Visits & medical services prices at St. Luke's Jerome Medical Center

Jerome, ID · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) $118 $118 1.2×
Ablate Heart Dysrhythm Focus (93650) $21,588 $21,588 2.8×
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $7 $7 0.1×
Acoustic Reflex Testing (92568) $104 $104 2.8×
Actigraphy Testing Recording Analysis I&R (95803) $282 $282 4.8×
Actinotherapy Ultraviolet Light (96900) $104 $104 2.8×
Acupunct W/Stimul 15 Min (97813) $65 $65 2.3×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $65 $65 2.3×
Admn Sarscov2 Vacc 1 Dose (90480) $110 $110 2.7×
Advncd Care Plan 30 Min (99497) $245 $245 2.4×
Aep Hearing Status Deter Broadband Stimuli I&R (92651) $817 $817 3.8×
Aep neurodiagnostic i&r (92653) $817 $817 3.8×
Aep threshold estimation mlt frequencies i&r (92652) $817 $817 3.8×
Airway Inhalation Treatment (94640) $463 $463 2.1×
Airway resistance by oscillometry (94728) $360 $360 2.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $52 $52 0.4×
Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) $13 $13 0.1×
Analysis Cochlear Implt Pt <7 Yr Prgrmg (92601) $73 $73 0.6×
Analyze neurostim complex (95972) $435 $435 4.6×
Analyze neurostim no prog (95970)
range across 3 matching MRF lines		 $611–$763.75 $611–$763.75 varies
Analyze Neurostim Simple (95971) $435 $435 4.6×
Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) $562 $562 2.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $35 $35 2.4×
Application Modality 1/> Areas Infrared (97026) $16 $16 2.4×
Application on-body injector (96377) $161 $161 3.5×
Arrhythmia Induction (93618) $5,753 $5,753 4.8×
Assessment of aphasia per hr (96105) $237 $237 2.4×
Assessment of tinnitus (92625) $13 $13 0.1×
Assmt & care planning pt w/cognitive impairment (99483) $173 $173 1.7×
Audiometry Air & Bone (92553) $98 $98 0.8×
Auditory Function, 60 Min (92620) $21 $21 0.2×
Basic vestibular evaluation (92540) $59 $59 0.3×
Behavral qualit analys voice (92524) $270 $270 2.5×
Biofeedback training any modality (90901) $97 $97 2.4×
Bioimpedance Cv Analysis (93701) $515 $515 3.9×
Brief Emotional/Behav Assmt (96127) $114 $114 3.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $709 $709 1.9×
Bundle of his recording (93600) $21,588 $21,588 2.8×
C motor evoked uppr limbs (95928) $4,833 $4,833 5.7×
C motor evoked upr&lwr limbs (95939) $4,833 $4,833 5.7×
Caloric vestibular test w/rec bi monothermal (92538) $12 $12 0.1×
Caloric Vstblr Test W/Rec (92537) $17 $17 0.1×
Canalith repositioning proc (95992) $186 $186 4.6×
Car seat/bed test 60 min (94780) $90 $90 2.4×
Cardiac Stress Tst,Tracing Only (93017) $1,079 $1,079 5.0×
Cardiopulmonary exercise testing (94621) $709 $709 1.9×
Cardiopulmonary resuscitation (92950) $1,233 $1,233 5.8×
Cardioversion (92960) $2,582 $2,582 3.9×
Cardioversion elective internal (92961) $2,582 $2,582 3.9×
Care mgmt services behavioral hlth cond 20 mins (99484) $86 $86 2.3×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $19,903 $19,903 6.2×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $19,903 $19,903 6.2×
Cbt 1st hour (94644) $296 $296 2.2×
Cdp-Sot 6 Conditions W/I&R W/Mct & Adt (92549) $41 $41 0.3×
Cervical & Ocular Vemp Testing W/I&R (92519) $817 $817 3.8×
Cervical Vemp Testing W/I&R (92517) $414 $414 3.2×
Chemo Admin Peritoneal Cavity (96446) $1,358 $1,358 4.1×
Chemo Anti-Neopl Sq/Im (96401) $292 $292 4.1×
Chemo Hormon Antineopl Sq/Im (96402) $292 $292 4.1×
Chemo Ia Push (96420) $1,358 $1,358 4.1×
Chemo Intralesional Over 7 (96406) $860 $860 4.1×
