Visits & medical services prices at White Mountain Regional Medical Center
Springerville, AZ · every code in this section with a posted price and a Medicare benchmark.
157 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acupunct W/Stimul 15 Min (97813) | $42.26 | $74.14 | 1.4× |
| Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) | $38.29 | $67.17 | 1.2× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $71 | $124.56 | 1.6× |
| Airway Inhalation Treatment (94640) range across 4 matching MRF lines |
$54.17–$111.72 | $95.04–$196 | varies |
| Analyze neurostim complex (95972) | $120.05 | $210.61 | 1.2× |
| Analyze neurostim no prog (95970) | $145.87 | $255.92 | 1.0× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 4 matching MRF lines |
$23.80–$63.02 | $41.76–$110.57 | varies |
| Application Modality 1/> Areas Infrared (97026) | $34.52 | $60.56 | 5.2× |
| Assessment of aphasia per hr (96105) | $222.41 | $390.19 | 2.3× |
| Behavral qualit analys voice (92524) | $215.30 | $377.72 | 2.0× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 3 matching MRF lines |
$79.89–$397.29 | $140.15–$697 | varies |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$59.70–$91.08 | $104.73–$159.79 | varies |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$37.55–$50.84 | $65.87–$89.19 | varies |
| Cardiopulmonary exercise testing (94621) | $799.14 | $1,402 | 2.0× |
| Cardiopulmonary resuscitation (92950) range across 6 matching MRF lines |
$101.06–$620.73 | $177.30–$1,089 | varies |
| Cardioversion (92960) range across 6 matching MRF lines |
$178.30–$1,074.61 | $312.81–$1,885.28 | varies |
| Cbt 1st hour (94644) | $187.25 | $328.50 | 1.3× |
| Chemo IV infusion addl hr (96415) | $151.80 | $266.32 | 2.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $383.83 | $673.39 | 1.1× |
| Chest Wall Manipulation (94668) | $90.06 | $158 | 0.6× |
| Chiropract manj 3-4 regions (98941) | $59.42 | $104.25 | 2.6× |
| Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) | $39.61 | $69.49 | 1.7× |
| Color/duplex Doppler, complete (93975) range across 4 matching MRF lines |
$167.14–$755.48 | $293.23–$1,325.41 | varies |
| Color/duplex Doppler, limited (93976) range across 4 matching MRF lines |
$109.58–$480.17 | $192.25–$842.41 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $62.24 | $109.19 | 1.9× |
| Continuous Pulse Ox (94762) range across 3 matching MRF lines |
$42.10–$220.02 | $73.86–$386 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$83.19–$401.35 | $145.94–$704.13 | varies |
| Cpt initial (94667) | $123.69 | $217 | 0.9× |
| Critical care first hour (99291) range across 2 matching MRF lines |
$353.71–$1,945.98 | $620.55–$3,414 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 5 matching MRF lines |
$58.96–$281.58 | $103.44–$494 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) range across 3 matching MRF lines |
$54.83–$775.77 | $96.20–$1,361 | varies |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 7 matching MRF lines |
$37.94–$528.96 | $66.57–$928 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 12 matching MRF lines |
$65.68–$835.62 | $115.23–$1,466 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 8 matching MRF lines |
$42.20–$572.34 | $74.03–$1,004.10 | varies |
| ECG/monitoring and analysis (93271) | $222.48 | $390.32 | 2.2× |
| Echo Congenital Complete (93303) | $728.75 | $1,278.50 | 1.2× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$54.65–$465.77 | $95.88–$817.14 | varies |
| Echo transesophageal (93312) | $1,314.84 | $2,306.74 | 2.3× |
| Eeg 41-60 Minutes (95812) | $645.19 | $1,131.91 | 2.8× |
| EEG awake and asleep (95819) range across 2 matching MRF lines |
$572.06–$780.58 | $1,003.62–$1,369.44 | varies |
| EEG awake drowsy (95816) | $682.21 | $1,196.86 | 3.0× |
| EEG extended monitoring 61-119 minutes (95813) | $910.59 | $1,597.53 | 4.0× |
| EKG signal averaged (93278) | $262.03 | $459.70 | 4.2× |
| Electrical Stimulation Ea 15 Min (97032) range across 3 matching MRF lines |
$35.36–$68.55 | $62.03–$120.27 | varies |
| Electrocardiogram Tracing (93005) range across 5 matching MRF lines |
$68.58–$172.60 | $120.31–$302.80 | varies |
| Emergency Dept Visit Level 2 (99282) range across 3 matching MRF lines |
$57–$346.42 | $100–$607.75 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$118.21–$593.94 | $207.39–$1,042 | varies |
| Emergency Dept Visit Level 4 (99284) range across 2 matching MRF lines |
$201.15–$945.04 | $352.89–$1,657.96 | varies |
| Emg 3 Extremities (95863) | $464.80 | $815.44 | 3.4× |
