Visits & medical services prices at Southwell Medical

Adel, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Actigraphy testing recording analysis i&r (95803) $50.44 $100.88 1.0×
Aep threshold estimation mlt frequencies i&r (92652) $752.50 $1,505 4.0×
Airway inhalation treatment (94640) $208.34 $416.67 1.1×
Analyze Neurostim Complex (95972) $118 $236 1.4×
Analyze neurostim no prog (95970) $141.50 $283 1.2×
Appl on-body injector for timed subq injection (96377) $58.16 $116.30 1.4×
Assessment of aphasia (96105) $183.25 $366.50 1.9×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $50 $100 1.3×
Behav assmt w/score & docd/stand instrument (96127) $7.50 $15 0.2×
Behavioral and qualitative analysis of voice and resonance (92524) $138.49 $276.98 1.3×
Blink reflex test (95933) $75.52 $151.04 1.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $111.20 $222.39 0.3×
C motor evoked uppr limbs (95928) $678.53 $1,357.06 0.9×
C motor evoked upr&lwr limbs (95939) $725.99 $1,451.98 1.0×
Canalith Repositioning (95992) $73.50 $147 1.8×
Capsule endoscopy (91110) $762.33 $1,524.65 1.0×
Car seat/bed test 60 min (94780) $43.39 $86.78 1.3×
Cardiac Stress Tst,Tracing Only (93017) $521 $1,042 2.8×
Cardiopulmonary exercise testing (94621) $236 $472 0.7×
Cardiopulmonary resuscitation (92950) $378.50 $757 2.0×
Cardioversion (92960) $590.98 $1,181.95 1.0×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $3,263.64 $6,527.27 1.1×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $3,250.46 $6,500.92 1.1×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $6,426.38 $12,852.75 2.3×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $3,832.09 $7,664.17 1.3×
Cbt 1st hour (94644) $124.99 $249.98 1.1×
Chemo Admin Peritoneal Cavity (96446) $366.32 $732.62 1.3×
Chemo Hormon Antineopl Sq/Im (96402) $100.11 $200.22 1.6×
Chemo IV push addl drug (96411) $135.08 $270.15 2.1×
Chemo Iv Push Sngl Drug (96409) $409 $818 1.4×
Chemo prolong 8+ hrs infuse w/pump (96416) $409 $818 1.4×
Chemother, IV infusion, 1 hr (96413) $409 $818 1.4×
Chemother, IV infusion, ea add hr (96415) $85.50 $171 1.4×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $100.11 $200.22 1.6×
Chemotx Admn Cns Req Spinal Puncture (96450) $304.02 $608.02 1.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $76.66 $153.31 1.2×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions (98940) $20 $40 1.1×
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions (98941) $28 $56 1.5×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $37.50 $75 0.4×
Color/duplex Doppler, complete (93975) $723 $1,446 3.5×
Color/duplex Doppler, limited (93976) $224 $448 2.4×
Cont Gluc Monitoring Patient Provided Equipment (95249) $84.50 $169 1.6×
Continuous Glucose Monitoring (95250) $118.50 $237 1.0×
Coronary artery angio s&i (93454) $3,263.64 $6,527.27 1.1×
Cortical mapping 1st hr (95961) $412.45 $824.90 0.5×
Cpap initiation and management (94660) $569.50 $1,139 3.0×
Cpt initial (94667) $181.42 $362.84 1.6×
Critical care (99291) $946.06 $1,892.11 1.3×
Ctr motor ep std transcrnl motor stimj lwr limbs (95929) $179.28 $358.56 0.5×
Debridement Open Wound 20 Sq Cm< (97597) $120.50 $241 0.7×
Demo &/or eval,pt use,aerosol device (94664) $208.34 $416.67 1.1×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $831.19 $1,662.37 2.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $319 $638 1.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $151.50 $303 1.7×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $675 $1,350 3.2×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $378.50 $757 4.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $757 $1,514 3.6×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $378.50 $757 4.1×
Dup-scan xtr veins unilateral/limited study (93971) $460.50 $921 5.0×
Duplex hemodialysis access (93990) $187 $374 2.0×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $233.25 $466.50 2.5×
Duplex scan extracranial art compl bi study (93880) $382.14 $764.28 1.8×
Echo Heart Xthoracic,Limited (93308) $336 $672 1.6×
