Visits & medical services prices at SSM Health Waupun Memorial Hospital
Waupun, WI · every code in this section with a posted price and a Medicare benchmark.
274 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Ablate Heart Dysrhythm Focus (93650) | $7,418.95 | $13,489 | 1.0× |
| Actigraphy Testing Recording Analysis I&R (95803) | $205.70 | $374 | 3.6× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $66.55 | $121 | 1.7× |
| Advncd Care Plan 30 Min (99497) | $132 | $240 | 1.3× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$112.75–$129.80 | $205–$236 | varies |
| Analyze neurostim no prog (95970) | $350.96 | $638.10 | 2.7× |
| Analyze Pacemaker System (93724) | $706.75 | $1,285 | 2.4× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $52.80 | $96 | 3.7× |
| Application Modality 1/> Areas Infrared (97026) | $37.40 | $68 | 5.6× |
| Application on-body injector (96377) | $101.75 | $185 | 2.2× |
| Assmt & care planning pt w/cognitive impairment (99483) | $424.05 | $771 | 4.3× |
| Behavral qualit analys voice (92524) | $284.90 | $518 | 2.6× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $134.75 | $245 | 1.6× |
| Bfb training ea addl 15 min (90913) | $134.75 | $245 | 4.1× |
| Biofeedback training any modality (90901) | $118.25 | $215 | 2.9× |
| Breath hydrogen/methane test (91065) | $607.75 | $1,105 | 2.9× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $303.05 | $551 | 0.8× |
| Bundle of his recording (93600) | $7,333.70 | $13,334 | 1.0× |
| C motor evoked uppr limbs (95928) | $707.30 | $1,286 | 0.8× |
| C motor evoked upr&lwr limbs (95939) | $1,419 | $2,580 | 1.7× |
| Canalith repositioning proc (95992) | $119.35 | $217 | 2.9× |
| Car seat/bed test 60 min (94780) | $277.75 | $505 | 7.7× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,001.55 | $1,821 | 4.8× |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$529.65–$669.90 | $963–$1,218 | varies |
| Cardioversion (92960) range across 3 matching MRF lines |
$606.10–$1,458.05 | $1,102–$2,651 | varies |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $66 | $120 | 2.5× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $8,092.15 | $14,713 | 2.6× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $7,956.30 | $14,466 | 2.5× |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$271.70–$312.40 | $494–$568 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $139.70 | $254 | 2.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $141.35 | $257 | 2.0× |
| Chemo Ia Push (96420) | $611.60 | $1,112 | 1.9× |
| Chemo IV infusion addl hr (96415) | $213.40 | $388 | 3.1× |
| Chemo IV push addl drug (96411) | $237.92 | $432.58 | 3.4× |
| Chemother Prolong Infuse W/Pump (96416) | $491.70 | $894 | 1.5× |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) | $212.30 | $386 | 0.7× |
| Chemotherapy Into Cns (96450) | $393.80 | $716 | 1.2× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $185.35 | $337 | 2.7× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $499.40 | $908 | 1.6× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $309.65 | $563 | 1.0× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $388.85 | $707 | 1.2× |
| Chest Wall Manipulation (94668) | $91.30 | $166 | 0.7× |
| Color/duplex Doppler, complete (93975) | $1,599.40 | $2,908 | 6.9× |
| Color/duplex Doppler, limited (93976) | $684.75 | $1,245 | 6.7× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $435.05 | $791 | 3.4× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $162.25 | $295 | 2.8× |
| Continuous Pulse Ox (94762) | $273.35 | $497 | 2.2× |
| Coronary Art/Grft Angio S&I (93455) | $6,017.55 | $10,941 | 1.9× |
| Coronary Artery Angio S&I (93454) | $6,475.15 | $11,773 | 2.1× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $231.55 | $421 | 1.1× |
| Cpt initial (94667) | $118.25 | $215 | 0.9× |
| Critical care first hour (99291) range across 2 matching MRF lines |
$546.70–$1,657.15 | $994–$3,013 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$243.65–$278.85 | $443–$507 | varies |
