Visits & medical services prices at San Luis Valley Health Regional Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Aep threshold estimation mlt frequencies i&r (92652) $394.35 $717 1.7×
Airway inhalation treatment (94640) $106.15 $193 0.5×
Appl on-body injector for timed subq injection (96377) $41.25 $75 0.8×
Behav assmt w/score & docd/stand instrument (96127) $3.85 $7 0.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $319.55 $581 0.8×
Canalith Repositioning (95992) $50.60 $92 1.2×
Cardiac Stress Tst,Tracing Only (93017) $652.30 $1,186 2.9×
Cardiopulmonary resuscitation (92950) $270.05 $491 1.2×
Cardioversion (92960) $218.35 $397 0.3×
Cbt 1st hour (94644) $113.85 $207 0.8×
Chemo Hormon Antineopl Sq/Im (96402) $133.65 $243 1.8×
Chemo IV push addl drug (96411) $200.20 $364 2.6×
Chemo Iv Push Sngl Drug (96409) $373.45 $679 1.1×
Chemo prolong 8+ hrs infuse w/pump (96416) $568.15 $1,033 1.6×
Chemother, IV infusion, 1 hr (96413) $480.42 $873.50 1.4×
Chemother, IV infusion, ea add hr (96415) $190.30 $346 2.5×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $178.75 $325 2.4×
Chemotherapy, unspecified procedure (96549) $222.20 $404 4.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $234.85 $427 3.1×
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×
Debridement Open Wound 20 Sq Cm< (97597) $26.95 $49 0.1×
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×
Echo Heart Xthoracic,Limited (93308) $570.90 $1,038 2.3×
Echo r-t 2d w/probe placement only (93313) $1,505.90 $2,738 2.6×
EEG awake asleep (95819) $681.45 $1,239 3.0×
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 speech sound production (92522) $207.90 $378 1.9×
Evaluation of swallowing function (92610) $260.15 $473 3.1×
External ECG rec>7d<15d recording (93246) $138.05 $251 3.5×
External Ecg Scanning Analysis Report (93226) $168.30 $306 2.7×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $112.20 $204 0.6×
Holter Monitor Recording (93225) $348.15 $633 2.5×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $24.75 $45 0.6×
Immunization Admin (90471) $26.95 $49 0.4×
Immunotherapy, 2+ Injections (95117) $28.05 $51 0.6×
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×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $234.02 $425.50 2.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $175.45 $319 0.8×
Newborn resuscitation (99465) $572 $1,040 0.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $287.10 $522 2.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $184.25 $335 1.4×
Nonphysician Telephone Assessment 11-20 Min (98967) $38.50 $70 1.5×
Nonphysician Telephone Assessment 21-30 Min (98968) $59.95 $109 1.7×
Nonphysician Telephone Assessment 5-10 Min (98966) $19.80 $36 1.4×
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×
Ot re-eval est plan care (97168) $88.55 $161 1.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $165 $300 1.2×
Paraffin bath (97018) $25.85 $47 4.3×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $142.45 $259 0.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,940.95 $3,529 2.1×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $6.60 $12 0.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $28.60 $52 0.6×
Pt Electric Current Therapy (97033) $40.70 $74 2.1×
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) $152.90 $278 1.6×
Pt Gait Training Therapy (97116) $52.80 $96 1.8×
Pt Infrared Therapy (97026) $25.85 $47 3.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $80.85 $147 2.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $169.68 $308.50 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×
Pt-focused hlth risk assmt (96160) $26.40 $48 0.7×
Pulm function test by gas (94727) $135.85 $247 0.6×
Pulmonary stress testing (94618) $48.40 $88 0.3×
Pure Tone Audiometry, Air (92552) $113.85 $207 0.8×
Refill/Maint Pump/Resvr Syst (96522) $215.60 $392 1.0×
Refill/maint, portable pump (96521) $350.90 $638 1.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $290.40 $528 7.4×
Sleep study unattended (95806) $72.60 $132 0.3×
Speech sound lang comprehen (92523) $260.15 $473 1.1×
Spirometry (94010) $135.85 $247 0.6×
Standardized Cognitive Performance Testing (96125) $169.95 $309 1.7×
Stress echo (93350) $1,208.35 $2,197 2.1×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $52.25 $95 2.3×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $52.25 $95 2.5×
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×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $13.20 $24 0.3×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,383.80 $2,516 2.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $144.65 $263 1.9×
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×
Tympanometry (92567) $59.95 $109 1.5×
Ultraviolet Light Therapy (96900) $65.45 $119 1.7×
Unlisted allergy/clinical immunologic service or procedure Cardiac Catheterization (95199) $10.45 $19 0.3×
Vasc Duplex Extrem Venous,Bilat (93970) $573.65 $1,043 2.3×
Vasopneumatic device (97016) $29.70 $54 2.5×
Ventilation assist & mgmt inpatient 1st day (94002) $1,208.35 $2,197 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $974.60 $1,772 1.5×