Visits & medical services prices at Wray Community District Hospital

Wray, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $97.28 $129.71 0.4×
Application of heat wave therapy (97024) $84.98 $113.30 11.6×
Assessment of aphasia (96105) $254.48 $339.30 2.6×
Biofeedback training any modality (90901) $82.80 $110.40 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $513.58 $684.78 1.3×
Canalith Repositioning (95992) $68.62 $91.50 1.7×
Cardiac Stress Tst,Tracing Only (93017) $791.02 $1,054.69 3.5×
Cardiopulmonary resuscitation (92950) $1,152.66 $1,536.88 5.1×
Cardioversion (92960) $751.60 $1,002.13 1.1×
Cbt 1st hour (94644) $200.85 $267.80 1.4×
Chemo IV push addl drug (96411) $99.52 $132.70 1.3×
Chemo Iv Push Sngl Drug (96409) $69.18 $92.25 0.2×
Chemo prolong 8+ hrs infuse w/pump (96416) $270 $360 0.8×
Chemother, IV infusion, 1 hr (96413) $568.95 $758.60 1.6×
Chemother, IV infusion, ea add hr (96415) $168.75 $225 2.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $89.18 $118.90 1.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $250.73 $334.30 3.3×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $22.42 $29.90 0.2×
Color/duplex Doppler, complete (93975) $486.92 $649.22 1.9×
Continuous Glucose Monitoring (95250) $71.40 $95.20 0.5×
Cpap initiation and management (94660) $399.06 $532.08 1.7×
Critical care (99291) $1,431.68 $1,908.90 1.6×
Debridement Open Wound 20 Sq Cm< (97597) $124.54 $166.05 0.6×
Demo &/or eval,pt use,aerosol device (94664) $99.63 $132.84 0.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $686.05 $914.73 2.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $475.36 $633.81 4.3×
Dup-scan xtr veins unilateral/limited study (93971) $621.71 $828.94 5.6×
Duplex scan extracranial art compl bi study (93880) $793.55 $1,058.07 3.2×
Echo Heart Xthoracic,Limited (93308) $567.72 $756.96 2.3×
EKG (93005) $167.90 $223.86 2.7×
EKG rhythm strip (93041) $144.12 $192.16 2.3×
Er level 1 (99281) $146.20 $194.94 1.6×
Er level ii (99282) $260.42 $347.22 1.6×
Er level iii (99283) $555.22 $740.30 1.9×
Er level IV (99284) $697.41 $929.88 1.6×
Er level v (99285) $930.56 $1,240.74 1.5×
Evaluation of speech sound production (92522) $177.11 $236.15 1.6×
Evaluation of swallowing function (92610) $142.68 $190.25 1.7×
Exercise tst brncspsm (94617) $153.56 $204.75 1.1×
External ECG rec>48hr<7d recording (93242) $97.87 $130.49 2.5×
External ECG rec>7d<15d recording (93246) $97.87 $130.49 2.5×
External Ecg Scanning Analysis Report (93226) $185.35 $247.13 3.0×
Flow volume loop (94375) $53.43 $71.24 0.2×
Group Therapeutic Procedures (97150) $67.40 $89.86 3.7×
Holter Monitor Recording (93225) $156.58 $208.78 1.1×
Immunization Admin (90471) $58.80 $78.40 0.8×
Immunotherapy, 2+ Injections (95117) $2.92 $3.90 0.1×
Inhlj Brncl Challenge Tstg W/Histamine/Methachol (95070) $90.97 $121.29 0.2×
Injection intra arterial (96373) $60.64 $80.86 0.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $108.82 $145.10 1.7×
IV infusion hydration each additional hour (96361) $95.55 $127.40 1.9×
IV infusion hydration initial 31 min-1 hour (96360) $48.75 $65 0.2×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $101.20 $134.94 1.3×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $301.27 $401.70 1.3×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $51.58 $68.77 1.0×
IV push initial (96374) $133.33 $177.78 0.6×
Manual therapy 15 min (97140) $107.10 $142.80 3.9×
Massage 15 min (97124) $87.88 $117.18 3.0×
Maximum voluntary ventilation (94200) $465.76 $621.01 7.5×
Mechanical chest wall oscillation (94669) $119.84 $159.79 0.5×
Mechanical traction (97012) $53.16 $70.88 3.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $16.16 $21.54 0.5×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $55.72 $74.30 1.5×
Neg press wnd tx </=50 sq cm (97607) $86.38 $115.18 0.2×