| Dialysis One Evaluation (90945) | $74.80 | $136 | 0.2× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $750.20 | $1,364 | 3.2× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) | $585.20 | $1,064 | 5.8× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,456.95 | $2,649 | 6.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $725.45 | $1,319 | 7.1× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,358.50 | $2,470 | 5.9× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$679.80–$782.65 | $1,236–$1,423 | varies |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $900.90 | $1,638 | 3.9× |
| Duplex Scan Hemodialysis Access (93990) | $900.90 | $1,638 | 8.9× |
| Duplex up extrem art bilat (93930) | $799.15 | $1,453 | 3.4× |
| Duplex up extrem art unilat/ltd (93931) | $420.20 | $764 | 4.1× |
| Echo Congenital Complete (93303) | $1,199 | $2,180 | 2.3× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$506–$652.30 | $920–$1,186 | varies |
| Echo r-t 2d w/probe placement only (93313) | $983.95 | $1,789 | 1.9× |
| Echo transesophag montr cardiac pump functj (93318) | $843.70 | $1,534 | 1.6× |
| Echo transesophageal (93312) | $1,158.30 | $2,106 | 2.2× |
| Eeg 41-60 Minutes (95812) | $956.45 | $1,739 | 4.6× |
| EEG awake and asleep (95819) | $778.80 | $1,416 | 3.7× |
| EEG awake drowsy (95816) | $661.65 | $1,203 | 3.2× |
| EEG cerebral death evaluation (95824) | $757.35 | $1,377 | 2.1× |
| EEG extended monitoring 61-119 minutes (95813) | $851.40 | $1,548 | 4.1× |
| Eeg Sleep Only (95822) | $326.70 | $594 | 1.6× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $216.48 | $393.60 | 6.0× |
| Electrical Stimulation Ea 15 Min (97032) | $54.45 | $99 | 3.7× |
| Electrocardiogram Tracing (93005) | $171.60 | $312 | 3.0× |
| Electrophysiology Evaluation (93642) | $1,559.80 | $2,836 | 1.3× |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$162.80–$363.55 | $296–$661 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$239.80–$544.50 | $436–$990 | varies |
| Emergency Dept Visit Level 4 (99284) range across 3 matching MRF lines |
$358.05–$1,012.90 | $651–$1,841.64 | varies |
| Ep & ablate supravent arrhyt (93653) | $25,527.15 | $46,413 | 1.0× |
| Ep & ablate ventric tachy (93654) | $25,527.15 | $46,413 | 1.0× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $9,067.30 | $16,486 | 1.2× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) | $9,067.30 | $16,486 | 1.2× |
| Er level 1 (99281) | $179.85 | $327 | 2.2× |
| Er level v (99285) range across 3 matching MRF lines |
$523.05–$1,415.70 | $951–$2,574 | varies |
| Evaluate pt use of inhaler (94664) | $112.75 | $205 | 0.5× |
| Evaluate Speech Production (92522) range across 6 matching MRF lines |
$246.40–$492.25 | $448–$895 | varies |
| Evaluate Swallowing Function (92610) | $246.95 | $449 | 2.9× |
| Evaluation of speech fluency (92521) | $320.10 | $582 | 2.4× |
| Exercise test for bronchospasm (94617) | $522.50 | $950 | 4.0× |
| External ECG rec>48hr<7d recording (93242) | $128.15 | $233 | 3.5× |
| External ECG rec>7d<15d recording (93246) | $128.15 | $233 | 3.5× |
| External Ecg Scanning Analysis Report (93226) | $1,201.75 | $2,185 | 21.0× |
| Extracranial Bilat Study (93880) | $963.05 | $1,751 | 4.2× |
| Extracranial Uni/Ltd Study (93882) | $481.80 | $876 | 4.7× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $862.95 | $1,569 | 1.6× |
| Flexible endoscopic eval swallow c/v rec (92612) | $394.35 | $717 | 2.0× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) | $497.75 | $905 | 0.6× |
| Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) | $409.75 | $745 | 2.0× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $2,185.15 | $3,973 | 2.6× |
| Gi tract capsule endoscopy (91110) | $2,550.35 | $4,637 | 2.9× |
| Group Therapeutic Procedures (97150) | $50.05 | $91 | 2.8× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $5,959.80 | $10,836 | 1.9× |
| Holter monitor recording (93225) | $462 | $840 | 3.6× |
| Icd Device Interrogate (93289) | $168.30 | $306 | 4.6× |
| Icd device progr eval dual (93283) | $145.20 | $264 | 4.0× |
