Visits & medical services prices at UT Health East Texas Jacksonville Hospital

Jacksonville, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Aep hearing status deter broadband stimuli i&r (92651) $48.40 $484 0.2×
Airway inhalation treatment (94640) $48.20 $482 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $186.50 $1,865 0.5×
Car seat/bed test 60 min (94780) $12.80 $128 0.3×
Cardiac Stress Tst,Tracing Only (93017) $259 $2,590 1.2×
Cardiopulmonary resuscitation (92950) $160.80 $1,608 0.7×
Cardioversion (92960) $206.20 $2,062 0.3×
Caregiver training 1st 30 min (97550) $17.60 $176 0.3×
Cbt 1st hour (94644) $52.90 $529 0.4×
Chemo Iv Push Sngl Drug (96409) $109 $1,090 0.3×
Chemother, IV infusion, 1 hr (96413) $146.90 $1,469 0.4×
Chemother, IV infusion, ea add hr (96415) $54.70 $547 0.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $22.70 $227 0.3×
Color/duplex Doppler, complete (93975) $316.70 $3,167 1.3×
Color/duplex Doppler, limited (93976) $217.10 $2,171 2.1×
Cpap initiation and management (94660) $176.30 $1,763 0.8×
Cpt initial (94667) $40.10 $401 0.3×
Critical care (99291) $403 $4,030 0.5×
Debridement Open Wound 20 Sq Cm< (97597) $88.80 $888 0.4×
Demo &/or eval,pt use,aerosol device (94664) $79.40 $794 0.4×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $166.50 $1,665 0.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $123.90 $1,239 1.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $286.80 $2,868 1.2×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $181.90 $1,819 1.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $286.80 $2,868 1.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $181.90 $1,819 1.7×
Dup-scan xtr veins unilateral/limited study (93971) $190.20 $1,902 1.8×
Duplex hemodialysis access (93990) $40.70 $407 0.4×
Duplex scan extracranial art compl bi study (93880) $241.30 $2,413 1.0×
Echo Heart Xthoracic,Limited (93308) $109.90 $1,099 0.5×
Echo Transthoracic - Congenital Tte Complete (93303) $209.60 $2,096 0.4×
EEG awake asleep (95819) $249.90 $2,499 1.2×
EEG awake drowsy (95816) $225.30 $2,253 1.0×
Eeg Extended Monitoring 61-119 Minutes (95813) $275.90 $2,759 1.3×
EKG (93005) $85.50 $855 1.4×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $270.30 $2,703 1.2×
Er level 1 (99281) $29.90 $299 0.4×
Er level ii (99282) $50.60 $506 0.3×
Er level iii (99283) $147.10 $1,471 0.5×
Er level IV (99284) $243.40 $2,434 0.6×
Er level v (99285) $366.30 $3,663 0.6×
Evaluation of speech fluency (92521) $67.10 $671 0.5×
Evaluation of swallowing function (92610) $98.60 $986 1.2×
Exhaled air analysis o2 (94680) $48.10 $481 0.4×
External ECG rec>48hr<7d recording (93242) $19.40 $194 0.5×
External ECG rec>7d<15d recording (93246) $21 $210 0.6×
Group Therapeutic Procedures (97150) $6.30 $63 0.3×
Hemodialysis (90935) $222.60 $2,226 0.3×
Holter Monitor Recording (93225) $48.80 $488 0.4×
Immunization Admin (90471) $52.40 $272.50 0.7×
Immunotherapy, 2+ Injections (95117) $25.20 $252 0.5×
Injection intra arterial (96373) $67.10 $671 0.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $36.30 $363 0.6×
IV infusion hydration each additional hour (96361) $49.20 $492 1.0×
IV infusion hydration initial 31 min-1 hour (96360) $90.60 $906 0.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $37 $370 0.5×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $99.60 $996 0.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $49.70 $497 1.1×
IV push initial (96374) $79.10 $791 0.4×
Manual therapy 15 min (97140) $18.45 $184.50 0.7×
Massage 15 min (97124) $9.90 $99 0.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $6 $60 0.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $9.90 $99 0.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $112.70 $1,127 1.2×
Multiple sleep latency test (95805) $456.80 $4,568 0.5×
Neg press wnd tx </=50 sq cm (97607) $120.80 $1,208 0.3×
Neg press wound tx >50 cm (97608) $141 $1,410 0.3×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $73 $730 0.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $120.80 $1,208 0.3×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $79.80 $798 0.6×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $74.60 $746 0.6×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $10.40 $104 0.3×
Ot eval high complex 60 min (97167) $45.10 $451 0.4×
Ot eval low complex 30 min (97165) $34.50 $345 0.3×
Ot eval mod complex 45 min (97166) $46.30 $463 0.5×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $70.10 $701 0.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $669.60 $6,696 0.8×
Polysom <6 yrs 4/> paramtrs (95782) $709.40 $7,094 0.8×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $730.30 $7,303 0.8×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $25.20 $252 0.5×
Pt eval high complex 45 min (97163) $117.70 $1,177 1.2×
Pt eval low complex 20 min (97161) $42.90 $429 0.4×
Pt Gait Training Therapy (97116) $40.30 $403 1.4×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $12.30 $123 0.4×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $82.20 $822 0.8×
Pt re-evaluation (97164) $40.80 $408 0.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $25.60 $256 0.8×
Pulmonary stress testing (94618) $74 $740 0.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $14 $140 0.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $75.20 $752 0.4×
Rt Chest Wall Manipulation,Subsequent (94668) $40.10 $401 0.3×
Sc Ther Infusion Reset Pump (96371) $22.70 $227 0.3×
Sensory Integration Ea 15 Min (97533) $19.60 $196 0.3×
Sleep study unattended (95806) $52 $520 0.2×
Slp stdy unatnd w/min hrt rate/o2 sat/resp anal (95801) $41.80 $418 0.7×
Spirometry (94010) $48.20 $482 0.2×
Standardized Cognitive Performance Testing (96125) $70.90 $709 0.7×
Stress echo (93350) $180 $1,800 0.3×
Stress Tte Complete (93351) $213.70 $2,137 0.4×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $14.70 $147 0.3×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $67.10 $671 0.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $15.65 $156.50 0.7×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $15.50 $155 0.7×
Ther/Proph/Diag Inj Sc/Im (96372) $52.70 $527 0.7×
Therapeutic Activities (97530) $22.20 $222 0.6×
Therapeutic phlebotomy (99195) $160.90 $1,609 1.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $650.10 $6,501 1.2×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $190.40 $1,904 0.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $84.60 $846 1.1×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $47.70 $477 0.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $48.50 $485 1.0×
Unlisted pulmonary service/procedure (94799) $73.60 $736 0.6×
Vasc Duplex Extrem Venous,Bilat (93970) $287.30 $2,873 1.2×
Vasc Duplex Scan Extracranial,Limited (93882) $125 $1,250 1.2×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $135.90 $1,359 0.6×
Ventilation assist & mgmt inpatient 1st day (94002) $316 $3,160 0.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $316 $3,160 0.5×
Vital capacity total (94150) $21.50 $215 0.2×