Re-Eval Est Plan Care (97168) | $92.80 | $116 | 1.4× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $170.40 | $213 | 1.3× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $159.20 | $199 | 1.2× |
| Patch/Application Test Specify Number Tests (95044) | $8 | $10 | 0.0× |
| Patient-initiated spirometric phys/qhp r&i only (94016) | $36 | $45 | 1.5× |
| Pdt dstr prmlg les phys/qhp (96573) | $326.40 | $408 | 1.6× |
| Pdt dstr prmlg les skn illum/activj per day (96567) | $196 | $245 | 1.0× |
| Penile Vascular Study,Ltd or F/U (93981) | $230.40 | $288 | 2.2× |
| Percutaneous tests w/allergenic extracts (95004) | $5.60 | $7 | 0.0× |
| Phlebotomy therapeutic (99195) | $133.60 | $167 | 1.0× |
| Photo patch test(s) (95052) | $8.80 | $11 | 0.1× |
| Photochemotx Psoralens&Ultraviolet Puva (96912) | $148 | $185 | 2.5× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $78.40 | $98 | 1.3× |
| Physical Performance Test (97750) | $45.60 | $57 | 1.4× |
| Plethysmography (94726) | $302.40 | $378 | 0.8× |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$82.40–$86.40 | $103–$108 | varies |
| Pm device progr eval dual (93280) range across 2 matching MRF lines |
$115.20–$120.80 | $144–$151 | varies |
| Pm device progr eval multi (93281) range across 3 matching MRF lines |
$123.20–$128 | $154–$160 | varies |
| Pm Device Progr Eval Sngl (93279) range across 2 matching MRF lines |
$99.20–$102.40 | $124–$128 | varies |
| Pm/Icd Remote Tech Serv (93296) | $30.40 | $38 | 0.8× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $1,818.40 | $2,273 | 2.1× |
| Polysom <6 yrs 4/> paramtrs (95782) | $890.40 | $1,113 | 1.0× |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) | $890.40 | $1,113 | 1.0× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $21.60 | $27 | 0.5× |
| Prepj& Antigen Allergen Immunotherapy 1 Insect (95145) | $52.80 | $66 | 1.1× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) range across 2 matching MRF lines |
$116.80–$121.60 | $146–$152 | varies |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $94.40 | $118 | 0.9× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 2 matching MRF lines |
$14.40–$16 | $18–$20 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 2 matching MRF lines |
$17.60–$18.40 | $22–$23 | varies |
| Psych diag eval w/med srvcs (90792) | $287.20 | $359 | 1.6× |
| Psychiatric diagnostic evaluation (90791) | $256.80 | $321 | 1.4× |
| Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) | $92.80 | $116 | 0.7× |
| Psytx Crisis Initial 60 Min (90839) | $207.20 | $259 | 1.1× |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) | $16 | $20 | 0.4× |
| Pt Eval High Complex (97163) | $153.60 | $192 | 1.6× |
| Pt eval low complex 20 min (97161) | $92.80 | $116 | 0.9× |
| Pt Eval Mod Complex (97162) | $123.20 | $154 | 1.3× |
| Pt gait training 15 min (97116) | $58.40 | $73 | 2.0× |
| Pt mechanical traction (97012) | $65.60 | $82 | 4.6× |
| Pt Re-Eval Est Plan Care (97164) | $123.20 | $154 | 1.8× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) range across 2 matching MRF lines |
$4–$4.80 | $5–$6 | varies |
| Pulm function test by gas (94727) | $64 | $80 | 0.3× |
| Pulmonary Stress Testing (94618) | $51.20 | $64 | 0.4× |
| Pure Tone Audiometry Air (92552) range across 2 matching MRF lines |
$49.60–$60 | $62–$75 | varies |
| Quan puplmtry phy/qhp uni/bi (95919) | $24 | $30 | 0.2× |
| Rapid Desensitization Procedure Each Hour (95180) | $208 | $260 | 0.5× |
| Refill/Maint Portable Pump (96521) | $213.60 | $267 | 1.0× |
| Rem interrog icpms <30 d phys/qhp (93297) | $89.60 | $112 | 2.3× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) | $150.40 | $188 | 3.9× |
