Visits & medical services prices at Saint Joseph Regional Medical Center - Plymouth

Plymouth, IN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $10,145.85 $15,609 1.2×
Airway Inhalation Treatment (94640) $91 $140 0.4×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $124.80 $192 8.7×
Application Modality 1/> Areas Infrared (97026) $99.45 $153 14.9×
Assessment of aphasia per hr (96105) $300.95 $463 3.1×
Behavral qualit analys voice (92524) $392.60 $604 3.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $589.55 $907 1.5×
Canalith repositioning proc (95992) $63.70 $98 1.6×
Cardiac Stress Tst,Tracing Only (93017) $865.80 $1,332 3.8×
Cardiopulmonary resuscitation (92950) $756.60 $1,164 3.3×
Cardioversion (92960) $3,261.15 — 4.7×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $12,975.95 $19,963 3.8×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $12,477.40 $19,196 3.6×
Cbt 1st hour (94644) $188.50 $290 1.3×
Chemo Anti-Neopl Sq/Im (96401) $210.60 $324 2.8×
Chemo Hormon Antineopl Sq/Im (96402) $210.60 $324 2.8×
Chemo Ia Push (96420) $451.75 $695 1.3×
Chemo IV infusion addl hr (96415) $382.85 $589 5.0×
Chemotherapy Into Cns (96450) $847.60 $1,304 2.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $382.85 $589 5.0×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $440.70 $678 1.3×
Chest Wall Manipulation (94668) $87.75 $135 0.6×
Color/duplex Doppler, complete (93975) $1,220.70 $1,878 4.8×
Color/duplex Doppler, limited (93976)
range across 2 matching MRF lines		 $787.80–$1,170.65 — varies
Continuous Pulse Ox (94762) $497.25 $765 3.7×
Coronary Art/Grft Angio S&I (93455) $9,319.05 $14,337 2.7×
Coronary Artery Angio S&I (93454) $8,898.50 $13,690 2.6×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 2 matching MRF lines		 $369.20–$460.85 $568–$709 varies
Cpt initial (94667) $260.65 $401 1.9×
Critical care first hour (99291) $1,910.35 $2,939 2.2×
Debridement Open Wound 20 Sq Cm< (97597) $1,742 — 8.2×
Dialysis One Evaluation (90945) $581.75 $895 1.3×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,071.85 $1,649 4.2×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $534.95 $823 4.8×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $944.45 $1,453 3.7×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $560.30 $862 5.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,104.35 $1,699 4.4×
Dup-scan xtr veins unilateral/limited study (93971) $820.30 $1,262 7.4×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $488.80 $752 1.9×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $280.80 $432 2.5×
Duplex Scan Hemodialysis Access (93990) $458.90 $706 4.1×
Duplex up extrem art bilat (93930) $592.15 $911 2.3×
Duplex up extrem art unilat/ltd (93931) $375.70 $578 3.4×
ECG/monitoring and analysis (93271) $547.95 $843 5.4×
Echo Congenital Complete (93303) $1,245.40 $1,916 2.2×
Echo Heart Xthoracic,Limited (93308) $808.60 $1,244 3.2×
Echo r-t 2d w/probe placement only (93313) $737.10 $1,134 1.3×
Echo transesophageal (93312) $2,104.05 $3,237 3.6×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,791.40 $2,756 3.1×
EEG awake and asleep (95819) $870.35 $1,339 3.8×
EEG awake drowsy (95816) $780 $1,200 3.4×
EEG cont rec w/video by tech min 8 channels (95700) $556.40 $856 2.4×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $505.05 $777 2.2×
EEG wo vid ea 12-26hr unmntr (95708) $1,065.35 $1,639 2.7×
Electrical Stimulation Ea 15 Min (97032) $124.15 $191 8.4×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines		 $778.05–$1,121.90 — varies
Emergency Dept Visit Level 2 (99282) $332.41 — 2.0×
Emergency Dept Visit Level 3 (99283) $1,023.20 — 3.5×
Emergency Dept Visit Level 4 (99284) $2,527.33 — 5.7×
Ep & ablate supravent arrhyt (93653) $27,777.75 $42,735 1.0×
