Visits & medical services prices at Provident Hospital of Chicago
Chicago, IL · every code in this section with a posted price and a Medicare benchmark.
557 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 1St psychiatric collab care mgmt 1st 70 mins (99492) | $182 | $260 | 1.7× |
| 1St set-up & prgrmg phys/qhp of wearable cvdfb (93745) range across 2 matching MRF lines |
$105.70–$549.50 | $151–$785 | varies |
| Ablate Heart Dysrhythm Focus (93650) likely a partial charge, not the full procedure |
$1,052.80 | $1,504 | 0.1× |
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) | $230.30 | $329 | 1.7× |
| Acoustic Reflex Testing (92568) | $67.20 | $96 | 1.7× |
| Actigraphy Testing Recording Analysis I&R (95803) | $78.40 | $112 | 1.2× |
| Actinotherapy Ultraviolet Light (96900) range across 2 matching MRF lines |
$42.70–$67.20 | $61–$96 | varies |
| Acupunct W/Stimul 15 Min (97813) range across 3 matching MRF lines |
$51.80–$63 | $74–$90 | varies |
| Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) | $51.80 | $74 | 1.7× |
| Admn Sarscov2 Vacc 1 Dose (90480) range across 2 matching MRF lines |
$30.80–$75.60 | $44–$108 | varies |
| Advncd Care Plan 30 Min (99497) range across 2 matching MRF lines |
$123.20–$182 | $176–$260 | varies |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $386.40 | $552 | 1.7× |
| Aep threshold estimation mlt frequencies i&r (92652) | $386.40 | $552 | 1.7× |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$16.10–$392 | $23–$560 | varies |
| Airway resistance by oscillometry (94728) range across 2 matching MRF lines |
$23.10–$230.30 | $33–$329 | varies |
| Allg test perq & ic drug/biol immed react w/ i&r (95018) range across 2 matching MRF lines |
$11.90–$67.20 | $17–$96 | varies |
| Allg tstg perq & ic venoms immed react w/i&r (95017) range across 2 matching MRF lines |
$6.30–$51.80 | $9–$74 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) | $42.70 | $61 | 0.3× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) range across 2 matching MRF lines |
$11.90–$238 | $17–$340 | varies |
| Analysis Cochlear Implt Pt <7 Yr Prgrmg (92601) | $230.30 | $329 | 1.7× |
| Analyze neurostim complex (95972) range across 2 matching MRF lines |
$67.20–$170.10 | $96–$243 | varies |
| Analyze neurostim no prog (95970) range across 2 matching MRF lines |
$30.80–$238 | $44–$340 | varies |
| Analyze Neurostim Simple (95971) range across 2 matching MRF lines |
$66.50–$170.10 | $95–$243 | varies |
| Analyze Pacemaker System (93724) range across 2 matching MRF lines |
$418.60–$549.50 | $598–$785 | varies |
| Ans parasymp & symp w/tilt (95924) | $161 | $230 | 0.7× |
| Ant Sgm Imaging W/Fluoroscein Angio & I&R (92287) range across 2 matching MRF lines |
$40.60–$238 | $58–$340 | varies |
| Ant sgm imaging w/microscopy endothelial analy (92286) range across 2 matching MRF lines |
$37.80–$238 | $54–$340 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $25.90 | $37 | 1.8× |
| Arrhythmia Induction (93618) | $429.80 | $614 | 0.3× |
| Assessment of aphasia per hr (96105) | $170.10 | $243 | 1.8× |
| Assessment of tinnitus (92625) | $230.30 | $329 | 1.7× |
| Assmt & care planning pt w/cognitive impairment (99483) | $182 | $260 | 1.7× |
| Audiometry Air & Bone (92553) | $230.30 | $329 | 1.7× |
| Auditory Function, 60 Min (92620) | $230.30 | $329 | 1.7× |
| Basic vestibular evaluation (92540) | $386.40 | $552 | 1.7× |
| Behavral qualit analys voice (92524) | $192.50 | $275 | 1.8× |
| Biofeedback training any modality (90901) range across 2 matching MRF lines |
$30.10–$34.30 | $43–$49 | varies |
| Bioimpedance Cv Analysis (93701) | $49 | $70 | 0.3× |
| Bis Xtracell Fluid Analysis (93702) | $235.20 | $336 | 1.7× |
| Blink reflex test (95933) range across 2 matching MRF lines |
$58.80–$105.70 | $84–$151 | varies |
| Breath hydrogen/methane test (91065) range across 2 matching MRF lines |
$18.20–$386.40 | $26–$552 | varies |
| Breathing response to hypoxia (94450) range across 2 matching MRF lines |
$42–$230.30 | $60–$329 | varies |
| Brief Emotional/Behav Assmt (96127) | $67.20 | $96 | 1.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$19.60–$667.80 | $28–$954 | varies |
| Bundle of his recording (93600) likely a partial charge, not the full procedure |
$230.30 | $329 | 0.0× |
| C motor evoked uppr limbs (95928) range across 2 matching MRF lines |
$144.90–$1,535.80 | $207–$2,194 | varies |
| C motor evoked upr&lwr limbs (95939) range across 2 matching MRF lines |
$214.20–$1,535.80 | $306–$2,194 | varies |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$53.90–$63 | $77–$90 | varies |
| Car seat/bed test 60 min (94780) range across 2 matching MRF lines |
$38.50–$67.20 | $55–$96 | varies |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$70.70–$386.40 | $101–$552 | varies |
| Cardiopulmonary exercise testing (94621) range across 2 matching MRF lines |
$124.60–$667.80 | $178–$954 | varies |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$333.90–$386.40 | $477–$552 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$178.50–$1,182.30 | $255–$1,689 | varies |
| Cardioversion elective internal (92961) | $453.60 | $648 | 0.6× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $57.40 | $82 | 2.2× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $742 | $1,060 | 0.2× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $587.30 | $839 | 0.2× |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$112–$238 | $160–$340 | varies |
| Chemo Admin Peritoneal Cavity (96446) | $590.80 | $844 | 1.7× |
| Chemo Anti-Neopl Sq/Im (96401) | $128.80 | $184 | 1.7× |
| Chemo Hormon Antineopl Sq/Im (96402) | $128.80 | $184 | 1.7× |
| Chemo Ia Push (96420) range across 2 matching MRF lines |
$189.70–$590.80 | $271–$844 | varies |
| Chemo intralesional up to 7 (96405) | $128.80 | $184 | 1.7× |
| Chemo IV infusion addl hr (96415) | $128.80 | $184 | 1.7× |
| Chemo IV push addl drug (96411) | $128.80 | $184 | 1.7× |
| Chemother Prolong Infuse W/Pump (96416) | $590.80 | $844 | 1.7× |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) range across 2 matching MRF lines |
$252.70–$590.80 | $361–$844 | varies |
| Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) | $84 | $120 | 1.7× |
| Chemotherapy Into Cns (96450) range across 3 matching MRF lines |
$128.10–$590.80 | $183–$844 | varies |
| Chemotherapy Intracavitary (96440) | $590.80 | $844 | 1.7× |
| Chemotherapy Unspecified (96549) | $84 | $120 | 1.7× |
| Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) | $590.80 | $844 | 1.7× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $128.80 | $184 | 1.7× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $590.80 | $844 | 1.7× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $590.80 | $844 | 1.7× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $590.80 | $844 | 1.7× |
| Chest Wall Manipulation (94668) range across 2 matching MRF lines |
$70.70–$238 | $101–$340 | varies |
| Chron Care Mgmt Srvc 20 Min (99490) range across 2 matching MRF lines |
$82.60–$182 | $118–$260 | varies |
| Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) | $667.80 | $954 | 1.7× |
| Cmptr ophth dx img ant segmt (92132) range across 2 matching MRF lines |
$28–$105.70 | $40–$151 | varies |
| Colon Motility 6 Hr Study (91117) | $228.90 | $327 | 1.0× |
| Color Vision Xm Extended Anomaloscope/Equiv (92283) range across 2 matching MRF lines |
$16.10–$105.70 | $23–$151 | varies |
| Color/duplex Doppler, complete (93975) range across 2 matching MRF lines |
$100.80–$427 | $144–$610 | varies |
| Color/duplex Doppler, limited (93976) range across 2 matching MRF lines |
$69.30–$187.60 | $99–$268 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $57.40 | $82 | 1.8× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) range across 2 matching MRF lines |
$149.80–$317.80 | $214–$454 | varies |
| Compre cptr mtn alys w/dyn plntr pres meas walkg (96001) | $160.30 | $229 | 0.2× |
| Comprehensive computer-based motion analysis by video-taping and 3D kinematics; Facility (96000) | $128.10 | $183 | 0.3× |
| Comprehensive Hearing Test (92557) | $230.30 | $329 | 1.7× |
| Computerized dynamic posturography (92548) | $238 | $340 | 1.7× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) range across 2 matching MRF lines |
$30.10–$105.70 | $43–$151 | varies |
| Computerized Ophthalmic Imaging Retina (92134) range across 2 matching MRF lines |
$32.20–$105.70 | $46–$151 | varies |
| Conditioning Play Audiometry (92582) | $230.30 | $329 | 1.7× |
| Cont gluc mntr physician/qhp provided equiptment (95250) range across 2 matching MRF lines |
$238.70–$272.30 | $341–$389 | varies |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $111.30 | $159 | 1.8× |
| Contact Lens Fit,Corneoscleral Lens (92313) range across 2 matching MRF lines |
$64.40–$238 | $92–$340 | varies |
| Continuous Pulse Ox (94762) range across 2 matching MRF lines |
$43.40–$230.30 | $62–$329 | varies |
| Cornea hysteresis determin impulse stimj uni/bi (92145) range across 2 matching MRF lines |
$25.90–$105.70 | $37–$151 | varies |
| Corneal Topography (92025) range across 2 matching MRF lines |
$34.30–$105.70 | $49–$151 | varies |
| Coronary Art/Grft Angio S&I (93455) | $556.50 | $795 | 0.2× |
| Coronary Artery Angio S&I (93454) | $476.70 | $681 | 0.1× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$61.60–$392 | $88–$560 | varies |
| Cpt initial (94667) range across 2 matching MRF lines |
$49.70–$238 | $71–$340 | varies |
| Critical care first hour (99291) range across 2 matching MRF lines |
$385.70–$1,327.20 | $551–$1,896 | varies |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) range across 2 matching MRF lines |
$143.50–$667.80 | $205–$954 | varies |
| Dark Adaptation Eye Exam (92284) range across 2 matching MRF lines |
$25.20–$798.70 | $36–$1,141 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) | $359.10 | $513 | 1.7× |
| Developmental tst admin phys/qhp 1st hour (96112) range across 2 matching MRF lines |
$199.50–$230.30 | $285–$329 | varies |
| Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming Facility (92602) | $230.30 | $329 | 1.7× |
| Dialysis One Evaluation (90945) range across 2 matching MRF lines |
$142.80–$746.20 | $204–$1,066 | varies |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) | $667.80 | $954 | 1.7× |
| Duodenal motility study (91022) range across 2 matching MRF lines |
$137.90–$667.80 | $197–$954 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) range across 2 matching MRF lines |
$74.20–$427 | $106–$610 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) range across 2 matching MRF lines |
$45.50–$187.60 | $65–$268 | varies |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) range across 2 matching MRF lines |
$109.20–$187.60 | $156–$268 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) range across 2 matching MRF lines |
$70–$427 | $100–$610 | varies |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 2 matching MRF lines |
$43.40–$187.60 | $62–$268 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$61.60–$427 | $88–$610 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$38.50–$187.60 | $55–$268 | varies |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) range across 2 matching MRF lines |
$74.90–$427 | $107–$610 | varies |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) range across 2 matching MRF lines |
$46.20–$187.60 | $66–$268 | varies |
| Duplex Scan Hemodialysis Access (93990) range across 2 matching MRF lines |
$44.80–$187.60 | $64–$268 | varies |
| Duplex up extrem art bilat (93930) range across 2 matching MRF lines |
$70.70–$427 | $101–$610 | varies |
| Duplex up extrem art unilat/ltd (93931) range across 2 matching MRF lines |
$44.10–$187.60 | $63–$268 | varies |
| Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) | $230.30 | $329 | 1.7× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) | $230.30 | $329 | 1.7× |
| Dyn surf EMG walkg/funcjal actv 1-12 musc (96002) range across 2 matching MRF lines |
$34.30–$386.40 | $49–$552 | varies |
| Ear and throat examination (92502) | $161 | $230 | 0.3× |
| Ear Protector Evaluation (92596) | $67.20 | $96 | 1.7× |
| ECG/monitoring and analysis (93271) range across 2 matching MRF lines |
$170.10–$242.90 | $243–$347 | varies |
| Echo Congenital Complete (93303) range across 2 matching MRF lines |
$109.20–$977.20 | $156–$1,396 | varies |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$45.50–$427 | $65–$610 | varies |
| Echo r-t 2d w/probe placement only (93313) range across 2 matching MRF lines |
$977.20 | $29–$1,396 | 1.7× |
| Echo transesophag congen probe plcmt only (93316) range across 2 matching MRF lines |
$46.90–$977.20 | $67–$1,396 | varies |
| Echo transesophag montr cardiac pump functj (93318) range across 2 matching MRF lines |
$190.40–$977.20 | $272–$1,396 | varies |
| Echo transesophageal (93312) range across 2 matching MRF lines |
$191.10–$977.20 | $273–$1,396 | varies |
| Echo Transesophageal - Congenital Tee Complete (93315) range across 2 matching MRF lines |
$224–$977.20 | $320–$1,396 | varies |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $147.70 | $211 | 0.3× |