| Rem mntr physiol param 1st dev supply ea 30 d (99454) | $66.40 | $83 | 1.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $12 | $15 | 0.3× |
| Respiratory flow volume loop (94375) | $302.40 | $378 | 1.4× |
| Right Heart Cath (93451) | $1,215.20 | $1,519 | 0.4× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $293.60 | $367 | 1.4× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $155.20 | $194 | 1.3× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $73.60 | $92 | 1.5× |
| Same day nb discharge (99463) range across 2 matching MRF lines |
$157.60–$160 | $197–$200 | varies |
| Self Care Mngment Training (97535) | $49.60 | $62 | 1.5× |
| Self-meas bp pt educaj/traing & dev calibration (99473) | $17.60 | $22 | 0.6× |
| Sensory Integration Ea 15 Min (97533) | $38.40 | $48 | 0.6× |
| Sleep study attended (95807) | $1,223.20 | $1,529 | 3.2× |
| Sleep study unattended (95806) | $143.20 | $179 | 0.6× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $317.60 | $397 | 1.4× |
| Speech sound lang comprehen (92523) | $343.20 | $429 | 1.5× |
| Spirometry (94010) range across 2 matching MRF lines |
$39.20–$40.80 | $49–$51 | varies |
| Ssep lower limbs (95926) | $209.60 | $262 | 1.0× |
| Standardized Cognitive Performance Testing (96125) | $191.20 | $239 | 1.9× |
| Stress Tte Only (93350) | $272 | $340 | 0.5× |
| Temp transcutaneous pacing (92953) | $468 | $585 | 0.7× |
| Testing Autonomic Nervous System Function (95923) | $175.20 | $219 | 1.3× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $30.40 | $38 | 1.4× |
| Ther Ivntj Ea Addl 15 Min (97130) | $29.60 | $37 | 1.4× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $52.80 | $66 | 1.4× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $68 | $85 | 2.3× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $111.20 | $139 | 1.1× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $21.60 | $27 | 0.3× |
| Ther/Proph/Diag Iv Inf Init (96365) | $88.80 | $111 | 0.4× |
| Therapeutic Activities (97530) | $48.80 | $61 | 1.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$40.80–$41.60 | $51–$52 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$21.60–$22.40 | $27–$28 | varies |
| Trans Care Mgmt 14 Day Disch (99495) | $300 | $375 | 2.2× |
| Trans Care Mgmt 7 Day Disch (99496) | $404 | $505 | 3.0× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) | $61.60 | $77 | 1.6× |
| Tte w/doppler, complete (93306) | $288.80 | $361 | 0.5× |
| Tte W/O Doppler Complete (93307) | $556.80 | $696 | 2.3× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $118.40 | $148 | 1.6× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $22.40 | $28 | 0.5× |
| Tympanometry (92567) | $24 | $30 | 0.6× |
| Tympanometry and reflex threshold measurements (92550) | $32.80 | $41 | 0.1× |
| Upr/L Xtremity Art 2 Levels (93922) | $121.60 | $152 | 0.9× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $154.40 | $193 | 0.7× |
| Veeg 2-12 hr intmt mntr (95712) | $464 | $580 | 1.2× |
| Veeg 2-12 hr unmonitored (95711) | $464 | $580 | 2.1× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $888.80 | $1,111 | 2.3× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $888.80 | $1,111 | 2.3× |
| Vent Mgmt Inpat Init Day (94002) | $1,054.40 | $1,318 | 1.7× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $742.40 | $928 | 1.2× |
| Vital capacity, total (94150) | $38.40 | $48 | 0.3× |
| Wheelchair Mgmt Ea 15 Min (97542) | $52 | $65 | 1.7× |
| Whirlpool Therapy (97022) | $24 | $30 | 1.5× |
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.