Visits & medical services prices at Ste. Genevieve County Memorial Hospital

Ste. Genevieve, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) $134 $268 1.3×
Acoustic reflex testing (92568) $28.50 $57 0.8×
Advance care planning first 30 mins (99497) $81 $162 0.8×
Airway inhalation treatment (94640) $42 $84 0.2×
Ambulatory Bp Recording (93786) $222.75 $445.50 1.7×
Analyze Neurostim Complex (95972) $61.50 $123 0.6×
Analyze neurostim no prog (95970) $20.50 $41 0.2×
Anorectal manometry (91125) $449.50 $899 1.2×
Appl on-body injector for timed subq injection (96377) $115.75 $231.50 2.5×
Assessment of aphasia (96105) $95.25 $190.50 1.0×
Behav assmt w/score & docd/stand instrument (96127) $6 $12 0.2×
Behavioral and qualitative analysis of voice and resonance (92524) $304.25 $608.50 2.8×
Bfb training 1st 15 min (90912) $102.75 $205.50 1.3×
Bfb training ea addl 15 min (90913) $147.12 $294.25 4.5×
Biofeedback training any modality (90901) $67.75 $135.50 1.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $155.62 $311.25 0.4×
Canalith Repositioning (95992) $42.50 $85 1.0×
Capsule endoscopy (91110) $900 $1,800 1.0×
Cardiac Stress Tst,Tracing Only (93017) $218 $436 1.0×
Cardiopulmonary resuscitation (92950) $782.50 $1,565 3.6×
Cardioversion (92960) $478 $956 0.7×
Cbt 1st hour (94644) $177.50 $355 1.3×
Chemo Hormon Antineopl Sq/Im (96402) $185.88 $371.75 2.6×
Chemo IV push addl drug (96411) $66.75 $133.50 0.9×
Chemo Iv Push Sngl Drug (96409) $435.50 $871 1.3×
Chemother, IV infusion, 1 hr (96413) $538.50 $1,077 1.6×
Chemother, IV infusion, ea add hr (96415) $87.75 $175.50 1.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $185.88 $371.75 2.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $178.75 $357.50 2.5×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions (98940) $34 $68 1.6×
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions (98941) $51.50 $103 2.4×
Chiropractic manipulative treatment (CMT); spinal, 5 regions (98942) $72.50 $145 3.4×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $48 $96 0.5×
Colon Motility 6 Hr Study (91117) $130.25 $260.50 0.6×
Color/duplex Doppler, complete (93975) $451.50 $903 1.9×
Color/duplex Doppler, limited (93976) $236.25 $472.50 2.3×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $106 $212 0.6×
Cont Gluc Monitoring Patient Provided Equipment (95249) $50 $100 0.8×
Continuous Glucose Monitoring (95250) $129.50 $259 1.0×
Cpap initiation and management (94660) $595.75 $1,191.50 2.7×
Cpt initial (94667) $137.50 $275 1.0×
Critical care (99291) $454.50 $909 0.5×
Debridement Open Wound 20 Sq Cm< (97597) $91 $182 0.5×
Demo &/or eval,pt use,aerosol device (94664) $88.38 $176.75 0.4×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $203.50 $407 0.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $174 $348 1.7×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $607.88 $1,215.75 2.5×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $337.25 $674.50 3.2×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $608.12 $1,216.25 2.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $337.50 $675 3.2×
Dup-scan xtr veins unilateral/limited study (93971) $683 $1,366 6.5×
Duplex scan extracranial art compl bi study (93880) $451.50 $903 1.9×
Ear and throat examination (92502) $90 $180 0.2×
Echo Heart Xthoracic,Limited (93308) $427.12 $854.25 1.8×
Echo transesophageal (93312) $32.50 $65 0.1×
Echo Transthoracic - Congenital Tte Limited (93304) $668.50 $1,337 1.2×
EEG awake drowsy (95816) $300.75 $601.50 1.4×
EKG (93005) $49.38 $98.75 0.8×
EKG rhythm strip (93041) $26.75 $53.50 0.5×
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $55 $110 0.6×
Elec alys nstim pls gen smpl sc/perph w/prgrmg (95971) $49 $98 0.5×
Electrogastrography, diagnostic, transcutaneous; UNSCHEDULED (91132) $27.50 $55 0.1×
EMG four extremities (95864) $117 $234 0.9×
EMG one extremity (95860) $121.50 $243 0.9×
EMG two extremities (95861) $175 $350 1.3×
Er level 1 (99281) $79 $158 0.9×
Er level ii (99282) $146.25 $292.50 1.0×
Er level iii (99283) $180.25 $360.50 0.7×
Er level IV (99284) $298 $596 0.7×
Er level v (99285) $367 $734 0.6×
Esoph imped funct test > 1hr - esophageal ph monitoring 24-hour (91038) $52.50 $105 0.1×
Evaluation of speech fluency (92521) $175.25 $350.50 1.3×
Evaluation of speech sound production (92522) $295 $590 2.6×
Evaluation of swallowing function (92610) $169.75 $339.50 2.0×
Evoked Auditory Test,Comprehsv (92588) $30.50 $61 0.1×
Evoked auditory test,limited (92587) $22 $44 0.1×
Exercise tst brncspsm (94617) $94.50 $189 0.7×
External ECG rec>48hr<7d recording (93242) $370 $740 9.9×
