Visits & medical services prices at Saint James Hospital

Pontiac, IL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $419.20 $524 3.0×
Aep Hearing Status Deter Broadband Stimuli I&R (92651) $261.60 $327 1.1×
Aep neurodiagnostic i&r (92653) $1,257.60 $1,572 5.4×
Aep threshold estimation mlt frequencies i&r (92652) $1,257.60 $1,572 5.4×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines		 $136–$167.20 $170–$209 varies
Airway resistance by oscillometry (94728) $659.20 $824 4.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786)
range across 2 matching MRF lines		 $336.80–$427.20 $421–$534 varies
Analyze neurostim complex (95972) $830.40 $1,038 8.2×
Analyze Neurostim Simple (95971) $861.60 $1,077 8.5×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $107.20 $134 7.5×
Application on-body injector (96377) $96.80 $121 1.9×
Assessment of aphasia per hr (96105) $400 $500 4.1×
Audiometry Air & Bone (92553) $201.60 $252 1.5×
Basic vestibular evaluation (92540) $1,813.60 $2,267 7.8×
Behavral qualit analys voice (92524) $477.60 $597 4.4×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $82.40 $103 1.0×
Bfb training ea addl 15 min (90913) $56.80 $71 1.7×
Breathing response to hypoxia (94450) $298.40 $373 2.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $1,030.40 $1,288 2.6×
Caloric vestibular test w/rec bi monothermal (92538) $384 $480 1.7×
Caloric Vstblr Test W/Rec (92537) $767.20 $959 5.6×
Canalith repositioning proc (95992) $157.60 $197 3.9×
Car seat/bed test 60 min (94780) $250.40 $313 6.3×
Cardiac Stress Tst,Tracing Only (93017) $1,232 $1,540 5.3×
Cardiopulmonary exercise testing (94621) $1,484.80 $1,856 3.7×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines		 $470.40–$1,314.40 $588–$1,643 varies
Cardioversion (92960)
range across 2 matching MRF lines		 $1,352.80–$1,509.60 $1,691–$1,887 varies
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $56 $70 2.1×
Cbt 1st hour (94644) $136 $170 1.0×
Chemo Hormon Antineopl Sq/Im (96402) $538.40 $673 7.0×
Chemo IV infusion addl hr (96415) $183.20 $229 2.4×
Chemo IV push addl drug (96411) $252 $315 3.3×
Chemother Prolong Infuse W/Pump (96416) $1,424 $1,780 4.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $183.20 $229 2.4×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $889.60 $1,112 2.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $675.20 $844 1.9×
Chest Wall Manipulation (94668) $136 $170 1.0×
Color/duplex Doppler, complete (93975) $1,561.60 $1,952 6.1×
Color/duplex Doppler, limited (93976) $975.20 $1,219 8.7×
Community/Work Reintegration Trainj Ea 15 Min (97537) $144 $180 4.5×
Comprehensive Hearing Test (92557) $380 $475 2.8×
Computerized dynamic posturography (92548) $453.60 $567 3.2×
Conditioning Play Audiometry (92582) $340 $425 2.5×
Cont gluc mntr physician/qhp provided equiptment (95250) $735.20 $919 5.2×
Continuous Pulse Ox (94762) $1,088 $1,360 7.9×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $574.40 $718 2.4×
Cpt initial (94667) $136 $170 1.0×
Critical care first hour (99291) $3,133.60 $3,917 3.5×
Debridement Open Wound 20 Sq Cm< (97597) $250.40 $313 1.2×
Developmental tst admin phys/qhp 1st hour (96112) $442.40 $553 3.2×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $354.40 $443 0.9×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $931.20 $1,164 3.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $1,229.60 $1,537 11.0×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,709.60 $2,137 6.7×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,416.80 $1,771 12.6×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,709.60 $2,137 6.7×
Dup-scan xtr veins unilateral/limited study (93971)
range across 3 matching MRF lines		 $1,349.60–$1,416.80 $1,687–$1,771 varies
Duplex up extrem art bilat (93930) $18,401.60 $23,002 72.0×
Duplex up extrem art unilat/ltd (93931) $1,480 $1,850 13.2×
ECG/monitoring and analysis (93271) $721.60 $902 7.1×
Echo Congenital Complete (93303) $1,283.20 $1,604 2.2×
Echo Heart Xthoracic,Limited (93308) $1,186.40 $1,483 4.6×
Echo transesophageal (93312)
range across 2 matching MRF lines		 $3,208.80–$3,374.40 $4,011–$4,218 varies
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $2,973.60 $3,717 5.1×
Eeg 41-60 Minutes (95812) $2,169.60 $2,712 9.4×
EEG awake and asleep (95819)
range across 2 matching MRF lines		 $1,471.20–$1,495.20 $1,839–$1,869 varies
EEG awake drowsy (95816) $1,495.20 $1,869 6.5×
