Visits & medical services prices at Jennie M Melham Memorial Medical Center
Broken Bow, NE · every code in this section with a posted price and a Medicare benchmark.
118 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) | $339.50 | $339.50 | 1.5× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $62 | $62 | 4.3× |
| Assessment of aphasia per hr (96105) | $300 | $300 | 3.1× |
| Behavral qualit analys voice (92524) | $280 | $280 | 2.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $777.79 | $777.79 | 2.0× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,504.65 | $1,504.65 | 6.7× |
| Cardiopulmonary exercise testing (94621) | $522.54 | $522.54 | 1.3× |
| Cardioversion (92960) | $2,458.13 | $2,458.13 | 3.6× |
| Cbt 1st hour (94644) | $336.89 | $336.89 | 2.4× |
| Chemo Anti-Neopl Sq/Im (96401) | $382.67 | $382.67 | 5.1× |
| Chemo Hormon Antineopl Sq/Im (96402) | $438.32 | $438.32 | 5.9× |
| Chemo IV infusion addl hr (96415) | $392.60 | $392.60 | 5.3× |
| Chemo IV push addl drug (96411) | $370 | $370 | 4.9× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $478.36 | $478.36 | 6.4× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $965.07 | $965.07 | 2.8× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $560.27 | $560.27 | 1.6× |
| Chest Wall Manipulation (94668) | $307.42 | $307.42 | 2.2× |
| Color/duplex Doppler, complete (93975) | $1,149.89 | $1,149.89 | 4.6× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $84 | $84 | 2.6× |
| Continuous Pulse Ox (94762) | $542.59 | $542.59 | 4.1× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $958 | $958 | 4.2× |
| Cpt initial (94667) | $264.32 | $264.32 | 1.9× |
| Critical care first hour (99291) | $2,132.24 | $2,132.24 | 2.5× |
| Debridement Open Wound 20 Sq Cm< (97597) | $147 | $147 | 0.7× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $996.10 | $996.10 | 4.0× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $612.50 | $612.50 | 5.6× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,430.17 | $1,430.17 | 5.8× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $1,103.85 | $1,103.85 | 10.2× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,580.11 | $1,580.11 | 6.4× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,289.14 | $1,289.14 | 11.9× |
| Duplex Scan Hemodialysis Access (93990) | $877 | $877 | 8.1× |
| Duplex up extrem art bilat (93930) | $1,013 | $1,013 | 4.1× |
| Duplex up extrem art unilat/ltd (93931) | $796 | $796 | 7.3× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$995.76–$1,147.11 | $995.76–$1,147.11 | varies |
| EEG awake and asleep (95819) | $1,551.54 | $1,551.54 | 6.9× |
| Electrical Stimulation Ea 15 Min (97032) | $86 | $86 | 5.9× |
| Electrocardiogram Tracing (93005) | $358.32 | $358.32 | 5.8× |
| Emergency Dept Visit Level 2 (99282) | $460 | $460 | 2.9× |
| Emergency Dept Visit Level 3 (99283) | $775 | $775 | 2.7× |
| Emergency Dept Visit Level 4 (99284) | $1,200 | $1,200 | 2.8× |
| Er level v (99285) | $1,925 | $1,925 | 3.1× |
| Evaluate Speech Production (92522) | $309.44 | $309.44 | 2.8× |
| Evaluate Swallowing Function (92610) | $371.81 | $371.81 | 4.4× |
| Evaluation of speech fluency (92521) | $344.85 | $344.85 | 2.6× |
| External ECG rec>48hr<7d recording (93242) | $473.12 | $473.12 | 12.2× |
| External ECG rec>7d<15d recording (93246) | $455 | $455 | 11.7× |
| External Ecg Scanning Analysis Report (93226) | $871.46 | $871.46 | 14.2× |
| Extracranial Bilat Study (93880) | $1,648.80 | $1,648.80 | 6.7× |
| Extracranial Uni/Ltd Study (93882) | $893 | $893 | 8.2× |
| Holter monitor recording (93225) | $564.20 | $564.20 | 4.1× |
| Icd Device Interrogate (93289) | $128 | $128 | 3.3× |
| Icd device progr eval dual (93283) | $155.20 | $155.20 | 4.0× |
| Icd Device Progr Eval Mult (93284) | $153.79 | $153.79 | 4.0× |
| Immunization administration (90471) | $76.30 | $76.30 | 1.0× |
| Intracutaneous tests w/allergenic extracts (95024) | $16 | $16 | 0.3× |
| Irrig Drug Delivery Device (96523) | $183.12 | $183.12 | 3.0× |
| IV infusion hydration each additional hour (96361) | $324.51 | $324.51 | 6.7× |
