Visits & medical services prices at Upson Regional Medical Center

Thomaston, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $201.60 $336 7.1×
Acupuncture 1/> ndls w/elec stimj 1st 15 min (97813) $286.20 $477 10.1×
Airway inhalation treatment (94640) $186.60 $311 0.9×
Analyze Neurostim Complex (95972) $1,057.80 $1,763 11.3×
Assessment of aphasia (96105) $684 $1,140 7.0×
Behavioral and qualitative analysis of voice and resonance (92524) $477 $795 4.4×
Bfb training 1st 15 min (90912) $412.20 $687 5.0×
Biofeedback training any modality (90901) $152.40 $254 3.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $1,615.20 $2,692 4.4×
Car seat/bed test 60 min (94780) $85.80 $143 2.3×
Cardiac Stress Tst,Tracing Only (93017) $1,450.20 $2,417 6.8×
Cardiopulmonary resuscitation (92950) $831.60 $1,386 3.9×
Cardioversion (92960) $1,720.80 $2,868 2.6×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $5,476.20 $9,127 1.7×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $5,475.60 $9,126 1.7×
Cath Perc Clos,Cong Interatrial Commun W/Impl (93580) $29,513.40 $49,189 1.6×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $8,029.80 $13,383 2.5×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $8,029.80 $13,383 2.5×
Cbt 1st hour (94644) $645 $1,075 4.9×
Chemo Hormon Antineopl Sq/Im (96402) $199.20 $332 2.8×
Chemo IV push addl drug (96411) $234.60 $391 3.3×
Chemo Iv Push Sngl Drug (96409) $322.20 $537 1.0×
Chemother, IV infusion, 1 hr (96413) $513 $855 1.6×
Chemother, IV infusion, ea add hr (96415) $294.60 $491 4.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $229.80 $383 3.2×
Color/duplex Doppler, complete (93975) $1,224.60 $2,041 5.2×
Color/duplex Doppler, limited (93976) $658.20 $1,097 6.4×
Coronary artery angio s&i (93454) $6,024 $10,040 1.9×
Cpap initiation and management (94660) $705 $1,175 3.3×
Cpt initial (94667) $129 $215 1.0×
Critical care (99291) $501 $835 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $465 $775 2.4×
Demo &/or eval,pt use,aerosol device (94664) $231.60 $386 1.1×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $556.80 $928 1.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,264.80 $2,108 5.4×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $758.40 $1,264 7.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $980.40 $1,634 4.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $616.20 $1,027 6.0×
Dup-scan xtr veins unilateral/limited study (93971) $643.20 $1,072 6.3×
Duplex hemodialysis access (93990) $256.20 $427 2.5×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $775.20 $1,292 7.5×
Duplex scan extracranial art compl bi study (93880) $1,237.20 $2,062 5.3×
Echo Heart Xthoracic,Limited (93308) $460.20 $767 2.0×
Echo transesophageal (93312) $2,672.40 $4,454 5.0×
Echo Transthoracic - Congenital Tte Complete (93303) $1,404.60 $2,341 2.6×
Echo Transthoracic - Congenital Tte Limited (93304) $1,404.60 $2,341 2.6×
EEG awake asleep (95819) $64.20 $107 0.3×
EEG cont rec w/video by tech min 8 channels (95700) $191.40 $319 0.9×
Eeg Extended Monitoring 61-119 Minutes (95813) $506.40 $844 2.4×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $191.40 $319 0.9×
EKG (93005) $389.40 $649 6.7×
Electroconvulsive Therapy (90870) $132 $220 0.2×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $64.20 $107 0.3×
EMG cranial nerve bilat (95868) $399.60 $666 1.9×
EMG four extremities (95864) $898.20 $1,497 7.1×
EMG one extremity (95860) $689.40 $1,149 5.3×
EMG three extremities (95863) $623.40 $1,039 4.9×
EMG two extremities (95861) $759 $1,265 5.8×
Er level 1 (99281) $474.60 $791 5.7×
Er level ii (99282) $657.60 $1,096 4.4×
Er level iii (99283) $1,335.60 $2,226 5.0×
Er level IV (99284) $1,669.20 $2,782 4.1×
Er level v (99285) $2,347.20 $3,912 4.0×
Evaluation of speech fluency (92521) $421.80 $703 3.2×
Evaluation of speech sound production (92522) $342 $570 3.1×
Evaluation of swallowing function (92610) $543.60 $906 6.4×
Evoked auditory test,limited (92587) $629.40 $1,049 3.0×
External ECG rec>48hr<7d recording (93242) $64.80 $108 1.8×
External ECG rec>7d<15d recording (93246) $106.80 $178 2.9×
