Visits & medical services prices at Susan B Allen Memorial Hospital

El Dorado, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Aep Neurodiagnostic I&R (92653) $260 $400 1.3×
Airway inhalation treatment (94640) $242.78 $373.50 1.2×
Application of heat wave therapy (97024) $100.10 $154 13.6×
Behavioral and qualitative analysis of voice and resonance (92524) $197.60 $304 1.8×
Blink reflex test (95933) $78.65 $121 1.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $215.15 $331 0.6×
Cardiac Stress Tst,Tracing Only (93017) $480.35 $739 2.4×
Cardiopulmonary resuscitation (92950) $585 $900 2.9×
Cardioversion (92960) $857.02 $1,318.50 1.4×
Cbt 1st hour (94644) $180.70 $278 1.5×
Chemo IV push addl drug (96411) $100.75 $155 1.5×
Chemo Iv Push Sngl Drug (96409) $303.55 $467 1.0×
Chemother, IV infusion, 1 hr (96413) $372.45 $573 1.2×
Chemother, IV infusion, ea add hr (96415) $172.25 $265 2.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $121.55 $187 1.8×
Color/duplex Doppler, limited (93976) $520 $800 5.4×
Cpap initiation and management (94660) $772.85 $1,189 3.8×
Cpt initial (94667) $167.05 $257 1.4×
Critical care (99291) $1,105.32 $1,700.50 1.5×
Debridement Open Wound 20 Sq Cm< (97597) $323.05 $497 1.7×
Demo &/or eval,pt use,aerosol device (94664) $262.60 $404 1.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $449.15 $691 2.0×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $274.95 $423 2.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $675.35 $1,039 3.1×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $484.25 $745 5.0×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $671.45 $1,033 3.1×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $436.80 $672 4.5×
Dup-scan xtr veins unilateral/limited study (93971) $302.90 $466 3.1×
Duplex scan extracranial art compl bi study (93880) $633.10 $974 2.9×
Echo Heart Xthoracic,Limited (93308) $495.95 $763 2.3×
EEG awake asleep (95819) $449.15 $691 2.3×
EEG awake drowsy (95816) $500.50 $770 2.5×
EKG (93005) $91.65 $141 1.7×
EMG four extremities (95864) $252.20 $388 2.1×
EMG one extremity (95860) $219.70 $338 1.8×
EMG thoracic paraspinal (95869) $252.20 $388 1.3×
EMG three extremities (95863) $252.20 $388 2.1×
EMG two extremities (95861) $219.70 $338 1.8×
Er level 1 (99281) $135.85 $209 1.7×
Er level ii (99282) $225.55 $347 1.6×
Er level iii (99283) $359.45 $553 1.4×
Er level IV (99284) $538.85 $829 1.4×
Er level v (99285) $763.10 $1,174 1.4×
Evaluation of speech fluency (92521) $189.80 $292 1.4×
Evaluation of speech sound production (92522) $198.25 $305 1.8×
Evaluation of swallowing function (92610) $286.65 $441 3.4×
External ECG rec>48hr<7d recording (93242) $422.50 $650 12.3×
External ECG rec>7d<15d recording (93246) $567.45 $873 16.5×
External Ecg Scanning Analysis Report (93226) $175.50 $270 3.2×
Holter Monitor Recording (93225) $526.18 $809.50 4.3×
Immunization Admin (90471) $39.65 $61 0.6×
Injection intra arterial (96373) $303.55 $467 1.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $99.45 $153 1.8×
IV infusion hydration each additional hour (96361) $809.90 $1,246 18.8×
IV infusion hydration initial 31 min-1 hour (96360) $352.62 $542.50 1.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $138.45 $213 2.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $347.10 $534 1.8×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $115.70 $178 2.7×
IV push initial (96374) $340.60 $524 1.7×
Manual therapy 15 min (97140) $79.95 $123 2.9×
Maximum voluntary ventilation (94200) $215.80 $332 4.0×
Mechanical traction (97012) $55.25 $85 3.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $15.60 $24 0.5×
Motor &/sens nrv cndj preconf eltrd array limb (95905) $144.30 $222 0.4×
Multiple sleep latency test (95805) $2,018.25 $3,105 2.6×
