Visits & medical services prices at St. John's Episcopal Hospital at South Shore
Far Rockaway, NY · every code in this section with a posted price and a Medicare benchmark.
189 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acoustic Reflex Testing (92568) | $128 | $128 | 2.7× |
| Actinotherapy Ultraviolet Light (96900) | $139.86 | $139.86 | 3.0× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $120 | $120 | 2.4× |
| Advncd Care Plan 30 Min (99497) | $303.85 | $303.85 | 2.4× |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $565.40 | $565.40 | 2.1× |
| Airway Inhalation Treatment (94640) | $749.05 | $749.05 | 2.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 2 matching MRF lines |
$69.01–$74.57 | $69.01–$74.57 | varies |
| Application Modality 1/> Areas Diathermy (97024) | $69.01 | $69.01 | 9.4× |
| Audiometry Air & Bone (92553) | $565.40 | $565.40 | 3.5× |
| Behavral qualit analys voice (92524) | $273.80 | $273.80 | 2.5× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $1,335.60 | $1,335.60 | 2.9× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,001.70 | $1,001.70 | 3.7× |
| Cardiopulmonary resuscitation (92950) | $1,001.70 | $1,001.70 | 3.7× |
| Cardioversion (92960) | $2,059.05 | $2,059.05 | 2.5× |
| Chemo Anti-Neopl Sq/Im (96401) | $473.02 | $473.02 | 5.3× |
| Chemo Hormon Antineopl Sq/Im (96402) | $473.02 | $473.02 | 5.3× |
| Chemo Ia Push (96420) | $1,195.36 | $1,195.36 | 2.9× |
| Chemo Intralesional Over 7 (96406) | $767.97 | $767.97 | 2.9× |
| Chemo intralesional up to 7 (96405) | $233.73 | $233.73 | 2.6× |
| Chemo IV infusion addl hr (96415) | $474.14 | $474.14 | 5.3× |
| Chemo IV push addl drug (96411) | $261.56 | $261.56 | 2.9× |
| Chemother Prolong Infuse W/Pump (96416) | $1,195.36 | $1,195.36 | 2.9× |
| Chemotherapy Into Cns (96450) | $1,195.36 | $1,195.36 | 2.9× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $474.14 | $474.14 | 5.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $1,195.36 | $1,195.36 | 2.9× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $767.97 | $767.97 | 1.9× |
| Chest Wall Manipulation (94668) | $562.07 | $562.07 | 3.4× |
| Chron Care Mgmt Srvc 20 Min (99490) | $303.85 | $303.85 | 2.4× |
| Cmptr ophth dx img ant segmt (92132) | $224.83 | $224.83 | 3.1× |
| Color/duplex Doppler, complete (93975) | $1,725.15 | $1,725.15 | 5.8× |
| Color/duplex Doppler, limited (93976) | $1,725.15 | $1,725.15 | 13.2× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $85.70 | $85.70 | 2.7× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $584.33 | $584.33 | 2.6× |
| Comprehensive Hearing Test (92557) | $547.60 | $547.60 | 3.4× |
| Conditioning Play Audiometry (92582) | $547.60 | $547.60 | 3.4× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $465.23 | $465.23 | 2.8× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $224.83 | $224.83 | 3.1× |
| Continuous Pulse Ox (94762) | $547.60 | $547.60 | 3.4× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $749.05 | $749.05 | 2.7× |
| Cpt initial (94667) | $562.07 | $562.07 | 3.4× |
| Critical care first hour (99291) | $2,949.45 | $2,949.45 | 2.9× |
| Debridement Open Wound 20 Sq Cm< (97597) | $678.93 | $678.93 | 2.7× |
| Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) | $751.35 | $751.35 | 3.0× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $1,274.38 | $1,274.38 | 4.3× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $802.47 | $802.47 | 6.1× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) | $1,326.70 | $1,326.70 | 10.2× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,229.87 | $1,229.87 | 4.1× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $1,057.35 | $1,057.35 | 8.1× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,285.52 | $1,285.52 | 4.3× |
