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.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $53.10 | $59 | 1.3× |
| Airway Inhalation Treatment (94640) | $268.20 | $298 | 1.2× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $89.10 | $99 | 6.2× |
| Application Modality 1/> Areas Infrared (97026) | $53.10 | $59 | 7.9× |
| Application on-body injector (96377) | $114.30 | $127 | 2.4× |
| Assessment of aphasia per hr (96105) | $405 | $450 | 4.2× |
| Behavral qualit analys voice (92524) range across 2 matching MRF lines |
$239.40–$425.70 | $266–$473 | varies |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$21.60–$532.80 | $24–$592 | varies |
| Canalith repositioning proc (95992) | $127.80 | $142 | 3.1× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,081.80 | $1,202 | 4.9× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$387.90–$1,131.30 | $431–$1,257 | varies |
| Cardioversion (92960) | $1,840.50 | $2,045 | 2.7× |
| Cbt 1st hour (94644) | $683.10 | $759 | 5.0× |
| Chemo Anti-Neopl Sq/Im (96401) | $277.20 | $308 | 3.8× |
| Chemo Hormon Antineopl Sq/Im (96402) | $226.80 | $252 | 3.1× |
| Chemo IV infusion addl hr (96415) | $284.40 | $316 | 3.9× |
| Chemo IV push addl drug (96411) | $336.60 | $374 | 4.6× |
| Chemother Prolong Infuse W/Pump (96416) | $718.20 | $798 | 2.1× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $317.70 | $353 | 4.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $727.20 | $808 | 2.2× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $441 | $490 | 1.3× |
| Chest Wall Manipulation (94668) | $183.60 | $204 | 1.4× |
| Color/duplex Doppler, complete (93975) | $859.50 | $955 | 3.5× |
| Color/duplex Doppler, limited (93976) | $726.30 | $807 | 6.8× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $90 | $100 | 2.8× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $403.20 | $448 | 3.0× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $177.30 | $197 | 2.9× |
| Continuous Pulse Ox (94762) | $348.30 | $387 | 2.6× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $811.80 | $902 | 3.6× |
| Cpt initial (94667) | $152.10 | $169 | 1.1× |
| Critical care first hour (99291) range across 2 matching MRF lines |
$747–$3,753 | $830–$4,170 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$75.60–$378 | $84–$420 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) range across 2 matching MRF lines |
$81–$1,148.40 | $90–$1,276 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) range across 2 matching MRF lines |
$49.50–$987.30 | $55–$1,097 | varies |
| 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 Xtr Veins Complete Bilateral Study (93970) | $1,337.40 | $1,486 | 5.5× |
| Dup-scan xtr veins unilateral/limited study (93971) | $793.80 | $882 | 7.4× |
| Duplex up extrem art bilat (93930) | $1,530 | $1,700 | 6.3× |
| Duplex up extrem art unilat/ltd (93931) | $48.60 | $54 | 0.5× |
| Echo Heart Xthoracic,Limited (93308) | $854.10 | $949 | 3.5× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $2,013.30 | $2,237 | 3.6× |
| EEG awake drowsy (95816) | $1,521.90 | $1,691 | 6.9× |
| Electrical Stimulation Ea 15 Min (97032) | $89.10 | $99 | 6.1× |
| Electrocardiogram Tracing (93005) | $312.30 | $347 | 5.2× |
| Emergency Dept Visit Level 2 (99282) | $118.80 | $132 | 0.8× |
| Emergency Dept Visit Level 3 (99283) | $244.80 | $272 | 0.9× |
| Emergency Dept Visit Level 4 (99284) | $362.70 | $403 | 0.9× |
| Er level 1 (99281) | $88.20 | $98 | 1.0× |
| Er level v (99285) | $594.90 | $661 | 1.0× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) range across 2 matching MRF lines |
$103.50–$2,399.40 | $115–$2,666 | varies |
| Evaluate pt use of inhaler (94664) | $188.10 | $209 | 0.8× |
| Evaluate Speech Production (92522) | $329.40 | $366 | 2.9× |
| Evaluate Swallowing Function (92610) | $347.40 | $386 | 4.1× |
| Evaluation of speech fluency (92521) | $304.20 | $338 | 2.3× |
| 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× |
| Extracranial Bilat Study (93880) | $1,242.90 | $1,381 | 5.1× |
| Extracranial Uni/Ltd Study (93882) | $786.60 | $874 | 7.4× |
| 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× |
| Immunization administration (90471) | $111.60 | $124 | 1.5× |
| Inital newborn e/m (99460) | $197.10 | $219 | 1.4× |
| Iontophoresis 15 min (97033) | $97.20 | $108 | 5.1× |
| Irrig Drug Delivery Device (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 ther proph addl sequential to 1 hr (96367) | $270.90 | $301 | 3.7× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $213.30 | $237 | 4.5× |
| IV push initial (96374) | $288 | $320 | 1.3× |
| Laryngeal Function Studies (92520) | $239.40 | $266 | 1.8× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $982.80 | $1,092 | 4.5× |
| Mechanical chest wall oscillation per session (94669) | $317.70 | $353 | 1.4× |
| 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× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $35.10 | $39 | 2.1× |
