Visits & medical services prices at Aurora Medical Center Summit

Summit, WI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $42.50 $85 1.0×
Aep Hearing Status Deter Broadband Stimuli I&R (92651) $147.50 $295 0.7×
Aep neurodiagnostic i&r (92653) $705 $1,410 3.2×
Aep threshold estimation mlt frequencies i&r (92652) $705 $1,410 3.2×
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines		 $47.50–$85 $95–$170 varies
Airway resistance by oscillometry (94728) $240 $480 1.8×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $202.50 $405 1.5×
Analyze neurostim complex (95972) $885 $1,770 9.2×
Analyze Neurostim Simple (95971) $500 $1,000 5.2×
Appl modality 1+ areas lllt po pain reduction (97037) $17.50 $35 0.5×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $77.50 $155 5.4×
Application on-body injector (96377) $110 $220 2.3×
Assessment of aphasia per hr (96105) $292.50 $585 3.0×
Behavral qualit analys voice (92524) $227.50 $455 2.1×
Biofeedback training any modality (90901) $92.50 $185 2.3×
Breath hydrogen/methane test (91065) $905 $1,810 4.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $467.50 $935 1.2×
Canalith repositioning proc (95992) $105 $210 2.6×
Car seat/bed test 60 min (94780) $130 $260 3.4×
Cardiac Stress Tst,Tracing Only (93017) $995 $1,990 4.6×
Cardiopulmonary exercise testing (94621) $1,190 $2,380 3.2×
Cardiopulmonary resuscitation (92950) $1,225 $2,450 5.6×
Cardioversion (92960) $1,325 $2,650 2.0×
Cbt 1st hour (94644) $180 $360 1.3×
Chemo Admin Peritoneal Cavity (96446) $590 $1,180 1.8×
Chemo Anti-Neopl Sq/Im (96401) $147.50 $295 2.0×
Chemo Hormon Antineopl Sq/Im (96402) $122.50 $245 1.7×
Chemo Ia Push (96420) $307.50 $615 0.9×
Chemo IV infusion addl hr (96415) $235 $470 3.2×
Chemo IV push addl drug (96411) $207.50 $415 2.8×
Chemotherapy Into Cns (96450) $645 $1,290 1.9×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $235 $470 3.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $470 $940 1.4×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $272.50 $545 0.8×
Chest Wall Manipulation (94668) $60 $120 0.4×
Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) $730 $1,460 1.9×
Color/duplex Doppler, complete (93975) $575 $1,150 2.4×
Color/duplex Doppler, limited (93976) $385 $770 3.6×
Community/Work Reintegration Trainj Ea 15 Min (97537) $87.50 $175 2.7×
Continuous Pulse Ox (94762) $222.50 $445 1.7×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $170 $340 0.8×
Cpt initial (94667) $120 $240 0.9×
Cptrizd oph dx img pst sgm uni/bi rta oct angrph (92137) $510 $1,020 2.3×
Critical care first hour (99291) $1,705 $3,410 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $227.50 $455 1.1×
Developmental tst admin phys/qhp 1st hour (96112) $400 $800 3.1×
Dialysis One Evaluation (90945)
range across 2 matching MRF lines		 $650–$845 $1,300–$1,690 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $590 $1,180 2.4×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $395 $790 3.7×
Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) $510 $1,020 4.8×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $965 $1,930 4.0×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $645 $1,290 6.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,015 $2,030 4.2×
Dup-scan xtr veins unilateral/limited study (93971) $675 $1,350 6.4×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $1,090 $2,180 4.5×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $730 $1,460 6.9×
Duplex Scan Hemodialysis Access (93990) $600 $1,200 5.7×
Duplex up extrem art bilat (93930) $710 $1,420 2.9×
Duplex up extrem art unilat/ltd (93931) $475 $950 4.5×
ECG/monitoring and analysis (93271) $395 $790 4.1×
Echo Congenital Complete (93303)
range across 2 matching MRF lines		 $1,340–$1,500 $2,680–$3,000 varies
