Visits & medical services prices at Essentia Health St. Mary's Hospital - Superior
Superior, WI · every code in this section with a posted price and a Medicare benchmark.
159 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Aep neurodiagnostic i&r (92653) | $259.39 | $351 | 1.2× |
| Aep threshold estimation mlt frequencies i&r (92652) | $254.22 | $344 | 1.2× |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$49.51–$150.02 | $67–$203 | varies |
| Airway resistance by oscillometry (94728) | $224.66 | $304 | 1.8× |
| Analyze Neurostim Simple (95971) | $147.80 | $200 | 1.6× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $62.82 | $85 | 4.4× |
| Assessment of aphasia per hr (96105) | $243.87 | $330 | 2.5× |
| Behavral qualit analys voice (92524) | $284.52 | $385 | 2.6× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $161.84 | $219 | 2.0× |
| Bfb training ea addl 15 min (90913) | $123.41 | $167 | 3.8× |
| Biofeedback training any modality (90901) | $66.51 | $90 | 1.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$328.86–$345.11 | $445–$467 | varies |
| Canalith repositioning proc (95992) | $133.02 | $180 | 3.3× |
| Car seat/bed test 60 min (94780) | $116.76 | $158 | 3.2× |
| Cardiac Stress Tst,Tracing Only (93017) | $786.30 | $1,064 | 3.7× |
| Cardiopulmonary resuscitation (92950) | $716.09 | $969 | 3.4× |
| Cardioversion (92960) | $1,342.76 | $1,817 | 2.1× |
| Cbt 1st hour (94644) | $121.20 | $164 | 0.9× |
| Chemo Anti-Neopl Sq/Im (96401) | $249.04 | $337 | 3.5× |
| Chemo Hormon Antineopl Sq/Im (96402) | $177.36 | $240 | 2.5× |
| Chemo IV infusion addl hr (96415) | $221.70 | $300 | 3.2× |
| Chemo IV push addl drug (96411) | $232.05 | $314 | 3.3× |
| Chemother Prolong Infuse W/Pump (96416) | $507.69 | $687 | 1.6× |
| Chemotherapy Into Cns (96450) | $313.34 | $424 | 1.0× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $300.77 | $407 | 4.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $573.46 | $776 | 1.8× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $385.02 | $521 | 1.2× |
| Chest Wall Manipulation (94668) | $126.37 | $171 | 1.0× |
| Color/duplex Doppler, complete (93975) | $1,022.78 | $1,384 | 4.4× |
| Color/duplex Doppler, limited (93976) range across 2 matching MRF lines |
$512.13–$513.60 | $693–$695 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $75.38 | $102 | 2.4× |
| Continuous Pulse Ox (94762) | $255.69 | $346 | 2.0× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$77.60–$745.65 | $105–$1,009 | varies |
| Cpt initial (94667) | $150.02 | $203 | 1.2× |
| Critical care first hour (99291) | $1,847.50 | $2,500 | 2.3× |
| Debridement Open Wound 20 Sq Cm< (97597) | $390.19 | $528 | 2.0× |
| Developmental tst admin phys/qhp 1st hour (96112) | $312.60 | $423 | 2.5× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $946.66 | $1,281 | 4.1× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $602.28 | $815 | 5.9× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $966.61 | $1,308 | 4.1× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$604.50–$619.28 | $818–$838 | varies |
| Duplex up extrem art bilat (93930) | $651.80 | $882 | 2.8× |
| Duplex up extrem art unilat/ltd (93931) | $540.95 | $732 | 5.3× |
| Echo Congenital Complete (93303) | $1,313.20 | $1,777 | 2.5× |
| Echo Heart Xthoracic,Limited (93308) | $727.92 | $985 | 3.1× |
| EEG cont rec w/video by tech min 8 channels (95700) | $410.14 | $555 | 1.9× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $931.14 | $1,260 | 4.4× |
| EEG w/o vid 2-12hr cont mntr (95707) | $1,340.55 | $1,814 | 6.4× |
| EEG w/o vid ea 12-26hr intmt (95709) | $2,231.04 | $3,019 | 6.1× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $2,677.40 | $3,623 | 7.3× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $1,117.37 | $1,512 | 5.3× |
