Visits & medical services prices at Southeast Colorado Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $190.50 $238.50 0.8×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $44 $55
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $62 $78
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $43 $54
Assessment of aphasia (96105) $293 $366
Behavioral & qualit analysis voice and resonance (92524) $178 $222
Bipap initial day (94660) $508 $635 2.2×
Breathing capacity test (94010) $381 $476 1.7×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $680 $850 1.7×
Canalith repositioning (95992) $123 $153.50
Cardioversion elective external (92960) $1,264 $1,580 1.8×
Cardioversion elective internal (92961) $1,264 $1,580 1.8×
Chest physiotherapy initial (94667) $200 $250 1.4×
Color/duplex Doppler, limited (93976) $334 $417 3.0×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $155 $194
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $200 $250 1.4×
Cpr (92950) $697 $871 3.1×
Critical care ill/injured patient init 30-74 min (99291) $1,775 $2,219 2.0×
Debridement open wound 20 sq cm< (97597) $478 $597 2.3×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $693 $866 2.8×
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $334 $417 3.0×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $693 $866 2.8×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $334 $417 3.0×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $693 $866 2.8×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $334 $417 3.0×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $693 $866 2.8×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $334 $417 3.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $963.50 $1,204.50 1.7×
EKG 12 lead tracing only (93005) $166 $208 2.7×
Emergency department visit high mdm (99285) $1,411 $1,764 2.2×
Emergency department visit low mdm (99283) $290.50 $363 1.0×
Emergency department visit may not req phys/qhp (99281) $134 $167 1.5×
Emergency department visit moderate mdm (99284) $1,066 $1,333 2.4×
Emergency department visit straightforward mdm (99282) $246 $308 1.5×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $357.50 $447
Evaluate pt use of inhaler (94664) $170 $212 0.7×
Evaluation of speech fluency (92521) $382 $477
Evaluation of speech sound production articulate (92522) $318 $398
External ECG rec>48hr<7d recording (93242) $86 $107 2.2×
External ECG rec>7d<15d recording (93246) $145 $181 3.7×
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $293 $366 2.1×
Immunization administration (90471) $111 $139 1.5×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $137 $171 2.8×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $184 $230 0.8×
IV infusion hydration each additional hour (96361) $79 $99 1.6×
IV infusion hydration initial 31 min-1 hour (96360) $189 $236 0.8×
IV infusion ther proph addl sequential to 1 hr (96367) $86 $107 1.1×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $196 $245 0.9×
IV tx, each additional hour (96366) $84 $105 1.7×
Lwr xtr vasc stdy bilat (93924) $411 $514 1.8×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $200 $250 1.4×
Mechanical chest wall oscillation lung function (94669) $170 $212 0.7×
Mechanical traction therapy (97012) $45 $56
Neg pressure wound therapy non dme </= 50 sq cm (97607) $940 $1,175 2.2×
Non-invasive physiologic study extremity 3 levels (93923) $411 $514 1.8×
Noninvasive ear/pulse oximetry overnight monitor (94762) $254 $318 1.9×
Occupational therapy eval high complex 60 mins (97167) $320 $400
Occupational therapy eval low complex 30 mins (97165) $214 $267
Occupational therapy eval mod complex 45 mins (97166) $267 $334
Oral function therapy (92526) $145 $181
Orthc/prostc mgmt sbsq enc (97763) $160 $200
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $149 $186
Ot manual therapy ea 15 min (97140) $92 $115
Ot neuromuscular re-education (97112) $106 $132
Ot paraffin bath (97018) $18 $23
Ot re-evaluation (97168) $189 $236
OT Therapeutic Activities Charges (97530) $97 $121
Ot wheelchair management (97542) $99 $124
Phlebotomy therapeutic (99195) $170 $212 1.2×
Physical therapy evaluation high complex 45 mins (97163) $302 $378
Physical therapy evaluation low complex 20 mins (97161) $202 $252
Physical therapy evaluation mod complex 30 mins (97162) $252 $315
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $2,125 $2,656 2.3×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $122 $152
Pt gait training 15 min (97116) $90 $113
Pt physical performance test (97750) $101 $126
Pt re-evaluation (97164) $198 $247
Remote 30 day ECG rev/report (93270) $34 $42 0.9×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $155 $194
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $157 $196
Speech sound lang comprehen (92523) $353 $441
Standardized cognitive performance testing (96125) $327 $409
Temp transcutaneous pacing (92953) $1,264 $1,580 1.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $66 $83
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $65 $81
Therapeutic prophylactic/dx injection subq/im (96372) $117 $146 1.5×
Tte w/doppler complete (93306) $965 $1,206 1.7×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $115 $144
Upr/l xtremity art 2 levels (93922) $297 $371 2.1×
Ventilation ip/obs initial day (94002) $1,169 $1,461 1.8×
Ventilator subsequent day (94003) $1,169 $1,461 1.8×