Echo transesophageal (93312) $1,721 $3,442 3.6×
Echo Transthoracic - Congenital Tte Complete (93303) $586.18 $1,172.34 1.2×
Echo Transthoracic - Congenital Tte Limited (93304) $504.59 $1,009.18 1.1×
EEG awake asleep (95819) $438.63 $877.26 2.3×
EEG awake drowsy (95816) $197.14 $394.28 1.0×
EEG cerebral death evaluation (95824) $334.45 $668.90 1.0×
EEG coma or sleep only (95822) $197.14 $394.28 1.0×
Eeg Extended Monitoring 61-119 Minutes (95813) $270.27 $540.54 1.4×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $378.50 $757 2.0×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $674 $1,348 2.1×
EKG (93005) $111.58 $223.15 2.2×
EKG rhythm strip (93041) $52.76 $105.52 1.0×
Elec alys implt cplx cn npgt prgrmg (95977) $111.50 $223 1.3×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $45 $90 1.4×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $330.92 $661.84 1.7×
EMG cranial nerve bilat (95868) $240.92 $481.84 1.3×
EMG cranial nerve unilat (95867) $240.92 $481.84 1.3×
EMG four extremities (95864) $1,079.69 $2,159.37 9.6×
EMG one extremity (95860) $352.73 $705.45 3.0×
EMG thoracic paraspinal (95869) $210.24 $420.48 1.1×
EMG three extremities (95863) $802.92 $1,605.84 7.1×
EMG two extremities (95861) $658.57 $1,317.13 5.6×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $1,117.86 $2,235.71 1.0×
Er level 1 (99281) $107 $214 1.4×
Er level ii (99282) $190.10 $380.18 1.4×
Er level iii (99283) $281.65 $563.30 1.2×
Er level IV (99284) $456.44 $912.88 1.2×
Er level v (99285) $610.50 $1,221 1.2×
Evaluation of speech fluency (92521) $138.49 $276.98 1.0×
Evaluation of speech sound production (92522) $138.49 $276.98 1.2×
Evaluation of swallowing function (92610) $225.47 $450.94 2.7×
Evaluation with prescription of speech-generating alternative (92607) $155.67 $311.34 1.3×
External ECG rec>48hr<7d recording (93242) $205.50 $411 6.3×
External ECG rec>48hr<7d scanning alys w/report (93243) $275.50 $551 2.4×
External ECG rec>7d<15d recording (93246) $80 $160 2.4×
External Ecg Scanning Analysis Report (93226) $230 $460 4.4×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $307 $614 1.5×
Group Therapeutic Procedures (97150) $62.25 $124.50 3.5×
Hemodialysis (90935) $366.95 $733.90 0.6×
Holter Monitor Recording (93225) $172.50 $345 1.5×
Icd Device Interrogate (93289) $121.88 $243.75 3.7×
Ilr Device Eval Progr (93285) $89 $178 2.7×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $16.50 $33 0.3×
Immunization Admin (90471) $43.25 $86.50 0.7×
Immunotherapy, 2+ Injections (95117) $13 $26 0.3×
Injection intra arterial (96373) $163.48 $326.96 0.9×
Ins swan ganz bedside (93503) $1,620.16 $3,240.32 1.2×
Interrog dev eval scrms phys/qhp in person (93291) $45.50 $91 1.8×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $74 $148 1.4×
IV infusion hydration each additional hour (96361) $45.28 $90.54 1.1×
IV infusion hydration initial 31 min-1 hour (96360) $184.37 $368.73 1.0×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $59.28 $118.54 0.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $259 $518 1.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $48 $96 1.2×
IV push initial (96374) $97.50 $195 0.5×
Manual therapy 15 min (97140) $98 $196 3.5×
Massage 15 min (97124) $53.50 $107 1.8×
Maximum voluntary ventilation (94200) $61.85 $123.69 1.2×
Mchnl sclp cool cap sply head meas fitg&educaj (97007) $2,126 $4,252 1.7×
Mechanical chest wall oscillation (94669) $229.94 $459.88 1.2×
Mechanical traction (97012) $72 $144 5.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $26 $52 0.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $28.50 $57 0.8×
Methacholine challenge (94070) $735.80 $1,471.59 2.3×
Mnt Group Ea 30 Min (97804) $13.50 $27 0.8×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $181.68 $363.36 2.0×
Motor &/sens nrv cndj preconf eltrd array limb (95905) $130.10 $260.18 0.3×
Multiple sleep latency test (95805) $1,335.75 $2,671.50 1.8×
Needle electromyography hemidiaphragm (95866) $151.60 $303.18 1.3×
Needle electromyography larynx (95865) $135.51 $271.02 1.2×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $98.24 $196.48 0.8×
