Visits & medical services prices at Ellsworth County Medical Center

Ellsworth, KS · every code in this section with a posted price and a Medicare benchmark.

142 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) $80 $80 0.9×
Airway inhalation treatment (94640) $41 $41 0.2×
Behav assmt w/score & docd/stand instrument (96127) $15 $15 0.4×
Behavioral and qualitative analysis of voice and resonance (92524) $165 $165 1.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $172.38 $172.38 0.5×
Canalith Repositioning (95992) $137.43 $137.43 3.4×
Cardiac Stress Tst,Tracing Only (93017) $442 $442 2.2×
Cardiopulmonary resuscitation (92950) $417.50 $417.50 2.1×
Cardioversion (92960) $410 $410 0.7×
Caregiver hlth risk assmt score doc stnd instrm (96161) $20 $20 0.6×
Chemo Iv Push Sngl Drug (96409) $160 $160 0.5×
Chemother, IV infusion, 1 hr (96413) $251.01 $251.01 0.8×
Chemother, IV infusion, ea add hr (96415) $250.51 $250.51 3.8×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $118 $118 1.8×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $143 $143 1.5×
Color vision examination (92283) $16 $16 0.3×
Color/duplex Doppler, complete (93975) $972.46 $972.46 4.4×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $308 $308 1.9×
Cont Gluc Monitoring Patient Provided Equipment (95249) $161.23 $161.23 3.0×
Cpap initiation and management (94660) $341.26 $341.26 1.7×
Cpt initial (94667) $97 $97 0.8×
Critical care (99291) $237.69 $237.69 0.3×
Debridement Open Wound 20 Sq Cm< (97597) $320.68 $320.68 1.7×
Demo &/or eval,pt use,aerosol device (94664) $53 $53 0.3×
Dermatological procedure (96999) $143.15 $143.15 0.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $606 $606 2.8×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $606 $606 2.8×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $606 $606 6.3×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $675 $675 3.1×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $606 $606 6.3×
Dup-scan xtr veins unilateral/limited study (93971) $606 $606 6.3×
Duplex scan extracranial art compl bi study (93880) $606 $606 2.8×
EKG (93005) $340 $340 6.3×
EKG rhythm strip (93041) $170 $170 3.1×
Er level 1 (99281) $70 $70 0.9×
Er level ii (99282) $90 $90 0.6×
Er level iii (99283) $150.51 $150.51 0.6×
Er level IV (99284) $232.78 $232.78 0.6×
Er level v (99285) $328.10 $328.10 0.6×
Evaluation of speech fluency (92521) $165 $165 1.2×
Evaluation of speech sound production (92522) $165 $165 1.5×
Evaluation of swallowing function (92610) $178 $178 2.1×
External Ecg Scanning Analysis Report (93226) $230.25 $230.25 4.2×
Flow volume loop (94375) $135.50 $135.50 0.7×
Group Therapeutic Procedures (97150) $35 $35 1.9×
Holter Monitor Recording (93225) $258.50 $258.50 2.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $58 $58 1.6×
Immunization Admin (90471) $58 $58 0.9×
Immunotherapy, 2+ Injections (95117) $27 $27 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $67.75 $67.75 1.2×
IV infusion hydration each additional hour (96361) $182 $182 4.2×
IV infusion hydration initial 31 min-1 hour (96360) $244 $244 1.2×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $165.25 $165.25 2.5×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $244 $244 1.2×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $182 $182 4.2×
IV push initial (96374) $58 $58 0.3×
Manual therapy 15 min (97140) $78 $78 2.8×
Massage 15 min (97124) $63.50 $63.50 2.1×
Mechanical chest wall oscillation (94669) $32 $32 0.2×
Mechanical traction (97012) $70 $70 4.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $35.12 $35.12 1.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $39.38 $39.38 1.1×
Mnt Group Ea 30 Min (97804) $18.62 $18.62 1.1×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $141 $141 1.5×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $150.70 $150.70 0.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $158 $158 0.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $606 $606 5.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $150 $150 1.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $50 $50 1.1×
