Visits & medical services prices at Avera St. Mary's Hospital

Pierre, SD · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Actinotherapy Ultraviolet Light (96900) $59.40 $66 1.6×
Admn Sarscov2 Vacc 1 Dose (90480) $73.80 $82 1.8×
Advncd Care Plan 30 Min (99497) $107.10 $119 1.0×
Airway Inhalation Treatment (94640)
range across 7 matching MRF lines
$201.60–$328.50 $224–$365 varies
Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) $1,080 $1,200 5.2×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035)
range across 2 matching MRF lines
$150.30–$157.50 $167–$175 varies
Brief Emotional/Behav Assmt (96127) $43.20 $48 1.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $827.10 $919 2.2×
Canalith repositioning proc (95992) $171 $190 4.2×
Car seat/bed test 60 min (94780) $225.90 $251 5.9×
Cardiac Stress Tst,Tracing Only (93017) $1,525.50 $1,695 6.9×
Cardiopulmonary resuscitation (92950) $927.90 $1,031 4.2×
Cardioversion (92960) $2,441.70 $2,713 3.6×
Caregiver hlth risk assmt score doc stnd instrm (96161) $35.10 $39 0.9×
Chemo Anti-Neopl Sq/Im (96401)
range across 2 matching MRF lines
$266.40–$288 $296–$320 varies
Chemo Hormon Antineopl Sq/Im (96402)
range across 2 matching MRF lines
$197.10–$288 $219–$320 varies
Chemo IV infusion addl hr (96415) $331.20 $368 4.5×
Chemo IV push addl drug (96411) $583.20 $648 7.9×
Chemother Prolong Infuse W/Pump (96416) $1,053.90 $1,171 3.1×
Chemotherapy Unspecified (96549) $122.40 $136 2.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $414 $460 5.6×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $822.60 $914 2.4×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $583.20 $648 1.7×
Chest Wall Manipulation (94668) $192.60 $214 1.4×
Color/duplex Doppler, complete (93975) $1,861.20 $2,068 7.6×
Color/duplex Doppler, limited (93976) $1,554.30 $1,727 14.6×
Cont gluc mntr physician/qhp provided equiptment (95250) $273.60 $304 2.0×
Cont Gluc Mntr Pt Prov Eqp (95249) $67.50 $75 1.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 2 matching MRF lines
$940.50–$1,369.80 $1,045–$1,522 varies
Cpt initial (94667) $276.30 $307 2.0×
Critical care first hour (99291) $2,801.70 $3,113 3.3×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines
$198–$579.60 $220–$644 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,403.10 $1,559 5.8×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $2,224.80 $2,472 9.1×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,304.10 $1,449 12.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,962.90 $2,181 8.1×
Dup-scan xtr veins unilateral/limited study (93971) $1,371.60 $1,524 12.8×
Echo Congenital Complete (93303) $3,272.40 $3,636 5.9×
Echo Heart Xthoracic,Limited (93308) $636.30 $707 2.6×
Echo transesophageal (93312) $4,182.30 $4,647 7.5×
Electrical Stimulation Ea 15 Min (97032)
range across 2 matching MRF lines
$157.50–$214.20 $175–$238 varies
Electrocardiogram Tracing (93005) $380.70 $423 6.3×
Emergency Dept Visit Level 2 (99282) $504.90 $561 3.2×
Emergency Dept Visit Level 3 (99283) $801 $890 2.9×
Emergency Dept Visit Level 4 (99284) $1,298.70 $1,443 3.0×
Er level 1 (99281) $340.20 $378 3.9×
Er level v (99285) $1,895.40 $2,106 3.1×
Evaluate pt use of inhaler (94664)
range across 2 matching MRF lines
$201.60–$212.40 $224–$236 varies
Evaluate Speech Production (92522) $383.40 $426 3.4×
Evaluate Swallowing Function (92610) $303.30 $337 3.6×
External ECG rec>48hr<7d recording (93242) $441.90 $491 11.6×
External ECG rec>7d<15d recording (93246) $441.90 $491 11.6×
External Ecg Scanning Analysis Report (93226) $1,240.20 $1,378 20.6×
Extracranial Bilat Study (93880) $1,902.60 $2,114 7.8×
Extracranial Uni/Ltd Study (93882) $320.40 $356 3.0×
F-up/limited tthrc echo congenital car anomaly (93304) $611.10 $679 1.1×
Holter monitor recording (93225) $462.60 $514 3.4×
Im Adm Intransl/Oral 1 Vaccine (90473) $69.30 $77 0.9×
Immunization administration (90471) $105.30 $117 1.4×
Iontophoresis 15 min (97033) $131.40 $146 6.9×
Irrig Drug Delivery Device (96523) $229.50 $255 3.8×
IV infusion hydration each additional hour (96361)
range across 3 matching MRF lines
$62.10–$154.80 $69–$172 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 3 matching MRF lines
$287.10–$682.20 $319–$758 varies
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines
$136.80–$162 $152–$180 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines
$154.80–$173.70 $172–$193 varies
IV push initial (96374)
range across 3 matching MRF lines
$261.90–$356.40 $291–$396 varies
Lung Function Test (Mbc/Mvv) (94200) $77.40 $86 1.3×
Mechanical chest wall oscillation per session (94669) $233.10 $259 1.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $86.40 $96 2.4×
Motion Fluoroscopy/Swallow (92611) $590.40 $656 6.5×
Muscle Test One Limb (95860) $368.10 $409 2.7×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $749.70 $833 1.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines
$215.10–$787.50 $239–$875 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $787.50 $875 1.9×
Nerve Conduction Studies 11-12 Studies (95912) $1,071 $1,190 2.8×
Nerve conduction studies 13 or more studies (95913) $547.20 $608 1.4×
Nerve Conduction Studies 3-4 Studies (95908) $309.60 $344 1.4×
Nerve conduction studies 5-6 studies (95909) $312.30 $347 1.4×
Nerve conduction studies 7-8 studies (95910) $343.80 $382 0.9×
Nerve Conduction Studies 9-10 Studies (95911) $507.60 $564 1.3×
Neuromuscular Reeducation (97112)
range across 2 matching MRF lines
$150.30–$158.40 $167–$176 varies
Newborn resuscitation (99465) $715.50 $795 1.1×
Oral Function Therapy (92526) $305.10 $339 3.6×
Orthc/Prostc Mgmt Sbsq Enc (97763) $110.70 $123 2.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760)
range across 2 matching MRF lines
$185.40–$200.70 $206–$223 varies
Ot eval high complexity (97167) $383.40 $426 3.8×
Ot Eval Low Complex (97165) $383.40 $426 3.8×
Ot Eval Moderate Complexity (97166) $383.40 $426 3.8×
Ot manual therapy 15 min (97140)
range across 3 matching MRF lines
$151.20–$158.40 $168–$176 varies
Ot paraffin bath (97018) $77.40 $86 12.9×
Ot Re-Eval Est Plan Care (97168) $185.40 $206 2.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $558 $620 4.2×
Patch/Application Test Specify Number Tests (95044) $18.90 $21 0.0×
Pdt dstr prmlg les phys/qhp (96573) $362.70 $403 1.8×
Pdt dstr prmlg les skn illum/activj per day (96567) $326.70 $363 1.6×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $335.70 $373 1.5×
Peripheral arterial disease rehab per session (93668) $201.60 $224 3.3×
Phlebotomy therapeutic (99195) $464.40 $516 3.4×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $506.70 $563 8.4×
Plethysmography (94726) $915.30 $1,017 2.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $7,138.80 $7,932 8.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $47.70 $53 1.0×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $48.60 $54 1.0×
Pt Eval High Complex (97163) $383.40 $426 3.9×
Pt eval low complex 20 min (97161) $383.40 $426 3.9×
Pt Eval Mod Complex (97162) $383.40 $426 3.9×
Pt gait training 15 min (97116) $150.30 $167 5.2×
Pt mechanical traction (97012) $122.40 $136 8.5×
Pt Re-Eval Est Plan Care (97164) $214.20 $238 3.2×
Pulm function test by gas (94727) $209.70 $233 1.0×
Pulmonary service/procedure (94799) $150.30 $167 1.1×
Pulmonary Stress Testing (94618) $261.90 $291 1.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $787.50 $875 3.8×
Self Care Mngment Training (97535)
range across 2 matching MRF lines
$150.30–$158.40 $167–$176 varies
Speech sound lang comprehen (92523)
range across 2 matching MRF lines
$429.30–$590.40 $477–$656 varies
Spirometry (94010) $441.90 $491 2.0×
Standardized Cognitive Performance Testing (96125) $310.50 $345 3.0×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $102.60 $114 4.6×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 2 matching MRF lines
$70.20–$154.80 $78–$172 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines
$282.60–$682.20 $314–$758 varies
Therapeutic Activities (97530)
range across 2 matching MRF lines
$150.30–$158.40 $167–$176 varies
Trans Care Mgmt 14 Day Disch (99495) $135 $150 1.0×
Trans Care Mgmt 7 Day Disch (99496) $188.10 $209 1.4×
Tte w/doppler, complete (93306) $4,422.60 $4,914 7.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $305.10 $339 4.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $306.90 $341 6.4×
Upr/L Xtremity Art 2 Levels (93922) $667.80 $742 4.9×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $1,511.10 $1,679 6.8×
Vent Mgmt Inpat Init Day (94002) $2,884.50 $3,205 4.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,920.60 $2,134 3.0×
Whirlpool Therapy (97022) $158.40 $176 10.1×

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.