Visits & medical services prices at Summit Pacific Medical Center

Elma, WA · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) — $240 —
Admn Sarscov2 Vacc 1 Dose (90480) — $44 —
Advncd Care Plan 30 Min (99497) — $286 —
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines
— $76–$364 —
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) — $76 —
Arrhythmia Induction (93618) — $1,267 —
Assessment of aphasia per hr (96105) — $341 —
Behavral qualit analys voice (92524) — $312 —
Brief Emotional/Behav Assmt (96127) — $21 —
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) — $245 —
Canalith repositioning proc (95992) — $137 —
Cardiac Stress Tst,Tracing Only (93017) — $587 —
Cardiopulmonary resuscitation (92950)
range across 3 matching MRF lines
— $1,347–$3,556 —
Cardioversion (92960)
range across 3 matching MRF lines
— $645–$1,835 —
Care mgmt services behavioral hlth cond 20 mins (99484) — $87 —
Caregiver hlth risk assmt score doc stnd instrm (96161) — $19 —
Cbt 1st hour (94644) — $1,241 —
Chemo IV infusion addl hr (96415) — $125 —
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) — $568 —
Chemotx admn IV push tq 1/1st sbst/drug (96409) — $422 —
Chest Wall Manipulation (94668) — $4,238 —
Chron Care Mgmt Srvc 20 Min (99490) — $128 —
Color/duplex Doppler, complete (93975) — $1,877 —
Color/duplex Doppler, limited (93976) — $1,594 —
Complex chronic care mgmt svc 1st 60 min cal mo (99487) — $142 —
Cpap Ventilation Cpap Initiation&Mgmt (94660) — $191 —
Cpt initial (94667) — $489 —
Critical care first hour (99291)
range across 3 matching MRF lines
— $1,591–$4,172 —
Debridement Open Wound 20 Sq Cm< (97597)
range across 6 matching MRF lines
— $86–$696 —
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) — $1,875 —
Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) — $1,174 —
Dup-scan lxtr art/artl bpgs compl bi study (93925) — $1,626 —
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) — $1,498 —
Dup-Scan Xtr Veins Complete Bilateral Study (93970) — $1,928 —
Dup-scan xtr veins unilateral/limited study (93971) — $1,178 —
Duplex up extrem art bilat (93930) — $1,393 —
Duplex up extrem art unilat/ltd (93931) — $990 —
Echo Heart Xthoracic,Limited (93308)
range across 3 matching MRF lines
— $614–$1,747 —
Echo transesophageal (93312)
range across 2 matching MRF lines
— $1,601–$4,555 —
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351)
range across 2 matching MRF lines
— $1,418–$4,033 —
Electrical Stimulation Ea 15 Min (97032) — $82 —
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines
— $38–$89.50 —
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
— $299–$776 —
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines
— $444–$1,159 —
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines
— $838–$2,196 —
Er level 1 (99281)
range across 2 matching MRF lines
— $154–$399 —
Er level v (99285)
range across 2 matching MRF lines
— $1,238–$3,240 —
Evaluate pt use of inhaler (94664) — $65 —
Evaluate Speech Production (92522) — $327 —
Evaluate Swallowing Function (92610) — $256 —
Evaluation of speech fluency (92521) — $397 —
External ECG rec>48hr<7d recording (93242) — $61 —
External ECG rec>7d<15d recording (93246) — $61 —
Extracranial Bilat Study (93880) — $1,977 —
Im Adm Intransl/Oral 1 Vaccine (90473) — $23 —
Immunization administration (90471)
range across 8 matching MRF lines
— $23–$47 —
Inital newborn e/m (99460) — $350 —
Interrogate Subq Defib (93261)
range across 3 matching MRF lines
— $105–$902 —
Irrig Drug Delivery Device (96523) — $277 —
IV infusion hydration each additional hour (96361)
range across 2 matching MRF lines
— $171–$289 —
IV infusion hydration initial 31 min-1 hour (96360)
range across 2 matching MRF lines
— $631–$1,067 —
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines
— $337–$572 —
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines
— $210–$354 —
IV push initial (96374)
range across 2 matching MRF lines
— $627–$1,060 —
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) — $102 —
Medical nutrition assmt&ivntj indiv each 15 mi (97802) — $111 —
Motion Fluoroscopy/Swallow (92611) — $353 —
Multiple Sleep Latency Test (95805)
range across 2 matching MRF lines
— $1,635–$3,281 —
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines
— $181–$701 —
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608)
