Visits & medical services prices at Mayo Clinic Health System - Fairmont

Fairmont, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
1St psychiatric collab care mgmt 1st 70 mins (99492) $412.72 $469 3.8×
Ablate Heart Dysrhythm Focus (93650) $10,694.64 $12,153 1.3×
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $167.20 $190 1.2×
Acoustic Reflex Testing (92568) $118.80 $135 2.9×
Actinotherapy Ultraviolet Light (96900) $77.44 $88 1.9×
Acupunct W/Stimul 15 Min (97813) $108.24 $123 3.5×
Admn Sarscov2 Vacc 1 Dose (90480) $41.36 $47 0.9×
Advncd Care Plan 30 Min (99497) $240.24 $273 2.2×
Aep Hearing Status Deter Broadband Stimuli I&R (92651) $476.08 $541 2.0×
Aep neurodiagnostic i&r (92653) $478.72 $544 2.0×
Aep threshold estimation mlt frequencies i&r (92652) $470.80 $535 2.0×
Airway Inhalation Treatment (94640) $211.20 $240 0.9×
Airway resistance by oscillometry (94728) $172.48 $196 1.2×
Analyze neurostim complex (95972)
range across 2 matching MRF lines
$331.76–$809.60 $377–$920 varies
Analyze Neurostim Simple (95971) $302.72 $344 2.9×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $39.60 $45 2.8×
Application on-body injector (96377) $87.12 $99 1.7×
Assessment of aphasia per hr (96105) $348.48 $396 3.6×
Audiometry Air & Bone (92553) $147.84 $168 1.1×
Behavral qualit analys voice (92524) $333.52 $379 3.0×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $183.04 $208 2.2×
Bfb training ea addl 15 min (90913) $152.24 $173 4.7×
Brief Emotional/Behav Assmt (96127) $34.32 $39 0.8×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $432.96 $492 1.1×
C motor evoked upr&lwr limbs (95939) $1,807.52 $2,054 1.9×
Canalith repositioning proc (95992) $253.44 $288 6.2×
Car seat/bed test 60 min (94780) $180.40 $205 4.5×
Cardiac Stress Tst,Tracing Only (93017) $432.96 $492 1.9×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines
$509.52–$1,235.52 $579–$1,404 varies
Cardioversion (92960)
range across 2 matching MRF lines
$840.40–$1,154.56 $955–$1,312 varies
Cardioversion elective internal (92961) $2,759.68 $3,136 3.9×
Care mgmt services behavioral hlth cond 20 mins (99484) $179.52 $204 4.4×
Caregiver hlth risk assmt score doc stnd instrm (96161) $45.76 $52 1.1×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $11,766.48 $13,371 3.4×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $9,425.68 $10,711 2.7×
Cbt 1st hour (94644) $318.56 $362 2.2×
Chemo Anti-Neopl Sq/Im (96401) $256.08 $291 3.3×
Chemo Hormon Antineopl Sq/Im (96402) $140.80 $160 1.8×
Chemo IV infusion addl hr (96415) $237.60 $270 3.0×
Chemo IV push addl drug (96411) $264.88 $301 3.4×
Chemother Prolong Infuse W/Pump (96416) $707.52 $804 2.0×
Chemotherapy Into Cns (96450) $248.16 $282 0.7×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $327.36 $372 4.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $723.36 $822 2.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $381.92 $434 1.1×
Chest Wall Manipulation (94668) $146.96 $167 1.0×
Chron Care Mgmt Srvc 20 Min (99490) $115.28 $131 1.0×
Color/duplex Doppler, limited (93976) $777.04 $883 6.9×
Community/Work Reintegration Trainj Ea 15 Min (97537) $75.68 $86 2.4×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $307.12 $349 1.6×
Comprehensive Hearing Test (92557) $214.72 $244 1.5×
Computerized Ophthalmic Imaging Retina (92134) $231.44 $263 3.6×
Conditioning Play Audiometry (92582) $212.08 $241 1.5×
Cont gluc mntr physician/qhp provided equiptment (95250) $557.92 $634 3.9×
Cont Gluc Mntr Pt Prov Eqp (95249) $324.72 $369 5.1×
Continuous Pulse Ox (94762) $279.84 $318 2.0×
Coronary Art/Grft Angio S&I (93455) $10,474.64 $11,903 3.0×
Coronary Artery Angio S&I (93454) $7,838.16 $8,907 2.2×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $934.56 $1,062 3.9×
Cpt initial (94667) $187.44 $213 1.3×
Critical care first hour (99291)
range across 4 matching MRF lines
$885.28–$5,579.20 $1,006–$6,340 varies
