Visits & medical services prices at Stonewall Memorial Hospital District

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $59.25 $79 0.3×
Ambulatory Bp Analysis (93788) $150 $200 1.1×
Ambulatory Bp Recording (93786) $165 $220 1.2×
Behav assmt w/score & docd/stand instrument (96127) $9 $12 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $432 $576 1.2×
Cardiopulmonary resuscitation (92950) $460.50 $614 2.1×
Cardioversion (92960) $499.88 $666.50 0.8×
Chemo Iv Push Sngl Drug (96409) $391.50 $522 1.2×
Chemother, IV infusion, 1 hr (96413) $610.50 $814 1.8×
Chemother, IV infusion, ea add hr (96415) $118.50 $158 1.6×
Color/duplex Doppler, complete (93975) $560.25 $747 2.3×
Color/duplex Doppler, limited (93976) $477 $636 4.5×
Cpap initiation and management (94660) $120 $160 0.5×
Cpt initial (94667) $59.25 $79 0.4×
Critical care (99291) $995.25 $1,327 1.2×
Debridement Open Wound 20 Sq Cm< (97597) $180.75 $241 0.9×
Demo &/or eval,pt use,aerosol device (94664) $54 $72 0.2×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $612 $816 2.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $468 $624 4.5×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $540 $720 2.3×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $450 $600 4.3×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $648 $864 2.7×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $486 $648 4.6×
Dup-scan xtr veins unilateral/limited study (93971) $375 $500 3.6×
Duplex scan extracranial art compl bi study (93880) $576 $768 2.4×
Echo Heart Xthoracic,Limited (93308) $392.25 $523 1.6×
EKG (93005) $106.50 $142 1.8×
Er level 1 (99281) $165 $220 1.9×
Er level ii (99282) $191.62 $255.50 1.2×
Er level iii (99283) $325.12 $433.50 1.2×
Er level IV (99284) $519.38 $692.50 1.2×
Er level v (99285) $737.25 $983 1.2×
External Ecg Scanning Analysis Report (93226) $187.50 $250 3.2×
Holter Monitor Recording (93225) $232.50 $310 1.7×
Immunization Admin (90471) $75 $100 1.0×
Immunotherapy, 2+ Injections (95117) $31.50 $42 0.7×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $111.75 $149 1.9×
IV infusion hydration each additional hour (96361) $87 $116 1.8×
IV infusion hydration initial 31 min-1 hour (96360) $395.25 $527 1.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $133.50 $178 1.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $395.25 $527 1.8×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $87 $116 1.8×
IV push initial (96374) $233.62 $311.50 1.1×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $47.25 $63 1.5×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $54.75 $73 1.5×
Mnt Group Ea 30 Min (97804) $26.25 $35 1.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $219.38 $292.50 1.6×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $424.50 $566 2.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $112.50 $150 0.9×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $187.50 $250 1.4×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $180 $240 1.4×
Peripheral arterial disease rehab per session (93668) $108 $144 1.8×
Phy/qhp op pulm rhb w/mntr (94626) $120.75 $161 2.0×
Phy/qhp op pulm rhb w/o mntr (94625) $112.50 $150 1.9×
Pr unlisted procedure psychiatric service/therapy, psychiatric service (90899) $45 $60 1.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $22.50 $30 0.5×
Psychiatric diagnostic evaluation (90791) $171.75 $229 1.0×
Psytx crisis initial 60 min (90839) $186 $248 1.0×
Pt-focused hlth risk assmt (96160) $50.25 $67 1.3×
Pulmonary stress testing (94618) $258.75 $345 1.9×
Spirometry (94010) $106.50 $142 0.5×
Temp transcutaneous pacing (92953) $271.50 $362 0.4×
Test for allergy using combination of methods with drug or biological (95018) $38.62 $51.50 1.0×
Ther/Proph/Diag Inj Sc/Im (96372) $53.25 $71 0.7×
Therapeutic phlebotomy (99195) $360 $480 2.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $864 $1,152 1.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $87 $116 1.8×
Vasc Duplex Extrem Venous,Bilat (93970) $468 $624 2.0×
Vasc Duplex Scan Extracranial,Limited (93882) $315.75 $421 3.0×
Ventilation assist & mgmt inpatient 1st day (94002) $852.38 $1,136.50 1.4×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $933 $1,244 1.5×