| Dup-scan xtr veins unilateral/limited study (93971) | $946.05 | $946.05 | 7.2× |
| Duplex Scan Hemodialysis Access (93990) | $802.47 | $802.47 | 6.1× |
| Duplex up extrem art bilat (93930) | $1,285.52 | $1,285.52 | 4.3× |
| Duplex up extrem art unilat/ltd (93931) | $1,090.74 | $1,090.74 | 8.4× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$1,057.35–$1,535.94 | $1,057.35–$1,535.94 | varies |
| Echo transesophageal (93312) range across 2 matching MRF lines |
$2,448.60–$2,726.85 | $2,448.60–$2,726.85 | varies |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) range across 2 matching MRF lines |
$1,953.32–$2,225 | $1,953.32–$2,225 | varies |
| EEG awake and asleep (95819) | $1,281.06 | $1,281.06 | 4.8× |
| EEG awake drowsy (95816) | $1,138.60 | $1,138.60 | 4.2× |
| Electrical Stimulation Ea 15 Min (97032) | $90.15 | $90.15 | 6.1× |
| Electrocardiogram Tracing (93005) range across 2 matching MRF lines |
$132.45–$224.83 | $132.45–$224.83 | varies |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$1,604.95–$1,777.46 | $1,604.95–$1,777.46 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$1,834.22–$2,006.74 | $1,834.22–$2,006.74 | varies |
| Emergency Dept Visit Level 4 (99284) | $2,063.50 | $2,063.50 | 4.0× |
| Emg 4 Extremities (95864) | $974.99 | $974.99 | 6.1× |
| Er level 1 (99281) | $1,427.98 | $1,427.98 | 13.6× |
| Er level v (99285) range across 2 matching MRF lines |
$2,292.78–$2,465.30 | $2,292.78–$2,465.30 | varies |
| Evaluate pt use of inhaler (94664) | $749.05 | $749.05 | 2.7× |
| Evaluate Speech Production (92522) | $259.33 | $259.33 | 2.3× |
| Evaluation of speech fluency (92521) | $321.66 | $321.66 | 2.4× |
| Evoked Auditory Test,Limited (92587) | $1,001.70 | $1,001.70 | 3.7× |
| Excimer laser tx psoriasis tot area <250 sq cm (96920) | $751.35 | $751.35 | 3.0× |
| Extracranial Bilat Study (93880) | $1,279.95 | $1,279.95 | 4.3× |
| Extracranial Uni/Ltd Study (93882) | $1,051.79 | $1,051.79 | 8.1× |
| Eye Exam With Photos (92230) | $1,784.14 | $1,784.14 | 3.8× |
| Fundus photography (92250) | $428.50 | $428.50 | 2.6× |
| Gonioscopy (92020) | $422.94 | $422.94 | 2.5× |
| Group Therapeutic Procedures (97150) | $50.09 | $50.09 | 2.8× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $2,454.16 | $2,454.16 | 2.9× |
| Holter monitor recording (93225) | $422.94 | $422.94 | 2.5× |
| Hubbard tank 15 min (97036) | $95.72 | $95.72 | 2.8× |
| Icd Device Interrogate (93289) | $152.48 | $152.48 | 3.3× |
| Icd device progr eval dual (93283) | $146.65 | $146.65 | 3.1× |
| Icd Device Progr Eval Mult (93284) | $146.65 | $146.65 | 3.1× |
| Ilr Device Eval Progr (93285) | $146.65 | $146.65 | 3.1× |
| Ilr Device Interrogate (93291) | $92.99 | $92.99 | 2.6× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $233.73 | $233.73 | 2.6× |
| Immunization administration (90471) | $233.73 | $233.73 | 2.6× |
| Iontophoresis 15 min (97033) | $94.61 | $94.61 | 5.0× |
| Irrig Drug Delivery Device (96523) | $239.29 | $239.29 | 3.2× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$149.14–$163.80 | $149.14–$163.80 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) | $767.97 | $767.97 | 2.9× |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$233.73–$252.66 | $233.73–$252.66 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$149.14–$163.80 | $149.14–$163.80 | varies |
