Visits & medical services prices at Smith County Memorial Hospital

Smith Center, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Advncd Care Plan 30 Min (99497) $100 $100 1.1×
Airway Inhalation Treatment (94640) $250 $250 1.2×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $82 $82 5.7×
Brief Emotional/Behav Assmt (96127) $25 $25 0.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $450 $450 1.3×
Canalith repositioning proc (95992) $78 $78 1.9×
Cardiac Stress Tst,Tracing Only (93017) $547.25 $547.25 2.8×
Care mgmt services behavioral hlth cond 20 mins (99484) $94 $94 2.7×
Cbt 1st hour (94644) $350 $350 2.9×
Chemo Hormon Antineopl Sq/Im (96402) $60 $60 0.9×
Chemo IV infusion addl hr (96415) $300.89 $300.89 4.5×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $300.89 $300.89 1.0×
Color/duplex Doppler, limited (93976) $738.28 $738.28 7.7×
Continuous Pulse Ox (94762) $300 $300 2.5×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $550 $550 2.7×
Critical care first hour (99291) $1,569.10 $1,569.10 2.1×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines
$146–$428.08 $146–$428.08 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $738.28 $738.28 3.4×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $738.28 $738.28 3.4×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $738.28 $738.28 7.7×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $738.28 $738.28 3.4×
Dup-scan xtr veins unilateral/limited study (93971) $738.28 $738.28 7.7×
Duplex up extrem art unilat/ltd (93931) $738.28 $738.28 7.7×
Echo Heart Xthoracic,Limited (93308) $884.07 $884.07 4.0×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines
$94.15–$94.30 $94.15–$94.30 varies
Emergency Dept Visit Level 2 (99282) $407.42 $407.42 2.9×
Emergency Dept Visit Level 3 (99283) $150 $150 0.6×
Emergency Dept Visit Level 4 (99284) $205.72 $205.72 0.5×
Er level 1 (99281) $261.53 $261.53 3.4×
Er level v (99285) $1,645.72 $1,645.72 3.0×
Evaluate Speech Production (92522) $178.37 $178.37 1.6×
Evaluate Swallowing Function (92610) $197.66 $197.66 2.3×
Evoked Auditory Test,Limited (92587) $86.50 $86.50 0.4×
External ECG rec>48hr<7d recording (93242) $289.12 $289.12 8.4×
External ECG rec>7d<15d recording (93246) $289.12 $289.12 8.4×
Extracranial Bilat Study (93880) $738.28 $738.28 3.4×
Holter monitor recording (93225) $289.12 $289.12 2.4×
Icd device progr eval dual (93283) $86.25 $86.25 2.5×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines
$20–$22.86 $20–$22.86 varies
Immunization administration (90471)
range across 2 matching MRF lines
$20–$31.71 $20–$31.71 varies
Iontophoresis 15 min (97033) $78 $78 4.1×
Irrig Drug Delivery Device (96523) $83.75 $83.75 1.5×
IV infusion hydration each additional hour (96361) $204.73 $204.73 4.8×
IV infusion hydration initial 31 min-1 hour (96360) $204.73 $204.73 1.0×
IV infusion ther proph addl sequential to 1 hr (96367) $204.73 $204.73 3.1×
IV infusion therapy prophylaxis/dx ea hour (96366) $204.73 $204.73 4.8×
IV push initial (96374)
range across 2 matching MRF lines
$66.69–$71 $66.69–$71 varies
Mechanical chest wall oscillation per session (94669) $132.25 $132.25 0.7×
Motion Fluoroscopy/Swallow (92611) $300 $300 3.3×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $343.59 $343.59 1.9×
Neuromuscular Reeducation (97112) $84 $84 2.6×
Oral Function Therapy (92526) $100.49 $100.49 1.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $72.27 $72.27 1.6×
Ot eval high complexity (97167) $248 $248 2.5×
Ot Eval Low Complex (97165) $218.48 $218.48 2.2×
Ot Eval Moderate Complexity (97166) $234.17 $234.17 2.3×
Ot manual therapy 15 min (97140) $81 $81 2.9×
Ot paraffin bath (97018) $38 $38 6.3×
Ot Re-Eval Est Plan Care (97168) $118.88 $118.88 1.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $242 $242 2.0×
Phlebotomy therapeutic (99195) $110 $110 0.9×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $327.75 $327.75 6.0×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $316.25 $316.25 5.8×
Pm device progr eval dual (93280) $74.75 $74.75 2.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811)
range across 2 matching MRF lines
$225–$2,514.23 $225–$2,514.23 varies
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $25 $25 0.6×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $32 $32 0.7×
Pt Eval High Complex (97163) $248 $248 2.5×
Pt eval low complex 20 min (97161) $228 $228 2.3×
Pt Eval Mod Complex (97162) $235.24 $235.24 2.4×
Pt gait training 15 min (97116) $69 $69 2.4×
Pt mechanical traction (97012) $83 $83 5.8×
Pt Re-Eval Est Plan Care (97164) $124.90 $124.90 1.9×
Pulmonary Stress Testing (94618) $143.75 $143.75 1.2×
Remote 30 Day Ecg Rev/Report (93270) $184.15 $184.15 5.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 2 matching MRF lines
$189.45–$307.44 $189.45–$307.44 varies
Self Care Mngment Training (97535)
range across 2 matching MRF lines
$55–$65 $55–$65 varies
Sleep study unattended (95806)
range across 2 matching MRF lines
$316.40–$415 $316.40–$415 varies
Speech sound lang comprehen (92523) $178.37 $178.37 0.8×
Spirometry (94010) $125 $125 0.6×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $80 $80 2.2×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $63 $63 2.1×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines
$53–$67 $53–$67 varies
Ther/Proph/Diag Iv Inf Init (96365) $204.73 $204.73 1.0×
Therapeutic Activities (97530) $94 $94 2.7×
Tte w/doppler, complete (93306) $2,352.87 $2,352.87 4.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $119.43 $119.43 1.6×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines
$66.69–$71 $66.69–$71 varies
Tympanometry (92567) $22 $22 0.6×
Upr/L Xtremity Art 2 Levels (93922) $738.28 $738.28 6.0×

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.