Visits & medical services prices at UT Health San Antonio Multispecialty & Research Ho

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

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

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ProcedurePosted cashPosted gross× Medicare
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $290.40 $484 2.2×
Actinotherapy Ultraviolet Light (96900) $22.80 $38 0.6×
Admn Sarscov2 Vacc 1 Dose (90480) $76.20 $127 1.9×
Advncd Care Plan 30 Min (99497) $166.20 $277 1.6×
Airway Inhalation Treatment (94640) $396.60 $661 1.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $237.60 $396 1.8×
Analysis w/prgrmg aud brainstem implant pr hr (92640) $290.40 $484 2.2×
Analyze neurostim complex (95972) $180 $300 1.9×
Analyze neurostim no prog (95970) $237.60 $396 1.8×
Analyze Neurostim Simple (95971) $180 $300 1.9×
Anrct mano rct sensation&rct balo expulsion test (91125) $697.20 $1,162 1.9×
Ant sgm imaging w/microscopy endothelial analy (92286) $237.60 $396 1.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $27 $45 1.9×
Application on-body injector (96377) $88.80 $148 1.9×
Assessment of aphasia per hr (96105) $183 $305 1.9×
Assmt & care planning pt w/cognitive impairment (99483) $166.20 $277 1.6×
Audiometry Air & Bone (92553) $290.40 $484 2.2×
Basic vestibular evaluation (92540) $290.40 $484 1.3×
Behavral qualit analys voice (92524) $208.80 $348 1.9×
Biofeedback training any modality (90901) $40.20 $67 1.0×
Bis Xtracell Fluid Analysis (93702) $290.40 $484 2.2×
Blink reflex test (95933) $114 $190 1.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $583.20 $972 1.6×
Caloric vestibular test w/rec bi monothermal (92538) $290.40 $484 1.3×
Caloric Vstblr Test W/Rec (92537) $290.40 $484 2.2×
Canalith repositioning proc (95992) $60 $100 1.5×
Cardiac Stress Tst,Tracing Only (93017) $583.20 $972 2.7×
Cardiopulmonary resuscitation (92950) $583.20 $972 2.7×
Cardioversion (92960) $1,209.60 $2,016 1.8×
Cbt 1st hour (94644) $237.60 $396 1.8×
Chemo Admin Peritoneal Cavity (96446) $629.40 $1,049 1.9×
Chemo Anti-Neopl Sq/Im (96401) $131.40 $219 1.8×
Chemo Hormon Antineopl Sq/Im (96402) $131.40 $219 1.8×
Chemo Ia Push (96420) $629.40 $1,049 1.9×
Chemo Intralesional Over 7 (96406) $398.40 $664 1.9×
Chemo intralesional up to 7 (96405) $131.40 $219 1.8×
Chemo IV infusion addl hr (96415) $131.40 $219 1.8×
Chemo IV push addl drug (96411) $131.40 $219 1.8×
Chemother Prolong Infuse W/Pump (96416) $629.40 $1,049 1.9×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $629.40 $1,049 1.9×
Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) $88.80 $148 1.9×
Chemotherapy Into Cns (96450) $629.40 $1,049 1.9×
Chemotherapy Intracavitary (96440) $629.40 $1,049 1.9×
Chemotherapy Unspecified (96549) $88.80 $148 1.9×
Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) $629.40 $1,049 1.9×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $131.40 $219 1.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $629.40 $1,049 1.9×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $629.40 $1,049 1.9×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $629.40 $1,049 1.9×
Chest Wall Manipulation (94668) $237.60 $396 1.8×
Chron Care Mgmt Srvc 20 Min (99490) $166.20 $277 1.6×
Cmptr ophth dx img ant segmt (92132) $114 $190 1.9×
Color/duplex Doppler, complete (93975) $455.40 $759 1.9×
Color/duplex Doppler, limited (93976) $204.60 $341 1.9×
Community/Work Reintegration Trainj Ea 15 Min (97537) $60 $100 1.9×
Comprehensive Hearing Test (92557) $290.40 $484 2.2×
Computerized dynamic posturography (92548) $237.60 $396 1.8×
