Visits & medical services prices at Black River Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) $19.80 $22 0.2×
Actigraphy Testing Recording Analysis I&R (95803) $550.80 $612 9.6×
Actinotherapy Ultraviolet Light (96900) $19.80 $22 0.5×
Admn Sarscov2 Vacc 1 Dose (90480) $135.90 $151 3.4×
Advncd Care Plan 30 Min (99497)
range across 2 matching MRF lines
$92.70–$280.80 $103–$312 varies
Airway Inhalation Treatment (94640)
range across 17 matching MRF lines
$19.80–$334.80 $22–$372 varies
Analyze neurostim no prog (95970) $254.70 $283 2.0×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035)
range across 4 matching MRF lines
$19.80–$97.20 $22–$108 varies
Application on-body injector (96377) $144 $160 3.2×
Assessment of aphasia per hr (96105) $253.80 $282 2.6×
Assmt & care planning pt w/cognitive impairment (99483) $235.80 $262 2.4×
Behavral qualit analys voice (92524) $337.50 $375 3.1×
Biofeedback training any modality (90901)
range across 2 matching MRF lines
$86.40–$100.80 $96–$112 varies
Blink reflex test (95933) $291.60 $324 5.1×
Brief Emotional/Behav Assmt (96127) $24.30 $27 0.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060)
range across 4 matching MRF lines
$19.80–$630.90 $22–$701 varies
Canalith repositioning proc (95992)
range across 2 matching MRF lines
$19.80–$230.40 $22–$256 varies
Car seat/bed test 60 min (94780) $226.80 $252 6.3×
Cardiac Stress Tst,Tracing Only (93017) $1,289.70 $1,433 6.1×
Cardiopulmonary resuscitation (92950)
range across 4 matching MRF lines
$818.10–$996.30 $909–$1,107 varies
Cardioversion (92960) $1,400.40 $1,556 2.2×
Care mgmt services behavioral hlth cond 20 mins (99484) $19.80 $22 0.5×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $69.30 $77 2.7×
Cbt 1st hour (94644) $265.50 $295 2.1×
Chemo Anti-Neopl Sq/Im (96401)
range across 3 matching MRF lines
$364.50–$375.30 $405–$417 varies
Chemo Hormon Antineopl Sq/Im (96402)
range across 3 matching MRF lines
$166.50–$171.90 $185–$191 varies
Chemo IV infusion addl hr (96415)
range across 2 matching MRF lines
$144–$318.60 $160–$354 varies
Chemo IV push addl drug (96411)
range across 4 matching MRF lines
$309.60–$345.60 $344–$384 varies
Chemother Prolong Infuse W/Pump (96416)
range across 2 matching MRF lines
$1,179.90–$1,215 $1,311–$1,350 varies
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417)
range across 3 matching MRF lines
$360.90–$371.70 $401–$413 varies
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413)
range across 2 matching MRF lines
$870.30–$896.40 $967–$996 varies
Chemotx admn IV push tq 1/1st sbst/drug (96409)
range across 3 matching MRF lines
$558.90–$576 $621–$640 varies
Chest Wall Manipulation (94668)
range across 4 matching MRF lines
$108.90–$137.70 $121–$153 varies
Chiropract manj 3-4 regions (98941) $19.80 $22 0.9×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) $19.80 $22 0.9×
Chron Care Mgmt Srvc 20 Min (99490) $75.60 $84 0.8×
Color/duplex Doppler, complete (93975) $1,853.10 $2,059 8.0×
Color/duplex Doppler, limited (93976) $2,138.40 $2,376 21.1×
Community/Work Reintegration Trainj Ea 15 Min (97537)
range across 2 matching MRF lines
$108.90–$121.50 $121–$135 varies
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $87.30 $97 0.5×
Cont gluc mntr physician/qhp provided equiptment (95250) $494.10 $549 3.8×
Cont Gluc Mntr Pt Prov Eqp (95249) $288.90 $321 5.0×
Continuous Pulse Ox (94762)
range across 2 matching MRF lines
$444.60–$458.10 $494–$509 varies
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 13 matching MRF lines
$69.30–$1,454.40 $77–$1,616 varies
Cpt initial (94667)
range across 4 matching MRF lines
$137.70–$215.10 $153–$239 varies
Critical care first hour (99291)
range across 5 matching MRF lines
$2,505.60–$2,804.40 $2,784–$3,116 varies
Debridement Open Wound 20 Sq Cm< (97597)
range across 6 matching MRF lines
$162–$449.10 $180–$499 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,139.40 $1,266 4.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $1,040.40 $1,156 10.2×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,656.90 $1,841 7.1×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,023.30 $1,137 10.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 3 matching MRF lines
