Visits & medical services prices at Great Plains Health

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

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

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ProcedureCash priceGross charge× Medicare
Actigraphy testing recording analysis i&r (95803) $122.50 $259 2.0×
Aep hearing status deter broadband stimuli i&r (92651) $275.50 $571.50 1.2×
Aep Neurodiagnostic I&R (92653) $528 $988.50 2.4×
Aep threshold estimation mlt frequencies i&r (92652) $297 $643.50 1.3×
Airway inhalation treatment (94640) $272 $494 1.2×
Allg tstg perq & ic venoms immed react w/ i&r (95017) $37 $61 1.2×
Ambulatory Bp Analysis (93788) $406 $676 2.9×
Ambulatory Bp Recording (93786) $406 $676 2.9×
Analyze neurostim no prog (95970) $207 $368 1.5×
Appl on-body injector for timed subq injection (96377) $76 $127 1.6×
Assessment of aphasia (96105) $323 $539 3.3×
Behav assmt w/score & docd/stand instrument (96127) $33 $60 0.9×
Behavioral and qualitative analysis of voice and resonance (92524) $275 $458 2.5×
Bis extracellular fluid alys lymphedema assmnt (93702) $469 $782 3.5×
Blink reflex test (95933) $149.50 $349 2.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $463 $910 1.2×
Canalith Repositioning (95992) $63 $198 1.5×
Capsule endoscopy (91110) $704.50 $1,334 0.7×
Car seat/bed test 60 min (94780) $59 $98 1.5×
Cardiac Stress Tst,Tracing Only (93017) $1,109 $1,849 4.9×
Cardiopulmonary resuscitation (92950) $568 $1,174 2.5×
Cardioversion (92960) $1,256 $2,227.50 1.8×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $5,550.50 $9,580 1.6×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $5,574 $9,658 1.7×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $5,590 $9,712 1.7×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $5,562.50 $9,620 1.7×
Cbt 1st hour (94644) $130 $289 0.9×
Chemo Hormon Antineopl Sq/Im (96402) $119.50 $238 1.6×
Chemo IV push addl drug (96411) $137 $297 1.8×
Chemo Iv Push Sngl Drug (96409) $522.50 $996 1.5×
Chemo prolong 8+ hrs infuse w/pump (96416) $894 $1,490 2.6×
Chemother, IV infusion, 1 hr (96413) $538 $1,059 1.6×
Chemother, IV infusion, ea add hr (96415) $192 $391 2.6×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $151 $343 2.0×
Chemotx Admn Cns Req Spinal Puncture (96450) $505 $938 1.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $143.50 $318 1.9×
Color/duplex Doppler, complete (93975) $883.50 $1,798.50 3.6×
Color/duplex Doppler, limited (93976) $419.50 $893 3.9×
Computerized Ophthalmic Imaging Anterior Segment (92132) $101.50 $189 1.7×
Computerized Ophthalmic Imaging Optic Nerve (92133) $105.50 $203 1.7×
Cont Gluc Monitoring Patient Provided Equipment (95249) $130 $285 2.1×
Continuous Glucose Monitoring (95250) $297.50 $670 2.2×
Corneal Topography (92025) $103.50 $197 1.7×
Coronary artery angio s&i (93454) $10,706 $18,410 3.2×
Cpap initiation and management (94660) $272 $546 1.2×
Cpt initial (94667) $174 $290 1.3×
Cptrized oph dx img pst segment uni/bi retina (92134) $108 $211 1.8×
Cptrz oph img pst sg rta oct (92137) $490 $862.50 2.2×
Critical care (99291) $2,493 $4,653 2.9×
Debridement Open Wound 20 Sq Cm< (97597) $391 $651 1.9×
Demo &/or eval,pt use,aerosol device (94664) $223 $411.50 1.0×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $446 $848.50 1.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $820 $1,587.50 3.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $866.50 $1,742.50 3.5×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $408.50 $857 3.8×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $832.50 $1,629.50 3.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $393.50 $807 3.6×
Dup-scan xtr veins unilateral/limited study (93971) $606 $1,297 5.6×
Duplex hemodialysis access (93990) $320.50 $563 3.0×
Duplex scan extracranial art compl bi study (93880) $828.50 $1,615.50 3.3×
Echo Heart Xthoracic,Limited (93308) $504 $957.50 2.0×
Echo transesophageal (93312) $1,055 $1,895 1.9×
Echo Transthoracic - Congenital Tte Complete (93303) $1,030 $1,795.50 1.8×
Echo Transthoracic - Congenital Tte Limited (93304) $1,965 $3,275 3.5×
Ed special anterior segment photography with interpretation and report; with fluorescein angiography (92287) $305.50 $697 2.2×
EEG awake asleep (95819) $1,202 $2,146 5.4×
EEG awake drowsy (95816) $643.50 $1,143.50 2.9×
