Visits & medical services prices at Gundersen Moundview Hospital and Clinics
Friendship, WI · every code in this section with a posted price and a Medicare benchmark.
140 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) range across 2 matching MRF lines |
$10.16–$29.97 | $20–$59 | varies |
| Airway Inhalation Treatment (94640) | $159.51 | $314 | 0.7× |
| Allg tstg perq & ic venoms immed react w/i&r (95017) range across 2 matching MRF lines |
$24.38–$62.99 | $48–$124 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $51.31 | $101 | 3.6× |
| Assessment of aphasia per hr (96105) | $319.02 | $628 | 3.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $558.80 | $1,100 | 1.5× |
| Canalith repositioning proc (95992) | $75.69 | $149 | 1.9× |
| Cardiac Stress Tst,Tracing Only (93017) | $916.43 | $1,804 | 4.4× |
| Cardiopulmonary resuscitation (92950) | $456.69 | $899 | 2.2× |
| Cardioversion (92960) | $869.19 | $1,711 | 1.4× |
| Cbt 1st hour (94644) | $101.09 | $199 | 0.8× |
| Chemo Anti-Neopl Sq/Im (96401) | $109.22 | $215 | 1.6× |
| Chemo Hormon Antineopl Sq/Im (96402) | $104.14 | $205 | 1.5× |
| Chemo IV infusion addl hr (96415) | $109.22 | $215 | 1.6× |
| Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) | $69.09 | $136 | 1.5× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $562.36 | $1,107 | 1.8× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $309.37 | $609 | 1.0× |
| Chest Wall Manipulation (94668) | $96.52 | $190 | 0.7× |
| Color/duplex Doppler, complete (93975) | $414.53 | $816 | 1.8× |
| Color/duplex Doppler, limited (93976) | $427.23 | $841 | 4.2× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $95 | $187 | 3.0× |
| Comprehensive Hearing Test (92557) | $102.62 | $202 | 0.8× |
| Continuous Pulse Ox (94762) | $121.41 | $239 | 1.0× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$356.62–$386.08 | $702–$760 | varies |
| Cpt initial (94667) | $96.52 | $190 | 0.7× |
| Critical care first hour (99291) | $1,254.76 | $2,470 | 1.6× |
| Debridement Open Wound 20 Sq Cm< (97597) | $104.65 | $206 | 0.5× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $321.56 | $633 | 1.4× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $522.22 | $1,028 | 2.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $294.13 | $579 | 2.9× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,171.96 | $2,307 | 5.1× |
| Dup-scan xtr veins unilateral/limited study (93971) | $596.39 | $1,174 | 5.9× |
| Duplex up extrem art bilat (93930) | $842.77 | $1,659 | 3.6× |
| Duplex up extrem art unilat/ltd (93931) | $565.40 | $1,113 | 5.6× |
| ECG/monitoring and analysis (93271) | $1,109.98 | $2,185 | 12.0× |
| Echo Congenital Complete (93303) | $1,354.33 | $2,666 | 2.6× |
| Echo Heart Xthoracic,Limited (93308) | $682.75 | $1,344 | 2.9× |
| Electrical Stimulation Ea 15 Min (97032) | $86.36 | $170 | 5.9× |
| Electrocardiogram Tracing (93005) | $158.50 | $312 | 2.8× |
| Emergency Dept Visit Level 2 (99282) | $328.68 | $647 | 2.2× |
| Emergency Dept Visit Level 3 (99283) | $481.08 | $947 | 1.8× |
| Emergency Dept Visit Level 4 (99284) | $687.83 | $1,354 | 1.7× |
| Er level 1 (99281) | $173.23 | $341 | 2.1× |
| Er level v (99285) | $1,037.34 | $2,042 | 1.8× |
| Evaluate pt use of inhaler (94664) | $159.51 | $314 | 0.7× |
| Evaluate Speech Production (92522) | $168.66 | $332 | 1.5× |
| Evaluate Swallowing Function (92610) | $292.61 | $576 | 3.4× |
| Evaluation of speech fluency (92521) | $203.20 | $400 | 1.5× |
| External ECG rec>48hr<7d recording (93242) | $50.80 | $100 | 1.4× |
| External ECG rec>7d<15d recording (93246) | $51.31 | $101 | 1.4× |
| External Ecg Scanning Analysis Report (93226) | $682.75 | $1,344 | 11.9× |
| Extracranial Bilat Study (93880) | $1,121.16 | $2,207 | 4.8× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $823.98 | $1,622 | 1.6× |
| Group Therapeutic Procedures (97150) | $58.93 | $116 | 3.3× |
| Holter monitor recording (93225) | $824.99 | $1,624 | 6.4× |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 2 matching MRF lines |
$10.16–$19.30 | $20–$38 | varies |
| Immunization administration (90471) range across 14 matching MRF lines |
$10.16–$52.32 | $20–$103 | varies |
| Iontophoresis 15 min (97033) | $96.01 | $189 | 5.0× |
| Irrig Drug Delivery Device (96523) | $125.98 | $248 | 2.2× |
| IV infusion hydration each additional hour (96361) | $106.17 | $209 | 2.3× |
| IV infusion hydration initial 31 min-1 hour (96360) | $267.72 | $527 | 1.3× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $155.96 | $307 | 2.2× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $106.68 | $210 | 2.3× |
| IV push initial (96374) | $184.40 | $363 | 0.9× |
| Lung Function Test (Mbc/Mvv) (94200) | $46.74 | $92 | 0.8× |
| Motion Fluoroscopy/Swallow (92611) | $354.08 | $697 | 3.9× |
| Multiple Sleep Latency Test (95805) | $2,921 | $5,750 | 3.5× |
| Nasopharyngoscopy (92511) | $169.67 | $334 | 0.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $121.41 | $239 | 0.6× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $233.17 | $459 | 0.6× |
| Neuromuscular Reeducation (97112) | $89.41 | $176 | 2.7× |
