Visits & medical services prices at Boone County Health Center

Albion, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Advncd Care Plan 30 Min (99497) $179 $179 1.7×
Airway Inhalation Treatment (94640)
range across 7 matching MRF lines		 $46–$251 $46–$251 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $80 $80 5.6×
Application on-body injector (96377) $155 $155 3.2×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $190 $190 2.3×
Bfb training ea addl 15 min (90913) $25 $25 0.8×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $700 $700 1.8×
Canalith repositioning proc (95992) $115 $115 2.8×
Car seat/bed test 60 min (94780) $151 $151 3.9×
Cardiac Stress Tst,Tracing Only (93017) $1,100 $1,100 4.9×
Cardiopulmonary resuscitation (92950) $656 $656 2.9×
Cardioversion (92960) $393 $393 0.6×
Chemo Anti-Neopl Sq/Im (96401) $300 $300 4.0×
Chemo Hormon Antineopl Sq/Im (96402)
range across 2 matching MRF lines		 $63–$275 $63–$275 varies
Chemo IV infusion addl hr (96415) $250 $250 3.3×
Chemo IV push addl drug (96411) $305 $305 4.1×
Chemother Prolong Infuse W/Pump (96416) $700 $700 2.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $390 $390 5.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $700 $700 2.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $425 $425 1.2×
Chest Wall Manipulation (94668) $210 $210 1.5×
Chron Care Mgmt Srvc 20 Min (99490) $119 $119 1.1×
Color/duplex Doppler, complete (93975) $1,154 $1,154 4.7×
Color/duplex Doppler, limited (93976) $652 $652 6.0×
Cont gluc mntr physician/qhp provided equiptment (95250) $314 $314 2.3×
Cont Gluc Mntr Pt Prov Eqp (95249) $140 $140 2.3×
Continuous Pulse Ox (94762) $450 $450 3.4×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $691 $691 3.0×
Cpt initial (94667) $200 $200 1.4×
Critical care first hour (99291) $1,755 $1,755 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $194 $194 0.9×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $920 $920 3.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $803 $803 7.4×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,204 $1,204 4.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $953 $953 8.8×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,405 $1,405 5.7×
Dup-scan xtr veins unilateral/limited study (93971) $1,104 $1,104 10.2×
Duplex up extrem art bilat (93930) $1,150 $1,150 4.6×
Duplex up extrem art unilat/ltd (93931) $928 $928 8.5×
ECG/monitoring and analysis (93271) $265 $265 2.7×
Echo Heart Xthoracic,Limited (93308) $950 $950 3.8×
Electrical Stimulation Ea 15 Min (97032) $75 $75 5.1×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines		 $19–$300 $19–$300 varies
Emergency Dept Visit Level 2 (99282) $360 $360 2.3×
Emergency Dept Visit Level 3 (99283) $565 $565 2.0×
Emergency Dept Visit Level 4 (99284) $877 $877 2.0×
Er level 1 (99281) $210 $210 2.4×
Er level v (99285) $1,442 $1,442 2.3×
Evaluate Speech Production (92522) $320 $320 2.9×
Evaluate Swallowing Function (92610) $330 $330 3.9×
External Ecg Scanning Analysis Report (93226) $425 $425 6.9×
Extracranial Bilat Study (93880) $1,455 $1,455 5.9×
Extracranial Uni/Ltd Study (93882) $700 $700 6.4×
Holter monitor recording (93225) $370 $370 2.7×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines		 $33–$40 $33–$40 varies
Immunization administration (90471)
range across 3 matching MRF lines		 $36–$75 $36–$75 varies
Irrig Drug Delivery Device (96523) $90 $90 1.5×
IV infusion hydration each additional hour (96361) $157 $157 3.2×
IV infusion hydration initial 31 min-1 hour (96360) $416 $416 1.9×
IV infusion ther proph addl sequential to 1 hr (96367) $225 $225 3.0×
IV infusion therapy prophylaxis/dx ea hour (96366) $180 $180 3.7×
IV push initial (96374)
range across 2 matching MRF lines		 $79–$269 $79–$269 varies
Lung Function Test (Mbc/Mvv) (94200) $320 $320 5.2×
Mechanical chest wall oscillation per session (94669) $250 $250 1.1×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $28 $28 0.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $31 $31 0.8×