External Ecg Scanning Analysis Report (93226) $453 $755 7.8×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $1,330.20 $2,217 3.6×
Group Therapeutic Procedures (97150) $108.60 $181 6.0×
Holter Monitor Recording (93225) $403.20 $672 3.1×
Icd Device Interrogate (93289) $432 $720 11.8×
Ilr Device Eval Progr (93285) $99 $165 2.7×
Immunization Admin (90471) $246 $410 3.5×
Inital newborn e/m (99460) $180 $300 1.4×
Initial normal newborn care, same day discharge (99463) $221.40 $369 1.7×
Ins swan ganz bedside (93503) $2,508.60 $4,181 1.6×
Interrog dev eval scrms phys/qhp in person (93291) $198.60 $331 7.0×
Interrogate subq defib (93261) $75.60 $126 2.1×
Interrogation eval in person wr defibrillator (93292) $268.20 $447 7.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $184.80 $308 3.2×
IV infusion hydration each additional hour (96361) $234.60 $391 5.1×
IV infusion hydration initial 31 min-1 hour (96360) $674.40 $1,124 3.2×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $229.20 $382 3.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $926.40 $1,544 4.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $234.60 $391 5.1×
IV push initial (96374) $370.20 $617 1.8×
Laryngeal Function Studies (92520) $868.20 $1,447 6.6×
Manual therapy 15 min (97140) $151.20 $252 5.5×
Massage 15 min (97124) $100.80 $168 3.4×
Measurement of heart blood flow and respiration (93701) $82.80 $138 0.6×
Mechanical traction (97012) $129.60 $216 9.0×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $704.40 $1,174 7.7×
Multiple sleep latency test (95805) $3,238.80 $5,398 3.8×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $265.20 $442 2.0×
Neg press wnd tx </=50 sq cm (97607) $927.60 $1,546 2.3×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $294.90 $491.50 1.5×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $287.40 $479 0.7×
Nerve conduction studies 13/> studies (95913) $702 $1,170 1.9×
Nerve Conduction Studies 3-4 Studies (95908) $362.10 $603.50 1.7×
Nerve Conduction Studies 9-10 Studies (95911) $634.50 $1,057.50 1.7×
Nerve conduction studies; 1-2 studies (95907) $362.10 $603.50 1.7×
Nerve conduction studies; 11-12 studies (95912) $702 $1,170 1.9×
Nerve conduction studies; 5-6 studies (95909) $384 $640 1.8×
Nerve conduction studies; 7-8 studies (95910) $384 $640 1.0×
Newborn resuscitation (99465) $375.30 $625.50 0.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $1,359.60 $2,266 10.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $2,400 $4,000 11.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $106.20 $177 2.3×
Ot eval high complex 60 min (97167) $355.80 $593 3.5×
Ot eval low complex 30 min (97165) $355.80 $593 3.5×
Ot eval mod complex 45 min (97166) $355.80 $593 3.5×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $92.40 $154 1.8×
Ot Prosthetic Training, Each 15 Min (97761) $76.20 $127 1.9×
Ot Range Motion Measure,Each Extrem (95851) $107.40 $179 4.1×
Ot re-eval est plan care (97168) $243 $405 3.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $315 $525 2.5×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $90 $150 0.7×
Paraffin bath (97018) $72.30 $120.50 12.0×
Perq Transcath Cls Mitral (93590) $29,513.40 $49,189 1.6×
Phy/qhp op pulm rhb w/o mntr (94625) $514.20 $857 8.9×
Plethysmography (94726) $1,501.20 $2,502 4.1×
Pm device eval in person (93288) $447.60 $746 12.2×
Pm device progr eval dual (93280) $101.40 $169 2.8×
Pm device progr eval sngl (93279) $117 $195 3.2×
Pm/Icd Remote Tech Serv (93296) $357.30 $595.50 9.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $7,021.20 $11,702 8.3×
Polysom <6 yrs 4/> paramtrs (95782) $3,274.80 $5,458 3.9×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $3,273.60 $5,456 3.9×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $75.60 $126 2.1×
Programming of dual lead implantable defibrillator system (93283) $149.40 $249 4.1×
Programming of single lead implantable defibrillator system (93282) $177 $295 4.8×
Prq balloon valvuloplasty aortic valve (92986) $9,371.40 $15,619 1.7×
