Visits & medical services prices at Upper Connecticut Valley Hospital

Colebrook, NH · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $75.48 $136 5.3×
Assessment of aphasia per hr (96105) $242.54 $437 2.5×
Bedside Swallowing Eval (92610) $215.90 $389 2.5×
Behavioral and qualitative analysis of voice and resonance (92524) $251.42 $453 2.3×
Chemother, IV infusion, 1 hr (96413) $634.37 $1,143 1.8×
Chemother, IV infusion, ea add hr (96415) $144.30 $260 1.9×
Critical care (99291) $2,076.81 $3,742 2.4×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $997.89 $1,798 3.9×
Dup-scan xtr veins unilateral/limited study (93971) $820.29 $1,478 7.3×
Duplex scan extracranial art compl bi study (93880) $779.78 $1,405 3.1×
Electrocardiogram Tracing (93005) $182.60 $329 2.9×
Er level 1 (99281) $138.20 $249 1.5×
Er level ii (99282) $249.75 $450 1.5×
Er level iii (99283) $440.67 $794 1.5×
Er level IV (99284) $693.20 $1,249 1.6×
Er level v (99285) $995.12 $1,793 1.6×
External ECG rec>48hr<7d recording (93242) $252.53 $455 6.3×
External ECG rec>7d<15d recording (93246) $252.53 $455 6.3×
Immunization Admin (90471) $29.98 $54 0.4×
Irrig drug delivery device (96523) $121.55 $219 1.9×
IV infusion hydration each additional hour (96361) $202.58 $365 4.1×
IV infusion hydration initial 31 min-1 hour (96360) $259.19 $467 1.1×
IV infusion ther proph addl sequential to 1 hr (96367) $139.31 $251 1.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $341.88 $616 1.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $113.22 $204 2.3×
IV push ea addl new drug (96375) $127.38 $229.50 2.5×
IV push initial (96374) $189.26 $341 0.8×
Manual therapy 15 min (97140) $97.12 $175 3.5×
Massage 15 min (97124) $45.51 $82 1.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $35.52 $64 1.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $37.74 $68 1.0×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $397.38 $716 2.8×
Ot eval high complex 60 min (97167) $272.51 $491 2.7×
Ot eval low complex 30 min (97165) $213.68 $385 2.1×
Ot eval mod complex 45 min (97166) $240.87 $434 2.4×
Ot therapeutic activity 15 min (97530) $95.74 $172.50 2.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $165.95 $299 1.2×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $127.65 $230 0.9×
Phlebotomy therapeutic (99195) $181.49 $327 1.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $22.20 $40 0.4×
Pt Electrical Stimulation (97032) $70.49 $127 4.8×
Pt eval high complex 45 min (97163) $272.51 $491 2.8×
Pt eval low complex 20 min (97161) $213.68 $385 2.2×
Pt eval mod complex 30 min (97162) $240.87 $434 2.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $98.24 $177 3.0×
Pt re-evaluation (97164) $117.11 $211 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $89.91 $162 2.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $61.05 $110 2.7×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $56.06 $101 2.7×
Therapeutic prophylactic/dx injection subq/im (96372) $80.20 $144.50 1.0×
Tte w/doppler, complete (93306) $1,523.48 $2,745 2.6×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $198.14 $357 2.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $173.72 $313 2.1×