Visits & medical services prices at St. Elizabeth Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $142.10 $355.22 0.6×
Behavioral and qualitative analysis of voice and resonance (92524) $80.53 $201.32 0.7×
Bfb training 1st 15 min (90912) $128.22 $320.55 1.6×
Bfb training ea addl 15 min (90913) $87.13 $217.82 2.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $294.53 $736.32 0.7×
Cardiac Stress Tst,Tracing Only (93017) $1,375.61 $3,439.02 6.0×
Cardiopulmonary resuscitation (92950) $2,234.08 $5,585.19 9.8×
Cardioversion (92960) $2,024.84 $5,062.09 2.9×
Caregiver training 1st 30 min (97550) $45.10 $112.74 0.9×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $20.63 $51.56 0.8×
Cbt 1st hour (94644) $417.94 $1,044.84 3.0×
Chemo Hormon Antineopl Sq/Im (96402) $440.20 $1,100.49 5.8×
Chemo IV push addl drug (96411) $468.83 $1,172.07 6.2×
Chemo Iv Push Sngl Drug (96409) $2,303.42 $5,758.54 6.6×
Chemo prolong 8+ hrs infuse w/pump (96416) $4,141.82 $10,354.55 11.9×
Chemother, IV infusion, 1 hr (96413) $1,906.47 $4,766.17 5.5×
Chemother, IV infusion, ea add hr (96415) $575.70 $1,439.23 7.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $328.96 $822.40 4.3×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $575.70 $1,439.23 7.6×
Color/duplex Doppler, complete (93975) $921.62 $2,304.05 3.7×
Color/duplex Doppler, limited (93976) $648.02 $1,620.03 5.9×
Cpap initiation and management (94660) $729.24 $1,823.10 3.2×
Cpt initial (94667) $142.95 $357.37 1.0×
Critical care (99291) $2,881.90 $7,204.73 3.3×
Debridement Open Wound 20 Sq Cm< (97597) $337.47 $843.66 1.6×
Demo &/or eval,pt use,aerosol device (94664) $311.93 $779.81 1.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $921.62 $2,304.05 3.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $648.02 $1,620.03 5.9×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $648.02 $1,620.03 5.9×
Dup-scan xtr veins unilateral/limited study (93971) $648.02 $1,620.03 5.9×
Duplex scan extracranial art compl bi study (93880) $921.62 $2,304.05 3.7×
Echo Heart Xthoracic,Limited (93308) $922 $2,304.98 3.7×
Echo transesophageal (93312) $1,872.04 $4,680.10 3.2×
EEG awake asleep (95819) $983.45 $2,458.62 4.3×
EEG awake drowsy (95816) $830.15 $2,075.36 3.6×
EKG (93005) $331.21 $828.02 5.3×
EKG rhythm strip (93041) $45.61 $114.02 0.7×
Er level 1 (99281) $205.56 $513.90 2.3×
Er level ii (99282) $331.48 $828.70 2.0×
Er level iii (99283) $676.58 $1,691.43 2.3×
Er level IV (99284) $897.12 $2,242.78 2.0×
Er level v (99285) $2,292.46 $5,731.13 3.6×
Evaluation of speech fluency (92521) $98.12 $245.30 0.7×
Evaluation of speech sound production (92522) $79.62 $199.03 0.7×
Evaluation of swallowing function (92610) $336.47 $841.16 4.0×
External ECG rec>48hr<7d recording (93242) $782.07 $1,955.16 19.8×
External ECG rec>7d<15d recording (93246) $1,446.20 $3,615.49 36.7×
External Ecg Scanning Analysis Report (93226) $207.60 $518.99 3.3×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $227.32 $568.29 1.1×
Group Therapeutic Procedures (97150) $62.44 $156.09 3.5×
Holter Monitor Recording (93225) $782.07 $1,955.16 5.6×
Immunization Admin (90471) $314.30 $785.73 4.1×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $234.73 $586.82 3.8×
IV infusion hydration each additional hour (96361) $234.69 $586.72 4.8×
IV infusion hydration initial 31 min-1 hour (96360) $312.33 $780.82 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $309.83 $774.56 4.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $541.70 $1,354.24 2.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $340.65 $851.61 6.9×
IV push initial (96374) $292.22 $730.55 1.3×
Low frequency non-thermal us (97610) $304.72 $761.79 1.4×
Manual therapy 15 min (97140) $115.40 $288.50 4.2×
Massage 15 min (97124) $130.01 $325.01 4.4×
Mechanical chest wall oscillation (94669) $292.88 $732.19 1.3×
Mechanical traction (97012) $67.23 $168.06 4.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $18.60 $46.50 0.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $26.06 $65.13 0.7×