Debridement Open Wound 20 Sq Cm< (97597)
range across 4 matching MRF lines
$94.16–$230.56 $107–$262 varies
Dialysis One Evaluation (90945) $1,955.36 $2,222 4.3×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $49.28 $56 0.1×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $718.96 $817 2.8×
Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) $487.52 $554 4.3×
Duplex up extrem art unilat/ltd (93931) $792 $900 7.0×
Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) $392.48 $446 2.8×
Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) $608.96 $692 4.4×
ECG/monitoring and analysis (93271) $1,035.76 $1,177 10.1×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines
$826.32–$1,092.08 $939–$1,241 varies
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,862.96 $2,117 3.1×
EEG awake drowsy (95816) $876.48 $996 3.7×
EEG cont rec w/video by tech min 8 channels (95700) $550 $625 2.4×
EEG extended monitoring 61-119 minutes (95813) $1,662.32 $1,889 7.1×
Electrical Stimulation Ea 15 Min (97032) $41.36 $47 2.8×
Electrocardiogram Tracing (93005)
range across 2 matching MRF lines
$31.68–$100.32 $36–$114 varies
Electrophysiology Evaluation (93642) $1,449.36 $1,647 1.1×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
$206.80–$339.68 $235–$386 varies
Emergency Dept Visit Level 3 (99283)
range across 3 matching MRF lines
$385.44–$555.28 $438–$631 varies
Emergency Dept Visit Level 4 (99284)
range across 3 matching MRF lines
$599.28–$915.20 $681–$1,040 varies
Ep & ablate supravent arrhyt (93653) $29,708.80 $33,760 1.0×
Ep & ablate ventric tachy (93654) $34,687.84 $39,418 1.2×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $12,466.08 $14,166 1.5×
Er level 1 (99281)
range across 2 matching MRF lines
$145.20–$184.80 $165–$210 varies
Er level v (99285)
range across 5 matching MRF lines
$826.32–$4,850.56 $939–$5,512 varies
Eval aud funcj cand/po surg implt dev 1st hr (92626) $291.28 $331 2.1×
Evaluate pt use of inhaler (94664) $185.68 $211 0.8×
Evaluate Speech Production (92522) $324.72 $369 2.9×
Evaluate Swallowing Function (92610) $535.92 $609 6.3×
Evaluation of speech fluency (92521) $240.24 $273 1.8×
Evoked Auditory Test,Limited (92587) $41.36 $47 0.2×
External Ecg Scanning Analysis Report (93226) $366.08 $416 5.7×
Flexible endoscopic eval swallow c/v rec (92612) $363.44 $413 1.8×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $1,025.20 $1,165 4.4×
Group Therapeutic Procedures (97150) $53.68 $61 3.0×
Health Behavior Assessment/Re-Assessment (96156) $416.24 $473 3.8×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $212.96 $242 5.2×
Health behavior ivntj indiv f2f 1st 30 min (96158) $134.64 $153 0.7×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $16,105.76 $18,302 4.6×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $848.32 $964 1.1×
Holter monitor recording (93225) $248.16 $282 1.7×
Icd Device Interrogate (93289) $239.36 $272 5.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $36.96 $42 0.5×
Immunization administration (90471) $41.36 $47 0.5×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $325.60 $370 0.8×
Iontophoresis 15 min (97033) $73.04 $83 3.8×
Irrig Drug Delivery Device (96523) $124.08 $141 1.9×
IV infusion hydration each additional hour (96361) $78.32 $89 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $263.12 $299 1.1×
IV infusion ther proph addl sequential to 1 hr (96367) $114.40 $130 1.5×
IV infusion therapy prophylaxis/dx ea hour (96366) $93.28 $106 1.8×
IV push initial (96374) $219.12 $249 1.0×
L Hrt Art/Grft Angio (93459) $11,801.68 $13,411 3.4×
Low frequency non-thermal us (97610) $300.96 $342 1.4×
Lung Function Test (Mbc/Mvv) (94200) $50.16 $57 0.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $57.20 $65 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $60.72 $69 1.7×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $29.04 $33 1.7×
Methacholine challenge (94070) $484 $550 1.2×