Osteopathic manipulative tx 1-2 body regions (98925) $61 $61 3.1×
Osteopathic manipulative tx 3-4 body regions (98926) $89 $89 4.5×
Osteopathic manipulative tx 5-6 body regions (98927) $107.50 $107.50 5.4×
Osteopathic manipulative tx 7-8 body regions (98928) $106 $106 5.3×
Osteopathic manipulative tx 9-10 body regions (98929) $124 $124 6.2×
Ot Contrast Bath Ea 15 Min (97034) $37.50 $37.50 2.7×
Ot eval high complex 60 min (97167) $166 $166 1.7×
Ot eval low complex 30 min (97165) $170 $170 1.7×
Ot eval mod complex 45 min (97166) $156 $156 1.6×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $36 $36 0.7×
Ot Prosthetic Training, Each 15 Min (97761) $56 $56 1.4×
Ot Range Motion Measure,Each Extrem (95851) $23 $23 0.9×
Ot re-eval est plan care (97168) $110 $110 1.6×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $122 $122 1.0×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $122 $122 1.0×
Paraffin bath (97018) $30.50 $30.50 5.1×
Peripheral arterial disease rehab per session (93668) $50 $50 0.9×
Phy/qhp op pulm rhb w/mntr (94626) $58.27 $58.27 1.1×
Phy/qhp op pulm rhb w/o mntr (94625) $58.27 $58.27 1.1×
Plethysmography (94726) $228 $228 0.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $580.46 $580.46 0.7×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $23 $23 0.5×
Prepj& antigen prv allergen immunotherapy 1 do (95144) $22 $22 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $22 $22 0.5×
Psych diag eval w/med srvcs (90792) $215 $215 1.3×
Pt Aquatic Therapy/Exercises (97113) $68 $68 1.8×
Pt Electric Current Therapy (97033) $59.50 $59.50 3.1×
Pt Electrical Stimulation (97032) $70 $70 4.8×
Pt eval high complex 45 min (97163) $190 $190 1.9×
Pt eval low complex 20 min (97161) $170 $170 1.7×
Pt Gait Training Therapy (97116) $68 $68 2.3×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $78 $78 2.4×
Pt Physical Performance Test (97750) $56 $56 1.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $180 $180 1.8×
Pt re-evaluation (97164) $115 $115 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $60 $60 1.9×
Pt Ultrasound Therapy (97035) $40 $40 2.8×
Pt Whirlpool Therapy (97022) $44 $44 2.8×
Pulm Funct Test Oscillometry (94728) $82 $82 0.7×
Pulmonary stress testing (94618) $342 $342 2.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $196.58 $196.58 1.1×
Rom meas&reprt hand w/wo comparison normal sid (95852) $19.50 $19.50 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $53 $53 0.4×
Sensory Integration Ea 15 Min (97533) $51 $51 0.8×
Sleep study attended (95807) $174.88 $174.88 0.5×
Sleep study unattended (95806) $327.29 $327.29 1.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $119.38 $119.38 0.6×
Slp stdy unatnd w/min hrt rate/o2 sat/resp anal (95801) $119.38 $119.38 2.2×
Smoking cessation > 10 min (99407) $56 $56 1.6×
Speech sound lang comprehen (92523) $241 $241 1.1×
Spirometry (94010) $382.50 $382.50 1.9×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $182 $182 4.2×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $139 $139 0.7×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $84.50 $84.50 3.8×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $54 $54 2.6×
Ther/Proph/Diag Inj Sc/Im (96372) $50 $50 0.8×
Therapeutic Activities (97530) $65.50 $65.50 1.9×
Therapeutic phlebotomy (99195) $101.50 $101.50 0.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $29 $29 0.8×
Trans Care Mgmt 14 Day Disch (99495) $394 $394 3.2×
Trans Care Mgmt 7 Day Disch (99496) $473 $473 3.9×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,975 $1,975 3.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $741 $741 3.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $110 $110 1.4×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $94 $94 1.1×
Tx/Pro/Dx Inj New Drug Addon (96375) $58 $58 1.3×
Tympanometry (92567) $32 $32 0.9×
Unlisted Cardiovascular Service/Procedure (93799) $1,545.02 $1,545.02 13.1×
Unlisted pulmonary service/procedure (94799) $50 $50 0.4×
Vasc Duplex Extrem Venous,Bilat (93970) $890.50 $890.50 4.1×
Vasopneumatic device (97016) $38 $38 3.2×
Vital capacity total (94150) $43 $43 0.4×
Wheelchair Mgmt Ea 15 Min (97542) $28 $28 0.9×