Nerve conduction studies 13/> studies (95913) $721.50 $1,110 2.1×
Nerve Conduction Studies 3-4 Studies (95908) $205.40 $316 1.0×
Nerve Conduction Studies 9-10 Studies (95911) $507.65 $781 1.5×
Nerve conduction studies; 1-2 studies (95907) $183.30 $282 0.9×
Nerve conduction studies; 11-12 studies (95912) $612.30 $942 1.8×
Nerve conduction studies; 5-6 studies (95909) $304.20 $468 1.5×
Nerve conduction studies; 7-8 studies (95910) $404.30 $622 1.2×
Neuromuscular junction test (95937) $189.15 $291 1.6×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $588.90 $906 3.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $202.15 $311 1.7×
Nonphysician Telephone Assessment 11-20 Min (98967) $26 $40 1.0×
Nonphysician Telephone Assessment 21-30 Min (98968) $39 $60 1.1×
Nonphysician Telephone Assessment 5-10 Min (98966) $13 $20 0.9×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $137.80 $212 3.0×
Ot eval high complex 60 min (97167) $241.15 $371 2.4×
Ot eval low complex 30 min (97165) $167.70 $258 1.7×
Ot eval mod complex 45 min (97166) $204.75 $315 2.0×
Ot Prosthetic Training, Each 15 Min (97761) $129.35 $199 3.2×
Ot Range Motion Measure,Each Extrem (95851) $22.64 $34.83 0.9×
Ot re-eval est plan care (97168) $228.15 $351 3.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $139.75 $215 1.2×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $173.55 $267 1.5×
Plethysmography (94726) $260 $400 0.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,107.95 $3,243 2.7×
Pt Aquatic Therapy/Exercises (97113) $282.10 $434 7.6×
Pt Electric Current Therapy (97033) $74.75 $115 3.9×
Pt Electrical Stimulation (97032) $153.40 $236 10.4×
Pt eval high complex 45 min (97163) $241.15 $371 2.5×
Pt eval low complex 20 min (97161) $167.70 $258 1.7×
Pt Gait Training Therapy (97116) $59.80 $92 2.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $140.40 $216 4.3×
Pt Physical Performance Test (97750) $55.90 $86 1.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $204.75 $315 2.1×
Pt re-evaluation (97164) $152.10 $234 2.3×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $68.25 $105 2.1×
Pt Ultrasound Therapy (97035) $70.20 $108 4.9×
Pt Whirlpool Therapy (97022) $180.05 $277 11.5×
Refill/Maint Pump/Resvr Syst (96522) $707.20 $1,088 3.6×
Refill/maint, portable pump (96521) $707.20 $1,088 3.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $130.65 $201 3.8×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $279.50 $430 1.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $267.80 $412 1.4×
Rt Chest Wall Manipulation,Subsequent (94668) $98.15 $151 0.8×
Sc Ther Infusion Reset Pump (96371) $460.20 $708 6.9×
Speech sound lang comprehen (92523) $247.65 $381 1.1×
Spirometry (94010) $258.70 $398 1.3×
Standardized Cognitive Performance Testing (96125) $141.05 $217 1.4×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $113.10 $174 2.6×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $257.72 $396.50 1.3×
Temp transcutaneous pacing (92953) $812.50 $1,250 1.3×
Ther/Proph/Diag Inj Sc/Im (96372) $93.28 $143.50 1.4×
Therapeutic Activities (97530) $56.55 $87 1.6×
Therapeutic phlebotomy (99195) $132.92 $204.50 1.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,660.10 $2,554 3.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $156 $240 2.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $150.15 $231 1.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $118.30 $182 2.7×
Ultraviolet Light Therapy (96900) $32.50 $50 0.9×
Vasc Duplex Extrem Venous,Bilat (93970) $659.10 $1,014 3.0×
Ventilation assist & mgmt inpatient 1st day (94002) $1,226.55 $1,887 2.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,226.55 $1,887 2.2×
Wheelchair Mgmt Ea 15 Min (97542) $129.35 $199 4.2×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $484.25 $745 5.5×