Visits & medical services prices at Johnson County Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Acupunct W/Stimul 15 Min (97813) $56 $56 1.9×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $52 $52 1.7×
Airway Inhalation Treatment (94640)
range across 5 matching MRF lines		 $59–$347 $59–$347 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $78 $78 5.4×
Assmt & care planning pt w/cognitive impairment (99483) $310 $310 2.9×
Behavral qualit analys voice (92524) $541 $541 4.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $694 $694 1.8×
Canalith repositioning proc (95992) $135 $135 3.3×
Cardiac Stress Tst,Tracing Only (93017) $1,634 $1,634 7.3×
Cardiopulmonary resuscitation (92950) $912 $912 4.1×
Cardioversion (92960) $1,512 $1,512 2.2×
Chemo Anti-Neopl Sq/Im (96401) $293 $293 3.9×
Chemo Hormon Antineopl Sq/Im (96402) $271 $271 3.6×
Chemo IV infusion addl hr (96415) $224 $224 3.0×
Chemo IV push addl drug (96411) $292 $292 3.9×
Chemother Prolong Infuse W/Pump (96416) $613 $613 1.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $287 $287 3.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $605 $605 1.8×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $381 $381 1.1×
Chest Wall Manipulation (94668)
range across 4 matching MRF lines		 $133–$136 $133–$136 varies
Color/duplex Doppler, complete (93975) $1,092 $1,092 4.4×
Color/duplex Doppler, limited (93976) $833 $833 7.7×
Community/Work Reintegration Trainj Ea 15 Min (97537) $114 $114 3.6×
Comprehensive Hearing Test (92557) $132 $132 1.0×
Cont gluc mntr physician/qhp provided equiptment (95250) $167 $167 1.2×
Cont Gluc Mntr Pt Prov Eqp (95249) $67 $67 1.1×
Continuous Pulse Ox (94762) $459 $459 3.4×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $910 $910 4.0×
Cpt initial (94667) $194 $194 1.4×
Critical care first hour (99291) $2,203 $2,203 2.6×
Debridement Open Wound 20 Sq Cm< (97597) $513 $513 2.5×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,139 $1,139 4.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $818 $818 7.5×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,228 $1,228 5.0×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,011 $1,011 9.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,423 $1,423 5.7×
Dup-scan xtr veins unilateral/limited study (93971) $1,134 $1,134 10.4×
Duplex Scan Hemodialysis Access (93990) $811 $811 7.5×
Duplex up extrem art bilat (93930) $1,145 $1,145 4.6×
Duplex up extrem art unilat/ltd (93931) $947 $947 8.7×
ECG/monitoring and analysis (93271) $809 $809 8.2×
Echo Heart Xthoracic,Limited (93308) $869 $869 3.5×
Electrical Stimulation Ea 15 Min (97032) $78 $78 5.3×
Electrocardiogram Tracing (93005) $340 $340 5.6×
Emergency Dept Visit Level 2 (99282) $410 $410 2.6×
Emergency Dept Visit Level 3 (99283) $780 $780 2.8×
Emergency Dept Visit Level 4 (99284) $1,131 $1,131 2.6×
Er level 1 (99281) $230 $230 2.6×
Er level v (99285) $1,731 $1,731 2.8×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $274 $274 2.1×
Evaluate pt use of inhaler (94664)
range across 3 matching MRF lines		 $170–$224 $170–$224 varies
Evaluate Speech Production (92522) $303 $303 2.7×
Evaluate Swallowing Function (92610) $348 $348 4.1×
Evaluation of speech fluency (92521) $307 $307 2.3×
External ECG rec>48hr<7d recording (93242) $520 $520 13.4×
External ECG rec>48hr<7d scanning alys w/report (93243) $269 $269 1.9×
External ECG rec>7d<15d recording (93246) $789 $789 20.3×
External ECG rec>7d<15d scanning alys w/report (93247) $283 $283 2.0×
External Ecg Scanning Analysis Report (93226) $735 $735 12.0×
Extracranial Bilat Study (93880) $1,383 $1,383 5.6×
Extracranial Uni/Ltd Study (93882) $882 $882 8.1×
Flexible endoscopic eval swallow c/v rec (92612) $506 $506 2.5×
Holter monitor recording (93225) $563 $563 4.1×
Im Adm Intransl/Oral 1 Vaccine (90473) $33 $33 0.4×
Immunization administration (90471) $107 $107 1.4×
Intracranial Complete Study (93886) $625 $625 2.5×
Iontophoresis 15 min (97033) $114 $114 6.0×
Irrig Drug Delivery Device (96523)
range across 2 matching MRF lines		 $77–$135 $77–$135 varies
IV infusion hydration each additional hour (96361) $151 $151 3.1×
IV infusion hydration initial 31 min-1 hour (96360) $394 $394 1.8×
