Visits & medical services prices at San Luis Valley Health Conejos County Hospital

La Jara, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $106.15 $193 0.5×
Canalith Repositioning (95992) $50.60 $92 1.2×
Cbt 1st hour (94644) $113.85 $207 0.8×
Color/duplex Doppler, complete (93975) $689.70 $1,254 2.7×
Cpap initiation and management (94660) $921.25 $1,675 4.0×
Critical care (99291) $1,488.30 $2,706 1.7×
Demo &/or eval,pt use,aerosol device (94664) $80.30 $146 0.3×
Dup-scan xtr veins unilateral/limited study (93971) $349.80 $636 3.2×
Duplex scan extracranial art compl bi study (93880) $481.80 $876 1.9×
EKG (93005) $146.85 $267 2.4×
Er level 1 (99281) $71.50 $130 0.8×
Er level ii (99282) $208.45 $379 1.3×
Er level iii (99283) $343.75 $625 1.2×
Er level IV (99284) $605.55 $1,101 1.4×
Er level v (99285) $940.50 $1,710 1.5×
Evaluation of swallowing function (92610) $260.15 $473 3.1×
External Ecg Scanning Analysis Report (93226) $168.30 $306 2.7×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $24.75 $45 0.6×
Immunization Admin (90471) $26.95 $49 0.4×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $96.80 $176 1.6×
IV infusion hydration each additional hour (96361) $68.20 $124 1.4×
IV infusion hydration initial 31 min-1 hour (96360) $197.45 $359 0.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $102.85 $187 1.4×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $362.72 $659.50 1.6×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $70.95 $129 1.4×
IV push initial (96374) $276.65 $503 1.2×
Manual therapy 15 min (97140) $111.65 $203 4.0×
Massage 15 min (97124) $42.90 $78 1.4×
Mechanical traction (97012) $39.60 $72 2.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $42.90 $78 1.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $55.55 $101 1.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $184.25 $335 1.4×
Osteopathic manipulative tx 1-2 body regions (98925) $15.40 $28 0.7×
Ot eval high complex 60 min (97167) $131.45 $239 1.3×
Ot eval low complex 30 min (97165) $163.90 $298 1.6×
Ot eval mod complex 45 min (97166) $163.90 $298 1.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,940.95 $3,529 2.1×
Polysom <6 yrs 4/> paramtrs (95782) $2,185.15 $3,973 2.4×
Pt Electrical Stimulation (97032) $58.85 $107 4.0×
Pt eval high complex 45 min (97163) $169.40 $308 1.7×
Pt eval low complex 20 min (97161) $169.95 $309 1.7×
Pt Gait Training Therapy (97116) $52.80 $96 1.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $80.85 $147 2.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $169.40 $308 1.7×
Pt re-evaluation (97164) $92.40 $168 1.4×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $58.85 $107 1.8×
Pt Ultrasound Therapy (97035) $44 $80 3.1×
Standardized Cognitive Performance Testing (96125) $188.10 $342 1.8×
Ther/Proph/Diag Inj Sc/Im (96372) $95.70 $174 1.3×
Therapeutic Activities (97530) $64.90 $118 1.9×
Therapeutic phlebotomy (99195) $171.05 $311 1.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $144.65 $263 1.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $102.85 $187 2.1×
Vasc Duplex Extrem Venous,Bilat (93970) $573.65 $1,043 2.3×
Vasopneumatic device (97016) $29.70 $54 2.5×