Methacholine challenge (94070) $1,033.07 $2,582.67 2.6×
Mnt Group Ea 30 Min (97804) $28.80 $72 1.7×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $403.76 $1,009.40 4.4×
Multiple sleep latency test (95805) $3,223.94 $8,059.84 3.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $345.74 $864.32 1.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $458.86 $1,147.16 1.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $263.89 $659.71 1.9×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $1,399.31 $3,498.26 6.1×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $181.46 $453.63 1.3×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $185.20 $463 0.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $143.46 $358.64 3.1×
Ot Contrast Bath Ea 15 Min (97034) $21.97 $54.92 1.6×
Ot eval high complex 60 min (97167) $371.54 $928.85 3.7×
Ot eval low complex 30 min (97165) $303.99 $759.97 3.0×
Ot eval mod complex 45 min (97166) $337.76 $844.39 3.4×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $47.92 $119.80 1.0×
Ot Range Motion Measure,Each Extrem (95851) $172.79 $431.96 6.6×
Ot re-eval est plan care (97168) $228.52 $571.29 3.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $229.01 $572.52 1.7×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $238.55 $596.37 1.8×
Paraffin bath (97018) $85.89 $214.72 14.3×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $220.48 $551.18 1.0×
Plethysmography (94726) $414.12 $1,035.30 1.1×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,229.50 $5,573.73 2.5×
Psychiatric diagnostic evaluation (90791) $236 $590 1.3×
Pt Aquatic Therapy/Exercises (97113) $76.34 $190.82 2.1×
Pt Electric Current Therapy (97033) $110.84 $277.10 5.8×
Pt Electrical Stimulation (97032) $171.60 $428.98 11.7×
Pt eval high complex 45 min (97163) $371.54 $928.85 3.8×
Pt eval low complex 20 min (97161) $303.99 $759.97 3.1×
Pt Gait Training Therapy (97116) $76.85 $192.12 2.6×
Pt group caregiver training (97552) $19.26 $48.15 0.9×
Pt Infrared Therapy (97026) $11.97 $29.92 1.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $119.95 $299.86 3.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $337.76 $844.39 3.5×
Pt re-evaluation (97164) $228.52 $571.29 3.4×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $127.95 $319.86 3.9×
Pt Ultrasound Therapy (97035) $113.13 $282.82 7.9×
Pt Whirlpool Therapy (97022) $143.20 $358 9.1×
Pulmonary stress testing (94618) $726.46 $1,816.14 5.2×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $223.94 $559.84 5.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $133.56 $333.89 0.6×
Rom meas&reprt hand w/wo comparison normal sid (95852) $19.26 $48.15 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $96.19 $240.46 0.7×
Sensory Integration Ea 15 Min (97533) $183.96 $459.88 3.0×
Sleep study unattended (95806) $217.03 $542.56 1.0×
Speech sound lang comprehen (92523) $135.46 $338.63 0.6×
Spirometry (94010) $209.29 $523.21 0.9×
Standardized Cognitive Performance Testing (96125) $214.12 $535.28 2.1×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $153.43 $383.57 6.9×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $153.43 $383.57 7.3×
Ther/Proph/Diag Inj Sc/Im (96372) $193.67 $484.17 2.5×
Therapeutic Activities (97530) $102.04 $255.09 2.9×
Therapeutic phlebotomy (99195) $94.18 $235.44 0.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $93.51 $233.77 2.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,872.04 $4,680.10 3.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $194.68 $486.69 2.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $235.02 $587.55 2.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $291.80 $729.48 5.9×
Vasc Duplex Extrem Venous,Bilat (93970) $921.62 $2,304.05 3.7×
Ventilation assist & mgmt inpatient 1st day (94002) $1,620.22 $4,050.53 2.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $708.01 $1,770.01 1.1×
Wheelchair Mgmt Ea 15 Min (97542) $118.95 $297.36 3.8×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $1,118.33 $2,795.81 11.2×