| Emg 4 Extremities (95864) | $528.25 | $926.75 | 3.8× |
| Er level 1 (99281) range across 3 matching MRF lines |
$19.02–$200.64 | $33.36–$352 | varies |
| Er level v (99285) range across 2 matching MRF lines |
$291.38–$1,366.77 | $511.20–$2,397.85 | varies |
| Evaluate pt use of inhaler (94664) range across 4 matching MRF lines |
$22.45–$131.09 | $39.38–$229.98 | varies |
| Evaluate Speech Production (92522) | $207.42 | $363.90 | 1.9× |
| Evaluate Swallowing Function (92610) | $230.54 | $404.46 | 2.7× |
| Evaluation of speech fluency (92521) | $255.54 | $448.31 | 1.9× |
| External ECG rec>7d<15d scanning alys w/report (93247) range across 2 matching MRF lines |
$266.09–$401.17 | $466.82–$703.80 | varies |
| External Ecg Scanning Analysis Report (93226) | $400.71 | $703 | 6.4× |
| Extracranial Bilat Study (93880) range across 3 matching MRF lines |
$55.75–$761.52 | $97.81–$1,336 | varies |
| Group Therapeutic Procedures (97150) | $68.15 | $119.57 | 3.8× |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$30.46–$320.34 | $53.43–$562 | varies |
| Icd Device Interrogate (93289) | $122.95 | $215.70 | 3.1× |
| Icd device progr eval dual (93283) range across 2 matching MRF lines |
$52.16–$89.12 | $91.51–$156.35 | varies |
| Ilr Device Interrogate (93291) | $24.02 | $42.14 | 0.8× |
| Immunization administration (90471) range across 2 matching MRF lines |
$33.79–$63.75 | $59.28–$111.85 | varies |
| Insert/Place Heart Catheter (93503) | $255.19 | $447.71 | 0.2× |
| Iontophoresis 15 min (97033) range across 2 matching MRF lines |
$71–$75.33 | $124.57–$132.15 | varies |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$20.59–$108.30 | $36.12–$190 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$54–$301.76 | $94.74–$529.41 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$112.39–$147.63 | $197.18–$259 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$93.21–$119.13 | $163.52–$209 | varies |
| IV push initial (96374) range across 3 matching MRF lines |
$124.26–$195.35 | $218–$342.72 | varies |
| Mechanical chest wall oscillation per session (94669) | $132.81 | $233 | 0.6× |
| Motion Fluoroscopy/Swallow (92611) | $266.39 | $467.35 | 2.9× |
| Multiple Sleep Latency Test (95805) range across 3 matching MRF lines |
$1,700.94–$1,846.01 | $2,984.10–$3,238.61 | varies |
| Muscle Test 2 Limbs (95861) | $376.08 | $659.79 | 2.6× |
| Muscle Test One Limb (95860) | $268.04 | $470.25 | 1.9× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $177.68 | $311.72 | 0.8× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $139.46 | $244.67 | 0.7× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $189.72 | $332.85 | 0.4× |
| Nerve Conduction Studies 1-2 Studies (95907) | $211.54 | $371.13 | 0.9× |
| Nerve Conduction Studies 11-12 Studies (95912) | $567.34 | $995.33 | 1.4× |
| Nerve conduction studies 13 or more studies (95913) | $642.98 | $1,128.04 | 1.6× |
| Nerve Conduction Studies 3-4 Studies (95908) | $271.80 | $476.84 | 1.2× |
| Nerve conduction studies 5-6 studies (95909) | $322.02 | $564.94 | 1.4× |
| Nerve conduction studies 7-8 studies (95910) | $427.74 | $750.42 | 1.1× |
| Nerve Conduction Studies 9-10 Studies (95911) | $508.81 | $892.65 | 1.3× |
| Neuromuscular Reeducation (97112) range across 4 matching MRF lines |
$62.56–$74.33 | $109.75–$130.41 | varies |
| Nose Allergy Test (95065) | $58.37 | $102.41 | 1.5× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) | $106.59 | $187 | 0.8× |
| Oral Function Therapy (92526) | $156.25 | $274.12 | 1.9× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $89.69 | $157.35 | 1.8× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 4 matching MRF lines |
$70.99–$82.03 | $124.54–$143.91 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $24.34 | $42.70 | 1.1× |
| Ot Contrast Bath Ea 15 Min (97034) range across 2 matching MRF lines |
$47.60–$50.51 | $83.51–$88.61 | varies |
| Ot eval high complexity (97167) | $200.67 | $352.06 | 2.0× |
| Ot Eval Low Complex (97165) | $172.66 | $302.92 | 1.7× |
| Ot Eval Moderate Complexity (97166) | $186.66 | $327.48 | 1.9× |
| Ot manual therapy 15 min (97140) range across 4 matching MRF lines |
$56.44–$75.86 | $99.01–$133.08 | varies |
| Ot paraffin bath (97018) range across 2 matching MRF lines |
$51.61–$54.77 | $90.55–$96.09 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) | $67.44 | $118.32 | 1.7× |
| Ot Re-Eval Est Plan Care (97168) | $110.70 | $194.21 | 1.6× |
| Ot rom hand (95852) | $58.11 | $101.94 | 2.7× |