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines		 $162–$213 $162–$213 varies
IV infusion therapy prophylaxis/dx ea hour (96366) $159 $159 3.3×
IV push initial (96374)
range across 2 matching MRF lines		 $317–$365 $317–$365 varies
Lung Function Test (Mbc/Mvv) (94200) $204 $204 3.3×
Lwr Xtr Vasc Stdy Bilat (93924) $993 $993 4.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $53 $53 1.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $76 $76 2.1×
Motion Fluoroscopy/Swallow (92611) $472 $472 5.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $386 $386 1.9×
Neuromuscular Reeducation (97112) $110 $110 3.4×
Oral Function Therapy (92526) $286 $286 3.4×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $105 $105 2.3×
Ot eval high complexity (97167) $220 $220 2.2×
Ot Eval Low Complex (97165) $187 $187 1.9×
Ot Eval Moderate Complexity (97166) $254 $254 2.5×
Ot manual therapy 15 min (97140) $112 $112 4.0×
Ot paraffin bath (97018) $71 $71 11.8×
Ot Re-Eval Est Plan Care (97168) $107 $107 1.6×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $276 $276 2.1×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $150 $150 1.1×
Phlebotomy therapeutic (99195) $267 $267 1.9×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $304 $304 5.0×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $248 $248 4.0×
Plethysmography (94726) $598 $598 1.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,547 $4,547 5.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $31 $31 0.6×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $41 $41 0.8×
Psych diag eval w/med srvcs (90792) $330 $330 1.8×
Psychiatric diagnostic evaluation (90791) $290 $290 1.6×
Pt Eval High Complex (97163) $300 $300 3.1×
Pt eval low complex 20 min (97161) $230 $230 2.4×
Pt Eval Mod Complex (97162) $270 $270 2.8×
Pt gait training 15 min (97116) $100 $100 3.4×
Pt mechanical traction (97012) $80 $80 5.6×
Pt Re-Eval Est Plan Care (97164) $118 $118 1.7×
Pulmonary service/procedure (94799) $196 $196 1.5×
Pulmonary Stress Testing (94618) $427 $427 3.1×
Pure Tone Audiometry Air (92552) $78 $78 0.6×
Remote 30 Day Ecg Tech Supp (93229) $1,787 $1,787 4.6×
Respiratory flow volume loop (94375) $188 $188 0.8×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $1,150 $1,150 18.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $180 $180 0.9×
Self Care Mngment Training (97535) $103 $103 3.2×
Sensory Integration Ea 15 Min (97533) $175 $175 2.9×
Sleep study unattended (95806) $586 $586 2.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $586 $586 2.6×
Speech Audiometry Complete (92556) $88 $88 1.4×
Speech sound lang comprehen (92523) $524 $524 2.3×
Spirometry (94010) $471 $471 2.1×
Standardized Cognitive Performance Testing (96125) $591 $591 5.7×
Stress Tte Only (93350) $1,638 $1,638 2.9×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $112 $112 5.0×
Ther Ivntj Ea Addl 15 Min (97130) $62 $62 2.9×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $72 $72 2.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $130 $130 1.3×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines		 $54–$230 $54–$230 varies
Ther/Proph/Diag Iv Inf Init (96365) $425 $425 1.9×
Therapeutic Activities (97530)
range across 3 matching MRF lines		 $102–$121 $102–$121 varies
Tobacco Use Cessation Intensive >10 Minutes (99407) $104 $104 2.7×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines		 $53–$72 $53–$72 varies
Trans Care Mgmt 14 Day Disch (99495) $284 $284 2.1×
Trans Care Mgmt 7 Day Disch (99496) $323 $323 2.3×
Tte w/doppler, complete (93306) $2,401 $2,401 4.2×
Tte W/O Doppler Complete (93307) $2,355 $2,355 9.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $305 $305 4.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $199 $199 4.1×
Tympanometry (92567) $66 $66 1.7×
Upr/L Xtremity Art 2 Levels (93922) $542 $542 3.9×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $740 $740 3.3×
Vasopneumatic device (97016) $96 $96 8.0×
Vent Mgmt Inpat Init Day (94002) $1,299 $1,299 2.0×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $222 $222 0.3×
Vital capacity, total (94150) $110 $110 0.8×
Wheelchair Mgmt Ea 15 Min (97542) $103 $103 3.3×

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.