EEG cont rec w/video by tech min 8 channels (95700) $1,055.20 $1,319 4.6×
EEG extended monitoring 61-119 minutes (95813) $2,265.60 $2,832 9.8×
Eeg Sleep Only (95822) $1,612.80 $2,016 7.0×
Electrical Stimulation Ea 15 Min (97032) $115.20 $144 7.8×
Electrocardiogram Tracing (93005) $351.20 $439 5.6×
Emergency Dept Visit Level 2 (99282) $506.40 $633 3.1×
Emergency Dept Visit Level 3 (99283) $864 $1,080 3.0×
Emergency Dept Visit Level 4 (99284) $1,368.80 $1,711 3.1×
Ep & ablate supravent arrhyt (93653) $20,607.20 $25,759 0.7×
Ep & ablate ventric tachy (93654) $20,607.20 $25,759 0.7×
Er level 1 (99281) $244 $305 2.7×
Er level v (99285) $2,275.20 $2,844 3.6×
Evaluate Speech Production (92522) $391.20 $489 3.5×
Evaluate Swallowing Function (92610) $412.80 $516 4.9×
Evaluation of speech fluency (92521) $483.20 $604 3.6×
Evoked Auditory Test,Limited (92587) $264 $330 1.1×
External ECG rec>48hr<7d recording (93242) $254.40 $318 6.4×
External ECG rec>48hr<7d scanning alys w/report (93243) $721.60 $902 5.1×
External ECG rec>7d<15d recording (93246) $424 $530 10.6×
External ECG rec>7d<15d scanning alys w/report (93247) $721.60 $902 5.1×
External Ecg Scanning Analysis Report (93226) $721.60 $902 11.4×
Extracranial Bilat Study (93880) $1,219.20 $1,524 4.8×
Extracranial Uni/Ltd Study (93882) $798.40 $998 7.1×
Flexible endoscopic eval swallow c/v rec (92612) $500.80 $626 2.5×
Group Therapeutic Procedures (97150) $52.80 $66 2.9×
Holter monitor recording (93225) $721.60 $902 5.1×
Immunization administration (90471)
range across 2 matching MRF lines		 $108–$120.80 $135–$151 varies
Iontophoresis 15 min (97033) $115.20 $144 6.1×
Irrig Drug Delivery Device (96523) $252 $315 4.0×
IV infusion hydration each additional hour (96361) $300.80 $376 6.0×
IV infusion hydration initial 31 min-1 hour (96360) $633.60 $792 2.8×
IV infusion ther proph addl sequential to 1 hr (96367) $336.80 $421 4.4×
IV infusion therapy prophylaxis/dx ea hour (96366) $308.80 $386 6.2×
IV push initial (96374) $364 $455 1.6×
Low frequency non-thermal us (97610) $371.20 $464 1.7×
Lwr Xtr Vasc Stdy Bilat (93924)
range across 2 matching MRF lines		 $1,011.20–$1,772.80 $1,264–$2,216 varies
Mechanical chest wall oscillation per session (94669) $124.80 $156 0.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $91.20 $114 2.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $91.20 $114 2.5×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $123.20 $154 7.2×
Methacholine challenge (94070) $1,565.60 $1,957 3.9×
Motion Fluoroscopy/Swallow (92611) $547.20 $684 6.0×
Multiple Sleep Latency Test (95805)
range across 2 matching MRF lines		 $2,682.40–$4,873.60 $3,353–$6,092 varies
Needle electromyography larynx (95865) $441.60 $552 3.1×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $336 $420 0.8×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $360.80 $451 0.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines		 $292–$292.80 $365–$366 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606)
range across 2 matching MRF lines		 $379.20–$502.40 $474–$628 varies
Neuromuscular Reeducation (97112) $144 $180 4.4×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $1,568.80 $1,961 3.9×
Optokinetic Nystagmus Test (92544) $366.40 $458 2.7×
Oral Function Therapy (92526)
range across 2 matching MRF lines		 $144–$288 $180–$360 varies
Orthc/Prostc Mgmt Sbsq Enc (97763) $144 $180 2.9×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $140 $175 3.0×
Oscillating Tracking Test (92545) $366.40 $458 1.6×
Ot eval high complexity (97167) $371.20 $464 3.7×
Ot Eval Low Complex (97165) $308.80 $386 3.1×
Ot Eval Moderate Complexity (97166) $329.60 $412 3.3×
Ot manual therapy 15 min (97140) $140 $175 5.1×
Ot paraffin bath (97018) $70.40 $88 11.7×
Ot Prosthetic Training, Each 15 Min (97761) $164 $205 4.1×
Ot Re-Eval Est Plan Care (97168) $214.40 $268 3.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $288.80 $361 2.1×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $238.40 $298 1.7×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $248 $310 1.1×
Percutaneous tests w/allergenic extracts (95004) $62.40 $78 0.1×
Peripheral arterial disease rehab per session (93668) $179.20 $224 2.8×
Phlebotomy therapeutic (99195)
range across 2 matching MRF lines		 $308–$581.60 $385–$727 varies
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $193.60 $242 3.1×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $193.60 $242 3.1×
