Visits & medical services prices at Gundersen St. Elizabeth's Hospital

Wabasha, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $37.76 $62 0.9×
Airway Inhalation Treatment (94640) $199.75 $328 0.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $46.28 $76 3.2×
Behavral qualit analys voice (92524) $241.77 $397 2.2×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $173.57 $285 2.1×
Bfb training ea addl 15 min (90913) $68.82 $113 2.1×
Brief Emotional/Behav Assmt (96127) $35.32 $58 0.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $451.27 $741 1.1×
Canalith repositioning proc (95992) $91.96 $151 2.3×
Cardiac Stress Tst,Tracing Only (93017) $450.66 $740 1.9×
Cardiopulmonary resuscitation (92950) $367.23 $603 1.6×
Cardioversion (92960) $878.18 $1,442 1.2×
Cbt 1st hour (94644) $125.45 $206 0.9×
Chemo Hormon Antineopl Sq/Im (96402) $151.03 $248 1.9×
Chemo IV infusion addl hr (96415) $46.89 $77 0.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $258.83 $425 3.3×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $517.04 $849 1.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $405.59 $666 1.1×
Chest Wall Manipulation (94668) $120.58 $198 0.8×
Color/duplex Doppler, complete (93975) $823.98 $1,353 3.2×
Color/duplex Doppler, limited (93976) $126.06 $207 1.1×
Computerized Ophthalmic Imaging Retina (92134) $74.91 $123 1.2×
Cont gluc mntr physician/qhp provided equiptment (95250) $206.45 $339 1.4×
Cont Gluc Mntr Pt Prov Eqp (95249) $74.91 $123 1.2×
Continuous Pulse Ox (94762) $242.99 $399 1.8×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $199.75 $328 0.8×
Cpt initial (94667) $120.58 $198 0.8×
Critical care first hour (99291) $1,760.62 $2,891 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $246.04 $404 1.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $538.36 $884 2.1×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $403.77 $663 1.6×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $285.62 $469 2.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $887.31 $1,457 3.5×
Dup-scan xtr veins unilateral/limited study (93971) $370.88 $609 3.3×
Duplex up extrem art unilat/ltd (93931) $126.06 $207 1.1×
Echo Heart Xthoracic,Limited (93308) $604.74 $993 2.4×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $890.36 $1,462 1.5×
Electrical Stimulation Ea 15 Min (97032) $48.72 $80 3.3×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines
$133.37–$199.75 $219–$328 varies
Emergency Dept Visit Level 2 (99282) $289.88 $476 1.8×
Emergency Dept Visit Level 3 (99283) $488.42 $802 1.7×
Emergency Dept Visit Level 4 (99284) $786.83 $1,292 1.8×
Er level 1 (99281) $193.05 $317 2.1×
Er level v (99285) $1,149.18 $1,887 1.8×
Evaluate pt use of inhaler (94664) $199.75 $328 0.8×
Evaluate Speech Production (92522) $241.77 $397 2.2×
Evaluate Swallowing Function (92610) $241.77 $397 2.8×
Evaluation of speech fluency (92521) $241.77 $397 1.8×
External ECG rec>48hr<7d recording (93242) $63.95 $105 1.6×
External ECG rec>7d<15d recording (93246) $79.17 $130 2.0×
External Ecg Scanning Analysis Report (93226) $190.01 $312 3.0×
Extracranial Bilat Study (93880) $810.58 $1,331 3.2×
Gonioscopy (92020) $35.93 $59 0.3×
Group Therapeutic Procedures (97150) $59.07 $97 3.3×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $132.15 $217 3.3×
Holter monitor recording (93225) $190.01 $312 1.3×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines
$12.79–$49.94 $21–$82 varies
Immunization administration (90471)
range across 9 matching MRF lines
$12.79–$99.27 $21–$163 varies
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $503.03 $826 1.3×
Iontophoresis 15 min (97033) $62.73 $103 3.3×
Irrig Drug Delivery Device (96523) $170.52 $280 2.7×
IV infusion hydration each additional hour (96361) $68.21 $112 1.4×
IV infusion hydration initial 31 min-1 hour (96360) $328.86 $540 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $108.40 $178 1.4×
IV infusion therapy prophylaxis/dx ea hour (96366) $68.21 $112 1.4×