Neg press wound tx >50 cm (97608) $55.67 $74.23 0.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $56.25 $75 0.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $88.96 $118.61 0.2×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $446.06 $594.75 2.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $205.82 $274.43 1.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $79.22 $105.63 1.7×
Osteopathic manipulative tx 3-4 body regions (98926) $7.90 $10.53 0.3×
Osteopathic manipulative tx 5-6 body regions (98927) $10.24 $13.66 0.4×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $63.38 $84.50 2.0×
Ot Contrast Bath Ea 15 Min (97034) $38.46 $51.28 2.7×
Ot eval high complex 60 min (97167) $199.55 $266.07 2.0×
Ot eval low complex 30 min (97165) $137.66 $183.54 1.4×
Ot eval mod complex 45 min (97166) $172.15 $229.53 1.7×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $40.56 $54.08 0.8×
Ot Prosthetic Training, Each 15 Min (97761) $40.56 $54.08 1.0×
Ot re-eval est plan care (97168) $132.93 $177.24 1.9×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $195.44 $260.58 1.4×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $103.64 $138.19 0.8×
Paraffin bath (97018) $72.54 $96.72 12.1×
Patient-initiated spirometric phys/qhp r&i only (94016) $48.07 $64.09 1.9×
Phy/qhp op pulm rhb w/mntr (94626) $184.09 $245.45 3.0×
Phy/qhp op pulm rhb w/o mntr (94625) $128.17 $170.89 2.1×
Plethysmography (94726) $186.23 $248.30 0.5×
Pm device progr eval dual (93280) $87.99 $117.32 2.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,837.44 $3,783.26 3.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $17.16 $22.88 0.3×
Pt Aquatic Therapy/Exercises (97113) $115.04 $153.39 3.1×
Pt Electric Current Therapy (97033) $83.08 $110.76 4.4×
Pt Electrical Stimulation (97032) $38.46 $51.28 2.6×
Pt eval high complex 45 min (97163) $177.34 $236.46 1.8×
Pt eval low complex 20 min (97161) $177.34 $236.46 1.8×
Pt Gait Training Therapy (97116) $80.73 $107.64 2.8×
Pt Infrared Therapy (97026) $71.85 $95.80 10.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $97.96 $130.62 3.0×
Pt Physical Performance Test (97750) $84.98 $113.30 2.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $177.34 $236.46 1.8×
Pt re-evaluation (97164) $59.62 $79.49 0.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $89.38 $119.18 2.8×
Pt Ultrasound Therapy (97035) $86.55 $115.40 6.0×
Pt Whirlpool Therapy (97022) $107.62 $143.50 6.9×
Pulmonary stress testing (94618) $319.60 $426.14 2.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $71.18 $94.90 1.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $170.86 $227.82 0.8×
Rt Chest Wall Manipulation,Subsequent (94668) $56.14 $74.86 0.4×
Sensory Integration Ea 15 Min (97533) $55.45 $73.93 0.9×
Smoking cessation > 10 min (99407) $6.14 $8.19 0.2×
Speech sound lang comprehen (92523) $224.52 $299.36 1.0×
Spirometry (94010) $200.85 $267.80 0.9×
Standardized Cognitive Performance Testing (96125) $224.48 $299.30 2.2×
Temp transcutaneous pacing (92953) $200.36 $267.15 0.3×
Ther/Proph/Diag Inj Sc/Im (96372) $77.08 $102.76 1.0×
Therapeutic Activities (97530) $72.93 $97.24 2.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,601.95 $2,135.93 2.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $151.20 $201.60 2.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $164.74 $219.66 2.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $76.54 $102.05 1.5×
Vasc Duplex Extrem Venous,Bilat (93970) $877.09 $1,169.45 3.5×
Vasopneumatic device (97016) $110.86 $147.80 9.2×
Ventilation assist & mgmt inpatient 1st day (94002) $573.21 $764.28 0.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $399.06 $532.08 0.6×
Vital capacity total (94150) $53.92 $71.89 0.4×
Wheelchair Mgmt Ea 15 Min (97542) $42.92 $57.22 1.4×