CarePrice

South Lincoln Medical Center

, Kemmerer

ProcedureCodeCash Price
DEXAMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGRAMJ7637< $1
INJECTION PROMETHAZINE HCL TOJ2550$4.73
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH LESS THAN THREE INCHES, PER YARDA6448$7.88
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARDA6449$7.88
ADMIN INFLUENZA VIRUS VACCINEG0008$7.88
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO FIVE INCHES, PER YARDA6450$7.88
INJ TRIAMCINOLONE ACETONIDEJ3301$8.66
IQ TSTS SEQL&INCRL AIRBORNE95027$9.45
INJECTION ONABOTULINUMTOXIN AJ0585$10.06
PT VASOPNEUMATIC 1UNIT97016$10.42
AMBL BP MNTR W/SW A/R93788$11.03
EMOTIONAL BEHAVIORAL ASSESSMT96127$11.03
PADDING BANDAGE, NON-ELASTIC, NON-WOVEN/NON-KNITTED, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARDA6441$11.25
Potassium hydroxide prepsQ0112$11.48
PATCH/APPLICATION TESTS95044$11.81
URINALYSIS81003$12.99
PERCUT ALLERGY SKIN TESTS95004$13.39
HB CAPILLARY DRAWING CHARGE36416$14.96
HB BREAST TOMO UNI DIAG77061$15
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTIONJ2360$15.36
Strep a ag ia87430$15.75
Urinalysis volume measure81050$15.75
GLUCOSE BLOOD TEST W/DEVICE82962$15.75
LAB STREPTOCOCCUS GRP A87880$15.75
ADM SET PEU NEB DISP 2/MA7003$15.75
DOME/MOUTH PIECE USN 2YRA7016$15.75
IMMUNIZATION ADMIN 1 VACCINE90471$16.29
IMMUNIZATION ADMIN ADDL VACC90472$16.29
IMMUNIZATION ADMIN ORAL90473$16.29
IMMUNIZATION ADMIN ORAL ADD'L90474$16.29
IM ADMIN 1ST/ONLY COMPONENT90460$16.29
IM ADMIN EACH ADDL COMPONENT90461$16.29
PCV15 VACCINE IM90671$16.29
ADMINISTRATION OF RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, SEASONAL DOSE BY INTRAMUSCULAR INJECTION, WITH COUNSELING BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL96380$16.29
ALL TSTG PERQ&IQ W/VENOMS95017$16.54
ICUT ALLERGY TEST DRUG/BUG95024$16.54
SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]) VACCINE, MRNA-LNP, SPIKE PROTEIN, BIVALENT, PRESERVATIVE FREE, 50 MCG/0.5 ML DOSAGE, FOR INTRAMUSCULAR USE91313$17.11
EKG INTERPRETATION93010$17.33
ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATIONG0405$17.33
INJECT TESTOSTERONE CYPIONATEJ1071$17.33
AFLURIA QUADRIVALENT FLU VACCINE90688$17.96
INFLUENZA VIRUS VACCINE, QUADRIVALENT (CCIIV4), DERIVED FROM CELL CULTURES, SUBUNIT, ANTIBIOTIC FREE, 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE90756$17.96
ALLERGEN IMMUNOTHRPY SNGL INJ95115$18.11
PHYSICIAN SERVICE REQUIRED TO ESTABLISH AND DOCUMENT THE NEED FOR A POWER MOBILITY DEVICEG0372$18.11
PHYSICIAN DOCUMENTATION OF FACE-TO-FACE VISIT FOR DURABLE MEDICAL EQUIPMENT DETERMINATION PERFORMED BY NURSE PRACTITIONER, PHYSICIAN ASSISTANT OR CLINICAL NURSE SPECIALISTG0454$18.90
PHYSICIAN REVIEW, INTERPRETATION, AND PATIENT MANAGEMENT OF HOME INR TESTING FOR PATIENT WITH EITHER MECHANICAL HEART VALVE(S), CHRONIC ATRIAL FIBRILLATION, OR VENOUS THROMBOEMBOLISM WHO MEETS MEDICARE COVERAGE CRITERIA; TESTING NOT OCCURRING MORE FREQUENG0250$18.90
