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Patient Price Information List

Disclaimer: Pullman Regional Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Pullman Regional Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2021. Pullman Regional Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Cascade Valley Hospital

Arlington

WA

Grays Harbor Community Hospital

Aberdeen

WA

Gritman Medical Center

Moscow

ID

Island Hospital

Anacortes

WA

Jefferson Healthcare

Port Townsend

WA

Lourdes Medical Center

Pasco

WA

PMH Medical Center

Prosser

WA

Providence Holy Family Hospital

Spokane

WA

Providence Sacred Heart Med Ctr

Spokane

WA

Saint Joseph Regional Med Ctr

Lewiston

ID

Sunnyside Community Hospital

Sunnyside

WA

Tri-State Memorial Hospital

Clarkston

WA

Valley Hospital

Spokane Valley

WA

Whitman Hospital Medical Center

Colfax

WA

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Semi-Private Room

$1,448
$2,135

32% lower than market

Swing Bed

$1,360
$1,360

Approximately equal to market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$2,186
$3,377

35% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$867
$813

7% higher than market

Anesthetic agent and/or steroid injection into lower or sacral spine nerve root with imaging guidance (single level) [HCPCS 64483]

$1,459
$2,892

50% lower than market

Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]

$4,271
$8,488

50% lower than market

Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]

$3,001
$9,549

69% lower than market

Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]

$3,335
$10,071

67% lower than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$2,559
$7,943

68% lower than market

Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]

$2,712
$8,942

70% lower than market

Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]

$2,086
$8,394

75% lower than market

Gallbladder removal with an endoscope [HCPCS 47562]

$14,306
$29,626

52% lower than market

Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]

$5,112
$22,022

77% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$1,460
$1,553

6% lower than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$3,205
$3,654

12% lower than market

Imaging of leg joint by MRI without contrast [HCPCS 73721]

$2,377
$2,434

2% lower than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$2,546
$2,565

1% lower than market

Knee cartilage removal with endoscope (one knee) [HCPCS 29881]

$7,972
$15,467

48% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$80
$58

37% higher than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$49
$39

26% higher than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$147
$127

15% higher than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$45
$62

28% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$125
$127

2% lower than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$68
$97

31% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$45
$62

28% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$53
$97

45% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$141
$107

32% higher than market

Lab analysis to measure the amount of free PSA (prostate specific antigen) in serum specimen [HCPCS 84154]

$99
$133

26% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$140
$118

19% higher than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$143
$114

25% higher than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$107
$129

17% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$151
$133

13% higher than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$373
$490

24% lower than market

Mammography of both breasts for diagnosis [HCPCS 77066]

$352
$590

40% lower than market

Mammography of one breast for diagnosis [HCPCS 77065]

$352
$463

24% lower than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 45-59 minutes) [HCPCS 99204]

$374
$284

32% higher than market

Pelvis CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 72193]

$2,194
$2,450

10% lower than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$83
$104

20% lower than market

Prostate gland biopsy [HCPCS 55700]

$4,271
$3,845

11% higher than market

Psychotherapy treatment by physician face-to-face with patient (30 minutes) [HCPCS 90832]

$86
$162

47% lower than market

Psychotherapy treatment by physician face-to-face with patient (45 minutes) [HCPCS 90834]

$115
$205

44% lower than market

Psychotherapy treatment by physician face-to-face with patient (60 minutes) [HCPCS 90837]

$156
$177

12% lower than market

Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]

$4,502
$4,021

12% higher than market

Spinal canal injection of substance into lower back or sacrum with imaging guidance [HCPCS 62323]

$2,243
$2,517

11% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$423
$587

28% lower than market

Total Knee or Hip Replacement

$46,299
$71,386

35% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Critical care delivery to critically ill or injured patient (first 30-74 minutes) [HCPCS 99291]

$2,967
$3,309

10% lower than market

Emergency department visit for minor problem [HCPCS 99281]

$158
$253

37% lower than market

Emergency department visit for problem of high severity [HCPCS 99284]

$1,287
$1,130

14% higher than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$295
$452

35% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$641
$769

17% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$2,322
$2,062

13% higher than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Drug screening read by chemistry analyzers [HCPCS 80307]

