Visits & medical services prices at Avera Holy Family Hospital
Estherville, IA · every code in this section with a posted price and a Medicare benchmark.
93 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $79.54 | $82 | 2.0× |
| Airway Inhalation Treatment (94640) range across 6 matching MRF lines |
$229.89–$284.21 | $237–$293 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 2 matching MRF lines |
$106.70–$115.43 | $110–$119 | varies |
| Behavral qualit analys voice (92524) | $173.63 | $179 | 1.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $473.36 | $488 | 1.3× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,024.32 | $1,056 | 4.9× |
| Cardiopulmonary resuscitation (92950) | $826.44 | $852 | 4.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $209.52 | $216 | 3.0× |
| Chemo IV infusion addl hr (96415) | $138.71 | $143 | 2.0× |
| Chemo IV push addl drug (96411) | $243.47 | $251 | 3.5× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $452.99 | $467 | 6.5× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $677.06 | $698 | 2.1× |
| Color/duplex Doppler, complete (93975) | $1,192.13 | $1,229 | 5.2× |
| Color/duplex Doppler, limited (93976) | $352.11 | $363 | 3.5× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $147.44 | $152 | 2.6× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$346.29–$560.66 | $357–$578 | varies |
| Critical care first hour (99291) | $1,797.41 | $1,853 | 2.3× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$213.40–$268.69 | $220–$277 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,031.11 | $1,063 | 4.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,678.10 | $1,730 | 7.3× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,053.42 | $1,086 | 10.5× |
| Echo Heart Xthoracic,Limited (93308) | $532.53 | $549 | 2.3× |
| Electrical Stimulation Ea 15 Min (97032) | $141.62 | $146 | 9.6× |
| Electrocardiogram Tracing (93005) | $149.38 | $154 | 2.6× |
| Emergency Dept Visit Level 2 (99282) | $345.32 | $356 | 2.3× |
| Emergency Dept Visit Level 3 (99283) | $633.41 | $653 | 2.4× |
| Emergency Dept Visit Level 4 (99284) | $1,757.64 | $1,812 | 4.4× |
| Er level 1 (99281) range across 2 matching MRF lines |
$189.15–$684.82 | $195–$706 | varies |
| Er level v (99285) | $3,133.10 | $3,230 | 5.5× |
| Evaluate pt use of inhaler (94664) range across 2 matching MRF lines |
$315.25–$509.25 | $325–$525 | varies |
| Evaluate Speech Production (92522) | $222.13 | $229 | 2.0× |
| Evaluate Swallowing Function (92610) | $440.38 | $454 | 5.2× |
| External ECG rec>48hr<7d recording (93242) | $670.27 | $691 | 18.7× |
| External ECG rec>7d<15d recording (93246) | $670.27 | $691 | 18.7× |
| External Ecg Scanning Analysis Report (93226) | $675.12 | $696 | 11.9× |
| Extracranial Bilat Study (93880) | $1,031.11 | $1,063 | 4.5× |
| Flexible endoscopic eval swallow c/v rec (92612) | $1,063.12 | $1,096 | 5.3× |
| Holter monitor recording (93225) | $436.50 | $450 | 3.4× |
| Immunization administration (90471) | $76.63 | $79 | 1.1× |
| Iontophoresis 15 min (97033) range across 2 matching MRF lines |
$129.01–$173.63 | $133–$179 | varies |
| Irrig Drug Delivery Device (96523) | $185.27 | $191 | 3.3× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$132.89–$138.71 | $137–$143 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) | $455.90 | $470 | 2.2× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $210.49 | $217 | 3.0× |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$180.42–$183.33 | $186–$189 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$239.59–$305.55 | $247–$315 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $43.65 | $45 | 1.4× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $57.23 | $59 | 1.6× |
| Motion Fluoroscopy/Swallow (92611) | $455.90 | $470 | 5.0× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $418.07 | $431 | 1.1× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $213.40 | $220 | 1.1× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $439.41 | $453 | 1.1× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$103.79–$126.10 | $107–$130 | varies |
| Oral Function Therapy (92526) | $312.34 | $322 | 3.7× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $193.03 | $199 | 4.2× |
| Ot eval high complexity (97167) | $340.47 | $351 | 3.4× |
| Ot Eval Low Complex (97165) | $283.24 | $292 | 2.8× |
| Ot Eval Moderate Complexity (97166) | $345.32 | $356 | 3.4× |
| Ot manual therapy 15 min (97140) range across 4 matching MRF lines |
$132.89–$137.74 | $137–$142 | varies |
| Ot paraffin bath (97018) | $115.43 | $119 | 19.2× |
| Ot Re-Eval Est Plan Care (97168) | $194 | $200 | 2.8× |
| Phlebotomy therapeutic (99195) | $156.17 | $161 | 1.2× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $4,915.96 | $5,068 | 6.0× |
| Polysom <6 yrs 4/> paramtrs (95782) | $1,907.99 | $1,967 | 2.3× |
| Pt Eval High Complex (97163) | $383.15 | $395 | 3.9× |
| Pt eval low complex 20 min (97161) | $291.97 | $301 | 3.0× |
| Pt Eval Mod Complex (97162) | $345.32 | $356 | 3.5× |
| Pt gait training 15 min (97116) | $118.34 | $122 | 4.1× |
| Pt mechanical traction (97012) | $100.88 | $104 | 7.0× |
| Pt Re-Eval Est Plan Care (97164) | $262.87 | $271 | 3.9× |
| Pulmonary Stress Testing (94618) | $164.90 | $170 | 1.3× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $213.40 | $220 | 1.1× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $534.47 | $551 | 4.4× |
| Self Care Mngment Training (97535) | $132.89 | $137 | 4.1× |
| Sensory Integration Ea 15 Min (97533) | $102.82 | $106 | 1.7× |
| Slp caregiver training 1st 30 min (97550) | $108.64 | $112 | 2.1× |
| Speech sound lang comprehen (92523) | $336.59 | $347 | 1.5× |
| Standardized Cognitive Performance Testing (96125) | $134.83 | $139 | 1.3× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $106.70 | $110 | 4.8× |
| Ther Ivntj Ea Addl 15 Min (97130) | $106.70 | $110 | 5.1× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $134.83 | $139 | 3.6× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 3 matching MRF lines |
$72.75–$229.89 | $75–$237 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $455.90 | $470 | 2.2× |
| Therapeutic Activities (97530) | $126.10 | $130 | 3.6× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $37.83 | $39 | 1.1× |
| Trans Care Mgmt 14 Day Disch (99495) | $224.07 | $231 | 1.8× |
| Trans Care Mgmt 7 Day Disch (99496) | $312.34 | $322 | 2.4× |
| Tte w/doppler, complete (93306) | $3,224.28 | $3,324 | 6.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $332.71 | $343 | 4.4× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$148.41–$199.82 | $153–$206 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $635.35 | $655 | 5.0× |
| Vasopneumatic device (97016) | $83.42 | $86 | 6.9× |
| Whirlpool Therapy (97022) | $198.85 | $205 | 12.7× |
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.