TISSUE EXAM KOH PREP OF SKIN87220$19.02
SMEAR PRIM SRC WET MOUNT87210$19.02
INFLUENZA VIRUS VACCINE 3+YRS90658$19.58
ANTIGEN THERAPY SERVICES95170$19.69
HB SP-DEVELOPMENTAL SCREENINGG0451$19.69
REMOVAL OF SUTURES; BY A PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY CLOSED THE WOUNDS0630$19.69
METHYLPRDLA80MG(100)J1040$20.48
FLUZONE HIGH DOSE VACCINE90662$20.67
NORMAL SALINE SOLUTION 1000CCJ7030$21.23
ALLERGEN IMMUNOTHERAPY 2+ INJ95117$21.26
INFLUENZA VIRUS VACCINE90685$21.66
INFLUENZA VIRUS VACCINE90686$21.66
INFLUENZA VIRUS VACCINE, QUADRIVALENT (IIV4), SPLIT VIRUS, 0.25 ML DOSAGE, FOR INTRAMUSCULAR USE90687$21.66
HB EMS-GROUND MILEAGEA0425$21.71
SCREENING PERFORMED AND POSITIVE AND PROVISION OF RECOMMENDATIONSG9919$21.75
SCREENING PERFORMED AND NEGATIVEG9920$21.75
INJECTION VITAMIN B-12J3420$23.25
CAREGIVER HEALTH RISK ASSMT96161$23.63
Glycosylated hb home device83037$23.63
HB EKG SCREEN W INIT PRE P/E NO I&R-ONLY MCG0404$23.63
SKIN TEST TUBERCULOSIS86580$23.63
DEVELOPMENTAL SCREENING96110$23.63
BRIEF VRTUL CHEKIN MD/QHP 5-10G2012$24.41
PAYMENT FOR A TELEHEALTH DISTANT SITE SERVICE FURNISHED BY A RURAL HEALTH CLINIC (RHC) OR FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ONLYG2025$24.41
PF PHONE E M PHYS QHP 5 10MIN99441$24.41
HIGH COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE GREATER THAN OR EQUAL TO 1.35 FOOT POUNDS AT 50% MAXIMUM STRETCH, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARDA6452$24.75
COLLAGEN DRESSING, STERILE, SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACHA6022$24.92
Group behave couns 2-10G0473$25.20
ANTIGEN THERAPY SERVICES95144$25.20
INJECTION CEFTRIAXONE SODIUMJ0696$25.64
REMOVE IMPACTED EAR WAX UNI69209$25.99
ANTIGEN THERAPY SERVICES95165$25.99
BLOOD COUNT HEMGLOBIN85018$26.25
IQ TSTS ALLERGY DELAYED RXN95028$27.56
HB RX FLU - AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE (90694)90694$27.56
GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIEDA6549$27.56
SKIN SUB GRAFT T/A/L ADD-ON15272$27.75
TRIM NAIL(S) ANY NUMBER11719$28.35
INJ ONDANSETRON HYDROCHLORIDEJ2405$28.49
URINALYSIS81002$28.72
SMOKING/TOBACCO CESSATION99406$29.14
HB DIAB TRAIN GROUP/30 MING0109$29.14
ADMN SARSCOV2 VACC 1 DOSE90480$29.60
CARDIO STRSS TST INTRP W REPRT93018$29.93
INJ KETOROLAC TROMETHAMINEJ1885$30.22
HB CC PYXIS-ARM SLING LGA4565$30.75
METHYLPRED LA 40MG JJ1030$31.20
LAB INFLUENZA87804$31.50
LAB RESPIRATORY SYNCYTIAL87807$31.50
HB MED NUTRITION TX-GRP PER 30 MIN97804$32.29
MEDICAL NUTRITION THERAPY, REASSESSMENT AND SUBSEQUENT INTERVENTION(S) FOLLOWING SECOND REFERRAL IN SAME YEAR FOR CHANGE IN DIAGNOSIS, MEDICAL CONDITION, OR TREATMENT REGIMEN (INCLUDING ADDITIONAL HOURS NEEDED FOR RENAL DISEASE), GROUP (2 OR MORE INDIVIDUG0271$32.29
INJ DEXAMETHASONE SOD PHOSPHJ1100$32.54
COLLECTION VENOUS BLOOD36415$32.63
URINALYSIS81001$33.75