Visits & medical services prices at Brown County Hospital

Ainsworth, 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
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines		 $239–$955 $318–$1,273 varies
Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) $40 $53 0.3×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $65 $87 4.5×
Behavral qualit analys voice (92524) $253 $337 2.3×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $78 $104 0.9×
Bfb training ea addl 15 min (90913) $78 $104 2.4×
Biofeedback training any modality (90901) $122 $163 3.0×
Brief Emotional/Behav Assmt (96127) $40 $53 1.0×
Cardiac Stress Tst,Tracing Only (93017) $931 $1,241 4.2×
Cardiopulmonary resuscitation (92950) $1,269 $1,692 5.7×
Cardioversion (92960) $1,414 $1,885 2.1×
Chemo Anti-Neopl Sq/Im (96401) $232 $309 3.1×
Chemo Hormon Antineopl Sq/Im (96402) $263 $350 3.5×
Chemo IV infusion addl hr (96415) $263 $350 3.5×
Chemo IV push addl drug (96411) $272 $362 3.6×
Chemother Prolong Infuse W/Pump (96416) $287 $382 0.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $287 $382 3.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $383 $510 1.1×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $327 $436 1.0×
Chron Care Mgmt Srvc 20 Min (99490) $62 $82 0.6×
Color/duplex Doppler, complete (93975) $920 $1,227 3.7×
Color/duplex Doppler, limited (93976) $546 $728 5.0×
Community/Work Reintegration Trainj Ea 15 Min (97537) $64 $85 2.0×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $191 $254 1.0×
Critical care first hour (99291) $1,552 $2,069 1.8×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines		 $158–$179 $211–$239 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $726 $968 2.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $599 $799 5.5×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,019 $1,359 4.1×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $773 $1,031 7.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,187 $1,582 4.8×
Dup-scan xtr veins unilateral/limited study (93971) $861 $1,148 7.9×
Duplex Scan Hemodialysis Access (93990) $719 $959 6.6×
Duplex up extrem art bilat (93930) $964 $1,285 3.9×
Duplex up extrem art unilat/ltd (93931) $790 $1,053 7.3×
ECG/monitoring and analysis (93271) $209 $279 2.1×
Echo Heart Xthoracic,Limited (93308) $749 $998 3.0×
Echo transesophageal (93312) $2,189 $2,918 3.9×
Electrical Stimulation Ea 15 Min (97032) $64 $85 4.4×
Electrocardiogram Tracing (93005) $271 $361 4.4×
Emergency Dept Visit Level 2 (99282) $287 $382 1.8×
Emergency Dept Visit Level 3 (99283) $470 $626 1.7×
Emergency Dept Visit Level 4 (99284) $709 $945 1.6×
Er level 1 (99281) $168 $224 1.9×
Er level v (99285) $1,138 $1,517 1.8×
Evaluate pt use of inhaler (94664) $34 $45 0.1×
Evaluate Speech Production (92522) $253 $337 2.3×
Evaluate Swallowing Function (92610) $279 $372 3.3×
Evaluation of speech fluency (92521) $237 $316 1.8×
External ECG rec>48hr<7d recording (93242) $478 $637 12.3×
External ECG rec>48hr<7d scanning alys w/report (93243) $793 $1,057 5.7×
External ECG rec>7d<15d recording (93246) $464 $619 12.0×
External ECG rec>7d<15d scanning alys w/report (93247) $820 $1,093 5.9×
External Ecg Scanning Analysis Report (93226) $551 $734 9.0×
Extracranial Bilat Study (93880) $1,193 $1,591 4.8×
Extracranial Uni/Ltd Study (93882) $790 $1,053 7.3×
Group Therapeutic Procedures (97150) $89 $119 4.9×
Holter monitor recording (93225) $397 $529 2.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $28 $37 0.4×
Immunization administration (90471) $32 $43 0.4×
Iontophoresis 15 min (97033) $104 $138 5.5×
Irrig Drug Delivery Device (96523) $120 $160 2.0×
IV infusion hydration each additional hour (96361) $136 $181 2.8×
IV infusion hydration initial 31 min-1 hour (96360) $318 $424 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $191 $255 2.6×
