Visits & medical services prices at Gordon Memorial Hospital District
Gordon, NE · every code in this section with a posted price and a Medicare benchmark.
117 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $32 | $32 | 0.8× |
| Airway Inhalation Treatment (94640) | $300 | $300 | 1.3× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 3 matching MRF lines |
$90–$110 | $90–$110 | varies |
| Behavral qualit analys voice (92524) | $395 | $395 | 3.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $750 | $750 | 1.9× |
| Canalith repositioning proc (95992) | $140 | $140 | 3.4× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$877–$1,070 | $877–$1,070 | varies |
| Cardioversion (92960) | $1,735 | $1,735 | 2.5× |
| Chemo Anti-Neopl Sq/Im (96401) | $400 | $400 | 5.4× |
| Chemo Hormon Antineopl Sq/Im (96402) | $365 | $365 | 4.9× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $530 | $530 | 1.5× |
| Chest Wall Manipulation (94668) | $250 | $250 | 1.8× |
| Chron Care Mgmt Srvc 20 Min (99490) | $73 | $73 | 0.7× |
| Color/duplex Doppler, complete (93975) | $1,470 | $1,470 | 5.9× |
| Color/duplex Doppler, limited (93976) | $1,320 | $1,320 | 12.2× |
| Continuous Pulse Ox (94762) | $470 | $470 | 3.5× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $900 | $900 | 4.0× |
| Cpt initial (94667) | $220 | $220 | 1.6× |
| Critical care first hour (99291) | $2,650 | $2,650 | 3.1× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$190–$375 | $190–$375 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $1,220 | $1,220 | 4.9× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $970 | $970 | 8.9× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,520 | $1,520 | 6.1× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $1,220 | $1,220 | 11.2× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$1,810–$1,820 | $1,810–$1,820 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,270 | $1,270 | 11.7× |
| Duplex up extrem art bilat (93930) | $1,320 | $1,320 | 5.3× |
| Duplex up extrem art unilat/ltd (93931) | $1,070 | $1,070 | 9.9× |
| Electrical Stimulation Ea 15 Min (97032) range across 3 matching MRF lines |
$80–$105 | $80–$105 | varies |
| Electrocardiogram Tracing (93005) range across 3 matching MRF lines |
$20–$346 | $20–$346 | varies |
| Emergency Dept Visit Level 2 (99282) range across 3 matching MRF lines |
$122–$600 | $122–$600 | varies |
| Emergency Dept Visit Level 3 (99283) | $950 | $950 | 3.4× |
| Emergency Dept Visit Level 4 (99284) | $1,350 | $1,350 | 3.1× |
| Er level 1 (99281) | $375 | $375 | 4.3× |
| Er level v (99285) | $1,800 | $1,800 | 2.9× |
| Evaluate pt use of inhaler (94664) | $175 | $175 | 0.8× |
| Evaluate Speech Production (92522) | $370 | $370 | 3.3× |
| Evaluate Swallowing Function (92610) | $510 | $510 | 6.0× |
| External Ecg Scanning Analysis Report (93226) | $864 | $864 | 14.1× |
| Extracranial Bilat Study (93880) | $1,720 | $1,720 | 6.9× |
| Eye exam w anesth; limited (92019) | $120 | $120 | 0.0× |
| Holter monitor recording (93225) | $621 | $621 | 4.5× |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 10 matching MRF lines |
$4–$32 | $4–$32 | varies |
| Immunization administration (90471) range across 12 matching MRF lines |
$4–$95 | $4–$95 | varies |
| Iontophoresis 15 min (97033) range across 3 matching MRF lines |
$130–$150 | $130–$150 | varies |
| Irrig Drug Delivery Device (96523) | $210 | $210 | 3.4× |
| IV infusion hydration each additional hour (96361) | $185 | $185 | 3.8× |
| IV infusion hydration initial 31 min-1 hour (96360) | $390 | $390 | 1.8× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $215 | $215 | 2.9× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $365 | $365 | 7.5× |
| IV push initial (96374) | $290 | $290 | 1.3× |
| Low frequency non-thermal us (97610) | $265 | $265 | 1.3× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $100 | $100 | 3.2× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $155 | $155 | 4.2× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $30 | $30 | 1.8× |
| Multiple Sleep Latency Test (95805) | $2,160 | $2,160 | 2.4× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $275 | $275 | 0.7× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $300 | $300 | 0.7× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$305–$325 | $305–$325 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 2 matching MRF lines |
$410–$430 | $410–$430 | varies |