$253
$296

14% lower than market

Lab analysis by immunoassay (ELISA) to identify Hepatitis B surface antigen [HCPCS 87340]

$103
$108

5% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify antigen of severe acute respiratory syndrome coronavirus 2 (Covid-19) [HCPCS 87635]

$100
$217

54% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify clostridium difficile by amplified probe technique [HCPCS 87493]

$150
$181

17% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify Staphylococcus aureus, methicillin resistant (MRSA bacteria) by amplified probe technique [HCPCS 87641]

$164
$242

32% lower than market

Lab analysis of any culture (except blood) to identify aerobic isolates (each isolate) [HCPCS 87077]

$59
$86

31% lower than market

Lab analysis of any culture (except blood) to identify anaerobic bacteria [HCPCS 87075]

$158
$139

13% higher than market

Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]

$99
$108

9% lower than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$198
$142

40% higher than market

Lab analysis of complex special stain to identify parasites [HCPCS 87209]

$75
$112

33% lower than market

Lab analysis of smear to identify and measre the amount of parasites in culture [HCPCS 87177]

$75
$86

12% lower than market

Lab analysis of special fluorescent and/or acid fast stain to idenitfy microorganisms [HCPCS 87206]

$45
$69

35% lower than market

Lab analysis of stool culture to identify bacteria [HCPCS 87045]

$99
$101

2% lower than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$99
$88

13% higher than market

Lab analysis of urine specimen by dipstick to detect the hormone found in women in early pregnancy [HCPCS 81025]

$80
$75

7% higher than market

Lab analysis to identify antibodies for autoimmune disorder assessment (any method) [HCPCS 86235]

$112
$89

26% higher than market

Lab analysis to identify gonadotropin (reproductive hormone) in serum or urine specimen [HCPCS 84703]

$81
$108

25% lower than market

Lab analysis to identify infectious agent antibodies (quantitative) [HCPCS 86317]

$45
$78

43% lower than market

Lab analysis to identify substances by immunoassay technique (multiple step method) [HCPCS 83516]

$205
$161

27% higher than market

Lab analysis to identify white blood cells (manual) with microscope [HCPCS 85007]

$21
$47

56% lower than market

Lab analysis to measure blood count (hemoglobin) [HCPCS 85018]

$27
$35

22% lower than market

Lab analysis to measure blood glucose (sugar) level with hand-held instrument [HCPCS 82962]

$26
$28

6% lower than market

Lab analysis to measure coagulation function measurement of D-dimer (quantitative) [HCPCS 85379]

$145
$155

7% lower than market

Lab analysis to measure free testosterone (hormone) level in serum specimen [HCPCS 84402]

$150
$124

21% higher than market

Lab analysis to measure free thyroxine (thyroid chemical) in serum specimen [HCPCS 84439]

$78
$101

23% lower than market

Lab analysis to measure red blood cell concentration [HCPCS 85014]

$27
$38

29% lower than market

Lab analysis to measure red blood cell sedimentation rate to detect inflammation (automated) [HCPCS 85652]

$56
$51

11% higher than market

Lab analysis to measure red blood cell sedimentation rate to detect inflammation (non-automated) [HCPCS 85651]

$56
$49

15% higher than market

Lab analysis to measure red blood count (automated test) [HCPCS 85045]

$40
$58

32% lower than market

Lab analysis to measure the ammonia level [HCPCS 82140]

$124
$153

19% lower than market

Lab analysis to measure the amount of blood gases [HCPCS 82803]

$198
$224

12% lower than market

Lab analysis to measure the amount of blood in stool specimen to screen for colon tumors [HCPCS 82270]

$31
$54

43% lower than market

Lab analysis to measure the amount of carbamazepine (total) in blood specimen [HCPCS 80156]

$96
$134

29% lower than market

Lab analysis to measure the amount of free thyroid hormone, T3 in serum specimen [HCPCS 84481]

$114
$132

13% lower than market

Lab analysis to measure the amount of gammaglobulin (immune system protein) [HCPCS 82784]

$80
$74

8% higher than market

Lab analysis to measure the amount of lithium in blood specimen [HCPCS 80178]

