Visits & medical services prices at Sublette County Health

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $268.20 $298 1.2×
Appl on-body injector for timed subq injection (96377) $114.30 $127 2.4×
Assessment of aphasia (96105) $405 $450 4.2×
Behavioral and qualitative analysis of voice and resonance (92524) $332.55 $369.50 3.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $277.20 $308 0.7×
Canalith Repositioning (95992) $127.80 $142 3.1×
Cardiac Stress Tst,Tracing Only (93017) $1,081.80 $1,202 4.9×
Cardiopulmonary resuscitation (92950) $759.60 $844 3.4×
Cardioversion (92960) $1,840.50 $2,045 2.7×
Cbt 1st hour (94644) $683.10 $759 5.0×
Chemo Hormon Antineopl Sq/Im (96402) $226.80 $252 3.1×
Chemo IV push addl drug (96411) $336.60 $374 4.6×
Chemo Iv Push Sngl Drug (96409) $441 $490 1.3×
Chemo prolong 8+ hrs infuse w/pump (96416) $718.20 $798 2.1×
Chemother, IV infusion, 1 hr (96413) $727.20 $808 2.2×
Chemother, IV infusion, ea add hr (96415) $284.40 $316 3.9×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $277.20 $308 3.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $317.70 $353 4.3×
Color/duplex Doppler, complete (93975) $859.50 $955 3.5×
Color/duplex Doppler, limited (93976) $726.30 $807 6.8×
Cont Gluc Monitoring Patient Provided Equipment (95249) $177.30 $197 2.9×
Continuous Glucose Monitoring (95250) $403.20 $448 3.0×
Cpap initiation and management (94660) $811.80 $902 3.6×
Cpt initial (94667) $152.10 $169 1.1×
Critical care (99291) $2,250 $2,500 2.7×
Debridement Open Wound 20 Sq Cm< (97597) $226.80 $252 1.1×
Demo &/or eval,pt use,aerosol device (94664) $188.10 $209 0.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $614.70 $683 2.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $518.40 $576 4.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,168.20 $1,298 4.8×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $896.40 $996 8.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,530 $1,700 6.3×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $48.60 $54 0.5×
Dup-scan xtr veins unilateral/limited study (93971) $793.80 $882 7.4×
Duplex scan extracranial art compl bi study (93880) $1,242.90 $1,381 5.1×
Echo Heart Xthoracic,Limited (93308) $854.10 $949 3.5×
EEG awake drowsy (95816) $1,521.90 $1,691 6.9×
EKG (93005) $312.30 $347 5.2×
EKG rhythm strip (93041) $173.70 $193 2.9×
Er level 1 (99281) $88.20 $98 1.0×
Er level ii (99282) $118.80 $132 0.8×
Er level iii (99283) $244.80 $272 0.9×
Er level IV (99284) $362.70 $403 0.9×
Er level v (99285) $594.90 $661 1.0×
Esophgl balo distension dx std w/provocation (91040) $1,251.45 $1,390.50 3.3×
Evaluation of speech fluency (92521) $304.20 $338 2.3×
Evaluation of speech sound production (92522) $329.40 $366 2.9×
Evaluation of swallowing function (92610) $347.40 $386 4.1×
Evaluation with prescription of speech-generating alternative (92607) $354.60 $394 2.9×
External ECG rec>48hr<7d recording (93242) $290.70 $323 7.6×
External ECG rec>7d<15d recording (93246) $263.70 $293 6.9×
External Ecg Scanning Analysis Report (93226) $415.80 $462 6.9×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $932.40 $1,036 4.2×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,712.70 $1,903 2.0×
Group Therapeutic Procedures (97150) $108 $120 6.0×
Holter Monitor Recording (93225) $415.80 $462 3.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $53.10 $59 1.3×
Immunization Admin (90471) $111.60 $124 1.5×
Inital newborn e/m (99460) $197.10 $219 1.4×
Initial normal newborn care, same day discharge (99463) $230.40 $256 1.7×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $200.70 $223 3.3×
IV infusion hydration each additional hour (96361) $253.80 $282 5.3×
IV infusion hydration initial 31 min-1 hour (96360) $494.10 $549 2.3×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $270.90 $301 3.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $550.80 $612 2.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $213.30 $237 4.5×
IV push initial (96374) $288 $320 1.3×
Laryngeal Function Studies (92520) $239.40 $266 1.8×
Manual therapy 15 min (97140) $121.50 $135 4.4×
Massage 15 min (97124) $93.60 $104 3.1×
Mechanical chest wall oscillation (94669) $317.70 $353 1.4×
Mechanical traction (97012) $94.50 $105 6.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $66.60 $74 2.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $84.60 $94 2.3×
Methacholine challenge (94070) $450.45 $500.50 1.2×
