Visits & medical services prices at Gundersen St. Josephs Hospital and Clinics

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

167 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
$10.52–$32.61 $20–$62 varies
Airway Inhalation Treatment (94640) $173.58 $330 0.8×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $97.84 $186 6.8×
Application on-body injector (96377) $82.06 $156 1.8×
Assessment of aphasia per hr (96105) $473.93 $901 4.9×
Audiometry Air & Bone (92553) $127.82 $243 1.0×
Behavral qualit analys voice (92524) $487.60 $927 4.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $589.12 $1,120 1.6×
Canalith repositioning proc (95992) $155.17 $295 3.8×
Cardiac Stress Tst,Tracing Only (93017) $254.06 $483 1.2×
Cardiopulmonary resuscitation (92950) $576.50 $1,096 2.7×
Cardioversion (92960) $772.17 $1,468 1.2×
Cbt 1st hour (94644) $198.83 $378 1.5×
Chemo Anti-Neopl Sq/Im (96401) $222.50 $423 3.2×
Chemo Hormon Antineopl Sq/Im (96402) $109.93 $209 1.6×
Chemo IV infusion addl hr (96415) $86.26 $164 1.2×
Chemo IV push addl drug (96411) $168.85 $321 2.4×
Chemother Prolong Infuse W/Pump (96416) $394.50 $750 1.2×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $482.87 $918 1.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $197.78 $376 2.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $401.34 $763 1.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $310.34 $590 1.0×
Chest Wall Manipulation (94668) $105.20 $200 0.8×
Color/duplex Doppler, complete (93975) $503.38 $957 2.2×
Color/duplex Doppler, limited (93976) $288.77 $549 2.8×
Community/Work Reintegration Trainj Ea 15 Min (97537) $105.20 $200 3.3×
Comprehensive Hearing Test (92557) $122.03 $232 1.0×
Computerized Ophthalmic Imaging Retina (92134) $180.42 $343 3.1×
Cont gluc mntr physician/qhp provided equiptment (95250) $366.10 $696 2.8×
Cont Gluc Mntr Pt Prov Eqp (95249) $120.45 $229 2.1×
Continuous Pulse Ox (94762) $215.13 $409 1.7×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $432.37 $822 2.0×
Cpt initial (94667) $105.20 $200 0.8×
Critical care first hour (99291) $1,259.24 $2,394 1.6×
Debridement Open Wound 20 Sq Cm< (97597) $100.99 $192 0.5×
Developmental tst admin phys/qhp 1st hour (96112) $279.83 $532 2.2×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $805.31 $1,531 7.9×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,154.57 $2,195 5.0×
Dup-scan xtr veins unilateral/limited study (93971) $963.11 $1,831 9.5×
Ear and throat examination (92502) $366.62 $697 0.7×
ECG/monitoring and analysis (93271) $752.71 $1,431 8.2×
Echo Congenital Complete (93303) $457.09 $869 0.9×
Echo Heart Xthoracic,Limited (93308) $532.84 $1,013 2.3×
Echo transesophageal (93312)
range across 2 matching MRF lines
$532.31–$1,835.21 $1,012–$3,489 varies
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,213.48 $2,307 2.3×
Electrical Stimulation Ea 15 Min (97032) $81.53 $155 5.5×
Electrocardiogram Tracing (93005) $77.85 $148 1.4×
Emergency Dept Visit Level 2 (99282) $302.45 $575 2.0×
Emergency Dept Visit Level 3 (99283) $436.05 $829 1.6×
Emergency Dept Visit Level 4 (99284) $602.27 $1,145 1.5×
Er level 1 (99281) $139.92 $266 1.7×
Er level v (99285) $2,398.03 $4,559 4.1×
Evaluate pt use of inhaler (94664) $173.58 $330 0.8×
Evaluate Speech Production (92522) $487.60 $927 4.4×
Evaluate Swallowing Function (92610) $487.60 $927 5.7×
Evaluation of speech fluency (92521) $487.60 $927 3.7×
Evoked Auditory Test,Limited (92587) $52.60 $100 0.3×
External ECG rec>48hr<7d recording (93242) $53.65 $102 1.5×
External ECG rec>7d<15d recording (93246) $52.07 $99 1.4×
External Ecg Scanning Analysis Report (93226) $328.22 $624 5.7×
Extracranial Bilat Study (93880) $1,023.60 $1,946 4.4×
F-up/limited tthrc echo congenital car anomaly (93304) $457.09 $869 0.9×
Holter monitor recording (93225) $105.20 $200 0.8×
Icd Device Interrogate (93289) $168.85 $321 4.7×
Icd device progr eval dual (93283) $221.97 $422 6.1×
Ilr Device Interrogate (93291) $110.46 $210 3.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $14.73 $28 0.2×
Immunization administration (90471)
range across 5 matching MRF lines
$23.67–$24.72 $45–$47 varies
Iontophoresis 15 min (97033) $49.44 $94 2.6×
Irrig Drug Delivery Device (96523) $138.86 $264 2.4×
IV infusion hydration each additional hour (96361) $66.28 $126 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $283.51 $539 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $139.92 $266 2.0×
IV infusion therapy prophylaxis/dx ea hour (96366) $89.42 $170 2.0×
IV push initial (96374) $203.04 $386 1.0×
Mechanical chest wall oscillation per session (94669) $37.35 $71 0.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $76.80 $146 2.1×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $35.77 $68 2.1×
Methacholine challenge (94070) $478.13 $909 1.3×
Multiple Sleep Latency Test (95805) $2,419.07 $4,599 2.9×
Nasopharyngoscopy (92511) $231.97 $441 1.2×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $338.74 $644 0.9×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $338.74 $644 0.9×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $170.42 $324 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $327.17 $622 0.8×
