Visits & medical services prices at CHI Health St. Mary's

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $198.37 $239 0.9×
Ambulatory Bp Analysis (93788) $206.67 $249 1.5×
Ambulatory Bp Recording (93786) $163.51 $197 1.2×
Analyze neurostim no prog (95970) $173.47 $209 1.3×
Anogenital exam, child (99170) $332.83 $401 1.6×
Appl on-body injector for timed subq injection (96377) $164.34 $198 3.4×
Behavioral and qualitative analysis of voice and resonance (92524) $269.75 $325 2.5×
Bfb training ea addl 15 min (90913) $144.42 $174 4.4×
Biofeedback training any modality (90901) $80.51 $97 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $698.86 $842 1.8×
Canalith Repositioning (95992) $180.94 $218 4.4×
Car seat/bed test 60 min (94780) $360.22 $434 9.3×
Cardiac Stress Tst,Tracing Only (93017) $1,216.78 $1,466 5.4×
Cardiopulmonary resuscitation (92950) $981.89 $1,183 4.4×
Cardioversion (92960) $959.06 $1,155.50 1.4×
Caregiver training 1st 30 min (97550) $48.97 $59 0.9×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $48.97 $59 1.9×
Chemo Hormon Antineopl Sq/Im (96402) $217.46 $262 2.9×
Chemo inj subarach/intravent (96542) $297.97 $359 0.9×
Chemo IV push addl drug (96411) $330.34 $398 4.4×
Chemo Iv Push Sngl Drug (96409) $330.34 $398 1.0×
Chemo prolong 8+ hrs infuse w/pump (96416) $557.76 $672 1.6×
Chemother, IV infusion, 1 hr (96413) $428.28 $516 1.2×
Chemother, IV infusion, ea add hr (96415) $119.52 $144 1.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $217.46 $262 2.9×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $330.34 $398 4.4×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $145.25 $175 1.4×
Color/duplex Doppler, complete (93975) $694.71 $837 2.8×
Color/duplex Doppler, limited (93976) $441.98 $532.50 4.1×
Cont Gluc Monitoring Patient Provided Equipment (95249) $140.27 $169 2.3×
Continuous Glucose Monitoring (95250) $318.72 $384 2.3×
Cpap initiation and management (94660) $835.81 $1,007 3.7×
Cpt initial (94667) $249.83 $301 1.8×
Critical care (99291) $1,547.12 $1,864 1.8×
Debridement Open Wound 20 Sq Cm< (97597) $125.33 $151 0.6×
Demo &/or eval,pt use,aerosol device (94664) $102.92 $124 0.5×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $3,480.19 $4,193 8.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $320.38 $386 1.3×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $543.65 $655 5.0×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $666.08 $802.50 2.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $549.46 $662 5.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,184.41 $1,427 4.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,071.53 $1,291 9.9×
Dup-scan xtr veins unilateral/limited study (93971) $666.08 $802.50 6.1×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $1,807.32 $2,177.50 7.3×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $189.66 $228.50 1.7×
Duplex scan extracranial art compl bi study (93880) $823.36 $992 3.3×
Echo Heart Xthoracic,Limited (93308) $469.78 $566 1.9×
Echo transesophageal (93312) $2,206.97 $2,659 3.9×
EEG awake asleep (95819) $870.67 $1,049 3.9×
EEG awake drowsy (95816) $772.73 $931 3.4×
Eeg Extended Monitoring 61-119 Minutes (95813) $1,068.21 $1,287 4.8×
EKG (93005) $265.60 $320 4.3×
EKG rhythm strip (93041) $163.51 $197 2.7×
Elec alys implt cplx cn npgt prgrmg (95977) $131.97 $159 1.3×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $52.29 $63 1.3×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $1,226.74 $1,478 5.5×
EMG one extremity (95860) $269.75 $325 2.0×
EMG two extremities (95861) $390.10 $470 2.8×
Er level 1 (99281) $115.78 $139.50 1.3×
Er level ii (99282) $223.27 $269 1.4×
Er level iii (99283) $355.24 $428 1.3×
Er level IV (99284) $566.06 $682 1.3×
Er level v (99285) $900.96 $1,085.50 1.5×
Evaluation of speech fluency (92521) $269.75 $325 2.0×
Evaluation of speech sound production (92522) $269.75 $325 2.4×
Evaluation of swallowing function (92610) $285.52 $344 3.4×
