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.

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $38.29 $67.17 1.2×
Acupuncture 1/> ndls w/elec stimj 1st 15 min (97813) $42.26 $74.14 1.4×
Airway inhalation treatment (94640) $89.60 $157.20 0.4×
Analyze Neurostim Complex (95972) $120.05 $210.61 1.2×
Analyze neurostim no prog (95970) $145.87 $255.92 1.0×
Application of allergenic extract onto mucous membrane of nose with reaction analysis (95065) $58.37 $102.41 1.5×
Assessment of aphasia (96105) $222.41 $390.19 2.3×
Behavioral and qualitative analysis of voice and resonance (92524) $215.30 $377.72 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $397.29 $697 1.0×
Canalith Repositioning (95992) $75.39 $132.26 1.9×
Cardiac Stress Tst,Tracing Only (93017) $44.20 $77.53 0.2×
Cardiopulmonary exercise testing (94621) $799.14 $1,402 2.0×
Cardiopulmonary resuscitation (92950) $567.96 $996.42 2.5×
Cardioversion (92960) $859.50 $1,507.88 1.2×
Cbt 1st hour (94644) $187.25 $328.50 1.3×
Chemother, IV infusion, 1 hr (96413) $383.83 $673.39 1.1×
Chemother, IV infusion, ea add hr (96415) $151.80 $266.32 2.0×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions (98940) $39.61 $69.49 1.7×
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions (98941) $59.42 $104.25 2.6×
Color/duplex Doppler, complete (93975) $482.94 $847.26 1.9×
Color/duplex Doppler, limited (93976) $210.48 $369.28 1.9×
Cpap initiation and management (94660) $363.26 $637.29 1.6×
Cpt initial (94667) $123.69 $217 0.9×
Critical care (99291) $1,149.84 $2,017.28 1.3×
Debridement Open Wound 20 Sq Cm< (97597) $108.47 $190.29 0.5×
Demo &/or eval,pt use,aerosol device (94664) $109.78 $192.60 0.5×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $67.37 $118.20 0.3×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $239.91 $420.90 2.2×
Dup-scan xtr veins unilateral/limited study (93971) $289.62 $508.10 2.6×
Duplex scan extracranial art compl bi study (93880) $532.90 $934.92 2.1×
Echo Heart Xthoracic,Limited (93308) $260.21 $456.51 1.0×
Echo transesophageal (93312) $1,314.84 $2,306.74 2.3×
Echo Transthoracic - Congenital Tte Complete (93303) $728.75 $1,278.50 1.2×
EEG awake asleep (95819) $676.32 $1,186.53 2.9×
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 (93005) $70.63 $123.92 1.1×
EKG rhythm strip (93041) $85.50 $150 1.4×
Ekg Signal Averaging (93278) $262.03 $459.70 4.2×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $645.19 $1,131.91 2.8×
EMG four extremities (95864) $528.25 $926.75 3.8×
EMG one extremity (95860) $268.04 $470.25 1.9×
EMG thoracic paraspinal (95869) $177.68 $311.72 0.8×
EMG three extremities (95863) $464.80 $815.44 3.4×
EMG two extremities (95861) $376.08 $659.79 2.6×
Er level 1 (99281) $42.75 $75 0.5×
Er level ii (99282) $69.46 $121.86 0.4×
Er level iii (99283) $356.08 $624.70 1.2×
Er level IV (99284) $573.10 $1,005.42 1.3×
Er level v (99285) $829.08 $1,454.52 1.3×
Evaluation of speech fluency (92521) $255.54 $448.31 1.9×
Evaluation of speech sound production (92522) $207.42 $363.90 1.9×
Evaluation of swallowing function (92610) $230.54 $404.46 2.7×
External ECG rec>7d<15d scanning alys w/report (93247) $333.63 $585.31 2.4×
External Ecg Scanning Analysis Report (93226) $400.71 $703 6.4×
Flow volume loop (94375) $51.49 $90.34 0.2×
Group Therapeutic Procedures (97150) $68.15 $119.57 3.8×
Holter Monitor Recording (93225) $175.40 $307.72 1.2×
Icd Device Interrogate (93289) $122.95 $215.70 3.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $71 $124.56 1.6×
Immunization Admin (90471) $48.77 $85.56 0.6×
Immunotherapy, 2+ Injections (95117) $14.25 $25 0.3×
Injection intra arterial (96373) $122.82 $215.48 0.5×
Ins swan ganz bedside (93503) $255.19 $447.71 0.2×
Interrog dev eval scrms phys/qhp in person (93291) $24.02 $42.14 0.8×
IV infusion hydration each additional hour (96361) $20.59 $36.12 0.4×
IV infusion hydration initial 31 min-1 hour (96360) $177.88 $312.08 0.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $130.01 $228.09 1.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $297.96 $522.74 1.3×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $106.17 $186.26 2.1×
IV push initial (96374) $124.26 $218 0.5×
Manual therapy 15 min (97140) $71.50 $125.43 2.6×
Massage 15 min (97124) $53.90 $94.56 1.8×
Mechanical chest wall oscillation (94669) $132.81 $233 0.6×
