Visits & medical services prices at Jefferson County Health Center
Fairfield, IA · every code in this section with a posted price and a Medicare benchmark.
177 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) range across 5 matching MRF lines |
$22.80–$41.40 | $38–$69 | varies |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$31.20–$134.40 | $52–$224 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 2 matching MRF lines |
$14.40–$49.20 | $24–$82 | varies |
| Application Modality 1/> Areas Infrared (97026) | $25.80 | $43 | 3.9× |
| Application on-body injector (96377) | $73.20 | $122 | 1.6× |
| Assessment of aphasia per hr (96105) | $89.40 | $149 | 0.9× |
| Behavral qualit analys voice (92524) | $129 | $215 | 1.2× |
| Biofeedback training any modality (90901) | $69 | $115 | 1.7× |
| Brief Emotional/Behav Assmt (96127) | $11.40 | $19 | 0.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $288 | $480 | 0.8× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$71.40–$79.80 | $119–$133 | varies |
| Cardiac Stress Tst,Tracing Only (93017) | $500.40 | $834 | 2.4× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$462.60–$663 | $771–$1,105 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$393–$738.60 | $655–$1,231 | varies |
| Caregiver hlth risk assmt score doc stnd instrm (96161) | $11.40 | $19 | 0.3× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $19.20 | $32 | 0.7× |
| Chemo Anti-Neopl Sq/Im (96401) | $127.20 | $212 | 1.8× |
| Chemo Hormon Antineopl Sq/Im (96402) | $117.60 | $196 | 1.7× |
| Chemo Intralesional Over 7 (96406) range across 2 matching MRF lines |
$46.80–$115.20 | $78–$192 | varies |
| Chemo intralesional up to 7 (96405) range across 2 matching MRF lines |
$32.40–$93 | $54–$155 | varies |
| Chemo IV infusion addl hr (96415) | $129.60 | $216 | 1.9× |
| Chemo IV push addl drug (96411) | $132.60 | $221 | 1.9× |
| Chemother Prolong Infuse W/Pump (96416) | $282.60 | $471 | 0.9× |
| Chemotherapy Intracavitary (96440) | $225 | $375 | 0.7× |
| Chemotherapy Unspecified (96549) | $215.40 | $359 | 4.8× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $202.80 | $338 | 2.9× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $355.20 | $592 | 1.1× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $209.40 | $349 | 0.7× |
| Chest Wall Manipulation (94668) | $83.40 | $139 | 0.7× |
| Chron Care Mgmt Srvc 20 Min (99490) | $44.40 | $74 | 0.5× |
| Cmptr ophth dx img ant segmt (92132) range across 2 matching MRF lines |
$56.40–$81 | $94–$135 | varies |
| Color/duplex Doppler, limited (93976) | $189 | $315 | 1.9× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $40.80 | $68 | 1.3× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $100.20 | $167 | 0.6× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) range across 2 matching MRF lines |
$77.40–$81 | $129–$135 | varies |
| Computerized Ophthalmic Imaging Retina (92134) range across 2 matching MRF lines |
$79.80–$81 | $133–$135 | varies |
| Cont gluc mntr physician/qhp provided equiptment (95250) range across 2 matching MRF lines |
$215.40–$277.80 | $359–$463 | varies |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $103.20 | $172 | 1.8× |
| Continuous Pulse Ox (94762) | $192.60 | $321 | 1.6× |
| Corneal Topography (92025) range across 2 matching MRF lines |
$40.20–$81 | $67–$135 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$375.60–$381.60 | $626–$636 | varies |
| Cpt initial (94667) | $109.20 | $182 | 0.9× |
| Critical care first hour (99291) | $672 | $1,120 | 0.8× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 5 matching MRF lines |
$23.40–$198.60 | $39–$331 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $888.60 | $1,481 | 3.9× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $444.60 | $741 | 4.4× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $670.80 | $1,118 | 2.9× |
| Dup-scan xtr veins unilateral/limited study (93971) | $459 | $765 | 4.6× |
| Echo Heart Xthoracic,Limited (93308) | $470.40 | $784 | 2.1× |
| EEG awake drowsy (95816) | $367.20 | $612 | 1.8× |
| EEG extended monitoring 61-119 minutes (95813) | $283.80 | $473 | 1.4× |
| Electrical Stimulation Ea 15 Min (97032) range across 2 matching MRF lines |
$42–$55.20 | $70–$92 | varies |
| Electrocardiogram Tracing (93005) range across 3 matching MRF lines |
$18–$117 | $30–$195 | varies |
| Emergency Dept Visit Level 2 (99282) | $112.80 | $188 | 0.8× |
| Emergency Dept Visit Level 3 (99283) | $180 | $300 | 0.7× |
| Emergency Dept Visit Level 4 (99284) | $290.40 | $484 | 0.7× |