| Icd Device Progr Eval Mult (93284) | $135.30 | $246 | 3.7× |
| Icm Device Eval (93290) | $144.10 | $262 | 4.0× |
| Ilr Device Eval Progr (93285) | $91.30 | $166 | 2.5× |
| Ilr Device Interrogate (93291) | $133.10 | $242 | 4.7× |
| Immunization administration (90471) | $49.50 | $90 | 0.7× |
| Intra-atrial recording (93602) | $7,333.70 | $13,334 | 1.0× |
| Iontophoresis 15 min (97033) | $66 | $120 | 3.5× |
| Irrig Drug Delivery Device (96523) | $71.50 | $130 | 1.2× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$125.40–$144.65 | $228–$263 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$255.20–$293.70 | $464–$534 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$132–$151.80 | $240–$276 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$132–$151.80 | $240–$276 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$185.90–$213.40 | $338–$388 | varies |
| L Hrt Art/Grft Angio (93459) | $8,731.80 | $15,876 | 2.8× |
| Liver Elastography W/O Imag W/I&R (91200) | $322.30 | $586 | 2.6× |
| Lung Function Test (Mbc/Mvv) (94200) | $369.60 | $672 | 6.5× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $750.20 | $1,364 | 3.6× |
| Mechanical chest wall oscillation per session (94669) | $106.15 | $193 | 0.5× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $53.90 | $98 | 1.7× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $65.45 | $119 | 1.8× |
| Methacholine challenge (94070) | $1,166 | $2,120 | 3.2× |
| Motility study esophagus (91010) | $1,289.20 | $2,344 | 3.6× |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$198.55–$506 | $361–$920 | varies |
| Multiple Family Group Psychotherapy (90849) range across 2 matching MRF lines |
$94.05–$102.30 | $171–$186 | varies |
| Multiple Sleep Latency Test (95805) | $2,283.05 | $4,151 | 2.7× |
| Muscle Test 2 Limbs (95861) | $225.50 | $410 | 1.7× |
| Muscle Test Nonparaspinal (95870) | $138.05 | $251 | 1.1× |
| Muscle Test One Limb (95860) | $166.10 | $302 | 1.3× |
| Nasopharyngoscopy (92511) | $229.90 | $418 | 1.2× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $361.35 | $657 | 1.7× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) | $180.95 | $329 | 0.9× |
| Needle electromyography larynx (95865) | $188.65 | $343 | 1.5× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $298.10 | $542 | 0.8× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $298.10 | $542 | 0.8× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $269.50 | $490 | 1.4× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $301.40 | $548 | 0.8× |
| Nerve Conduction Studies 11-12 Studies (95912) | $1,032.20 | $1,876.72 | 2.8× |
| Nerve conduction studies 13 or more studies (95913) | $1,327.39 | $2,413.43 | 3.7× |
| Nerve Conduction Studies 3-4 Studies (95908) | $430.32 | $782.40 | 2.1× |
| Nerve conduction studies 5-6 studies (95909) | $515.13 | $936.60 | 2.5× |
| Nerve conduction studies 7-8 studies (95910) | $761.48 | $1,384.50 | 2.1× |
| Nerve Conduction Studies 9-10 Studies (95911) | $890.94 | $1,619.89 | 2.5× |
| Neurobehavioral Status Exam (96116) | $89.10 | $162 | 0.4× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $275.22 | $500.40 | 2.2× |
| Neuromuscular Reeducation (97112) | $66.55 | $121 | 2.0× |
| Nonphysician Telephone Assessment 11-20 Min (98967) | $91.85 | $167 | 3.7× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $137.50 | $250 | 4.0× |
| Nonphysician Telephone Assessment 5-10 Min (98966) | $46.20 | $84 | 3.4× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $204.05 | $371 | 0.6× |
| Oral Function Therapy (92526) | $363 | $660 | 4.3× |
| Oral Speech Device Eval (92597) | $374 | $680 | 5.3× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $48.95 | $89 | 1.0× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $67.10 | $122 | 1.5× |
| Ot eval high complexity (97167) | $154 | $280 | 1.5× |
| Ot Eval Low Complex (97165) | $113.85 | $207 | 1.1× |
| Ot Eval Moderate Complexity (97166) | $134.75 | $245 | 1.3× |
| Ot manual therapy 15 min (97140) | $68.20 | $124 | 2.5× |