Flow volume loop (94375) $37 $74 0.2×
Fluorescein angiography (92235) $112.50 $225 0.5×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $48 $96 0.1×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $46.50 $93 0.2×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,051.50 $2,103 1.2×
Group Therapeutic Procedures (97150) $46.25 $92.50 2.6×
Hydrotherapy (97036) $91.62 $183.25 2.6×
Icd Device Interrogate (93289) $53.75 $107.50 1.4×
Imaging of colon using capsule endoscope, with interpretation and report (91113) $115 $230 0.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $36.50 $73 0.9×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $14 $28 0.2×
Immunization Admin (90471) $49.25 $98.50 0.7×
Immunotherapy, 2+ Injections (95117) $103 $206 2.2×
Inital newborn e/m (99460) $191 $382 1.4×
Initial normal newborn care, same day discharge (99463) $104 $208 0.8×
Interrogation of vad (93750) $56 $112 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $262.75 $525.50 4.4×
IV infusion hydration each additional hour (96361) $69 $138 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $293 $586 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $128.50 $257 1.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $294.32 $588.65 1.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $68.50 $137 1.5×
IV push initial (96374) $152.75 $305.50 0.7×
Liver elastography w/o imag w/i&r (91200) $15 $30 0.1×
Manual therapy 15 min (97140) $128 $256 4.6×
Massage 15 min (97124) $91 $182 3.1×
Maximum voluntary ventilation (94200) $59 $118 1.0×
Measurement of heart blood flow and respiration (93701) $70.25 $140.50 0.5×
Mechanical traction (97012) $50.38 $100.75 3.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $30 $60 0.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $38.38 $76.75 1.0×
Mnt Group Ea 30 Min (97804) $67.12 $134.25 3.9×
Motility study esophagus (91010) $643.88 $1,287.75 1.7×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $100.12 $200.25 1.1×
Motor &/sens nrv cndj preconf eltrd array limb (95905) $30 $60 0.1×
Multiple Family Group Psychotherapy (90849) $103 $206 0.6×
Multiple sleep latency test (95805) $864.34 $1,728.68 1.0×
Nasopharyngoscopy (92511) $163.50 $327 0.8×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $21 $42 0.2×
Neg press wnd tx </=50 sq cm (97607) $344 $688 0.8×
Neg press wound tx >50 cm (97608) $405 $810 1.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $495.25 $990.50 2.5×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $974.50 $994.50 2.4×
Nerve conduction studies 13/> studies (95913) $285.50 $571 0.8×
Nerve Conduction Studies 3-4 Studies (95908) $69.50 $139 0.3×
Nerve Conduction Studies 9-10 Studies (95911) $253.50 $507 0.7×
Nerve conduction studies; 1-2 studies (95907) $56 $112 0.3×
Nerve conduction studies; 11-12 studies (95912) $269.50 $539 0.7×
Nerve conduction studies; 5-6 studies (95909) $151 $302 0.7×
Nerve conduction studies; 7-8 studies (95910) $209.25 $418.50 0.6×
Neurobehavioral Status Exam (96116) $92.50 $185 0.4×
Newborn resuscitation (99465) $393.62 $787.25 0.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $220.62 $441.25 1.7×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $748.50 $1,497 3.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $104.62 $209.25 0.8×
Nrpsyc tst eval phys/qhp 1st (96132) $130.50 $261 0.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $167.62 $335.25 3.6×
Osteopathic manipulative tx 1-2 body regions (98925) $44.50 $89 2.1×
Osteopathic manipulative tx 3-4 body regions (98926) $61 $122 2.8×
Osteopathic manipulative tx 5-6 body regions (98927) $75 $150 3.5×
Osteopathic manipulative tx 7-8 body regions (98928) $89.50 $179 4.1×
Osteopathic manipulative tx 9-10 body regions (98929) $104.50 $209 4.8×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $125.12 $250.25 3.9×
Ot eval high complex 60 min (97167) $174.50 $349 1.7×
Ot eval low complex 30 min (97165) $87.75 $175.50 0.9×
Ot eval mod complex 45 min (97166) $131.50 $263 1.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $92.38 $184.75 1.8×
Ot Prosthetic Training, Each 15 Min (97761) $151.75 $303.50 3.8×
Ot re-eval est plan care (97168) $87.75 $175.50 1.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $192.25 $384.50 1.5×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $173.50 $347 1.3×
Paraffin bath (97018) $33.50 $67 5.6×
Peripheral arterial disease rehab per session (93668) $160.25 $320.50 2.7×
Phy/qhp op pulm rhb w/mntr (94626) $124.62 $249.25 2.1×
Phy/qhp op pulm rhb w/o mntr (94625) $120.62 $241.25 2.0×
Plethysmography (94726) $129.25 $258.50 0.3×