Evaluation with prescription of speech-generating alternative (92607) $337.81 $407 2.8×
Evoked auditory test,limited (92587) $405.87 $489 1.8×
External ECG rec>48hr<7d recording (93242) $155.62 $187.50 4.0×
External ECG rec>7d<15d recording (93246) $333.24 $401.50 8.6×
External Ecg Scanning Analysis Report (93226) $797.63 $961 13.0×
Group Therapeutic Procedures (97150) $58.93 $71 3.3×
Holter Monitor Recording (93225) $295.06 $355.50 2.1×
Icd Device Interrogate (93289) $190.07 $229 4.9×
Ilr Device Eval Progr (93285) $212.48 $256 5.5×
Imaging of colon using capsule endoscope, with interpretation and report (91113) $1,051.61 $1,267 1.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $65.57 $79 1.6×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $45.65 $55 0.6×
Immunization Admin (90471) $76.36 $92 1.0×
Interrog dev eval scrms phys/qhp in person (93291) $144.42 $174 4.8×
Interrogate subq defib (93261) $135.29 $163 3.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $127.40 $153.50 2.1×
IV infusion hydration each additional hour (96361) $97.94 $118 2.0×
IV infusion hydration initial 31 min-1 hour (96360) $268.09 $323 1.2×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $126.16 $152 1.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $267.26 $322 1.2×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $118.69 $143 2.4×
IV push initial (96374) $194.64 $234.50 0.9×
Manual therapy 15 min (97140) $80.51 $97 2.9×
Massage 15 min (97124) $54.78 $66 1.8×
Mechanical chest wall oscillation (94669) $268.09 $323 1.2×
Mechanical traction (97012) $70.55 $85 4.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $41.50 $50 1.3×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $48.14 $58 1.3×
Methacholine challenge (94070) $957.82 $1,154 2.5×
Mnt Group Ea 30 Min (97804) $42.33 $51 2.5×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $346.52 $417.50 3.8×
Multiple sleep latency test (95805) $4,003.09 $4,823 4.5×
Nasopharyngoscopy (92511) $301.29 $363 1.5×
Neg press wnd tx </=50 sq cm (97607) $585.98 $706 1.4×
Neg press wound tx >50 cm (97608) $598.84 $721.50 1.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $120.35 $145 0.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $269.75 $325 0.6×
Nerve conduction studies 13/> studies (95913) $2,006.94 $2,418 5.2×
Nerve Conduction Studies 3-4 Studies (95908) $415.83 $501 1.9×
Nerve Conduction Studies 9-10 Studies (95911) $899.72 $1,084 2.3×
Nerve conduction studies; 1-2 studies (95907) $271.41 $327 1.2×
Nerve conduction studies; 11-12 studies (95912) $1,455.82 $1,754 3.8×
Nerve conduction studies; 5-6 studies (95909) $571.46 $688.50 2.5×
Nerve conduction studies; 7-8 studies (95910) $737.46 $888.50 1.9×
Newborn resuscitation (99465) $877.31 $1,057 1.3×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $344.86 $415.50 2.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $663.17 $799 3.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $434.92 $524 3.3×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $346.94 $418 0.9×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $73.04 $88 1.6×
Ot Contrast Bath Ea 15 Min (97034) $70.14 $84.50 5.0×
Ot eval high complex 60 min (97167) $205.84 $248 2.0×
Ot eval low complex 30 min (97165) $136.12 $164 1.4×
Ot eval mod complex 45 min (97166) $171.81 $207 1.7×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $71.38 $86 1.4×
Ot re-eval est plan care (97168) $136.12 $164 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $299.63 $361 2.2×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $299.63 $361 2.2×
Paraffin bath (97018) $70.14 $84.50 11.7×
Peripheral arterial disease rehab per session (93668) $175.96 $212 2.9×
Phy/qhp op pulm rhb w/mntr (94626) $198.78 $239.50 3.2×
Phy/qhp op pulm rhb w/o mntr (94625) $187.58 $226 3.1×
Plethysmography (94726) $908.02 $1,094 2.3×
Pm device eval in person (93288) $154.38 $186 4.0×
Pm device progr eval dual (93280) $146.91 $177 3.8×
Pm device progr eval multi (93281) $151.89 $183 3.9×