Ep & ablate ventric tachy (93654) $27,777.75 $42,735 1.0×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $5,127.20 $7,888 0.6×
Er level 1 (99281) $254.15 — 2.8×
Er level v (99285) $5,579.27 — 8.9×
Evaluate pt use of inhaler (94664) $130 $200 0.6×
Evaluate Speech Production (92522) $392.60 $604 3.5×
Evaluate Swallowing Function (92610) $328.90 $506 3.9×
Evaluation of speech fluency (92521) $392.60 $604 2.9×
External ECG rec>48hr<7d recording (93242) $51.35 $79 1.3×
External ECG rec>7d<15d recording (93246) $86.45 $133 2.2×
External Ecg Scanning Analysis Report (93226) $460.20 $708 7.4×
Extracranial Bilat Study (93880) $914.55 $1,407 3.6×
Extracranial Uni/Ltd Study (93882) $380.90 $586 3.4×
F-up/limited tthrc echo congenital car anomaly (93304) $843.70 $1,298 1.5×
Flexible endoscopic eval swallow c/v rec (92612) $407.55 $627 2.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,274 $1,960 1.4×
Gi tract capsule endoscopy (91110) $1,257.10 $1,934 1.3×
Group Therapeutic Procedures (97150) $210.60 $324 11.7×
Holter monitor recording (93225) $501.80 $772 3.6×
Immunization administration (90471)
range across 2 matching MRF lines		 $10.40–$85.80 $16–$132 varies
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $758.55 $1,167 1.9×
Insert/Place Heart Catheter (93503) $1,097.20 $1,688 0.7×
Iontophoresis 15 min (97033) $195.65 $301 10.3×
Irrig Drug Delivery Device (96523) $206.05 $317 3.3×
IV infusion hydration each additional hour (96361) $1,048.61 — 21.2×
IV infusion hydration initial 31 min-1 hour (96360) $1,610.86 — 7.2×
IV infusion ther proph addl sequential to 1 hr (96367) $8,032.41 — 105.4×
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines		 $542.81–$5,661.01 — varies
IV push initial (96374) $794.17 — 3.5×
L Hrt Art/Grft Angio (93459) $12,898.60 $19,844 3.8×
Lung Function Test (Mbc/Mvv) (94200) $86.45 $133 1.4×
Lwr Xtr Vasc Stdy Bilat (93924) $890.50 $1,370 3.9×
Mechanical chest wall oscillation per session (94669) $273.65 $421 1.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $50.70 $78 1.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $52.65 $81 1.4×
Methacholine challenge (94070) $1,073.80 $1,652 2.7×
Motility study esophagus (91010) $1,444.95 $2,223 3.7×
Motion Fluoroscopy/Swallow (92611) $512.20 $788 5.6×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $401.05 $617 1.8×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $585.65 $901 1.4×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $690.95 $1,063 1.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $3,825.90 — 18.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $626.60 — 1.5×
Nerve Conduction Studies 1-2 Studies (95907) $1,300.65 $2,001 5.7×
Nerve conduction studies 13 or more studies (95913) $4,914 $7,560 12.4×
Nerve Conduction Studies 3-4 Studies (95908) $1,950 $3,000 8.5×
Nerve conduction studies 5-6 studies (95909) $2,599.35 $3,999 11.4×
Nerve conduction studies 7-8 studies (95910) $3,250.65 $5,001 8.2×
Nerve Conduction Studies 9-10 Studies (95911) $3,899.35 $5,999 9.9×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $144.95 $223 1.1×
Neuromuscular Reeducation (97112) $108.55 $167 3.3×
Oral Function Therapy (92526) $249.60 $384 3.0×
Oral Speech Device Eval (92597) $338 $520 4.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $70.20 $108 1.4×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760)
range across 2 matching MRF lines		 $503.75–$2,535.65 — varies
Ot eval high complexity (97167) $356.20 $548 3.5×
Ot Eval Low Complex (97165) $356.20 $548 3.5×
Ot Eval Moderate Complexity (97166) $356.20 $548 3.5×
Ot manual therapy 15 min (97140)
range across 2 matching MRF lines		 $1,576.25–$2,060.50 — varies
Ot paraffin bath (97018) $98.15 $151 16.3×
Ot Prosthetic Training, Each 15 Min (97761) $113.10 $174 2.8×