Chemo intralesional up to 7 (96405) $292 $292 4.1×
Chemo IV infusion addl hr (96415) $292 $292 4.1×
Chemo IV push addl drug (96411) $292 $292 4.1×
Chemother Prolong Infuse W/Pump (96416) $1,358 $1,358 4.1×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $1,358 $1,358 4.1×
Chemotherapy Into Cns (96450) $1,358 $1,358 4.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $292 $292 4.1×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $1,358 $1,358 4.1×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $1,358 $1,358 4.1×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $1,358 $1,358 4.1×
Chest Wall Manipulation (94668) $296 $296 2.2×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) $67 $67 3.1×
Chron Care Mgmt Srvc 20 Min (99490) $28 $28 0.3×
Color Vision Xm Extended Anomaloscope/Equiv (92283) $99 $99 1.7×
Color/duplex Doppler, complete (93975) $1,303 $1,303 5.5×
Color/duplex Doppler, limited (93976) $574 $574 5.5×
Community/Work Reintegration Trainj Ea 15 Min (97537) $80 $80 2.5×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $97 $97 0.6×
Comprehensive Hearing Test (92557) $414 $414 3.2×
Computerized dynamic posturography (92548) $28 $28 0.2×
Computerized Ophthalmic Imaging Optic Nerve (92133) $30 $30 0.5×
Computerized Ophthalmic Imaging Retina (92134) $32 $32 0.5×
Conditioning Play Audiometry (92582) $414 $414 3.2×
Cont gluc mntr physician/qhp provided equiptment (95250) $612 $612 4.6×
Cont Gluc Mntr Pt Prov Eqp (95249) $133 $133 2.3×
Continuous Pulse Ox (94762) $360 $360 2.8×
Coronary Art/Grft Angio S&I (93455) $19,903 $19,903 6.2×
Coronary Artery Angio S&I (93454) $19,903 $19,903 6.2×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $463 $463 2.1×
Cpt initial (94667) $296 $296 2.2×
Critical care first hour (99291) $3,661 $3,661 4.5×
Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) $2,502 $2,502 6.8×
Dark Adaptation Eye Exam (92284) $1,739 $1,739 3.9×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines		 $556–$1,112 $556–$1,112 varies
Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) $557 $557 2.8×
Developmental tst admin phys/qhp 1st hour (96112) $414 $414 3.2×
Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming Facility (92602) $62 $62 0.5×
Dialysis One Evaluation (90945) $1,170 $1,170 2.8×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $817 $817 2.2×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,303 $1,303 5.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $574 $574 5.5×
Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) $441 $441 4.3×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,303 $1,303 5.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $574 $574 5.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 2 matching MRF lines		 $1,303–$1,628 $1,303–$1,628 varies
Dup-scan xtr veins unilateral/limited study (93971)
range across 4 matching MRF lines		 $431–$574 $431–$574 varies
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $1,303 $1,303 5.5×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $574 $574 5.5×
Duplex Scan Hemodialysis Access (93990) $574 $574 5.5×
Duplex up extrem art bilat (93930) $1,303 $1,303 5.5×
Duplex up extrem art unilat/ltd (93931) $574 $574 5.5×
Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) $27 $27 0.2×
Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604)
range across 2 matching MRF lines		 $47–$58.75 $47–$58.75 varies
Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) $61 $61 0.5×
Ear and throat examination (92502) $1,169 $1,169 2.2×
