Visits & medical services prices at South Big Horn County Hospital (Three Rivers Health)

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $108.68 $144.90 0.5×
Behavioral and qualitative analysis of voice and resonance (92524) $258.15 $344.20 2.4×
Cardiopulmonary resuscitation (92950) $1,038 $1,384 4.7×
Cardioversion (92960) $822.45 $1,096.60 1.2×
Chemo Hormon Antineopl Sq/Im (96402) $78.07 $104.10 1.1×
Chemo IV push addl drug (96411) $135.60 $180.80 1.8×
Chemo Iv Push Sngl Drug (96409) $248.70 $331.60 0.7×
Chemo prolong 8+ hrs infuse w/pump (96416) $316.42 $421.90 0.9×
Chemother, IV infusion, 1 hr (96413) $322.73 $430.30 1.0×
Chemother, IV infusion, ea add hr (96415) $68.55 $91.40 0.9×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $179.40 $239.20 2.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $157.05 $209.40 2.1×
Color/duplex Doppler, complete (93975) $350.10 $466.80 1.4×
Color/duplex Doppler, limited (93976) $421.80 $562.40 3.9×
Critical care (99291) $1,494.98 $1,993.30 1.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $610.05 $813.40 2.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $339.60 $452.80 3.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $657.22 $876.30 2.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $397.95 $530.60 3.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $657.22 $876.30 2.7×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $397.95 $530.60 3.7×
Dup-scan xtr veins unilateral/limited study (93971) $685.80 $914.40 6.4×
Duplex scan extracranial art compl bi study (93880) $564 $752 2.3×
Echo Heart Xthoracic,Limited (93308) $723.60 $964.80 3.0×
EKG (93005) $212.62 $283.50 3.5×
Er level 1 (99281) $236.77 $315.70 2.7×
Er level ii (99282) $369.30 $492.40 2.4×
Er level iii (99283) $615.79 $821.05 2.2×
Er level IV (99284) $1,055.25 $1,407 2.5×
Er level v (99285) $1,507.28 $2,009.70 2.5×
Evaluation of speech fluency (92521) $312.45 $416.60 2.3×
Evaluation of speech sound production (92522) $262.20 $349.60 2.3×
Evaluation of swallowing function (92610) $200.85 $267.80 2.4×
External ECG rec>48hr<7d recording (93242) $91.12 $121.50 2.4×
External ECG rec>7d<15d recording (93246) $91.12 $121.50 2.4×
Group Therapeutic Procedures (97150) $25.65 $34.20 1.4×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $39.08 $52.10 0.5×
Immunization Admin (90471) $43.65 $58.20 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $102.38 $136.50 1.7×
IV infusion hydration each additional hour (96361) $93.45 $124.60 2.0×
IV infusion hydration initial 31 min-1 hour (96360) $320.25 $427 1.5×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $160.73 $214.30 2.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $360.98 $481.30 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $128.55 $171.40 2.7×
IV push initial (96374) $174.15 $232.20 0.8×
Manual therapy 15 min (97140) $100.20 $133.60 3.6×
Massage 15 min (97124) $87.68 $116.90 2.9×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $215.92 $287.90 2.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $191.32 $255.10 1.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $297.38 $396.50 1.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $128.62 $171.50 2.8×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $78.53 $104.70 2.4×
Ot Contrast Bath Ea 15 Min (97034) $34.28 $45.70 2.4×
Ot eval high complex 60 min (97167) $209.62 $279.50 2.1×
Ot eval low complex 30 min (97165) $209.62 $279.50 2.1×
Ot eval mod complex 45 min (97166) $209.62 $279.50 2.1×
Ot Prosthetic Training, Each 15 Min (97761) $98.02 $130.70 2.4×
Paraffin bath (97018) $87.68 $116.90 14.6×
Pt Electric Current Therapy (97033) $113.78 $151.70 6.0×
Pt eval high complex 45 min (97163) $209.62 $279.50 2.1×
Pt eval low complex 20 min (97161) $209.62 $279.50 2.1×
Pt Gait Training Therapy (97116) $100.20 $133.60 3.4×
Pt Infrared Therapy (97026) $60.30 $80.40 9.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $107.02 $142.70 3.3×
Pt Physical Performance Test (97750) $138.90 $185.20 4.1×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $209.62 $279.50 2.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $101.32 $135.10 3.1×
Pt Ultrasound Therapy (97035) $79.65 $106.20 5.5×
Pt Whirlpool Therapy (97022) $103.57 $138.10 6.6×
Sensory Integration Ea 15 Min (97533) $117.22 $156.30 1.9×
Speech sound lang comprehen (92523) $898.80 $1,198.40 4.0×
Standardized Cognitive Performance Testing (96125) $243.82 $325.10 2.4×
Ther/Proph/Diag Inj Sc/Im (96372) $40.58 $54.10 0.6×
Therapeutic Activities (97530) $110.40 $147.20 3.1×
Therapeutic phlebotomy (99195) $66.15 $88.20 0.5×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,240.12 $1,653.50 2.2×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,240.12 $1,653.50 5.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $421.05 $561.40 5.5×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $200.10 $266.80 2.4×
Tx/Pro/Dx Inj New Drug Addon (96375) $154.12 $205.50 3.2×
Vasc Duplex Extrem Venous,Bilat (93970) $679.42 $905.90 2.8×
Vasc Duplex Scan Extracranial,Limited (93882) $382.50 $510 3.6×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $650.03 $866.70 2.9×
Vasopneumatic device (97016) $95.62 $127.50 8.0×
Wheelchair Mgmt Ea 15 Min (97542) $74.78 $99.70 2.4×
Xtrnl mobile cv telemetry w/technical support (93229) $253.35 $337.80 0.7×