Visits & medical services prices at Spanish Peaks Regional Health Center

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

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $124.20 $138 1.2×
Airway inhalation treatment (94640) $216.45 $240.50 0.9×
Allergy injection single (95115) $46.80 $52 0.9×
Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed (99170) $243.90 $271 1.1×
Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed (91125) $422.10 $469 1.1×
Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) $41.40 $46
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $60.30 $67
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $86.40 $96
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $39.15 $43.50
Application of a modality to 1 or more areas; vasopneumatic devices Other Outpatient (97016) $55.35 $61.50
Assessment of aphasia (96105) $269.10 $299
Assmt & care pln pt cog imp (99483) $412.20 $458 3.8×
Behav assmt w/score & docd/stand instrument (96127) $26.10 $29 0.7×
Behavioral & qualit analysis voice and resonance (92524) $345.15 $383.50
Bfb training ea addl 15 min (90913) $47.70 $53
Biofeedback training by any modality Other Outpatient (90901) $61.20 $68
Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when… (90912) $121.50 $135
Bipap initial day (94660) $414 $460 1.8×
Breath hydrogen/methane test (91065) $141.30 $157 0.6×
Breathing capacity test (94010) $311.40 $346 1.4×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $569.70 $633 1.4×
Cardiovascular procedure unlisted (93799) $127.80 $142 0.9×
Cardiovascular stress test (93017) $806.40 $896 3.5×
Cardioversion elective external (92960) $891.90 $991 1.3×
Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a… (99484) $65.70 $73 1.7×
Chemo anti-neopl sq/im (96401) $195.30 $217 2.6×
Chest physiotherapy initial (94667) $245.70 $273 1.8×
Chron care mgmt srvc 20 min (99490) $109.80 $122 1.0×
Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal,… (91117) $198.90 $221 0.9×
Color/duplex Doppler, complete (93975) $669.60 $744 2.7×
Color/duplex Doppler, limited (93976) $322.20 $358 2.9×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $74.70 $83
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) $109.80 $122 0.6×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $245.70 $273 1.8×
Cpr (92950) $422.10 $469 1.9×
Critical care ill/injured patient init 30-74 min (99291) $761.40 $846 0.9×
Debridement open wound 20 sq cm< (97597) $249.30 $277 1.2×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $669.60 $744 2.7×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $252.90 $281 2.3×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $669.60 $744 2.7×
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $252.90 $281 2.3×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $669.60 $744 2.7×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $322.20 $358 2.9×
ECG monit/reprt up to 48 hrs (93226) $307.80 $342 4.9×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,380.60 $1,534 2.4×
EEG awake/drowsy (95816) $814.50 $905 3.6×
EKG 12 lead tracing only (93005) $186.30 $207 3.0×
EKG rhythm strip (93041) $139.50 $155 2.2×
Electroconvulsive therapy (90870) $258.30 $287 0.3×
Emergency department visit high mdm (99285) $748.80 $832 1.2×
Emergency department visit low mdm (99283) $306 $340 1.1×
Emergency department visit may not req phys/qhp (99281) $96.30 $107 1.1×
Emergency department visit moderate mdm (99284) $515.70 $573 1.2×
Emergency department visit straightforward mdm (99282) $185.40 $206 1.1×
Esoph balloon distension tst (91040) $848.70 $943 2.2×
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s)… (91038) $656.10 $729 1.7×
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s)… (91037) $264.60 $294 1.2×
Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and… (91010) $347.40 $386 0.9×
Esophagus, acid perfusion (Bernstein) test for esophagitis (91030) $224.10 $249 0.6×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $321.30 $357
Evaluate pt use of inhaler (94664) $414 $460 1.8×
Evaluation of speech fluency (92521) $269.10 $299
Evaluation of speech sound production articulate (92522) $252.90 $281
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $531.90 $591 3.8×
Gastroesophag reflx test w/cath ph eltrd plcmt (91034) $299.70 $333 0.8×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $740.70 $823 0.8×
Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and… (91110) $1,215 $1,350 1.3×
Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report Age… (91111) $1,454.40 $1,616 1.5×
Gi transit & pres meas wireless capsule w/interp (91112) $2,685.60 $2,984 2.8×
Hot/cold pack (97010) $88.20 $98
Im adm intransl/oral 1 vaccine (90473) $19.51 $21.68 0.3×
Imm admn sarscov2 vaccine single dose (90480) $46.20 $51.34 1.1×
Immunization administration (90471) $72.90 $81 1.0×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) $132.30 $147 0.9×
Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health… (99492) $225 $250 2.1×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $135.90 $151 2.8×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $414 $460 1.8×
