Visits & medical services prices at St. Bernards Five Rivers Medical Center

Pocahontas, AR · every code in this section with a posted price and a Medicare benchmark.

114 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) $76.50 $85 0.8×
Airway inhalation treatment (94640) $346.50 $385 1.7×
Behav assmt w/score & docd/stand instrument (96127) $8.10 $9 0.2×
Breath Hydrogen/Methane Test (91065) $243 $270 1.2×
Canalith Repositioning (95992) $72 $80 1.8×
Cardiac Stress Tst,Tracing Only (93017) $459 $510 2.3×
Cardiopulmonary resuscitation (92950) $459 $510 2.3×
Cardioversion (92960) $967.50 $1,075 1.6×
Caregiver training 1st 30 min (97550) $76.50 $85 1.4×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $40.50 $45 1.6×
Cbt 1st hour (94644) $207 $230 1.7×
Chemo Hormon Antineopl Sq/Im (96402) $76.50 $85 1.2×
Chemotx Admn Cns Req Spinal Puncture (96450) $580.50 $645 1.9×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $63 $70 0.7×
Color/duplex Doppler, complete (93975) $418.50 $465 1.9×
Color/duplex Doppler, limited (93976) $189 $210 2.0×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $49.50 $55 0.3×
Cpap initiation and management (94660) $346.50 $385 1.7×
Cpt initial (94667) $207 $230 1.7×
Critical care (99291) $1,201.50 $1,335 1.6×
Debridement Open Wound 20 Sq Cm< (97597) $315 $350 1.7×
Demo &/or eval,pt use,aerosol device (94664) $22.50 $25 0.1×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $189 $210 2.0×
Dup-scan artl infl&ven o/f pen vsl f-up/lmtd std (93981) $189 $210 2.0×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $189 $210 2.0×
Dup-scan xtr veins unilateral/limited study (93971) $189 $210 2.0×
Duplex scan extracranial art compl bi study (93880) $418.50 $465 1.9×
Echo Heart Xthoracic,Limited (93308) $240.75 $267.50 1.1×
EEG awake asleep (95819) $459 $510 2.3×
EEG awake drowsy (95816) $459 $510 2.3×
EEG cerebral death evaluation (95824) $877.50 $975 2.6×
EEG coma or sleep only (95822) $450 $500 2.3×
EKG (93005) $60.75 $67.50 1.1×
EKG rhythm strip (93041) $105.75 $117.50 2.0×
Er level 1 (99281) $126 $140 1.6×
Er level ii (99282) $234 $260 1.7×
Er level iii (99283) $405 $450 1.6×
Er level IV (99284) $634.50 $705 1.7×
Er level v (99285) $909 $1,010 1.7×
Evaluation of speech sound production (92522) $153 $170 1.4×
Evaluation of swallowing function (92610) $144 $160 1.7×
External ECG rec>48hr<7d recording (93242) $198 $220 5.8×
External ECG rec>48hr<7d scanning alys w/report (93243) $198 $220 1.6×
External Ecg Scanning Analysis Report (93226) $198 $220 3.7×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $310.50 $345 1.6×
Group Therapeutic Procedures (97150) $31.50 $35 1.7×
Holter Monitor Recording (93225) $198 $220 1.6×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $72 $80 1.9×
Immunization Admin (90471) $90 $100 1.4×
Immunotherapy, 2+ Injections (95117) $26.55 $29.50 0.6×
Injection intra arterial (96373) $333 $370 1.7×
Intralesional Chemo Admin,8+ Lesn (96406) $369 $410 1.9×
Intralesional Chemo Admin,<8 Lesn (96405) $121.50 $135 1.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $103.50 $115 1.9×
IV infusion hydration each additional hour (96361) $67.50 $75 1.6×
IV infusion hydration initial 31 min-1 hour (96360) $333 $370 1.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $112.50 $125 1.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $333 $370 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $72 $80 1.7×
IV push initial (96374) $333 $370 1.7×
Manual therapy 15 min (97140) $49.50 $55 1.8×
Massage 15 min (97124) $49.50 $55 1.7×
Mechanical traction (97012) $24.75 $27.50 1.7×
Methacholine challenge (94070) $540 $600 1.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $319.50 $355 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $670.50 $745 1.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $189 $210 1.6×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $76.50 $85 1.7×
Ot eval high complex 60 min (97167) $265.50 $295 2.6×
Ot eval low complex 30 min (97165) $135 $150 1.3×
Ot eval mod complex 45 min (97166) $198 $220 2.0×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $58.50 $65 1.2×
Ot Prosthetic Training, Each 15 Min (97761) $67.50 $75 1.7×
Ot re-eval est plan care (97168) $126 $140 1.8×
Paraffin bath (97018) $13.50 $15 2.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $24.30 $27 0.6×
Psytx crisis initial 60 min (90839) $225 $250 1.4×
Pt Aquatic Therapy/Exercises (97113) $67.50 $75 1.8×
Pt Electric Current Therapy (97033) $36 $40 1.9×
Pt Electrical Stimulation (97032) $27 $30 1.8×
Pt eval high complex 45 min (97163) $265.50 $295 2.7×
Pt eval low complex 20 min (97161) $135 $150 1.4×
Pt Gait Training Therapy (97116) $45 $50 1.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $58.50 $65 1.8×
Pt Physical Performance Test (97750) $63 $70 1.9×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $198 $220 2.0×
Pt re-evaluation (97164) $126 $140 1.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $58.50 $65 1.8×
Pt Ultrasound Therapy (97035) $22.50 $25 1.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $324 $360 1.8×
Rt Chest Wall Manipulation,Subsequent (94668) $207 $230 1.7×
Smoking cessation > 10 min (99407) $36 $40 1.1×
Speech sound lang comprehen (92523) $333 $370 1.5×
Spirometry (94010) $67.50 $75 0.3×
Stress Tte Complete (93351) $810 $900 1.6×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $36 $40 1.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $36 $40 1.7×
Ther/prop/diag inj/inf proc (96379) $72 $80 1.7×
Ther/Proph/Diag Inj Sc/Im (96372) $108 $120 1.6×
Therapeutic Activities (97530) $67.50 $75 1.9×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $22.50 $25 0.7×
Trans Care Mgmt 14 Day Disch (99495) $193.50 $215 1.6×
Trans Care Mgmt 7 Day Disch (99496) $329.85 $366.50 2.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $351 $390 0.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $135 $150 1.8×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $144 $160 1.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $72 $80 1.7×
Unlisted pulmonary service/procedure (94799) $270 $300 2.3×
Vasc Duplex Extrem Venous,Bilat (93970) $418.50 $465 1.9×
Vasc Duplex Scan Extracranial,Limited (93882) $207 $230 2.2×
Ventilation assist & mgmt inpatient 1st day (94002) $1,003.50 $1,115 1.8×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,003.50 $1,115 1.8×
Vital capacity total (94150) $256.50 $285 2.2×
Wheelchair Mgmt Ea 15 Min (97542) $54 $60 1.7×