Visits & medical services prices at Iowa Specialty Hospital - Belmond

Belmond, IA · every code in this section with a posted price and a Medicare benchmark.

232 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 6 matching MRF lines
$27.60–$39.60 $46–$66 varies
Advncd Care Plan 30 Min (99497) $123.60 $206 1.3×
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines
$41.40–$369.60 $69–$616 varies
Airway resistance by oscillometry (94728) $264 $440 2.1×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $270.60 $451 2.1×
Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) $141.60 $236 1.1×
Analyze neurostim complex (95972) $168.60 $281 1.8×
Analyze neurostim no prog (95970) $123 $205 1.0×
Analyze Neurostim Simple (95971)
range across 2 matching MRF lines
$91.80–$98.40 $153–$164 varies
Anrct mano rct sensation&rct balo expulsion test (91125)
range across 4 matching MRF lines
$265.20–$1,110 $442–$1,850 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $87.60 $146 6.1×
Application on-body injector (96377) $141 $235 3.1×
Assessment of aphasia per hr (96105) $148.80 $248 1.5×
Assmt & care planning pt w/cognitive impairment (99483) $397.20 $662 4.1×
Audiometry Air & Bone (92553)
range across 2 matching MRF lines
$64.80–$69 $108–$115 varies
Behavral qualit analys voice (92524) $111 $185 1.0×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $129.60 $216 1.6×
Bfb training ea addl 15 min (90913) $76.20 $127 2.3×
Biofeedback training any modality (90901)
range across 3 matching MRF lines
$75.60–$98.40 $126–$164 varies
Breath hydrogen/methane test (91065)
range across 2 matching MRF lines
$39–$469.20 $65–$782 varies
Brief Emotional/Behav Assmt (96127) $37.80 $63 1.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060)
range across 2 matching MRF lines
$25.80–$604.80 $43–$1,008 varies
Canalith repositioning proc (95992) $73.80 $123 1.8×
Car seat/bed test 60 min (94780) $85.80 $143 2.4×
Cardiac Stress Tst,Tracing Only (93017) $610.80 $1,018 2.9×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines
$553.20–$695.40 $922–$1,159 varies
Cardioversion (92960)
range across 2 matching MRF lines
$289.80–$1,078.80 $483–$1,798 varies
Care mgmt services behavioral hlth cond 20 mins (99484) $66.60 $111 1.8×
Caregiver hlth risk assmt score doc stnd instrm (96161) $9.60 $16 0.3×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $38.40 $64 1.5×
Cbt 1st hour (94644) $102 $170 0.8×
Chemo Anti-Neopl Sq/Im (96401) $366.60 $611 5.3×
Chemo Hormon Antineopl Sq/Im (96402)
range across 2 matching MRF lines
$54–$366.60 $90–$611 varies
Chemo IV infusion addl hr (96415) $267.60 $446 3.9×
Chemo IV push addl drug (96411) $289.20 $482 4.2×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $334.20 $557 4.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $735.60 $1,226 2.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $468 $780 1.5×
Chest Wall Manipulation (94668)
range across 2 matching MRF lines
$82.20–$115.20 $137–$192 varies
Chron Care Mgmt Srvc 20 Min (99490) $115.80 $193 1.2×
Color Vision Xm Extended Anomaloscope/Equiv (92283) $100.20 $167 1.8×
Color/duplex Doppler, complete (93975)
range across 3 matching MRF lines
$250.80–$1,097.40 $418–$1,829 varies
Community/Work Reintegration Trainj Ea 15 Min (97537)
range across 2 matching MRF lines
$63–$65.40 $105–$109 varies
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $127.20 $212 0.7×
Comprehensive Hearing Test (92557)
range across 2 matching MRF lines
$66.60–$70.80 $111–$118 varies
Conditioning Play Audiometry (92582) $121.20 $202 1.0×
Cont gluc mntr physician/qhp provided equiptment (95250) $348 $580 2.7×
