Visits & medical services prices at Wentworth-Douglass Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $13,627.80 $22,713 1.6×
Airway inhalation treatment (94640) $123 $205 0.5×
Ambulatory Bp Analysis (93788) $403.80 $673 2.8×
Ambulatory Bp Recording (93786) $176.40 $294 1.2×
Analyze neurostim simple (95971) $1,127.40 $1,879 11.1×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $49.20 $82 3.4×
Application on-body injector (96377) $166.20 $277 3.3×
Assessment of aphasia per hr (96105) $459 $765 4.7×
Bedside Swallowing Eval (92610) $319.20 $532 3.8×
Behavioral and qualitative analysis of voice and resonance (92524) $389.40 $649 3.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $546 $910 1.4×
Cardiac Stress Tst,Tracing Only (93017) $1,048.80 $1,748 4.5×
Cardiopulmonary exercise testing (94621) $638.40 $1,064 1.6×
Cardiopulmonary resuscitation (92950) $1,336.80 $2,228 5.8×
Cardioversion (92960) $2,995.80 $4,993 4.2×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $9,460.20 $15,767 2.7×
Chemo Hormon Antineopl Sq/Im (96402) $199.20 $332 2.6×
Chemo IV push addl drug (96411) $304.20 $507 4.0×
Chemo prolong 8+ hrs infuse w/pump (96416) $735.60 $1,226 2.1×
Chemother, IV infusion, 1 hr (96413) $733.80 $1,223 2.1×
Chemother, IV infusion, ea add hr (96415) $157.80 $263 2.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $412.80 $688 5.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $354 $590 4.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $564 $940 1.6×
Color/duplex Doppler, complete (93975) $1,605 $2,675 6.3×
Color/duplex Doppler, limited (93976) $903.60 $1,506 8.1×
Coronary art/grft angio s&i (93455) $9,295.80 $15,493 2.7×
Coronary artery angio s&i (93454) $8,156.40 $13,594 2.4×
Cpap/bipap (94660) $255.60 $426 1.1×
Cpt initial (94667) $171 $285 1.2×
Critical care (99291) $2,491.20 $4,152 2.8×
Debridement Open Wound 20 Sq Cm< (97597) $460.80 $768 2.2×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $1,086 $1,810 4.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,575.60 $2,626 6.2×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $918.60 $1,531 8.2×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,206 $2,010 4.7×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $753.60 $1,256 6.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,167.60 $1,946 4.6×
Dup-scan xtr veins unilateral/limited study (93971) $715.20 $1,192 6.4×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $1,648.20 $2,747 6.5×
Duplex scan extracranial art compl bi study (93880) $1,172.40 $1,954 4.6×
Echo Heart Xthoracic,Limited (93308) $1,073.40 $1,789 4.2×
Echo transesophageal (93312) $1,940.40 $3,234 3.3×
Echo Transthoracic - Congenital Tte Complete (93303) $1,152.60 $1,921 2.0×
Echo Transthoracic - Congenital Tte Limited (93304) $614.40 $1,024 1.1×
EEG awake and asleep (95819) $1,425 $2,375 6.2×
EEG awake drowsy (95816) $1,178.40 $1,964 5.1×
EEG cont rec w/video by tech min 8 channels (95700) $1,031.40 $1,719 4.5×
EEG greater than 1 hour (95813) $1,222.20 $2,037 5.3×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $1,649.40 $2,749 7.2×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $1,924.20 $3,207 4.8×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $2,473.80 $4,123 6.2×
Electrocardiogram Tracing (93005) $220.20 $367 3.5×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $1,031.40 $1,719 4.5×
Ep & ablate supravent arrhyt (93653) $49,215.60 $82,026 1.8×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $15,072 $25,120 1.8×
Er level iii (99283) $732 $1,220 2.5×
Er level IV (99284) $1,314 $2,190 2.9×
Er level v (99285) $1,942.20 $3,237 3.1×
Esoph balloon distension tst (91040) $7,206 $12,010 18.1×
Evaluate Pt Use Of Inhaler (94664) $116.40 $194 0.5×
External ECG rec>48hr<7d recording (93242) $337.80 $563 8.5×
External ECG rec>7d<15d recording (93246) $337.80 $563 8.5×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $2,107.20 $3,512 9.1×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $6,736.20 $11,227 7.3×
Hemodialysis (90935) $1,626.60 $2,711 2.2×
Holter Monitor (93225) $532.80 $888 3.8×
Immunization Admin (90471) $28.80 $48 0.4×
Interrog dev eval scrms phys/qhp in person (93291) $103.80 $173 3.4×
Interrog device eval heart (93289) $197.40 $329 5.0×
Interrogate subq defib (93261) $133.80 $223 3.4×
Irrig drug delivery device (96523) $157.20 $262 2.5×
IV infusion hydration each additional hour (96361) $200.40 $334 4.0×
IV infusion hydration initial 31 min-1 hour (96360) $499.20 $832 2.2×
IV infusion ther proph addl sequential to 1 hr (96367) $256.20 $427 3.3×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $624.60 $1,041 2.8×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $177 $295 3.5×
IV push ea addl new drug (96375) $136.20 $227 2.7×
IV push initial (96374) $321 $535 1.4×
L hrt art/grft angio (93459) $10,222.80 $17,038 3.0×
Low frequency non-thermal us (97610) $357 $595 1.7×