| EEG wo vid ea 12-26hr unmntr (95708) | $1,859.32 | $2,516 | 5.1× |
| Electrical Stimulation Ea 15 Min (97032) | $72.42 | $98 | 4.9× |
| Electrocardiogram Tracing (93005) | $195.84 | $265 | 3.4× |
| Emergency Dept Visit Level 2 (99282) | $335.51 | $454 | 2.2× |
| Emergency Dept Visit Level 3 (99283) | $548.34 | $742 | 2.1× |
| Emergency Dept Visit Level 4 (99284) | $897.15 | $1,214 | 2.2× |
| Er level 1 (99281) | $208.40 | $282 | 2.5× |
| Er level v (99285) | $1,364.93 | $1,847 | 2.3× |
| Evaluate pt use of inhaler (94664) | $158.15 | $214 | 0.7× |
| Evaluate Speech Production (92522) | $284.52 | $385 | 2.5× |
| Evaluate Swallowing Function (92610) | $306.68 | $415 | 3.6× |
| Evaluation of speech fluency (92521) | $334.77 | $453 | 2.5× |
| External Ecg Scanning Analysis Report (93226) | $370.98 | $502 | 6.4× |
| Extracranial Bilat Study (93880) | $861.67 | $1,166 | 3.7× |
| Extracranial Uni/Ltd Study (93882) | $473.70 | $641 | 4.6× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $721.26 | $976 | 1.4× |
| Flexible endoscopic eval swallow c/v rec (92612) | $382.06 | $517 | 1.9× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $1,377.50 | $1,864 | 1.6× |
| Holter monitor recording (93225) | $284.52 | $385 | 2.2× |
| Immunization administration (90471) range across 5 matching MRF lines |
$44.34–$57.64 | $60–$78 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $673.97 | $912 | 1.8× |
| Iontophoresis 15 min (97033) | $106.42 | $144 | 5.6× |
| Irrig Drug Delivery Device (96523) | $153.71 | $208 | 2.7× |
| IV infusion hydration each additional hour (96361) | $121.94 | $165 | 2.7× |
| IV infusion hydration initial 31 min-1 hour (96360) | $322.20 | $436 | 1.6× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $185.49 | $251 | 2.6× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $151.50 | $205 | 3.3× |
| IV push initial (96374) | $205.44 | $278 | 1.0× |
| Mechanical chest wall oscillation per session (94669) | $223.92 | $303 | 1.0× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 3 matching MRF lines |
$59.86–$60.60 | $81–$82 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$65.03–$65.77 | $88–$89 | varies |
| Methacholine challenge (94070) | $600.81 | $813 | 1.6× |
| Muscle Test 2 Limbs (95861) | $209.14 | $283 | 1.6× |
| Muscle Test One Limb (95860) | $158.88 | $215 | 1.2× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $339.94 | $460 | 0.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $368.76 | $499 | 1.9× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $373.20 | $505 | 0.9× |
| Neuromuscular Reeducation (97112) | $72.42 | $98 | 2.2× |
| Newborn resuscitation (99465) | $482.57 | $653 | 0.7× |
| Nitric oxide expired gas determination (95012) | $89.42 | $121 | 2.5× |
| Oral Function Therapy (92526) | $226.13 | $306 | 2.7× |
| Oral Speech Device Eval (92597) | $328.86 | $445 | 4.6× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $102.72 | $139 | 2.1× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $84.25 | $114 | 1.8× |
| Ot Contrast Bath Ea 15 Min (97034) | $73.90 | $100 | 5.3× |
| Ot eval high complexity (97167) | $200.27 | $271 | 2.0× |
| Ot Eval Low Complex (97165) | $169.23 | $229 | 1.7× |
| Ot Eval Moderate Complexity (97166) | $184.75 | $250 | 1.8× |
| Ot manual therapy 15 min (97140) | $92.38 | $125 | 3.3× |
| Ot paraffin bath (97018) | $65.03 | $88 | 10.8× |
| Ot Prosthetic Training, Each 15 Min (97761) | $80.55 | $109 | 2.0× |
| Ot Re-Eval Est Plan Care (97168) | $135.98 | $184 | 2.0× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$245.35–$322.20 | $332–$436 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $208.40 | $282 | 1.7× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $318.51 | $431 | 1.5× |
| Peripheral arterial disease rehab per session (93668) | $69.47 | $94 | 1.2× |