| Ot paraffin bath (97018) | $38.50 | $70 | 6.4× |
| Ot Prosthetic Training, Each 15 Min (97761) | $50.60 | $92 | 1.3× |
| Ot Re-Eval Est Plan Care (97168) | $85.25 | $155 | 1.2× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$288.75–$369.60 | $525–$672 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $238.70 | $434 | 1.9× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $237.60 | $432 | 1.1× |
| Peripheral arterial disease rehab per session (93668) | $238.15 | $433 | 4.2× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $6,612.65 | $12,023 | 1.2× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) | $7,643.35 | $13,897 | 0.7× |
| Phlebotomy therapeutic (99195) | $183.70 | $334 | 1.4× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $147.95 | $269 | 2.6× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $132.55 | $241 | 2.3× |
| Physical Performance Test (97750) range across 2 matching MRF lines |
$72.05–$75.90 | $131–$138 | varies |
| Plethysmography (94726) | $535.70 | $974 | 1.5× |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$124.30–$143 | $226–$260 | varies |
| Pm device progr eval dual (93280) range across 2 matching MRF lines |
$113.85–$131.45 | $207–$239 | varies |
| Pm device progr eval multi (93281) | $108.35 | $197 | 3.0× |
| Pm Device Progr Eval Sngl (93279) | $96.25 | $175 | 2.7× |
| Pm/Icd Remote Tech Serv (93296) range across 2 matching MRF lines |
$139.15–$160.05 | $253–$291 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$3,328.60–$4,205.30 | $6,052–$7,646 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) range across 2 matching MRF lines |
$3,230.15–$3,788.40 | $5,873–$6,888 | varies |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) range across 2 matching MRF lines |
$3,329.15–$4,205.30 | $6,053–$7,646 | varies |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $121.55 | $221 | 3.4× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $30.25 | $55 | 0.7× |
| Prq Card Angio/Athrect 1 Art (92924) | $11,948.20 | $21,724 | 1.1× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $7,262.20 | $13,204 | 0.6× |
| Prq Card Stent/Ath/Angio (92933) | $10,491.80 | $19,076 | 0.6× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $7,279.80 | $13,236 | 0.6× |
| Psych diag eval w/med srvcs (90792) | $195.80 | $356 | 1.1× |
| Psychiatric diagnostic evaluation (90791) range across 3 matching MRF lines |
$191.40–$327.80 | $348–$596 | varies |
| Psychological tst eval svc phys/qhp first hour (96130) | $264.55 | $481 | 1.3× |
| Psycl/Nrpsyc Tst Auto Result (96146) | $51.15 | $93 | 1.8× |
| Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) | $92.40 | $168 | 0.2× |
| Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) | $50.05 | $91 | 0.4× |
| Psytx Crisis Initial 60 Min (90839) range across 2 matching MRF lines |
$118.25–$130.90 | $215–$238 | varies |
| Pt Eval High Complex (97163) | $155.10 | $282 | 1.6× |
| Pt eval low complex 20 min (97161) | $112.75 | $205 | 1.2× |
| Pt Eval Mod Complex (97162) | $134.20 | $244 | 1.4× |
| Pt gait training 15 min (97116) | $54.45 | $99 | 1.9× |
| Pt group caregiver training (97552) | $85.80 | $156 | 3.9× |
| Pt mechanical traction (97012) | $55.55 | $101 | 3.9× |
| Pt Re-Eval Est Plan Care (97164) | $91.30 | $166 | 1.4× |
| Pulm function test by gas (94727) | $531.85 | $967 | 2.5× |
| Pulmonary service/procedure (94799) range across 4 matching MRF lines |
$199.10–$397.65 | $362–$723 | varies |
| Pulmonary Stress Testing (94618) | $522.50 | $950 | 4.0× |
| Qnhp Ol Dig Assmt&Mgmt 11-20 (98971) | $76.45 | $139 | 3.3× |
| Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) | $120.45 | $219 | 3.5× |
| Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) | $43.45 | $79 | 3.5× |
| R hrt coronary artery angio (93456) | $8,820.90 | $16,038 | 2.8× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $8,723 | $15,860 | 2.8× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) | $505.45 | $919 | 1.6× |
| Refill/Maint Portable Pump (96521) | $380.60 | $692 | 1.8× |