$74
$73

1% higher than market

Lab analysis to measure the amount of methemoglobin (hemoglobin) [HCPCS 83050]

$67
$60

11% higher than market

Lab analysis to measure the amount of protein in body fluid specimen [HCPCS 84166]

$112
$130

14% lower than market

Lab analysis to measure the amount of substance by other immunoassay technique [HCPCS 83520]

$343
$148

131% higher than market

Lab analysis to measure the amount of substance by radioimmunoassay [HCPCS 83519]

$1,032
$180

475% higher than market

Lab analysis to measure the amount of tacrolimus in blood specimen [HCPCS 80197]

$109
$167

35% lower than market

Lab analysis to measure the amount of total cortisol (hormone) [HCPCS 82533]

$103
$157

35% lower than market

Lab analysis to measure the amount of total digoxin in blood specimen [HCPCS 80162]

$88
$131

33% lower than market

Lab analysis to measure the amount of total estradiol (hormone) [HCPCS 82670]

$190
$169

13% higher than market

Lab analysis to measure the amount of total valproic acid in blood specimen [HCPCS 80164]

$110
$122

10% lower than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$163
$174

6% lower than market

Lab analysis to measure the amount of vancomycin (antibiotic) in serum specimen [HCPCS 80202]

$105
$148

29% lower than market

Lab analysis to measure the amylase (enzyme) level in serum specimen [HCPCS 82150]

$87
$85

3% higher than market

Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]

$56
$55

2% higher than market

Lab analysis to measure the calprotectin (protein) level in stool specimen [HCPCS 83993]

$84
$326

74% lower than market

Lab analysis to measure the carboxyhemoglobin (protein) level [HCPCS 82375]

$50
$145

66% lower than market

Lab analysis to measure the carcinoembryonic antigen (cea) protein level [HCPCS 82378]

$119
$144

18% lower than market

Lab analysis to measure the creatine kinase (cardiac enzyme) level (MB fraction only) [HCPCS 82553]

$144
$174

18% lower than market

Lab analysis to measure the creatinine level to test for kidney function or muscle injury (other than blood specimen) [HCPCS 82570]

$40
$67

41% lower than market

Lab analysis to measure the cyanocobalamin (vitamin b-12) level [HCPCS 82607]

$100
$120

16% lower than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$117
$121

4% lower than market

Lab analysis to measure the folic acid level in serum specimen [HCPCS 82746]

$97
$111

13% lower than market

Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]

$84
$94

11% lower than market

Lab analysis to measure the iron binding capacity [HCPCS 83550]

$31
$78

60% lower than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$122
$134

9% lower than market

Lab analysis to measure the level of blood proteins (nephelometry) using light [HCPCS 83883]

$53
$183

71% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$73
$101

28% lower than market

Lab analysis to measure the liver enzyme (sgot), level in serum or plasma specimen [HCPCS 84450]

$63
$54

18% higher than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$67
$69

3% lower than market

Lab analysis to measure the microalbumin (protein) level in urine specimen [HCPCS 82043]

$47
$76

38% lower than market

Lab analysis to measure the natriuretic peptide (heart and blood vessel protein) level in plasma specimen [HCPCS 83880]

$322
$286

13% higher than market

Lab analysis to measure the organic acid level in urine specimen [HCPCS 83921]

$98
$150

35% lower than market

Lab analysis to measure the parathormone (parathyroid hormone) level [HCPCS 83970]

$122
$265

54% lower than market

Lab analysis to measure the prolactin (milk producing hormone) level in serum specimen [HCPCS 84146]

$95
$126

25% lower than market

Lab analysis to measure the sex hormone binding globulin (protein) level in serum specimen [HCPCS 84270]

$59
$97

39% lower than market

Lab analysis to measure the sodium level in urine specimen [HCPCS 84300]

$56
$69

19% lower than market

Lab analysis to measure the the alpha-fetoprotein (AFP) level in serum specimen [HCPCS 82105]

$84
$125

32% lower than market

Lab analysis to measure the total calcium level in blood specimen [HCPCS 82310]

$52
$59

11% lower than market

Lab analysis to measure the total creatine kinase (cardiac enzyme) level in blood specimen [HCPCS 82550]