| Methacholine challenge (94070) range across 2 matching MRF lines |
$58.50–$842.40 | $65–$936 | varies |
| Motility study esophagus (91010) range across 2 matching MRF lines |
$136.80–$2,082.60 | $152–$2,314 | varies |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$198.90–$423.90 | $221–$471 | varies |
| Multiple Sleep Latency Test (95805) range across 2 matching MRF lines |
$121.50–$3,685.50 | $135–$4,095 | varies |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $45 | $50 | 0.1× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$53.10–$326.70 | $59–$363 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $57.60 | $64 | 0.1× |
| Neuromuscular Reeducation (97112) | $116.10 | $129 | 3.5× |
| Newborn resuscitation (99465) range across 2 matching MRF lines |
$301.50–$967.50 | $335–$1,075 | varies |
| Oral Function Therapy (92526) | $261 | $290 | 3.1× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $121.50 | $135 | 2.4× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $124.20 | $138 | 2.7× |
| Ot Contrast Bath Ea 15 Min (97034) | $70.20 | $78 | 5.0× |
| Ot eval high complexity (97167) | $374.40 | $416 | 3.7× |
| Ot Eval Low Complex (97165) | $277.20 | $308 | 2.8× |
| Ot Eval Moderate Complexity (97166) | $334.80 | $372 | 3.3× |
| Ot manual therapy 15 min (97140) | $121.50 | $135 | 4.4× |
| Ot paraffin bath (97018) | $71.10 | $79 | 11.8× |
| 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× |
| Phlebotomy therapeutic (99195) | $246.60 | $274 | 1.8× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $232.20 | $258 | 3.9× |
| Physical Performance Test (97750) | $117.90 | $131 | 3.5× |
| Plethysmography (94726) range across 2 matching MRF lines |
$25.20–$414.90 | $28–$461 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$261.90–$4,808.70 | $291–$5,343 | varies |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) range across 2 matching MRF lines |
$174.60–$5,142.60 | $194–$5,714 | varies |
| Psycl/Nrpsyc Tst Auto Result (96146) | $234.90 | $261 | 7.9× |
| Pt Eval High Complex (97163) | $354.60 | $394 | 3.6× |
| Pt eval low complex 20 min (97161) | $234.90 | $261 | 2.4× |
| Pt Eval Mod Complex (97162) | $297.90 | $331 | 3.0× |
| Pt gait training 15 min (97116) | $112.50 | $125 | 3.9× |
| Pt mechanical traction (97012) | $94.50 | $105 | 6.6× |
| Pt Re-Eval Est Plan Care (97164) | $186.30 | $207 | 2.8× |
| Pulm function test by gas (94727) | $308.70 | $343 | 1.4× |
| Pulmonary service/procedure (94799) | $547.20 | $608 | 4.2× |
| Pulmonary Stress Testing (94618) range across 2 matching MRF lines |
$46.80–$383.40 | $52–$426 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $241.20 | $268 | 6.3× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $173.70 | $193 | 2.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $268.20 | $298 | 1.3× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $354.60 | $394 | 2.9× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $220.50 | $245 | 4.6× |
| Same day nb discharge (99463) | $230.40 | $256 | 1.7× |
| Self Care Mngment Training (97535) | $120.60 | $134 | 3.7× |
| Sensory Integration Ea 15 Min (97533) | $122.40 | $136 | 2.0× |
| Sleep study unattended (95806) range across 2 matching MRF lines |
$93.60–$609.30 | $104–$677 | varies |
| Speech sound lang comprehen (92523) | $639.90 | $711 | 2.8× |
| Spirometry (94010) range across 2 matching MRF lines |
$17.10–$236.70 | $19–$263 | varies |
| Stress Tte Only (93350) | $1,831.50 | $2,035 | 3.3× |
| Subcutaneous Infusion Each Additional Hour (96370) | $123.30 | $137 | 2.6× |
| Subcutaneous infusion initial 1 hr w/pump set-up (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 Ea Addl 15 Min (97130) | $109.80 | $122 | 5.2× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $235.80 | $262 | 6.4× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $93.60 | $104 | 3.1× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $292.50 | $325 | 2.9× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$31.50–$144 | $35–$160 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $550.80 | $612 | 2.5× |
| Therapeutic Activities (97530) | $126.90 | $141 | 3.6× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $57.60 | $64 | 1.5× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $36 | $40 | 0.9× |
| Tte w/doppler, complete (93306) | $2,287.80 | $2,542 | 4.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $297.90 | $331 | 3.9× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $219.60 | $244 | 4.6× |
| Unlisted cardiovascular service/procedure (93799) range across 2 matching MRF lines |
$119.70–$1,113.30 | $133–$1,237 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $466.20 | $518 | 3.4× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $658.80 | $732 | 3.0× |
| Vasopneumatic device (97016) | $108.90 | $121 | 9.1× |
| Vent Mgmt Inpat Init 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× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.