Irrigaj implntd venous access drug delivery syst (96523) $162.90 $181 2.6×
IV infusion hydration each additional hour (96361) $124.20 $138 2.5×
IV infusion hydration initial 31 min-1 hour (96360) $414 $460 1.8×
IV infusion ther proph addl sequential to 1 hr (96367) $188.10 $209 2.5×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $444.60 $494 2.0×
IV tx, each additional hour (96366) $124.20 $138 2.5×
Liver elastography (91200) $47.70 $53 0.4×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $245.70 $273 1.8×
Mechanical chest wall oscillation lung function (94669) $414 $460 1.8×
Mechanical traction therapy (97012) $46.80 $52
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $99 $110
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) $85.50 $95
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $368.10 $409
Multi-family group psychotherapy - psychologist (90849) $53.10 $59 0.3×
Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (Amytal) interview) (90865) $244.80 $272 1.3×
Negative pressure wound therapy dme </= 50 sq cm (97605) $162 $180 0.8×
Negative pressure wound therapy dme >50 sq cm (97606) $429.75 $477.50 1.0×
Noninvasive ear/pulse oximetry overnight monitor (94762) $330.30 $367 2.4×
Occupational therapy eval high complex 60 mins (97167) $207.90 $231
Occupational therapy eval low complex 30 mins (97165) $156.60 $174
Occupational therapy eval mod complex 45 mins (97166) $182.70 $203
Oral function therapy (92526) $195.75 $217.50
Orthc/prostc mgmt sbsq enc (97763) $102.15 $113.50
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $102.15 $113.50
Ot manual therapy ea 15 min (97140) $92.70 $103
Ot neuromuscular re-education (97112) $104.85 $116.50
Ot paraffin bath (97018) $36.90 $41
Ot re-evaluation (97168) $179.55 $199.50
OT Therapeutic Activities Charges (97530) $100.80 $112
Ot wheelchair management (97542) $95.40 $106
Outpatient cardiac rehab w/cont ECG monitoring (93798) $268.20 $298 2.0×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $316.80 $352 2.3×
Phlebotomy therapeutic (99195) $248.40 $276 1.8×
Physical therapy evaluation high complex 45 mins (97163) $207.90 $231
Physical therapy evaluation low complex 20 mins (97161) $156.60 $174
Physical therapy evaluation mod complex 30 mins (97162) $182.70 $203
Pr gastric motility manometric studies (91020) $434.70 $483 1.1×
Pr hypnotherapy (90880) $154.80 $172 1.4×
Professional services for allergen immunotherapy; 2 or more injections (95117) $69.30 $77 1.4×
Psych diag eval w/med srvcs (90792) $288.90 $321 1.5×
Psychiatric diagnostic evaluation (90791) $258.30 $287 1.4×
Psychoanalysis (90845) $140.40 $156 0.7×
Psytx crisis initial 60 min (90839) $207.90 $231 1.1×
Pt gait training 15 min (97116) $87.75 $97.50
Pt physical performance test (97750) $94.50 $105
Pt re-evaluation (97164) $163.80 $182
Pt Work Hardening/conditioningwork Reconditioning Initial Charge (97545) $152.10 $169
Pulm funct tst plethysmograp (94726) $569.70 $633 1.4×
Recording and interpretation of stomach electrical activity (91132) $728.10 $809 3.2×
Recording and interpretation of stomach electrical activity with drug administration (91133) $760.50 $845 5.4×
Rectal sensation, tone, and compliance study (eg, barostat) (91124) $821.70 $913 3.6×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $83.70 $93 2.1×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $28.80 $32 0.2×
Remote 30 day ECG rev/report (93270) $117 $130 3.0×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $101.70 $113
Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device… (99473) $18.90 $21 0.6×
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $72 $80
Speech sound lang comprehen (92523) $291.15 $323.50
Standardized cognitive performance testing (96125) $251.10 $279
Study of upper small bowel to assess movement (91022) $264.60 $294 0.7×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $86.40 $96 1.7×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $414 $460 1.8×
Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care… (99493) $216.90 $241 2.0×
Temp transcutaneous pacing (92953) $1,207.80 $1,342 1.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $77.40 $86
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $97.20 $108
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $43.20 $48
Therapeutic prophylactic/dx injection subq/im (96372) $140.40 $156 1.8×
Tobacco use cessation intensive >10 minutes (99407) $41.40 $46 1.0×
Tobacco use cessation intermediate 3-10 minutes (99406) $23.40 $26 0.6×
Trans care mgmt 14 day disch (99495) $305.10 $339 2.2×
Trans care mgmt 7 day disch (99496) $410.40 $456 2.9×
Tte w/doppler complete (93306) $1,546.20 $1,718 2.7×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $206.10 $229
Upr/l xtremity art 2 levels (93922) $314.10 $349 2.2×
Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) (97546) $128.70 $143
Wound(s) care non-selective (97602) $170.10 $189 0.8×