Computerized Ophthalmic Imaging Optic Nerve (92133) $114 $190 1.9×
Computerized Ophthalmic Imaging Retina (92134) $114 $190 1.9×
Cont gluc mntr physician/qhp provided equiptment (95250) $235.80 $393 1.8×
Contact Lens Fit,Corneoscleral Lens (92313) $237.60 $396 1.8×
Continuous Pulse Ox (94762) $290.40 $484 2.2×
Cornea hysteresis determin impulse stimj uni/bi (92145) $114 $190 1.9×
Corneal Topography (92025) $114 $190 1.9×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $396.60 $661 1.8×
Cpt initial (94667) $237.60 $396 1.8×
Cptrizd oph dx img pst sgm uni/bi rta oct angrph (92137) $403.80 $673 1.9×
Critical care first hour (99291) $1,648.80 $2,748 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $372 $620 1.8×
Dialysis One Evaluation (90945)
range across 5 matching MRF lines
$823.20–$3,000 $1,372–$5,000 varies
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $583.20 $972 1.6×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $455.40 $759 1.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $204.60 $341 1.9×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $455.40 $759 1.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $204.60 $341 1.9×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $455.40 $759 1.9×
Dup-scan xtr veins unilateral/limited study (93971) $204.60 $341 1.9×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $455.40 $759 1.9×
Duplex Scan Hemodialysis Access (93990) $204.60 $341 1.9×
Duplex up extrem art bilat (93930) $455.40 $759 1.9×
Duplex up extrem art unilat/ltd (93931) $204.60 $341 1.9×
Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) $290.40 $484 2.2×
Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) $290.40 $484 2.2×
Echo Congenital Complete (93303) $1,014 $1,690 1.8×
Echo Heart Xthoracic,Limited (93308) $455.40 $759 1.9×
Echo transesophageal (93312) $1,025.40 $1,709 1.9×
Echo Transesophageal - Congenital Tee Complete (93315) $1,025.40 $1,709 1.9×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,002.60 $1,671 1.8×
Ecog Implanted Brain Npgt W/Rec I&R <30 Days (95836) $70.20 $117 1.9×
Eeg 41-60 Minutes (95812) $583.20 $972 2.7×
EEG awake and asleep (95819) $569.40 $949 2.6×
EEG awake drowsy (95816) $569.40 $949 2.6×
EEG cerebral death evaluation (95824) $697.20 $1,162 1.9×
EEG cont rec w/video by tech min 8 channels (95700) $286.20 $477 1.3×
EEG extended monitoring 61-119 minutes (95813) $583.20 $972 2.7×
Eeg Sleep Only (95822) $403.80 $673 1.9×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $403.80 $673 1.9×
EEG wo vid ea 12-26hr unmntr (95708) $697.20 $1,162 1.9×
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $180 $300 1.9×
Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) $180 $300 1.9×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $70.20 $117 1.9×
Electrical Stimulation Ea 15 Min (97032) $27.60 $46 1.9×
Electro-Oculography (92270) $235.80 $393 1.8×
Electrocardiogram Tracing (93005) $114 $190 1.9×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $290.40 $484 2.2×
Evaluate pt use of inhaler (94664) $396.60 $661 1.8×
Evaluate Speech Production (92522) $211.80 $353 1.9×
Evaluate Swallowing Function (92610) $133.80 $223 1.6×
Evaluation of speech fluency (92521) $253.20 $422 1.9×
Evoked Auditory Test,Limited (92587) $583.20 $972 2.7×
External ECG rec>48hr<7d recording (93242) $75 $125 2.0×
External ECG rec>48hr<7d scanning alys w/report (93243) $237.60 $396 1.8×
External ECG rec>7d<15d recording (93246) $75 $125 2.0×
External ECG rec>7d<15d scanning alys w/report (93247) $237.60 $396 1.8×