Ear Protector Evaluation (92596) $163 $163 4.4×
ECG/monitoring and analysis (93271) $458 $458 4.9×
Echo Congenital Complete (93303) $2,729 $2,729 5.0×
Echo Heart Xthoracic,Limited (93308) $1,206 $1,206 5.1×
Echo transesophag congen probe plcmt only (93316) $2,729 $2,729 5.0×
Echo transesophag montr cardiac pump functj (93318) $2,729 $2,729 5.0×
Echo transesophageal (93312) $2,729 $2,729 5.0×
Echo Transesophageal - Congenital Tee Complete (93315) $2,729 $2,729 5.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,910 $1,910 3.5×
Eeg 41-60 Minutes (95812) $1,464 $1,464 6.8×
EEG awake and asleep (95819) $1,464 $1,464 6.8×
EEG awake drowsy (95816) $1,464 $1,464 6.8×
EEG cerebral death evaluation (95824) $2,502 $2,502 6.8×
EEG cont rec w/video by tech min 8 channels (95700) $743 $743 3.5×
EEG extended monitoring 61-119 minutes (95813) $1,464 $1,464 6.8×
Eeg Sleep Only (95822) $1,464 $1,464 6.8×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $1,464 $1,464 6.8×
EEG w/o vid 2-12hr cont mntr (95707) $1,464 $1,464 6.8×
EEG w/o vid ea 12-26hr intmt (95709) $2,502 $2,502 6.8×
Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) $2,502 $2,502 6.8×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $1,464 $1,464 6.8×
EEG wo vid ea 12-26hr unmntr (95708) $2,502 $2,502 6.8×
EKG signal averaged (93278) $296 $296 5.1×
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $435 $435 4.6×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $435 $435 4.6×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $177 $177 4.8×
Electrical Stimulation Ea 15 Min (97032) $36 $36 2.4×
Electrocardiogram Tracing (93005) $296 $296 5.1×
Electrocochleography (92584) $414 $414 3.2×
Electrophysiology Evaluation (93642) $5,753 $5,753 4.8×
Emergency Dept Visit Level 2 (99282) $688 $688 4.5×
Emergency Dept Visit Level 3 (99283) $1,204 $1,204 4.4×
Emergency Dept Visit Level 4 (99284) $1,851 $1,851 4.5×
Emg 3 Extremities (95863) $230 $230 1.8×
Emg 4 Extremities (95864) $743 $743 5.8×
Endomyocardial Biopsy (93505) $18,849 $18,849 6.0×
Ep & ablate supravent arrhyt (93653) $62,005 $62,005 2.4×
Ep & ablate ventric tachy (93654) $62,005 $62,005 2.4×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $21,588 $21,588 2.8×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $21,588 $21,588 2.8×
Er level 1 (99281) $383 $383 4.6×
Er level v (99285)
range across 3 matching MRF lines		 $2,665–$5,330 $2,665–$5,330 varies
Esoph Atrial Electrogram (93615) $5,753 $5,753 4.8×
Esophageal Capsule Endoscopy (91111) $2,526 $2,526 2.8×
Esophagus acid perfusion test esophagitis (91030) $1,475 $1,475 4.0×
Esophgl Balo Distension Dx Std W/Provocation (91040) $1,475 $1,475 4.0×
Esophgl funcj g-esop rflx impd eltrd prolng (91038) $1,475 $1,475 4.0×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $24 $24 0.2×
Evaluate pt use of inhaler (94664) $463 $463 2.1×
Evaluate Speech Production (92522) $274 $274 2.4×
Evaluate Swallowing Function (92610) $210 $210 2.5×
Evaluation of speech fluency (92521) $330 $330 2.5×
Evoked Auditory Test,Limited (92587) $817 $817 3.8×
Excimer laser tx psoriasis tot area <250 sq cm (96920) $556 $556 2.8×
Exercise test for bronchospasm (94617) $296 $296 2.2×
Exhaled Air Analysis O2 (94680) $360 $360 2.8×
External ECG rec>48hr<7d recording (93242) $196 $196 5.3×
External ECG rec>7d<15d recording (93246) $196 $196 5.3×
External Ecg Scanning Analysis Report (93226) $296 $296 5.1×
Extracranial Bilat Study (93880) $1,303 $1,303 5.5×
Extracranial Uni/Ltd Study (93882) $574 $574 5.5×