| Eeg 41-60 Minutes (95812) range across 2 matching MRF lines |
$107.10–$386.40 | $153–$552 | varies |
| EEG awake and asleep (95819) range across 2 matching MRF lines |
$104.30–$386.40 | $149–$552 | varies |
| EEG awake drowsy (95816) range across 2 matching MRF lines |
$103.60–$386.40 | $148–$552 | varies |
| EEG cerebral death evaluation (95824) range across 2 matching MRF lines |
$70–$667.80 | $100–$954 | varies |
| EEG cont rec w/video by tech min 8 channels (95700) range across 2 matching MRF lines |
$386.40–$417.90 | $552–$597 | varies |
| EEG extended monitoring 61-119 minutes (95813) range across 2 matching MRF lines |
$161–$386.40 | $230–$552 | varies |
| Eeg Sleep Only (95822) range across 2 matching MRF lines |
$104.30–$386.40 | $149–$552 | varies |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) range across 2 matching MRF lines |
$218.40–$386.40 | $312–$552 | varies |
| EEG w/o vid 2-12hr cont mntr (95707) range across 2 matching MRF lines |
$386.40–$841.40 | $552–$1,202 | varies |
| EEG w/o vid ea 12-26hr intmt (95709) range across 2 matching MRF lines |
$667.80–$1,259.30 | $954–$1,799 | varies |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) range across 2 matching MRF lines |
$667.80–$1,575.70 | $954–$2,251 | varies |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) range across 2 matching MRF lines |
$386.40–$665.70 | $552–$951 | varies |
| EEG wo vid ea 12-26hr unmntr (95708) range across 2 matching MRF lines |
$322–$667.80 | $460–$954 | varies |
| EKG signal averaged (93278) range across 2 matching MRF lines |
$23.10–$105.70 | $33–$151 | varies |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) range across 2 matching MRF lines |
$81.20–$170.10 | $116–$243 | varies |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) range across 2 matching MRF lines |
$60.90–$67.20 | $87–$96 | varies |
| Electrical Stimulation Ea 15 Min (97032) | $25.90 | $37 | 1.8× |
| Electro-Oculography (92270) range across 2 matching MRF lines |
$74.90–$238 | $107–$340 | varies |
| Electrocardiogram Tracing (93005) | $105.70 | $151 | 1.7× |
| Electroconvulsive Therapy (90870) | $1,535.80 | $2,194 | 1.7× |
| Electrogastrography, diagnostic, transcutaneous; Non-Facility (91132) | $50.40 | $72 | 0.2× |
| Electrogastrography, diagnostic, transcutaneous; with provocative testing Non-Facility (91133) | $62.30 | $89 | 0.4× |
| Electrophysiologic Follow-Up W/Pac/Rec W/Arrhyt (93624) likely a partial charge, not the full procedure |
$480.20 | $686 | 0.1× |
| Electrophysiology Evaluation (93642) | $503.30 | $719 | 0.4× |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$79.80–$301 | $114–$430 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$137.90–$528.50 | $197–$755 | varies |
| Emergency Dept Visit Level 4 (99284) range across 2 matching MRF lines |
$235.20–$1,068.20 | $336–$1,526 | varies |
| Emg 3 Extremities (95863) range across 2 matching MRF lines |
$180.60–$230.30 | $258–$329 | varies |
| Emg 4 Extremities (95864) range across 2 matching MRF lines |
$191.10–$230.30 | $273–$329 | varies |
| Endomyocardial Biopsy (93505) range across 2 matching MRF lines |
$419.30–$5,645.50 | $599–$8,065 | varies |
| Ep & ablate supravent arrhyt (93653) likely a partial charge, not the full procedure |
$1,513.40 | $2,162 | 0.1× |
| Ep & ablate ventric tachy (93654) likely a partial charge, not the full procedure |
$1,823.50 | $2,605 | 0.1× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) likely a partial charge, not the full procedure |
$1,227.80 | $1,754 | 0.1× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) likely a partial charge, not the full procedure |
$762.30 | $1,089 | 0.1× |
| Ep Esophageal Recording Atria+Pacing (93616) | $106.40 | $152 | 0.1× |
| Er level 1 (99281) range across 2 matching MRF lines |
$21.70–$165.20 | $31–$236 | varies |
| Er level v (99285) range across 2 matching MRF lines |
$338.10–$1,327.20 | $483–$1,896 | varies |
| Ergonovine provocation test (93024) | $97.30 | $139 | 0.2× |
| Esoph Atrial Electrogram (93615) | $65.80 | $94 | 0.1× |
| Esophageal Capsule Endoscopy (91111) | $87.50 | $125 | 0.1× |
| Esophagus acid perfusion test esophagitis (91030) | $87.50 | $125 | 0.2× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) | $95.90 | $137 | 0.2× |
| Esophgl funcj g-esop rflx impd eltrd prolng (91038) | $109.90 | $157 | 0.3× |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $230.30 | $329 | 1.7× |
| Evaluate pt use of inhaler (94664) range across 2 matching MRF lines |
$37.10–$392 | $53–$560 | varies |
| Evaluate Speech Production (92522) | $196.70 | $281 | 1.8× |
| Evaluate Swallowing Function (92610) | $124.60 | $178 | 1.5× |
| Evaluation of speech fluency (92521) | $235.20 | $336 | 1.8× |
| Evoked Auditory Test,Limited (92587) | $386.40 | $552 | 1.7× |
| Excimer laser tx psoriasis 250-500 sq cm (96921) range across 2 matching MRF lines |
$85.40–$359.10 | $122–$513 | varies |
| Excimer laser tx psoriasis >500 sq cm (96922) | $727.30 | $1,039 | 1.7× |
| Excimer laser tx psoriasis tot area <250 sq cm (96920) range across 2 matching MRF lines |
$75.60–$359.10 | $108–$513 | varies |
| Exercise test for bronchospasm (94617) | $56.70 | $81 | 0.4× |
| Exhaled Air Analysis O2 (94680) range across 2 matching MRF lines |
$23.10–$230.30 | $33–$329 | varies |
| External ECG rec>48hr<7d recording (93242) range across 2 matching MRF lines |
$21.70–$67.20 | $31–$96 | varies |
| External ECG rec>48hr<7d scanning alys w/report (93243) range across 2 matching MRF lines |
$238–$431.90 | $340–$617 | varies |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$62.30–$105.70 | $89–$151 | varies |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$71.40–$427 | $102–$610 | varies |
| Extracranial Uni/Ltd Study (93882) range across 2 matching MRF lines |
$46.20–$187.60 | $66–$268 | varies |
| Eye Allergy Tests (95060) | $72.80 | $104 | 0.5× |
| Eye exam w anesth; complete (92018) range across 2 matching MRF lines |
$207.90–$4,251.10 | $297–$6,073 | varies |
| Eye exam w anesth; limited (92019) range across 2 matching MRF lines |
$4,251.10 | $155–$6,073 | 1.7× |
| Eye Exam With Photos (92230) range across 2 matching MRF lines |
$50.40–$667.80 | $72–$954 | varies |
| F-up/limited tthrc echo congenital car anomaly (93304) range across 2 matching MRF lines |
$63–$977.20 | $90–$1,396 | varies |
| Facial nerve function studies (92516) | $386.40 | $552 | 1.7× |
| Filtered Speech Test (92571) | $67.20 | $96 | 1.7× |