External Ecg Scanning Analysis Report (93226) $114 $190 1.9×
Extracranial Bilat Study (93880) $455.40 $759 1.9×
Extracranial Uni/Ltd Study (93882) $204.60 $341 1.9×
F-up/limited tthrc echo congenital car anomaly (93304) $1,014 $1,690 1.8×
Flexible endoscopic eval swallow c/v rec (92612) $125.40 $209 0.6×
Flexible ndsc eval swlng&laryn sens c/v rec (92616) $183.60 $306 0.8×
Fluorescein angiography (92235) $583.20 $972 2.7×
Fluorescein Icg Angrph W/Multiframe I&R Uni/Bi (92242) $583.20 $972 2.7×
Full Field Electroretinography W/I&R (92273) $583.20 $972 2.7×
Fundus photography (92250) $237.60 $396 1.8×
Gi tract capsule endoscopy (91110) $1,684.20 $2,807 1.8×
Gonioscopy (92020) $237.60 $396 1.8×
Group Therapeutic Procedures (97150) $34.20 $57 1.9×
Health Behavior Assessment/Re-Assessment (96156) $166.20 $277 1.6×
Health behavior ivntj group f2f 1st 30 min (96164) $70.20 $117 1.9×
Health behavior ivntj indiv f2f 1st 30 min (96158) $296.40 $494 1.7×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $1,298.40 $2,164 1.9×
Holter monitor recording (93225) $237.60 $396 1.8×
Icd Device Interrogate (93289) $70.20 $117 1.9×
Icd device progr eval dual (93283) $70.20 $117 1.9×
Icd Device Progr Eval Mult (93284) $70.20 $117 1.9×
Icm Device Eval (93290) $70.20 $117 1.9×
Ilr Device Eval Progr (93285) $70.20 $117 1.9×
Ilr Device Interrogate (93291) $55.80 $93 1.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $131.40 $219 1.8×
Immunization administration (90471) $131.40 $219 1.8×
Indocyanine-green angrph w/multiframe i&r uni/bi (92240) $583.20 $972 2.7×
Interrogate Subq Defib (93261) $70.20 $117 1.9×
Intracranial Complete Study (93886) $455.40 $759 1.9×
Io anal gast n-stim subsq (95981) $114 $190 1.9×
Io ga n-stim subsq w/reprog (95982) $70.20 $117 1.9×
Iontophoresis 15 min (97033) $36.60 $61 1.9×
Irrig Drug Delivery Device (96523) $114 $190 1.9×
IV infusion hydration each additional hour (96361) $88.80 $148 1.9×
IV infusion hydration initial 31 min-1 hour (96360) $398.40 $664 1.9×
IV infusion ther proph addl sequential to 1 hr (96367) $131.40 $219 1.8×
IV infusion therapy prophylaxis/dx ea hour (96366) $88.80 $148 1.9×
IV push initial (96374) $398.40 $664 1.9×
Laryngeal Function Studies (92520) $237.60 $396 1.8×
Mechanical chest wall oscillation per session (94669) $396.60 $661 1.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $51.60 $86 1.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $60.60 $101 1.6×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $29.40 $49 1.7×
Motility study esophagus (91010) $697.20 $1,162 1.9×
Motion Fluoroscopy/Swallow (92611) $168.60 $281 1.8×
Multifocal Electroretinography W/I&R (92274) $290.40 $484 2.2×
Muscle Test Nonparaspinal (95870) $237.60 $396 1.8×
Muscle Test One Limb (95860) $235.80 $393 1.8×
Nasopharyngoscopy (92511) $368.40 $614 1.8×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $403.80 $673 1.9×
Needle EMG w/1 fiber electrode quan meas jitter (95872) $290.40 $484 1.3×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $741 $1,235 1.8×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $741 $1,235 1.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $372 $620 1.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $741 $1,235 1.8×
Nerve Conduction Studies 1-2 Studies (95907) $290.40 $484 1.3×
Nerve Conduction Studies 11-12 Studies (95912) $996 $1,660 2.7×
Nerve conduction studies 13 or more studies (95913) $996 $1,660 2.7×
Nerve Conduction Studies 3-4 Studies (95908) $583.20 $972 2.7×
Nerve conduction studies 5-6 studies (95909) $583.20 $972 2.7×
