Visits & medical services prices at Star Valley Medical Center

Afton, WY · every code in this section with a posted price and a Medicare benchmark.

159 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) $14.70 $21 0.1×
Aerosol inhalation pentamidine (94642) $276.50 $395 1.2×
Airway inhalation treatment (94640) $123.90 $177 0.6×
Allergy injection single (95115) $12.25 $17.50 0.3×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $57.40 $82
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $140 $200
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $49.70 $71
Application of a modality to 1 or more areas; vasopneumatic devices Other Outpatient (97016) $53.20 $76
Assessment of aphasia (96105) $148.40 $212
Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks… (97755) $121.80 $174
Behavioral & qualit analysis voice and resonance (92524) $448 $640
Bipap initial day (94660) $682.15 $974.50 3.0×
Breath hydrogen/methane test (91065) $660.80 $944 3.0×
Breathing capacity test (94010) $165.20 $236 0.7×
Bronchial allergy tests (95070) $717.50 $1,025 1.9×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $406.70 $581 1.1×
Canalith repositioning (95992) $121.10 $173
Cardiovascular stress test (93017) $820.75 $1,172.50 3.7×
Cardioversion elective external (92960) $550.90 $787 0.8×
Chemo anti-neopl sq/im (96401) $195.30 $279 2.7×
Chemo hormon antineopl sq/im (96402) $233.80 $334 3.2×
Chemo IV infus each addl seq (96417) $301.70 $431 4.1×
Chemo IV infusion addl hr (96415) $427.70 $611 5.8×
Chemo IV push addl drug (96411) $266.70 $381 3.6×
Chemother prolong infuse w/pump (96416) $641.20 $916 1.9×
Chemotherapy administration into the peritoneal cavity via implanted port or catheter (96446) $457.10 $653 1.4×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $468.30 $669 1.4×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $343.70 $491 1.0×
Chest physiotherapy initial (94667) $352.80 $504 2.6×
Color/duplex Doppler, complete (93975) $531.30 $759 2.2×
Color/duplex Doppler, limited (93976) $358.40 $512 3.4×
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) $133.70 $191 0.7×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $346.50 $495 2.5×
Cpr (92950) $704.90 $1,007 3.2×
Critical care ill/injured patient init 30-74 min (99291) $2,333.45 $3,333.50 2.8×
Ctr motr ep std transcrnl motr stim upr&low limb (95939) $748.30 $1,069 0.9×
Debridement open wound 20 sq cm< (97597) $257.60 $368 1.3×
Duplex hemodialysis access (93990) $343.70 $491 3.2×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $340.90 $487 1.4×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $316.40 $452 3.0×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $813.75 $1,162.50 3.3×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $1,072.40 $1,532 4.4×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $378 $540 3.5×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $766.50 $1,095 3.1×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $606.90 $867 5.7×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $632.80 $904 2.6×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $343.70 $491 3.2×
ECG monit/reprt up to 48 hrs (93226) $291.90 $417 4.8×
ECG/monitoring and analysis (93271) $209.30 $299 2.2×
EEG awake/drowsy (95816) $875 $1,250 4.0×
EKG 12 lead tracing only (93005) $201.25 $287.50 3.3×
Emergency department visit high mdm (99285) $1,749.65 $2,499.50 2.9×
Emergency department visit low mdm (99283) $762.30 $1,089 2.7×
Emergency department visit may not req phys/qhp (99281) $248.15 $354.50 2.9×
Emergency department visit moderate mdm (99284) $1,248.80 $1,784 2.9×
Emergency department visit straightforward mdm (99282) $465.85 $665.50 3.0×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $303.80 $434
Evaluate pt use of inhaler (94664) $226.10 $323 1.0×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $74.90 $107
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $257.60 $368
Evaluation of speech fluency (92521) $430.50 $615
Evaluation of speech sound production articulate (92522) $359.10 $513
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $217.35 $310.50 1.6×
Fluidotherapy (97022) $56.70 $81
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $205.10 $293 0.9×
Hast w/oxygen titrate (94453) $164.50 $235 1.2×
Health behavior assessment/re-assessment (96156) $145.60 $208 1.4×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $38.50 $55 1.0×
Health behavior ivntj group f2f 1st 30 min (96164) $38.50 $55 1.0×
Health behavior ivntj indiv f2f 1st 30 min (96158) $151.20 $216 0.8×
High altitude simulation test (HAST), with interpretation and report by a physician or other qualified health care… (94452) $164.50 $235 1.2×
Imm admn sarscov2 vaccine single dose (90480) $37.10 $53 0.9×
Immunization administration (90471) $79.45 $113.50 1.1×
Infrared therapy (97026) $9.80 $14
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $219.80 $314 4.6×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $212.10 $303 1.0×
Irrigaj implntd venous access drug delivery syst (96523) $219.80 $314 3.6×
IV infusion hydration each additional hour (96361) $176.05 $251.50 3.7×