Neuromuscular Reeducation (97112) $105.20 $200 3.2×
Newborn resuscitation (99465) $632.25 $1,202 1.0×
Nonphysician Telephone Assessment 11-20 Min (98967) $57.86 $110 2.3×
Nonphysician Telephone Assessment 21-30 Min (98968) $86.79 $165 2.5×
Nonphysician Telephone Assessment 5-10 Min (98966) $29.46 $56 2.2×
Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) $177.79 $338 1.4×
Oral Function Therapy (92526) $222.50 $423 2.6×
Orthc/Prostc Mgmt Sbsq Enc (97763) $113.09 $215 2.3×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $105.20 $200 2.3×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $32.09 $61 1.5×
Osteopathic manipulative tx 3-4 body regions (98926) $42.61 $81 2.0×
Osteopathic manipulative tx 5-6 body regions (98927) $58.91 $112 2.8×
Osteopathic manipulative tx 7-8 body regions (98928) $65.22 $124 3.1×
Osteopathic manipulative tx 9-10 body regions (98929) $75.22 $143 3.6×
Ot Contrast Bath Ea 15 Min (97034) $105.20 $200 7.5×
Ot eval high complexity (97167) $333.48 $634 3.3×
Ot Eval Low Complex (97165) $273.52 $520 2.7×
Ot Eval Moderate Complexity (97166) $303.50 $577 3.0×
Ot manual therapy 15 min (97140) $105.20 $200 3.8×
Ot paraffin bath (97018) $46.81 $89 7.8×
Ot Prosthetic Training, Each 15 Min (97761) $179.89 $342 4.5×
Ot Re-Eval Est Plan Care (97168) $134.66 $256 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $262.47 $499 2.1×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $109.93 $209 0.9×
Peripheral arterial disease rehab per session (93668) $73.64 $140 1.3×
Phlebotomy therapeutic (99195) $148.33 $282 1.1×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $160.43 $305 2.8×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $160.43 $305 2.8×
Physical Performance Test (97750) $105.20 $200 3.1×
Pm device eval in person (93288) $109.93 $209 3.0×
Pm device progr eval dual (93280) $168.85 $321 4.7×
Pm Device Progr Eval Sngl (93279) $142.55 $271 3.9×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,982.87 $7,572 4.8×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $180.42 $343 5.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $38.92 $74 0.9×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $47.87 $91 1.1×
Pt Eval High Complex (97163) $333.48 $634 3.4×
Pt eval low complex 20 min (97161) $273.52 $520 2.8×
Pt Eval Mod Complex (97162) $303.50 $577 3.1×
Pt gait training 15 min (97116) $105.20 $200 3.6×
Pt mechanical traction (97012) $108.36 $206 7.5×
Pt Re-Eval Est Plan Care (97164) $125.71 $239 1.9×
Pulm function test by gas (94727) $132.03 $251 0.6×
Pulmonary Stress Testing (94618) $105.20 $200 0.8×
Pure Tone Audiometry Air (92552) $105.20 $200 0.8×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $73.11 $139 2.0×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $109.41 $208 0.8×
Remote 30 Day Ecg Rev/Report (93270) $71.01 $135 2.0×
Remote 30 Day Ecg Tech Supp (93229) $1,232.42 $2,343 3.4×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $77.85 $148 1.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $73.64 $140 0.4×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $487.60 $927 4.0×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $222.50 $423 4.7×
Self Care Mngment Training (97535) $136.76 $260 4.2×
Sensory Integration Ea 15 Min (97533) $109.93 $209 1.8×
Sleep study unattended (95806) $601.22 $1,143 2.9×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $587.02 $1,116 2.8×
Speech sound lang comprehen (92523) $487.60 $927 2.2×
Spirometry (94010) $152.54 $290 0.7×
Standardized Cognitive Performance Testing (96125) $473.93 $901 4.6×
Stress Tte Only (93350) $2,992.94 $5,690 5.6×
Subcutaneous Infusion Each Additional Hour (96370) $96.26 $183 2.1×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $283.51 $539 1.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $118.35 $225 5.3×
Ther Ivntj Ea Addl 15 Min (97130) $118.35 $225 5.6×
Ther Px 1/> Areas Each 15 Minutes Massage (97124)
range across 6 matching MRF lines
$13.15–$84.69 $25–$161 varies
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $233.02 $443 2.3×
Ther/Proph/Diag Inj Sc/Im (96372) $61.02 $116 0.9×
Ther/Proph/Diag Iv Inf Init (96365) $283.51 $539 1.4×
Therapeutic Activities (97530) $113.62 $216 3.2×
Tobacco Use Cessation Intensive >10 Minutes (99407) $100.99 $192 2.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $49.97 $95 1.4×
Tte w/doppler, complete (93306) $1,219.79 $2,319 2.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $222.50 $423 2.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $94.68 $180 2.1×
Tympanometry (92567) $33.14 $63 0.9×
Upr/L Xtremity Art 2 Levels (93922) $409.23 $778 3.2×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $553.88 $1,053 2.6×
Vasopneumatic device (97016) $40.50 $77 3.4×
Vent Mgmt Inpat Init Day (94002) $505.49 $961 0.8×
Vital capacity, total (94150) $132.03 $251 1.1×
Wheelchair Mgmt Ea 15 Min (97542) $105.20 $200 3.4×

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.