Visits & medical services prices at Jefferson Community Health & Life

Fairbury, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $63.75 $85 2.1×
Advance care planning first 30 mins (99497) $135.75 $181 1.3×
Airway inhalation treatment (94640) $74.62 $99.50 0.3×
Behavioral and qualitative analysis of voice and resonance (92524) $252 $336 2.3×
Canalith Repositioning (95992) $99 $132 2.4×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $67.50 $90 0.6×
Cont Gluc Monitoring Patient Provided Equipment (95249) $124.50 $166 2.0×
Continuous Glucose Monitoring (95250) $297.75 $397 2.2×
Debridement Open Wound 20 Sq Cm< (97597) $206.25 $275 1.0×
EKG (93005) $256.50 $342 4.2×
Evoked auditory test,limited (92587) $145.50 $194 0.6×
External Ecg Scanning Analysis Report (93226) $612 $816 10.0×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $37.50 $50 0.9×
Immunization Admin (90471) $23.25 $31 0.3×
Immunotherapy, 2+ Injections (95117) $34.50 $46 0.7×
Inital newborn e/m (99460) $152.25 $203 1.1×
IV infusion hydration each additional hour (96361) $132.75 $177 2.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $306.75 $409 1.4×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $257.25 $343 5.3×
Manual therapy 15 min (97140) $91.50 $122 3.3×
Massage 15 min (97124) $62.25 $83 2.1×
Mechanical traction (97012) $68.25 $91 4.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $59.25 $79 1.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $53.25 $71 1.4×
Multiple Family Group Psychotherapy (90849) $58.50 $78 0.3×
Newborn resuscitation (99465) $233.25 $311 0.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $87 $116 1.9×
Osteopathic manipulative tx 3-4 body regions (98926) $75 $100 3.3×
Osteopathic manipulative tx 7-8 body regions (98928) $119.25 $159 5.3×
Ot eval high complex 60 min (97167) $201 $268 2.0×
Ot eval low complex 30 min (97165) $167.25 $223 1.7×
Ot Prosthetic Training, Each 15 Min (97761) $91.50 $122 2.3×
Paraffin bath (97018) $62.25 $83 10.4×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $16.50 $22 0.3×
Pt Aquatic Therapy/Exercises (97113) $81.75 $109 2.2×
Pt Electric Current Therapy (97033) $99.75 $133 5.2×
Pt Electrical Stimulation (97032) $65.25 $87 4.4×
Pt Gait Training Therapy (97116) $81.75 $109 2.8×
Pt Infrared Therapy (97026) $18.75 $25 2.8×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $162.75 $217 1.7×
Pt re-evaluation (97164) $86.25 $115 1.3×
Pt Whirlpool Therapy (97022) $81.75 $109 5.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $150 $200 0.7×
Self-meas bp pt educaj/traing & dev calibration (99473) $23.25 $31 0.8×
Ther/Proph/Diag Inj Sc/Im (96372) $25.50 $34 0.3×
Therapeutic Activities (97530) $87 $116 2.5×
Therapeutic phlebotomy (99195) $135 $180 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $24.75 $33 0.6×
Trans Care Mgmt 14 Day Disch (99495) $340.50 $454 2.5×
Trans Care Mgmt 7 Day Disch (99496) $460.50 $614 3.3×
Vasopneumatic device (97016) $69.75 $93 5.8×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $644.25 $859 6.5×