| Phlebotomy therapeutic (99195) | $115.63 | $202.86 | 0.8× |
| Physical Performance Test (97750) | $75.96 | $133.26 | 2.3× |
| Plethysmography (94726) range across 3 matching MRF lines |
$69.98–$299.25 | $122.78–$525 | varies |
| Pm device eval in person (93288) | $48.19 | $84.55 | 1.2× |
| Pm device progr eval dual (93280) | $77.25 | $135.52 | 1.9× |
| Pm Device Progr Eval Sngl (93279) | $66.02 | $115.83 | 1.7× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $2,821.50 | $4,950 | 3.1× |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) | $1,631.66 | $2,862.56 | 1.8× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $14.25 | $25 | 0.3× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $14.25 | $25 | 0.3× |
| Psych diag eval w/med srvcs (90792) | $165.96 | $291.15 | 0.9× |
| Psychiatric diagnostic evaluation (90791) | $301.42 | $528.81 | 1.6× |
| Pt Eval High Complex (97163) | $185.07 | $324.69 | 1.9× |
| Pt eval low complex 20 min (97161) | $157.06 | $275.54 | 1.6× |
| Pt Eval Mod Complex (97162) | $171.07 | $300.12 | 1.7× |
| Pt gait training 15 min (97116) | $65 | $114.03 | 2.2× |
| Pt mechanical traction (97012) range across 2 matching MRF lines |
$30.60–$65.35 | $53.68–$114.65 | varies |
| Pt Re-Eval Est Plan Care (97164) | $95.97 | $168.37 | 1.4× |
| Pt ultraviolet (97028) | $41.89 | $73.49 | 5.0× |
| Pulm function test by gas (94727) | $224.80 | $394.38 | 1.0× |
| Pulmonary service/procedure (94799) range across 2 matching MRF lines |
$71.09–$81.28 | $124.72–$142.59 | varies |
| Pulmonary Stress Testing (94618) | $212.32 | $372.49 | 1.5× |
| Remote 30 Day Ecg Rev/Report (93270) range across 2 matching MRF lines |
$208.62–$391.50 | $366–$686.85 | varies |
| Respiratory flow volume loop (94375) | $51.49 | $90.34 | 0.2× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $85.50 | $150 | 1.4× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 4 matching MRF lines |
$71.60–$195.51 | $125.62–$343 | varies |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) range across 2 matching MRF lines |
$15.64–$55.60 | $27.44–$97.54 | varies |
| Self Care Mngment Training (97535) range across 3 matching MRF lines |
$67.98–$72.12 | $119.27–$126.53 | varies |
| Sleep study attended (95807) | $845.88 | $1,484 | 2.1× |
| Sleep study unattended (95806) range across 2 matching MRF lines |
$158.04–$463.98 | $277.26–$814 | varies |
| Speech sound lang comprehen (92523) | $430.85 | $755.88 | 1.9× |
| Spin/Brain Pump Refil & Main (95991) | $263.39 | $462.09 | 0.8× |
| Spirometry (94010) range across 4 matching MRF lines |
$47.53–$216.60 | $83.39–$380 | varies |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$723.07–$888.49 | $1,268.54–$1,558.75 | varies |
| Subcutaneous Infusion Each Additional Hour (96370) | $74.96 | $131.51 | 1.5× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $206.45 | $362.20 | 0.9× |
| Subq Infusion Additional Pump Infusion Site (96371) | $92.12 | $161.62 | 1.2× |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$525.20–$551.46 | $921.40–$967.47 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 2 matching MRF lines |
$48.96–$58.84 | $85.89–$103.23 | varies |
| Ther/Proph/Diag Inj Ia (96373) | $122.82 | $215.48 | 0.5× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 3 matching MRF lines |
$23.73–$99.75 | $41.64–$175 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$260.20–$335.73 | $456.49–$589 | varies |
| Therapeutic Activities (97530) range across 5 matching MRF lines |
$65.28–$175.95 | $114.52–$308.68 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $41.58 | $72.95 | 1.0× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 4 matching MRF lines |
$18.49–$32.82 | $32.43–$57.58 | varies |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$1,002.41–$1,268.68 | $1,758.61–$2,225.76 | varies |
| Tte W/O Doppler Complete (93307) | $577.46 | $1,013.09 | 2.3× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $160.99 | $282.44 | 2.1× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$105.62–$131.24 | $185.29–$230.25 | varies |
| Vent Mgmt Inpat Init Day (94002) | $926.82 | $1,626 | 1.4× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $791.16 | $1,388 | 1.2× |
| Vital capacity, total (94150) range across 3 matching MRF lines |
$74.14–$130.53 | $130.07–$229 | varies |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$60.68–$64.38 | $106.45–$112.94 | varies |
| Whirlpool Therapy (97022) range across 2 matching MRF lines |
$40.79–$71.60 | $71.57–$125.62 | varies |
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.