| Refill/Maint Pump/Resvr Syst (96522) | $308.55 | $561 | 1.5× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) | $168.30 | $306 | 4.6× |
| Remote 30 Day Ecg Rev/Report (93270) | $349.25 | $635 | 9.6× |
| Right Heart Cath (93451) | $3,161.95 | $5,749 | 1.0× |
| Right ventricular recording (93603) | $1,256.20 | $2,284 | 1.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $170.50 | $310 | 0.9× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $261.25 | $475 | 2.1× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $122.10 | $222 | 2.6× |
| Self Care Mngment Training (97535) | $48.40 | $88 | 1.5× |
| Sensory Integration Ea 15 Min (97533) | $52.80 | $96 | 0.9× |
| Short-latency somatosens ep std upr limbs (95925) | $789.25 | $1,435 | 3.8× |
| Sleep study attended (95807) range across 2 matching MRF lines |
$3,230.15–$3,598.65 | $5,873–$6,543 | varies |
| Slp caregiver training 1st 30 min (97550) | $75.90 | $138 | 1.4× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $613.80 | $1,116 | 2.9× |
| Somatosensory Testing (95938) | $1,357.40 | $2,468 | 1.6× |
| Speech sound lang comprehen (92523) | $569.80 | $1,036 | 2.5× |
| Spin/Brain Pump Refil & Main (95991) | $509.30 | $926 | 1.7× |
| Spirometry (94010) | $172.15 | $313 | 0.8× |
| Ssep lower limbs (95926) | $793.65 | $1,443 | 3.8× |
| Standardized Cognitive Performance Testing (96125) | $494.45 | $899 | 4.8× |
| Stress Tte Only (93350) | $862.95 | $1,569 | 1.6× |
| Temp transcutaneous pacing (92953) | $981.20 | $1,784 | 1.5× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $54.45 | $99 | 2.4× |
| Ther Ivntj Ea Addl 15 Min (97130) | $54.45 | $99 | 2.6× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $89.10 | $162 | 2.4× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $54.45 | $99 | 1.8× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $155.10 | $282 | 1.5× |
| Ther/Proph/Diag Inj Ia (96373) range across 2 matching MRF lines |
$90.75–$105.60 | $165–$192 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$51.70–$59.40 | $94–$108 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$262.35–$300.85 | $477–$547 | varies |
| Therapeutic Activities (97530) | $61.60 | $112 | 1.8× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,786.40 | $3,248 | 4.9× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $46.20 | $84 | 1.3× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $30.80 | $56 | 0.8× |
| Trans Care Mgmt 14 Day Disch (99495) | $192.42 | $349.85 | 1.5× |
| Trans Care Mgmt 7 Day Disch (99496) | $282.22 | $513.13 | 2.2× |
| Transcath Closure of Asd (93580) | $20,724.55 | $37,681 | 1.2× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) | $84.70 | $154 | 2.3× |
| Tte w/doppler, complete (93306) | $1,695.10 | $3,082 | 3.2× |
| Tx atrial fib pulm vein isol (93656) | $25,527.15 | $46,413 | 1.0× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $163.90 | $298 | 2.2× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $15.95 | $29 | 0.7× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$185.90–$213.40 | $338–$388 | varies |
| Unlisted cardiovascular service/procedure (93799) range across 3 matching MRF lines |
$135.85–$3,587.65 | $247–$6,523 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $538.45 | $979 | 4.2× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $552.75 | $1,005 | 2.6× |
| Valvuloplasty aortic valve (92986) | $6,168.25 | $11,215 | 1.1× |
| Valvuloplasty mitral valve (92987) | $10,877.90 | $19,778 | 1.0× |
| Vasopneumatic device (97016) | $46.75 | $85 | 3.9× |
| Vent Mgmt Inpat Init Day (94002) | $849.75 | $1,545 | 1.4× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $849.75 | $1,545 | 1.4× |
| Visual Evoked Potential Test (95930) | $785.40 | $1,428 | 3.7× |
| Vital capacity, total (94150) | $93.50 | $170 | 0.7× |
| Wheelchair Mgmt Ea 15 Min (97542) | $48.95 | $89 | 1.6× |
| Whirlpool Therapy (97022) | $46.75 | $85 | 3.0× |
| Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) | $146.85 | $267 | 2.6× |
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.