$84
$86

2% lower than market

Lab analysis to measure the vitamin B-1 (thiamine) level in blood specimen [HCPCS 84425]

$145
$138

5% higher than market

Lab analysis to measure the vitamin B-6 level in plasma specimen [HCPCS 84207]

$99
$138

28% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$144
$165

13% lower than market

Lab analysis to measure total testosterone (hormone) level in serum specimen [HCPCS 84403]

$66
$158

58% lower than market

Lab analysis to measure urea nitrogen level in serum or plasma specimen to assess kidney function (quantitative) [HCPCS 84520]

$53
$54

1% lower than market

Lab analysis to screen for autoimmune disorders [HCPCS 86038]

$99
$94

6% higher than market

Lab blood analysis to confirm blood unit compatibility by antiglobulin technique [HCPCS 86922]

$102
$126

19% lower than market

Lab blood analysis to confirm blood unit compatibility by immediate spin technique [HCPCS 86920]

$103
$126

18% lower than market

Lab blood analysis to confirm blood unit compatibility by incubation technique [HCPCS 86921]

$94
$107

12% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$58
$110

47% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]

$36
$62

42% lower than market

Lab blood analysis to identify the coating of red blood cells by antibody (Coombs test) (indirect, each reagent) [HCPCS 86885]

$82
$104

21% lower than market

Lab examination of specimen by the selective celllular enhancement technique to diagnose disease [HCPCS 88112]

$121
$197

39% lower than market

Lab genetic analysis of tumor (manual) [HCPCS 88360]

$165
$261

37% lower than market

Pathology lab analysis by flow cytometry technique for DNA or cell analysis technical component (each additional marker) [HCPCS 88185]

$224
$54

313% higher than market

Pathology lab analysis of special stained specimen slides to examine tissue (each additional procedure) [HCPCS 88341]

$109
$149

27% lower than market

Pathology lab analysis of special stained specimen slides to examine tissue (initial procedure) [HCPCS 88342]

$170
$322

47% lower than market

Pathology lab analysis of tissue with microscope (intermediate complexity) [HCPCS 88305]

$182
$239

24% lower than market

Pathology lab analysis of tissue with microscope (moderately high complexity) [HCPCS 88307]

$405
$482

16% lower than market

Pathology lab analysis of tissue with microscope (moderately low complexity) [HCPCS 88304]

$132
$218

39% lower than market

Pathology lab analysis with tissue preparation for examination by removing any calcium present [HCPCS 88311]

$18
$67

73% lower than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Administration of external shock to heart to regulate heart beat [HCPCS 92960]

$1,786
$1,622

10% higher than market

Chemotherapy administration into vein by infusion (each additional hour) [HCPCS 96415]

$312
$194

61% higher than market

Drug administration beneath the skin or into muscle by injection for therapy, diagnosis, or prevention [HCPCS 96372]

$89
$161

44% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$496
$506

2% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$180
$136

33% higher than market

External 48-hour EKG heart rhythm tracing, analysis, and interpretation with scanning analysis and report [HCPCS 93226]

$604
$320

89% higher than market

Hydration administration into vein by infusion (31 minutes to 1 hour) [HCPCS 96360]

$503
$450

12% higher than market

Immunization administration of vaccine into, between, or beneath the skin or into muscle (each additional vaccine) [HCPCS 90472]

$45
$77

42% lower than market

Immunization administration of vaccine into, between, or beneath the skin or into muscle (single vaccine) [HCPCS 90471]

$89
$110

19% lower than market

Implanted venous access drug delivery device irrigation [HCPCS 96523]

$218
$174

25% higher than market

Manual chest wall manipulation for improved lung function (initial evaluation) [HCPCS 94667]

$255
$287

11% lower than market

Manual chest wall manipulation for improved lung function (subsequent evaluation) [HCPCS 94668]

$160
$210

24% lower than market

Mechanical traction application to 1 or more areas [HCPCS 97012]

$83
$105

21% lower than market

Medical nutrition therapy assessment and intervention (each 15 minutes) [HCPCS 97802]

$70
$54

28% higher than market

Medical nutrition therapy re-assessment and intervention (each 15 minutes) [HCPCS 97803]