EEG cerebral death evaluation (95824) $1,069.50 $1,853 2.8×
EEG coma or sleep only (95822) $644 $1,144.50 2.9×
EEG cont rec w/video by tech min 8 channels (95700) $610 $1,017 2.7×
Eeg Extended Monitoring 61-119 Minutes (95813) $666 $1,217.50 3.0×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $1,202 $2,003 5.4×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $2,054 $3,424 5.3×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $2,054 $3,424 5.3×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $2,054 $3,424 5.3×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $1,202 $2,003 5.4×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $1,202 $2,003 5.4×
EKG (93005) $258 $439.50 4.2×
EKG rhythm strip (93041) $137.50 $235.50 2.2×
Elec alys implt cplx cn npgt prgrmg (95977) $176 $358 1.8×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $85.50 $191 2.2×
Electroconvulsive Therapy (90870) $477 $932.50 0.5×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $643.50 $1,143.50 2.9×
EMG thoracic paraspinal (95869) $671.50 $1,236.50 3.0×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $2,424.50 $4,342.50 1.9×
Er level 1 (99281) $127 $237 1.5×
Er level ii (99282) $230.50 $433 1.4×
Er level iii (99283) $810 $1,509.50 2.9×
Er level IV (99284) $1,252 $2,357 2.9×
Er level v (99285) $1,809.50 $3,408.50 2.9×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $237 $395 3.3×
Evaluation of speech sound production (92522) $136 $227 1.2×
Evaluation of swallowing function (92610) $266 $444 3.1×
Evaluation with prescription of speech-generating alternative (92607) $388 $647 3.2×
Exam of visual field with extended testing (92083) $213.50 $390 1.5×
Exam of visual field with limited testing (92081) $101 $188 1.6×
Exercise tst brncspsm (94617) $193 $322 1.4×
External ECG rec>48hr<7d recording (93242) $176 $294 4.5×
External ECG rec>48hr<7d scanning alys w/report (93243) $579 $965 4.2×
External ECG rec>7d<15d recording (93246) $176 $294 4.5×
External ECG rec>7d<15d scanning alys w/report (93247) $579 $965 4.2×
External Ecg Scanning Analysis Report (93226) $267 $445 4.4×
External ocular photography (92285) $75 $152 1.9×
Eye exam, new patient,comprehesv (92004) $150 $371 1.1×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $606 $1,010 3.0×
Fundus photography w/interpretation & report (92250) $217 $402 1.6×
Gonioscopy (92020) $121.50 $228 0.9×
Group Therapeutic Procedures (97150) $58 $96 3.2×
Hemodialysis (90935) $680.50 $1,224.50 1.0×
Holter Monitor Recording (93225) $579 $965 4.2×
Icd Device Interrogate (93289) $87 $191 2.2×
Ilr Device Eval Progr (93285) $78.50 $163 2.0×
Img retina detcj/mntr ds poc auto a/r uni/bi (92229) $130.50 $287.50 2.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $54.50 $140.50 1.3×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $306.50 $550 4.1×
Immunization Admin (90471) $131 $261.50 1.8×
Immunotherapy, 2+ Injections (95117) $35.50 $73 0.7×
Ingestion challenge test initial 120 minutes (95076) $451 $844.50 1.2×
Inhlj Brncl Challenge Tstg W/Histamine/Methachol (95070) $790 $1,317 2.0×
Ins swan ganz bedside (93503) $2,532.50 $4,329.50 1.5×
Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system… (93146) $80 $176 0.6×
Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system… (93145) $72.50 $151 0.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $72.50 $153 1.2×
IV infusion hydration each additional hour (96361) $114 $222 2.3×
IV infusion hydration initial 31 min-1 hour (96360) $378 $710 1.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $143 $238 1.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $449 $913 2.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $107 $231 2.2×
IV push initial (96374) $274.50 $503.50 1.2×
L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) $5,558 $9,606 1.7×
Liver elastography w/o imag w/i&r (91200) $386 $660.50 2.9×
Low frequency non-thermal us (97610) $328 $546 1.6×
Manual therapy 15 min (97140) $87 $145 3.1×
Massage 15 min (97124) $88 $146 3.0×
Mechanical chest wall oscillation (94669) $272 $453 1.2×
Mechanical traction (97012) $46 $76 3.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $39 $104.50 1.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $48.50 $122 1.3×
Methacholine challenge (94070) $253 $456.50 0.7×
Motility study esophagus (91010) $516.50 $1,129.50 1.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $288 $480 3.1×