Eye exam w anesth; complete (92018) $6,355 $6,355 2.7×
Eye exam w anesth; limited (92019) $6,355 $6,355 2.7×
Eye Exam With Photos (92230) $2,502 $2,502 6.8×
F-up/limited tthrc echo congenital car anomaly (93304) $2,729 $2,729 5.0×
Facial nerve function studies (92516) $1,464 $1,464 6.8×
Filtered Speech Test (92571) $64 $64 1.7×
Flexible endoscopic eval swallow c/v rec (92612) $474 $474 2.4×
Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) $4,833 $4,833 5.7×
Fundus photography (92250) $611 $611 4.6×
Gastric motility studies (91020) $1,475 $1,475 4.0×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $1,475 $1,475 4.0×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $863 $863 4.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,475 $1,475 1.7×
Gi tract capsule endoscopy (91110) $2,526 $2,526 2.8×
Gi wireless capsule measure (91112) $2,526 $2,526 2.8×
Gonioscopy (92020) $611 $611 4.6×
Group Therapeutic Procedures (97150) $44 $44 2.4×
Health Behavior Assessment/Re-Assessment (96156) $268 $268 2.7×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $86 $86 2.3×
Health behavior ivntj group f2f 1st 30 min (96164) $86 $86 2.3×
Health behavior ivntj indiv f2f 1st 30 min (96158) $466 $466 2.6×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $19,903 $19,903 6.2×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $1,915 $1,915 2.8×
High altitude simulation test (94452) $296 $296 2.2×
High Altitude Simulatj W/Phys I&R W/O2 Titration (94453) $296 $296 2.2×
Holter monitor recording (93225) $644 $644 4.9×
Hypnotherapy (90880) $268 $268 2.7×
Icd Device Interrogate (93289) $186 $186 5.0×
Icd device progr eval dual (93283) $186 $186 5.0×
Icd Device Progr Eval Mult (93284) $186 $186 5.0×
Icm Device Eval (93290) $186 $186 5.0×
Ilr Device Eval Progr (93285) $186 $186 5.0×
Ilr Device Interrogate (93291) $122 $122 4.3×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines		 $20.13–$110 $20.13–$110 varies
Img retina detcj/mntr ds rem clin staff uni/bi (92227) $282 $282 4.8×
Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) $28 $28 0.8×
Immunization administration (90471)
range across 6 matching MRF lines		 $20.13–$110 $20.13–$110 varies
Ingestion challenge test initial 120 minutes (95076) $105 $105 0.3×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $2,502 $2,502 6.8×
Insert/Place Heart Catheter (93503) $9,172 $9,172 5.9×
Interrog&prgrmg impl phrenic nrv stimulator sys (93151) $458 $458 4.9×
Interrog&prgrmg ipnss during polysomnography (93152) $1,493 $1,493 4.9×
Interrogate Subq Defib (93261) $186 $186 5.0×
Interrogation eval in person wr defibrillator (93292) $186 $186 5.0×
Interrogation without programming ipnss (93153) $458 $458 4.9×
Intra-atrial pacing (93610) $21,588 $21,588 2.8×
Intra-atrial recording (93602) $21,588 $21,588 2.8×
Intracranial Complete Study (93886) $1,001 $1,001 4.2×
Intraventricular pacing (93612) $21,588 $21,588 2.8×
Io anal gast n-stim subsq (95981) $45 $45 0.8×
Io ga n-stim subsq w/reprog (95982) $177 $177 4.8×
Iontophoresis 15 min (97033) $47 $47 2.5×
Irrig Drug Delivery Device (96523) $207 $207 3.5×
IV infusion hydration each additional hour (96361) $161 $161 3.5×
IV infusion hydration initial 31 min-1 hour (96360) $734 $734 3.5×
IV infusion ther proph addl sequential to 1 hr (96367) $249 $249 3.5×
IV infusion therapy prophylaxis/dx ea hour (96366) $161 $161 3.5×
IV push initial (96374) $734 $734 3.5×
L Hrt Art/Grft Angio (93459) $19,903 $19,903 6.2×
L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) $19,903 $19,903 6.2×
