Visits & medical services prices at Stephens Memorial Hospital

Breckenridge, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $64.04 $91.49 0.3×
Appl on-body injector for timed subq injection (96377) $79.70 $113.86 1.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $436.80 $624 1.2×
Cardiac Stress Tst,Tracing Only (93017) $679.62 $970.89 3.1×
Cardiopulmonary resuscitation (92950) $570.05 $814.36 2.6×
Cardioversion (92960) $779.44 $1,113.49 1.2×
Cbt 1st hour (94644) $142.80 $204 1.1×
Chemo IV push addl drug (96411) $125.56 $179.38 1.7×
Chemo Iv Push Sngl Drug (96409) $411.13 $587.32 1.2×
Chemother, IV infusion, 1 hr (96413) $640.73 $915.32 1.9×
Chemother, IV infusion, ea add hr (96415) $129.15 $184.50 1.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $114.85 $164.07 1.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $125.56 $179.38 1.7×
Color/duplex Doppler, complete (93975) $1,032.50 $1,475 4.3×
Color/duplex Doppler, limited (93976) $698.84 $998.35 6.7×
Cpap initiation and management (94660) $376.80 $538.29 1.7×
Cpt initial (94667) $59.21 $84.59 0.4×
Critical care (99291) $1,081.40 $1,544.86 1.3×
Debridement Open Wound 20 Sq Cm< (97597) $71.18 $101.68 0.4×
Demo &/or eval,pt use,aerosol device (94664) $60.99 $87.13 0.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $946.40 $1,352 3.9×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $704.90 $1,007 6.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $346.74 $495.33 1.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $683.90 $977 6.5×
Dup-scan xtr veins unilateral/limited study (93971) $710.75 $1,015.35 6.8×
Duplex scan extracranial art compl bi study (93880) $868.18 $1,240.25 3.6×
Echo Heart Xthoracic,Limited (93308) $457.30 $653.28 1.9×
Echo Transthoracic - Congenital Tte Complete (93303) $910 $1,300 1.7×
EEG awake asleep (95819) $847.37 $1,210.52 3.9×
EKG (93005) $189 $270 3.2×
EKG rhythm strip (93041) $112.70 $161 1.9×
Er level 1 (99281) $173.53 $247.90 2.0×
Er level ii (99282) $132.30 $189 0.9×
Er level iii (99283) $176.75 $252.50 0.6×
Er level IV (99284) $517.80 $739.72 1.2×
Er level v (99285) $883.22 $1,261.74 1.5×
Evaluation of swallowing function (92610) $129.86 $185.52 1.5×
Exercise tst brncspsm (94617) $231 $330 1.7×
Exhaled air analysis o2 (94680) $122.54 $175.05 0.9×
External ECG rec>48hr<7d recording (93242) $373.56 $533.65 10.0×
External ECG rec>7d<15d recording (93246) $374.84 $535.48 10.0×
Holter Monitor Recording (93225) $411.84 $588.35 3.1×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $125.28 $178.96 1.7×
Immunization Admin (90471) $125.56 $179.38 1.7×
Immunotherapy, 2+ Injections (95117) $71.82 $102.60 1.5×
Injection intra arterial (96373) $296.97 $424.24 1.4×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $120.46 $172.08 2.0×
IV infusion hydration each additional hour (96361) $77.70 $111 1.7×
IV infusion hydration initial 31 min-1 hour (96360) $309.59 $442.27 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $128.11 $183.02 1.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $358.20 $511.71 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $132.02 $188.60 2.8×
IV push initial (96374) $401.10 $573 1.9×
Liver elastography w/o imag w/i&r (91200) $305.40 $436.29 2.4×
Manual therapy 15 min (97140) $67.42 $96.31 2.4×
Massage 15 min (97124) $39.01 $55.73 1.3×
Maximum voluntary ventilation (94200) $82.82 $118.31 1.4×
Mechanical traction (97012) $31.76 $45.37 2.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $54.60 $78 1.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $62.30 $89 1.7×
Mnt Group Ea 30 Min (97804) $28.70 $41 1.7×
Neg press wnd tx </=50 sq cm (97607) $652.40 $932 1.6×
Neg press wound tx >50 cm (97608) $353.76 $505.38 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $263.63 $376.62 1.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $351.92 $502.75 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $292.60 $418 2.2×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $101.87 $145.53 2.2×
Ot Contrast Bath Ea 15 Min (97034) $32.09 $45.84 2.3×
Ot eval high complex 60 min (97167) $112 $160 1.1×
Ot eval low complex 30 min (97165) $196.71 $281.01 2.0×
Ot eval mod complex 45 min (97166) $112 $160 1.1×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $111.59 $159.42 2.2×
Ot re-eval est plan care (97168) $133.64 $190.92 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $82.82 $118.32 0.6×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $171.27 $244.67 1.3×
Paraffin bath (97018) $17.18 $24.54 2.9×
Phy/qhp op pulm rhb w/mntr (94626) $119.39 $170.55 2.0×
Phy/qhp op pulm rhb w/o mntr (94625) $119.39 $170.55 2.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,324.53 $4,749.32 3.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $46.57 $66.52 1.0×
Pt Electric Current Therapy (97033) $51.41 $73.44 2.7×
Pt Electrical Stimulation (97032) $29.02 $41.46 2.0×
Pt eval high complex 45 min (97163) $182.55 $260.79 1.9×
Pt eval low complex 20 min (97161) $125.52 $179.32 1.3×
Pt Gait Training Therapy (97116) $43.32 $61.88 1.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $72.28 $103.26 2.2×
Pt Physical Performance Test (97750) $50.41 $72.02 1.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $178.78 $255.40 1.8×
Pt re-evaluation (97164) $123.24 $176.05 1.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $68.18 $97.40 2.1×
Pt Ultrasound Therapy (97035) $26.18 $37.39 1.8×
Pt Whirlpool Therapy (97022) $36.79 $52.55 2.3×
Pulmonary stress testing (94618) $231.53 $330.75 1.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $71.18 $101.68 0.4×
Sc Ther Infusion Reset Pump (96371) $128.33 $183.33 1.8×
Speech group therapy (92508) $23.74 $33.92 1.0×
Speech sound lang comprehen (92523) $557.84 $796.91 2.5×
Spirometry (94010) $237.30 $339 1.1×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $79.70 $113.86 1.7×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $411.32 $587.60 1.9×
Temp transcutaneous pacing (92953) $458.78 $655.40 0.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $57.21 $81.73 2.6×
Ther/prop/diag inj/inf proc (96379) $93.41 $133.44 2.0×
Ther/Proph/Diag Inj Sc/Im (96372) $91.22 $130.32 1.3×
Therapeutic Activities (97530) $64.20 $91.72 1.8×
Therapeutic phlebotomy (99195) $193.05 $275.78 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $48.20 $68.85 1.3×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $945 $1,350 1.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $47.48 $67.82 0.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $48.30 $69 0.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $77.73 $111.04 1.7×
Unlisted pulmonary service/procedure (94799) $88.20 $125.99 0.7×
Vasc Duplex Extrem Venous,Bilat (93970) $1,010.80 $1,444 4.2×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $366.80 $524 1.7×
Ventilation assist & mgmt inpatient 1st day (94002) $429.41 $613.44 0.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,435.66 $2,050.94 2.3×
Wheelchair Mgmt Ea 15 Min (97542) $58.80 $84.01 1.9×