Mnt Group Ea 30 Min (97804) $35.10 $39 2.1×
Motility study esophagus (91010) $1,109.70 $1,233 2.9×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $311.40 $346 3.4×
Multiple sleep latency test (95805) $1,903.50 $2,115 2.2×
Neg press wnd tx </=50 sq cm (97607) $45 $50 0.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $189.90 $211 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $57.60 $64 0.1×
Newborn resuscitation (99465) $634.50 $705 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $466.20 $518 3.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $658.80 $732 3.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $348.30 $387 2.6×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $124.20 $138 2.7×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $90 $100 2.8×
Ot Contrast Bath Ea 15 Min (97034) $70.20 $78 5.0×
Ot eval high complex 60 min (97167) $374.40 $416 3.7×
Ot eval low complex 30 min (97165) $277.20 $308 2.8×
Ot eval mod complex 45 min (97166) $334.80 $372 3.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $121.50 $135 2.4×
Ot re-eval est plan care (97168) $208.80 $232 3.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $282.60 $314 2.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $262.80 $292 2.0×
Paraffin bath (97018) $71.10 $79 11.8×
Phy/qhp op pulm rhb w/o mntr (94625) $232.20 $258 3.9×
Plethysmography (94726) $220.05 $244.50 0.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,535.30 $2,817 2.9×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $2,658.60 $2,954 3.0×
Psycl/Nrpsyc Tst Auto Result (96146) $234.90 $261 7.9×
Pt Aquatic Therapy/Exercises (97113) $235.80 $262 6.4×
Pt Electric Current Therapy (97033) $97.20 $108 5.1×
Pt Electrical Stimulation (97032) $89.10 $99 6.1×
Pt eval high complex 45 min (97163) $354.60 $394 3.6×
Pt eval low complex 20 min (97161) $234.90 $261 2.4×
Pt Gait Training Therapy (97116) $112.50 $125 3.9×
Pt Infrared Therapy (97026) $53.10 $59 7.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $116.10 $129 3.5×
Pt Physical Performance Test (97750) $117.90 $131 3.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $297.90 $331 3.0×
Pt re-evaluation (97164) $186.30 $207 2.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $120.60 $134 3.7×
Pt Ultrasound Therapy (97035) $89.10 $99 6.2×
Pulm function test by gas (94727) $308.70 $343 1.4×
Pulmonary stress testing (94618) $215.10 $239 1.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $241.20 $268 6.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $268.20 $298 1.3×
Rt Chest Wall Manipulation,Subsequent (94668) $183.60 $204 1.4×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $220.50 $245 4.6×
Sensory Integration Ea 15 Min (97533) $122.40 $136 2.0×
Sleep study unattended (95806) $351.45 $390.50 1.6×
Smoking cessation > 10 min (99407) $57.60 $64 1.5×
Speech sound lang comprehen (92523) $639.90 $711 2.8×
Spirometry (94010) $126.90 $141 0.6×
Stress echo (93350) $1,831.50 $2,035 3.3×
Stress Tte Complete (93351) $2,013.30 $2,237 3.6×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $123.30 $137 2.6×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $486.90 $541 2.2×
Temp transcutaneous pacing (92953) $919.80 $1,022 1.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $101.70 $113 4.5×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $109.80 $122 5.2×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $292.50 $325 2.9×
Ther/Proph/Diag Inj Sc/Im (96372) $87.75 $97.50 1.2×
Therapeutic Activities (97530) $126.90 $141 3.6×
Therapeutic phlebotomy (99195) $246.60 $274 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $36 $40 0.9×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,287.80 $2,542 4.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $297.90 $331 3.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $261 $290 3.1×
Tx/Pro/Dx Inj New Drug Addon (96375) $219.60 $244 4.6×
Unlisted Cardiovascular Service/Procedure (93799) $616.50 $685 4.7×
Unlisted pulmonary service/procedure (94799) $547.20 $608 4.2×
Vasc Duplex Extrem Venous,Bilat (93970) $1,337.40 $1,486 5.5×
Vasc Duplex Scan Extracranial,Limited (93882) $786.60 $874 7.4×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $982.80 $1,092 4.5×
Vasopneumatic device (97016) $108.90 $121 9.1×
Ventilation assist & mgmt inpatient 1st day (94002) $2,093.40 $2,326 3.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,116 $1,240 1.8×
Wheelchair Mgmt Ea 15 Min (97542) $108 $120 3.5×