| Fitting of spectacle mounted low vision aid; single element system Facility (92354) range across 2 matching MRF lines |
$25.90–$67.20 | $37–$96 | varies |
| Fitting of spectacle mounted low vision aid; telescopic or other compound lens system Non-Facility OP Neurology,… (92355) range across 2 matching MRF lines |
$41.30–$67.20 | $59–$96 | varies |
| Fitting of spectacle prosthesis for aphakia; monofocal Facility (92352) range across 2 matching MRF lines |
$27.30–$105.70 | $39–$151 | varies |
| Fitting of spectacle prosthesis for aphakia; multifocal Facility (92353) range across 2 matching MRF lines |
$37.10–$105.70 | $53–$151 | varies |
| Flexible Endoscopic Eval Laryn Sensory C/V Rec (92614) | $115.50 | $165 | 0.8× |
| Flexible endoscopic eval swallow c/v rec (92612) | $116.90 | $167 | 0.6× |
| Flexible ndsc eval swlng&laryn sens c/v rec (92616) | $176.40 | $252 | 0.8× |
| Fluorescein angiography (92235) range across 2 matching MRF lines |
$74.90–$386.40 | $107–$552 | varies |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) range across 2 matching MRF lines |
$325.50–$1,535.80 | $465–$2,194 | varies |
| Fundus photography (92250) range across 2 matching MRF lines |
$37.10–$238 | $53–$340 | varies |
| Gastric motility studies (91020) | $137.90 | $197 | 0.3× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) | $93.80 | $134 | 0.2× |
| Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) | $94.50 | $135 | 0.4× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $160.30 | $229 | 0.2× |
| Gi tract capsule endoscopy (91110) | $214.20 | $306 | 0.2× |
| Gi wireless capsule measure (91112) | $201.60 | $288 | 0.2× |
| Gonioscopy (92020) range across 2 matching MRF lines |
$30.10–$238 | $43–$340 | varies |
| Group Therapeutic Procedures (97150) | $32.20 | $46 | 1.8× |
| Health Behavior Assessment/Re-Assessment (96156) | $182 | $260 | 1.7× |
| Health behavior ivntj fam w/pt f2f 1st 30 min (96167) | $67.20 | $96 | 1.7× |
| Health behavior ivntj group f2f 1st 30 min (96164) | $67.20 | $96 | 1.7× |
| Health behavior ivntj indiv f2f 1st 30 min (96158) | $317.80 | $454 | 1.7× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $820.40 | $1,172 | 0.2× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) range across 2 matching MRF lines |
$114.80–$1,227.10 | $164–$1,753 | varies |
| High altitude simulation test (94452) range across 2 matching MRF lines |
$27.30–$238 | $39–$340 | varies |
| High Altitude Simulatj W/Phys I&R W/O2 Titration (94453) range across 2 matching MRF lines |
$35.70–$238 | $51–$340 | varies |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$32.90–$238 | $47–$340 | varies |
| Hubbard tank 15 min (97036) | $56.70 | $81 | 1.6× |
| Hypnotherapy (90880) | $182 | $260 | 1.7× |
| Ic Tsts W/Allgic Xtrcs Dlyd Typ Rxn W/Reading (95028) range across 2 matching MRF lines |
$23.10–$67.20 | $33–$96 | varies |
| Icd Device Interrogate (93289) range across 2 matching MRF lines |
$65.10–$67.20 | $93–$96 | varies |
| Icd device progr eval dual (93283) range across 2 matching MRF lines |
$67.20–$99.40 | $96–$142 | varies |
| Icd Device Progr Eval Mult (93284) range across 2 matching MRF lines |
$67.20–$107.80 | $96–$154 | varies |
| Icm Device Eval (93290) range across 2 matching MRF lines |
$37.10–$67.20 | $53–$96 | varies |
| Ilr Device Eval Progr (93285) range across 2 matching MRF lines |
$46.20–$67.20 | $66–$96 | varies |
| Ilr Device Interrogate (93291) range across 2 matching MRF lines |
$31.50–$51.80 | $45–$74 | varies |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $16.71 | $23.87 | 0.2× |
| Img retina detcj/mntr ds rem clin staff uni/bi (92227) | $105.70 | $151 | 1.7× |
| Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) range across 2 matching MRF lines |
$30.10–$67.20 | $43–$96 | varies |
| Immunization administration (90471) | $16.71 | $23.87 | 0.2× |
| Indocyanine-green angrph w/multiframe i&r uni/bi (92240) range across 2 matching MRF lines |
$87.50–$386.40 | $125–$552 | varies |
| Ingestion challenge test initial 120 minutes (95076) range across 2 matching MRF lines |
$114.80–$667.80 | $164–$954 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) range across 2 matching MRF lines |
$72.80–$667.80 | $104–$954 | varies |
| Inital newborn e/m (99460) | $151.90 | $217 | 1.1× |
| Insert/Place Heart Catheter (93503) range across 2 matching MRF lines |
$157.50–$2,814.70 | $225–$4,021 | varies |
| Interrogate Subq Defib (93261) range across 2 matching MRF lines |
$65.10–$67.20 | $93–$96 | varies |
| Interrogation eval in person wr defibrillator (93292) range across 2 matching MRF lines |
$37.10–$67.20 | $53–$96 | varies |
| Interrogation vad in person (93750) | $65.80 | $94 | 0.6× |
| Intra-atrial pacing (93610) likely a partial charge, not the full procedure |
$319.90 | $457 | 0.0× |
| Intra-atrial recording (93602) likely a partial charge, not the full procedure |
$226.80 | $324 | 0.0× |
| Intracranial Complete Study (93886) range across 2 matching MRF lines |
$84.70–$427 | $121–$610 | varies |
| Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens,… (95027) range across 2 matching MRF lines |
$9.10–$51.80 | $13–$74 | varies |
| Intracutaneous tests w/allergenic extracts (95024) range across 2 matching MRF lines |
$105.70 | $4–$151 | 1.7× |
| Intraventricular pacing (93612) likely a partial charge, not the full procedure |
$318.50 | $455 | 0.0× |
| Iontophoresis 15 min (97033) | $34.30 | $49 | 1.8× |
| Irrig Drug Delivery Device (96523) | $105.70 | $151 | 1.7× |
| Ischemic limb exercise test (95875) range across 2 matching MRF lines |
$108.50–$230.30 | $155–$329 | varies |
| IV infusion hydration each additional hour (96361) | $84 | $120 | 1.7× |
| IV infusion hydration initial 31 min-1 hour (96360) | $380.80 | $544 | 1.7× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $128.80 | $184 | 1.7× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $84 | $120 | 1.7× |
| IV push initial (96374) | $380.80 | $544 | 1.7× |
| L Hrt Art/Grft Angio (93459) | $667.10 | $953 | 0.2× |
| L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) | $457.80 | $654 | 0.1× |
| Laryngeal Function Studies (92520) | $238 | $340 | 1.7× |
| Liver Elastography W/O Imag W/I&R (91200) range across 2 matching MRF lines |
$20.30–$230.30 | $29–$329 | varies |
| Loudness balance test (92562) | $386.40 | $552 | 1.7× |
| Lung Function Test (Mbc/Mvv) (94200) range across 2 matching MRF lines |
$30.80–$105.70 | $44–$151 | varies |
| Lwr Xtr Vasc Stdy Bilat (93924) range across 2 matching MRF lines |
$46.90–$386.40 | $67–$552 | varies |
| Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor,… (95966) range across 2 matching MRF lines |
$386.40–$1,535.80 | $552–$2,194 | varies |
| Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral… (95965) range across 2 matching MRF lines |
$765.10–$1,535.80 | $1,093–$2,194 | varies |
| Meas Spiro Frcd Exp Flo Pre&Post Bronch Inf/2yrs (94012) | $386.40 | $552 | 1.7× |
| Measurement Lung Volumes Infant/Child/2 Yrs (94013) | $32.20 | $46 | 0.1× |
| Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age Facility (94011) | $133.70 | $191 | 1.0× |
| Mechanical chest wall oscillation per session (94669) | $46.90 | $67 | 0.2× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $48.30 | $69 | 1.5× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $56.70 | $81 | 1.5× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $27.30 | $39 | 1.6× |
| Methacholine challenge (94070) range across 2 matching MRF lines |
$53.20–$667.80 | $76–$954 | varies |
| Microvolt T-Wave Assess (93025) | $67.90 | $97 | 0.5× |
| Modification of contact lens (separate procedure), with medical supervision of adaptation Facility (92325) range across 2 matching MRF lines |
$83.30–$238 | $119–$340 | varies |
| Motility study esophagus (91010) | $667.80 | $954 | 1.7× |
| Motion Fluoroscopy/Swallow (92611) | $161 | $230 | 1.8× |
| Motor &/sens nrv cndj preconf eltrd array limb (95905) | $798.70 | $1,141 | 1.7× |
| Multiple Family Group Psychotherapy (90849) | $317.80 | $454 | 1.7× |
| Multiple Sleep Latency Test (95805) range across 2 matching MRF lines |
$105.70–$1,535.80 | $151–$2,194 | varies |
| Muscle Test 2 Limbs (95861) range across 2 matching MRF lines |
$148.40–$238 | $212–$340 | varies |
| Muscle Test Hemidiaphragm (95866) range across 2 matching MRF lines |
$120.40–$230.30 | $172–$329 | varies |
| Muscle Test Nonparaspinal (95870) range across 2 matching MRF lines |
$36.40–$238 | $52–$340 | varies |
| Muscle Test One Limb (95860) range across 2 matching MRF lines |
$93.10–$238 | $133–$340 | varies |
| Narcosynthesis (90865) | $317.80 | $454 | 1.7× |
| Nasal function studies (92512) | $386.40 | $552 | 1.7× |
| Nasopharyngoscopy (92511) | $357 | $510 | 1.7× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) range across 2 matching MRF lines |
$112.70–$386.40 | $161–$552 | varies |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) range across 2 matching MRF lines |
$74.90–$386.40 | $107–$552 | varies |
| Needle electromyography larynx (95865) range across 2 matching MRF lines |
$151.90–$238 | $217–$340 | varies |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) range across 2 matching MRF lines |
$36.40–$386.40 | $52–$552 | varies |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) range across 2 matching MRF lines |
$281.40–$386.40 | $402–$552 | varies |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $727.30 | $1,039 | 1.7× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) range across 2 matching MRF lines |
$44.80–$727.30 | $64–$1,039 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$38.50–$359.10 | $55–$513 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $727.30 | $1,039 | 1.7× |
| Nerve Conduction Studies 1-2 Studies (95907) range across 2 matching MRF lines |
$97.30–$386.40 | $139–$552 | varies |
| Nerve Conduction Studies 11-12 Studies (95912) range across 2 matching MRF lines |
$288.40–$667.80 | $412–$954 | varies |
| Nerve conduction studies 13 or more studies (95913) range across 2 matching MRF lines |
$341.60–$667.80 | $488–$954 | varies |
| Nerve Conduction Studies 3-4 Studies (95908) range across 2 matching MRF lines |
$122.50–$386.40 | $175–$552 | varies |
| Nerve conduction studies 5-6 studies (95909) range across 2 matching MRF lines |
$146.30–$386.40 | $209–$552 | varies |
| Nerve conduction studies 7-8 studies (95910) range across 2 matching MRF lines |
$192.50–$667.80 | $275–$954 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 2 matching MRF lines |
$240.80–$667.80 | $344–$954 | varies |
| Neurobehavioral Status Exam (96116) | $386.40 | $552 | 1.7× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) range across 2 matching MRF lines |
$62.30–$230.30 | $89–$329 | varies |
| Neuromuscular Reeducation (97112) | $58.10 | $83 | 1.8× |
| Newborn resuscitation (99465) range across 2 matching MRF lines |
$231.70–$1,182.30 | $331–$1,689 | varies |
| Nitric oxide expired gas determination (95012) | $35.70 | $51 | 0.9× |
| Nonphysician Telephone Assessment 11-20 Min (98967) | $40.60 | $58 | 1.6× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $56 | $80 | 1.6× |
| Nonphysician Telephone Assessment 5-10 Min (98966) | $21 | $30 | 1.5× |
| Nose Allergy Test (95065) | $50.40 | $72 | 1.3× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $667.80 | $954 | 1.7× |
| O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) range across 2 matching MRF lines |
$667.80 | $26–$954 | 1.7× |
| Oculoelectromyography (92265) range across 2 matching MRF lines |
$80.50–$105.70 | $115–$151 | varies |
| Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) range across 2 matching MRF lines |
$53.90–$238 | $77–$340 | varies |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) range across 2 matching MRF lines |
$140.70–$238.70 | $201–$341 | varies |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) range across 2 matching MRF lines |
$112.70–$238.70 | $161–$341 | varies |
| Ophth medical xm&eval intermediate estab pt (92012) range across 2 matching MRF lines |
$75.60–$238.70 | $108–$341 | varies |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) range across 2 matching MRF lines |
$68.60–$238.70 | $98–$341 | varies |
| Ophthalmodynamometry (92260) range across 2 matching MRF lines |
$16.80–$67.20 | $24–$96 | varies |
| Optokinetic Nystagmus Test (92544) | $230.30 | $329 | 1.7× |
| Oral Function Therapy (92526) | $149.10 | $213 | 1.8× |
| Oral Speech Device Eval (92597) | $128.80 | $184 | 1.8× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $90.30 | $129 | 1.8× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $82.60 | $118 | 1.8× |
| Oscillating Tracking Test (92545) | $386.40 | $552 | 1.7× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$37.10–$39.20 | $53–$56 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$39.20–$56 | $56–$80 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) range across 2 matching MRF lines |
$39.20–$75.60 | $56–$108 | varies |
| Osteopathic manipulative tx 7-8 body regions (98928) range across 2 matching MRF lines |
$39.20–$93.80 | $56–$134 | varies |