Ot Re-Eval Est Plan Care (97168) $141.70 $218 2.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $230.10 $354 1.7×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $180.05 $277 1.3×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $239.85 $369 1.0×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $8,989.50 $13,830 1.5×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $11,529.05 $17,737 0.9×
Phlebotomy therapeutic (99195) $157.95 $243 1.1×
Physical Performance Test (97750) $102.70 $158 3.0×
Plethysmography (94726) $288.60 $444 0.7×
Pm device eval in person (93288) $119.60 $184 3.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,823.95 $5,883 4.2×
Polysom <6 yrs 4/> paramtrs (95782) $3,339.70 $5,138 3.7×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $3,823.95 $5,883 4.2×
Prq Card Angio/Athrect 1 Art (92924) $14,474.20 $22,268 1.2×
Prq Card Stent W/Angio 1 Vsl (92928) $12,380.55 $19,047 1.0×
Prq Revasc Byp Graft 1 Vsl (92937) $10,799.75 $16,615 0.9×
Pt Eval High Complex (97163) $366.60 $564 3.7×
Pt eval low complex 20 min (97161) $366.60 $564 3.7×
Pt Eval Mod Complex (97162) $366.60 $564 3.7×
Pt gait training 15 min (97116) $113.10 $174 3.9×
Pt mechanical traction (97012) $117.65 $181 8.2×
Pt Re-Eval Est Plan Care (97164) $141.70 $218 2.1×
Pulmonary service/procedure (94799) $216.45 $333 1.6×
Pulmonary Stress Testing (94618) $213.85 $329 1.5×
R Hrt Art/Grft Angio (93457) $10,236.85 $15,749 3.0×
R&L Hrt Cath W/Ventriclgrphy (93453) $12,788.75 $19,675 3.7×
Remote 30 Day Ecg Rev/Report (93270) $369.85 $569 9.4×
Respiratory flow volume loop (94375) $352.95 $543 1.5×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $1,199.90 — 5.7×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $284.05 $437 2.3×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $53.95 $83 1.1×
Self Care Mngment Training (97535) $106.60 $164 3.3×
Sensory Integration Ea 15 Min (97533) $102.70 $158 1.7×
Sleep study unattended (95806) $787.15 $1,211 3.4×
Speech sound lang comprehen (92523) $412.75 $635 1.8×
Spirometry (94010) $353.60 $544 1.5×
Stress Tte Only (93350) $1,587.30 $2,442 2.7×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $115.05 $177 3.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $126.75 $195 4.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $298.35 $459 2.9×
Ther/Proph/Diag Inj Sc/Im (96372) $1,541.15 — 20.2×
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines		 $542.81–$1,472.05 — varies
Therapeutic Activities (97530) $110.50 $170 3.2×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $1,604.85 $2,469 4.1×
Transcath Closure of Asd (93580) $14,016.60 $21,564 0.7×
Tte w/doppler, complete (93306) $1,996.15 $3,071 3.5×
Tx atrial fib pulm vein isol (93656) $27,777.75 $42,735 1.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $385.45 $593 5.1×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $30.55 $47 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $2,583.78 — 52.2×
Unlisted cardiovascular service/procedure (93799)
range across 2 matching MRF lines		 $1,511.25–$4,972.50 $2,325–$7,650 varies
Upr/L Xtremity Art 2 Levels (93922) $407.55 $627 2.9×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $750.75 $1,155 3.3×
Vasopneumatic device (97016) $157.95 $243 13.1×
Veeg 2-12 hr intmt mntr (95712) $556.40 $856 1.4×
Veeg 2-12 hr unmonitored (95711) $556.40 $856 2.4×
Veeg Ea 12-26 Hr Unmntr (95714) $1,114.10 $1,714 2.8×
Veeg ea 12-26hr cont mntr (95716) $1,812.20 $2,788 2.0×
Vent Mgmt Inpat Init Day (94002) $1,621.10 $2,494 2.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,015.95 $1,563 1.6×
Visual Evoked Potential Test (95930) $401.05 $617 1.8×
Vital capacity, total (94150) $216.45 $333 1.6×
Wheelchair Mgmt Ea 15 Min (97542) $1,624.35 — 52.3×
Whirlpool Therapy (97022) $124.80 $192 7.9×

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.