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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ProcedurePosted cashPosted gross× Medicare
Actinotherapy Ultraviolet Light (96900) $142 $142 3.4×
Admn Sarscov2 Vacc 1 Dose (90480) $48 $48 1.1×
Advncd Care Plan 30 Min (99497) $199 $199 1.8×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines		 $51–$996 $51–$996 varies
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+ areas lllt po pain reduction (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×
Behavral qualit analys voice (92524) $160 $160 1.5×
Blink reflex test (95933) $145 $145 2.2×
Brief Emotional/Behav Assmt (96127) $17 $17 0.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060)
range across 3 matching MRF lines		 $183–$1,010 $183–$1,010 varies
Canalith repositioning proc (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)
range across 2 matching MRF lines		 $738–$1,314 $738–$1,314 varies
Cardioversion (92960)
range across 3 matching MRF lines		 $362–$2,164 $362–$2,164 varies
Care mgmt services behavioral hlth cond 20 mins (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 Anti-Neopl Sq/Im (96401) $328 $328 4.1×
Chemo Hormon Antineopl Sq/Im (96402) $317 $317 4.0×
Chemo IV infusion addl hr (96415) $241 $241 3.0×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $1,275 $1,275 3.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $1,096 $1,096 3.0×
Chest Wall Manipulation (94668) $595 $595 4.0×
Chron Care Mgmt Srvc 20 Min (99490) $93 $93 0.8×
Color Vision Xm Extended Anomaloscope/Equiv (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 mntr physician/qhp provided equiptment (95250) $266 $266 1.8×
Cont Gluc Mntr Pt Prov Eqp (95249) $95 $95 1.4×
Continuous Pulse Ox (94762) $720 $720 5.0×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $2,198 $2,198 9.0×
Cpt initial (94667) $595 $595 4.0×
Critical care first hour (99291)
range across 4 matching MRF lines		 $693–$3,276 $693–$3,276 varies
Debridement Open Wound 20 Sq Cm< (97597)
range across 4 matching MRF lines		 $280–$1,033 $280–$1,033 varies
Developmental tst admin phys/qhp 1st hour (96112) $331 $331 2.3×
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×
Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) $137 $137 1.0×
Echo Heart Xthoracic,Limited (93308)
range across 3 matching MRF lines		 $45–$585 $45–$585 varies
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $94 $94 0.9×
Electrical Stimulation Ea 15 Min (97032) $36 $36 2.4×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines		 $60–$291 $60–$291 varies
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines		 $220–$882 $220–$882 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines		 $331–$1,323 $331–$1,323 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines		 $513–$1,764 $513–$1,764 varies
Emg 3 Extremities (95863) $386 $386 2.7×
Emg 4 Extremities (95864) $431 $431 3.0×
Er level 1 (99281)
range across 2 matching MRF lines		 $95–$441 $95–$441 varies
Er level v (99285)
range across 2 matching MRF lines		 $750–$2,205 $750–$2,205 varies
Evaluate pt use of inhaler (94664)
range across 3 matching MRF lines		 $55–$662 $55–$662 varies
Evaluate Speech Production (92522) $299 $299 2.7×
Evaluate Swallowing Function (92610) $196 $196 2.3×
Evaluation of speech fluency (92521) $507 $507 3.8×
Evoked Auditory Test,Limited (92587)
range across 2 matching MRF lines		 $40–$381 $40–$381 varies
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×
Extracranial Bilat Study (93880) $964 $964 3.6×
Extracranial Uni/Ltd Study (93882) $956 $956 8.2×
Flexible endoscopic eval swallow c/v rec (92612) $336 $336 1.7×
Fundus photography (92250) $132 $132 0.9×
Holter monitor recording (93225) $45 $45 0.3×
Im Adm Intransl/Oral 1 Vaccine (90473) $56 $56 0.7×
Immunization administration (90471)
range across 7 matching MRF lines		 $30–$206 $30–$206 varies
Ingestion challenge test initial 120 minutes (95076) $215 $215 0.5×
Inital newborn e/m (99460) $233 $233 1.6×
Irrig Drug Delivery Device (96523)
range across 2 matching MRF lines		 $65–$257 $65–$257 varies
IV infusion hydration each additional hour (96361)
range across 4 matching MRF lines		 $38–$157 $38–$157 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 3 matching MRF lines		 $125–$737 $125–$737 varies
IV infusion ther proph addl sequential to 1 hr (96367) $255 $255 3.2×
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 3 matching MRF lines		 $51–$150 $51–$150 varies
IV push initial (96374)
range across 3 matching MRF lines		 $122–$516 $122–$516 varies
