Visits & medical services prices at Putnam County Memorial Hospital

Unionville, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $609.66 $609.66 2.8×
Allg tstg perq & ic venoms immed react w/ i&r (95017) $46.31 $46.31 1.6×
Biofeedback training any modality (90901) $154.50 $154.50 3.8×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $897.18 $897.18 2.4×
Cardiopulmonary resuscitation (92950) $897.18 $897.18 4.1×
Cardioversion (92960) $1,860.30 $1,860.30 2.8×
Cbt 1st hour (94644) $365.13 $365.13 2.7×
Chemo IV push addl drug (96411) $336.60 $336.60 4.7×
Chemo Iv Push Sngl Drug (96409) $336.60 $336.60 1.0×
Chemo prolong 8+ hrs infuse w/pump (96416) $548.96 $548.96 1.7×
Chemother, IV infusion, 1 hr (96413) $783.45 $783.45 2.4×
Chemother, IV infusion, ea add hr (96415) $187.24 $187.24 2.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $126.60 $126.60 1.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $207.32 $207.32 2.9×
Cpap initiation and management (94660) $609.66 $609.66 2.8×
Cpt initial (94667) $365.13 $365.13 2.7×
Critical care (99291) $1,582.23 $1,582.23 1.9×
Demo &/or eval,pt use,aerosol device (94664) $609.66 $609.66 2.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $1,400.82 $1,400.82 5.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,400.82 $1,400.82 5.9×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $628.50 $628.50 6.0×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $440.26 $440.26 1.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $313.48 $313.48 3.0×
Dup-scan xtr veins unilateral/limited study (93971) $628.50 $628.50 6.0×
Duplex scan extracranial art compl bi study (93880) $1,400.82 $1,400.82 5.9×
Echo Heart Xthoracic,Limited (93308) $1,400.82 $1,400.82 5.9×
EKG (93005) $174.84 $174.84 3.0×
Er level 1 (99281) $158.82 $158.82 1.9×
Er level ii (99282) $295.60 $295.60 1.9×
Er level iii (99283) $513.16 $513.16 1.9×
Er level IV (99284) $811.16 $811.16 1.9×
Er level v (99285) $1,176.84 $1,176.84 2.0×
Evaluation of speech fluency (92521) $329.92 $329.92 2.5×
Evaluation of speech sound production (92522) $50.15 $50.15 0.4×
Evaluation of swallowing function (92610) $245.21 $245.21 2.9×
External ECG rec>48hr<7d recording (93242) $117.04 $117.04 3.1×
External ECG rec>7d<15d recording (93246) $116.96 $116.96 3.1×
External Ecg Scanning Analysis Report (93226) $174.84 $174.84 3.0×
Group Therapeutic Procedures (97150) $33.60 $33.60 1.9×
Holter Monitor Recording (93225) $303.56 $303.56 2.3×
Icd Device Interrogate (93289) $74.58 $74.58 2.0×
Immunization Admin (90471) $77.50 $77.50 1.1×
Immunotherapy, 2+ Injections (95117) $16.72 $16.72 0.4×
Ingestion challenge test initial 120 minutes (95076) $623.90 $623.90 1.7×
Interrog dev eval icpms phys/qhp in person (93290) $89.12 $89.12 2.4×
Interrog dev eval scrms phys/qhp in person (93291) $65.74 $65.74 2.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $114.81 $114.81 1.9×
IV infusion hydration each additional hour (96361) $82.54 $82.54 1.8×
IV infusion hydration initial 31 min-1 hour (96360) $394.97 $394.97 1.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $140.35 $140.35 1.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $337.62 $337.62 1.6×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $123.36 $123.36 2.6×
IV push initial (96374) $233.40 $233.40 1.1×
Manual therapy 15 min (97140) $90.28 $90.28 3.3×
Massage 15 min (97124) $50.15 $50.15 1.7×
Mechanical traction (97012) $33.44 $33.44 2.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $57.96 $57.96 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $57.96 $57.96 1.6×
Mnt Group Ea 30 Min (97804) $32.41 $32.41 1.9×
Multiple Family Group Psychotherapy (90849) $89.55 $89.55 0.5×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $344.41 $344.41 1.7×
Nerve conduction studies 13/> studies (95913) $658.76 $658.76 1.8×
Nerve Conduction Studies 3-4 Studies (95908) $342.09 $342.09 1.6×
Nerve Conduction Studies 9-10 Studies (95911) $606.84 $606.84 1.6×
Nerve conduction studies; 1-2 studies (95907) $195.03 $195.03 0.9×
Nerve conduction studies; 11-12 studies (95912) $631.35 $631.35 1.7×
Nerve conduction studies; 5-6 studies (95909) $354.65 $354.65 1.6×
