Visits & medical services prices at Gundersen Boscobel Area Hospital and Clinics

Boscobel, WI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480)
range across 2 matching MRF lines		 $10.30–$30.39 $20–$59 varies
Airway Inhalation Treatment (94640) $161.71 $314 0.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $84.46 $164 5.9×
Application on-body injector (96377) $37.60 $73 0.8×
Assessment of aphasia per hr (96105) $232.78 $452 2.4×
Behavral qualit analys voice (92524) $257.50 $500 2.4×
Brief Emotional/Behav Assmt (96127) $32.45 $63 0.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $289.95 $563 0.8×
Canalith repositioning proc (95992)
range across 2 matching MRF lines		 $133.90–$139.05 $260–$270 varies
Cardiac Stress Tst,Tracing Only (93017) $550.54 $1,069 2.6×
Cardiopulmonary resuscitation (92950) $303.85 $590 1.4×
Cardioversion (92960) $213.21 $414 0.3×
Cbt 1st hour (94644) $260.08 $505 2.0×
Chemo Anti-Neopl Sq/Im (96401) $265.23 $515 3.8×
Chemo Hormon Antineopl Sq/Im (96402) $126.69 $246 1.8×
Chemo IV infusion addl hr (96415) $109.70 $213 1.6×
Chemo IV push addl drug (96411) $235.87 $458 3.4×
Chemother Prolong Infuse W/Pump (96416) $395.01 $767 1.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $265.74 $516 3.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $410.46 $797 1.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $183.34 $356 0.6×
Chest Wall Manipulation (94668) $114.33 $222 0.9×
Color/duplex Doppler, complete (93975) $741.09 $1,439 3.2×
Color/duplex Doppler, limited (93976) $255.96 $497 2.5×
Community/Work Reintegration Trainj Ea 15 Min (97537) $84.46 $164 2.6×
Continuous Pulse Ox (94762) $147.81 $287 1.2×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $368.74 $716 1.7×
Cpt initial (94667) $139.57 $271 1.1×
Critical care first hour (99291) $1,122.19 $2,179 1.4×
Debridement Open Wound 20 Sq Cm< (97597) $205.49 $399 1.1×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $221.97 $431 1.0×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $161.20 $313 1.6×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,015.07 $1,971 4.4×
Dup-scan xtr veins unilateral/limited study (93971) $506.76 $984 5.0×
ECG/monitoring and analysis (93271) $544.36 $1,057 5.9×
Echo Congenital Complete (93303) $445.48 $865 0.8×
Echo Heart Xthoracic,Limited (93308) $738 $1,433 3.2×
Electrical Stimulation Ea 15 Min (97032) $53.05 $103 3.6×
Electrocardiogram Tracing (93005) $215.79 $419 3.8×
Emergency Dept Visit Level 2 (99282) $256.99 $499 1.7×
Emergency Dept Visit Level 3 (99283) $359.99 $699 1.4×
Emergency Dept Visit Level 4 (99284) $652.51 $1,267 1.6×
Er level 1 (99281) $147.29 $286 1.8×
Er level v (99285) $946.57 $1,838 1.6×
Evaluate pt use of inhaler (94664) $161.71 $314 0.8×
Evaluate Speech Production (92522) $225.06 $437 2.0×
Evaluate Swallowing Function (92610) $210.12 $408 2.5×
Evaluation of speech fluency (92521) $265.74 $516 2.0×
Exercise test for bronchospasm (94617) $98.37 $191 0.8×
External ECG rec>48hr<7d recording (93242) $51.50 $100 1.4×
External ECG rec>7d<15d recording (93246) $103 $200 2.8×
External Ecg Scanning Analysis Report (93226) $273.98 $532 4.8×
Extracranial Bilat Study (93880) $872.41 $1,694 3.8×
F-up/limited tthrc echo congenital car anomaly (93304) $425.91 $827 0.8×
Holter monitor recording (93225) $264.20 $513 2.0×
Im Adm Intransl/Oral 1 Vaccine (90473) $53.56 $104 0.8×
Immunization administration (90471)
range across 15 matching MRF lines		 $10.30–$24.21 $20–$47 varies
Iontophoresis 15 min (97033) $53.56 $104 2.8×
Irrig Drug Delivery Device (96523)
range across 2 matching MRF lines		 $74.16–$74.68 $144–$145 varies
IV infusion hydration each additional hour (96361) $86.01 $167 1.9×
IV infusion hydration initial 31 min-1 hour (96360) $183.34 $356 0.9×
IV infusion ther proph addl sequential to 1 hr (96367) $119.48 $232 1.7×