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines		 $890–$945 $1,780–$1,890 varies
Echo r-t 2d w/probe placement only (93313) $2,640 $5,280 4.8×
Echo transesophag montr cardiac pump functj (93318)
range across 2 matching MRF lines		 $1,215–$1,320 $2,430–$2,640 varies
Echo transesophageal (93312)
range across 2 matching MRF lines		 $1,510–$1,615 $3,020–$3,230 varies
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351)
range across 2 matching MRF lines		 $1,655–$1,760 $3,310–$3,520 varies
Ecog Implanted Brain Npgt W/Rec I&R <30 Days (95836) $230 $460 6.1×
Eeg 41-60 Minutes (95812) $920 $1,840 4.2×
EEG awake and asleep (95819) $740 $1,480 3.4×
EEG awake drowsy (95816) $680 $1,360 3.1×
EEG cerebral death evaluation (95824) $865 $1,730 2.3×
EEG cont rec w/video by tech min 8 channels (95700) $2,665 $5,330 12.2×
EEG extended monitoring 61-119 minutes (95813) $1,205 $2,410 5.5×
Eeg Sleep Only (95822) $865 $1,730 4.0×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $1,330 $2,660 6.1×
EEG w/o vid 2-12hr cont mntr (95707) $1,330 $2,660 6.1×
EEG w/o vid ea 12-26hr intmt (95709) $2,665 $5,330 7.1×
Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) $2,665 $5,330 7.1×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $1,330 $2,660 6.1×
EEG wo vid ea 12-26hr unmntr (95708) $2,665 $5,330 7.1×
EKG signal averaged (93278) $447.50 $895 7.5×
Electrical Stimulation Ea 15 Min (97032) $67.50 $135 4.6×
Electrocardiogram Tracing (93005) $147.50 $295 2.5×
Electroconvulsive Therapy (90870) $915 $1,830 1.1×
Emergency Dept Visit Level 2 (99282)
range across 3 matching MRF lines		 $295–$470 $590–$940 varies
Emergency Dept Visit Level 3 (99283)
range across 3 matching MRF lines		 $460–$940 $920–$1,880 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines		 $525–$780 $1,050–$1,560 varies
Emg 3 Extremities (95863) $422.50 $845 3.2×
Emg 4 Extremities (95864) $482.50 $965 3.7×
Er level 1 (99281)
range across 5 matching MRF lines		 $62.50–$335 $125–$670 varies
Er level v (99285)
range across 2 matching MRF lines		 $585–$1,135 $1,170–$2,270 varies
Esophageal Capsule Endoscopy (91111) $2,790 $5,580 3.0×
Evaluate pt use of inhaler (94664) $70 $140 0.3×
Evaluate Speech Production (92522) $227.50 $455 2.0×
Evaluate Swallowing Function (92610) $337.50 $675 4.0×
Evaluation of speech fluency (92521) $227.50 $455 1.7×
Evoked Auditory Test,Limited (92587) $115 $230 0.5×
Exercise test for bronchospasm (94617) $187.50 $375 1.4×
External Ecg Scanning Analysis Report (93226) $535 $1,070 9.0×
Extracranial Bilat Study (93880) $1,030 $2,060 4.3×
Extracranial Uni/Ltd Study (93882) $685 $1,370 6.5×
F-up/limited tthrc echo congenital car anomaly (93304)
range across 2 matching MRF lines		 $875–$950 $1,750–$1,900 varies
Flexible Endoscopic Eval Laryn Sensory C/V Rec (92614) $405 $810 2.7×
Flexible endoscopic eval swallow c/v rec (92612) $405 $810 2.0×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $1,500 $3,000 4.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,500 $3,000 1.7×
Gi tract capsule endoscopy (91110) $2,975 $5,950 3.2×
Group Therapeutic Procedures (97150) $80 $160 4.4×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $1,020 $2,040 1.5×
Holter monitor recording (93225) $440 $880 3.3×
Immunization administration (90471) $32.50 $65 0.4×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $412.50 $825 1.1×
Insert/Place Heart Catheter (93503) $2,080 $4,160 1.3×
Intracranial Complete Study (93886) $1,030 $2,060 4.3×
Iontophoresis 15 min (97033) $120 $240 6.3×
Irrig Drug Delivery Device (96523) $112.50 $225 1.9×
IV infusion hydration each additional hour (96361) $147.50 $295 3.1×
IV infusion hydration initial 31 min-1 hour (96360) $287.50 $575 1.3×
IV infusion ther proph addl sequential to 1 hr (96367) $147.50 $295 2.0×
IV infusion therapy prophylaxis/dx ea hour (96366) $147.50 $295 3.1×
