Visits & medical services prices at Samaritan Hospital

Moses Lake, WA · 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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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $199 $199 1.8×
Airway inhalation treatment (94640) $523.50 $523.50 2.1×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $39 $39 0.9×
Analyze neurostim simple (95971) $124 $124 1.2×
Appl modality 1+lllt po pain (97037) $25 $25 0.6×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $91 $91 6.3×
Assessment of aphasia per hr (96105) $243 $243 2.5×
Assmt & care planning pt w/cognitive impairment (99483) $409 $409 3.6×
Bedside Swallowing Eval (92610) $196 $196 2.3×
Behavioral and qualitative analysis of voice and resonance (92524) $160 $160 1.5×
Brief Emotional/Behavioral Assessment (96127) $17 $17 0.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $346 $346 0.8×
Canalith Repositioning Procedure (95992) $79 $79 1.9×
Car seat/bed test 60 min (94780) $100 $100 2.4×
Cardiac Stress Tst,Tracing Only (93017) $459 $459 1.9×
Cardiopulmonary resuscitation (92950) $1,026 $1,026 4.3×
Cardioversion (92960) $374 $374 0.5×
Care mgmt svc bhvl hlth cond (99484) $75 $75 1.8×
Caregiver hlth risk assmt score doc stnd instrm (96161) $20 $20 0.5×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $47 $47 1.8×
Cbt 1st hour (94644) $720 $720 4.9×
Chemo Hormon Antineopl Sq/Im (96402) $317 $317 4.0×
Chemother, IV infusion, 1 hr (96413) $1,275 $1,275 3.5×
Chemother, IV infusion, ea add hr (96415) $241 $241 3.0×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $328 $328 4.1×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $1,096 $1,096 3.0×
Chronic care management services 1st 20 min (99490) $93 $93 0.8×
Color Vision Examination (92283) $86 $86 1.3×
Color/duplex Doppler, complete (93975) $964 $964 3.6×
Color/duplex Doppler, limited (93976) $964 $964 8.3×
Cont Gluc Monitoring Patient Provided Equipment (95249) $95 $95 1.4×
Continuous Glucose Monitoring (95250) $266 $266 1.8×
Cpap/bipap (94660) $2,198 $2,198 9.0×
Cpt initial (94667) $595 $595 4.0×
Critical care (99291) $693 $693 0.8×
Debridement Open Wound 20 Sq Cm< (97597) $280 $280 1.3×
Developmental tst admin phys/qhp 1st hour (96112) $331 $331 2.3×
Distort Product Evoked Otoacoustic Emisns Limitd (92587) $210.50 $210.50 0.9×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $964 $964 3.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $739 $739 6.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $964 $964 3.6×
Dup-scan xtr veins unilateral/limited study (93971) $712 $712 6.1×
Duplex scan extracranial art compl bi study (93880) $964 $964 3.6×
Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) $137 $137 1.0×
Echo Heart Xthoracic,Limited (93308) $208 $208 0.8×
EKG rhythm strip (93041) $142 $142 2.2×
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $94 $94 0.9×
Electrocardiogram Tracing (93005) $175.50 $175.50 2.7×
EMG four extremities (95864) $431 $431 3.0×
EMG one extremity (95860) $214 $214 1.4×
EMG three extremities (95863) $386 $386 2.7×
EMG two extremities (95861) $302 $302 2.0×
Er level 1 (99281) $268 $268 2.9×
Er level ii (99282) $551 $551 3.2×
Er level iii (99283) $827 $827 2.7×
Er level IV (99284) $1,138.50 $1,138.50 2.4×
Er level v (99285) $1,477.50 $1,477.50 2.2×
Eval speech sound production (92522) $299 $299 2.7×
Evaluate Pt Use Of Inhaler (94664) $95 $95 0.4×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $226 $226 1.8×
Evaluation of speech fluency (92521) $507 $507 3.8×
Exhaled Air Analysis (94690) $326 $326 5.0×
External ECG rec>48hr<7d recording (93242) $25 $25 0.6×
External ECG rec>7d<15d recording (93246) $25 $25 0.6×
External Ecg Scanning Analysis Report (93226) $72 $72 1.1×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $336 $336 1.7×
Fundus photography w/interpretation & report (92250) $132 $132 0.9×
Holter Monitor (93225) $45 $45 0.3×
Imm admn sarscov2 vaccine single dose (90480) $48 $48 1.1×
Immune Admin Oral/Nasal (90473) $56 $56 0.7×
Immunization Admin (90471) $56 $56 0.7×
Ingestion challenge test initial 120 minutes (95076) $215 $215 0.5×
Inital newborn e/m (99460) $233 $233 1.6×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) $341 $341 2.3×
Intrapulmonary Surfactant Administj Phys/Qhp (94610) $406 $406 1.7×
Irrig drug delivery device (96523) $161 $161 2.4×
IV infusion hydration each additional hour (96361) $97.50 $97.50 1.9×
IV infusion hydration initial 31 min-1 hour (96360) $516 $516 2.2×
IV infusion ther proph addl sequential to 1 hr (96367) $255 $255 3.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $826 $826 3.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $150 $150 2.9×
IV push ea addl new drug (96375) $178 $178 3.4×
IV push initial (96374) $516 $516 2.2×
Manual therapy 15 min (97140) $317 $317 11.4×
Massage 15 min (97124) $56 $56 1.9×
Maximum voluntary ventilation (94200) $57 $57 0.9×
Mechanical chest wall oscillation (94669) $692 $692 2.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $72 $72 2.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $97 $100 2.6×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $245 $245 2.7×
Nasopharyngoscopy (92511) $382 $382 1.7×
Needle Emg W/1 Fiber Electrode Quan Meas Jitter (95872) $342 $342 1.4×
Neg press wound tx >50 cm (97608) $1,587 $1,587 3.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $93 $93 0.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $315 $315 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $92 $92 0.2×