Needle EMG w/1 fiber electrode quan meas jitter (95872) $145.04 $290.09 0.8×
Neg press wnd tx </=50 sq cm (97607) $244.95 $489.89 0.7×
Neg press wound tx >50 cm (97608) $481.50 $963 1.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $120.85 $241.70 0.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $244.95 $489.89 0.7×
Nerve conduction studies 13/> studies (95913) $2,623.48 $5,246.95 8.0×
Nerve Conduction Studies 3-4 Studies (95908) $564.03 $1,128.06 3.0×
Nerve Conduction Studies 9-10 Studies (95911) $1,873.91 $3,747.82 5.7×
Nerve conduction studies; 1-2 studies (95907) $374.77 $749.54 2.0×
Nerve conduction studies; 11-12 studies (95912) $2,248.70 $4,497.39 6.9×
Nerve conduction studies; 5-6 studies (95909) $1,124.34 $2,248.67 5.9×
Nerve conduction studies; 7-8 studies (95910) $1,499.13 $2,998.25 4.6×
Neuromuscular junction test (95937) $391.82 $783.63 3.5×
Nitric oxide expired gas determination (95012) $49 $98 1.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $293.62 $587.23 2.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $672.50 $1,345 3.6×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $150.46 $300.91 1.3×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $264.37 $528.74 0.8×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $55 $110 1.2×
Osteopathic manipulative tx 1-2 body regions (98925) $31.50 $63 1.7×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $48.25 $96.50 1.5×
Ot Contrast Bath Ea 15 Min (97034) $106 $212 7.6×
Ot eval high complex 60 min (97167) $163.38 $326.75 1.6×
Ot eval low complex 30 min (97165) $133.62 $267.25 1.3×
Ot eval mod complex 45 min (97166) $147.62 $295.25 1.5×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $73 $146 1.5×
Ot Prosthetic Training, Each 15 Min (97761) $50.50 $101 1.2×
Ot re-eval est plan care (97168) $69.32 $138.62 1.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $120.25 $240.50 1.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $120.25 $240.50 1.1×
Paraffin bath (97018) $53.50 $107 8.9×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $176.88 $353.75 0.9×
Peripheral arterial disease rehab per session (93668) $80.50 $161 1.6×
Phy/qhp op pulm rhb w/mntr (94626) $88.50 $177 1.7×
Phy/qhp op pulm rhb w/o mntr (94625) $88.50 $177 1.7×
Plethysmography (94726) $88 $176 0.3×
Pm device eval in person (93288) $48.25 $96.50 1.5×
Pm device progr eval dual (93280) $85.50 $171 2.6×
Pm device progr eval multi (93281) $93.75 $187.50 2.9×
Pm device progr eval sngl (93279) $50.25 $100.50 1.5×
Pm/Icd Remote Tech Serv (93296) $50.50 $101 1.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,850 $3,700 2.5×
Polysom <6 yrs 4/> paramtrs (95782) $743.50 $1,487 1.0×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $1,880 $3,760 2.5×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $88.50 $177 2.7×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $10.50 $21 0.3×
Programming of dual lead implantable defibrillator system (93283) $85.50 $171 2.6×
Programming of single lead implantable defibrillator system (93282) $88.75 $177.50 2.7×
Prq card revasc chronic 1vsl (92943) $9,305.34 $18,610.68 0.9×
Prq Card Stent W/Angio 1 Vsl (92928) $5,334.18 $10,668.35 0.5×
Prq Card Stent/Ath/Angio (92933) $20,151.10 $40,302.20 1.3×
Prq revasc byp graft 1 vsl (92937) $9,305.34 $18,610.68 0.9×
Prq tcat plmt ntrac st 2+les (92930) $21,250 $42,500 1.3×
Prq trluml coronary angio/atherect one art/brnch (92924) $13,068.02 $26,136.05 1.3×
Prq trluml coronary angioplasty one art/branch (92920) $5,205.22 $10,410.42 1.0×
Psych diag eval w/med srvcs (90792) $142.50 $285 0.9×
Psychiatric diagnostic evaluation (90791) $130 $260 0.8×
Pt Electric Current Therapy (97033) $77 $154 4.0×
Pt Electrical Stimulation (97032) $72 $144 4.9×
Pt eval high complex 45 min (97163) $156.56 $313.12 1.6×
Pt eval low complex 20 min (97161) $132.32 $264.62 1.4×
Pt Gait Training Therapy (97116) $72 $144 2.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $53.50 $107 1.6×