| Phlebotomy therapeutic (99195) | $215.05 | $291 | 1.7× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $219.48 | $297 | 3.8× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $186.97 | $253 | 3.2× |
| Physical Performance Test (97750) | $86.46 | $117 | 2.6× |
| Plethysmography (94726) range across 2 matching MRF lines |
$286.73–$331.81 | $388–$449 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $3,887.14 | $5,260 | 4.6× |
| Psychiatric diagnostic evaluation (90791) | $256.43 | $347 | 1.5× |
| Pt Eval High Complex (97163) | $200.27 | $271 | 2.0× |
| Pt eval low complex 20 min (97161) | $168.49 | $228 | 1.7× |
| Pt Eval Mod Complex (97162) | $184.01 | $249 | 1.9× |
| Pt gait training 15 min (97116) | $75.38 | $102 | 2.6× |
| Pt mechanical traction (97012) | $81.29 | $110 | 5.7× |
| Pt Re-Eval Est Plan Care (97164) | $137.45 | $186 | 2.0× |
| Pulm function test by gas (94727) range across 2 matching MRF lines |
$221.70–$280.82 | $300–$380 | varies |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$133.02–$167.75 | $180–$227 | varies |
| Pulmonary Stress Testing (94618) range across 3 matching MRF lines |
$237.22–$266.78 | $321–$361 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $268.26 | $363 | 7.4× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $276.39 | $374 | 1.4× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $328.86 | $445 | 2.7× |
| Self Care Mngment Training (97535) | $66.51 | $90 | 2.1× |
| Sleep study unattended (95806) | $540.21 | $731 | 2.6× |
| Speech sound lang comprehen (92523) | $300.77 | $407 | 1.3× |
| Spirometry (94010) range across 2 matching MRF lines |
$171.45–$186.23 | $232–$252 | varies |
| Standardized Cognitive Performance Testing (96125) | $254.96 | $345 | 2.5× |
| Stress Tte Only (93350) | $1,175.01 | $1,590 | 2.2× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $82.03 | $111 | 3.7× |
| Ther Ivntj Ea Addl 15 Min (97130) | $80.55 | $109 | 3.8× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $87.94 | $119 | 2.4× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $240.18 | $325 | 2.3× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $87.94 | $119 | 1.3× |
| Ther/Proph/Diag Iv Inf Init (96365) | $370.24 | $501 | 1.8× |
| Therapeutic Activities (97530) | $73.90 | $100 | 2.1× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $70.94 | $96 | 1.9× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $31.04 | $42 | 0.8× |
| Tte w/doppler, complete (93306) | $1,622.10 | $2,195 | 3.0× |
| Tx atrial fib pulm vein isol (93656) | $13,404.72 | $18,139 | 0.5× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $209.88 | $284 | 2.8× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $109.37 | $148 | 4.5× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $124.89 | $169 | 2.7× |
| Upr/L Xtremity Art 2 Levels (93922) | $451.53 | $611 | 3.5× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $676.92 | $916 | 3.2× |
| Vasopneumatic device (97016) | $67.25 | $91 | 5.6× |
| Veeg 2-12 Hr Cont Mntr (95713) | $1,608.80 | $2,177 | 4.4× |
| Veeg 2-12 hr intmt mntr (95712) | $1,340.55 | $1,814 | 3.7× |
| Veeg 2-12 hr unmonitored (95711) | $1,117.37 | $1,512 | 5.3× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $2,677.40 | $3,623 | 7.3× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $2,231.04 | $3,019 | 6.1× |
| Veeg ea 12-26hr cont mntr (95716) | $3,213.17 | $4,348 | 3.8× |
| Vent Mgmt Inpat Init Day (94002) range across 2 matching MRF lines |
$815.86–$1,113.67 | $1,104–$1,507 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $747.87 | $1,012 | 1.2× |
| Wheelchair Mgmt Ea 15 Min (97542) | $68.73 | $93 | 2.2× |
| Whirlpool Therapy (97022) | $90.90 | $123 | 5.8× |
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.