Motion Fluoroscopy/Swallow (92611) $480 $480 5.2×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines		 $450–$656 $450–$656 varies
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608)
range across 2 matching MRF lines		 $500–$648 $500–$648 varies
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines		 $78–$220 $78–$220 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $350 $350 0.8×
Neuromuscular Reeducation (97112) $105 $105 3.2×
Oral Function Therapy (92526) $270 $270 3.2×
Orthc/Prostc Mgmt Sbsq Enc (97763) $95 $95 1.9×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $100 $100 2.2×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $49 $49 2.2×
Ot eval high complexity (97167) $200 $200 2.0×
Ot Eval Low Complex (97165) $140 $140 1.4×
Ot Eval Moderate Complexity (97166) $170 $170 1.7×
Ot manual therapy 15 min (97140) $105 $105 3.8×
Ot Re-Eval Est Plan Care (97168) $240 $240 3.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $260 $260 1.9×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $120 $120 0.9×
Peripheral arterial disease rehab per session (93668) $170 $170 2.8×
Phlebotomy therapeutic (99195) $155 $155 1.1×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $250 $250 4.1×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $235 $235 3.8×
Plethysmography (94726) $558 $558 1.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,700 $4,700 5.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $22 $22 0.5×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $31 $31 0.6×
Psychiatric diagnostic evaluation (90791) $265 $265 1.4×
Psytx Crisis Initial 60 Min (90839) $285 $285 1.5×
Pt Eval High Complex (97163) $250 $250 2.6×
Pt eval low complex 20 min (97161) $160 $160 1.6×
Pt Eval Mod Complex (97162) $190 $190 1.9×
Pt gait training 15 min (97116) $90 $90 3.1×
Pt mechanical traction (97012) $75 $75 5.2×
Pt Re-Eval Est Plan Care (97164) $140 $140 2.1×
Pulmonary service/procedure (94799) $175 $175 1.3×
Pulmonary Stress Testing (94618) $400 $400 2.9×
Pure Tone Audiometry Air (92552) $63 $63 0.5×
Remote 30 Day Ecg Rev/Report (93270) $350 $350 9.0×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $230 $230 1.9×
Self Care Mngment Training (97535) $100 $100 3.1×
Speech sound lang comprehen (92523) $375 $375 1.7×
Spirometry (94010) $330 $330 1.5×
Stress Tte Only (93350) $1,500 $1,500 2.6×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129)
range across 2 matching MRF lines		 $115–$120 $115–$120 varies
Ther Ivntj Ea Addl 15 Min (97130)
range across 2 matching MRF lines		 $85–$100 $85–$100 varies
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $130 $130 3.5×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $70 $70 2.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $263 $263 2.6×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 2 matching MRF lines		 $28–$157 $28–$157 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 3 matching MRF lines		 $137–$440 $137–$440 varies
Therapeutic Activities (97530)
range across 2 matching MRF lines		 $140–$300 $140–$300 varies
Tobacco Use Cessation Intensive >10 Minutes (99407) $51 $51 1.3×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $33 $33 0.8×
Trans Care Mgmt 14 Day Disch (99495) $399 $399 2.9×
Trans Care Mgmt 7 Day Disch (99496) $540 $540 3.9×
Tte w/doppler, complete (93306) $2,200 $2,200 3.9×
Tte W/O Doppler Complete (93307) $1,500 $1,500 6.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $300 $300 3.9×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines		 $34–$225 $34–$225 varies
Tympanometry (92567) $36 $36 0.9×
Upr/L Xtremity Art 2 Levels (93922) $450 $450 3.3×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $878 $878 3.9×
Vasopneumatic device (97016) $80 $80 6.7×
Vent Mgmt Inpat Init Day (94002) $1,450 $1,450 2.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $750 $750 1.2×
Wheelchair Mgmt Ea 15 Min (97542) $91 $91 2.9×
Whirlpool Therapy (97022) $90 $90 5.7×

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.