Pm device progr eval sngl (93279) $124.50 $150 3.2×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,790.61 $4,567 4.3×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $135.29 $163 3.5×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $224.93 $271 5.8×
Programming of dual lead implantable defibrillator system (93283) $192.56 $232 5.0×
Programming of single lead implantable defibrillator system (93282) $190.07 $229 4.9×
Pt Aquatic Therapy/Exercises (97113) $79.68 $96 2.1×
Pt Electric Current Therapy (97033) $68.48 $82.50 3.6×
Pt Electrical Stimulation (97032) $51.46 $62 3.5×
Pt eval high complex 45 min (97163) $205.84 $248 2.1×
Pt eval low complex 20 min (97161) $136.12 $164 1.4×
Pt Gait Training Therapy (97116) $84.24 $101.50 2.9×
Pt Infrared Therapy (97026) $104.58 $126 15.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $82.17 $99 2.5×
Pt Physical Performance Test (97750) $104.58 $126 3.1×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $171.81 $207 1.8×
Pt re-evaluation (97164) $136.12 $164 2.0×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $84.66 $102 2.6×
Pt Ultrasound Therapy (97035) $58.10 $70 4.0×
Pt Whirlpool Therapy (97022) $109.14 $131.50 7.0×
Pulm Funct Test Oscillometry (94728) $118.69 $143 0.9×
Pulmonary stress testing (94618) $241.12 $290.50 1.7×
Refill/Maint Pump/Resvr Syst (96522) $92.96 $112 0.4×
Refill/maint, portable pump (96521) $514.60 $620 2.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $392.59 $473 10.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $97.11 $117 0.5×
Rom meas&reprt hand w/wo comparison normal sid (95852) $136.95 $165 6.4×
Rt Chest Wall Manipulation,Subsequent (94668) $249.83 $301 1.8×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $146.91 $177 3.1×
Sensory Integration Ea 15 Min (97533) $70.55 $85 1.2×
Sleep study attended (95807) $1,879.95 $2,265 4.9×
Sleep study unattended (95806) $517.92 $624 2.3×
Smoking cessation > 10 min (99407) $26.56 $32 0.7×
Speech group therapy (92508) $107.90 $130 4.5×
Speech sound lang comprehen (92523) $274.73 $331 1.2×
Spirometry (94010) $345.28 $416 1.5×
Standardized Cognitive Performance Testing (96125) $150.23 $181 1.5×
Stress echo (93350) $1,398.55 $1,685 2.5×
Temp transcutaneous pacing (92953) $1,008.45 $1,215 1.5×
Tensilon test (95857) $150.23 $181 0.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $125.33 $151 5.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $125.33 $151 6.0×
Ther/prop/diag inj/inf proc (96379) $126.16 $152 2.6×
Ther/Proph/Diag Inj Sc/Im (96372) $170.98 $206 2.3×
Therapeutic Activities (97530) $85.08 $102.50 2.4×
Therapeutic phlebotomy (99195) $243.60 $293.50 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $26.56 $32 0.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,266.58 $1,526 2.2×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,382.78 $1,666 5.6×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $168.49 $203 2.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $185.09 $223 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $135.29 $163 2.8×
Ultraviolet Therapy (97028) $31.54 $38 3.8×
Unlisted otorhinolaryngological service (92700) $118.69 $143 4.0×
Unlisted pulmonary service/procedure (94799) $125.33 $151 0.9×
Vasc Duplex Extrem Venous,Bilat (93970) $1,240.85 $1,495 5.0×
Vasc Duplex Scan Extracranial,Limited (93882) $1,013.43 $1,221 9.3×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $693.05 $835 3.1×
Vasopneumatic device (97016) $75.53 $91 6.3×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $678.94 $818 1.8×
Veeg by tech 2-12 hr intermittent monitoring (95712) $353.58 $426 0.9×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $678.94 $818 1.8×
Ventilation assist & mgmt inpatient 1st day (94002) $1,260.77 $1,519 2.0×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $854.90 $1,030 1.3×
Wheelchair Mgmt Ea 15 Min (97542) $59.76 $72 1.9×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $1,020.90 $1,230 10.3×