$70
$40

76% higher than market

Oxygen saturation measurement in blood by ear or finger device (continuous overnight monitoring) [HCPCS 94762]

$286
$394

27% lower than market

Physician services for outpatient heart rehab with continuous EKG monitoring (per session) [HCPCS 93798]

$284
$224

27% higher than market

Routine EKG (electrocardiogram) interpretation and report [HCPCS 93010]

$50
$55

9% lower than market

Sleep pattern monitoring of patient in sleep lab with continued pressured respiratory assistance by mask or breathing tube (6 years of age or older) [HCPCS 95811]

$3,779
$4,444

15% lower than market

Swallowing function evaluation by fluoroscopy with video recording [HCPCS 92611]

$447
$497

10% lower than market

Tetanus and diphtheria toxoids vaccine for injection into muscle (7 years of age or older) [HCPCS 90714]

$46
$91

50% lower than market

Therapeutic excercises and water pool therapy to 1 or more areas (each 15 minutes) [HCPCS 97113]

$94
$68

38% higher than market

Training on wheelchair management (each 15 minutes) [HCPCS 97542]

$73
$122

40% lower than market

OUTPATIENT OBSERVATION

Description

Our Charge
Market Charge

Variance

Hospital observation care on discharge date [HCPCS 99217]

$178
$214

17% lower than market

Hospital observation or inpatient care provided to patients admitted and discharged on the same date of service for problem(s) of high severity (55 minutes per day) [HCPCS 99236]

$467
$756

38% lower than market

Hospital observation or inpatient care provided to patients admitted and discharged on the same date of service for problem(s) of moderate severity (50 minutes per day) [HCPCS 99235]

$386
$549

30% lower than market

Hospital observation per hr [HCPCS G0378]

$338
$200

69% higher than market

Initial observation care (typically 50 minutes) [HCPCS 99219]

$248
$366

32% lower than market

Initial observation care (typically 70 minutes) [HCPCS 99220]

$326
$520

37% lower than market

OUTPATIENT OTHER

Description

Our Charge
Market Charge

Variance

Non-covered item or service [HCPCS A9270]

$15
$97

84% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Alteplase recombinant [HCPCS J2997]

$2
$131

98% lower than market

Cefazolin sodium injection [HCPCS J0690]

$7
$18

62% lower than market

Chemotherapy administration into vein by infusion (up to 1 hour, single drug) [HCPCS 96413]

$750
$791

5% lower than market

Diazepam injection [HCPCS J3360]

$49
$82

40% lower than market

Diphenhydramine hcl injectio [HCPCS J1200]

$50
$49

3% higher than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of new drug) [HCPCS 96375]

$104
$137

24% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (initial drug) [HCPCS 96374]

$156
$330

53% lower than market

F18 fdg [HCPCS A9552]

$824
$1,295

36% lower than market

Fentanyl citrate injection [HCPCS J3010]

$50
$63

21% lower than market

Haloperidol injection [HCPCS J1630]

$50
$54

8% lower than market

Hydralazine hcl injection [HCPCS J0360]

$50
$86

42% lower than market

Hydromorphone injection [HCPCS J1170]

$50
$64

21% lower than market

Infliximab not biosimil 10mg [HCPCS J1745]

$6
$41

85% lower than market

Inj enoxaparin sodium [HCPCS J1650]

$4
$6

34% lower than market

Inj midazolam hydrochloride [HCPCS J2250]

$13
$37

66% lower than market

Inj naloxone hydrochloride [HCPCS J2310]

$11
$131

92% lower than market

Inj perflutren lip micros,ml [HCPCS Q9957]

$198
$262

25% lower than market

Ketorolac tromethamine inj [HCPCS J1885]

$13
$159

92% lower than market

Lorazepam injection [HCPCS J2060]

$50
$63

21% lower than market

Meperidine hydrochl /100 mg [HCPCS J2175]

$6
$69

91% lower than market

Methylprednisolone injection [HCPCS J2930]

$58
$64

10% lower than market

Metoclopramide hcl injection [HCPCS J2765]

$50
$51

2% lower than market

Neostigmine methylslfte inj [HCPCS J2710]

$1
$16

93% lower than market

Succinycholine chloride inj [HCPCS J0330]