range across 2 matching MRF lines
— $217–$814 —
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 3 matching MRF lines
— $106–$428 —
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606)
range across 2 matching MRF lines
— $150–$536 —
Neuromuscular Reeducation (97112) — $120 —
Nonphysician Telephone Assessment 11-20 Min (98967) — $72 —
Nonphysician Telephone Assessment 21-30 Min (98968) — $107 —
Nonphysician Telephone Assessment 5-10 Min (98966) — $38 —
Oral Function Therapy (92526) — $302 —
Orthc/Prostc Mgmt Sbsq Enc (97763) — $137 —
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) — $134 —
Osteopathic Manipulative Tx 1-2 Body Regions (98925) — $87 —
Osteopathic manipulative tx 3-4 body regions (98926) — $133 —
Osteopathic manipulative tx 5-6 body regions (98927) — $174 —
Ot eval high complexity (97167) — $276 —
Ot Eval Low Complex (97165) — $289 —
Ot Eval Moderate Complexity (97166) — $276 —
Ot manual therapy 15 min (97140) — $107 —
Ot Re-Eval Est Plan Care (97168) — $171 —
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) — $322 —
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) — $260 —
Phlebotomy therapeutic (99195) — $720 —
Pm device eval in person (93288)
range across 3 matching MRF lines
— $61–$549 —
Pm device progr eval dual (93280)
range across 3 matching MRF lines
— $109–$866 —
Pm device progr eval multi (93281)
range across 3 matching MRF lines
— $127–$1,013 —
Pm Device Progr Eval Sngl (93279)
range across 3 matching MRF lines
— $93–$740 —
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811)
range across 2 matching MRF lines
— $1,635–$3,281 —
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) — $142 —
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) — $44 —
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) — $114 —
Psych diag eval w/med srvcs (90792) — $508 —
Psychiatric diagnostic evaluation (90791) — $360 —
Psychoanalysis (90845) — $296 —
Psytx Crisis Initial 60 Min (90839) — $401 —
Pt Eval High Complex (97163) — $262 —
Pt eval low complex 20 min (97161) — $262 —
Pt Eval Mod Complex (97162) — $262 —
Pt gait training 15 min (97116) — $102 —
Pt mechanical traction (97012) — $73 —
Pt Re-Eval Est Plan Care (97164) — $148 —
Pt-focused hlth risk assmt score doc stnd instrm (96160) — $19 —
Pulmonary Stress Testing (94618) — $70 —
Pure Tone Audiometry Air (92552) — $115 —
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 4 matching MRF lines
— $103–$383 —
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) — $558 —
Same day nb discharge (99463) — $300 —
Sbsq Psyc Collab Care Mgmt (99493) — $216 —
Self Care Mngment Training (97535) — $124 —
Sleep study unattended (95806)
range across 2 matching MRF lines
— $644–$1,240 —
Slp caregiver training 1st 30 min (97550) — $111 —
Speech sound lang comprehen (92523) — $608 —
Spirometry (94010) — $133 —
Standardized Cognitive Performance Testing (96125) — $386 —
Stress Tte Only (93350)
range across 2 matching MRF lines
— $1,261–$3,585 —
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) — $85 —
Ther Ivntj Ea Addl 15 Min (97130) — $83 —
Ther Px 1/> Areas Each 15 Minutes Massage (97124) — $89 —
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) — $360 —
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines
— $101–$471 —
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines
— $763–$1,292 —
Therapeutic Activities (97530) — $123 —
Tobacco Use Cessation Intensive >10 Minutes (99407) — $74 —
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines
— $44–$47 —
Trans Care Mgmt 14 Day Disch (99495) — $399 —
Trans Care Mgmt 7 Day Disch (99496) — $575 —
Tte w/doppler, complete (93306)
range across 2 matching MRF lines
— $1,093–$3,188 —
Tte W/O Doppler Complete (93307)
range across 2 matching MRF lines
— $682–$1,941 —
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) — $277 —
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) — $198 —
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines
— $248–$421 —
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines
— $324–$861 —
Upr/Lxtr Art Stdy 3+ Lvls (93923) — $1,330 —
Vent Mgmt Inpat Init Day (94002) — $1,880 —
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) — $1,324 —
Vital capacity, total (94150) — $181 —
Wheelchair Mgmt Ea 15 Min (97542) — $111 —

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.