|
|
Charges for commonly ordered diagnostic
and therapeutic services
| CPT CODE |
SERVICE/PROCEDURE |
GETTYSBURG HOSPITAL |
YORK HOSPITAL |
| |
Cardiac Diagnostics |
|
|
| 93017 |
Treadmill stress test |
$396.50 |
$396.50 |
| |
|
|
|
| 93350 |
Treadmill stress echocardiogram |
$1,672.75 |
$1,672.75 |
| |
|
|
|
| 93307 |
Echocardiogram |
$998.25 |
$998.25 |
| |
|
|
|
| 93510 |
Diagnostic cardiac catheterization (Left heart cath) |
$1,239.75 |
$1,239.75 |
| |
|
|
|
| |
Cardiac Rehabilitation |
|
|
| 93798 |
Therapy -- Initial visit |
$128.75 |
$128.75 |
| |
|
|
|
| |
Physical Therapy |
|
|
| 97001 |
Physical therapy evaluation |
$169.25 |
$169.25 |
| |
|
|
|
| 97140 |
Manual Therapy (15 min) |
$63.75 |
$63.75 |
| |
|
|
|
| |
Diagnostic Imaging Studies |
|
|
| 74150 |
CT Scan of the abdomen (unenhanced) |
$1,343.00 |
$1,343.00 |
| |
|
|
|
| 72141 |
MRI scan of the cervical spine (unenhanced) |
$1,190.00 |
$1,190.00 |
| |
|
|
|
| G0202/77052 |
Digital screening mammogram with computer aided detection |
$176.00 |
$176.00 |
| |
|
|
|
| 71010 |
X-ray – CXR frontal |
$123.00 |
$123.00 |
| |
|
|
|
| 71020 |
X-ray – CXR 2 Views |
$159.50 |
$159.50 |
| |
|
|
|
| |
Laboratory Studies |
|
|
| 80061 |
Lipid panel |
$72.00 |
$72.00 |
| |
|
|
|
| 81003 |
Routine urinalysis |
$16.75 |
$16.75 |
| |
|
|
|
|