Laryngeal Function Studies (92520) $341 $341 2.6×
Liver Elastography W/O Imag W/I&R (91200) $414 $414 3.2×
Loudness balance test (92562) $101 $101 0.5×
Lung Function Test (Mbc/Mvv) (94200) $136 $136 2.3×
Lwr Xtr Vasc Stdy Bilat (93924) $845 $845 3.9×
Mechanical chest wall oscillation per session (94669) $463 $463 2.1×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $78 $78 2.5×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $89 $89 2.4×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $41 $41 2.4×
Methacholine challenge (94070) $709 $709 1.9×
Motility study esophagus (91010) $1,475 $1,475 4.0×
Motion Fluoroscopy/Swallow (92611) $223 $223 2.4×
Motor &/sens nrv cndj preconf eltrd array limb (95905) $61 $61 0.1×
Multiple Family Group Psychotherapy (90849) $466 $466 2.6×
Multiple Sleep Latency Test (95805) $2,502 $2,502 2.9×
Muscle Test 2 Limbs (95861) $611 $611 4.6×
Muscle Test Nonparaspinal (95870) $611 $611 4.6×
Muscle Test One Limb (95860) $611 $611 4.6×
Narcosynthesis (90865) $466 $466 2.6×
Nasopharyngoscopy (92511) $543 $543 2.7×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $1,464 $1,464 6.8×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $1,464 $1,464 6.8×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $146 $146 0.7×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines		 $1,117–$2,234 $1,117–$2,234 varies
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $1,117 $1,117 2.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $556 $556 2.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,117 $1,117 2.8×
Nerve Conduction Studies 1-2 Studies (95907) $743 $743 3.5×
Nerve Conduction Studies 11-12 Studies (95912) $2,502 $2,502 6.8×
Nerve conduction studies 13 or more studies (95913) $2,502 $2,502 6.8×
Nerve Conduction Studies 3-4 Studies (95908) $1,464 $1,464 6.8×
Nerve conduction studies 5-6 studies (95909) $1,464 $1,464 6.8×
Nerve conduction studies 7-8 studies (95910) $1,464 $1,464 4.0×
Nerve Conduction Studies 9-10 Studies (95911) $2,502 $2,502 6.8×
Neurobehavioral Status Exam (96116) $894 $894 4.2×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $138 $138 1.1×
Neuromuscular Reeducation (97112) $81 $81 2.5×
Newborn resuscitation (99465) $1,711 $1,711 2.6×
Nitric oxide expired gas determination (95012) $90 $90 2.4×
Nonphysician Telephone Assessment 5-10 Min (98966) $33 $33 2.4×
Nrpsyc tst eval phys/qhp 1st (96132) $1,528 $1,528 4.1×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $709 $709 1.9×
Ocular Vemp Testing W/I&R (92518) $414 $414 3.2×
Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) $611 $611 4.6×
Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) $121 $121 0.9×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $612 $612 4.6×
Ophth medical xm&eval intermediate estab pt (92012) $612 $612 4.6×
Ophth Medical Xm&Eval Intermediate New Pt (92002) $612 $612 4.6×
Ophthalmodynamometry (92260) $186 $186 5.0×
Opscpy extnd optic nrv/macula drawing i&r uni/bi (92202) $282 $282 4.8×
Optokinetic Nystagmus Test (92544) $7 $7 0.1×
Oral Function Therapy (92526) $209 $209 2.5×
Oral Speech Device Eval (92597) $180 $180 2.5×
Orthc/Prostc Mgmt Sbsq Enc (97763) $124 $124 2.5×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $114 $114 2.5×
Oscillating Tracking Test (92545) $7 $7 0.0×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $67 $67 3.1×
Osteopathic manipulative tx 3-4 body regions (98926) $67 $67 3.1×
Osteopathic manipulative tx 5-6 body regions (98927) $21 $21 1.0×
