Visits & medical services prices at Sistersville General Hospital

Sistersville, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $48.63 $81.05 1.8×
Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the… (97813) $51.92 $86.54 1.9×
Advance care planning first 30 mins (99497) $140.42 $234.04 1.4×
Airway inhalation treatment (94640) $216.06 $360.10 1.0×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $31.64 $52.74 0.9×
Allg tstg perq & ic venoms immed react w/ i&r (95017) $26.80 $44.67 1.0×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $104 $173.33 7.2×
Assessment of aphasia per hr (96105) $189.53 $315.89 1.9×
Bedside Swallowing Eval (92610) $108.42 $180.70 1.3×
Behavioral and qualitative analysis of voice and resonance (92524) $120.05 $200.08 1.1×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $190.65 $317.75 2.3×
Bfb training ea addl 15 min (90913) $78.30 $130.50 2.4×
Biofeedback training any modality (90901) $111.20 $185.33 2.7×
Bis extracellular fluid alys lymphedema assmnt (93702) $155.88 $259.81 1.3×
Brief Emotional/Behavioral Assessment (96127) $18.90 $31.50 0.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $401.33 $668.88 1.1×
Canalith Repositioning Procedure (95992) $122.63 $204.38 3.0×
Cardiopulmonary resuscitation (92950) $455.96 $759.94 2.2×
Cardioversion (92960) $1,136.05 $1,893.42 1.8×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $51.67 $86.11 2.0×
Chemo Hormon Antineopl Sq/Im (96402) $32.95 $54.92 0.5×
Chemother, IV infusion, 1 hr (96413) $1,167.22 $1,945.36 3.7×
Chemother, IV infusion, ea add hr (96415) $219.53 $365.88 3.2×
Chemotherapy into cns (96450) $607.84 $1,013.06 1.9×
Chronic care management services 1st 20 min (99490) $88.91 $148.19 0.9×
Color/duplex Doppler, complete (93975) $455.78 $759.64 2.0×
Cont Gluc Monitoring Patient Provided Equipment (95249) $30.83 $51.39 0.5×
Continuous Glucose Monitoring (95250) $63.89 $106.49 0.5×
Corneal Topography (92025) $64.81 $108.02 1.1×
Cpap/bipap (94660) $219.77 $366.28 1.0×
Cpt initial (94667) $129.28 $215.46 1.0×
Cptrized oph dx img anterior segment uni/bi (92132) $60.04 $100.06 1.1×
Cptrized oph dx img pst segment uni/bi retina (92134) $72.51 $120.85 1.3×
Critical care (99291) $691.39 $1,152.32 0.9×
Debridement Open Wound 20 Sq Cm< (97597) $307.71 $512.84 1.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $235.60 $392.67 2.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $503.62 $839.36 2.2×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $377.27 $628.78 3.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $662.75 $1,104.59 2.9×
Dup-scan xtr veins unilateral/limited study (93971) $366.43 $610.72 3.7×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $348.22 $580.36 1.5×
Duplex scan extracranial art compl bi study (93880) $595.08 $991.80 2.6×
Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) $239.84 $399.73 1.9×
Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) $239.84 $399.73 1.9×
EEG awake drowsy (95816) $1,648.14 $2,746.89 8.0×
EKG rhythm strip (93041) $39.43 $65.72 0.7×
Electrocardiogram Tracing (93005) $36.57 $60.95 0.6×
Er level 1 (99281) $70.18 $116.98 0.9×
Er level ii (99282) $99.98 $166.64 0.7×
Er level iii (99283) $157.92 $263.20 0.6×
Er level IV (99284) $221.52 $369.20 0.6×
Er level v (99285) $390.06 $650.10 0.7×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $239.84 $399.73 1.9×
Eval speech sound production (92522) $115.03 $191.71 1.0×
Eval to use/fit voice prosth (92597) $99.54 $165.90 1.4×
Evaluate Pt Use Of Inhaler (94664) $118.54 $197.58 0.6×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $182.84 $304.74 1.5×
Evaluation of speech fluency (92521) $141.65 $236.08 1.1×
Eye exam, new patient,comprehesv (92004) $200.23 $333.71 1.6×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $45.50 $75.84 0.2×
Gonioscopy (92020) $93.89 $156.48 0.7×
Group Therapeutic Procedures (97150) $74.44 $124.07 4.1×
Health Behavior Assessment/Re-Assessment (96156) $165.66 $276.10 1.7×
Health behavior ivntj indiv f2f 1st 30 min (96158) $128.84 $214.74 0.8×