Nerve conduction studies; 7-8 studies (95910) $379.16 $379.16 1.0×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $730.26 $730.26 5.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $446.49 $446.49 3.5×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $897.18 $897.18 2.4×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $66.32 $66.32 1.4×
Osteopathic manipulative tx 1-2 body regions (98925) $68.01 $68.01 3.1×
Osteopathic manipulative tx 3-4 body regions (98926) $54.49 $54.49 2.5×
Osteopathic manipulative tx 7-8 body regions (98928) $152.04 $152.04 7.0×
Osteopathic manipulative tx 9-10 body regions (98929) $194.68 $194.68 9.0×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $60.19 $60.19 1.9×
Ot eval high complex 60 min (97167) $258.62 $258.62 2.6×
Ot eval low complex 30 min (97165) $249.12 $249.12 2.5×
Ot eval mod complex 45 min (97166) $249.12 $249.12 2.5×
Ot Prosthetic Training, Each 15 Min (97761) $62.42 $62.42 1.5×
Ot re-eval est plan care (97168) $163.75 $163.75 2.4×
Paraffin bath (97018) $16.72 $16.72 2.8×
Patch/Application Test Specify Number Tests (95044) $1,894.83 $1,894.83 2.2×
Percutaneous tests w/allergenic extracts (95004) $20.06 $20.06 0.0×
Pm device eval in person (93288) $78.06 $78.06 2.1×
Pm device progr eval dual (93280) $74.58 $74.58 2.0×
Pm device progr eval sngl (93279) $94.73 $94.73 2.5×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $81.98 $81.98 1.7×
Prepj& antigen allergen immunotherapy 4 insect (95148) $129.32 $129.32 1.8×
Prepj& antigen allergen immunotherapy 5 insect (95149) $129.32 $129.32 1.8×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $14.49 $14.49 0.3×
Psych diag eval w/med srvcs (90792) $325.46 $325.46 1.8×
Psychiatric diagnostic evaluation (90791) $202.85 $202.85 1.1×
Psychoanalysis (90845) $205.16 $205.16 1.2×
Psytx crisis initial 60 min (90839) $301 $301 1.7×
Pt Electric Current Therapy (97033) $52.39 $52.39 2.8×
Pt Electrical Stimulation (97032) $36.78 $36.78 2.5×
Pt eval high complex 45 min (97163) $256.31 $256.31 2.6×
Pt eval low complex 20 min (97161) $266.20 $266.20 2.7×
Pt Gait Training Therapy (97116) $75.75 $75.75 2.6×
Pt Infrared Therapy (97026) $16.72 $16.72 2.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $101.72 $101.72 3.1×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $256.31 $256.31 2.6×
Pt re-evaluation (97164) $173.14 $173.14 2.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $121.20 $121.20 3.7×
Pt Ultrasound Therapy (97035) $25.64 $25.64 1.8×
Pulmonary stress testing (94618) $365.13 $365.13 2.7×
Rem interrog icpms <30 d phys/qhp (93297) $53.66 $53.66 1.4×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $53.66 $53.66 1.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $107.79 $107.79 2.9×
Rt Chest Wall Manipulation,Subsequent (94668) $365.13 $365.13 2.7×
Sleep study unattended (95806) $446.49 $446.49 2.1×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $446.49 $446.49 2.1×
Smoking cessation > 10 min (99407) $75.84 $75.84 2.0×
Speech sound lang comprehen (92523) $329.92 $329.92 1.5×
Spirometry (94010) $446.49 $446.49 2.1×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $135.78 $135.78 2.9×
Temp transcutaneous pacing (92953) $1,860.30 $1,860.30 2.8×
Test for allergy using allergenic extract injected into skin (95024) $120.97 $120.97 2.0×
Test for allergy using combination of methods with drug or biological (95018) $58.24 $58.24 1.6×
Ther/Proph/Diag Inj Sc/Im (96372) $99.56 $99.56 1.4×
Therapeutic Activities (97530) $91.98 $91.98 2.6×
Therapeutic phlebotomy (99195) $235.23 $235.23 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $69.13 $69.13 1.8×
Trans Care Mgmt 14 Day Disch (99495) $341.20 $341.20 2.6×
Trans Care Mgmt 7 Day Disch (99496) $483.37 $483.37 3.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $3,153.78 $3,153.78 5.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $141.54 $141.54 1.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $186.13 $186.13 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $138.98 $138.98 3.0×
Vasc Duplex Extrem Venous,Bilat (93970) $1,400.82 $1,400.82 5.9×
Wheelchair Mgmt Ea 15 Min (97542) $61.86 $61.86 2.0×