Osteopathic manipulative tx 7-8 body regions (98928) $23 $23 1.1×
Osteopathic manipulative tx 9-10 body regions (98929) $26 $26 1.2×
Ot Contrast Bath Ea 15 Min (97034) $34 $34 2.4×
Ot eval high complexity (97167) $253 $253 2.5×
Ot Eval Low Complex (97165) $253 $253 2.5×
Ot Eval Moderate Complexity (97166) $253 $253 2.5×
Ot manual therapy 15 min (97140) $68 $68 2.5×
Ot paraffin bath (97018) $15 $15 2.5×
Ot Prosthetic Training, Each 15 Min (97761) $101 $101 2.5×
Ot Re-Eval Est Plan Care (97168) $174 $174 2.5×
Ot rom hand (95852) $87 $87 4.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $334 $334 2.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $334 $334 2.6×
Oxygen Uptake Rest Indirect (94690) $136 $136 2.3×
Pdt dstr prmlg les phys/qhp (96573) $451 $451 2.3×
Pdt dstr prmlg les skn illum/activj per day (96567) $269 $269 1.4×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $463 $463 2.1×
Percutaneous tests w/allergenic extracts (95004) $4,833 $4,833 5.7×
Peripheral arterial disease rehab per session (93668) $157 $157 2.7×
Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930) $33,500 $33,500 1.8×
Perq transcath closure pda (93582) $23,450 $23,450 1.3×
Perq Transcath Cls Mitral (93590) $23,450 $23,450 1.3×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $15,720 $15,720 2.8×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $28,020 $28,020 2.4×
Phlebotomy therapeutic (99195) $341 $341 2.6×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $136 $136 2.3×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $136 $136 2.3×
Physical Performance Test (97750) $83 $83 2.5×
Plethysmography (94726) $709 $709 1.9×
Pm device eval in person (93288) $186 $186 5.0×
Pm device progr eval dual (93280) $186 $186 5.0×
Pm device progr eval multi (93281) $186 $186 5.0×
Pm Device Progr Eval Sngl (93279) $186 $186 5.0×
Pm/Icd Remote Tech Serv (93296) $186 $186 5.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,833 $4,833 5.7×
Polysom <6 yrs 4/> paramtrs (95782) $4,833 $4,833 5.7×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $4,833 $4,833 5.7×
Positional nystagmus test (92542) $8 $8 0.1×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $22 $22 0.5×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $186 $186 5.0×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $186 $186 5.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $21 $21 0.5×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $25 $25 0.5×
Prq Card Angio/Athrect 1 Art (92924) $28,020 $28,020 2.4×
Prq Card Stent W/Angio 1 Vsl (92928) $28,020 $28,020 2.4×
Prq Card Stent/Ath/Angio (92933) $33,500 $33,500 1.8×
Prq Revasc Byp Graft 1 Vsl (92937) $28,020 $28,020 2.4×
Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) $23,450 $23,450 1.3×
Prq trluml pulmonary art balloon angiop 1 vsl (92997) $28,020 $28,020 2.4×
Psych diag eval w/med srvcs (90792) $466 $466 2.6×
Psychiatric diagnostic evaluation (90791) $466 $466 2.6×
Psychoanalysis (90845) $466 $466 2.6×
Psychological tst eval svc phys/qhp first hour (96130) $894 $894 4.2×
Psycl/Nrpsyc Tst Auto Result (96146) $71 $71 2.5×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $1,062 $1,062 2.4×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $373 $373 2.8×
Psytx Crisis Initial 60 Min (90839) $466 $466 2.6×
Pt Eval High Complex (97163) $246 $246 2.5×
Pt eval low complex 20 min (97161) $246 $246 2.5×
Pt Eval Mod Complex (97162) $246 $246 2.5×
Pt gait training 15 min (97116) $72 $72 2.5×
Pt group caregiver training (97552) $54 $54 2.5×