| Osteopathic manipulative tx 9-10 body regions (98929) range across 2 matching MRF lines |
$39.20–$110.60 | $56–$158 | varies |
| Ot Contrast Bath Ea 15 Min (97034) | $25.20 | $36 | 1.8× |
| Ot eval high complexity (97167) | $181.30 | $259 | 1.8× |
| Ot Eval Low Complex (97165) | $177.80 | $254 | 1.8× |
| Ot Eval Moderate Complexity (97166) | $181.30 | $259 | 1.8× |
| Ot manual therapy 15 min (97140) | $49 | $70 | 1.8× |
| Ot paraffin bath (97018) | $11.90 | $17 | 2.0× |
| Ot Prosthetic Training, Each 15 Min (97761) | $72.80 | $104 | 1.8× |
| Ot Re-Eval Est Plan Care (97168) | $126 | $180 | 1.8× |
| Ot rom hand (95852) | $10.50 | $15 | 0.5× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $231 | $330 | 1.7× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $231 | $330 | 1.7× |
| Oxygen Uptake Rest Indirect (94690) range across 2 matching MRF lines |
$7.70–$105.70 | $11–$151 | varies |
| Patch/Application Test Specify Number Tests (95044) | $1,535.80 | $2,194 | 1.7× |
| Patient-initiated spirometric phys/qhp r&i only (94016) | $45.50 | $65 | 1.8× |
| Patient-initiated spirometric recording (94015) | $63 | $90 | 0.3× |
| Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of… (94014) | $107.80 | $154 | 0.2× |
| Penile Vascular Study,Ltd or F/U (93981) range across 2 matching MRF lines |
$39.90–$187.60 | $57–$268 | varies |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) range across 2 matching MRF lines |
$62.30–$392 | $89–$560 | varies |
| Percutaneous tests w/allergenic extracts (95004) | $1,535.80 | $2,194 | 1.7× |
| Perq transcath closure pda (93582) likely a partial charge, not the full procedure |
$1,223.60 | $1,748 | 0.1× |
| Perq Transcath Cls Aortic (93591) likely a partial charge, not the full procedure |
$1,427.30 | $2,039 | 0.1× |
| Perq Transcath Cls Mitral (93590) likely a partial charge, not the full procedure |
$1,740.20 | $2,486 | 0.1× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) likely a partial charge, not the full procedure |
$826 | $1,180 | 0.1× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) likely a partial charge, not the full procedure |
$1,352.40 | $1,932 | 0.1× |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$177.10–$238 | $253–$340 | varies |
| Photo patch test(s) (95052) | $11.90 | $17 | 0.2× |
| Photo Tests (95056) | $93.10 | $133 | 0.7× |
| Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) range across 2 matching MRF lines |
$105.70–$203.70 | $151–$291 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) range across 4 matching MRF lines |
$48.30–$105.70 | $69–$151 | varies |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) range across 2 matching MRF lines |
$32.90–$105.70 | $47–$151 | varies |
| Physical Performance Test (97750) | $60.20 | $86 | 1.8× |
| Plethysmography (94726) range across 2 matching MRF lines |
$22.40–$667.80 | $32–$954 | varies |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$36.40–$67.20 | $52–$96 | varies |
| Pm device progr eval dual (93280) | $67.20 | $96 | 1.7× |
| Pm device progr eval multi (93281) range across 2 matching MRF lines |
$67.20–$74.20 | $96–$106 | varies |
| Pm Device Progr Eval Sngl (93279) range across 2 matching MRF lines |
$56–$67.20 | $80–$96 | varies |
| Pm/Icd Remote Tech Serv (93296) range across 2 matching MRF lines |
$56.70–$67.20 | $81–$96 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$226.80–$1,535.80 | $324–$2,194 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) range across 2 matching MRF lines |
$217.70–$1,535.80 | $311–$2,194 | varies |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) range across 3 matching MRF lines |
$236.60–$1,535.80 | $338–$2,194 | varies |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) range across 2 matching MRF lines |
$149.10–$1,535.80 | $213–$2,194 | varies |
| Positional nystagmus test (92542) | $238 | $340 | 1.7× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $5.60 | $8 | 0.1× |
| Prepj& Antigen Allergen Immunotherapy 1 Insect (95145) | $5.60 | $8 | 0.1× |
| Prepj& antigen allergen immunotherapy 2 insect (95146) | $5.60 | $8 | 0.1× |
| Prepj& Antigen Allergen Immunotherapy 3 Insect (95147) | $5.60 | $8 | 0.1× |
| Prepj& antigen allergen immunotherapy 5 insect (95149) | $5.60 | $8 | 0.1× |
| Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of… (92311) range across 2 matching MRF lines |
$74.90–$798.70 | $107–$1,141 | varies |
| Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and… (92316) range across 2 matching MRF lines |
$47.60–$238 | $68–$340 | varies |
| Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and… (92315) range across 2 matching MRF lines |
$32.20–$238 | $46–$340 | varies |
| Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and… (92317) range across 2 matching MRF lines |
$32.20–$67.20 | $46–$96 | varies |
| Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) range across 2 matching MRF lines |
$67.20–$74.20 | $96–$106 | varies |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) range across 2 matching MRF lines |
$67.20–$73.50 | $96–$105 | varies |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $182 | $260 | 1.7× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $19.60 | $28 | 0.4× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $23.10 | $33 | 0.5× |
| Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify… (95148) | $5.60 | $8 | 0.1× |
| Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single… (95144) | $5.60 | $8 | 0.1× |
| Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole… (95170) | $5.60 | $8 | 0.1× |
| Prosthesis service for aphakia, temporary (disposable or loan, including materials) Facility (92358) range across 2 matching MRF lines |
$21.70–$105.70 | $31–$151 | varies |
| Prq Card Angio/Athrect 1 Art (92924) likely a partial charge, not the full procedure |
$1,001 | $1,430 | 0.1× |
| Prq Card Stent W/Angio 1 Vsl (92928) likely a partial charge, not the full procedure |
$991.20 | $1,416 | 0.1× |
| Prq Card Stent/Ath/Angio (92933) likely a partial charge, not the full procedure |
$1,180.90 | $1,687 | 0.1× |
| Prq Revasc Byp Graft 1 Vsl (92937) likely a partial charge, not the full procedure |
$1,117.90 | $1,597 | 0.1× |
| Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) likely a partial charge, not the full procedure |
$2,447.90 | $3,497 | 0.1× |
| Prq trluml pulmonary art balloon angiop 1 vsl (92997) likely a partial charge, not the full procedure |
$1,141.70 | $1,631 | 0.1× |
| Psych diag eval w/med srvcs (90792) | $317.80 | $454 | 1.7× |
| Psychiatric diagnostic evaluation (90791) | $317.80 | $454 | 1.7× |
