Visits & medical services prices at St. Mary's Good Samaritan Hospital

Greensboro, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Airway Inhalation Treatment (94640) $53.30 $82 0.3×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $90.35 $139 6.3×
Behavral qualit analys voice (92524) $287.95 $443 2.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $586.95 $903 1.8×
Canalith repositioning proc (95992) $122.85 $189 3.0×
Cardiac Stress Tst,Tracing Only (93017) $512.85 $789 2.7×
Cardiopulmonary exercise testing (94621) $600.60 $924 1.8×
Cardiopulmonary resuscitation (92950) $336.70 $518 1.8×
Cardioversion (92960) $3,774.74 — 6.5×
Cbt 1st hour (94644) $48.10 $74 0.4×
Chemo IV infusion addl hr (96415) $141.05 $217 2.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $677.30 $1,042 2.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $666.25 $1,025 2.3×
Chest Wall Manipulation (94668) $43.55 $67 0.4×
Color/duplex Doppler, complete (93975) $1,114.10 $1,714 5.3×
Color/duplex Doppler, limited (93976) $247.65 $381 2.7×
Continuous Pulse Ox (94762) $165.75 $255 1.5×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $211.25 $325 1.1×
Cpt initial (94667) $90.35 $139 0.8×
Critical care first hour (99291) $761.80 $1,172 1.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $386.10 $594 1.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $253.50 $390 2.8×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $777.40 $1,196 3.7×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $284.70 $438 3.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $690.95 $1,063 3.3×
Dup-scan xtr veins unilateral/limited study (93971) $371.80 $572 4.1×
Duplex up extrem art bilat (93930) $1,054.95 $1,623 5.0×
Duplex up extrem art unilat/ltd (93931) $464.75 $715 5.1×
ECG/monitoring and analysis (93271) $209.30 $322 2.5×
Echo Heart Xthoracic,Limited (93308) $477.10 $734 2.3×
Echo transesophageal (93312) $1,151.15 $1,771 2.4×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,103.05 $1,697 2.3×
Electrical Stimulation Ea 15 Min (97032) $68.90 $106 4.7×
Electrocardiogram Tracing (93005) $115.05 $177 2.2×
Emergency Dept Visit Level 2 (99282) $286.65 — 2.1×
Emergency Dept Visit Level 3 (99283) $549.28 — 2.3×
Emergency Dept Visit Level 4 (99284) $1,256.35 — 3.4×
Er level 1 (99281) $148.20 — 2.0×
Er level v (99285) $2,214 — 4.2×
Evaluate pt use of inhaler (94664) $59.80 $92 0.3×
Evaluate Speech Production (92522) $198.25 $305 1.8×
Evaluate Swallowing Function (92610) $198.25 $305 2.3×
External ECG rec>48hr<7d recording (93242) $82.55 $127 2.5×
External ECG rec>7d<15d recording (93246) $135.20 $208 4.1×
Extracranial Bilat Study (93880) $791.70 $1,218 3.8×
Extracranial Uni/Ltd Study (93882) $453.05 $697 4.9×
Gi tract capsule endoscopy (91110) $1,883.70 $2,898 2.4×
Gi tract imaging intraluminal colon i&r (91113) $1,438.45 $2,213 1.8×
Holter monitor recording (93225) $254.80 $392 2.2×
Immunization administration (90471) $50.70 $78 0.8×
Irrig Drug Delivery Device (96523) $85.80 $132 1.7×
IV infusion hydration each additional hour (96361) $1,029.60 — 25.1×
IV infusion hydration initial 31 min-1 hour (96360) $772.20 — 4.1×
IV infusion ther proph addl sequential to 1 hr (96367) $6,630.55 — 105.1×
IV infusion therapy prophylaxis/dx ea hour (96366) $6,630.55 — 161.6×
IV push initial (96374) $137.80 — 0.7×
Mechanical chest wall oscillation per session (94669) $369.85 $569 1.9×
Motion Fluoroscopy/Swallow (92611) $330.20 $508 3.6×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $751.40 $1,156 2.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $148.20 $228 0.8×
Neuromuscular Reeducation (97112) $88.40 $136 2.7×
Oral Function Therapy (92526) $143 $220 1.7×
Ot eval high complexity (97167) $227.50 $350 2.3×
Ot Eval Low Complex (97165) $227.50 $350 2.3×
Ot Eval Moderate Complexity (97166) $227.50 $350 2.3×
Ot manual therapy 15 min (97140) $73.45 $113 2.6×
Phlebotomy therapeutic (99195) $133.90 $206 1.1×
Pt Eval High Complex (97163) $227.50 $350 2.3×
Pt eval low complex 20 min (97161) $227.50 $350 2.3×
Pt Eval Mod Complex (97162) $227.50 $350 2.3×
Pt gait training 15 min (97116) $83.85 $129 2.9×
Pt mechanical traction (97012) $70.85 $109 4.9×
Pt Re-Eval Est Plan Care (97164) $139.10 $214 2.1×
Remote 30 Day Ecg Rev/Report (93270) $175.50 $270 5.4×
Remote 30 Day Ecg Tech Supp (93229) $323.05 $497 1.0×
Self Care Mngment Training (97535) $76.05 $117 2.3×
Sensory Integration Ea 15 Min (97533) $55.25 $85 0.9×
Slp caregiver training 1st 30 min (97550) $58.50 $90 1.1×
Speech sound lang comprehen (92523) $198.25 $305 0.9×
Standardized Cognitive Performance Testing (96125) $215.80 $332 2.1×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $95.55 $147 4.3×
Ther Ivntj Ea Addl 15 Min (97130) $95.55 $147 4.5×
Ther/Proph/Diag Inj Ia (96373) $55.25 $85 0.3×
Ther/Proph/Diag Inj Sc/Im (96372) $5,823.90 — 92.3×
Ther/Proph/Diag Iv Inf Init (96365) $2,918.30 — 15.7×
Therapeutic Activities (97530) $83.85 $129 2.4×
Tte w/doppler, complete (93306) $1,188.20 $1,828 2.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $127.40 $196 1.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $7,438.70 — 181.3×
Upr/L Xtremity Art 2 Levels (93922) $429.65 $661 3.7×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $473.20 $728 2.5×
Vent Mgmt Inpat Init Day (94002) $627.90 $966 1.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $369.85 $569 0.7×
Wheelchair Mgmt Ea 15 Min (97542)
range across 2 matching MRF lines		 $39.65–$70.20 $61–$108 varies

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.