Cont Gluc Mntr Pt Prov Eqp (95249) $144 $240 2.5×
Continuous Pulse Ox (94762) $180 $300 1.5×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $360 $600 1.7×
Cpt initial (94667) $115.80 $193 0.9×
Critical care first hour (99291) $289.20 $482 0.4×
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines
$220.80–$301.80 $368–$503 varies
Dup-scan aorta ivc iliac vascl/bpgs complete (93978)
range across 2 matching MRF lines
$97.20–$663.60 $162–$1,106 varies
Dup-scan lxtr art/artl bpgs compl bi study (93925)
range across 2 matching MRF lines
$102.60–$679.80 $171–$1,133 varies
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926)
range across 2 matching MRF lines
$62.40–$548.40 $104–$914 varies
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 2 matching MRF lines
$61.80–$809.40 $103–$1,349 varies
Dup-scan xtr veins unilateral/limited study (93971)
range across 2 matching MRF lines
$38.40–$591 $64–$985 varies
Duplex up extrem art bilat (93930)
range across 2 matching MRF lines
$70.80–$718.20 $118–$1,197 varies
Duplex up extrem art unilat/ltd (93931)
range across 2 matching MRF lines
$67.20–$552.60 $112–$921 varies
Ear and throat examination (92502) $185.40 $309 0.4×
ECG/monitoring and analysis (93271) $579.60 $966 6.3×
Echo Congenital Complete (93303)
range across 2 matching MRF lines
$115.20–$717 $192–$1,195 varies
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines
$47.40–$397.80 $79–$663 varies
EEG awake and asleep (95819) $532.20 $887 2.6×
EEG awake drowsy (95816)
range across 2 matching MRF lines
$105–$498 $175–$830 varies
Eeg Sleep Only (95822) $553.20 $922 2.7×
Electrical Stimulation Ea 15 Min (97032) $95.40 $159 6.5×
Electrocardiogram Tracing (93005)
range across 3 matching MRF lines
$24.60–$129.60 $41–$216 varies
Emergency Dept Visit Level 2 (99282) $69.60 $116 0.5×
Emergency Dept Visit Level 3 (99283) $118.20 $197 0.5×
Emergency Dept Visit Level 4 (99284) $162.60 $271 0.4×
Er level 1 (99281) $62.40 $104 0.8×
Er level v (99285) $239.40 $399 0.4×
Ergonovine provocation test (93024)
range across 2 matching MRF lines
$585–$631.80 $975–$1,053 varies
Esophageal Capsule Endoscopy (91111)
range across 2 matching MRF lines
$84–$1,930.80 $140–$3,218 varies
Evaluate pt use of inhaler (94664)
range across 3 matching MRF lines
$144.60–$194.40 $241–$324 varies
Evaluate Speech Production (92522) $315 $525 2.8×
Evaluate Swallowing Function (92610) $326.40 $544 3.8×
Evaluation of speech fluency (92521) $132.60 $221 1.0×
Evoked Auditory Test,Limited (92587) $102.60 $171 0.5×
Exercise test for bronchospasm (94617)
range across 2 matching MRF lines
$63.60–$213.60 $106–$356 varies
External ECG rec>48hr<7d recording (93242) $132 $220 3.7×
External ECG rec>7d<15d recording (93246) $150 $250 4.2×
External Ecg Scanning Analysis Report (93226) $535.80 $893 9.4×
Extracranial Bilat Study (93880)
range across 3 matching MRF lines
$48–$854.40 $80–$1,424 varies
Extracranial Uni/Ltd Study (93882)
range across 2 matching MRF lines
$44.40–$75 $74–$125 varies
Gastroesophag reflx test w/telemtry ph eltrd (91035)
range across 2 matching MRF lines
$153–$1,537.80 $255–$2,563 varies
Gi tract capsule endoscopy (91110)
range across 2 matching MRF lines
$234–$2,205.60 $390–$3,676 varies
Group Therapeutic Procedures (97150) $121.20 $202 6.7×
Health Behavior Assessment/Re-Assessment (96156) $156 $260 1.6×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $130.80 $218 3.6×
Health behavior ivntj group f2f 1st 30 min (96164) $27.60 $46 0.8×
Health behavior ivntj indiv f2f 1st 30 min (96158) $129 $215 0.8×
Holter monitor recording (93225) $264.60 $441 2.1×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines
$11.81–$30.60 $19.68–$51 varies
Immunization administration (90471)
range across 6 matching MRF lines
$11.81–$64.80 $19.68–$108 varies
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $634.20 $1,057 1.8×
Iontophoresis 15 min (97033) $136.20 $227 7.2×
Irrig Drug Delivery Device (96523) $295.20 $492 5.2×
IV infusion hydration each additional hour (96361)
range across 4 matching MRF lines
$28.80–$306 $48–$510 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 2 matching MRF lines
$75–$418.80 $125–$698 varies
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines
$190.20–$325.20 $317–$542 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines
$42–$468 $70–$780 varies
IV push initial (96374)
range across 4 matching MRF lines
$94.80–$410.40 $158–$684 varies
Lung Function Test (Mbc/Mvv) (94200) $124.80 $208 2.2×
Lwr Xtr Vasc Stdy Bilat (93924)
range across 2 matching MRF lines
$49.20–$757.80 $82–$1,263 varies
Mechanical chest wall oscillation per session (94669) $144.60 $241 0.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $55.20 $92 1.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $58.20 $97 1.6×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $45.60 $76 2.7×
Methacholine challenge (94070)
range across 2 matching MRF lines
$55.20–$617.40 $92–$1,029 varies
Motion Fluoroscopy/Swallow (92611) $274.20 $457 3.0×
Multiple Sleep Latency Test (95805)
range across 2 matching MRF lines
$149.40–$1,653 $249–$2,755 varies
Nasopharyngoscopy (92511)
range across 2 matching MRF lines
$204.60–$219.60 $341–$366 varies
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines
$352.80–$630.60 $588–$1,051 varies
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $939.60 $1,566 2.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines
$44.40–$360 $74–$600 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $543.60 $906 1.4×
Nerve Conduction Studies 11-12 Studies (95912)
range across 2 matching MRF lines
$460.20–$1,101.60 $767–$1,836 varies
Nerve conduction studies 13 or more studies (95913)
range across 2 matching MRF lines
$533.40–$1,548 $889–$2,580 varies
Nerve conduction studies 5-6 studies (95909)
range across 2 matching MRF lines
$239.40–$619.80 $399–$1,033 varies
Nerve conduction studies 7-8 studies (95910)
range across 2 matching MRF lines
$324.60–$743.40 $541–$1,239 varies
Nerve Conduction Studies 9-10 Studies (95911)
range across 2 matching MRF lines
$378–$1,003.20 $630–$1,672 varies
Neurobehavioral Status Exam (96116)
range across 2 matching MRF lines
$99–$168.60 $165–$281 varies
Neuromuscular Reeducation (97112) $100.80 $168 3.1×
Nonphysician Telephone Assessment 11-20 Min (98967)
range across 2 matching MRF lines
$37.20–$114.60 $62–$191 varies
Nonphysician Telephone Assessment 21-30 Min (98968)
range across 2 matching MRF lines
$55.80–$134.40 $93–$224 varies
Nonphysician Telephone Assessment 5-10 Min (98966)
range across 2 matching MRF lines
$22.20–$97.80 $37–$163 varies
Nrpsyc tst eval phys/qhp 1st (96132) $231.60 $386 0.6×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $246.60 $411 0.7×
Oral Function Therapy (92526) $220.80 $368 2.6×
Orthc/Prostc Mgmt Sbsq Enc (97763)
range across 3 matching MRF lines
$58.80–$105.60 $98–$176 varies
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760)
range across 2 matching MRF lines
$88.80–$168 $148–$280 varies
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $67.20 $112 3.2×
Osteopathic manipulative tx 3-4 body regions (98926) $65.40 $109 3.2×
Osteopathic manipulative tx 5-6 body regions (98927) $64.80 $108 3.1×
