Visits & medical services prices at Box Butte General Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Aep Neurodiagnostic I&R (92653) $260.10 $289 1.2×
Airway inhalation treatment (94640) $269.10 $299 1.2×
Ambulatory Bp Analysis (93788) $245.70 $273 1.8×
Ambulatory Bp Recording (93786) $276.30 $307 2.0×
Assessment of aphasia (96105) $335.70 $373 3.5×
Behavioral and qualitative analysis of voice and resonance (92524) $395.10 $439 3.6×
Bfb training 1st 15 min (90912) $151.20 $168 1.8×
Bfb training ea addl 15 min (90913) $133.20 $148 4.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $693.90 $771 1.8×
C motor evoked upr&lwr limbs (95939) $2,990.70 $3,323 3.4×
Canalith Repositioning (95992) $114.75 $127.50 2.8×
Cardiac Stress Tst,Tracing Only (93017) $1,251.45 $1,390.50 5.6×
Cardiopulmonary resuscitation (92950) $860.40 $956 3.8×
Cardioversion (92960) $1,725.30 $1,917 2.5×
Caregiver training 1st 30 min (97550) $240.30 $267 4.6×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $190.80 $212 7.3×
Cbt 1st hour (94644) $483.30 $537 3.5×
Chemo IV push addl drug (96411) $284.40 $316 3.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $417.60 $464 5.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $318.60 $354 4.3×
Color/duplex Doppler, complete (93975) $1,476 $1,640 6.0×
Color/duplex Doppler, limited (93976) $1,568.70 $1,743 14.5×
Cont Gluc Monitoring Patient Provided Equipment (95249) $208.80 $232 3.4×
Continuous Glucose Monitoring (95250) $332.10 $369 2.4×
Cpap initiation and management (94660) $820.35 $911.50 3.6×
Cpt initial (94667) $235.80 $262 1.7×
Critical care (99291) $1,900.35 $2,111.50 2.2×
Ctr motor ep std transcrnl motor stimj lwr limbs (95929) $1,261.80 $1,402 3.3×
Debridement Open Wound 20 Sq Cm< (97597) $287.55 $319.50 1.4×
Demo &/or eval,pt use,aerosol device (94664) $174.60 $194 0.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $903.15 $1,003.50 8.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,476 $1,640 6.0×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $987.75 $1,097.50 9.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,531.80 $1,702 6.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $965.70 $1,073 8.9×
Dup-scan xtr veins unilateral/limited study (93971) $1,092.60 $1,214 10.1×
Duplex hemodialysis access (93990) $965.70 $1,073 8.9×
Duplex scan extracranial art compl bi study (93880) $1,525.50 $1,695 6.2×
Echo Heart Xthoracic,Limited (93308) $886.05 $984.50 3.6×
Echo Transthoracic - Congenital Tte Complete (93303) $1,577.70 $1,753 2.8×
Echo Transthoracic - Congenital Tte Limited (93304) $965.70 $1,073 1.7×
EKG (93005) $346.50 $385 5.7×
EKG rhythm strip (93041) $276.30 $307 4.5×
EMG four extremities (95864) $2,773.80 $3,082 20.8×
EMG two extremities (95861) $2,673 $2,970 19.3×
Er level 1 (99281) $213.30 $237 2.4×
Er level ii (99282) $388.35 $431.50 2.4×
Er level iii (99283) $574.65 $638.50 2.0×
Er level IV (99284) $902.25 $1,002.50 2.1×
Er level v (99285) $1,657.35 $1,841.50 2.7×
Evaluation of speech fluency (92521) $570.15 $633.50 4.3×
Evaluation of speech sound production (92522) $283.95 $315.50 2.5×
Evaluation of swallowing function (92610) $407.25 $452.50 4.8×
Evaluation with prescription of speech-generating alternative (92607) $403.20 $448 3.3×
External ECG rec>48hr<7d recording (93242) $153 $170 3.9×
External ECG rec>7d<15d recording (93246) $251.10 $279 6.5×
Group Therapeutic Procedures (97150) $114.30 $127 6.3×
Holter Monitor Recording (93225) $557.10 $619 4.0×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $52.20 $58 1.2×
Immunization Admin (90471) $44.10 $49 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $124.65 $138.50 2.0×
IV infusion hydration each additional hour (96361) $207 $230 4.3×
IV infusion hydration initial 31 min-1 hour (96360) $369.90 $411 1.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $158.85 $176.50 2.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $372.60 $414 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $116.55 $129.50 2.4×
IV push initial (96374) $222.30 $247 1.0×
Liver elastography w/o imag w/i&r (91200) $1,017 $1,130 7.6×
Manual therapy 15 min (97140) $128.70 $143 4.6×
Massage 15 min (97124) $102.60 $114 3.5×
Mechanical chest wall oscillation (94669) $322.20 $358 1.4×
Mechanical traction (97012) $111.60 $124 7.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $115.65 $128.50 3.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $273.60 $304 7.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $529.65 $588.50 5.8×
Multiple sleep latency test (95805) $3,153.60 $3,504 3.5×
Needle electromyography larynx (95865) $1,140.30 $1,267 8.3×
Neg press wnd tx </=50 sq cm (97607) $738 $820 1.7×