IV push initial (96374) $112.50 $225 0.5×
Lung Function Test (Mbc/Mvv) (94200) $115 $230 1.9×
Lwr Xtr Vasc Stdy Bilat (93924) $745 $1,490 3.4×
Mechanical chest wall oscillation per session (94669) $92.50 $185 0.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803)
range across 2 matching MRF lines		 $45–$50 $90–$100 varies
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $57.50 $115 1.6×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $20 $40 1.2×
Methacholine challenge (94070) $600 $1,200 1.6×
Mlt fam group bhv mgmt/modificaj traing 1st 60 (96202) $60 $120 3.0×
Mlt fam group bhv mgmt/modificaj traing ea addl (96203) $15 $30 2.8×
Motility study esophagus (91010) $1,895 $3,790 5.0×
Motion Fluoroscopy/Swallow (92611) $337.50 $675 3.7×
Multiple Sleep Latency Test (95805) $2,545 $5,090 2.9×
Muscle Test 2 Limbs (95861) $372.50 $745 2.8×
Muscle Test One Limb (95860) $240 $480 1.8×
Nasopharyngoscopy (92511) $495 $990 2.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $585 $1,170 1.4×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $885 $1,770 2.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $220 $440 1.1×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $330 $660 0.8×
Nerve Conduction Studies 1-2 Studies (95907) $155 $310 0.7×
Nerve Conduction Studies 11-12 Studies (95912) $352.50 $705 0.9×
Nerve conduction studies 13 or more studies (95913) $397.50 $795 1.1×
Nerve Conduction Studies 3-4 Studies (95908) $170 $340 0.8×
Nerve conduction studies 5-6 studies (95909) $197.50 $395 0.9×
Nerve conduction studies 7-8 studies (95910) $232.50 $465 0.6×
Nerve Conduction Studies 9-10 Studies (95911) $297.50 $595 0.8×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $182.50 $365 1.4×
Neuromuscular Reeducation (97112) $87.50 $175 2.7×
Newborn resuscitation (99465) $515 $1,030 0.8×
Nonphysician Telephone Assessment 11-20 Min (98967) $82.50 $165 3.3×
Nonphysician Telephone Assessment 21-30 Min (98968) $105 $210 3.0×
Nonphysician Telephone Assessment 5-10 Min (98966) $50 $100 3.7×
Opscpy extnd optic nrv/macula drawing i&r uni/bi (92202) $85 $170 1.4×
Opscpy extnd rta drawing & scl deprsn i&r uni/bi (92201) $132.50 $265 2.2×
Oral Function Therapy (92526) $270 $540 3.2×
Oral Speech Device Eval (92597) $345 $690 4.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $70 $140 1.4×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $92.50 $185 2.0×
Ot eval high complexity (97167) $310 $620 3.1×
Ot Eval Low Complex (97165) $177.50 $355 1.8×
Ot Eval Moderate Complexity (97166) $240 $480 2.4×
Ot manual therapy 15 min (97140) $87.50 $175 3.2×
Ot paraffin bath (97018) $35 $70 5.8×
Ot Prosthetic Training, Each 15 Min (97761) $87.50 $175 2.2×
Ot Re-Eval Est Plan Care (97168) $125 $250 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $240 $480 1.8×
Patient-initiated spirometric recording (94015) $135 $270 0.6×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $140 $280 0.6×
Peripheral arterial disease rehab per session (93668) $132.50 $265 2.2×
Phlebotomy therapeutic (99195) $125 $250 0.9×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $190 $380 3.2×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $175 $350 2.9×
Physical Performance Test (97750) $87.50 $175 2.6×
Plethysmography (94726) $367.50 $735 1.0×
Pm device progr eval dual (93280) $307.50 $615 8.1×
Pm/Icd Remote Tech Serv (93296) $140 $280 3.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,385 $6,770 3.9×
Pt Eval High Complex (97163) $310 $620 3.2×
Pt eval low complex 20 min (97161) $177.50 $355 1.8×
Pt Eval Mod Complex (97162) $240 $480 2.5×
Pt gait training 15 min (97116) $87.50 $175 3.0×
Pt mechanical traction (97012) $92.50 $185 6.4×
Pt Re-Eval Est Plan Care (97164) $125 $250 1.9×
Pulm function test by gas (94727) $240 $480 1.1×