$1
$16

91% lower than market

Tc99m mebrofenin [HCPCS A9537]

$115
$328

65% lower than market

Tc99m medronate [HCPCS A9503]

$125
$258

52% lower than market

Tc99m sestamibi [HCPCS A9500]

$9,681
$226

4177% higher than market

Tc99m sulfur colloid [HCPCS A9541]

$259
$485

47% lower than market

Tetanus, diphtheria toxoids and acellular pertussis (whooping cough) vaccine for injection into muscle (7 years of age or older) [HCPCS 90715]

$53
$127

58% lower than market

Vancomycin hcl injection [HCPCS J3370]

$16
$21

27% lower than market

Vitamin k phytonadione inj [HCPCS J3430]

$3
$15

83% lower than market

Zoledronic acid 1mg [HCPCS J3489]

$19
$102

82% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Elec stim other than wound [HCPCS G0283]

$114
$80

43% higher than market

Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]

$94
$136

31% lower than market

Hot wax bath application to 1 or more areas [HCPCS 97018]

$62
$64

2% lower than market

Occupational therapy evaluation (typically 30 minutes) [HCPCS 97165]

$166
$306

46% lower than market

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$104
$121

14% lower than market

Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]

$166
$312

47% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$166
$339

51% lower than market

Physical therapy evaluation (typically 45 minutes) [HCPCS 97163]

$166
$364

54% lower than market

Physical therapy procedure to re-educate brain-to-nerve-to-muscle function (each 15 minutes) [HCPCS 97112]

$94
$129

27% lower than market

Physical therapy re-evaluation (typically 20 minutes) [HCPCS 97164]

$94
$188

50% lower than market

Physical therapy techniques to 1 or more regions (each 15 minutes) [HCPCS 97140]

$104
$131

21% lower than market

Speech, language, voice, communication, and/or hearing processing disorder treatment [HCPCS 92507]

$260
$276

6% lower than market

Swallowing function evaluation [HCPCS 92610]

$374
$423

12% lower than market

Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]

$104
$113

8% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Aerosol generator, nebulizer, metered dose inhaler, or intermittent positive pressure breathing (IPPB) device demonstration and/or evaluation for patient use [HCPCS 94664]

$179
$267

33% lower than market

Amount and speed of breathed air measurement and graphic recording before and after medication administration [HCPCS 94060]

$521
$556

6% lower than market

External 48-hour EKG heart rhythm tracing, analysis, and interpretation with recording [HCPCS 93225]

$265
$592

55% lower than market

Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]

$162
$223

27% lower than market

OUTPATIENT RESPIRATORY THERAPY

Description

Our Charge
Market Charge

Variance

Airway inhalation treatment to relieve airway obstruction or for sputum collection (inhaled pressure or nonpressure treatment) [HCPCS 94640]

$188
$272

31% lower than market

Lung diffusing capacity measurement [HCPCS 94729]

$328
$385

15% lower than market

Lung volumes measurement by plethysmography [HCPCS 94726]

$368
$469

21% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Blood specimen collection from central or peripheral venous catheter [HCPCS 36592]

$722
$2,084

65% lower than market

Colorectal cancer screening; colonoscopy on invididual not meeting high risk [HCPCS G0121]

$2,311
$6,999

67% lower than market

Dye injection of dye for x-ray imaging of shoulder joint [HCPCS 23350]

$2,583
$2,850

9% lower than market

Indwelling bladder catheter insertion (simple) [HCPCS 51702]

$5,349
$6,578

19% lower than market

Initial groin hernia repair with endoscope [HCPCS 49650]

$23,224
$28,618

19% lower than market

Needle insertion into vein for collection of blood sample [HCPCS 36415]

$31
$29

9% higher than market

Peripheral nerve or branch destruction [HCPCS 64640]

$1,575
$5,881

73% lower than market

Simple repair of wound of face, ears, eyelids, nose, lips and/or mouth (2.5 cm or less) [HCPCS 12011]

$6,179
$3,651

69% higher than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.6 to 7.5 cm) [HCPCS 12002]

$2,639
$3,280

20% lower than market

Temporary bladder catheter insertion [HCPCS 51701]

