Visits & medical services prices at Sullivan County Memorial Hospital

Milan, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $204 $204 0.9×
Behavioral and qualitative analysis of voice and resonance (92524) $200 $200 1.8×
Canalith Repositioning (95992) $83 $83 2.0×
Cardiopulmonary resuscitation (92950) $840 $840 3.9×
Cardioversion (92960) $522 $522 0.8×
Cardioversion internal (92961) $1,764 $1,764 2.7×
Color/duplex Doppler, complete (93975) $380 $380 1.6×
Color/duplex Doppler, limited (93976) $190 $190 1.8×
Cpt initial (94667) $92 $92 0.7×
Critical care (99291) $1,591.50 $1,591.50 1.9×
Demo &/or eval,pt use,aerosol device (94664) $204 $204 0.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $355 $355 1.5×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $215 $215 2.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $355 $355 1.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $215 $215 2.1×
Dup-scan xtr veins unilateral/limited study (93971) $460 $460 4.4×
Duplex scan extracranial art compl bi study (93880) $380 $380 1.6×
Echo Transthoracic - Congenital Tte Limited (93304) $665 $665 1.2×
EKG (93005) $115 $115 1.9×
Er level 1 (99281) $225 $225 2.7×
Er level ii (99282) $419 $419 2.7×
Er level iii (99283) $735 $735 2.7×
Er level IV (99284) $1,145 $1,145 2.7×
Er level v (99285) $1,644 $1,644 2.8×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $200 $200 2.8×
Evaluation of speech sound production (92522) $200 $200 1.8×
Evaluation of swallowing function (92610) $200 $200 2.4×
External ECG rec>48hr<7d recording (93242) $50 $50 1.3×
External ECG rec>7d<15d recording (93246) $50 $50 1.3×
Filtered Speech Test (92571) $90 $90 2.4×
Immunization Admin (90471) $70 $70 1.0×
Injection intra arterial (96373) $620 $620 2.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $86 $86 1.5×
IV infusion hydration each additional hour (96361) $54 $54 1.2×
IV infusion hydration initial 31 min-1 hour (96360) $205 $205 1.0×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $96 $96 1.3×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $205 $205 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $68 $68 1.4×
IV push initial (96374) $205 $205 1.0×
Manual therapy 15 min (97140) $55 $55 2.0×
Massage 15 min (97124) $45 $45 1.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $30 $30 0.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $40 $40 1.1×
Mnt Group Ea 30 Min (97804) $16 $16 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $285 $285 2.1×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $86 $86 0.7×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $55 $55 1.7×
Ot eval high complex 60 min (97167) $240 $240 2.4×
Ot eval low complex 30 min (97165) $160 $160 1.6×
Ot eval mod complex 45 min (97166) $200 $200 2.0×
Ot re-eval est plan care (97168) $125 $125 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $132 $132 1.0×
Pt Electric Current Therapy (97033) $50 $50 2.6×
Pt Electrical Stimulation (97032) $50 $50 3.4×
Pt eval high complex 45 min (97163) $200 $200 2.0×
Pt eval low complex 20 min (97161) $150 $150 1.5×
Pt Gait Training Therapy (97116) $45 $45 1.5×
Pt Infrared Therapy (97026) $25 $25 3.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $90 $90 2.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $160 $160 1.6×
Pt re-evaluation (97164) $125 $125 1.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $60 $60 1.9×
Pt Ultrasound Therapy (97035) $50 $50 3.5×
Rt Chest Wall Manipulation,Subsequent (94668) $89 $89 0.7×
Speech sound lang comprehen (92523) $360 $360 1.6×
Temp transcutaneous pacing (92953) $1,764 $1,764 2.7×
Ther/Proph/Diag Inj Sc/Im (96372) $70 $70 1.0×
Therapeutic Activities (97530) $55 $55 1.6×
Therapeutic phlebotomy (99195) $261 $261 2.0×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $985 $985 1.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $200 $200 2.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $200 $200 2.4×
Tx/Pro/Dx Inj New Drug Addon (96375) $78 $78 1.7×
Tympanometry (92567) $102 $102 2.7×
Vasc Duplex Extrem Venous,Bilat (93970) $690 $690 2.9×
Vital capacity total (94150) $54 $54 0.4×
Wheelchair Mgmt Ea 15 Min (97542) $60 $60 1.9×