Osteopathic manipulative tx 7-8 body regions (98928) $106.20 $177 5.1×
Osteopathic manipulative tx 9-10 body regions (98929) $129 $215 6.2×
Ot eval high complexity (97167) $170.40 $284 1.7×
Ot Eval Low Complex (97165) $121.80 $203 1.2×
Ot Eval Moderate Complexity (97166) $145.20 $242 1.4×
Ot manual therapy 15 min (97140) $102 $170 3.7×
Ot paraffin bath (97018) $48.60 $81 8.1×
Ot Prosthetic Training, Each 15 Min (97761)
range across 2 matching MRF lines
$87–$106.80 $145–$178 varies
Ot Re-Eval Est Plan Care (97168) $145.80 $243 2.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $159.60 $266 1.3×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $132 $220 1.1×
Oxygen Uptake Rest Indirect (94690)
range across 2 matching MRF lines
$145.20–$162.60 $242–$271 varies
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $204 $340 1.0×
Percutaneous tests w/allergenic extracts (95004) $9.60 $16 0.0×
Peripheral arterial disease rehab per session (93668) $109.20 $182 1.9×
Phlebotomy therapeutic (99195) $196.80 $328 1.5×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $229.20 $382 4.0×
Plethysmography (94726)
range across 2 matching MRF lines
$24–$382.80 $40–$638 varies
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811)
range across 2 matching MRF lines
$253.20–$3,106.80 $422–$5,178 varies
Prepj& allergen immunotherapy 1/mlt antigen (95165) $13.20 $22 0.3×
Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) $84 $140 0.9×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115)
range across 2 matching MRF lines
$22.20–$108 $37–$180 varies
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117)
range across 2 matching MRF lines
$28.80–$114 $48–$190 varies
Psych diag eval w/med srvcs (90792) $197.40 $329 1.2×
Psychiatric diagnostic evaluation (90791)
range across 2 matching MRF lines
$178.80–$300 $298–$500 varies
Psychological tst eval svc phys/qhp first hour (96130) $212.40 $354 1.0×
Psycl/Nrpsyc Tst Auto Result (96146) $94.80 $158 3.4×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $79.20 $132 0.6×
Psytx Crisis Initial 60 Min (90839) $156 $260 0.9×
Pt Eval High Complex (97163) $287.40 $479 2.9×
Pt eval low complex 20 min (97161) $239.40 $399 2.4×
Pt Eval Mod Complex (97162) $261.60 $436 2.7×
Pt gait training 15 min (97116) $93 $155 3.2×
Pt group caregiver training (97552) $33 $55 1.5×
Pt mechanical traction (97012) $61.80 $103 4.3×
Pt Re-Eval Est Plan Care (97164) $144 $240 2.1×
Pt-focused hlth risk assmt score doc stnd instrm (96160) $9.60 $16 0.3×
Pulm function test by gas (94727) $24 $40 0.1×
Pulmonary service/procedure (94799) $162.60 $271 1.3×
Pulmonary Stress Testing (94618) $213.60 $356 1.7×
Pure Tone Audiometry Air (92552)
range across 4 matching MRF lines
$27.60–$85.80 $46–$143 varies
Qnhp Ol Dig Assmt&Mgmt 11-20 (98971) $57.60 $96 2.5×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98972) $67.20 $112 2.0×
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98970) $45 $75 3.6×
Rectal sensation tone&compliance study (91124)
range across 2 matching MRF lines
$552–$962.40 $920–$1,604 varies
Rem mntr physiol param 1st dev supply ea 30 d (99454)
range across 3 matching MRF lines
$34.80–$116.40 $58–$194 varies
Rem mntr physiol param 1st set up pt educaj eqp (99453)
range across 3 matching MRF lines
$34.20–$172.80 $57–$288 varies
Rem ther mntr dev sply data muscskel sys ea 30 d (98977)
range across 3 matching MRF lines
$80.40–$91.80 $134–$153 varies
Remote 30 Day Ecg Rev/Report (93270) $284.40 $474 7.9×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975)
range across 3 matching MRF lines
$35.40–$90 $59–$150 varies