IV push initial (96374) $328.86 $540 1.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $36.54 $60 1.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $40.80 $67 1.1×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $60.90 $100 3.6×
Methacholine challenge (94070) $614.48 $1,009 1.5×
Motion Fluoroscopy/Swallow (92611) $241.77 $397 2.6×
Multiple Sleep Latency Test (95805) $1,678.40 $2,756 1.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $188.79 $310 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $362.36 $595 0.8×
Neuromuscular Reeducation (97112) $91.96 $151 2.8×
Nitric oxide expired gas determination (95012) $60.29 $99 1.5×
Oral Function Therapy (92526) $154.69 $254 1.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $69.43 $114 1.4×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $105.97 $174 2.3×
Ot eval high complexity (97167) $216.20 $355 2.2×
Ot Eval Low Complex (97165) $174.78 $287 1.7×
Ot Eval Moderate Complexity (97166) $193.05 $317 1.9×
Ot manual therapy 15 min (97140) $91.96 $151 3.3×
Ot paraffin bath (97018) $18.27 $30 3.0×
Ot Prosthetic Training, Each 15 Min (97761) $99.27 $163 2.5×
Ot Re-Eval Est Plan Care (97168) $119.97 $197 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $214.98 $353 1.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $214.98 $353 1.5×
Peripheral arterial disease rehab per session (93668) $108.40 $178 1.7×
Phlebotomy therapeutic (99195) $120.58 $198 0.8×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $199.75 $328 3.1×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $199.75 $328 3.1×
Physical Performance Test (97750) $111.45 $183 3.3×
Plethysmography (94726) $291.71 $479 0.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,328.79 $5,466 3.6×
Pt Eval High Complex (97163) $208.28 $342 2.1×
Pt eval low complex 20 min (97161) $140.68 $231 1.4×
Pt Eval Mod Complex (97162) $168.69 $277 1.7×
Pt gait training 15 min (97116) $82.82 $136 2.8×
Pt mechanical traction (97012) $47.50 $78 3.3×
Pt Re-Eval Est Plan Care (97164) $113.27 $186 1.7×
Pulm function test by gas (94727)
range across 2 matching MRF lines
$72.47–$244.21 $119–$401 varies
Pulmonary service/procedure (94799)
range across 5 matching MRF lines
$151.64–$188.79 $249–$310 varies
Pulmonary Stress Testing (94618) $190.62 $313 1.3×
Remote 30 Day Ecg Rev/Report (93270) $66.38 $109 1.7×
Remote 30 Day Ecg Tech Supp (93229) $367.84 $604 0.9×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $74.91 $123 1.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $188.79 $310 0.9×
Self Care Mngment Training (97535) $105.97 $174 3.3×
Sensory Integration Ea 15 Min (97533) $141.90 $233 2.3×
Sleep study unattended (95806) $356.87 $586 1.5×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $608.39 $999 2.6×
Speech sound lang comprehen (92523) $227.77 $374 1.0×
Spirometry (94010) $151.64 $249 0.7×
Stress Tte Only (93350) $1,299 $2,133 2.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $76.73 $126 3.4×
Ther Ivntj Ea Addl 15 Min (97130) $61.51 $101 2.9×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $87.09 $143 2.9×
Ther/Proph/Diag Inj Sc/Im (96372) $108.40 $178 1.4×
Ther/Proph/Diag Iv Inf Init (96365) $328.86 $540 1.4×
Therapeutic Activities (97530) $99.27 $163 2.8×
Tobacco Use Cessation Intensive >10 Minutes (99407) $110.84 $182 2.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $31.06 $51 0.8×
Tte w/doppler, complete (93306) $1,252.71 $2,057 2.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $166.87 $274 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $68.21 $112 1.4×
Unlisted cardiovascular service/procedure (93799) $242.38 $398 1.7×
Vent Mgmt Inpat Init Day (94002) $579.77 $952 0.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $406.20 $667 0.6×
Vital capacity, total (94150) $188.79 $310 1.4×
Wheelchair Mgmt Ea 15 Min (97542) $87.09 $143 2.8×

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.