$1,317.60–$1,455.30 $1,464–$1,617 varies
Dup-scan xtr veins unilateral/limited study (93971)
range across 6 matching MRF lines
$1,017.90–$1,045.80 $1,131–$1,162 varies
Duplex up extrem art bilat (93930) $1,615.50 $1,795 7.0×
Duplex up extrem art unilat/ltd (93931) $1,218.60 $1,354 12.0×
Dyn surf EMG walkg/funcjal actv 1-12 musc (96002) $880.20 $978 4.2×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines
$524.70–$1,089.90 $583–$1,211 varies
Electrical Stimulation Ea 15 Min (97032)
range across 3 matching MRF lines
$86.40–$124.20 $96–$138 varies
Electrocardiogram Tracing (93005)
range across 9 matching MRF lines
$134.10–$246.60 $149–$274 varies
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
$279–$287.10 $310–$319 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines
$412.20–$424.80 $458–$472 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines
$738.90–$761.40 $821–$846 varies
Emg 3 Extremities (95863) $625.50 $695 5.0×
Emg 4 Extremities (95864) $830.70 $923 6.6×
Er level 1 (99281)
range across 2 matching MRF lines
$222.30–$228.60 $247–$254 varies
Er level v (99285)
range across 2 matching MRF lines
$1,492.20–$1,537.20 $1,658–$1,708 varies
Evaluate pt use of inhaler (94664)
range across 4 matching MRF lines
$19.80–$189.90 $22–$211 varies
Evaluate Speech Production (92522) $376.20 $418 3.4×
Evaluate Swallowing Function (92610) $703.80 $782 8.3×
Evaluation of speech fluency (92521) $265.50 $295 2.0×
External ECG rec>48hr<7d recording (93242) $84.60 $94 2.3×
External ECG rec>7d<15d recording (93246)
range across 3 matching MRF lines
$21.60–$198.90 $24–$221 varies
Extracranial Bilat Study (93880)
range across 2 matching MRF lines
$1,339.20–$1,701 $1,488–$1,890 varies
Fundus photography (92250) $40.50 $45 0.3×
Group Therapeutic Procedures (97150) $104.40 $116 5.8×
Health Behavior Assessment/Re-Assessment (96156) $19.80 $22 0.2×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $19.80 $22 0.5×
Health behavior ivntj group f2f 1st 30 min (96164) $19.80 $22 0.5×
Health behavior ivntj indiv f2f 1st 30 min (96158) $19.80 $22 0.1×
High Altitude Simulatj W/Phys I&R W/O2 Titration (94453)
range across 2 matching MRF lines
$414.90–$432.90 $461–$481 varies
Holter monitor recording (93225) $573.30 $637 4.4×
Hypnotherapy (90880) $19.80 $22 0.2×
Ic Tsts W/Allgic Xtrcs Dlyd Typ Rxn W/Reading (95028) $42.30 $47 1.2×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 3 matching MRF lines
$135.90–$144 $151–$160 varies
Immunization administration (90471)
range across 6 matching MRF lines
$140.40–$1,173.44 $156–$1,303.83 varies
Iontophoresis 15 min (97033) $122.40 $136 6.4×
Irrig Drug Delivery Device (96523)
range across 4 matching MRF lines
$146.70–$224.10 $163–$249 varies
IV infusion hydration each additional hour (96361)
range across 4 matching MRF lines
$19.80–$237.60 $22–$264 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 3 matching MRF lines
$299.70–$573.30 $333–$637 varies
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines
$315.90–$325.80 $351–$362 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 3 matching MRF lines
$154.80–$256.50 $172–$285 varies
IV push initial (96374)
range across 5 matching MRF lines
$38.70–$346.50 $43–$385 varies
Mechanical chest wall oscillation per session (94669)
range across 4 matching MRF lines
$112.50–$343.80 $125–$382 varies
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803)
range across 2 matching MRF lines
$34.20–$63 $38–$70 varies
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $63 $70 1.7×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $34.20 $38 2.0×
Methacholine challenge (94070)
range across 2 matching MRF lines
$1,047.60–$1,079.10 $1,164–$1,199 varies
Motion Fluoroscopy/Swallow (92611)
range across 2 matching MRF lines
$405.90–$773.10 $451–$859 varies
Multiple Family Group Psychotherapy (90849) $19.80 $22 0.1×
Multiple Sleep Latency Test (95805) $3,408.30 $3,787 4.1×
Muscle Test 2 Limbs (95861) $556.20 $618 4.3×
Muscle Test Hemidiaphragm (95866) $324 $360 2.6×