IV infusion hydration initial 31 min-1 hour (96360) $316.05 $451.50 1.5×
IV infusion ther proph addl sequential to 1 hr (96367) $219.80 $314 3.0×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $592.90 $847 2.7×
IV tx, each additional hour (96366) $207.20 $296 4.3×
Lwr xtr vasc stdy bilat (93924) $388.50 $555 1.8×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $226.10 $323 1.7×
Maximum voluntary ventilation (94200) $81.90 $117 1.4×
Mechanical traction therapy (97012) $72.10 $103
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $131.60 $188
Medical nutrition group (97804) $27.30 $39
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) $94.50 $135
Methacholine challenge (94070) $506.80 $724 1.3×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $284.90 $407
Multiple sleep latency (95805) $2,370.90 $3,387 2.7×
Needle electromyography 2 extremities with or without related paraspinal areas 95861 (95861) $1,803.90 $2,577 13.3×
Negative pressure wound therapy dme </= 50 sq cm (97605) $227.50 $325 1.1×
Negative pressure wound therapy dme >50 sq cm (97606) $1,089.90 $1,557 2.6×
Nerve conduction studies 7-8 studies (95910) $386.40 $552 1.0×
Non-invasive physiologic study extremity 3 levels (93923) $440.30 $629 2.0×
Noninvasive ear/pulse oximetry overnight monitor (94762) $205.10 $293 1.6×
Occupational therapy eval high complex 60 mins (97167) $359.10 $513
Occupational therapy eval low complex 30 mins (97165) $211.40 $302
Occupational therapy eval mod complex 45 mins (97166) $293.30 $419
Oral function therapy (92526) $217 $310
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $94.50 $135
Osteopath manj 1-2 regions (98925) $72.10 $103 3.3×
Osteopath manj 3-4 regions (98926) $118.30 $169 5.4×
Osteopath manj 9-10 regions (98929) $25.90 $37 1.2×
Osteopathic manipulative tx 5-6 body regions (98927) $168 $240 7.6×
Osteopathic manipulative tx 7-8 body regions (98928) $24.50 $35 1.1×
Ot manual therapy ea 15 min (97140) $121.80 $174
Ot neuromuscular re-education (97112) $175 $250
Ot paraffin bath (97018) $9.10 $13
Ot re-evaluation (97168) $194.60 $278
OT Therapeutic Activities Charges (97530) $192.15 $274.50
Ot wheelchair management (97542) $102.90 $147
Outpatient cardiac rehab w/cont ECG monitoring (93798) $220.50 $315 1.7×
Phlebotomy therapeutic (99195) $184.10 $263 1.4×
Physical therapy evaluation high complex 45 mins (97163) $348.60 $498
Physical therapy evaluation low complex 20 mins (97161) $174.30 $249
Physical therapy evaluation mod complex 30 mins (97162) $258.30 $369
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $4,044.60 $5,778 4.6×
Professional services for allergen immunotherapy; 2 or more injections (95117) $23.80 $34 0.5×
Psychiatric diagnostic evaluation (90791) $282.10 $403 1.6×
Psytx crisis initial 60 min (90839) $296.80 $424 1.6×
Pt gait training 15 min (97116) $102.90 $147
Pt physical performance test (97750) $109.20 $156
Pt re-evaluation (97164) $126.70 $181
Pt Work Hardening/conditioningwork Reconditioning Initial Charge (97545) $156.80 $224
Pulm funct tst plethysmograp (94726) $317.45 $453.50 0.8×
Pulmonary stress testing (94618) $280 $400 2.1×
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section… (95851) $33.60 $48
Refilling and maintenance of portable pump (96521) $641.90 $917 3.0×
Remote 30 day ECG rev/report (93270) $209.30 $299 5.5×
Respiratory flow volume loop (94375) $586.60 $838 2.7×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $126.70 $181
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $88.90 $127
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95938) $1,152.90 $1,647 1.3×
Sleep study unattended (95806) $410.90 $587 1.9×
Speech sound lang comprehen (92523) $514.50 $735
Standardized cognitive performance testing (96125) $276.50 $395
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $925.40 $1,322 8.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $62.30 $89
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $71.40 $102
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $26.60 $38
Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Other Outpatient (97113) $258.30 $369
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $93.80 $134
Therapeutic prophylactic/dx injection subq/im (96372) $19.60 $28 0.3×
Therapeutic services for the use of speech-generating device, including programming and modification Other Outpatient (92609) $166.60 $238
Tobacco use cessation intensive >10 minutes (99407) $45.50 $65 1.2×
Tobacco use cessation intermediate 3-10 minutes (99406) $49.35 $70.50 1.3×
Tte f-up or lmtd (93308) $751.10 $1,073 3.1×
Tte w/doppler complete (93306) $1,622.60 $2,318 2.9×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $207.90 $297
Tx speech language voice commj auditry 2/>indiv (92508) $35 $50
Upr/l xtremity art 2 levels (93922) $247.10 $353 1.8×
Us temperature gradient studies raynaud's eval (93740) $461.30 $659 3.5×
Ventilation ip/obs initial day (94002) $1,076.60 $1,538 1.7×
Ventilator subsequent day (94003) $1,682.10 $2,403 2.7×
Vital capacity total (94150) $252.70 $361 1.9×
Wound(s) care non-selective (97602) $263.90 $377 1.3×