Pm device eval in person (93288) $34.25 $68.50 0.9×
Pm device progr eval dual (93280) $56.75 $113.50 1.5×
Pm device progr eval multi (93281) $61.25 $122.50 1.6×
Pm device progr eval sngl (93279) $47.50 $95 1.3×
Pm/Icd Remote Tech Serv (93296) $26 $52 0.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,501.38 $3,002.75 1.7×
Positional Nystagmus Test (92542) $28.25 $56.50 0.2×
Principal care mgmt svc 1st 30 staff cal mo (99426) $55 $110 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $89.88 $179.75 1.9×
Programming of dual lead implantable defibrillator system (93283) $77 $154 2.1×
Programming of single lead implantable defibrillator system (93282) $59.50 $119 1.6×
Psych diag eval w/med srvcs (90792) $170 $340 1.0×
Psychiatric diagnostic evaluation (90791) $107.50 $215 0.6×
Psychoanalysis (90845) $98 $196 0.6×
Psytx crisis initial 60 min (90839) $85.50 $171 0.5×
Pt Aquatic Therapy/Exercises (97113) $204.75 $409.50 5.5×
Pt Electric Current Therapy (97033) $233.62 $467.25 12.3×
Pt Electrical Stimulation (97032) $97.38 $194.75 6.6×
Pt eval high complex 45 min (97163) $135.75 $271.50 1.4×
Pt eval low complex 20 min (97161) $60.75 $121.50 0.6×
Pt Gait Training Therapy (97116) $151.75 $303.50 5.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $140.75 $281.50 4.3×
Pt Physical Performance Test (97750) $172.75 $345.50 5.1×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $90.50 $181 0.9×
Pt re-evaluation (97164) $67.75 $135.50 1.0×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $160.88 $321.75 5.0×
Pt Ultrasound Therapy (97035) $77 $154 5.4×
Pt Whirlpool Therapy (97022) $50.12 $100.25 3.2×
Pulm function test by gas (94727) $213.50 $427 1.0×
Pulmonary stress testing (94618) $263 $526 2.0×
Rectal sensation tone&compliance study (91124) $225 $450 1.0×
Refill/maint, portable pump (96521) $76 $152 0.4×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $23.50 $47 0.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $418.50 $837 11.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $68.25 $136.50 0.3×
Rt Chest Wall Manipulation,Subsequent (94668) $43.25 $86.50 0.3×
Sbsq psychiatric collab care mgmt 1st 60 mins (99493) $124.50 $249 1.2×
Self-meas bp pt educaj/traing & dev calibration (99473) $10 $20 0.3×
Sleep study attended (95807) $381.50 $763 1.0×
Sleep study unattended (95806) $470.25 $940.50 2.2×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $40 $80 0.2×
Slp stdy unatnd w/min hrt rate/o2 sat/resp anal (95801) $40 $80 0.7×
Smoking cessation > 10 min (99407) $44.25 $88.50 1.2×
Speech group therapy (92508) $126 $252 5.2×
Speech sound lang comprehen (92523) $136 $272 0.6×
Spirometry (94010) $129.25 $155.75 0.6×
Standardized Cognitive Performance Testing (96125) $200.25 $400.50 1.9×
Stress echo (93350) $160.50 $321 0.3×
Stress Tte Complete (93351) $1,231.88 $2,463.75 2.3×
Temp transcutaneous pacing (92953) $301.38 $602.75 0.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $64.25 $128.50 2.9×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $185.25 $370.50 8.8×
Ther/prop/diag inj/inf proc (96379) $517.50 $1,035 11.0×
Ther/Proph/Diag Inj Sc/Im (96372) $107.88 $215.75 1.5×
Therapeutic Activities (97530) $151.75 $303.50 4.3×
Therapeutic phlebotomy (99195) $234.50 $469 1.8×
Tilt Table Eval (93660) $101 $202 0.3×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $30.75 $61.50 0.8×
Trans Care Mgmt 14 Day Disch (99495) $191.50 $383 1.4×
Trans Care Mgmt 7 Day Disch (99496) $259.50 $519 1.9×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $34.25 $68.50 0.9×
Tstg Ans Funcj Vasomotor Adrenergic Innervaj (95922) $86 $172 0.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,258.75 $2,517.50 2.3×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $267 $534 1.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $255 $510 3.3×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $108 $216 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $120.50 $241 2.6×
Tympanometry (92567) $28.50 $57 0.8×
Ultraviolet Light Therapy (96900) $17.50 $35 0.5×
Ultraviolet Therapy (97028) $43.50 $87 5.2×
Unlisted Cardiovascular Service/Procedure (93799) $29 $58 0.2×
Vasc Duplex Extrem Venous,Bilat (93970) $1,255.50 $2,511 5.3×
Vasc Duplex Scan Extracranial,Limited (93882) $23.50 $47 0.2×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $360.38 $720.75 1.7×
Vasopneumatic device (97016) $38 $76 3.2×
Ventilation assist & mgmt inpatient 1st day (94002) $595.75 $1,191.50 1.0×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $141.75 $283.50 0.2×
Vital capacity total (94150) $51 $102 0.4×