| IV push initial (96374) | $767.97 | $767.97 | 2.9× |
| Mechanical chest wall oscillation per session (94669) | $768.27 | $768.27 | 2.8× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 2 matching MRF lines |
$113.53–$133.56 | $113.53–$133.56 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $133.56 | $133.56 | 3.6× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $64.55 | $64.55 | 3.8× |
| Nasopharyngoscopy (92511) | $632.18 | $632.18 | 2.5× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $678.93 | $678.93 | 2.7× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $1,247.67 | $1,247.67 | 2.5× |
| Neuromuscular Reeducation (97112) | $132.45 | $132.45 | 4.0× |
| Newborn resuscitation (99465) | $2,059.05 | $2,059.05 | 2.5× |
| Nitric oxide expired gas determination (95012) | $128 | $128 | 2.7× |
| Nonphysician Telephone Assessment 11-20 Min (98967) | $325 | $325 | 13.0× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $359.50 | $359.50 | 10.3× |
| Nonphysician Telephone Assessment 5-10 Min (98966) | $282.70 | $282.70 | 20.7× |
| Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) | $422.94 | $422.94 | 2.5× |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) | $456.33 | $456.33 | 2.7× |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) | $456.33 | $456.33 | 2.7× |
| Ophth medical xm&eval intermediate estab pt (92012) | $456.33 | $456.33 | 2.7× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) | $456.33 | $456.33 | 2.7× |
| Oral Function Therapy (92526) | $657.78 | $657.78 | 7.8× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $205.91 | $205.91 | 4.1× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $132.45 | $132.45 | 2.9× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $111.30 | $111.30 | 4.1× |
| Ot Contrast Bath Ea 15 Min (97034) | $69.01 | $69.01 | 4.9× |
| Ot eval high complexity (97167) | $536.47 | $536.47 | 5.3× |
| Ot Eval Low Complex (97165) | $377.31 | $377.31 | 3.8× |
| Ot Eval Moderate Complexity (97166) | $448.54 | $448.54 | 4.5× |
| Ot manual therapy 15 min (97140) | $84.59 | $84.59 | 3.1× |
| Ot paraffin bath (97018) | $69.01 | $69.01 | 11.5× |
| Ot Prosthetic Training, Each 15 Min (97761) | $132.45 | $132.45 | 3.3× |
| Ot Re-Eval Est Plan Care (97168) | $235.96 | $235.96 | 3.4× |
| Penile Vascular Study,Ltd or F/U (93981) | $1,686.19 | $1,686.19 | 12.9× |
| Percutaneous tests w/allergenic extracts (95004) | $47.86 | $47.86 | 0.0× |
| Phlebotomy therapeutic (99195) | $457.62 | $457.62 | 2.8× |
| Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) | $220.92 | $220.92 | 3.0× |
| Physical Performance Test (97750) | $132.45 | $132.45 | 3.9× |
| Plethysmography (94726) range across 2 matching MRF lines |
$935–$999.47 | $935–$999.47 | varies |
| Pm device eval in person (93288) | $152.48 | $152.48 | 3.3× |
| Pm device progr eval dual (93280) | $146.65 | $146.65 | 3.1× |
| Pm device progr eval multi (93281) | $146.65 | $146.65 | 3.1× |
| Pm Device Progr Eval Sngl (93279) | $146.65 | $146.65 | 3.1× |
| Pm/Icd Remote Tech Serv (93296) | $146.65 | $146.65 | 3.1× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $146.65 | $146.65 | 3.1× |
| Pt Eval High Complex (97163) | $560.95 | $560.95 | 5.7× |
| Pt eval low complex 20 min (97161) | $400.68 | $400.68 | 4.1× |
| Pt Eval Mod Complex (97162) | $471.91 | $471.91 | 4.8× |
| Pt gait training 15 min (97116) | $11.13 | $11.13 | 0.4× |
| Pt mechanical traction (97012) | $90.15 | $90.15 | 6.3× |
