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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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $173 $192 1.6×
Airway inhalation treatment (94640) $271 $301 1.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $645 $717 1.7×
Cardiac Stress Tst,Tracing Only (93017) $1,094 $1,216 4.9×
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions (98940) $61 $68 2.7×
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions (98941) $88 $98 3.9×
Chiropractic manipulative treatment (CMT); spinal, 5 regions (98942) $115 $128 5.1×
Color/duplex Doppler, complete (93975) $1,109 $1,232 4.5×
Critical care (99291) $1,649 $1,832 1.9×
Demo &/or eval,pt use,aerosol device (94664) $46 $51 0.2×
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 Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,042 $1,158 4.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,122 $1,247 10.3×
Dup-scan xtr veins unilateral/limited study (93971) $986 $1,095 9.1×
Duplex scan extracranial art compl bi study (93880) $1,390 $1,544 5.6×
Echo Heart Xthoracic,Limited (93308) $847 $941 3.4×
EKG (93005) $299 $332 4.9×
EKG rhythm strip (93041) $158 $175 2.6×
Electroconvulsive Therapy (90870) $32 $36 0.0×
Er level 1 (99281) $192 $213 2.2×
Er level ii (99282) $316 $351 2.0×
Er level iii (99283) $490 $544 1.7×
Er level IV (99284) $789 $877 1.8×
Er level v (99285) $1,190 $1,322 1.9×
Evaluation of speech fluency (92521) $262 $291 2.0×
Evaluation of speech sound production (92522) $323 $359 2.9×
Evaluation of swallowing function (92610) $318 $353 3.7×
External ECG rec>48hr<7d recording (93242) $442 $491 11.4×
External ECG rec>7d<15d recording (93246) $885 $983 22.8×
Holter Monitor Recording (93225) $489 $543 3.5×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $6 $7 0.1×
Immunization Admin (90471) $55 $61 0.7×
Immunotherapy, 2+ Injections (95117) $36 $40 0.7×
Interrog dev eval scrms phys/qhp in person (93291) $87 $97 2.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (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, therap/proph/diagnost,add infusion,1st hour (96367) $207 $230 2.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $374 $416 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $276 $307 5.7×
IV push initial (96374) $250 $278 1.1×
Manual therapy 15 min (97140) $97 $108 3.5×
Massage 15 min (97124) $63 $70 2.1×
Mechanical traction (97012) $71 $79 4.9×
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 press wnd tx </=50 sq cm (97607) $699 $777 1.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $503 $559 1.2×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $514 $571 3.7×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $867 $963 3.9×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $65 $72 2.0×
Ot eval high complex 60 min (97167) $221 $245 2.2×
Ot eval low complex 30 min (97165) $168 $187 1.7×
Ot eval mod complex 45 min (97166) $201 $223 2.0×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $48 $53 1.0×
Ot Range Motion Measure,Each Extrem (95851) $36 $40 1.4×
Ot re-eval est plan care (97168) $138 $153 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $260 $289 1.9×
Paraffin bath (97018) $59 $66 9.8×
Percutaneous tests w/allergenic extracts (95004) $14 $15 0.0×
Peripheral arterial disease rehab per session (93668) $207 $230 3.4×
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×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $193 $214 5.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $24 $27 0.5×
Programming of dual lead implantable defibrillator system (93283) $278 $309 7.2×
Pt Aquatic Therapy/Exercises (97113) $103 $114 2.8×
Pt Electric Current Therapy (97033) $103 $114 5.4×
Pt Electrical Stimulation (97032) $71 $79 4.8×
Pt eval high complex 45 min (97163) $256 $284 2.6×
Pt eval low complex 20 min (97161) $155 $172 1.6×
Pt Gait Training Therapy (97116) $81 $90 2.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $84 $93 2.6×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $186 $207 1.9×
Pt re-evaluation (97164) $112 $124 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $93 $103 2.9×
Pt Ultrasound Therapy (97035) $71 $79 4.9×
Pulmonary stress testing (94618) $381 $423 2.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $140 $156 0.7×
Speech sound lang comprehen (92523) $323 $359 1.4×
Spirometry (94010) $326 $362 1.5×
Ther/Proph/Diag Inj Sc/Im (96372) $140 $155 1.9×
Therapeutic Activities (97530) $92 $102 2.6×
Therapeutic phlebotomy (99195) $194 $216 1.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,111 $2,346 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $281 $312 3.7×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $262 $291 3.1×
Tx/Pro/Dx Inj New Drug Addon (96375) $221 $246 4.5×
Ultraviolet Therapy (97028) $17 $19 2.0×
Vasc Duplex Extrem Venous,Bilat (93970) $1,304 $1,449 5.3×
Vasc Duplex Scan Extracranial,Limited (93882) $728 $809 6.7×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $854 $949 3.8×