Physical Performance Test (97750) $141.60 $177 4.2×
Plethysmography (94726) $627.20 $784 1.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811)
range across 2 matching MRF lines		 $5,011.20–$6,683.20 $6,264–$8,354 varies
Polysom <6 yrs 4/> paramtrs (95782) $5,586.40 $6,983 6.1×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $6,613.60 $8,267 7.2×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $4,684 $5,855 5.1×
Positional nystagmus test (92542) $366.40 $458 2.6×
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $212 $265 1.9×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $335.20 $419 0.7×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $120.80 $151 3.2×
Pt Eval High Complex (97163) $371.20 $464 3.8×
Pt eval low complex 20 min (97161) $308.80 $386 3.2×
Pt Eval Mod Complex (97162) $329.60 $412 3.4×
Pt gait training 15 min (97116) $140 $175 4.8×
Pt group caregiver training (97552) $46.40 $58 2.1×
Pt mechanical traction (97012) $107.20 $134 7.5×
Pt Re-Eval Est Plan Care (97164) $214.40 $268 3.2×
Pt ultraviolet (97028) $36.80 $46 4.4×
Pulm function test by gas (94727) $810.40 $1,013 3.5×
Pulmonary Stress Testing (94618) $497.60 $622 3.5×
Pure Tone Audiometry Air (92552) $206.40 $258 1.4×
Refill/Maint Portable Pump (96521) $380 $475 1.7×
Refill/Maint Pump/Resvr Syst (96522) $380 $475 1.7×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $90.40 $113 2.3×
Rem ther mntr dev sply resp (98976) $90.40 $113 2.3×
Remote 30 Day Ecg Rev/Report (93270) $254.40 $318 6.4×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $313.60 $392 2.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $333.60 $417 1.6×
Select picture audiometry (92583) $168 $210 2.7×
Self Care Mngment Training (97535) $140 $175 4.3×
Sensory Integration Ea 15 Min (97533) $144 $180 2.4×
Sinusoidal Vertical Axis Rotational Testing (92546) $419.20 $524 3.0×
Sleep study attended (95807) $6,068 $7,585 15.2×
Sleep study unattended (95806) $1,648.80 $2,061 7.1×
Slp caregiver training 1st 30 min (97550) $112 $140 2.1×
Slp Stdy Unatnd W/Anal (95801) $101.60 $127 1.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $939.20 $1,174 4.1×
Speech Audiometry Complete (92556) $173.60 $217 2.7×
Speech audiometry threshold (92555) $122.40 $153 1.9×
Speech sound lang comprehen (92523) $541.60 $677 2.4×
Spin/Brain Pump Refil & Main (95991) $837.60 $1,047 2.5×
Spirometry (94010) $344.80 $431 1.5×
Spontaneous Nystagmus Test (92541) $366.40 $458 2.6×
Standardized Cognitive Performance Testing (96125) $373.60 $467 3.6×
Stress Tte Only (93350) $1,284 $1,605 2.2×
Synthetic Sentence Identification Test (92576) $336 $420 8.4×
Tensilon Test (95857) $519.20 $649 2.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $144 $180 6.4×
Ther Ivntj Ea Addl 15 Min (97130) $144 $180 6.8×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $144 $180 3.9×
Ther/Proph/Diag Inj Ia (96373) $276 $345 1.2×
Ther/Proph/Diag Inj Sc/Im (96372) $223.20 $279 2.9×
Ther/Proph/Diag Iv Inf Init (96365) $737.60 $922 3.2×
Therapeutic Activities (97530) $140 $175 4.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $52 $65 1.3×
Tte w/doppler, complete (93306)
range across 2 matching MRF lines		 $2,999.20–$3,112 $3,749–$3,890 varies
Tte W/O Doppler Complete (93307) $1,087.20 $1,359 4.3×
Tx atrial fib pulm vein isol (93656) $20,607.20 $25,759 0.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507)
range across 3 matching MRF lines		 $111.20–$342.40 $139–$428 varies
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $172.80 $216 7.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $324.80 $406 6.5×
Tympanometry (92567) $179.20 $224 4.5×
Tympanometry and reflex threshold measurements (92550) $304.80 $381 1.3×
Unlisted otorhinolaryngological service (92700) $200 $250 6.5×
Upr/L Xtremity Art 2 Levels (93922) $509.60 $637 3.6×
Upr/Lxtr Art Stdy 3+ Lvls (93923)
range across 2 matching MRF lines		 $989.60–$1,184.80 $1,237–$1,481 varies
Vasopneumatic device (97016) $70.40 $88 5.9×
Vent Mgmt Inpat Init Day (94002) $1,258.40 $1,573 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,020 $1,275 1.5×
Visual reinforcement audiometry (vra) (92579) $280 $350 1.2×
Vital capacity, total (94150) $131.20 $164 1.0×
Wheelchair Mgmt Ea 15 Min (97542) $144 $180 4.6×
Whirlpool Therapy (97022) $83.20 $104 5.3×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.