| Neuromuscular Reeducation (97112) range across 5 matching MRF lines |
$105–$125 | $105–$125 | varies |
| Oral Function Therapy (92526) | $335 | $335 | 4.0× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $125 | $125 | 2.5× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $160 | $160 | 3.5× |
| Ot eval high complexity (97167) range across 3 matching MRF lines |
$280–$295 | $280–$295 | varies |
| Ot Eval Low Complex (97165) range across 3 matching MRF lines |
$205–$220 | $205–$220 | varies |
| Ot Eval Moderate Complexity (97166) range across 3 matching MRF lines |
$235–$250 | $235–$250 | varies |
| Ot manual therapy 15 min (97140) range across 5 matching MRF lines |
$120–$140 | $120–$140 | varies |
| Ot paraffin bath (97018) | $100 | $100 | 16.6× |
| Ot Prosthetic Training, Each 15 Min (97761) | $145 | $145 | 3.6× |
| Ot Re-Eval Est Plan Care (97168) range across 3 matching MRF lines |
$175–$190 | $175–$190 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $344 | $344 | 2.6× |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$83–$168 | $83–$168 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $425 | $425 | 6.9× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $270 | $270 | 4.4× |
| Physical Performance Test (97750) | $95 | $95 | 2.8× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $5,076 | $5,076 | 5.7× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $18 | $18 | 0.4× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $21 | $21 | 0.4× |
| Pt Eval High Complex (97163) range across 3 matching MRF lines |
$310–$330 | $310–$330 | varies |
| Pt eval low complex 20 min (97161) range across 3 matching MRF lines |
$175–$195 | $175–$195 | varies |
| Pt Eval Mod Complex (97162) range across 4 matching MRF lines |
$215–$235 | $215–$235 | varies |
| Pt gait training 15 min (97116) range across 3 matching MRF lines |
$110–$130 | $110–$130 | varies |
| Pt mechanical traction (97012) | $110 | $110 | 7.7× |
| Pt Re-Eval Est Plan Care (97164) range across 3 matching MRF lines |
$125–$145 | $125–$145 | varies |
| Pulmonary service/procedure (94799) range across 2 matching MRF lines |
$240–$260 | $240–$260 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $416 | $416 | 10.7× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 5 matching MRF lines |
$54–$265 | $54–$265 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $505 | $505 | 4.1× |
| Self Care Mngment Training (97535) range across 5 matching MRF lines |
$145–$160 | $145–$160 | varies |
| Speech sound lang comprehen (92523) | $485 | $485 | 2.1× |
| Spirometry (94010) | $350 | $350 | 1.6× |
| Temp transcutaneous pacing (92953) | $765 | $765 | 1.1× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $140 | $140 | 6.3× |
| Ther Ivntj Ea Addl 15 Min (97130) | $130 | $130 | 6.2× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $135 | $135 | 3.6× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 2 matching MRF lines |
$95–$115 | $95–$115 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 5 matching MRF lines |
$10–$185 | $10–$185 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $420 | $420 | 1.9× |
| Therapeutic Activities (97530) range across 5 matching MRF lines |
$115–$135 | $115–$135 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $90 | $90 | 2.3× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $50 | $50 | 1.3× |
| Trans Care Mgmt 14 Day Disch (99495) | $210 | $210 | 1.5× |
| Trans Care Mgmt 7 Day Disch (99496) | $300 | $300 | 2.2× |
| Tte w/doppler, complete (93306) | $2,650 | $2,650 | 4.7× |
| Tte W/O Doppler Complete (93307) | $1,970 | $1,970 | 8.0× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $360 | $360 | 4.7× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $195 | $195 | 8.1× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $215 | $215 | 4.4× |
| Upr/L Xtremity Art 2 Levels (93922) | $670 | $670 | 4.8× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $1,370 | $1,370 | 6.1× |
| Vent Mgmt Inpat Init Day (94002) | $1,500 | $1,500 | 2.3× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,250 | $1,250 | 1.9× |
| Visual field xm uni/bi w/interpretj limited exam (92081) | $85 | $85 | 1.4× |
| Vital capacity, total (94150) | $150 | $150 | 1.1× |
| Wheelchair Mgmt Ea 15 Min (97542) | $125 | $125 | 4.0× |
| Whirlpool Therapy (97022) | $125 | $125 | 8.0× |
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.