Muscle Test Nonparaspinal (95870) $274.50 $305 2.1×
Muscle Test One Limb (95860) $405.90 $451 3.1×
Nasopharyngoscopy (92511) $261.90 $291 1.4×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $480.60 $534 2.3×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $463.50 $515 2.2×
Needle electromyography larynx (95865) $341.10 $379 2.6×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $387.90 $431 1.8×
Needle EMG w/1 fiber electrode quan meas jitter (95872) $531 $590 2.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $1,207.80 $1,342 3.1×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $1,207.80 $1,342 3.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 4 matching MRF lines
$121.50–$1,086.30 $135–$1,207 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606)
range across 3 matching MRF lines
$187.20–$1,514.70 $208–$1,683 varies
Nerve Conduction Studies 1-2 Studies (95907)
range across 3 matching MRF lines
$364.50–$390.60 $405–$434 varies
Nerve Conduction Studies 11-12 Studies (95912) $2,117.70 $2,353 5.8×
Nerve conduction studies 13 or more studies (95913) $2,770.20 $3,078 7.6×
Nerve Conduction Studies 3-4 Studies (95908) $663.30 $737 3.2×
Nerve conduction studies 5-6 studies (95909) $1,056.60 $1,174 5.0×
Nerve conduction studies 7-8 studies (95910) $1,515.60 $1,684 4.2×
Nerve Conduction Studies 9-10 Studies (95911) $1,904.40 $2,116 5.3×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $390.60 $434 3.1×
Neuromuscular Reeducation (97112) $151.20 $168 4.6×
Newborn resuscitation (99465) $1,089.90 $1,211 1.7×
Nitric oxide expired gas determination (95012) $19.80 $22 0.5×
Nrpsyc tst eval phys/qhp 1st (96132) $116.10 $129 0.3×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $289.80 $322 0.8×
Oral Function Therapy (92526)
range across 3 matching MRF lines
$309.60–$435.60 $344–$484 varies
Orthc/Prostc Mgmt Sbsq Enc (97763)
range across 2 matching MRF lines
$108.90–$196.20 $121–$218 varies
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760)
range across 4 matching MRF lines
$108.90–$183.60 $121–$204 varies
Osteopathic manipulative tx 3-4 body regions (98926) $19.80 $22 0.9×
Osteopathic manipulative tx 5-6 body regions (98927) $19.80 $22 0.9×
Ot Contrast Bath Ea 15 Min (97034)
range across 2 matching MRF lines
$89.10–$99.90 $99–$111 varies
Ot eval high complexity (97167) $450 $500 4.5×
Ot Eval Low Complex (97165) $315 $350 3.1×
Ot Eval Moderate Complexity (97166) $360 $400 3.6×
Ot manual therapy 15 min (97140)
range across 6 matching MRF lines
$102.60–$153 $114–$170 varies
Ot paraffin bath (97018)
range across 3 matching MRF lines
$89.10–$92.70 $99–$103 varies
Ot Prosthetic Training, Each 15 Min (97761) $112.50 $125 2.8×
Ot Re-Eval Est Plan Care (97168) $171.90 $191 2.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $453.60 $504 3.6×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $331.20 $368 1.6×
Percutaneous tests w/allergenic extracts (95004) $9 $10 0.0×
Phlebotomy therapeutic (99195) $438.30 $487 3.4×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $496.80 $552 8.7×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $512.10 $569 8.9×
Physical Performance Test (97750)
range across 3 matching MRF lines
$110.70–$139.50 $123–$155 varies
Plethysmography (94726)
range across 2 matching MRF lines
$475.20–$489.60 $528–$544 varies
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $6,328.80 $7,032 7.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115)
range across 3 matching MRF lines
$74.70–$88.20 $83–$98 varies
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117)
range across 4 matching MRF lines
$17.10–$102.60 $19–$114 varies
Psych diag eval w/med srvcs (90792)
range across 3 matching MRF lines
$137.70–$253.80 $153–$282 varies
Psychiatric diagnostic evaluation (90791) $201.60 $224 1.2×
Psychoanalysis (90845) $19.80 $22 0.1×
Psytx Crisis Initial 60 Min (90839) $125.10 $139 0.7×
Pt Eval High Complex (97163) $450 $500 4.6×
Pt eval low complex 20 min (97161) $315 $350 3.2×
Pt Eval Mod Complex (97162) $360 $400 3.7×
Pt gait training 15 min (97116)
range across 2 matching MRF lines
