Visits & medical services prices at Grand Itasca Clinic and Hospital
Grand Rapids, MN · every code in this section with a posted price and a Medicare benchmark.
182 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Actigraphy Testing Recording Analysis I&R (95803) range across 2 matching MRF lines |
$196.78–$198.94 | $463–$468.08 | varies |
| Admn Sarscov2 Vacc 1 Dose (90480) range across 2 matching MRF lines |
$9.02–$42.50 | $21.22–$100 | varies |
| Airway Inhalation Treatment (94640) range across 7 matching MRF lines |
$29.27–$276.27 | $68.87–$650.04 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) range across 3 matching MRF lines |
$195.08–$215.56 | $459–$507.19 | varies |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) range across 3 matching MRF lines |
$134.73–$141.85 | $317–$333.76 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 6 matching MRF lines |
$28–$58.97 | $65.87–$138.75 | varies |
| Application on-body injector (96377) range across 2 matching MRF lines |
$35.70–$214.63 | $84–$505 | varies |
| Audiometry Air & Bone (92553) | $90.10 | $212 | 0.7× |
| Behavral qualit analys voice (92524) range across 2 matching MRF lines |
$236.43–$237.58 | $556.30–$559 | varies |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $204 | $480 | 2.5× |
| Bfb training ea addl 15 min (90913) | $82.03 | $193 | 2.5× |
| Biofeedback training any modality (90901) | $108.38 | $255 | 2.6× |
| Brief Emotional/Behav Assmt (96127) | $9.78 | $23 | 0.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 2 matching MRF lines |
$242.25–$242.50 | $570–$570.57 | varies |
| Canalith repositioning proc (95992) range across 8 matching MRF lines |
$35.70–$112.26 | $84–$264.14 | varies |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$450.50–$450.55 | $1,060–$1,060.10 | varies |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$450.50–$473.03 | $1,060–$1,113 | varies |
| Cardioversion (92960) range across 3 matching MRF lines |
$239.28–$770.53 | $563–$1,813 | varies |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $38.25 | $90 | 1.5× |
| Cbt 1st hour (94644) | $159.38 | $375 | 1.2× |
| Chemo Anti-Neopl Sq/Im (96401) range across 2 matching MRF lines |
$139.83–$275.40 | $329–$648 | varies |
| Chemo Hormon Antineopl Sq/Im (96402) range across 3 matching MRF lines |
$65.40–$65.45 | $153.88–$154 | varies |
| Chemo IV infusion addl hr (96415) range across 4 matching MRF lines |
$54.34–$197.63 | $127.86–$465 | varies |
| Chemo IV push addl drug (96411) | $106.25 | $250 | 1.4× |
| Chemother Prolong Infuse W/Pump (96416) | $245.70 | $578.11 | 0.7× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) range across 3 matching MRF lines |
$123.58–$241.83 | $290.76–$569 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 4 matching MRF lines |
$250.55–$466.23 | $589.52–$1,097 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $193.38 | $455 | 0.6× |
| Chest Wall Manipulation (94668) | $155.98 | $367 | 1.1× |
| Color/duplex Doppler, complete (93975) | $497.25 | $1,170 | 2.0× |
| Color/duplex Doppler, limited (93976) range across 5 matching MRF lines |
$228.84–$230.78 | $538.43–$543.01 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $73.95 | $174 | 2.3× |
| Comprehensive Hearing Test (92557) range across 4 matching MRF lines |
$69.28–$72.68 | $163–$171 | varies |
| Conditioning Play Audiometry (92582) | $157.68 | $371 | 1.2× |
| Cont gluc mntr physician/qhp provided equiptment (95250) range across 3 matching MRF lines |
$277.95–$291.98 | $654–$687 | varies |
| Cont Gluc Mntr Pt Prov Eqp (95249) range across 2 matching MRF lines |
$117.30–$136 | $276–$320 | varies |
| Continuous Pulse Ox (94762) | $180.63 | $425 | 1.4× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$334.90–$335.17 | $788–$788.61 | varies |
| Cpt initial (94667) | $147.48 | $347 | 1.1× |
| Critical care first hour (99291) range across 6 matching MRF lines |
$1,022.72–$1,024.25 | $2,406.39–$2,410 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$125.80–$221 | $296–$520 | varies |
| Developmental tst admin phys/qhp 1st hour (96112) range across 2 matching MRF lines |
$251.60–$275.40 | $592–$648 | varies |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) range across 2 matching MRF lines |