Nerve conduction studies 7-8 studies (95910) $583.20 $972 1.6×
Nerve Conduction Studies 9-10 Studies (95911) $996 $1,660 2.7×
Neurobehavioral Status Exam (96116) $583.20 $972 2.7×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $290.40 $484 2.2×
Neuromuscular Reeducation (97112) $64.20 $107 2.0×
Nrpsyc tst eval phys/qhp 1st (96132) $996 $1,660 2.7×
Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) $237.60 $396 1.8×
Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) $246 $410 1.8×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $246 $410 1.8×
Ophth medical xm&eval intermediate estab pt (92012) $246 $410 1.8×
Ophth Medical Xm&Eval Intermediate New Pt (92002) $246 $410 1.8×
Opscpy extnd rta drawing & scl deprsn i&r uni/bi (92201) $114 $190 1.9×
Oral Function Therapy (92526) $160.80 $268 1.9×
Orthc/Prostc Mgmt Sbsq Enc (97763) $98.40 $164 2.0×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $90 $150 2.0×
Ot eval high complexity (97167) $192 $320 1.9×
Ot Eval Low Complex (97165) $192 $320 1.9×
Ot Eval Moderate Complexity (97166) $192 $320 1.9×
Ot manual therapy 15 min (97140) $51.60 $86 1.9×
Ot Prosthetic Training, Each 15 Min (97761) $78.60 $131 1.9×
Ot Re-Eval Est Plan Care (97168) $132.60 $221 1.9×
Patch/Application Test Specify Number Tests (95044) $138 $230 0.2×
Pdt dstr prmlg les skn illum/activj per day (96567) $115.80 $193 0.6×
Penile Vascular Study,Ltd or F/U (93981) $204.60 $341 1.9×
Phlebotomy therapeutic (99195) $237.60 $396 1.8×
Photo patch test(s) (95052) $114 $190 1.9×
Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) $114 $190 1.9×
Physical Performance Test (97750) $64.20 $107 1.9×
Pm device eval in person (93288) $70.20 $117 1.9×
Pm device progr eval dual (93280) $70.20 $117 1.9×
Pm device progr eval multi (93281) $70.20 $117 1.9×
Pm Device Progr Eval Sngl (93279) $70.20 $117 1.9×
Pm/Icd Remote Tech Serv (93296) $70.20 $117 1.9×
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of… (92311) $740.40 $1,234 1.6×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $70.20 $117 1.9×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $70.20 $117 1.9×
Psych diag eval w/med srvcs (90792) $296.40 $494 1.7×
Psychiatric diagnostic evaluation (90791) $296.40 $494 1.7×
Psycl/Nrpsyc Tst Auto Result (96146) $55.80 $93 1.9×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $740.40 $1,234 1.6×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $237.60 $396 1.8×
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $73.20 $122 1.9×
Pt Eval High Complex (97163) $190.20 $317 1.9×
Pt eval low complex 20 min (97161) $190.20 $317 1.9×
Pt Eval Mod Complex (97162) $190.20 $317 1.9×
Pt gait training 15 min (97116) $55.80 $93 1.9×
Pt mechanical traction (97012) $27 $45 1.9×
Pt Re-Eval Est Plan Care (97164) $132 $220 2.0×
Pt-focused hlth risk assmt score doc stnd instrm (96160) $53.40 $89 1.4×
Pure Tone Audiometry Air (92552) $237.60 $396 1.8×
Rectal sensation tone&compliance study (91124) $403.80 $673 1.9×
Refill/Maint Portable Pump (96521) $398.40 $664 1.9×
Refill/Maint Pump/Resvr Syst (96522) $398.40 $664 1.9×
Rem interrog icpms <30 d phys/qhp (93297) $70.20 $117 1.9×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $70.20 $117 1.9×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $70.20 $117 1.9×
Rem Mntr Wrls P-Art Prs Snr (93264) $68.40 $114 1.8×
Remote 30 Day Ecg Rev/Report (93270)
range across 2 matching MRF lines
$68.40–$70.20 $114–$117 varies
Remote 30 Day Ecg Tech Supp (93229) $583.20 $972 1.6×