Multiple sleep latency test (95805) $1,580 $2,781 1.8×
Nasopharyngoscopy (92511) $187.50 $359 0.9×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $315 $632.50 2.3×
Neg press wnd tx </=50 sq cm (97607) $345 $601.50 0.8×
Neg press wound tx >50 cm (97608) $346.50 $607.50 0.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $183.50 $338 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $350 $618.50 0.8×
Nerve conduction studies 13/> studies (95913) $2,054 $4,159 5.3×
Nerve Conduction Studies 3-4 Studies (95908) $688.50 $1,293.50 3.1×
Nerve Conduction Studies 9-10 Studies (95911) $1,193 $2,266 3.1×
Nerve conduction studies; 1-2 studies (95907) $374 $738.50 1.7×
Nerve conduction studies; 11-12 studies (95912) $1,217 $2,346 3.1×
Nerve conduction studies; 5-6 studies (95909) $706 $1,351.50 3.1×
Nerve conduction studies; 7-8 studies (95910) $739.50 $1,462.50 1.9×
Neurobehavioral Status Exam (96116) $125 $209 0.6×
Neuromuscular junction test (95937) $381 $761.50 2.9×
New patient problem focused exam of visual system (92002) $112.50 $246 0.8×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $734 $1,422 5.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $892 $1,796 4.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $235 $453 1.8×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $135.50 $323 1.0×
Ophth medical xm&eval intermediate estab pt (92012) $116 $257 0.8×
Ophthalmic biometry (92136) $228 $438 1.7×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $147 $245 3.2×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $102 $170 3.2×
Ot Contrast Bath Ea 15 Min (97034) $47 $79 3.3×
Ot eval high complex 60 min (97167) $233 $389 2.3×
Ot eval low complex 30 min (97165) $164 $273 1.6×
Ot eval mod complex 45 min (97166) $194 $323 1.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $89 $148 1.8×
Ot Prosthetic Training, Each 15 Min (97761) $147 $245 3.6×
Ot re-eval est plan care (97168) $122 $204 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $249 $415 1.9×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $397 $661 3.0×
Paraffin bath (97018) $22 $36 3.7×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $272 $453 1.2×
Peripheral arterial disease rehab per session (93668) $118 $196 1.9×
Perq Transcath Cls Mitral (93590)
likely a partial charge, not the full procedure
$1,439 $2,399 0.1×
Phy/qhp op pulm rhb w/mntr (94626) $133 $222 2.2×
Phy/qhp op pulm rhb w/o mntr (94625) $133 $222 2.2×
Plethysmography (94726) $463 $416.50 1.2×
Pm device eval in person (93288) $75 $151 1.9×
Pm device progr eval dual (93280) $88 $194 2.3×
Pm device progr eval multi (93281) $91 $205 2.3×
Pm device progr eval sngl (93279) $83.50 $179 2.2×
Pm/Icd Remote Tech Serv (93296) $76.50 $157 2.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,620 $2,857.50 1.8×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $106 $255 2.7×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $34 $68 0.7×
Programming of dual lead implantable defibrillator system (93283) $130 $334 3.4×
Programming of single lead implantable defibrillator system (93282) $117 $292 3.0×
Prq card revasc chronic 1vsl (92943) $14,123.50 $24,311.50 1.2×
Prq Card Stent W/Angio 1 Vsl (92928) $14,072.50 $24,141.50 1.2×
Prq Card Stent/Ath/Angio (92933) $32,663 $28,760 1.7×
Prq revasc byp graft 1 vsl (92937) $14,072 $24,139.50 1.2×
Prq tcat plmt ntrac st 2+les (92930) $28,284 $24,678 1.5×
Prq trl rvs ch occ ant&rtrgr (92945) $14,557.50 $24,955 1.2×
Prq trluml coronary angio/atherect one art/brnch (92924) $14,102 $24,239.50 1.2×
Prq trluml coronary angioplasty one art/branch (92920) $8,034.50 $14,008.50 1.4×
Psych diag eval w/med srvcs (90792) $241.50 $604 1.3×
Psychiatric diagnostic evaluation (90791) $241 $402 1.3×
Psycl tst eval phys/qhp 1st (96130) $163 $272 0.7×
Psycl/Nrpsyc Tst Auto Result (96146) $3 $5 0.1×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $37 $61 0.3×
Psytx crisis initial 60 min (90839) $196 $326 1.1×
Pt Aquatic Therapy/Exercises (97113) $121 $201 3.3×
Pt Electric Current Therapy (97033) $64 $107 3.4×
Pt eval high complex 45 min (97163) $210 $350 2.1×
Pt eval low complex 20 min (97161) $148 $247 1.5×
Pt Gait Training Therapy (97116) $98 $164 3.4×
Pt Infrared Therapy (97026) $17 $29 2.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $108 $180 3.3×