$5,160
$6,217

17% lower than market

Ureter (urinary duct) stent insertion with endoscope [HCPCS 52332]

$9,896
$16,534

40% lower than market

Ureter (urinary duct) stone crushing with stent with endoscope [HCPCS 52356]

$15,622
$22,456

30% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

3D radiographic procedure with computerized image post-processing [HCPCS 76377]

$998
$1,556

36% lower than market

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$1,998
$2,774

28% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$2,667
$4,297

38% lower than market

Abdominal and pelvic vessels CTA scan with contrast [HCPCS 74174]

$2,375
$3,120

24% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$885
$717

23% higher than market

Abdominal x-ray (2 views) [HCPCS 74019]

$405
$431

6% lower than market

Abdominal x-ray (single view) [HCPCS 74018]

$345
$336

3% higher than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$358
$432

17% lower than market

Arm CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73200]

$1,766
$1,771

Approximately equal to market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$374
$330

13% higher than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (complete, both arms or legs) [HCPCS 93970]

$1,201
$1,291

7% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$664
$894

26% lower than market

Arteries of both arms and legs ultrasound (limited) [HCPCS 93922]

$407
$465

13% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$1,371
$1,154

19% higher than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$2,299
$2,364

3% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$1,879
$1,546

22% higher than market

Chest x-ray (2 views) [HCPCS 71046]

$504
$346

46% higher than market

Chest x-ray (single view) [HCPCS 71045]

$241
$277

13% lower than market

CTA scan of chest blood vessels with contrast to examine injury, foreign bodies, or tumors [HCPCS 71275]

$2,282
$2,941

22% lower than market

CTA scan of head blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70496]

$2,210
$2,315

5% lower than market

CTA scan of neck blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70498]

$2,210
$2,666

17% lower than market

Digital tomography of both breasts (screening exam) [HCPCS 77063]

$95
$96

1% lower than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$374
$424

12% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$1,112
$1,544

28% lower than market

Finger(s) x-ray (minimum of 2 views) [HCPCS 73140]

$263
$293

10% lower than market

Fluoroscopic guidance for needle placement [HCPCS 77002]

$488
$621

21% lower than market

Fluoroscopy imaging guidance for procedure (up to 1 hour) [HCPCS 76000]

$725
$716

1% higher than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$358
$394

9% lower than market

Guidance to access blood vessel by ultrasound [HCPCS 76937]

$379
$416

9% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$358
$413

13% lower than market

Heart ultrasound and continuous monitoring performed during rest, exercise, and/or drug-induced stress with interpretation and report [HCPCS 93351]

$1,439
$2,311

38% lower than market

Hip x-ray of both hips with pelvis (2 views) [HCPCS 73521]

$121
$520

77% lower than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$126
$397

68% lower than market

Imaging for swallowing function evaluation with contrast [HCPCS 74230]

$606
$662

8% lower than market

Imaging of abdomen by MRI without contrast, followed by contrast [HCPCS 74183]

$3,573
$3,281

9% higher than market

Imaging of arm joint by MRI without contrast [HCPCS 73221]

$2,377
$2,522

6% lower than market

Imaging of bone and/or joint (whole body) [HCPCS 78306]

$1,682
$1,859

10% lower than market

Imaging of brain by MRI with contrast [HCPCS 70552]

$2,158
$3,044

29% lower than market

Imaging of brain by MRI without contrast [HCPCS 70551]

$2,231
$2,531

12% lower than market

Imaging of head blood vessels by MRA without contrast [HCPCS 70544]

$2,374
$2,440

3% lower than market

Imaging of heart vessels with SPECT tomography and drugs or exercise (multiple studies) [HCPCS 78452]

$3,706
$4,647

20% lower than market

Imaging of leg by MRI without contrast [HCPCS 73718]

$2,377
$2,351

1% higher than market

Imaging of lower spinal canal by MRI without contrast, followed by contrast [HCPCS 72158]

$2,962
$3,615

18% lower than market

Imaging of middle spinal canal by MRI without contrast [HCPCS 72146]

$2,546
$2,626

3% lower than market

Imaging of pelvis by MRI without contrast, followed by contrast [HCPCS 72197]