IV infusion therapy prophylaxis/dx ea hour (96366) $144 $192 3.0×
IV push initial (96374) $224 $298 1.0×
Lwr Xtr Vasc Stdy Bilat (93924) $788 $1,051 3.5×
Motion Fluoroscopy/Swallow (92611) $434 $578 4.7×
Nasopharyngoscopy (92511) $185 $246 0.9×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $336 $448 0.8×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $359 $478 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $214 $285 1.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $318 $424 0.8×
Neuromuscular Reeducation (97112) $80 $106 2.4×
Oral Function Therapy (92526) $239 $318 2.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $82 $109 1.6×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $85 $113 1.8×
Ot Contrast Bath Ea 15 Min (97034) $60 $80 4.3×
Ot eval high complexity (97167) $233 $311 2.3×
Ot Eval Low Complex (97165) $170 $226 1.7×
Ot Eval Moderate Complexity (97166) $180 $240 1.8×
Ot manual therapy 15 min (97140) $92 $123 3.3×
Ot paraffin bath (97018) $56 $75 9.3×
Ot Prosthetic Training, Each 15 Min (97761) $82 $109 2.0×
Ot Re-Eval Est Plan Care (97168) $122 $163 1.8×
Ot rom hand (95852) $64 $85 3.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $200 $266 1.5×
Patch/Application Test Specify Number Tests (95044) $9 $12 0.0×
Percutaneous tests w/allergenic extracts (95004) $7 $9 0.0×
Phlebotomy therapeutic (99195) $168 $224 1.2×
Physical Performance Test (97750)
range across 3 matching MRF lines		 $58–$89 $77–$119 varies
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,660 $4,880 4.1×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $25 $33 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115)
range across 2 matching MRF lines		 $15–$17 $20–$22 varies
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $19 $25 0.4×
Pt Eval High Complex (97163) $220 $293 2.2×
Pt eval low complex 20 min (97161) $148 $197 1.5×
Pt Eval Mod Complex (97162) $179 $239 1.8×
Pt gait training 15 min (97116) $76 $101 2.6×
Pt mechanical traction (97012) $64 $85 4.5×
Pt Re-Eval Est Plan Care (97164) $99 $132 1.5×
Pure Tone Audiometry Air (92552) $58 $77 0.4×
Refill/Maint Portable Pump (96521) $335 $447 1.5×
Remote 30 Day Ecg Rev/Report (93270) $308 $411 7.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $158 $211 0.8×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851)
range across 2 matching MRF lines		 $36–$74 $48–$99 varies
Self Care Mngment Training (97535) $92 $123 2.8×
Speech sound lang comprehen (92523) $303 $404 1.3×
Stress Tte Only (93350) $1,433 $1,910 2.5×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $86 $115 3.8×
Ther Ivntj Ea Addl 15 Min (97130) $86 $115 4.1×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $92 $123 2.5×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $60 $80 2.0×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines		 $32–$109 $43–$145 varies
Ther/Proph/Diag Iv Inf Init (96365) $335 $446 1.5×
Therapeutic Activities (97530) $92 $123 2.6×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $1,472 $1,963 3.8×
Tobacco Use Cessation Intensive >10 Minutes (99407) $46 $61 1.2×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $25 $33 0.6×
Trans Care Mgmt 14 Day Disch (99495) $325 $433 2.4×
Trans Care Mgmt 7 Day Disch (99496) $439 $585 3.2×
Tte w/doppler, complete (93306) $1,791 $2,388 3.2×
Tte W/O Doppler Complete (93307) $1,286 $1,715 5.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $255 $340 3.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $168 $224 3.5×
Tympanometry (92567) $26 $35 0.7×
Upr/L Xtremity Art 2 Levels (93922) $438 $584 3.2×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $766 $1,021 3.4×
Vasopneumatic device (97016) $66 $88 5.5×
Wheelchair Mgmt Ea 15 Min (97542) $68 $91 2.2×
Whirlpool Therapy (97022) $92 $123 5.9×

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.