Visits & medical services prices at Franklin County Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Advncd Care Plan 30 Min (99497) $173 $192 1.6×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines		 $50–$271 $55–$301 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $71 $79 4.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $645 $717 1.7×
Cardiac Stress Tst,Tracing Only (93017) $1,094 $1,216 4.9×
Chiropract manj 3-4 regions (98941) $88 $98 3.9×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) $61 $68 2.7×
Chiropractic manipulative treatment (CMT); spinal, 5 regions Facility (98942) $115 $128 5.1×
Color/duplex Doppler, complete (93975) $1,109 $1,232 4.5×
Community/Work Reintegration Trainj Ea 15 Min (97537) $65 $72 2.0×
Critical care first hour (99291) $1,649 $1,832 1.9×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $997 $1,108 4.0×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $684 $760 6.3×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,113 $1,237 4.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $905 $1,005 8.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,304 $1,449 5.3×
Dup-scan xtr veins unilateral/limited study (93971) $986 $1,095 9.1×
Duplex up extrem art bilat (93930) $1,042 $1,158 4.2×
Duplex up extrem art unilat/ltd (93931) $1,122 $1,247 10.3×
Echo Heart Xthoracic,Limited (93308) $847 $941 3.4×
Electrical Stimulation Ea 15 Min (97032) $71 $79 4.8×
Electrocardiogram Tracing (93005) $299 $332 4.9×
Electroconvulsive Therapy (90870) $32 $36 0.0×
Emergency Dept Visit Level 2 (99282) $316 $351 2.0×
Emergency Dept Visit Level 3 (99283) $490 $544 1.7×
Emergency Dept Visit Level 4 (99284) $789 $877 1.8×
Er level 1 (99281) $192 $213 2.2×
Er level v (99285) $1,190 $1,322 1.9×
Evaluate pt use of inhaler (94664) $46 $51 0.2×
Evaluate Speech Production (92522) $323 $359 2.9×
Evaluate Swallowing Function (92610) $318 $353 3.7×
Evaluation of speech fluency (92521) $262 $291 2.0×
External ECG rec>48hr<7d recording (93242) $442 $491 11.4×
External ECG rec>7d<15d recording (93246) $885 $983 22.8×
Extracranial Bilat Study (93880) $1,390 $1,544 5.6×
Extracranial Uni/Ltd Study (93882) $728 $809 6.7×
Holter monitor recording (93225) $489 $543 3.5×
Icd device progr eval dual (93283) $278 $309 7.2×
Icd Device Progr Eval Mult (93284) $193 $214 5.0×
Ilr Device Interrogate (93291) $87 $97 2.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $6 $7 0.1×
Immunization administration (90471)
range across 2 matching MRF lines		 $38–$72 $42–$80 varies
Iontophoresis 15 min (97033) $103 $114 5.4×
Irrig Drug Delivery Device (96523) $158 $175 2.6×
IV infusion hydration each additional hour (96361) $299 $332 6.1×
IV infusion hydration initial 31 min-1 hour (96360) $360 $400 1.6×
IV infusion ther proph addl sequential to 1 hr (96367) $207 $230 2.8×
IV infusion therapy prophylaxis/dx ea hour (96366) $276 $307 5.7×
IV push initial (96374) $250 $278 1.1×
Lwr Xtr Vasc Stdy Bilat (93924) $854 $949 3.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $111 $123 3.5×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $162 $180 4.4×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $699 $777 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $503 $559 1.2×
Neuromuscular Reeducation (97112) $84 $93 2.6×
Oral Function Therapy (92526) $262 $291 3.1×
Orthc/Prostc Mgmt Sbsq Enc (97763) $48 $53 1.0×
Ot eval high complexity (97167) $221 $245 2.2×
Ot Eval Low Complex (97165) $168 $187 1.7×
Ot Eval Moderate Complexity (97166) $201 $223 2.0×
Ot manual therapy 15 min (97140)
range across 5 matching MRF lines		 $59–$97 $66–$108 varies
Ot paraffin bath (97018) $59 $66 9.8×
Ot Re-Eval Est Plan Care (97168) $138 $153 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $260 $289 1.9×
Percutaneous tests w/allergenic extracts (95004) $14 $15 0.0×
Peripheral arterial disease rehab per session (93668) $207 $230 3.4×
Phlebotomy therapeutic (99195) $194 $216 1.4×
Pm device progr eval dual (93280) $124 $138 3.2×
Pm Device Progr Eval Sngl (93279) $194 $215 5.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,104 $4,560 4.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $24 $27 0.5×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $36 $40 0.7×
Pt Eval High Complex (97163) $256 $284 2.6×
Pt eval low complex 20 min (97161) $155 $172 1.6×
Pt Eval Mod Complex (97162) $186 $207 1.9×
Pt gait training 15 min (97116) $81 $90 2.8×
Pt mechanical traction (97012) $71 $79 4.9×
Pt Re-Eval Est Plan Care (97164) $112 $124 1.7×
Pt ultraviolet (97028) $17 $19 2.0×
Pulmonary Stress Testing (94618) $381 $423 2.8×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041)
range across 5 matching MRF lines		 $46–$292 $51–$324 varies
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $140 $156 0.7×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $36 $40 1.4×
Self Care Mngment Training (97535) $93 $103 2.9×
Speech sound lang comprehen (92523) $323 $359 1.4×
Spirometry (94010) $326 $362 1.5×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $103 $114 2.8×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $63 $70 2.1×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 6 matching MRF lines		 $43–$140 $48–$155 varies
Ther/Proph/Diag Iv Inf Init (96365) $374 $416 1.7×
Therapeutic Activities (97530) $92 $102 2.6×
Tte w/doppler, complete (93306) $2,111 $2,346 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $281 $312 3.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $221 $246 4.5×
Upr/L Xtremity Art 2 Levels (93922) $514 $571 3.7×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $867 $963 3.9×

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.