| IV infusion hydration initial 31 min-1 hour (96360) | $504.69 | $504.69 | 2.3× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $262.61 | $262.61 | 3.5× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $413.94 | $413.94 | 8.5× |
| IV push initial (96374) | $369.38 | $369.38 | 1.7× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $736 | $736 | 3.3× |
| Motion Fluoroscopy/Swallow (92611) | $505 | $505 | 5.5× |
| Multiple Sleep Latency Test (95805) | $3,505 | $3,505 | 3.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $396.26 | $396.26 | 1.9× |
| Neuromuscular Reeducation (97112) | $175.41 | $175.41 | 5.4× |
| Oral Function Therapy (92526) | $333.10 | $333.10 | 4.0× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $84 | $84 | 1.8× |
| Ot eval high complexity (97167) | $287 | $287 | 2.9× |
| Ot Eval Low Complex (97165) | $225.66 | $225.66 | 2.2× |
| Ot Eval Moderate Complexity (97166) | $262.25 | $262.25 | 2.6× |
| Ot manual therapy 15 min (97140) range across 4 matching MRF lines |
$84–$181.34 | $84–$181.34 | varies |
| Ot paraffin bath (97018) | $44 | $44 | 7.3× |
| Ot Prosthetic Training, Each 15 Min (97761) range across 2 matching MRF lines |
$59–$84 | $59–$84 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $399.74 | $399.74 | 3.0× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $171.60 | $171.60 | 1.3× |
| Percutaneous tests w/allergenic extracts (95004) | $14 | $14 | 0.0× |
| Phlebotomy therapeutic (99195) | $279.51 | $279.51 | 2.0× |
| Plethysmography (94726) | $731.02 | $731.02 | 1.9× |
| Pm device eval in person (93288) | $103 | $103 | 2.7× |
| Pm device progr eval dual (93280) | $128.16 | $128.16 | 3.3× |
| Pm device progr eval multi (93281) | $112 | $112 | 2.9× |
| Pm Device Progr Eval Sngl (93279) | $96.90 | $96.90 | 2.5× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $5,027.59 | $5,027.59 | 5.6× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $138 | $138 | 3.6× |
| Pt Eval High Complex (97163) | $291.88 | $291.88 | 3.0× |
| Pt eval low complex 20 min (97161) | $207.95 | $207.95 | 2.1× |
| Pt Eval Mod Complex (97162) | $243.85 | $243.85 | 2.5× |
| Pt gait training 15 min (97116) | $130.68 | $130.68 | 4.5× |
| Pt mechanical traction (97012) | $73 | $73 | 5.1× |
| Pulmonary service/procedure (94799) | $121 | $121 | 0.9× |
| Pulmonary Stress Testing (94618) | $436.21 | $436.21 | 3.2× |
| Remote 30 Day Ecg Rev/Report (93270) | $446 | $446 | 11.5× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$85–$198.46 | $85–$198.46 | varies |
| Sensory Integration Ea 15 Min (97533) | $84 | $84 | 1.4× |
| Sleep study unattended (95806) | $429 | $429 | 1.9× |
| Speech sound lang comprehen (92523) | $428.82 | $428.82 | 1.9× |
| Spirometry (94010) | $355.47 | $355.47 | 1.6× |
| Standardized Cognitive Performance Testing (96125) | $300 | $300 | 2.9× |
| Stress Tte Only (93350) | $1,976.85 | $1,976.85 | 3.5× |
| Ther Ivntj Ea Addl 15 Min (97130) | $60 | $60 | 2.9× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $69 | $69 | 2.3× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $255.15 | $255.15 | 2.5× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $205.60 | $205.60 | 2.8× |
| Ther/Proph/Diag Iv Inf Init (96365) | $576.45 | $576.45 | 2.6× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$192.35–$211.48 | $192.35–$211.48 | varies |
| Tte w/doppler, complete (93306) | $2,593.98 | $2,593.98 | 4.6× |
| Tte W/O Doppler Complete (93307) | $1,027 | $1,027 | 4.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $323.25 | $323.25 | 4.2× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $130 | $130 | 5.4× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $332.66 | $332.66 | 6.8× |
| Upr/L Xtremity Art 2 Levels (93922) | $621.52 | $621.52 | 4.5× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $863 | $863 | 3.8× |
| Vent Mgmt Inpat Init Day (94002) | $1,635.54 | $1,635.54 | 2.5× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $2,131.46 | $2,131.46 | 3.3× |
| Vital capacity, total (94150) | $34 | $34 | 0.3× |
| Wheelchair Mgmt Ea 15 Min (97542) | $84 | $84 | 2.7× |
| Whirlpool Therapy (97022) | $85 | $85 | 5.4× |
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.