| Er level 1 (99281) | $66 | $110 | 0.8× |
| Er level v (99285) | $501 | $835 | 0.9× |
| Evaluate pt use of inhaler (94664) | $58.80 | $98 | 0.3× |
| Evaluate Speech Production (92522) | $135.60 | $226 | 1.2× |
| Evaluate Swallowing Function (92610) | $225.60 | $376 | 2.7× |
| Evaluation of speech fluency (92521) | $157.80 | $263 | 1.2× |
| Evoked Auditory Test,Limited (92587) | $61.80 | $103 | 0.3× |
| External Ecg Scanning Analysis Report (93226) | $172.20 | $287 | 3.0× |
| Extracranial Bilat Study (93880) | $698.40 | $1,164 | 3.0× |
| Extracranial Uni/Ltd Study (93882) | $157.80 | $263 | 1.6× |
| Gonioscopy (92020) range across 2 matching MRF lines |
$40.20–$81 | $67–$135 | varies |
| Group Therapeutic Procedures (97150) range across 2 matching MRF lines |
$37.20–$83.40 | $62–$139 | varies |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$48–$278.40 | $80–$464 | varies |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $41.40 | $69 | 0.6× |
| Immunization administration (90471) range across 3 matching MRF lines |
$36.60–$43.80 | $61–$73 | varies |
| Iontophoresis 15 min (97033) | $64.80 | $108 | 3.4× |
| Irrig Drug Delivery Device (96523) | $96 | $160 | 1.7× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$26.40–$79.20 | $44–$132 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$91.20–$203.40 | $152–$339 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) | $114.60 | $191 | 1.7× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $96 | $160 | 2.1× |
| IV push initial (96374) range across 2 matching MRF lines |
$90–$145.80 | $150–$243 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $27 | $45 | 0.9× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $28.80 | $48 | 0.8× |
| Motion Fluoroscopy/Swallow (92611) | $238.80 | $398 | 2.6× |
| Multiple Sleep Latency Test (95805) | $1,296.60 | $2,161 | 1.6× |
| Nasopharyngoscopy (92511) | $227.40 | $379 | 1.2× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$56.40–$187.80 | $94–$313 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $246.60 | $411 | 0.6× |
| Neuromuscular Reeducation (97112) | $62.40 | $104 | 1.9× |
| Nitric oxide expired gas determination (95012) | $48 | $80 | 1.3× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $24 | $40 | 0.7× |
| Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) | $159.60 | $266 | 1.2× |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) | $150 | $250 | 1.2× |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) | $113.40 | $189 | 0.9× |
| Ophth medical xm&eval intermediate estab pt (92012) | $111.60 | $186 | 0.9× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) | $88.20 | $147 | 0.7× |
| Oral Function Therapy (92526) | $168 | $280 | 2.0× |
| Oral Speech Device Eval (92597) | $111.60 | $186 | 1.6× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 3 matching MRF lines |
$30–$60.60 | $50–$101 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 2 matching MRF lines |
$40.20–$65.40 | $67–$109 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$15–$43.80 | $25–$73 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) | $60 | $100 | 2.9× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $77.40 | $129 | 3.7× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $94.20 | $157 | 4.5× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $109.20 | $182 | 5.3× |
| Ot Contrast Bath Ea 15 Min (97034) range across 2 matching MRF lines |
$24.60–$25.80 | $41–$43 | varies |
| Ot eval high complexity (97167) | $165 | $275 | 1.6× |
| Ot Eval Low Complex (97165) | $135.60 | $226 | 1.3× |
| Ot Eval Moderate Complexity (97166) | $139.80 | $233 | 1.4× |
| Ot manual therapy 15 min (97140) | $63 | $105 | 2.3× |
| Ot paraffin bath (97018) | $40.20 | $67 | 6.7× |
| Ot Prosthetic Training, Each 15 Min (97761) range across 2 matching MRF lines |
$40.80–$42.60 | $68–$71 | varies |
| Ot Re-Eval Est Plan Care (97168) | $33.60 | $56 | 0.5× |
| Ot rom hand (95852) | $24.60 | $41 | 1.2× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $157.80 | $263 | 1.3× |
| Phlebotomy therapeutic (99195) | $123.60 | $206 | 1.0× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $150 | $250 | 2.6× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $150 | $250 | 2.6× |
| Physical Performance Test (97750) range across 2 matching MRF lines |
$40.80–$42 | $68–$70 | varies |
| Plethysmography (94726) range across 2 matching MRF lines |
