Visits & medical services prices at San Gorgonio Memorial Hospital
Banning, CA · every code in this section with a posted price and a Medicare benchmark.
83 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) range across 5 matching MRF lines |
$65.32–$724.74 | $326.60–$3,623.68 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $30.62 | $153.11 | 2.1× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $137.11 | $685.54 | 0.3× |
| Canalith repositioning proc (95992) | $114.60 | $573 | 2.8× |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$611.21–$632.60 | $3,056.04–$3,163.01 | varies |
| Cardiopulmonary resuscitation (92950) range across 4 matching MRF lines |
$333.89–$1,853.39 | $1,669.46–$9,266.94 | varies |
| Cardioversion (92960) range across 4 matching MRF lines |
$462.31–$1,360.49 | $2,311.53–$6,802.47 | varies |
| Cbt 1st hour (94644) | $20.35 | $101.75 | 0.1× |
| Chest Wall Manipulation (94668) range across 2 matching MRF lines |
$126.52–$130.95 | $632.62–$654.77 | varies |
| Color/duplex Doppler, complete (93975) | $576.20 | $2,881.01 | 1.9× |
| Color/duplex Doppler, limited (93976) range across 5 matching MRF lines |
$174.24–$545.26 | $871.18–$2,726.32 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$241.34–$985.82 | $1,206.69–$4,929.09 | varies |
| Cpt initial (94667) range across 2 matching MRF lines |
$130.32–$134.88 | $651.60–$674.41 | varies |
| Critical care first hour (99291) | $2,018.61 | $10,093.04 | 1.9× |
| Dialysis One Evaluation (90945) | $588.81 | $2,944.05 | 1.1× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) range across 2 matching MRF lines |
$556.72–$576.20 | $2,783.58–$2,881.01 | varies |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 2 matching MRF lines |
$263.41–$272.63 | $1,317.06–$1,363.16 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$556.72–$576.20 | $2,783.58–$2,881.01 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 3 matching MRF lines |
$263.41–$272.63 | $1,317.06–$1,363.16 | varies |
| Duplex Scan Hemodialysis Access (93990) | $272.63 | $1,363.16 | 2.0× |
| Duplex up extrem art bilat (93930) range across 2 matching MRF lines |
$556.72–$576.20 | $2,783.58–$2,881.01 | varies |
| Duplex up extrem art unilat/ltd (93931) range across 2 matching MRF lines |
$263.41–$272.63 | $1,317.06–$1,363.16 | varies |
| Echo Heart Xthoracic,Limited (93308) | $462.99 | $2,314.93 | 1.5× |
| Echo transesophag montr cardiac pump functj (93318) range across 2 matching MRF lines |
$38.69–$1,415.22 | $193.43–$7,076.10 | varies |
| Echo transesophageal (93312) | $714.66 | $3,573.29 | 1.0× |
| Eeg 41-60 Minutes (95812) | $474.75 | $2,373.74 | 1.7× |
| EEG awake and asleep (95819) range across 3 matching MRF lines |
$662.22–$685.40 | $3,311.10–$3,426.99 | varies |
| Electrocardiogram Tracing (93005) range across 3 matching MRF lines |
$185.41–$556.23 | $927.05–$2,781.15 | varies |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$144.20–$149.25 | $721–$746.24 | varies |
| Emergency Dept Visit Level 3 (99283) range across 3 matching MRF lines |
$228.62–$236.62 | $1,143.08–$1,183.09 | varies |
| Emergency Dept Visit Level 4 (99284) range across 3 matching MRF lines |
$638.50–$660.85 | $3,192.52–$3,304.26 | varies |
| Er level 1 (99281) range across 2 matching MRF lines |
$59.80–$61.89 | $299–$309.47 | varies |
| Er level v (99285) range across 3 matching MRF lines |
$1,003.41–$1,038.53 | $5,017.06–$5,192.66 | varies |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) range across 2 matching MRF lines |
$23.59–$24.30 | $117.96–$121.50 | varies |
| Evaluate pt use of inhaler (94664) | $135.19 | $675.97 | 0.5× |
| Evaluate Swallowing Function (92610) range across 5 matching MRF lines |
$59.10–$97.75 | $295.52–$488.73 | varies |
| Evoked Auditory Test,Limited (92587) | $99.14 | $495.72 | 0.4× |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$556.72–$576.20 | $2,783.58–$2,881.01 | varies |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) range across 2 matching MRF lines |
$552.33–$588.81 | $2,761.64–$2,944.05 | varies |
| Immunization administration (90471) range across 3 matching MRF lines |
$22.21–$22.99 | $111.05–$114.94 | varies |