Manual therapy 15 min (97140) $100.80 $168 3.6×
Mechanical traction (97012) $52.80 $88 3.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $69 $115 2.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $81.60 $136 2.2×
Methacholine challenge (94070) $730.80 $1,218 1.8×
Motility study esophagus (91010) $2,147.40 $3,579 5.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $396.60 $661 4.3×
Multiple Sleep Latency Test (95805) $3,447.60 $5,746 3.8×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $652.20 $1,087 1.5×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $291 $485 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $331.80 $553 0.8×
Nitric oxide expired gas determination (95012) $136.80 $228 3.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $535.20 $892 3.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $171 $285 1.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $172.80 $288 3.7×
Ot eval low complex 30 min (97165) $342 $570 3.4×
Ot eval mod complex 45 min (97166) $342 $570 3.4×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $129 $215 2.6×
Ot re-evaluation (97168) $229.80 $383 3.4×
Ot therapeutic activity 15 min (97530) $144 $240 4.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $283.20 $472 2.1×
Paraffin bath pt (97018) $18.60 $31 3.1×
Peripheral arterial disease rehab per session (93668) $222.60 $371 3.5×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $25,198.80 $41,998 4.1×
Phlebotomy therapeutic (99195) $530.40 $884 3.7×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $214.80 $358 3.4×
Plethysmography (94726) $281.40 $469 0.7×
Pm device eval in person (93288) $232.80 $388 5.8×
Pm device progr eval dual (93280) $143.40 $239 3.6×
Pm device progr eval multi (93281) $141.60 $236 3.6×
Pm device progr eval sngl (93279) $121.20 $202 3.0×
Pm/Icd Remote Tech Serv (93296) $135.60 $226 3.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,942.20 $8,237 5.4×
Polysom <6 yrs 4/> paramtrs (95782) $7,466.40 $12,444 8.1×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $181.80 $303 4.6×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $150.60 $251 3.8×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) $130.20 $217 3.3×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) $141.60 $236 3.6×
Prq Card Stent W/Angio 1 Vsl (92928) $34,908.60 $58,181 2.8×
Prq Card Stent/Ath/Angio (92933)
unusually low: confirm this is the full procedure
$6,933.60 $11,556 0.4×
Pt Aquatic Therapy/Exercises (97113) $141 $235 3.8×
Pt eval high complex 45 min (97163) $311.40 $519 3.2×
Pt eval low complex 20 min (97161) $317.40 $529 3.2×
Pt eval mod complex 30 min (97162) $311.40 $519 3.2×
Pt gait training 15 min (97116) $108.60 $181 3.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $125.40 $209 3.8×
Pt re-evaluation (97164) $211.20 $352 3.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $87 $145 2.7×
Pt Whirlpool Therapy (97022) $46.80 $78 3.0×
Pulm function test by gas (94727) $211.20 $352 0.9×
Pulmonary Service/Procedure (94799) $165.60 $276 1.2×
Pulmonary stress test simple (94618) $355.80 $593 2.5×
R hrt art/grft angio (93457) $11,233.20 $18,722 3.2×
R hrt coronary artery angio (93456) $10,114.20 $16,857 2.9×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $11,737.20 $19,562 3.4×
R&l hrt art/ventricle angio (93460) $11,015.40 $18,359 3.2×
Rem interrog icpms <30 d phys/qhp (93297) $201.60 $336 5.1×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $432.60 $721 10.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $189 $315 4.7×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $1,211.40 $2,019 3.7×
Right heart cath (93451) $8,376 $13,960 2.4×
Rt Chest Wall Manipulation,Subsequent (94668) $222 $370 1.6×
Speech sound lang comprehen (92523) $861 $1,435 3.8×
Spirometry (94010) $183.60 $306 0.8×
Standardized Cognitive Performance Testing (96125) $484.80 $808 4.7×
Stress echo (93350) $1,768.20 $2,947 3.0×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $772.80 $1,288 3.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $84.60 $141 3.8×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $81 $135 3.8×
Therapeutic prophylactic/dx injection subq/im (96372) $135.60 $226 1.8×
Tte w/doppler, complete (93306) $1,949.40 $3,249 3.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $346.20 $577 4.5×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $219 $365 2.6×
Unlisted Cardiovascular Service/Procedure (93799) $1,432.20 $2,387 10.4×
Upr/lxtr art stdy 3+ lvls (93923) $810 $1,350 3.5×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,021.80 $1,703 4.4×
Vasopneumatic device (97016) $45.60 $76 3.8×
Veeg 2-12 hr unmonitored (95711) $2,199 $3,665 9.5×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $2,748.60 $4,581 6.9×
Veeg by tech 2-12 hr intermittent monitoring (95712) $2,473.80 $4,123 6.2×
Veeg Ea 12-26 Hr Unmntr (95714) $2,473.80 $4,123 6.2×
Vent mgmt inpat init day (94002) $615.60 $1,026 0.9×