MCDH ChargeMasater 1.1.2019
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Service Code [key]
DescriptionPrice
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14104359FINGERSTICK,HEEL,EAR$32.00
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30100001INTENSIVE CARE ROOM$5,891.00
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30100002ROOM CHARGE ICU/CONVENIENCE$2,496.00
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30100003RECOVERY 1ST HOUR$908.00
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30100004RECOVERY EA ADDL 15MIN$229.00
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30100009CARDIOVERSION EXTRNL ELECTIVE$783.00
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30800002ROOM CHARGE$3,201.00
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30800003SEMI PRIVATE ROOM$3,201.00
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30800004WARD$1,783.00
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30800005NEGATIVE PRESSURE$4,992.00
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30800006OP IN INPT BED$0.00
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31700005ISOLATION ROOM$3,463.00
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31700009E&M LEVEL I$105.00
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31700015PHLEBOTOMY THERAPEUTIC$165.00
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31700016OBSERVATION PER HR$133.00
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31700018BLOOD TRANSF LEVEL III$1,960.00
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31700019BLOOD TRANSF LEVEL I$871.00
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31700020BLOOD TRANSF LEVEL II$1,307.00
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31700021RECOV PHASEII 1ST HR$454.00
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31700022RECOV PH II ADD 15MN$57.00
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31700023CHEMO INF 1ST HR$655.00
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31700026CHEMO IV PUSH INITIAL$297.00
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31700029CHEMO INF EACH ADDL HR$309.00
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31700030IV THERAPY 1ST HOUR$579.00
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31700031IV THERAPY EA ADD HR$226.00
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31700032MED/SURG SQ/IM INJ$72.00
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31700033IV PUSH EACH INITIAL$129.00
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31700035E&M DIRECT ADMIT TO OBSERV$164.00
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31700036CHEMO SQ/IM INJ NON HORM$173.00
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31700037OBS DIRECT ADMIT$164.00
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31700038OP E&M EST LEVEL V$195.00
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31700039IV PUSH EA ADDL NEW DRUG$81.00
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31700040REFILL/MAINT PORT PUMP$416.00
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31700041CHEMO IV PUSH EACH ADDL DRUG$183.00
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31700042IV INF HYDRATION EACH ADDL HR$59.00
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31700043IV INF HYDRATION 1ST HR$579.00
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31700045IV PUSH EA ADDL SAME DRUG$81.00
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31700046SQ INFUSION 1ST HOUR$579.00
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31700047SQ INFUSION EA ADDL HOUR$226.00
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31700048SQ INFUSION NEW SITE$128.00
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31700051BURN TX DRS/DEB PT SM$231.00
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31700052INFLUENZA VACCINE IM INJ$62.00
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31700053PNEUMONIA VACCINE IM INJ$60.00
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31700054HEP B VACCINE IM INJ$60.00
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31700057INJECT VACCINE$72.00
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31700058SEQUENTIAL IV THERAPY INF$128.00
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31700059CONCURRENT INFUSION$66.00
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31700061FINGER/HEEL STICK$32.00
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33800006OBSTETRICS ROOM$2,496.00
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33800007SEMI PRIVATE ROOM$2,496.00
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33800008OBSTETRICS PRIVATE ROOM$2,377.00
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33800009OBSTETRICS ISOLATION$3,463.00
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33800010OB OBS PER HOUR$84.00
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33800011IV INF HYDRATION 1ST HR$579.00
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33800012IV INF HYDRATION EACH ADDL HR$59.00
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33800013IV INF THERAPY 1ST HR$579.00
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33800014IV INFUSION EA ADDL HR$226.00
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33800015IV PUSH EACH INITIAL$129.00
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33800016IV PUSH EA ADDL NEW DRUG$81.00
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33800017IM INJECT VACCINE$72.00
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33800018OB SQ/IM INJ$72.00
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33800019EXTERNAL VERSION$321.00
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33800020EPISIOTOMY OR VAG REPAIR$1,260.00
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33800021IV PUSH EA ADDL SAME DRUG$81.00
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33800022SQ INFUSION 1ST HOUR$579.00
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33800023SQ INFUSION EA ADDL HOUR$226.00
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33800024SQ INFUSION NEW SITE$128.00
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33800025OB E&M LEVEL I$105.00
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33800027FINGERSTICK, HEEL, EAR$32.00
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35320100NURSERY LEVEL II$962.00
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35320101NURSERY LEVEL IV$2,404.00
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35320102NURSERY LEVEL 1$692.00
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35320108NURSERY LEVEL III$1,085.00
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35320109NURSERY SQ/IM INJ$72.00
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35320110NURSERY GENERAL$962.00
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35320238INITIAL HEARING SCREEN IP$60.00
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35320239INITIAL HEARING SCREEN OP$60.00
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35320240HEARING RESCREEN OP$60.00
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35620001SWING BED ROOM$2,609.00
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35620002REHAB IN SWING$1,128.00
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40130139ER-SUT C/SAL 1.2-2.5 CM$440.00
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40130140ER-SUT C/SAL 2.6-7.5 CM$561.00
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40130150ER BIOPSY SOFT TISSUE SHOULDER$1,465.00
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40130291ER-REP CMPLX/FCCMN 2.6-7.5 CM$768.00
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40130301ER-REP CMPLX/FCCMN 1.1-2.5 CM$508.00
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40130302ER-REP CMPLX/F 2.6-7.5 CM$2,059.00
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40130308ER EXCISION INGROWN TOENAIL$1,776.00
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40130310ER PERITONEAL LAVAGE$744.00
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40134001ER-BRIEF EVALUATION$300.00
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40134002LIMITED EVAL-ER$600.00
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40134003INTERMEDIATE EVAL-ER$900.00
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40134004EXTENDED EVAL-ER$1,700.00
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40134010COMPREHENSIVE EVAL-ER$2,500.00
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40134011CRITICAL CARE-ER$3,242.00
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40134015ER I&D ABSCESS SIMPLE$233.00
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40134017ER FB REM SQ SIMPLE$233.00
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40134018ER AVUL NAIL PLATE SIMPLE$162.00
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40134019ER EVAC SUBUNGUAL HEMAT$162.00
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40134020ER-SUT S/SNTE 2.5 CM OR <$192.00
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