$24.51–$24.65 | $57.67–$58 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $473.03 | $1,113 | 1.9× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $269.45 | $634 | 2.5× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $473.03 | $1,113 | 1.9× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $265.63 | $625 | 2.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $524.45 | $1,234 | 2.1× |
| Dup-scan xtr veins unilateral/limited study (93971) | $270.30 | $636 | 2.5× |
| Duplex up extrem art bilat (93930) | $520.20 | $1,224 | 2.1× |
| Duplex up extrem art unilat/ltd (93931) | $220.15 | $518 | 2.0× |
| Echo Congenital Complete (93303) | $664.70 | $1,564 | 1.2× |
| Echo Heart Xthoracic,Limited (93308) range across 4 matching MRF lines |
$461.34–$473.03 | $1,085.50–$1,113 | varies |
| Echo transesophageal (93312) | $928.20 | $2,184 | 1.6× |
| Electrical Stimulation Ea 15 Min (97032) range across 4 matching MRF lines |
$56.53–$58.13 | $133–$136.76 | varies |
| Electrocardiogram Tracing (93005) range across 15 matching MRF lines |
$12.47–$94.78 | $29.33–$223 | varies |
| Emergency Dept Visit Level 2 (99282) range across 8 matching MRF lines |
$239.85–$257.13 | $564.33–$605 | varies |
| Emergency Dept Visit Level 3 (99283) range across 9 matching MRF lines |
$301.54–$305.58 | $709.50–$719 | varies |
| Emergency Dept Visit Level 4 (99284) range across 8 matching MRF lines |
$516.38–$530.83 | $1,215–$1,249 | varies |
| Er level 1 (99281) range across 5 matching MRF lines |
$205.28–$219.73 | $483–$517 | varies |
| Er level v (99285) range across 7 matching MRF lines |
$746.52–$753.10 | $1,756.50–$1,772 | varies |
| Evaluate pt use of inhaler (94664) | $246.50 | $580 | 1.1× |
| Evaluate Speech Production (92522) | $211.65 | $498 | 1.9× |
| Evaluate Swallowing Function (92610) | $193.80 | $456 | 2.3× |
| Evaluation of speech fluency (92521) | $251.60 | $592 | 1.9× |
| Exercise test for bronchospasm (94617) | $155.55 | $366 | 1.1× |
| External ECG rec>48hr<7d recording (93242) range across 4 matching MRF lines |
$22.87–$23.41 | $53.80–$55.07 | varies |
| External ECG rec>7d<15d recording (93246) range across 4 matching MRF lines |
$22.10–$84.58 | $52–$199 | varies |
| External Ecg Scanning Analysis Report (93226) | $178.50 | $420 | 2.9× |
| Extracranial Bilat Study (93880) | $403.33 | $949 | 1.6× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $835.55 | $1,966 | 0.9× |
| Holter monitor recording (93225) range across 3 matching MRF lines |
$35.70–$162.35 | $84–$382 | varies |
| Icd device progr eval dual (93283) | $83.73 | $197 | 2.2× |
| Icd Device Progr Eval Mult (93284) | $89.25 | $210 | 2.3× |
| Ilr Device Interrogate (93291) | $61.63 | $145 | 2.1× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $9.02 | $21.22 | 0.1× |
| Immunization administration (90471) range across 4 matching MRF lines |
$9.02–$17 | $21.22–$40 | varies |
| Iontophoresis 15 min (97033) range across 4 matching MRF lines |
$62.48–$66.73 | $147–$157 | varies |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$49.30–$223.13 | $116–$525 | varies |
| IV infusion hydration each additional hour (96361) range across 8 matching MRF lines |
$24.63–$93.61 | $57.93–$220.25 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 8 matching MRF lines |
$76.01–$218.03 | $178.84–$513 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 7 matching MRF lines |
$55.61–$181.05 | $130.83–$426 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 8 matching MRF lines |
$39.48–$119.63 | $92.89–$281.47 | varies |
| IV push initial (96374) range across 13 matching MRF lines |
$80.24–$218.09 | $188.80–$513.15 | varies |
| Lung Function Test (Mbc/Mvv) (94200) | $155.55 | $366 | 2.6× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $362.53 | $853 | 1.6× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 3 matching MRF lines |
$82.88–$84.25 | $195–$198.23 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $87.55 | $206 | 2.4× |
| Methacholine challenge (94070) | $376.55 | $886 | 1.0× |
| Motility study esophagus (91010) | $1,013.20 | $2,384 | 2.6× |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$259.73–$266.48 | $611.13–$627 | varies |
| Multiple Sleep Latency Test (95805) | $1,318.35 | $3,102 | 1.5× |
| Muscle Test 2 Limbs (95861) | $156.40 | $368 | 1.1× |