Lung Function Test (Mbc/Mvv) (94200) $57 $57 0.9×
Mechanical chest wall oscillation per session (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)
range across 3 matching MRF lines		 $94–$100 $94–$100 varies
Motion Fluoroscopy/Swallow (92611) $245 $245 2.7×
Muscle Test 2 Limbs (95861) $302 $302 2.0×
Muscle Test One Limb (95860) $214 $214 1.4×
Nasopharyngoscopy (92511) $382 $382 1.7×
Needle EMG w/1 fiber electrode quan meas jitter (95872) $342 $342 1.4×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $93 $93 0.2×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $1,587 $1,587 3.5×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines		 $108–$522 $108–$522 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606)
range across 3 matching MRF lines		 $92–$522 $92–$522 varies
Nerve Conduction Studies 1-2 Studies (95907) $158 $158 0.7×
Nerve Conduction Studies 11-12 Studies (95912) $455 $455 1.1×
Nerve conduction studies 13 or more 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×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $177 $177 1.2×
Neuromuscular Reeducation (97112) $186 $186 5.7×
Newborn resuscitation (99465)
range across 5 matching MRF lines		 $604–$2,066 $604–$2,066 varies
Oral Function Therapy (92526) $213 $213 2.5×
Orthc/Prostc Mgmt Sbsq Enc (97763) $111 $111 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 complexity (97167) $353 $353 3.5×
Ot Eval Low Complex (97165) $309 $309 3.1×
Ot Eval Moderate Complexity (97166) $331 $331 3.3×
Ot manual therapy 15 min (97140) $317 $317 11.4×
Ot Prosthetic Training, Each 15 Min (97761) $155 $155 3.8×
Ot Re-Eval Est Plan Care (97168) $221 $221 3.2×
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×
Oxygen Uptake Rest Indirect (94690) $326 $326 5.0×
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×
Physical Performance Test (97750)
range across 2 matching MRF lines		 $41–$333 $41–$333 varies
Plethysmography (94726)
range across 2 matching MRF lines		 $98–$596 $98–$596 varies
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 Eval High Complex (97163) $373 $373 3.8×
Pt eval low complex 20 min (97161) $373 $373 3.8×
Pt Eval Mod Complex (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 Re-Eval Est Plan Care (97164) $193 $193 2.9×
Pt-focused hlth risk assmt score doc stnd instrm (96160) $10 $10 0.2×
Pulmonary Stress Testing (94618) $418 $418 2.8×
Pure Tone Audiometry Air (92552)
range across 2 matching MRF lines		 $50–$405 $50–$405 varies
Rem mntr physiol param 1st dev supply ea 30 d (99454) $98 $98 2.4×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $31 $31 0.2×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $86 $86 2.1×
Rem ther mntr dev sply resp (98976) $86 $86 2.1×
Remote 30 Day Ecg Rev/Report (93270) $16 $16 0.4×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $30 $30 0.2×
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×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $142 $142 2.2×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $226 $226 1.8×
Same day nb discharge (99463) $341 $341 2.3×
Self Care Mngment Training (97535) $122 $122 3.8×
Slp caregiver training 1st 30 min (97550) $92 $92 1.7×
Speech sound lang comprehen (92523) $460 $460 2.0×
Spirometry (94010)
range across 3 matching MRF lines		 $65–$720 $65–$720 varies
Standardized Cognitive Performance Testing (96125) $215 $215 2.1×
Surfactant Admin Thru Tube (94610) $406 $406 1.7×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $45 $45 2.0×
Ther Ivntj Ea Addl 15 Min (97130) $42 $42 2.0×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $56 $56 1.9×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $199 $199 1.9×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 4 matching MRF lines		 $56–$374 $56–$374 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 4 matching MRF lines		 $159–$826 $159–$826 varies
Therapeutic Activities (97530) $220 $220 6.3×
Tobacco Use Cessation Intensive >10 Minutes (99407) $53 $53 1.3×
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)
range across 3 matching MRF lines		 $121–$2,277 $121–$2,277 varies
Tte W/O Doppler Complete (93307)
range across 2 matching MRF lines		 $77–$1,844 $77–$1,844 varies
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/Pro/Dx Inj New Drug Addon (96375)
range across 4 matching MRF lines		 $55–$206 $55–$206 varies
Tympanometry (92567) $26 $26 0.6×
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×

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.