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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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $179 $179 1.7×
Airway inhalation treatment (94640) $251 $251 1.1×
Appl on-body injector for timed subq injection (96377) $155 $155 3.2×
Bfb training 1st 15 min (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 (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 Hormon Antineopl Sq/Im (96402) $169 $169 2.3×
Chemo IV push addl drug (96411) $305 $305 4.1×
Chemo Iv Push Sngl Drug (96409) $425 $425 1.2×
Chemo prolong 8+ hrs infuse w/pump (96416) $700 $700 2.0×
Chemother, IV infusion, 1 hr (96413) $700 $700 2.0×
Chemother, IV infusion, ea add hr (96415) $250 $250 3.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $300 $300 4.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $390 $390 5.2×
Chronic care mgmt svcs staff 1st 20 min cal mo (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 Monitoring Patient Provided Equipment (95249) $140 $140 2.3×
Continuous Glucose Monitoring (95250) $314 $314 2.3×
Cpap initiation and management (94660) $691 $691 3.0×
Cpt initial (94667) $200 $200 1.4×
Critical care (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 Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,150 $1,150 4.6×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $928 $928 8.5×
Dup-scan xtr veins unilateral/limited study (93971) $1,104 $1,104 10.2×
Duplex scan extracranial art compl bi study (93880) $1,455 $1,455 5.9×
Echo Heart Xthoracic,Limited (93308) $950 $950 3.8×
EKG (93005) $159.50 $159.50 2.6×
Er level 1 (99281) $210 $210 2.4×
Er level ii (99282) $360 $360 2.3×
Er level iii (99283) $565 $565 2.0×
Er level IV (99284) $877 $877 2.0×
Er level v (99285) $1,442 $1,442 2.3×
Evaluation of speech sound production (92522) $320 $320 2.9×
Evaluation of swallowing function (92610) $330 $330 3.9×
Evaluation with prescription of speech-generating alternative (92607) $230 $230 1.9×
External Ecg Scanning Analysis Report (93226) $425 $425 6.9×
Holter Monitor Recording (93225) $370 $370 2.7×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $36.50 $36.50 0.5×
Immunization Admin (90471) $75 $75 1.0×
Immunotherapy, 2+ Injections (95117) $31 $31 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (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, therap/proph/diagnost,add infusion,1st hour (96367) $225 $225 3.0×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $440 $440 2.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $180 $180 3.7×
IV push initial (96374) $174 $174 0.8×
Manual therapy 15 min (97140) $105 $105 3.8×
Massage 15 min (97124) $70 $70 2.4×
Maximum voluntary ventilation (94200) $320 $320 5.2×
Mechanical chest wall oscillation (94669) $250 $250 1.1×
Mechanical traction (97012) $75 $75 5.2×
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 Fluor Eval Swlng Funcj C/V Rec (92611) $480 $480 5.2×
Neg press wnd tx </=50 sq cm (97607) $553 $553 1.3×
Neg press wound tx >50 cm (97608) $574 $574 1.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $149 $149 0.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $350 $350 0.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $450 $450 3.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $878 $878 3.9×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $450 $450 3.4×
Orthotics mgmt & traing 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 complex 60 min (97167) $200 $200 2.0×
Ot eval low complex 30 min (97165) $140 $140 1.4×
Ot eval mod complex 45 min (97166) $170 $170 1.7×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $95 $95 1.9×
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×
Phy/qhp op pulm rhb w/mntr (94626) $250 $250 4.1×
Phy/qhp op pulm rhb w/o 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×
Psychiatric diagnostic evaluation (90791) $265 $265 1.4×
Psytx crisis initial 60 min (90839) $285 $285 1.5×
Pt Aquatic Therapy/Exercises (97113) $130 $130 3.5×
Pt Electrical Stimulation (97032) $75 $75 5.1×
Pt eval high complex 45 min (97163) $250 $250 2.6×
Pt eval low complex 20 min (97161) $160 $160 1.6×
Pt Gait Training Therapy (97116) $90 $90 3.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $105 $105 3.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $190 $190 1.9×
Pt re-evaluation (97164) $140 $140 2.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $100 $100 3.1×
Pt Ultrasound Therapy (97035) $80 $80 5.6×
Pt Whirlpool Therapy (97022) $90 $90 5.7×
Pulmonary stress testing (94618) $400 $400 2.9×
Pure Tone Audiometry, Air (92552) $63 $63 0.5×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $350 $350 9.0×
Rt Chest Wall Manipulation,Subsequent (94668) $210 $210 1.5×
Smoking cessation > 10 min (99407) $51 $51 1.3×
Speech sound lang comprehen (92523) $375 $375 1.7×
Spirometry (94010) $330 $330 1.5×
Stress echo (93350) $1,500 $1,500 2.6×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $117.50 $117.50 5.3×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $92.50 $92.50 4.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $263 $263 2.6×
Ther/Proph/Diag Inj Sc/Im (96372) $92.50 $92.50 1.2×
Therapeutic Activities (97530) $220 $220 6.3×
Therapeutic phlebotomy (99195) $155 $155 1.1×
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 - Tte Complete W/ Contrast (93306) $2,200 $2,200 3.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,500 $1,500 6.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $300 $300 3.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $270 $270 3.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $129.50 $129.50 2.7×
Tympanometry (92567) $36 $36 0.9×
Unlisted pulmonary service/procedure (94799) $175 $175 1.3×
Vasc Duplex Extrem Venous,Bilat (93970) $1,405 $1,405 5.7×
Vasc Duplex Scan Extracranial,Limited (93882) $700 $700 6.4×
Vasopneumatic device (97016) $80 $80 6.7×
Ventilation assist & mgmt inpatient 1st 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×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $265 $265 2.7×