Visits & medical services prices at Vandalia Health Mon Stonewall Jackson Memorial Hospital

Weston, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $587.34 $1,174.68 2.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $48.76 $97.51 3.4×
Application Modality 1/> Areas Infrared (97026) $21.67 $43.33 3.2×
Application on-body injector (96377) $130.81 $261.62 2.9×
Bedside Swallowing Eval (92610) $288.65 $577.30 3.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $864.34 $1,728.67 2.4×
Cardiac Stress Tst,Tracing Only (93017) $864.34 $1,728.67 4.2×
Cardiopulmonary resuscitation (92950) $864.34 $1,728.67 4.2×
Cardioversion (92960) $1,792.19 $3,584.38 2.8×
Cbt 1st hour (94644) $351.77 $703.53 2.8×
Chemo Hormon Antineopl Sq/Im (96402) $193.99 $387.98 2.8×
Chemo IV push addl drug (96411) $193.99 $387.98 2.8×
Chemo prolong 8+ hrs infuse w/pump (96416) $932.60 $1,865.20 2.9×
Chemother, IV infusion, 1 hr (96413) $932.60 $1,865.20 2.9×
Chemother, IV infusion, ea add hr (96415) $193.99 $387.98 2.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $193.99 $387.98 2.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $193.99 $387.98 2.8×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $932.60 $1,865.20 2.9×
Color/duplex Doppler, complete (93975) $674.77 $1,349.53 2.9×
Color/duplex Doppler, limited (93976) $302.75 $605.49 3.0×
Cpap/bipap (94660) $587.34 $1,174.68 2.8×
Cpt initial (94667) $351.77 $703.53 2.8×
Critical care (99291) $2,443.58 $4,887.16 3.1×
Debridement Open Wound 20 Sq Cm< (97597) $551.30 $1,102.60 2.9×
Dermatological procedure (96999) $551.30 $1,102.60 2.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $674.77 $1,349.53 2.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $302.75 $605.49 3.0×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $674.77 $1,349.53 2.9×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $302.75 $605.49 3.0×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $674.77 $1,349.53 2.9×
Dup-scan xtr veins unilateral/limited study (93971) $302.75 $605.49 3.0×
Duplex scan extracranial art compl bi study (93880) $674.77 $1,349.53 2.9×
Echo Heart Xthoracic,Limited (93308) $674.77 $1,349.53 2.9×
EEG awake and asleep (95819) $864.34 $1,728.67 4.2×
EEG awake drowsy (95816) $864.34 $1,728.67 4.2×
EEG coma or sleep only (95822) $864.34 $1,728.67 4.2×
Electrocardiogram Tracing (93005) $168.44 $336.88 3.0×
Er level 1 (99281) $244.48 $488.96 3.0×
Er level ii (99282) $450.38 $900.75 3.1×
Er level iii (99283) $785.70 $1,571.39 3.0×
Er level IV (99284) $1,219.65 $2,439.30 3.0×
Er level v (99285) $1,768.76 $3,537.51 3.1×
Evaluate Pt Use Of Inhaler (94664) $587.34 $1,174.68 2.8×
External ECG rec>48hr<7d recording (93242) $110.44 $220.87 3.1×
External ECG rec>48hr<7d scanning alys w/report (93243) $351.77 $703.53 2.8×
External ECG rec>7d<15d recording (93246) $110.44 $220.87 3.1×
External ECG rec>7d<15d scanning alys w/report (93247) $351.77 $703.53 2.8×
External Ecg Scanning Analysis Report (93226) $168.44 $336.88 3.0×
Hemodialysis (90935) $1,924.31 $3,848.61 2.9×
Holter Monitor (93225) $351.77 $703.53 2.8×
Immunization Admin (90471) $193.99 $387.98 2.8×
Iontophoresis 15 min (97033) $67.73 $135.45 3.6×
Irrig drug delivery device (96523) $168.44 $336.88 3.0×
IV infusion hydration each additional hour (96361) $130.81 $261.62 2.9×
IV infusion hydration initial 31 min-1 hour (96360) $590.23 $1,180.46 2.9×
IV infusion ther proph addl sequential to 1 hr (96367) $193.99 $387.98 2.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $590.23 $1,180.46 2.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $130.81 $261.62 2.9×
IV push ea addl new drug (96375) $130.81 $261.62 2.9×
IV push initial (96374) $590.23 $1,180.46 2.9×
Manual therapy 15 min (97140) $93.48 $186.95 3.4×
Massage 15 min (97124) $96.95 $193.90 3.3×
Maximum voluntary ventilation (94200) $168.44 $336.88 3.0×
Mechanical chest wall oscillation (94669) $587.34 $1,174.68 2.8×
Mechanical traction (97012) $50.54 $101.07 3.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $76.82 $153.63 2.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $217.28 $434.55 5.9×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $30 $60 1.8×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $313.37 $626.74 3.4×