| Psychoanalysis (90845) | $317.80 | $454 | 1.7× |
| Psychological tst eval svc phys/qhp first hour (96130) | $386.40 | $552 | 1.7× |
| Psycl/Nrpsyc Tst Auto Result (96146) | $51.80 | $74 | 1.7× |
| Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) | $798.70 | $1,141 | 1.7× |
| Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) | $238 | $340 | 1.7× |
| Psytx Crisis Initial 60 Min (90839) | $317.80 | $454 | 1.7× |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) | $67.90 | $97 | 1.8× |
| Pt Eval High Complex (97163) | $176.40 | $252 | 1.8× |
| Pt eval low complex 20 min (97161) | $176.40 | $252 | 1.8× |
| Pt Eval Mod Complex (97162) | $176.40 | $252 | 1.8× |
| Pt gait training 15 min (97116) | $51.80 | $74 | 1.8× |
| Pt group caregiver training (97552) | $18.90 | $27 | 0.9× |
| Pt mechanical traction (97012) | $25.90 | $37 | 1.8× |
| Pt Re-Eval Est Plan Care (97164) | $121.80 | $174 | 1.8× |
| Pt ultraviolet (97028) range across 2 matching MRF lines |
$15.40–$16.10 | $22–$23 | varies |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) range across 2 matching MRF lines |
$5.60–$67.20 | $8–$96 | varies |
| Pulm function test by gas (94727) range across 2 matching MRF lines |
$22.40–$386.40 | $32–$552 | varies |
| Pulmonary service/procedure (94799) | $230.30 | $329 | 1.7× |
| Pulmonary Stress Testing (94618) range across 2 matching MRF lines |
$42–$238 | $60–$340 | varies |
| Pure Tone Audiometry Air (92552) | $238 | $340 | 1.7× |
| Quan puplmtry phy/qhp uni/bi (95919) range across 2 matching MRF lines |
$31.50–$238 | $45–$340 | varies |
| R Hrt Art/Grft Angio (93457) | $696.50 | $995 | 0.2× |
| R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) | $519.40 | $742 | 0.1× |
| R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) | $339.50 | $485 | 0.1× |
| R hrt coronary artery angio (93456) | $617.40 | $882 | 0.2× |
| R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) | $739.20 | $1,056 | 0.2× |
| R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) | $571.20 | $816 | 0.2× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $627.20 | $896 | 0.2× |
| Rapid Desensitization Procedure Each Hour (95180) range across 2 matching MRF lines |
$158.90–$798.70 | $227–$1,141 | varies |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) range across 2 matching MRF lines |
$177.10–$590.80 | $253–$844 | varies |
| Refill/Maint Portable Pump (96521) | $380.80 | $544 | 1.7× |
| Refill/Maint Pump/Resvr Syst (96522) | $380.80 | $544 | 1.7× |
| Rem interrog icpms <30 d phys/qhp (93297) range across 2 matching MRF lines |
$44.80–$67.20 | $64–$96 | varies |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) range across 2 matching MRF lines |
$44.80–$67.20 | $64–$96 | varies |
| Rem mntr physiol param 1st dev supply ea 30 d (99454) | $67.20 | $96 | 1.7× |
| Rem mntr physiol param 1st set up pt educaj eqp (99453) | $238.70 | $341 | 1.7× |
| Rem Mntr Wrls P-Art Prs Snr (93264) | $56.70 | $81 | 1.4× |
| Remote 30 Day Ecg Rev/Report (93270) range across 2 matching MRF lines |
$16.10–$67.20 | $23–$96 | varies |
| Remote 30 Day Ecg Tech Supp (93229) range across 2 matching MRF lines |
$667.80–$1,339.80 | $954–$1,914 | varies |
| Repair and refitting spectacles; spectacle prosthesis for aphakia Facility (92371) range across 2 matching MRF lines |
$22.40–$105.70 | $32–$151 | varies |
| Repet Tms Tx Subseq Motr Threshld W/Deliv & Mngt (90869) | $559.30 | $799 | 2.4× |
| Replacement of contact lens (92326) range across 2 matching MRF lines |
$70–$105.70 | $100–$151 | varies |
| Respiratory flow volume loop (94375) range across 2 matching MRF lines |
$26.60–$386.40 | $38–$552 | varies |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) range across 2 matching MRF lines |
$15.40–$105.70 | $22–$151 | varies |
| Right Heart Cath (93451) | $254.80 | $364 | 0.1× |
| Right ventricular recording (93603) | $228.20 | $326 | 0.2× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $359.10 | $513 | 1.7× |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) | $14 | $20 | 0.5× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $217.70 | $311 | 1.8× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $86.10 | $123 | 1.8× |
| Rx&Fitg Contact Corneal Lens Aphakia Both Eyes (92312) range across 2 matching MRF lines |
$87.50–$238 | $125–$340 | varies |
| Rx/Physical Eeg Activaj Phys/Qhp Attendance (95954) range across 2 matching MRF lines |
$193.20–$667.80 | $276–$954 | varies |
| Same day nb discharge (99463) | $177.10 | $253 | 1.2× |
| Sbsq Psyc Collab Care Mgmt (99493) | $182 | $260 | 1.7× |
| Select picture audiometry (92583) | $105.70 | $151 | 1.7× |
| Self Care Mngment Training (97535) | $58.10 | $83 | 1.8× |
| Self-meas bp pt educaj/traing & dev calibration (99473) | $51.80 | $74 | 1.7× |
| Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) range across 2 matching MRF lines |
$64.40–$105.70 | $92–$151 | varies |
| Sensory Integration Ea 15 Min (97533) | $108.50 | $155 | 1.8× |
| Short-Latency Somatosens Ep Std Trnk/Head (95927) range across 2 matching MRF lines |
$49.70–$386.40 | $71–$552 | varies |
| Short-latency somatosens ep std upr limbs (95925) range across 2 matching MRF lines |
$51.10–$386.40 | $73–$552 | varies |
| Sinusoidal Vertical Axis Rotational Testing (92546) | $230.30 | $329 | 1.7× |
| Sleep study attended (95807) range across 2 matching MRF lines |
$109.90–$667.80 | $157–$954 | varies |
| Sleep study unattended (95806) range across 2 matching MRF lines |
$81.90–$386.40 | $117–$552 | varies |
| Slp caregiver training 1st 30 min (97550) | $81.20 | $116 | 1.5× |
| Slp Stdy Unatnd W/Anal (95801) range across 2 matching MRF lines |
$75.60–$105.70 | $108–$151 | varies |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) range across 2 matching MRF lines |
$71.40–$386.40 | $102–$552 | varies |
| Somatosensory Testing (95938) range across 2 matching MRF lines |
$82.60–$1,535.80 | $118–$2,194 | varies |
| Speech Audiometry Complete (92556) | $105.70 | $151 | 1.7× |
| Speech audiometry threshold (92555) | $105.70 | $151 | 1.7× |
| Speech sound lang comprehen (92523) | $402.50 | $575 | 1.8× |
| Spin/Brain Pump Refil & Main (95991) | $65.10 | $93 | 0.2× |
| Spirometry (94010) range across 2 matching MRF lines |
$16.10–$386.40 | $23–$552 | varies |
| Spontaneous Nystagmus Test (92541) | $238 | $340 | 1.7× |
| Ssep lower limbs (95926) range across 2 matching MRF lines |
$47.60–$386.40 | $68–$552 | varies |
| Staggered Spondaic Word Test (92572) | $230.30 | $329 | 1.7× |