Pulmonary service/procedure (94799) $287.50 $575 2.2×
Pulmonary Stress Testing (94618) $217.50 $435 1.6×
Qnhp Ol Dig Assmt&Mgmt 11-20 (98971) $62.50 $125 2.7×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) $100 $200 2.9×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) $30 $60 2.4×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $550 $1,100 1.6×
Rem Ther Mntr Dev Sply Cbt (98978) $72.50 $145 1.9×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $115 $230 3.0×
Rem ther mntr dev sply resp (98976) $115 $230 3.0×
Remote 30 Day Ecg Rev/Report (93270) $210 $420 5.6×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $70 $140 0.5×
Respiratory flow volume loop (94375) $237.50 $475 1.1×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $155 $310 2.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $157.50 $315 0.8×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $350 $700 2.9×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $175 $350 3.7×
Self Care Mngment Training (97535) $87.50 $175 2.7×
Sensory Integration Ea 15 Min (97533) $87.50 $175 1.4×
Short-latency somatosens ep std upr limbs (95925) $1,130 $2,260 5.2×
Sleep study unattended (95806) $337.50 $675 1.5×
Speech sound lang comprehen (92523) $340 $680 1.5×
Spirometry (94010) $265 $530 1.2×
Ssep lower limbs (95926) $1,130 $2,260 5.2×
Standardized Cognitive Performance Testing (96125) $230 $460 2.2×
Surfactant Admin Thru Tube (94610) $205 $410 0.9×
Temp transcutaneous pacing (92953) $815 $1,630 1.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $82.50 $165 3.7×
Ther Ivntj Ea Addl 15 Min (97130) $82.50 $165 3.9×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $100 $200 2.7×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $10.50 $21 0.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $217.50 $435 2.1×
Ther/Proph/Diag Inj Ia (96373) $87.50 $175 0.4×
Ther/Proph/Diag Inj Sc/Im (96372) $55 $110 0.8×
Ther/Proph/Diag Iv Inf Init (96365) $345 $690 1.6×
Therapeutic Activities (97530) $87.50 $175 2.5×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $2,790 $5,580 7.4×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $685 $1,370 6.5×
Tte w/doppler, complete (93306)
range across 2 matching MRF lines		 $1,820–$1,925 $3,640–$3,850 varies
Tte W/O Doppler Complete (93307)
range across 2 matching MRF lines		 $1,270–$1,325 $2,540–$2,650 varies
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $255 $510 3.3×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $75 $150 3.1×
Tx/Pro/Dx Inj New Drug Addon (96375) $112.50 $225 2.4×
Unlis neurological/neuromuscular dx px (95999) $242.50 $485 1.9×
Unlisted cardiovascular service/procedure (93799) $9,875 $19,750 75.8×
Unlisted noninvasive vascular diagnostic study (93998) $427.50 $855 14.6×
Unlisted otorhinolaryngological service (92700) $80 $160 2.7×
Upr/L Xtremity Art 2 Levels (93922) $362.50 $725 2.7×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $540 $1,080 2.5×
Vasopneumatic device (97016) $77.50 $155 6.4×
Veeg 2-12 Hr Cont Mntr (95713) $1,330 $2,660 3.5×
Veeg 2-12 hr intmt mntr (95712) $1,330 $2,660 3.5×
Veeg 2-12 hr unmonitored (95711) $1,330 $2,660 6.1×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $2,665 $5,330 7.1×
Veeg Ea 12-26 Hr Unmntr (95714) $2,665 $5,330 7.1×
Veeg ea 12-26hr cont mntr (95716) $2,665 $5,330 3.1×
Vent Mgmt Inpat Init Day (94002) $930 $1,860 1.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $700 $1,400 1.1×
Visual Evoked Potential Test (95930) $730 $1,460 3.3×
Vital capacity, total (94150) $55 $110 0.4×
Wada Activation Test Hemispheric Function W/Eeg (95958) $1,570 $3,140 1.8×
Wheelchair Mgmt Ea 15 Min (97542) $87.50 $175 2.8×
Whirlpool Therapy (97022) $102.50 $205 6.5×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $112.50 $225 1.9×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.