Prq Card Stent W/Angio 1 Vsl (92928) $14,960.40 $24,934 1.3×
Prq Card Stent/Ath/Angio (92933) $28,010.40 $46,684 1.6×
Prq trluml coronary angio/atherect one art/brnch (92924) $19,101.60 $31,836 1.7×
Prq trluml coronary angioplasty one art/branch (92920) $8,227.80 $13,713 1.5×
Psych diag eval w/med srvcs (90792) $154.80 $258 0.9×
Psychiatric diagnostic evaluation (90791) $154.80 $258 0.9×
Pt Aquatic Therapy/Exercises (97113) $123.60 $206 3.3×
Pt Electric Current Therapy (97033) $117.60 $196 6.2×
Pt Electrical Stimulation (97032) $186.60 $311 12.7×
Pt eval high complex 45 min (97163) $245.10 $408.50 2.5×
Pt eval low complex 20 min (97161) $304.20 $507 3.1×
Pt Gait Training Therapy (97116) $115.80 $193 4.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $171 $285 5.2×
Pt Physical Performance Test (97750) $129 $215 3.8×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $245.10 $408.50 2.5×
Pt re-evaluation (97164) $194.40 $324 2.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $138.90 $231.50 4.3×
Pt Ultrasound Therapy (97035) $120.60 $201 8.4×
Pt Whirlpool Therapy (97022) $62.40 $104 4.0×
Pulm function test by gas (94727) $647.40 $1,079 3.0×
R & l hrt cath w/njx l ventriculog img s&i (93453) $8,144.40 $13,574 2.6×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $8,144.40 $13,574 2.6×
R hrt art/grft angio (93457) $5,475.60 $9,126 1.7×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $8,144.40 $13,574 2.6×
Refill/Maint Pump/Resvr Syst (96522) $456.60 $761 2.2×
Rem interrog icpms <30 d phys/qhp (93297) $48 $80 1.3×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $69.60 $116 1.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $312.30 $520.50 8.5×
Right heart cath (93451) $5,475.60 $9,126 1.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $519.30 $865.50 2.6×
Rom meas&reprt hand w/wo comparison normal sid (95852) $91.20 $152 4.3×
Rt Chest Wall Manipulation,Subsequent (94668) $139.20 $232 1.1×
Sensory Integration Ea 15 Min (97533) $98.40 $164 1.6×
Sleep study unattended (95806) $271.80 $453 1.3×
Smoking cessation > 10 min (99407) $55.80 $93 1.5×
Somatosensory testing (95938) $1,975.20 $3,292 2.3×
Speech group therapy (92508) $117 $195 4.9×
Speech sound lang comprehen (92523) $709.80 $1,183 3.1×
Spirometry (94010) $1,209 $2,015 5.7×
Standardized Cognitive Performance Testing (96125) $414.60 $691 4.0×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $266.40 $444 5.8×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $625.20 $1,042 3.0×
Surfactant Admin Thru Tube (94610) $377.40 $629 1.8×
Test for allergy using combination of methods with drug or biological (95018) $292.80 $488 8.0×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $153.60 $256 6.9×
Ther/Proph/Diag Inj Sc/Im (96372) $222 $370 3.1×
Therapeutic Activities (97530) $177.60 $296 5.1×
Therapeutic phlebotomy (99195) $491.40 $819 3.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $68.10 $113.50 1.8×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $43.20 $72 1.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,801.40 $4,669 5.2×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,438.80 $2,398 6.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $398.40 $664 5.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $321.60 $536 3.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $270.60 $451 5.9×
Unlisted Cardiovascular Service/Procedure (93799) $247.20 $412 2.0×
Unlisted pulmonary service/procedure (94799) $519 $865 4.1×
Vasc Duplex Extrem Venous,Bilat (93970) $1,159.20 $1,932 4.9×
Vasc Duplex Scan Extracranial,Limited (93882) $941.40 $1,569 9.2×
Vasopneumatic device (97016) $92.40 $154 7.7×
Veeg by tech 2-12 hours unmonitored (95711) $506.40 $844 2.4×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $933.60 $1,556 2.5×
Veeg by tech 2-12 hr intermittent monitoring (95712) $506.40 $844 1.4×
Ventilation assist & mgmt inpatient 1st day (94002) $676.20 $1,127 1.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $450.60 $751 0.7×
Vital capacity total (94150) $586.80 $978 4.6×
Wheelchair Mgmt Ea 15 Min (97542) $90.90 $151.50 2.9×