Visits & medical services prices at Saline Memorial Hospital

Benton, AR · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $23,612.60
Airway inhalation treatment (94640) $291.84
Analyze Neurostim Complex (95972) $620.17
Assessment of aphasia (96105) $446.06
Behavioral and qualitative analysis of voice and resonance (92524) $391.33
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $1,169.01
C motor evoked upr&lwr limbs (95939) $4,226.71
Canalith Repositioning (95992) $179.09
Cardiac Stress Tst,Tracing Only (93017) $6,510.11
Cardiopulmonary resuscitation (92950) $5,201.38
Cardioversion (92960) $8,406.68
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $18,002.81
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $26,716.74
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $17,165.57
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $20,058.55
Cbt 1st hour (94644) $973.37
Chemother, IV infusion, 1 hr (96413) $1,334.84
Chemother, IV infusion, ea add hr (96415) $227.17
Color/duplex Doppler, limited (93976) $503.58
Coronary artery angio s&i (93454) $23,959.64
Cpap initiation and management (94660) $888.79
Cpt initial (94667) $492.48
Critical care (99291) $3,959.75
Debridement Open Wound 20 Sq Cm< (97597) $21,618.78
Demo &/or eval,pt use,aerosol device (94664) $727.96
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $1,067.88
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,145.82
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $802.57
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,067.88
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $802.57
Dup-scan xtr veins unilateral/limited study (93971) $1,052.95
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $1,079.49
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $519.01
Duplex scan extracranial art compl bi study (93880) $1,601.82
Echo Heart Xthoracic,Limited (93308) $13,707.21
Echo transesophageal (93312) $6,969.63
Echo Transthoracic - Congenital Tte Complete (93303) $2,447.49
EEG awake asleep (95819) $1,701.30
EEG cerebral death evaluation (95824) $2,109.23
EKG (93005) $258.69
EMG two extremities (95861) $623.47
Ep & ablate supravent arrhyt (93653) $89,003.26
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $23,612.60
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $23,612.60
Ep Electrophysiologic F/U Study (93624) $23,612.60
Er level 1 (99281) $724.62
Er level ii (99282) $1,179.25
Er level iii (99283) $1,766.56
Er level IV (99284) $2,475.94
Er level v (99285) $2,945.81
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $300.14
Evaluation of speech fluency (92521) $464.30
Evaluation of speech sound production (92522) $379.72
Evaluation of swallowing function (92610) $353.19
Evaluation with prescription of speech-generating alternative (92607) $524
External ECG rec>48hr<7d recording (93242) $152.08
External ECG rec>7d<15d recording (93246) $250.14
External Ecg Scanning Analysis Report (93226) $492.48
Group Therapeutic Procedures (97150) $74.62
Holter Monitor Recording (93225) $492.48
Hydrotherapy (97036) $129.35
Immunization Admin (90471) $276.93
Ins swan ganz bedside (93503) $5,067.43
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $321.69
IV infusion hydration each additional hour (96361) $227.17
IV infusion hydration initial 31 min-1 hour (96360) $867.24
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $482.54
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $945.16
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $308.43
IV push initial (96374) $797.87
Manual therapy 15 min (97140) $122.70
Massage 15 min (97124) $124.37
Mechanical chest wall oscillation (94669) $727.96
Mechanical traction (97012) $66.34
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $112.77
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $134.24
Mnt Group Ea 30 Min (97804) $63.17
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $371.44
Multiple sleep latency test (95805) $3,611.54
Neg press wnd tx </=50 sq cm (97607) $1,213.79
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $17,066.44
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,213.79
Newborn resuscitation (99465) $2,003.10
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $606.89
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $797.60
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $630.12
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $189.04
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $135.99
Ot Contrast Bath Ea 15 Min (97034) $72.96
Ot eval high complex 60 min (97167) $368.11
Ot eval low complex 30 min (97165) $368.11
Ot eval mod complex 45 min (97166) $368.11
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $194.02
Ot Prosthetic Training, Each 15 Min (97761) $164.18
Ot re-eval est plan care (97168) $248.75
Paraffin bath (97018) $43.11
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,226.71
Prq card revasc chronic 1vsl (92943) $57,039.62
Prq Card Stent W/Angio 1 Vsl (92928) $58,386.12
Prq Card Stent/Ath/Angio (92933) $56,701.11
Prq revasc byp graft 1 vsl (92937) $44,789.33
Prq trluml coronary angio/atherect one art/brnch (92924) $44,789.33
Prq trluml coronary angioplasty one art/branch (92920) $51,010.80
Pt Electric Current Therapy (97033) $127.68
Pt Electrical Stimulation (97032) $77.94
Pt eval high complex 45 min (97163) $341.58
Pt eval low complex 20 min (97161) $341.58
Pt Gait Training Therapy (97116) $124.37
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $142.60
Pt Physical Performance Test (97750) $152.56
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $341.58
Pt re-evaluation (97164) $222.22
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $169.12
Pt Ultrasound Therapy (97035) $53.06
Pt Whirlpool Therapy (97022) $94.52
Pulm function test by gas (94727) $630.12
Pulmonary stress testing (94618) $492.48
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $31,760.86
R hrt art/grft angio (93457) $27,449.66
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $29,562.17
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $479.21
Right heart cath (93451) $16,145.61
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $659.98
Rt Chest Wall Manipulation,Subsequent (94668) $453.08
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $215.56
Sensory Integration Ea 15 Min (97533) $139.29
Short-latency somatosens ep std lwr limbs (95926) $1,169.01
Short-latency somatosens ep std upr limbs (95925) $1,169.01
Sleep study unattended (95806) $3,289.85
Somatosensory testing (95938) $2,109.23
Speech group therapy (92508) $96.18
Speech sound lang comprehen (92523) $809.19
Spirometry (94010) $630.12
Standardized Cognitive Performance Testing (96125) $477.55
Stress echo (93350) $2,304.88
Stress Tte Complete (93351) $4,297.40
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $119.40
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $114.42
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $452.69
Ther/Proph/Diag Inj Sc/Im (96372) $3,874.71
Therapeutic Activities (97530) $162.52
Therapeutic phlebotomy (99195) $492.48
Tilt Table Eval (93660) $2,109.23
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $3,012.93
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $326.66
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $354.86
Tx/Pro/Dx Inj New Drug Addon (96375) $325.01
Unlisted Cardiovascular Service/Procedure (93799) $1,334.84
Vasc Duplex Extrem Venous,Bilat (93970) $1,401.17
Vasc Duplex Scan Extracranial,Limited (93882) $696.44
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $908.69
Vasopneumatic device (97016) $77.94
Ventilation assist & mgmt inpatient 1st day (94002) $2,362.92
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $2,362.92
Wheelchair Mgmt Ea 15 Min (97542) $135.99
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $565.44