$90–$235.20 | $150–$392 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$934.80–$2,335.20 | $1,558–$3,892 | varies |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $111 | $185 | 1.1× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 2 matching MRF lines |
$16.80–$37.80 | $28–$63 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 2 matching MRF lines |
$21–$90 | $35–$150 | varies |
| Pt Eval High Complex (97163) | $154.20 | $257 | 1.6× |
| Pt eval low complex 20 min (97161) | $133.20 | $222 | 1.4× |
| Pt Eval Mod Complex (97162) | $143.40 | $239 | 1.5× |
| Pt gait training 15 min (97116) | $62.40 | $104 | 2.1× |
| Pt group caregiver training (97552) | $16.20 | $27 | 0.7× |
| Pt mechanical traction (97012) | $50.40 | $84 | 3.5× |
| Pt Re-Eval Est Plan Care (97164) | $88.20 | $147 | 1.3× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) | $6.60 | $11 | 0.2× |
| Pulmonary Stress Testing (94618) range across 3 matching MRF lines |
$49.20–$165.60 | $82–$276 | varies |
| Pure Tone Audiometry Air (92552) | $48 | $80 | 0.4× |
| Refill/Maint Portable Pump (96521) | $247.80 | $413 | 1.2× |
| Remote 30 Day Ecg Rev/Report (93270) range across 2 matching MRF lines |
$21–$264 | $35–$440 | varies |
| Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) | $24.60 | $41 | 0.2× |
| Respiratory flow volume loop (94375) | $233.40 | $389 | 1.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$60.60–$262.80 | $101–$438 | varies |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) range across 2 matching MRF lines |
$24.60–$31.20 | $41–$52 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $187.20 | $312 | 1.5× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $27 | $45 | 0.6× |
| Self Care Mngment Training (97535) | $62.40 | $104 | 1.9× |
| Sensory Integration Ea 15 Min (97533) | $34.80 | $58 | 0.6× |
| Slp caregiver training 1st 30 min (97550) | $40.80 | $68 | 0.8× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $418.20 | $697 | 2.0× |
| Speech sound lang comprehen (92523) | $254.40 | $424 | 1.1× |
| Spirometry (94010) range across 3 matching MRF lines |
$58.20–$175.80 | $97–$293 | varies |
| Standardized Cognitive Performance Testing (96125) | $144 | $240 | 1.4× |
| Stress Tte Only (93350) | $970.20 | $1,617 | 1.8× |
| Temp transcutaneous pacing (92953) | $242.40 | $404 | 0.4× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $32.40 | $54 | 1.4× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $42.60 | $71 | 1.1× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $33.60 | $56 | 1.1× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) range across 2 matching MRF lines |
$101.40–$123 | $169–$205 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$43.20–$61.20 | $72–$102 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$111–$223.80 | $185–$373 | varies |
| Therapeutic Activities (97530) | $65.40 | $109 | 1.9× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $30 | $50 | 0.8× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $22.80 | $38 | 0.6× |
| Trans Care Mgmt 14 Day Disch (99495) | $241.20 | $402 | 1.9× |
| Trans Care Mgmt 7 Day Disch (99496) | $309 | $515 | 2.4× |
| Tte w/doppler, complete (93306) range across 2 matching MRF lines |
$104.40–$1,114.20 | $174–$1,857 | varies |
| Tte W/O Doppler Complete (93307) range across 2 matching MRF lines |
$76.20–$432 | $127–$720 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $161.40 | $269 | 2.1× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $75 | $125 | 3.1× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $76.80 | $128 | 1.7× |
| Tympanometry (92567) | $24.60 | $41 | 0.7× |
| Unlisted cardiovascular service/procedure (93799) | $108 | $180 | 0.9× |
| Unlisted ophthalmological service/procedure (92499) | $15.60 | $26 | 0.6× |
| Unlisted otorhinolaryngological service (92700) | $23.40 | $39 | 0.8× |
| Upr/L Xtremity Art 2 Levels (93922) range across 3 matching MRF lines |
$38.40–$300.60 | $64–$501 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $232.20 | $387 | 1.1× |
| Vasopneumatic device (97016) | $35.40 | $59 | 2.9× |
| Vent Mgmt Inpat Init Day (94002) range across 2 matching MRF lines |
$62.40–$808.80 | $104–$1,348 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $776.40 | $1,294 | 1.3× |
| Visual Field Exam Extended (92083) range across 2 matching MRF lines |
$74.40–$160.20 | $124–$267 | varies |
| Vital capacity, total (94150) | $103.80 | $173 | 0.8× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$39–$40.80 | $65–$68 | varies |
| Whirlpool Therapy (97022) | $45.60 | $76 | 2.9× |
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.