Pt mechanical traction (97012) $36 $36 2.5×
Pt Re-Eval Est Plan Care (97164) $169 $169 2.5×
Pt-focused hlth risk assmt score doc stnd instrm (96160) $86 $86 2.3×
Pulm function test by gas (94727) $360 $360 1.7×
Pulmonary service/procedure (94799) $296 $296 2.3×
Pulmonary Stress Testing (94618) $296 $296 2.2×
Pure Tone Audiometry Air (92552) $341 $341 2.6×
R Hrt Art/Grft Angio (93457) $19,903 $19,903 6.2×
R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) $19,903 $19,903 6.2×
R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) $19,903 $19,903 6.2×
R hrt coronary artery angio (93456) $19,903 $19,903 6.2×
R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) $19,903 $19,903 6.2×
R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) $19,903 $19,903 6.2×
R&L Hrt Cath W/Ventriclgrphy (93453) $19,903 $19,903 6.2×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $1,573 $1,573 4.8×
Refill/Maint Portable Pump (96521) $734 $734 3.5×
Refill/Maint Pump/Resvr Syst (96522) $860 $860 4.1×
Rem interrog icpms <30 d phys/qhp (93297) $82 $82 2.2×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $176 $176 4.8×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $99 $99 2.7×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $341 $341 2.6×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $99 $99 2.7×
Rem Mntr Wrls P-Art Prs Snr (93264) $36 $36 1.0×
Remote 30 Day Ecg Rev/Report (93270) $186 $186 5.0×
Respiratory flow volume loop (94375) $709 $709 3.3×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $296 $296 5.1×
Right Heart Cath (93451) $19,903 $19,903 6.2×
Right ventricular recording (93603) $5,753 $5,753 4.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $556 $556 2.8×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $103 $103 4.0×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $304 $304 2.5×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $119 $119 2.5×
Rx/Physical Eeg Activaj Phys/Qhp Attendance (95954) $2,502 $2,502 6.8×
Sbsq Psyc Collab Care Mgmt (99493) $75 $75 0.7×
Select picture audiometry (92583) $121 $121 2.1×
Self Care Mngment Training (97535) $80 $80 2.5×
Self-meas bp pt educaj/traing & dev calibration (99473) $30 $30 1.0×
Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) $282 $282 4.8×
Sensory Integration Ea 15 Min (97533) $149 $149 2.5×
Short-latency somatosens ep std upr limbs (95925) $1,464 $1,464 6.8×
Sinusoidal Vertical Axis Rotational Testing (92546) $239 $239 1.9×
Sleep study attended (95807) $2,502 $2,502 6.8×
Sleep study unattended (95806) $743 $743 3.5×
Slp caregiver training 1st 30 min (97550) $132 $132 2.5×
Slp Stdy Unatnd W/Anal (95801) $282 $282 4.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $743 $743 3.5×
Somatosensory Testing (95938) $2,502 $2,502 2.9×
Speech Audiometry Complete (92556) $157 $157 2.7×
Speech audiometry threshold (92555) $157 $157 2.7×
Speech sound lang comprehen (92523) $564 $564 2.5×
Spin/Brain Pump Refil & Main (95991) $1,387 $1,387 4.6×
Spirometry (94010) $360 $360 1.7×
Spontaneous Nystagmus Test (92541) $8 $8 0.1×
Ssep lower limbs (95926) $1,464 $1,464 6.8×
Staggered Spondaic Word Test (92572) $116 $116 0.9×
Standardized Cognitive Performance Testing (96125) $251 $251 2.4×
Stenger Test Speech (92577) $47 $47 0.1×
Stenger Test, Pure Tone (92565) $45 $45 0.8×
Stress Tte Only (93350) $1,910 $1,910 3.5×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $734 $734 3.5×
Surfactant Admin Thru Tube (94610) $463 $463 2.1×