Neg press wound tx >50 cm (97608) $738 $820 1.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $371.70 $413 1.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $738 $820 1.7×
Nerve Conduction Studies 3-4 Studies (95908) $1,429.20 $1,588 6.4×
Nerve Conduction Studies 9-10 Studies (95911) $2,529.90 $2,811 6.5×
Nerve conduction studies; 11-12 studies (95912) $2,896.20 $3,218 7.5×
Nerve conduction studies; 5-6 studies (95909) $1,798.20 $1,998 8.0×
Nerve conduction studies; 7-8 studies (95910) $2,162.70 $2,403 5.6×
Neuromuscular junction test (95937) $1,070.55 $1,189.50 8.0×
Newborn resuscitation (99465) $768.60 $854 1.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $606.60 $674 4.4×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $809.10 $899 3.6×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $471.60 $524 3.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $143.55 $159.50 3.1×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $131.40 $146 4.1×
Ot eval high complex 60 min (97167) $396 $440 3.9×
Ot eval low complex 30 min (97165) $177.30 $197 1.8×
Ot eval mod complex 45 min (97166) $253.80 $282 2.5×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $132.30 $147 2.6×
Ot Prosthetic Training, Each 15 Min (97761) $135.90 $151 3.4×
Ot Range Motion Measure,Each Extrem (95851) $128.70 $143 4.9×
Ot re-eval est plan care (97168) $153 $170 2.2×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $285.75 $317.50 2.1×
Paraffin bath (97018) $78.30 $87 13.0×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $306 $340 1.3×
Phy/qhp op pulm rhb w/mntr (94626) $231.30 $257 3.8×
Plethysmography (94726) $697.50 $775 1.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,302.80 $5,892 5.9×
Polysom <6 yrs 4/> paramtrs (95782) $4,485.60 $4,984 5.0×
Pt Aquatic Therapy/Exercises (97113) $192.60 $214 5.2×
Pt Electric Current Therapy (97033) $125.10 $139 6.6×
Pt Electrical Stimulation (97032) $100.80 $112 6.9×
Pt eval high complex 45 min (97163) $358.65 $398.50 3.7×
Pt eval low complex 20 min (97161) $171.90 $191 1.8×
Pt Gait Training Therapy (97116) $172.35 $191.50 5.9×
Pt group caregiver training (97552) $157.50 $175 7.1×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $135 $150 4.1×
Pt Physical Performance Test (97750) $132.30 $147 3.9×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $238.95 $265.50 2.4×
Pt re-evaluation (97164) $133.20 $148 2.0×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $274.05 $304.50 8.5×
Pt Ultrasound Therapy (97035) $100.80 $112 7.0×
Pulm Funct Test Oscillometry (94728) $250.20 $278 1.9×
Pulm function test by gas (94727) $468.45 $520.50 2.1×
Pulmonary stress testing (94618) $407.25 $452.50 2.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $397.80 $442 10.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $286.65 $318.50 1.4×
Rom meas&reprt hand w/wo comparison normal sid (95852) $105.30 $117 4.9×
Rt Chest Wall Manipulation,Subsequent (94668) $171.90 $191 1.2×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $153.90 $171 3.2×
Sc Ther Infusion Reset Pump (96371) $308.70 $343 4.1×
Sensory Integration Ea 15 Min (97533) $128.70 $143 2.1×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $376.20 $418 1.7×
Smoking cessation > 10 min (99407) $71.10 $79 1.8×
Somatosensory testing (95938) $4,772.70 $5,303 5.4×
Speech group therapy (92508) $153.90 $171 6.4×
Speech sound lang comprehen (92523) $380.25 $422.50 1.7×
Spirometry (94010) $316.35 $351.50 1.4×
Standardized Cognitive Performance Testing (96125) $349.20 $388 3.4×
Stress echo (93350) $1,623.60 $1,804 2.9×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $115.20 $128 2.4×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $724.95 $805.50 3.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $151.20 $168 6.8×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $116.10 $129 5.5×
Ther/Proph/Diag Inj Sc/Im (96372) $142.20 $158 1.9×
Therapeutic Activities (97530) $145.80 $162 4.2×
Therapeutic phlebotomy (99195) $191.25 $212.50 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $63.90 $71 1.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,326.05 $2,584.50 4.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $319.50 $355 4.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $360.45 $400.50 4.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $190.80 $212 3.9×
Unlisted pulmonary service/procedure (94799) $169.20 $188 1.3×
Vasc Duplex Extrem Venous,Bilat (93970) $1,520.10 $1,689 6.1×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,046.70 $1,163 4.7×
Vasopneumatic device (97016) $120.15 $133.50 10.0×
Ventilation assist & mgmt inpatient 1st day (94002) $1,715.40 $1,906 2.7×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,435.50 $1,595 2.2×
Wheelchair Mgmt Ea 15 Min (97542) $299.70 $333 9.6×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $692.10 $769 7.0×