Pt Physical Performance Test (97750) $108 $265 3.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $179 $299 1.8×
Pt re-evaluation (97164) $109 $181 1.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $110 $183 3.4×
Pt Ultrasound Therapy (97035) $43 $71 3.0×
Pt Whirlpool Therapy (97022) $55 $92 3.5×
Pulm Funct Test Oscillometry (94728) $235 $391 1.8×
Pulmonary stress testing (94618) $193 $403 1.4×
R & l hrt cath w/njx l ventriculog img s&i (93453) $5,577.50 $9,670 1.7×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $5,618.50 $9,807 1.7×
R hrt art/grft angio (93457) $5,601.50 $9,751 1.7×
R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) $5,580.50 $9,681 1.7×
R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) $5,498.50 $9,407 1.6×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $5,646.50 $9,900 1.7×
R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) $5,684.50 $10,027 1.7×
R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) $5,603 $9,755 1.7×
Refill/maint, portable pump (96521) $377 $629 1.7×
Rem interrog icpms <30 d phys/qhp (93297) $96.50 $223 2.5×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $121 $305 3.1×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $168 $280 4.3×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $788 $1,411 2.5×
Right heart cath (93451) $5,446.50 $9,233 1.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $268 $658 1.3×
Rt Chest Wall Manipulation,Subsequent (94668) $174 $290 1.3×
Sensormotor xm w/mlt meas ocular devij w/i&r spx (92060) $135 $301.50 2.2×
Sleep study attended (95807) $1,580 $2,634 4.1×
Sleep study unattended (95806) $469 $894 2.1×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $265.50 $494 1.2×
Smoking cessation > 10 min (99407) $53 $121 1.4×
Somatosensory testing (95938) $1,061 $1,826 1.2×
Speech sound lang comprehen (92523) $280 $467 1.2×
Spirometry (94010) $235 $474 1.0×
Stress echo (93350) $1,886 $3,320 3.3×
Stress Tte Complete (93351) $1,027.50 $1,992.50 1.8×
Surfactant Admin Thru Tube (94610) $177 $362.50 0.8×
Tcd Emboli Detect W/O Inj - Us Tc Dplr Ic Art Emb Det Wo Iv Mb Inj (93892) $523 $1,239 4.8×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $556 $1,348 5.1×
Test for allergy using combination of methods with drug or biological (95018) $59 $115 1.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $39 $65 1.7×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $38 $64 1.8×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $261 $435 2.5×
Ther/Proph/Diag Inj Sc/Im (96372) $83 $156 1.1×
Therapeutic Activities (97530) $127 $212 3.6×
Therapeutic phlebotomy (99195) $216.50 $480.50 1.6×
Tilt Table Eval (93660) $1,014.50 $1,808.50 2.6×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $43.50 $90 1.1×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $880 $1,787.50 3.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,037 $1,819.50 1.8×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $467.50 $835.50 1.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $245 $408 3.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $266 $444 3.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $65 $127 1.3×
Tympanometry (92567) $34.50 $71 0.9×
Unlisted Cardiovascular Service/Procedure (93799) $367.50 $717.50 2.8×
Unlisted Diagnostic Gastroenterology Procedure (91299) $786 $2,445 5.9×
Unlisted pulmonary service/procedure (94799) $218 $387 1.6×
Vasc Duplex Extrem Venous,Bilat (93970) $710 $1,267 2.9×
Vasc Duplex Scan Extracranial,Limited (93882) $535 $1,191 4.9×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $760 $1,325 3.4×
Vasopneumatic device (97016) $40 $66 3.3×
Veeg by tech 2-12 hours unmonitored (95711) $1,202 $2,003 5.4×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $2,054 $3,424 5.3×
Veeg by tech 2-12 hr intermittent monitoring (95712) $1,202 $2,003 3.1×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $3,968 $6,613 4.4×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $2,054 $3,424 5.3×
Veeg Ea 12-26 Hr Unmntr (95714) $2,054 $3,424 5.3×
Ventilation assist & mgmt inpatient 1st day (94002) $865 $1,441 1.3×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $865 $1,441 1.3×
Vital capacity total (94150) $235 $391 1.8×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $89 $148 1.5×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $412 $687 4.2×