IV infusion therapy prophylaxis/dx ea hour (96366) $79.83 $155 1.8×
IV push initial (96374) $183.34 $356 0.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $68.50 $133 1.9×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $31.93 $62 1.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $165.32 $321 0.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $300.76 $584 0.8×
Neuromuscular Reeducation (97112) $83.43 $162 2.5×
Oral Function Therapy (92526) $181.28 $352 2.2×
Orthc/Prostc Mgmt Sbsq Enc (97763) $99.91 $194 2.0×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $111.76 $217 2.4×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $26.27 $51 1.3×
Ot eval high complexity (97167) $252.35 $490 2.5×
Ot Eval Low Complex (97165) $196.73 $382 2.0×
Ot Eval Moderate Complexity (97166) $224.54 $436 2.2×
Ot manual therapy 15 min (97140) $86.01 $167 3.1×
Ot paraffin bath (97018) $30.39 $59 5.1×
Ot Prosthetic Training, Each 15 Min (97761) $87.04 $169 2.2×
Ot Re-Eval Est Plan Care (97168) $177.16 $344 2.6×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $194.16 $377 1.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $166.35 $323 1.3×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $294.07 $571 1.4×
Peripheral arterial disease rehab per session (93668) $180.77 $351 3.2×
Phlebotomy therapeutic (99195) $188.49 $366 1.5×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $189.01 $367 3.3×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $189.01 $367 3.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,002.45 $5,830 3.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $41.20 $80 0.9×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $40.17 $78 0.9×
Psych diag eval w/med srvcs (90792) $155.53 $302 0.9×
Psychiatric diagnostic evaluation (90791) $139.05 $270 0.8×
Pt Eval High Complex (97163) $221.97 $431 2.3×
Pt eval low complex 20 min (97161) $196.22 $381 2.0×
Pt Eval Mod Complex (97162) $196.22 $381 2.0×
Pt gait training 15 min (97116) $84.46 $164 2.9×
Pt mechanical traction (97012) $67.98 $132 4.7×
Pt Re-Eval Est Plan Care (97164) $129.78 $252 1.9×
Pulm function test by gas (94727)
range across 2 matching MRF lines		 $118.97–$207.03 $231–$402 varies
Pulmonary service/procedure (94799) $38.63 $75 0.3×
Pulmonary Stress Testing (94618) $114.33 $222 0.9×
Remote 30 Day Ecg Rev/Report (93270) $223.51 $434 6.2×
Remote 30 Day Ecg Tech Supp (93229) $1,148.45 $2,230 3.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $286.86 $557 1.5×
Self Care Mngment Training (97535) $84.98 $165 2.6×
Sensory Integration Ea 15 Min (97533) $71.59 $139 1.2×
Sleep study unattended (95806) $342.48 $665 1.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $399.64 $776 1.9×
Speech sound lang comprehen (92523) $481.53 $935 2.1×
Spirometry (94010) $160.17 $311 0.8×
Stress Tte Only (93350) $1,238.58 $2,405 2.3×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $64.89 $126 2.9×
Ther Ivntj Ea Addl 15 Min (97130) $64.89 $126 3.1×
Ther/Proph/Diag Inj Sc/Im (96372) $83.43 $162 1.2×
Ther/Proph/Diag Iv Inf Init (96365) $183.34 $356 0.9×
Therapeutic Activities (97530) $84.98 $165 2.4×
Tobacco Use Cessation Intensive >10 Minutes (99407) $71.59 $139 2.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $41.20 $80 1.1×
Trans Care Mgmt 14 Day Disch (99495) $101.97 $198 0.8×
Trans Care Mgmt 7 Day Disch (99496) $136.48 $265 1.1×
Tte w/doppler, complete (93306) $1,640.28 $3,185 3.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $229.69 $446 3.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $93.22 $181 2.0×
Vent Mgmt Inpat Init Day (94002) $554.66 $1,077 0.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $470.71 $914 0.8×
Vital capacity, total (94150) $123.09 $239 1.0×
Wheelchair Mgmt Ea 15 Min (97542) $75.71 $147 2.4×

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.