$3,424
$3,491

2% lower than market

Imaging of scrotum by ultrasound [HCPCS 76870]

$775
$886

13% lower than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$3,029
$2,576

18% higher than market

Joint or other non-blood vessel structure of arm or leg ultrasound (partial) [HCPCS 76882]

$426
$543

21% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$386
$423

9% lower than market

Knee x-ray (4 or more views) [HCPCS 73564]

$431
$467

8% lower than market

Leg CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73700]

$1,584
$1,780

11% lower than market

Leg ultrasound of arteries and arterial grafts of both legs (complete study) [HCPCS 93925]

$935
$976

4% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$345
$375

8% lower than market

Neck CT scan of the soft tissue of the neck with contrast to examine injury, foreign bodies, or tumors [HCPCS 70491]

$1,647
$2,200

25% lower than market

Nuclear medicine stomach emptying evaluation [HCPCS 78264]

$1,979
$2,030

2% lower than market

Pelvis CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 72192]

$1,883
$1,805

4% higher than market

Pelvis ultrasound, not pregrnancy related (complete) [HCPCS 76856]

$1,012
$925

9% higher than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$313
$366

15% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$379
$376

1% higher than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$1,785
$1,915

7% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$1,819
$1,889

4% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$444
$452

2% lower than market

Spinal x-ray of middle spine (2 views) [HCPCS 72070]

$386
$438

12% lower than market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$611
$608

Approximately equal to market

Thighbone x-ray (minimum of 2 views) [HCPCS 73552]

$99
$381

74% lower than market

Toe(s) x-ray (minimum of 2 views) [HCPCS 73660]

$315
$328

4% lower than market

Ultrasound application to 1 or more areas (each 15 minutes) [HCPCS 97035]

$62
$100

38% lower than market

Wrist x-ray (2 views) [HCPCS 73100]

$333
$289

15% higher than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$359
$411

13% lower than market

INPATIENT CARDIOLOGY

Description

Our Charge
Market Charge

Variance

Heart Failure with complications

$12,412
$18,651

33% lower than market

INPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Blood Infection with major complications

$43,364
$39,001

11% higher than market

INPATIENT ORTHOPEDIC SURGERY

Description

Our Charge
Market Charge

Variance

Total Shoulder Replacement

$51,058
$69,782

27% lower than market

INPATIENT PULMONOLOGY

Description

Our Charge
Market Charge

Variance

Pneumonia with complications

$7,173
$19,283

63% lower than market

Pneumonia with major complications

$16,993
$29,452

42% lower than market

Respiratory Failure

$22,630
$27,021

16% lower than market

INPATIENT SURGERY FOR MALIGNANCY

Description

Our Charge
Market Charge

Variance

Major male pelvic procedures without complications

$50,687
$53,415

5% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Pullman Regional Hospital for your healthcare needs. As part of our commitment to delivering EXCELLENT service, we want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Pullman Regional Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Pullman Regional Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills for your hospital visit, including your family doctor, specialists, physicians to read x-rays, give anesthesia, or do blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Pullman Regional Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Customer Call Center at 509-332-1163.

If you need more information about the price of a future service, please contact our Price Hotline at 509-332-1163. A CPT code is strongly encouraged when you call. You can obtain the CPT code from the ordering physician.

Financial Assistance

We are pleased to offer financial assistance to patients with limited resources and inadequate medical insurance coverage. Eligibility is determined by total family income/assets. The patient must agree to apply for other assistance available to pay hospital charges (Medicaid, Medicare, private insurance) before being discharged.

Pullman Regional Hospital's Charity Care Policy

Pullman Regional Hospital provides high quality care to everyone, regardless of their ability to pay.

Pullman Regional Hospital's charity care policy includes:

• Substantial charity care guidelines that provide free care for individuals and families who earn less than 200 percent of the federal poverty level.

• Sliding scale fees to provide substantially discounted care for individuals and families who are between 200 and 400 percent of the federal poverty level.

• Hardship policy for those patients who would not otherwise qualify for charity care but have unique circumstances.

In many cases, Pullman Regional Hospital offers interest free loans for up to one year to assist patients.

For more information, please contact our Customer Call Center at 509-332-1163.