Neg press wound tx >50 cm (97608) $1,098.04 $2,196.07 2.8×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $1,098.04 $2,196.07 2.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $551.30 $1,102.60 2.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,098.04 $2,196.07 2.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $351.77 $703.53 2.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $430.14 $860.28 3.5×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $162.76 $325.51 3.5×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $71.45 $142.89 3.5×
Ot Contrast Bath Ea 15 Min (97034) $49.83 $99.66 3.6×
Ot eval high complex 60 min (97167) $330.09 $660.18 3.3×
Ot eval low complex 30 min (97165) $330.09 $660.18 3.3×
Ot eval mod complex 45 min (97166) $330.09 $660.18 3.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $177.29 $354.57 3.5×
Ot Prosthetic Training, Each 15 Min (97761) $139.36 $278.71 3.4×
Ot Range Motion Measure,Each Extrem (95851) $73.42 $146.83 2.8×
Ot re-evaluation (97168) $221.64 $443.27 3.2×
Ot therapeutic activity 15 min (97530) $128.74 $257.47 3.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $363.88 $727.75 2.9×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $363.88 $727.75 2.9×
Paraffin bath pt (97018) $19.57 $39.14 3.3×
Peripheral arterial disease rehab per session (93668) $168.44 $336.88 3.0×
Phlebotomy therapeutic (99195) $330.14 $660.28 2.6×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $168.44 $336.88 3.0×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $168.44 $336.88 3.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,879.13 $5,758.26 3.5×
Pt Electrical Stimulation (97032) $50.54 $101.07 3.4×
Pt eval high complex 45 min (97163) $339.65 $679.30 3.5×
Pt eval low complex 20 min (97161) $339.65 $679.30 3.5×
Pt eval mod complex 30 min (97162) $339.65 $679.30 3.5×
Pt gait training 15 min (97116) $101.25 $202.49 3.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $117.02 $234.04 3.6×
Pt Physical Performance Test (97750) $114.04 $228.07 3.4×
Pt re-evaluation (97164) $231.22 $462.44 3.4×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $103.18 $206.36 3.2×
Pt Whirlpool Therapy (97022) $58.70 $117.40 3.7×
Pulm function test by gas (94727) $430.14 $860.28 2.1×
Pulmonary Service/Procedure (94799) $430.14 $860.28 3.5×
Pulmonary stress test simple (94618) $340.96 $681.90 2.7×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $103.85 $207.69 2.9×
Respiratory flow volume loop (94375) $864.34 $1,728.67 4.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $551.30 $1,102.60 2.9×
Rom meas&reprt hand w/wo comparison normal sid (95852) $58.70 $117.40 2.7×
Rt Chest Wall Manipulation,Subsequent (94668) $351.77 $703.53 2.8×
Sleep study attended (95807) $1,475.95 $2,951.90 4.1×
Sleep study unattended (95806) $430.14 $860.28 2.1×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $430.14 $860.28 2.1×
Slp stdy unatnd w/min hrt rate/o2 sat/resp anal (95801) $168.44 $336.88 3.0×
Spirometry (94010) $430.14 $860.28 2.1×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $590.23 $1,180.46 2.9×
Subcutaneous Infusion Each Additional Hour (96370) $130.81 $261.62 2.9×
Temp transcutaneous pacing (92953) $1,792.19 $3,584.38 2.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $80.86 $161.72 3.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $78.41 $156.82 3.7×
Therapeutic prophylactic/dx injection subq/im (96372) $193.99 $387.98 2.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $79.02 $158.03 2.2×
Tte w/doppler, complete (93306) $1,519.16 $3,038.32 2.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $263.16 $526.31 3.5×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $289.37 $578.73 3.4×
Upr/lxtr art stdy 3+ lvls (93923) $430.14 $860.28 2.1×
Vasc Duplex Scan Extracranial,Limited (93882) $302.75 $605.49 3.0×
Vasopneumatic device (97016) $40.81 $81.62 3.4×
Vent mgmt inpat init day (94002) $1,725.66 $3,451.32 2.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,725.66 $3,451.32 2.9×
Vital capacity, total (94150) $430.14 $860.28 3.5×