Holter Monitor (93225) $322.21 $537.02 2.5×
Imm admn sarscov2 vaccine single dose (90480) $39.89 $66.48 1.0×
Immunization Admin (90471) $127.89 $213.15 1.9×
Ingestion challenge test initial 120 minutes (95076) $408.45 $680.75 1.1×
Inital newborn e/m (99460) $123.94 $206.56 1.0×
Injection intra arterial (96373) $124.96 $208.26 0.6×
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) $38.77 $64.62 0.7×
Iontophoresis 15 min (97033) $107.28 $178.80 5.6×
Irrig drug delivery device (96523) $19.52 $32.53 0.3×
IV infusion hydration each additional hour (96361) $67.21 $112.02 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $184.83 $308.05 0.9×
IV infusion ther proph addl sequential to 1 hr (96367) $120.02 $200.03 1.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $384.06 $640.10 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $96.76 $161.28 2.2×
IV push ea addl new drug (96375) $72.02 $120.04 1.6×
IV push initial (96374) $180.02 $300.04 0.9×
Manual therapy 15 min (97140) $107.28 $178.80 3.9×
Massage 15 min (97124) $91.95 $153.25 3.1×
Mechanical chest wall oscillation (94669) $184.85 $308.09 0.9×
Mechanical traction (97012) $59.11 $98.52 4.1×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $118.04 $196.74 1.3×
Multiple Sleep Latency Test (95805) $626.60 $1,044.32 0.8×
Nasopharyngoscopy (92511) $133.33 $222.22 0.7×
Neg press wound tx >50 cm (97608) $759.31 $1,265.52 1.9×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $277.90 $463.17 0.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $138.24 $230.40 0.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $456.10 $760.17 1.2×
Nerve Conduction Studies 11-12 Studies (95912) $550.84 $918.07 1.5×
Nerve Conduction Studies 7-8 Studies (95910) $321.69 $536.15 0.9×
Neurobehavioral Status Exam (96116) $286.42 $477.36 1.4×
Nitric oxide expired gas determination (95012) $38.98 $64.97 1.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $403.13 $671.88 3.2×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $331.30 $552.16 2.7×
Nonphysician Telephone Assessment 11-20 Min (98967) $19.59 $32.65 0.8×
Nonphysician Telephone Assessment 21-30 Min (98968) $28.47 $47.45 0.8×
Nonphysician Telephone Assessment 5-10 Min (98966) $9.92 $16.54 0.7×
Nrpsyc tst eval phys/qhp 1st (96132) $325.04 $541.74 0.9×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $174.67 $291.11 1.4×
Ophth medical xm&eval intermediate estab pt (92012) $140.11 $233.51 1.1×
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92002) $134.35 $223.91 1.1×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $134.65 $224.41 2.9×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $43.70 $72.83 2.1×
Osteopathic manipulative tx 3-4 body regions (98926) $58.32 $97.20 2.8×
Osteopathic manipulative tx 5-6 body regions (98927) $72.56 $120.94 3.5×
Osteopathic manipulative tx 7-8 body regions (98928) $87.14 $145.24 4.2×
Osteopathic manipulative tx 9-10 body regions (98929) $102.57 $170.95 5.0×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $108.38 $180.63 3.4×
Ot Contrast Bath Ea 15 Min (97034) $63.49 $105.82 4.5×
Ot eval high complex 60 min (97167) $335 $558.33 3.3×
Ot eval low complex 30 min (97165) $254.38 $423.98 2.5×
Ot eval mod complex 45 min (97166) $335 $558.33 3.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $153.28 $255.46 3.1×
Ot Prosthetic Training, Each 15 Min (97761) $120.42 $200.70 3.0×
Ot Range Motion Measure,Each Extrem (95851) $52.30 $87.17 2.0×
Ot re-evaluation (97168) $186.10 $310.17 2.7×
Ot therapeutic activity 15 min (97530) $123.70 $206.16 3.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $191.24 $318.73 1.5×
Paraffin bath pt (97018) $37.21 $62.02 6.2×
Patch/Application Test Specify Number Tests (95044) $8.20 $13.66 0.0×
Percutaneous tests w/allergenic extracts (95004) $614.94 $1,024.90 0.7×
Peripheral arterial disease rehab per session (93668) $121.61 $202.68 2.1×
Phlebotomy therapeutic (99195) $213.49 $355.82 1.7×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $175.41 $292.35 3.1×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $175.41 $292.35 3.1×