| Nitric oxide expired gas determination (95012) | $61.98 | $122 | 1.7× |
| Oral Function Therapy (92526) | $192.53 | $379 | 2.3× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $79.76 | $157 | 1.7× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $16.76 | $33 | 0.8× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $19.30 | $38 | 0.9× |
| Ot eval high complexity (97167) | $205.23 | $404 | 2.0× |
| Ot Eval Low Complex (97165) range across 2 matching MRF lines |
$58.42–$129.03 | $115–$254 | varies |
| Ot Eval Moderate Complexity (97166) | $189.99 | $374 | 1.9× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$84.33–$87.88 | $166–$173 | varies |
| Ot paraffin bath (97018) | $47.75 | $94 | 7.9× |
| Ot Re-Eval Est Plan Care (97168) | $106.68 | $210 | 1.6× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 2 matching MRF lines |
$138.18–$421.64 | $272–$830 | varies |
| Patch/Application Test Specify Number Tests (95044) | $78.74 | $155 | 0.1× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $159.51 | $314 | 0.7× |
| Percutaneous tests w/allergenic extracts (95004) | $779.27 | $1,534 | 0.9× |
| Peripheral arterial disease rehab per session (93668) | $109.73 | $216 | 1.9× |
| Phlebotomy therapeutic (99195) | $232.66 | $458 | 1.8× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $146.81 | $289 | 2.6× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $146.81 | $289 | 2.6× |
| Physical Performance Test (97750) | $70.10 | $138 | 2.1× |
| Plethysmography (94726) | $184.40 | $363 | 0.5× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$3,720.59–$4,016.76 | $7,324–$7,907 | varies |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) range across 2 matching MRF lines |
$15.24–$22.86 | $30–$45 | varies |
| Prepj& Antigen Allergen Immunotherapy 1 Insect (95145) range across 2 matching MRF lines |
$15.24–$22.86 | $30–$45 | varies |
| Prepj& antigen allergen immunotherapy 2 insect (95146) range across 2 matching MRF lines |
$15.24–$22.86 | $30–$45 | varies |
| Prepj& Antigen Allergen Immunotherapy 3 Insect (95147) range across 2 matching MRF lines |
$24.38–$36.58 | $48–$72 | varies |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $22.86 | $45 | 0.5× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $22.86 | $45 | 0.5× |
| Pt Eval High Complex (97163) | $242.82 | $478 | 2.5× |
| Pt eval low complex 20 min (97161) range across 2 matching MRF lines |
$65.02–$142.75 | $128–$281 | varies |
| Pt Eval Mod Complex (97162) | $220.47 | $434 | 2.3× |
| Pt gait training 15 min (97116) | $84.33 | $166 | 2.9× |
| Pt mechanical traction (97012) | $89.41 | $176 | 6.2× |
| Pt Re-Eval Est Plan Care (97164) | $106.68 | $210 | 1.6× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$38.10–$121.41 | $75–$239 | varies |
| Pulmonary Stress Testing (94618) | $186.44 | $367 | 1.4× |
| Pure Tone Audiometry Air (92552) | $91.95 | $181 | 0.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $389.13 | $766 | 10.7× |
| Remote 30 Day Ecg Tech Supp (93229) | $583.69 | $1,149 | 1.6× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $158.50 | $312 | 2.8× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $318.01 | $626 | 2.6× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $154.94 | $305 | 3.2× |
| Self Care Mngment Training (97535) | $85.85 | $169 | 2.6× |
| Sensory Integration Ea 15 Min (97533) | $148.34 | $292 | 2.4× |
| Sleep study unattended (95806) | $361.70 | $712 | 1.7× |
| Speech Audiometry Complete (92556) | $107.70 | $212 | 1.9× |
| Speech audiometry threshold (92555) | $76.20 | $150 | 1.3× |
| Speech sound lang comprehen (92523) | $295.15 | $581 | 1.3× |
| Spirometry (94010) | $304.29 | $599 | 1.5× |
| Subcutaneous Infusion Each Additional Hour (96370) | $49.78 | $98 | 1.1× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $75.69 | $149 | 3.4× |
| Ther Ivntj Ea Addl 15 Min (97130) | $75.69 | $149 | 3.6× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $73.66 | $145 | 2.5× |
| Ther/Prop/Diag Inj/Inf Proc (96379) | $75.69 | $149 | 1.7× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $76.71 | $151 | 1.1× |
| Ther/Proph/Diag Iv Inf Init (96365) | $256.54 | $505 | 1.2× |
| Therapeutic Activities (97530) | $84.33 | $166 | 2.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $55.37 | $109 | 1.5× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $32 | $63 | 0.9× |
| Tte w/doppler, complete (93306) | $1,379.22 | $2,715 | 2.6× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $201.17 | $396 | 2.6× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $75.69 | $149 | 1.7× |
| Tympanometry (92567) | $40.64 | $80 | 1.1× |
| Upr/L Xtremity Art 2 Levels (93922) | $277.88 | $547 | 2.2× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 2 matching MRF lines |
$341.38–$347.47 | $672–$684 | varies |
| Vasopneumatic device (97016) | $37.08 | $73 | 3.1× |
| Vent Mgmt Inpat Init Day (94002) | $477.01 | $939 | 0.8× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $333.76 | $657 | 0.6× |
| Wheelchair Mgmt Ea 15 Min (97542) | $83.31 | $164 | 2.7× |
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.