| Pt Re-Eval Est Plan Care (97164) | $266.01 | $266.01 | 3.9× |
| Pt ultraviolet (97028) | $69.01 | $69.01 | 8.3× |
| Pulm function test by gas (94727) | $547.60 | $547.60 | 2.0× |
| Pure Tone Audiometry Air (92552) | $454.10 | $454.10 | 2.7× |
| Refill/Maint Portable Pump (96521) | $767.97 | $767.97 | 2.9× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) | $111.18 | $111.18 | 2.4× |
| Respiratory flow volume loop (94375) | $999.47 | $999.47 | 3.7× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $678.93 | $678.93 | 2.7× |
| Select picture audiometry (92583) | $228.16 | $228.16 | 3.1× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$100.17–$132.45 | $100.17–$132.45 | varies |
| Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) | $224.83 | $224.83 | 3.1× |
| Speech Audiometry Complete (92556) | $225.94 | $225.94 | 3.1× |
| Speech audiometry threshold (92555) | $138.01 | $138.01 | 1.9× |
| Speech sound lang comprehen (92523) | $542.03 | $542.03 | 2.4× |
| Spirometry (94010) | $547.60 | $547.60 | 2.0× |
| Subcutaneous Infusion Each Additional Hour (96370) | $149.14 | $149.14 | 2.6× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $767.97 | $767.97 | 2.9× |
| Subq Infusion Additional Pump Infusion Site (96371) | $302.74 | $302.74 | 3.4× |
| Temp transcutaneous pacing (92953) | $2,059.05 | $2,059.05 | 2.5× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $124.66 | $124.66 | 3.4× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $176.97 | $176.97 | 6.0× |
| Ther/Prop/Diag Inj/Inf Proc (96379) | $149.14 | $149.14 | 2.6× |
| Ther/Proph/Diag Inj Ia (96373) | $767.97 | $767.97 | 2.9× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $245.97 | $245.97 | 2.7× |
| Ther/Proph/Diag Iv Inf Init (96365) | $767.97 | $767.97 | 2.9× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$11.13–$132.45 | $11.13–$132.45 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $144.69 | $144.69 | 3.1× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 3 matching MRF lines |
$47.34–$128 | $47.34–$128 | varies |
| Tone Decay Test (92563) | $128 | $128 | 2.7× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) | $146.65 | $146.65 | 3.1× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$2,337.30–$2,726.85 | $2,337.30–$2,726.85 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $309.41 | $309.41 | 4.1× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $242.63 | $242.63 | 10.1× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $149.14 | $149.14 | 2.6× |
| Tympanometry (92567) | $128 | $128 | 2.7× |
| Tympanometry and reflex threshold measurements (92550) | $547.60 | $547.60 | 2.0× |
| Upr/L Xtremity Art 2 Levels (93922) | $539.80 | $539.80 | 3.3× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $556.50 | $556.50 | 2.1× |
| Vasopneumatic device (97016) | $90.15 | $90.15 | 7.5× |
| Vent Mgmt Inpat Init Day (94002) | $1,849.81 | $1,849.81 | 2.4× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,849.81 | $1,849.81 | 2.4× |
| Visual Field Exam Extended (92083) | $422.94 | $422.94 | 2.5× |
| Visual field xm uni/bi w/interp intermed exam (92082) | $224.83 | $224.83 | 3.1× |
| Visual field xm uni/bi w/interpretj limited exam (92081) | $224.83 | $224.83 | 3.1× |
| Visual reinforcement audiometry (vra) (92579) | $565.40 | $565.40 | 2.1× |
| Vital capacity, total (94150) | $547.60 | $547.60 | 3.4× |
| Wheelchair Mgmt Ea 15 Min (97542) | $86.81 | $86.81 | 2.8× |
| Whirlpool Therapy (97022) | $69.01 | $69.01 | 4.4× |
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.