| Nasopharyngoscopy (92511) | $140.68 | $331 | 0.7× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$66.85–$67.15 | $157.27–$158 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $88.12 | $207.33 | 0.2× |
| Neuromuscular Reeducation (97112) range across 12 matching MRF lines |
$69.70–$70.13 | $163.99–$165 | varies |
| Newborn resuscitation (99465) range across 2 matching MRF lines |
$735.33–$739.93 | $1,730.17–$1,741 | varies |
| Oral Function Therapy (92526) range across 5 matching MRF lines |
$208.25–$229.08 | $490–$539 | varies |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 2 matching MRF lines |
$104.98–$105.38 | $247–$247.93 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 3 matching MRF lines |
$79.48–$82.28 | $187–$193.58 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$26.35–$26.78 | $62–$63 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$29.33–$31.03 | $69–$73 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) range across 2 matching MRF lines |
$32.73–$33.58 | $77–$79 | varies |
| Ot eval high complexity (97167) | $191.25 | $450 | 1.9× |
| Ot Eval Low Complex (97165) range across 2 matching MRF lines |
$154.22–$154.70 | $362.85–$364 | varies |
| Ot Eval Moderate Complexity (97166) range across 2 matching MRF lines |
$168.92–$169.15 | $397.44–$398 | varies |
| Ot manual therapy 15 min (97140) range across 15 matching MRF lines |
$52.24–$70.13 | $122.90–$165 | varies |
| Ot paraffin bath (97018) range across 3 matching MRF lines |
$73.50–$77.05 | $172.92–$181.29 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) | $90.95 | $214 | 2.3× |
| Ot Re-Eval Est Plan Care (97168) | $99.88 | $235 | 1.5× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$156.40–$156.73 | $368–$368.76 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) range across 5 matching MRF lines |
$157.62–$158.10 | $370.86–$372 | varies |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $314.93 | $741 | 1.4× |
| Percutaneous tests w/allergenic extracts (95004) | $6.38 | $15 | 0.0× |
| Peripheral arterial disease rehab per session (93668) | $92.23 | $217 | 1.5× |
| Phlebotomy therapeutic (99195) range across 3 matching MRF lines |
$186–$200.60 | $437.64–$472 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $75.23 | $177 | 1.2× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) range across 3 matching MRF lines |
$71.40–$75.42 | $168–$177.44 | varies |
| Physical Performance Test (97750) range across 4 matching MRF lines |
$75.63–$75.91 | $177.94–$178.61 | varies |
| Plethysmography (94726) range across 2 matching MRF lines |
$227.38–$227.62 | $535–$535.57 | varies |
| Pm device eval in person (93288) | $105.40 | $248 | 2.7× |
| Pm device progr eval dual (93280) range across 3 matching MRF lines |
$79.05–$83.38 | $186–$196.19 | varies |
| Pm device progr eval multi (93281) | $63.33 | $149 | 1.6× |
| Pm Device Progr Eval Sngl (93279) | $70.98 | $167 | 1.8× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$1,517.95–$1,521.50 | $3,571.64–$3,580 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) | $1,719.98 | $4,047 | 1.9× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $22.60 | $53.17 | 0.5× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $76.50 | $180 | 2.0× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $19.98 | $47 | 0.4× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 2 matching MRF lines |
$22.95–$22.97 | $54–$54.04 | varies |
| Psychiatric diagnostic evaluation (90791) range across 3 matching MRF lines |
$157.25–$384.92 | $370–$905.69 | varies |
| Psytx Crisis Initial 60 Min (90839) range across 2 matching MRF lines |
$138.13–$249.90 | $325–$588 | varies |
| Pt Eval High Complex (97163) range across 3 matching MRF lines |
$157.40–$169.15 | $370.33–$398 | varies |
| Pt eval low complex 20 min (97161) range across 7 matching MRF lines |
$134.20–$192.95 | $315.75–$454 | varies |
| Pt Eval Mod Complex (97162) range across 3 matching MRF lines |
$144.04–$192.81 | $338.90–$453.67 | varies |
| Pt gait training 15 min (97116) range across 5 matching MRF lines |
$56.95–$81.18 | $134–$191 | varies |
| Pt mechanical traction (97012) range across 4 matching MRF lines |
$58.30–$64.34 | $137.15–$151.38 | varies |
| Pt Re-Eval Est Plan Care (97164) range across 2 matching MRF lines |