$127.80–$131.40 $142–$146 varies
Pt group caregiver training (97552) $51.30 $57 2.3×
Pt mechanical traction (97012)
range across 3 matching MRF lines
$19.80–$81.90 $22–$91 varies
Pt Re-Eval Est Plan Care (97164) $298.80 $332 4.4×
Pulmonary Stress Testing (94618)
range across 4 matching MRF lines
$247.50–$432.90 $275–$481 varies
Pure Tone Audiometry Air (92552) $99 $110 0.8×
Remote 30 Day Ecg Rev/Report (93270) $443.70 $493 12.2×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $112.50 $125 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 3 matching MRF lines
$164.70–$1,062.90 $183–$1,181 varies
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607)
range across 2 matching MRF lines
$440.10–$533.70 $489–$593 varies
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $362.70 $403 7.6×
Sbsq Psyc Collab Care Mgmt (99493) $19.80 $22 0.2×
Self Care Mngment Training (97535)
range across 5 matching MRF lines
$108.90–$144.90 $121–$161 varies
Self-meas bp pt educaj/traing & dev calibration (99473) $19.80 $22 0.7×
Sensory Integration Ea 15 Min (97533) $120.60 $134 2.0×
Sleep study unattended (95806) $1,048.50 $1,165 5.0×
Slp caregiver training 1st 30 min (97550)
range across 3 matching MRF lines
$69.30–$116.10 $77–$129 varies
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $1,017.90 $1,131 4.9×
Speech sound lang comprehen (92523) $727.20 $808 3.2×
Spirometry (94010)
range across 8 matching MRF lines
$19.80–$296.10 $22–$329 varies
Standardized Cognitive Performance Testing (96125)
range across 3 matching MRF lines
$265.50–$297.90 $295–$331 varies
Subcutaneous Infusion Each Additional Hour (96370)
range across 2 matching MRF lines
$137.70–$142.20 $153–$158 varies
Subcutaneous infusion initial 1 hr w/pump set-up (96369)
range across 2 matching MRF lines
$708.30–$729.90 $787–$811 varies
Temp transcutaneous pacing (92953) $1,874.70 $2,083 2.9×
Testing Autonomic Nervous System Function (95923) $415.80 $462 3.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129)
range across 2 matching MRF lines
$117–$130.50 $130–$145 varies
Ther Ivntj Ea Addl 15 Min (97130) $117 $130 5.6×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $114.30 $127 3.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124)
range across 3 matching MRF lines
$102.60–$116.10 $114–$129 varies
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $182.70 $203 1.8×
Ther/Proph/Diag Inj Ia (96373) $137.70 $153 0.7×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 7 matching MRF lines
$141.30–$185.40 $157–$206 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 4 matching MRF lines
$357.30–$682.20 $397–$758 varies
Therapeutic Activities (97530)
range across 5 matching MRF lines
$166.50–$270 $185–$300 varies
Tobacco Use Cessation Intensive >10 Minutes (99407)
range across 2 matching MRF lines
$33.30–$109.80 $37–$122 varies
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines
$21.60–$98.10 $24–$109 varies
Trans Care Mgmt 14 Day Disch (99495) $207.90 $231 1.6×
Trans Care Mgmt 7 Day Disch (99496) $282.60 $314 2.2×
Tstg Ans Funcj Cardiovagal Innervaj Parasymp (95921) $390.60 $434 3.1×
Tte w/doppler, complete (93306)
range across 2 matching MRF lines
$1,717.20–$2,681.10 $1,908–$2,979 varies
Tte W/O Doppler Complete (93307) $881.10 $979 3.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $405 $450 5.3×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 3 matching MRF lines
$153.90–$268.20 $171–$298 varies
Tympanometry (92567) $47.70 $53 1.3×
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines
$623.70–$663.30 $693–$737 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923) $864 $960 4.1×
Vent Mgmt Inpat Init Day (94002)
range across 3 matching MRF lines
$1,157.40–$2,239.20 $1,286–$2,488 varies
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003)
range across 3 matching MRF lines
$1,121.40–$1,154.70 $1,246–$1,283 varies
Vital capacity, total (94150)
range across 2 matching MRF lines
$38.70–$221.40 $43–$246 varies
Wheelchair Mgmt Ea 15 Min (97542)
range across 3 matching MRF lines
$89.10–$124.20 $99–$138 varies

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.