Mechanical traction (97012) $47.98 $84.16 3.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $266.39 $467.35 2.9×
Multiple sleep latency test (95805) $1,700.94 $2,984.10 1.9×
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 13/> 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 9-10 Studies (95911) $508.81 $892.65 1.3×
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; 5-6 studies (95909) $322.02 $564.94 1.4×
Nerve conduction studies; 7-8 studies (95910) $427.74 $750.42 1.1×
New patient problem focused exam of visual system (92002) $106.59 $187 0.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $179.38 $314.70 1.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $78.62 $137.94 1.7×
Osteopathic manipulative tx 1-2 body regions (98925) $24.34 $42.70 1.1×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $62.24 $109.19 1.9×
Ot Contrast Bath Ea 15 Min (97034) $49.06 $86.06 3.5×
Ot eval high complex 60 min (97167) $200.67 $352.06 2.0×
Ot eval low complex 30 min (97165) $172.66 $302.92 1.7×
Ot eval mod complex 45 min (97166) $186.66 $327.48 1.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $89.69 $157.35 1.8×
Ot Prosthetic Training, Each 15 Min (97761) $67.44 $118.32 1.7×
Ot Range Motion Measure,Each Extrem (95851) $35.62 $62.49 1.4×
Ot re-eval est plan care (97168) $110.70 $194.21 1.6×
Paraffin bath (97018) $53.19 $93.32 8.9×
Plethysmography (94726) $69.98 $122.78 0.2×
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×
Programming of dual lead implantable defibrillator system (93283) $70.64 $123.93 1.8×
Psych diag eval w/med srvcs (90792) $165.96 $291.15 0.9×
Psychiatric diagnostic evaluation (90791) $301.42 $528.81 1.6×
Pt Electric Current Therapy (97033) $73.16 $128.36 3.8×
Pt Electrical Stimulation (97032) $68.55 $120.27 4.7×
Pt eval high complex 45 min (97163) $185.07 $324.69 1.9×
Pt eval low complex 20 min (97161) $157.06 $275.54 1.6×
Pt Gait Training Therapy (97116) $65 $114.03 2.2×
Pt Infrared Therapy (97026) $34.52 $60.56 5.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $70.06 $122.92 2.1×
Pt Physical Performance Test (97750) $75.96 $133.26 2.3×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $171.07 $300.12 1.7×
Pt re-evaluation (97164) $95.97 $168.37 1.4×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $72.12 $126.53 2.2×
Pt Ultrasound Therapy (97035) $61.22 $107.40 4.3×
Pt Whirlpool Therapy (97022) $56.20 $98.60 3.6×
Pulm function test by gas (94727) $224.80 $394.38 1.0×
Pulmonary stress testing (94618) $212.32 $372.49 1.5×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $300.06 $526.42 7.5×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $263.39 $462.09 0.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $127.82 $224.24 0.6×
Rom meas&reprt hand w/wo comparison normal sid (95852) $58.11 $101.94 2.7×
Rt Chest Wall Manipulation,Subsequent (94668) $90.06 $158 0.6×
Sc Ther Infusion Reset Pump (96371) $92.12 $161.62 1.2×
Sleep study attended (95807) $845.88 $1,484 2.1×
Sleep study unattended (95806) $311.01 $545.63 1.3×
Smoking cessation > 10 min (99407) $41.58 $72.95 1.0×
Speech sound lang comprehen (92523) $430.85 $755.88 1.9×
Spirometry (94010) $142.30 $249.64 0.6×
Stress echo (93350) $805.78 $1,413.64 1.4×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $74.96 $131.51 1.5×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $206.45 $362.20 0.9×
Temp transcutaneous pacing (92953) $538.33 $944.44 0.8×
Ther/Proph/Diag Inj Sc/Im (96372) $72.45 $127.11 0.9×
Therapeutic Activities (97530) $69.96 $122.73 2.0×
Therapeutic phlebotomy (99195) $115.63 $202.86 0.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $31.92 $56 0.8×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,135.54 $1,992.18 1.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $577.46 $1,013.09 2.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $160.99 $282.44 2.1×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $156.25 $274.12 1.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $118.43 $207.77 2.4×
Ultraviolet Therapy (97028) $41.89 $73.49 5.0×
Unlisted pulmonary service/procedure (94799) $76.18 $133.66 0.6×
Vasc Duplex Extrem Venous,Bilat (93970) $432.90 $759.46 1.7×
Ventilation assist & mgmt inpatient 1st 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) $130.53 $229 1.0×
Wheelchair Mgmt Ea 15 Min (97542) $62.53 $109.70 2.0×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $222.48 $390.32 2.2×