| Standardized Cognitive Performance Testing (96125) | $179.90 | $257 | 1.7× |
| Stenger Test Speech (92577) | $667.80 | $954 | 1.7× |
| Stenger Test, Pure Tone (92565) | $105.70 | $151 | 1.7× |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$123.20–$977.20 | $176–$1,396 | varies |
| Subcutaneous Infusion Each Additional Hour (96370) | $84 | $120 | 1.7× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $380.80 | $544 | 1.7× |
| Subq Infusion Additional Pump Infusion Site (96371) | $128.80 | $184 | 1.7× |
| Surfactant Admin Thru Tube (94610) range across 2 matching MRF lines |
$89.60–$392 | $128–$560 | varies |
| Synthetic Sentence Identification Test (92576) | $67.20 | $96 | 1.7× |
| Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) range across 2 matching MRF lines |
$110.60–$187.60 | $158–$268 | varies |
| Temp transcutaneous pacing (92953) | $2.80 | $4 | 0.0× |
| Tensilon Test (95857) | $44.80 | $64 | 0.2× |
| Test to assess hearing loss using different tone pitches (92575) | $67.20 | $96 | 1.7× |
| Testing Autonomic Nervous System Function (95923) range across 2 matching MRF lines |
$80.50–$238 | $115–$340 | varies |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $38.50 | $55 | 1.7× |
| Ther Ivntj Ea Addl 15 Min (97130) | $37.80 | $54 | 1.8× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $53.90 | $77 | 1.8× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $182 | $260 | 1.8× |
| Ther/Prop/Diag Inj/Inf Proc (96379) | $84 | $120 | 1.7× |
| Ther/Proph/Diag Inj Ia (96373) | $380.80 | $544 | 1.7× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $128.80 | $184 | 1.7× |
| Ther/Proph/Diag Iv Inf Init (96365) | $380.80 | $544 | 1.7× |
| Therapeutic Activities (97530) | $62.30 | $89 | 1.8× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $163.10 | $233 | 0.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$42–$67.20 | $60–$96 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$21–$67.20 | $30–$96 | varies |
| Tone Decay Test (92563) | $67.20 | $96 | 1.7× |
| Trans Care Mgmt 14 Day Disch (99495) range across 2 matching MRF lines |
$230.30–$238.70 | $329–$341 | varies |
| Trans Care Mgmt 7 Day Disch (99496) range across 2 matching MRF lines |
$238.70–$311.50 | $341–$445 | varies |
| Transcath Closure of Asd (93580) likely a partial charge, not the full procedure |
$1,792.70 | $2,561 | 0.1× |
| Transcranial Doppler Intracran Art Emboli Detect (93892) range across 2 matching MRF lines |
$108.50–$187.60 | $155–$268 | varies |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) range across 2 matching MRF lines |
$67.20–$187.60 | $96–$268 | varies |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) range across 2 matching MRF lines |
$24.50–$67.20 | $35–$96 | varies |
| Tstg Ans Funcj Cardiovagal Innervaj Parasymp (95921) range across 2 matching MRF lines |
$80.50–$230.30 | $115–$329 | varies |
| Tstg ans funcj vasomotor adrenergic innervaj (95922) range across 2 matching MRF lines |
$84–$238 | $120–$340 | varies |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$123.20–$977.20 | $176–$1,396 | varies |
| Tte W/O Doppler Complete (93307) range across 2 matching MRF lines |
$78.40–$427 | $112–$610 | varies |
| Tx atrial fib pulm vein isol (93656) likely a partial charge, not the full procedure |
$1,715.70 | $2,451 | 0.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $135.10 | $193 | 1.8× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $42.70 | $61 | 1.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $84 | $120 | 1.7× |
| Tympanometry (92567) | $67.20 | $96 | 1.7× |
| Tympanometry and reflex threshold measurements (92550) | $386.40 | $552 | 1.7× |
| Unlisted cardiovascular service/procedure (93799) range across 2 matching MRF lines |
$47.60–$230.30 | $68–$329 | varies |
| Unlisted Diagnostic Gastroenterology Procedure (91299) | $18.90 | $27 | 0.1× |
| Unlisted otorhinolaryngological service (92700) | $51.80 | $74 | 1.7× |
| Unlisted Special Dermatological Service/Px (96999) | $140.70 | $201 | 0.7× |
| Upr/L Xtremity Art 2 Levels (93922) range across 2 matching MRF lines |
$23.10–$238 | $33–$340 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 2 matching MRF lines |
$42.70–$386.40 | $61–$552 | varies |
| Valvuloplasty aortic valve (92986) unusually low: confirm this is the full procedure |
$2,447.20 | $3,496 | 0.4× |
| Valvuloplasty mitral valve (92987) likely a partial charge, not the full procedure |
$2,522.10 | $3,603 | 0.2× |
| Valvuloplasty pulmonary valve (92990) likely a partial charge, not the full procedure |
$2,022.30 | $2,889 | 0.2× |
| Vasopneumatic device (97016) | $21.70 | $31 | 1.8× |
| Veeg 2-12 Hr Cont Mntr (95713) range across 2 matching MRF lines |
$667.80–$1,138.90 | $954–$1,627 | varies |
| Veeg 2-12 hr intmt mntr (95712) range across 2 matching MRF lines |
$667.80–$839.30 | $954–$1,199 | varies |
| Veeg 2-12 hr unmonitored (95711) range across 2 matching MRF lines |
$282.10–$386.40 | $403–$552 | varies |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) range across 2 matching MRF lines |
$667.80–$1,497.30 | $954–$2,139 | varies |
| Veeg Ea 12-26 Hr Unmntr (95714) range across 2 matching MRF lines |
$413–$667.80 | $590–$954 | varies |
| Veeg ea 12-26hr cont mntr (95716) range across 2 matching MRF lines |
$1,535.80–$2,024.40 | $2,194–$2,892 | varies |
| Vent Mgmt Inpat Init Day (94002) range across 2 matching MRF lines |
$165.20–$1,104.60 | $236–$1,578 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) range across 2 matching MRF lines |
$113.40–$1,104.60 | $162–$1,578 | varies |
| Visual Evoked Potential Test (95930) | $32.90 | $47 | 0.1× |
| Visual Field Exam Extended (92083) range across 2 matching MRF lines |
$47.60–$238 | $68–$340 | varies |
| Visual field xm uni/bi w/interp intermed exam (92082) range across 2 matching MRF lines |
$37.10–$105.70 | $53–$151 | varies |
| Visual field xm uni/bi w/interpretj limited exam (92081) range across 2 matching MRF lines |
$28.70–$105.70 | $41–$151 | varies |
| Visual reinforcement audiometry (vra) (92579) | $386.40 | $552 | 1.7× |
| Vital capacity, total (94150) | $230.30 | $329 | 1.7× |
| Wada Activation Test Hemispheric Function W/Eeg (95958) range across 2 matching MRF lines |
$411.60–$1,535.80 | $588–$2,194 | varies |
| Wheelchair Mgmt Ea 15 Min (97542) | $55.30 | $79 | 1.8× |
| Whirlpool Therapy (97022) | $28.70 | $41 | 1.8× |
| Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) range across 2 matching MRF lines |
$6.30–$67.20 | $9–$96 | varies |
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.