Pt Physical Performance Test (97750) $73.50 $147 2.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $144.56 $289.12 1.5×
Pt re-evaluation (97164) $73.12 $146.25 1.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $43.25 $86.50 1.3×
Pt Ultrasound Therapy (97035) $94.96 $189.92 6.6×
Pt Whirlpool Therapy (97022) $132.50 $265 8.4×
Pulm Funct Test Oscillometry (94728) $149.96 $299.92 1.3×
Pulm function test by gas (94727) $69.53 $139.06 0.4×
Pulmonary stress testing (94618) $160.50 $321 1.4×
R & l hrt cath w/njx l ventriculog img s&i (93453) $3,263.64 $6,527.27 1.1×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $4,418.35 $8,836.69 1.6×
R hrt art/grft angio (93457) $3,263.64 $6,527.27 1.1×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $7,761.82 $15,523.62 2.7×
Refill/maint, portable pump (96521) $223.08 $446.17 1.2×
Rem interrog icpms <30 d phys/qhp (93297) $32.50 $65 1.0×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $40.50 $81 1.2×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $100.50 $201 3.1×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $156.50 $313 1.3×
Right heart cath (93451) $3,597.48 $7,194.96 1.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $210.66 $421.32 1.2×
Rt Chest Wall Manipulation,Subsequent (94668) $111.97 $223.94 1.0×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $74.50 $149 1.6×
Sensory Integration Ea 15 Min (97533) $50 $100 0.8×
Short-latency somatosens ep std lwr limbs (95926) $1,223.30 $2,446.61 6.5×
Short-Latency Somatosens Ep Std Trnk/Head (95927) $1,710.42 $3,420.82 9.0×
Short-latency somatosens ep std upr limbs (95925) $617.14 $1,234.28 3.3×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $193.50 $387 1.0×
Somatosensory testing (95938) $872.43 $1,744.85 1.2×
Speech sound lang comprehen (92523) $138.49 $276.98 0.6×
Spirometry (94010) $92.67 $185.33 0.5×
Standardized Cognitive Performance Testing (96125) $211 $422 2.1×
Stress echo (93350) $595.02 $1,190.04 1.2×
Surfactant Admin Thru Tube (94610) $258 $516 1.3×
Temp transcutaneous pacing (92953) $503.19 $441.76 0.9×
Tensilon test (95857) $329.60 $659.19 1.7×
Testing of autonomic (sympathetic) nervous system function (95923) $179.75 $359.50 1.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $47.50 $95 2.1×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $47.50 $95 2.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $84.68 $169.34 0.8×
Ther/Proph/Diag Inj Sc/Im (96372) $85.50 $171 1.4×
Therapeutic Activities (97530) $72 $144 2.1×
Therapeutic phlebotomy (99195) $124.85 $249.70 1.1×
Tilt Table Eval (93660) $742.98 $1,485.96 2.3×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $43.50 $87 1.3×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $720.74 $1,441.48 3.4×
Transcranial Doppler Limited (93888) $335.51 $671.02 3.7×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $58.50 $117 1.8×
Tstg ans funcj parasymp&symp w/5 min pasive tilt (95924) $224.07 $448.14 1.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,653.50 $3,307 3.5×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $296 $592 1.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $92.58 $185.15 1.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $112 $224 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $57.50 $115 1.4×
Tympanometry (92567) $22.50 $45 0.7×
Unlisted Cardiovascular Service/Procedure (93799) $126.09 $252.18 1.1×
Unlisted noninvasive vascular diagnostic study (93998) $69.40 $138.81 2.7×
Vasc Duplex Extrem Venous,Bilat (93970) $700 $1,400 3.3×
Vasc Duplex Scan Extracranial,Limited (93882) $535 $1,070 5.8×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $569.43 $1,138.86 3.0×
Vasopneumatic device (97016) $45.50 $91 3.8×
Veeg by tech 2-12 hours unmonitored (95711) $378.50 $757 2.0×
Veeg Ea 12-26 Hr Unmntr (95714) $674 $1,348 2.1×
Ventilation assist & mgmt inpatient 1st day (94002) $1,033.13 $2,066.26 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $771.50 $1,542.99 1.4×
Visual Evoked Potential Test (95930) $499.16 $998.31 2.6×
Wheelchair Mgmt Ea 15 Min (97542) $48 $96 1.5×