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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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $199.75 $328 0.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $46.28 $76 3.2×
Bedside Swallowing Eval (92610) $241.77 $397 2.8×
Behavioral and qualitative analysis of voice and resonance (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/Behavioral Assessment (96127) $35.32 $58 0.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $451.27 $741 1.1×
Canalith Repositioning Procedure (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×
Chemother, IV infusion, 1 hr (96413) $517.04 $849 1.5×
Chemother, IV infusion, ea add 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 push tq 1/1st sbst/drug (96409) $405.59 $666 1.1×
Color/duplex Doppler, complete (93975) $823.98 $1,353 3.2×
Color/duplex Doppler, limited (93976) $126.06 $207 1.1×
Cont Gluc Monitoring Patient Provided Equipment (95249) $74.91 $123 1.2×
Continuous Glucose Monitoring (95250) $206.45 $339 1.4×
Cpap/bipap (94660) $199.75 $328 0.8×
Cpt initial (94667) $120.58 $198 0.8×
Cptrized oph dx img pst segment uni/bi retina (92134) $74.91 $123 1.2×
Critical care (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 Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $126.06 $207 1.1×
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 scan extracranial art compl bi study (93880) $810.58 $1,331 3.2×
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×
EKG rhythm strip (93041) $74.91 $123 1.2×
Electrocardiogram Tracing (93005) $166.56 $273.50 2.6×
Er level 1 (99281) $193.05 $317 2.1×
Er level ii (99282) $289.88 $476 1.8×
Er level iii (99283) $488.42 $802 1.7×
Er level IV (99284) $786.83 $1,292 1.8×
Er level v (99285) $1,149.18 $1,887 1.8×
Eval speech sound production (92522) $241.77 $397 2.2×
Evaluate Pt Use Of Inhaler (94664) $199.75 $328 0.8×
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×
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 (93225) $190.01 $312 1.3×
Imm admn sarscov2 vaccine single dose (90480) $37.76 $62 0.9×
Immune Admin Oral/Nasal (90473) $31.36 $51.50 0.4×
Immunization Admin (90471) $99.27 $163 1.3×
Inhalation bronchial challenge testing (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, therap/proph/diagnost,initial,1st hour (96365) $328.86 $540 1.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $68.21 $112 1.4×
IV push ea addl new drug (96375) $68.21 $112 1.4×
IV push initial (96374) $328.86 $540 1.4×
Manual therapy 15 min (97140) $91.96 $151 3.3×
Massage 15 min (97124) $87.09 $143 2.9×
Mechanical traction (97012) $47.50 $78 3.3×
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 Fluor Eval Swlng Funcj C/V Rec (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×
Nitric oxide expired gas determination (95012) $60.29 $99 1.5×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $242.99 $399 1.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $105.97 $174 2.3×
Ot eval high complex 60 min (97167) $216.20 $355 2.2×
Ot eval low complex 30 min (97165) $174.78 $287 1.7×
Ot eval mod complex 45 min (97166) $193.05 $317 1.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $69.43 $114 1.4×
Ot Prosthetic Training, Each 15 Min (97761) $99.27 $163 2.5×
Ot re-evaluation (97168) $119.97 $197 1.8×
Ot therapeutic activity 15 min (97530) $99.27 $163 2.8×
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×
Paraffin bath pt (97018) $18.27 $30 3.0×
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×
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 Electrical Stimulation (97032) $48.72 $80 3.3×
Pt eval high complex 45 min (97163) $208.28 $342 2.1×
Pt eval low complex 20 min (97161) $140.68 $231 1.4×
Pt eval mod complex 30 min (97162) $168.69 $277 1.7×
Pt gait training 15 min (97116) $82.82 $136 2.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $91.96 $151 2.8×
Pt Physical Performance Test (97750) $111.45 $183 3.3×
Pt re-evaluation (97164) $113.27 $186 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $105.97 $174 3.3×
Pulm function test by gas (94727) $158.34 $260 0.7×
Pulmonary Service/Procedure (94799) $151.64 $249 1.1×
Pulmonary stress test simple (94618) $190.62 $313 1.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $66.38 $109 1.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $188.79 $310 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $120.58 $198 0.8×
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×
Smoking cessation > 10 min (99407) $110.84 $182 2.7×
Speech sound lang comprehen (92523) $227.77 $374 1.0×
Spirometry (94010) $151.64 $249 0.7×
Stress echo (93350) $1,299 $2,133 2.2×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $76.73 $126 3.4×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $61.51 $101 2.9×
Therapeutic prophylactic/dx injection subq/im (96372) $108.40 $178 1.4×
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 Swallowing Dysfunction&/Oral Funcj Feeding (92526) $154.69 $254 1.8×
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×
Xtrnl mobile cv telemetry w/technical support (93229) $367.84 $604 0.9×