Plethysmography (94726) $157.03 $261.71 0.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,133.58 $3,555.96 2.6×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $27.87 $46.45 0.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $28.31 $47.19 0.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $39.45 $65.75 0.9×
Psych diag eval w/med srvcs (90792) $264.83 $441.39 1.6×
Psychiatric diagnostic evaluation (90791) $243.54 $405.90 1.4×
Psycl tst eval phys/qhp 1st (96130) $243.14 $405.24 1.2×
Psycl/nrpsyc tst phy/qhp 1st (96136) $45.78 $76.30 0.4×
Psycl/nrpsycl tst elec platform auto result (96146) $14.23 $23.72 0.5×
Psytx crisis initial 60 min (90839) $254.88 $424.80 1.5×
Pt Aquatic Therapy/Exercises (97113) $147.80 $246.33 4.0×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $90.67 $151.11 2.4×
Pt Electrical Stimulation (97032) $67.88 $113.13 4.6×
Pt eval high complex 45 min (97163) $336.09 $560.15 3.4×
Pt eval low complex 20 min (97161) $336.09 $560.15 3.4×
Pt eval mod complex 30 min (97162) $284.72 $474.54 2.9×
Pt gait training 15 min (97116) $100.72 $167.87 3.5×
Pt group caregiver training (97552) $45.71 $76.18 2.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $119.32 $198.86 3.6×
Pt Physical Performance Test (97750) $121.52 $202.54 3.6×
Pt re-evaluation (97164) $154.36 $257.26 2.3×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $123.70 $206.16 3.8×
Pt Whirlpool Therapy (97022) $78.83 $131.39 5.0×
Pulmonary stress test simple (94618) $243.64 $406.07 1.9×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) $77.66 $129.43 2.3×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) $28.36 $47.27 2.3×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98971) $50.08 $83.47 2.2×
Rapid Desensitization Procedure Each Hour (95180) $352.99 $588.32 0.8×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $36.49 $60.81 1.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $335.22 $558.72 1.7×
Rom meas&reprt hand w/wo comparison normal sid (95852) $44.60 $74.33 2.1×
Rt Chest Wall Manipulation,Subsequent (94668) $152.03 $253.38 1.2×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $54.75 $91.25 1.1×
Sensory Integration Ea 15 Min (97533) $95.92 $159.87 1.6×
Sleep study attended (95807) $644.06 $1,073.42 1.8×
Sleep study unattended (95806) $310.18 $516.96 1.5×
Slp caregiver training 1st 30 min (97550) $111.49 $185.81 2.1×
Smoking cessation > 10 min (99407) $54.28 $90.46 1.5×
Speech sound lang comprehen (92523) $238.60 $397.66 1.1×
Spirometry (94010) $217.72 $362.86 1.1×
Standardized Cognitive Performance Testing (96125) $143.15 $238.59 1.4×
Temp transcutaneous pacing (92953) $28.69 $47.82 0.0×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $57.13 $95.22 2.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $54.63 $91.05 2.6×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $174.80 $291.34 1.7×
Therapeutic prophylactic/dx injection subq/im (96372) $67.21 $112.02 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $20.92 $34.87 0.6×
Trans Care Mgmt 14 Day Disch (99495) $214.43 $357.39 1.7×
Trans Care Mgmt 7 Day Disch (99496) $278.29 $463.82 2.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $20.22 $33.70 0.3×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $28.65 $47.75 1.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $98.45 $164.08 1.2×
Tympanometry (92567) $21.44 $35.74 0.6×
Upr/lxtr art stdy 3+ lvls (93923) $430.36 $717.26 2.1×
Vasc Duplex Scan Extracranial,Limited (93882) $386.71 $644.51 3.9×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $629.97 $1,049.95 3.0×
Vasopneumatic device (97016) $66.77 $111.29 5.6×
Vent mgmt inpat init day (94002) $444.37 $740.62 0.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $444.37 $740.62 0.7×
Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann… (92083) $102.53 $170.88 0.8×
Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent… (92081) $55.93 $93.21 1.0×
Wheelchair Mgmt Ea 15 Min (97542) $101.37 $168.95 3.3×