$96.05–$97.97 | $226–$230.50 | varies |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$134.73–$332.90 | $317–$783.29 | varies |
| Pulmonary Stress Testing (94618) range across 2 matching MRF lines |
$348.08–$360.48 | $819–$848.18 | varies |
| Pure Tone Audiometry Air (92552) range across 5 matching MRF lines |
$68.05–$71.83 | $160.11–$169 | varies |
| Refill/Maint Portable Pump (96521) range across 2 matching MRF lines |
$240.98–$242.39 | $567–$570.32 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $251.60 | $592 | 6.5× |
| Respiratory flow volume loop (94375) | $208.68 | $491 | 0.9× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $96.48 | $227 | 1.6× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$111.35–$251.18 | $262–$591 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $364.23 | $857 | 3.0× |
| Self Care Mngment Training (97535) range across 4 matching MRF lines |
$73.95–$86.70 | $174–$204 | varies |
| Sensory Integration Ea 15 Min (97533) range across 2 matching MRF lines |
$90.76–$90.95 | $213.53–$214 | varies |
| Slp caregiver training 1st 30 min (97550) | $76.50 | $180 | 1.4× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) range across 2 matching MRF lines |
$1,351.88–$1,368.50 | $3,180.88–$3,220 | varies |
| Speech Audiometry Complete (92556) range across 4 matching MRF lines |
$81.60–$86.28 | $192–$203 | varies |
| Speech audiometry threshold (92555) | $52.70 | $124 | 0.9× |
| Speech sound lang comprehen (92523) range across 3 matching MRF lines |
$320.47–$410.13 | $754.03–$965 | varies |
| Spirometry (94010) | $134.73 | $317 | 0.6× |
| Standardized Cognitive Performance Testing (96125) range across 2 matching MRF lines |
$270.30–$287.73 | $636–$677 | varies |
| Stress Tte Only (93350) | $920.13 | $2,165 | 1.6× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 4 matching MRF lines |
$70.98–$74.94 | $167–$176.31 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) range across 4 matching MRF lines |
$55.25–$58.31 | $130–$137.18 | varies |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $82.03 | $193 | 2.2× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $76.08 | $179 | 2.6× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) range across 3 matching MRF lines |
$230.78–$268.12 | $543–$630.86 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 16 matching MRF lines |
$33.53–$89.44 | $78.89–$210.43 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 10 matching MRF lines |
$122.79–$280.50 | $288.90–$660 | varies |
| Therapeutic Activities (97530) range across 18 matching MRF lines |
$71.40–$81.13 | $168–$190.88 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 3 matching MRF lines |
$26.78–$27.63 | $63–$65 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 5 matching MRF lines |
$19.24–$19.66 | $45.25–$46.24 | varies |
| Trans Care Mgmt 14 Day Disch (99495) range across 5 matching MRF lines |
$147.66–$149.66 | $347.42–$352.13 | varies |
| Trans Care Mgmt 7 Day Disch (99496) range across 5 matching MRF lines |
$157.68–$166.38 | $371–$391.46 | varies |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$704.90–$705.08 | $1,658.58–$1,659 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 5 matching MRF lines |
$162.65–$163.72 | $382.70–$385.22 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 13 matching MRF lines |
$30.14–$75.23 | $70.90–$177 | varies |
| Tympanometry (92567) range across 4 matching MRF lines |
$31.73–$33.58 | $74.64–$79 | varies |
| Tympanometry and reflex threshold measurements (92550) | $42.49 | $99.96 | 0.2× |
| Upr/L Xtremity Art 2 Levels (93922) range across 2 matching MRF lines |
$131.33–$308.98 | $309–$727 | varies |
| Vasopneumatic device (97016) range across 5 matching MRF lines |
$61.63–$70.98 | $145–$167 | varies |
| Vent Mgmt Inpat Init Day (94002) range across 3 matching MRF lines |
$748–$752.45 | $1,760–$1,770.45 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $723.35 | $1,702 | 1.1× |
| Visual reinforcement audiometry (vra) (92579) | $67.15 | $158 | 0.3× |
| Vital capacity, total (94150) | $180.63 | $425 | 1.4× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$73.77–$73.95 | $173.57–$174 | varies |
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.