Repet tms tx initial w/map/motr threshld/del&m (90867) $569.40 $949 2.6×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $114 $190 1.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $372 $620 1.8×
Rx&Fitg Contact Corneal Lens Aphakia Both Eyes (92312) $237.60 $396 1.8×
Self Care Mngment Training (97535) $61.80 $103 1.9×
Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) $114 $190 1.9×
Sensory Integration Ea 15 Min (97533) $113.40 $189 1.9×
Speech Audiometry Complete (92556) $114 $190 1.9×
Speech audiometry threshold (92555) $114 $190 1.9×
Speech sound lang comprehen (92523) $433.80 $723 1.9×
Spin/Brain Pump Refil & Main (95991) $540 $900 1.8×
Spirometry (94010) $286.20 $477 1.3×
Ssep lower limbs (95926) $583.20 $972 2.7×
Standardized Cognitive Performance Testing (96125) $194.40 $324 1.9×
Stenger Test Speech (92577) $996 $1,660 2.7×
Stenger Test, Pure Tone (92565) $114 $190 1.9×
Stress Tte Only (93350) $1,025.40 $1,709 1.9×
Subcutaneous Infusion Each Additional Hour (96370) $88.80 $148 1.9×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $385.20 $642 1.8×
Surfactant Admin Thru Tube (94610) $396.60 $661 1.8×
Temp transcutaneous pacing (92953) $1,153.20 $1,922 1.7×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $42.60 $71 1.9×
Ther Ivntj Ea Addl 15 Min (97130) $40.80 $68 1.9×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $57.60 $96 1.9×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $195.60 $326 1.9×
Ther/Proph/Diag Inj Ia (96373) $398.40 $664 1.9×
Ther/Proph/Diag Inj Sc/Im (96372) $131.40 $219 1.8×
Ther/Proph/Diag Iv Inf Init (96365) $398.40 $664 1.9×
Therap repetitive tms tx subseq delivery & mng (90868) $569.40 $949 2.6×
Therapeutic Activities (97530) $69.60 $116 2.0×
Tobacco Use Cessation Intensive >10 Minutes (99407) $53.40 $89 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $53.40 $89 1.4×
Trans Care Mgmt 14 Day Disch (99495) $246 $410 1.8×
Trans Care Mgmt 7 Day Disch (99496) $246 $410 1.8×
Tte w/doppler, complete (93306) $1,025.40 $1,709 1.9×
Tte W/O Doppler Complete (93307) $455.40 $759 1.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $145.20 $242 1.9×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $46.20 $77 1.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $88.80 $148 1.9×
Tympanometry (92567) $75 $125 2.0×
Tympanometry and reflex threshold measurements (92550) $290.40 $484 1.3×
Unlis neurological/neuromuscular dx px (95999) $286.20 $477 2.2×
Unlisted Psychiatric Service/Procedure (90899) $53.40 $89 1.4×
Upr/L Xtremity Art 2 Levels (93922) $237.60 $396 1.8×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $290.40 $484 1.3×
Vasopneumatic device (97016) $22.20 $37 1.8×
Veeg 2-12 Hr Cont Mntr (95713) $697.20 $1,162 1.9×
Veeg 2-12 hr intmt mntr (95712) $697.20 $1,162 1.9×
Veeg 2-12 hr unmonitored (95711) $403.80 $673 1.9×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $697.20 $1,162 1.9×
Veeg Ea 12-26 Hr Unmntr (95714) $697.20 $1,162 1.9×
Veeg ea 12-26hr cont mntr (95716) $1,603.80 $2,673 1.9×
Vent Mgmt Inpat Init Day (94002) $1,164.60 $1,941 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,164.60 $1,941 1.9×
Visual Evoked Potential Test (95930) $569.40 $949 2.6×
Visual Field Exam Extended (92083) $237.60 $396 1.8×
Visual field xm uni/bi w/interp intermed exam (92082) $114 $190 1.9×
Visual field xm uni/bi w/interpretj limited exam (92081) $114 $190 1.9×
Vital capacity, total (94150) $290.40 $484 2.2×
Wheelchair Mgmt Ea 15 Min (97542) $60 $100 1.9×
Whirlpool Therapy (97022) $32.40 $54 2.1×
Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) $75 $125 2.0×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.