Synthetic Sentence Identification Test (92576) $92 $92 2.5×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $441 $441 4.3×
Temp transcutaneous pacing (92953) $2,582 $2,582 3.9×
Test to assess hearing loss using different tone pitches (92575) $151 $151 4.1×
Testing Autonomic Nervous System Function (95923) $151 $151 1.1×
Ther Activation Impl Phrenic Nrv Stimulator Sys (93150) $458 $458 4.9×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $56 $56 2.5×
Ther Ivntj Ea Addl 15 Min (97130) $53 $53 2.5×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $91 $91 2.5×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $74 $74 2.5×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $253 $253 2.5×
Ther/Proph/Diag Inj Ia (96373) $734 $734 3.5×
Ther/Proph/Diag Inj Sc/Im (96372) $249 $249 3.5×
Ther/Proph/Diag Iv Inf Init (96365) $734 $734 3.5×
Therapeutic Activities (97530) $86 $86 2.5×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $2,634 $2,634 7.1×
Tobacco Use Cessation Intensive >10 Minutes (99407) $79 $79 2.1×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $79 $79 2.1×
Tone Decay Test (92563) $73 $73 2.0×
Trans Care Mgmt 14 Day Disch (99495) $341 $341 2.6×
Trans Care Mgmt 7 Day Disch (99496) $341 $341 2.6×
Transcath Closure of Asd (93580) $23,450 $23,450 1.3×
Transcranial Doppler Intracran Art Emboli Detect (93892) $441 $441 4.3×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $441 $441 4.3×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $186 $186 5.0×
Tstg Ans Funcj Cardiovagal Innervaj Parasymp (95921) $87 $87 0.7×
Tte w/doppler, complete (93306) $2,729 $2,729 5.0×
Tte W/O Doppler Complete (93307) $1,206 $1,206 5.1×
Tx atrial fib pulm vein isol (93656) $62,005 $62,005 2.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $190 $190 2.5×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $59 $59 2.5×
Tx/Pro/Dx Inj New Drug Addon (96375) $161 $161 3.5×
Tympanometry (92567) $104 $104 2.8×
Tympanometry and reflex threshold measurements (92550) $46 $46 0.2×
Unlisted cardiovascular service/procedure (93799)
range across 6 matching MRF lines		 $1,021–$6,161 $1,021–$6,161 varies
Unlisted otorhinolaryngological service (92700) $223 $223 7.8×
Upr/L Xtremity Art 2 Levels (93922) $695 $695 5.3×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $845 $845 3.9×
Valvuloplasty aortic valve (92986) $15,720 $15,720 2.8×
Valvuloplasty mitral valve (92987) $28,020 $28,020 2.4×
Valvuloplasty pulmonary valve (92990) $28,020 $28,020 2.4×
Vasopneumatic device (97016) $29 $29 2.4×
Veeg 2-12 Hr Cont Mntr (95713) $2,502 $2,502 6.8×
Veeg 2-12 hr intmt mntr (95712) $1,464 $1,464 4.0×
Veeg 2-12 hr unmonitored (95711) $1,464 $1,464 6.8×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $2,502 $2,502 6.8×
Veeg Ea 12-26 Hr Unmntr (95714) $2,502 $2,502 6.8×
Veeg ea 12-26hr cont mntr (95716) $4,833 $4,833 5.7×
Vent Mgmt Inpat Init Day (94002) $1,473 $1,473 2.4×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,473 $1,473 2.4×
Visual Evoked Potential Test (95930) $1,464 $1,464 6.8×
Visual Field Exam Extended (92083) $611 $611 4.6×
Visual reinforcement audiometry (vra) (92579) $414 $414 1.9×
Vital capacity, total (94150) $360 $360 2.8×
Wada Activation Test Hemispheric Function W/Eeg (95958) $4,833 $4,833 5.7×
Wheelchair Mgmt Ea 15 Min (97542) $77 $77 2.5×
Whirlpool Therapy (97022) $38 $38 2.4×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $136 $136 2.3×
Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) $186 $186 5.0×

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.