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981)
range across 2 matching MRF lines
$63–$72 $105–$120 varies
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980)
range across 2 matching MRF lines
$77.40–$90 $129–$150 varies
Respiratory flow volume loop (94375)
range across 2 matching MRF lines
$29.40–$216.60 $49–$361 varies
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041)
range across 2 matching MRF lines
$86.40–$158.40 $144–$264 varies
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 3 matching MRF lines
$106.80–$916.20 $178–$1,527 varies
Self Care Mngment Training (97535)
range across 2 matching MRF lines
$95.40–$98.40 $159–$164 varies
Sensory Integration Ea 15 Min (97533) $98.40 $164 1.6×
Sleep study unattended (95806)
range across 3 matching MRF lines
$92.40–$598.80 $154–$998 varies
Slp caregiver training 1st 30 min (97550) $74.40 $124 1.4×
Slp Stdy Unatnd W/Anal (95801) $214.80 $358 3.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800)
range across 2 matching MRF lines
$72–$568.80 $120–$948 varies
Speech Audiometry Complete (92556)
range across 2 matching MRF lines
$64.80–$69 $108–$115 varies
Speech audiometry threshold (92555)
range across 2 matching MRF lines
$40.20–$43.20 $67–$72 varies
Speech sound lang comprehen (92523) $220.80 $368 1.0×
Spirometry (94010) $16.80 $28 0.1×
Standardized Cognitive Performance Testing (96125) $219.60 $366 2.1×
Stenger Test, Pure Tone (92565) $29.40 $49 0.5×
Stress Tte Only (93350)
range across 2 matching MRF lines
$123.60–$823.80 $206–$1,373 varies
Subcutaneous Infusion Each Additional Hour (96370) $286.20 $477 6.4×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $359.40 $599 1.8×
Subq Infusion Additional Pump Infusion Site (96371) $301.20 $502 4.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $166.20 $277 7.4×
Ther Ivntj Ea Addl 15 Min (97130) $101.40 $169 4.8×
Ther/Proph/Diag Inj Ia (96373) $306 $510 1.5×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines
$34.80–$156 $58–$260 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines
$137.40–$480 $229–$800 varies
Therapeutic Activities (97530)
range across 2 matching MRF lines
$35.40–$312 $59–$520 varies
Tobacco Use Cessation Intensive >10 Minutes (99407)
range across 4 matching MRF lines
$37.80–$75 $63–$125 varies
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines
$19.80–$59.40 $33–$99 varies
Trans Care Mgmt 14 Day Disch (99495) $219.60 $366 1.7×
Trans Care Mgmt 7 Day Disch (99496) $308.40 $514 2.4×
Tte w/doppler, complete (93306)
range across 3 matching MRF lines
$115.20–$1,336.20 $192–$2,227 varies
Tte W/O Doppler Complete (93307) $84 $140 0.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $228 $380 3.0×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 3 matching MRF lines
$41.40–$250.20 $69–$417 varies
Tympanometry (92567)
range across 2 matching MRF lines
$30.60–$33 $51–$55 varies
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines
$26.40–$362.40 $44–$604 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923)
range across 2 matching MRF lines
$91.20–$836.40 $152–$1,394 varies
Vasopneumatic device (97016) $64.80 $108 5.4×
Vent Mgmt Inpat Init Day (94002) $1,198.80 $1,998 2.0×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,000.20 $1,667 1.7×
Vital capacity, total (94150)
range across 2 matching MRF lines
$118.20–$135 $197–$225 varies
Wheelchair Mgmt Ea 15 Min (97542)
range across 2 matching MRF lines
$70.80–$85.20 $118–$142 varies
Whirlpool Therapy (97022) $148.80 $248 9.5×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $80.40 $134 1.4×

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.