| IV infusion hydration each additional hour (96361) range across 7 matching MRF lines |
$71.08–$931.40 | $355.42–$4,657 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 4 matching MRF lines |
$77.38–$84.89 | $386.92–$424.43 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 5 matching MRF lines |
$56.50–$112.99 | $282.48–$564.96 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 9 matching MRF lines |
$29.61–$302.71 | $148.06–$1,513.56 | varies |
| IV push initial (96374) range across 8 matching MRF lines |
$64.46–$108.01 | $322.28–$540.07 | varies |
| Mechanical chest wall oscillation per session (94669) | $41.47 | $207.34 | 0.1× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $21.91 | $109.56 | 0.7× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $34.12 | $170.62 | 0.9× |
| Motion Fluoroscopy/Swallow (92611) | $71.46 | $357.32 | 0.8× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $84.71 | $423.57 | 0.3× |
| Neuromuscular Reeducation (97112) range across 3 matching MRF lines |
$44.71–$80.86 | $223.55–$404.32 | varies |
| Newborn resuscitation (99465) | $1,323.36 | $6,616.82 | 1.6× |
| Oral Function Therapy (92526) | $23.59 | $117.96 | 0.3× |
| Ot eval high complexity (97167) | $336.95 | $1,684.73 | 3.4× |
| Ot Eval Low Complex (97165) range across 3 matching MRF lines |
$325.55–$336.95 | $1,627.75–$1,684.73 | varies |
| Ot Eval Moderate Complexity (97166) range across 3 matching MRF lines |
$325.55–$336.95 | $1,627.75–$1,684.73 | varies |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$46.28–$89.42 | $231.38–$447.10 | varies |
| Ot Re-Eval Est Plan Care (97168) | $336.95 | $1,684.73 | 4.9× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$27.64–$43.25 | $138.18–$216.27 | varies |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$100–$130 | $500–$650 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) range across 2 matching MRF lines |
$13.40–$13.87 | $67.02–$69.37 | varies |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $13.87 | $69.37 | 0.2× |
| Plethysmography (94726) | $141.22 | $706.10 | 0.3× |
| Pt Eval High Complex (97163) range across 2 matching MRF lines |
$132.62–$256.26 | $663.09–$1,281.32 | varies |
| Pt eval low complex 20 min (97161) range across 3 matching MRF lines |
$134.55–$139.26 | $672.77–$696.32 | varies |
| Pt Eval Mod Complex (97162) range across 3 matching MRF lines |
$128.13–$132.62 | $640.66–$663.09 | varies |
| Pt gait training 15 min (97116) range across 4 matching MRF lines |
$44.71–$89.42 | $223.55–$447.10 | varies |
| Pt Re-Eval Est Plan Care (97164) | $88.96 | $444.78 | 1.3× |
| Pulmonary service/procedure (94799) range across 2 matching MRF lines |
$139.60–$144.49 | $698.02–$722.46 | varies |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $131.17 | $655.84 | 1.7× |
| Self Care Mngment Training (97535) range across 3 matching MRF lines |
$93.37–$96.64 | $466.87–$483.22 | varies |
| Speech sound lang comprehen (92523) range across 3 matching MRF lines |
$58.10–$89.77 | $290.49–$448.84 | varies |
| Spirometry (94010) | $32.48 | $162.38 | 0.1× |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$705.39–$730.08 | $3,526.93–$3,650.38 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 2 matching MRF lines |
$46.28–$80.86 | $231.38–$404.32 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 6 matching MRF lines |
$42.97–$177.90 | $214.85–$889.48 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 6 matching MRF lines |
$90.79–$168.96 | $453.96–$844.81 | varies |
| Therapeutic Activities (97530) range across 7 matching MRF lines |
$44.71–$96.64 | $223.55–$483.22 | varies |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$993.72–$1,028.50 | $4,968.58–$5,142.49 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 2 matching MRF lines |
$24.18–$26.66 | $120.89–$133.32 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 8 matching MRF lines |
$41.81–$444.23 | $209.05–$2,221.16 | varies |
| Vent Mgmt Inpat Init Day (94002) range across 3 matching MRF lines |
$1,934.94–$2,002.66 | $9,674.70–$10,013.32 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $402.09 | $2,010.45 | 0.5× |
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.