Nerve Conduction Studies 11-12 Studies (95912) $455 $455 1.1×
Nerve conduction studies 13/> studies (95913) $524 $524 1.3×
Nerve Conduction Studies 3-4 Studies (95908) $219 $219 0.9×
Nerve Conduction Studies 5-6 Studies (95909) $261 $261 1.1×
Nerve Conduction Studies 7-8 Studies (95910) $344 $344 0.8×
Nerve Conduction Studies 9-10 Studies (95911) $410 $410 1.0×
Nerve conduction studies; 1-2 studies (95907) $158 $158 0.7×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $177 $177 1.2×
Newborn resuscitation (99465) $604 $604 0.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $720 $720 5.0×
Orbicularis Oculi Reflx Electrodiagnostic Test (95933) $145 $145 2.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $66 $66 1.4×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $78 $78 3.2×
Osteopathic manipulative tx 3-4 body regions (98926) $115 $115 4.8×
Osteopathic manipulative tx 5-6 body regions (98927) $145 $145 6.0×
Osteopathic manipulative tx 7-8 body regions (98928) $177 $177 7.4×
Osteopathic manipulative tx 9-10 body regions (98929) $210 $210 8.7×
Ot eval high complex 60 min (97167) $353 $353 3.5×
Ot eval low complex 30 min (97165) $309 $309 3.1×
Ot eval mod complex 45 min (97166) $331 $331 3.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $111 $111 2.2×
Ot Prosthetic Training, Each 15 Min (97761) $155 $155 3.8×
Ot re-evaluation (97168) $221 $221 3.2×
Ot therapeutic activity 15 min (97530) $220 $220 6.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $501 $501 3.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $501 $501 3.5×
Patch/Application Test Specify Number Tests (95044) $13 $13 0.0×
Percutaneous tests w/allergenic extracts (95004) $13 $13 0.0×
Peripheral arterial disease rehab per session (93668) $299 $299 4.5×
Phlebotomy therapeutic (99195) $192 $192 1.3×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $121 $121 1.8×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $121 $121 1.8×
Plethysmography (94726) $347 $347 0.8×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $26 $26 0.5×
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $101 $101 0.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $49 $49 0.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $49 $49 0.9×
Psych diag eval w/med srvcs (90792) $353 $353 1.8×
Psychiatric diagnostic evaluation (90791) $315 $315 1.6×
Psytx crisis initial 60 min (90839) $351 $351 1.8×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $155 $155 4.1×
Pt Electrical Stimulation (97032) $36 $36 2.4×
Pt eval high complex 45 min (97163) $373 $373 3.8×
Pt eval low complex 20 min (97161) $373 $373 3.8×
Pt eval mod complex 30 min (97162) $373 $373 3.8×
Pt gait training 15 min (97116) $210 $210 7.2×
Pt group caregiver training (97552) $39 $39 1.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $186 $186 5.7×
Pt Physical Performance Test (97750) $187 $187 5.5×
Pt re-evaluation (97164) $193 $193 2.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $122 $122 3.8×
Pt-focused hlth risk assmt (96160) $10 $10 0.2×
Pulmonary stress test simple (94618) $418 $418 2.8×
Pure Tone Audiometry Air Only (92552) $227.50 $227.50 1.5×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $31 $31 0.2×
Rem mntr physiol param dev (99454) $98 $98 2.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $16 $16 0.4×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $30 $30 0.2×
Remote therapeutic monitoring (eg, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily)… (98976) $86 $86 2.1×
Remote therapeutic monitoring (eg, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily)… (98977) $86 $86 2.1×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981) $59 $59 1.4×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980) $73 $73 1.3×
Rt Chest Wall Manipulation,Subsequent (94668) $595 $595 4.0×
Slp caregiver training 1st 30 min (97550) $92 $92 1.7×
Smoking cessation > 10 min (99407) $53 $53 1.3×
Speech sound lang comprehen (92523) $460 $460 2.0×
Spirometry (94010) $65 $65 0.3×
Standardized Cognitive Performance Testing (96125) $215 $215 2.1×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $45 $45 2.0×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $42 $42 2.0×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $199 $199 1.9×
Therapeutic prophylactic/dx injection subq/im (96372) $215 $215 2.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $69 $69 1.7×
Trans Care Mgmt 14 Day Disch (99495) $447 $447 3.0×
Trans Care Mgmt 7 Day Disch (99496) $590 $590 4.0×
Tte w/doppler, complete (93306) $403 $403 0.7×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $960.50 $960.50 3.6×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $306 $306 4.0×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $45 $45 1.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $213 $213 2.5×
Tympanometry (92567) $26 $26 0.6×
Ultraviolet Light Therapy (96900) $142 $142 3.4×
Vasc Duplex Scan Extracranial,Limited (93882) $956 $956 8.2×
Vasopneumatic device (97016) $113 $113 9.4×
Vent mgmt inpat init day (94002) $1,542 $1,542 2.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,619 $1,619 2.4×
Visual reinforcement audiometry (vra) (92579) $105 $105 0.4×
Vital capacity, total (94150) $596 $596 4.2×
Wheelchair Mgmt Ea 15 Min (97542) $333 $333 10.7×