Motion Fluoroscopy/Swallow (92611) $500.72 $569 5.5×
Muscle Test 2 Limbs (95861) $378.40 $430 2.6×
Muscle Test Nonparaspinal (95870) $260.48 $296 1.8×
Nasopharyngoscopy (92511)
range across 2 matching MRF lines
$128.48–$317.68 $146–$361 varies
Needle Electromyography Cranial Nrv Muscle Bi (95868) $484.88 $551 2.1×
Needle electromyography larynx (95865) $192.72 $219 1.3×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $237.60 $270 1.0×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607)
range across 2 matching MRF lines
$519.20–$708.40 $590–$805 varies
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608)
range across 2 matching MRF lines
$525.36–$700.48 $597–$796 varies
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 3 matching MRF lines
$177.76–$182.16 $202–$207 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606)
range across 3 matching MRF lines
$199.76–$415.36 $227–$472 varies
Neuromuscular Reeducation (97112) $83.60 $95 2.6×
Nitric oxide expired gas determination (95012) $116.16 $132 2.9×
Nonphysician Telephone Assessment 11-20 Min (98967) $101.20 $115 4.0×
Nonphysician Telephone Assessment 21-30 Min (98968) $146.96 $167 4.2×
Nonphysician Telephone Assessment 5-10 Min (98966) $65.12 $74 4.8×
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $212.96 $242 1.5×
Ophth medical xm&eval intermediate estab pt (92012) $173.36 $197 1.2×
Oral Function Therapy (92526) $224.40 $255 2.7×
Orthc/Prostc Mgmt Sbsq Enc (97763) $143.44 $163 2.9×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $169.84 $193 3.7×
Ot eval high complexity (97167) $302.72 $344 3.0×
Ot Eval Low Complex (97165) $225.28 $256 2.2×
Ot Eval Moderate Complexity (97166) $227.92 $259 2.3×
Ot manual therapy 15 min (97140) $84.48 $96 3.0×
Ot paraffin bath (97018) $33.44 $38 5.6×
Ot Prosthetic Training, Each 15 Min (97761) $113.52 $129 2.8×
Ot Re-Eval Est Plan Care (97168) $150.48 $171 2.2×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $191.84 $218 1.4×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $223.52 $254 1.6×
Patch/Application Test Specify Number Tests (95044) $34.32 $39 0.0×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $396 $450 1.7×
Peripheral arterial disease rehab per session (93668) $255.20 $290 4.0×
Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930) $37,418.48 $42,521 1.9×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $11,764.72 $13,369 1.9×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $18,698.24 $21,248 1.5×
Phlebotomy therapeutic (99195) $213.84 $243 1.5×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $287.76 $327 4.5×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $290.40 $330 4.5×
Physical Performance Test (97750) $111.76 $127 3.3×
Plethysmography (94726) $425.92 $484 1.1×
Pm Device Progr Eval Sngl (93279) $147.84 $168 3.7×
Pm/Icd Remote Tech Serv (93296) $190.96 $217 4.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,395.92 $3,859 3.7×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $62.48 $71 1.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $46.64 $53 0.9×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $71.28 $81 1.4×
Prq Card Angio/Athrect 1 Art (92924) $20,652.72 $23,469 1.7×
Prq Card Stent W/Angio 1 Vsl (92928) $20,015.60 $22,745 1.6×
Prq Card Stent/Ath/Angio (92933) $23,729.20 $26,965 1.2×
Prq Revasc Byp Graft 1 Vsl (92937) $19,724.32 $22,414 1.6×
Prq trl rvs ch occ ant&rtrgr (92945) $23,564.64 $26,778 1.9×
Psych diag eval w/med srvcs (90792) $562.32 $639 2.9×
Psychiatric diagnostic evaluation (90791) $494.56 $562 2.6×
Psycl/Nrpsyc Tst Auto Result (96146) $16.72 $19 0.5×
Psytx Crisis Initial 60 Min (90839) $445.28 $506 2.3×
Pt Eval High Complex (97163) $254.32 $289 2.6×
Pt eval low complex 20 min (97161) $224.40 $255 2.3×
Pt Eval Mod Complex (97162) $237.60 $270 2.4×
Pt gait training 15 min (97116) $78.32 $89 2.7×
Pt mechanical traction (97012) $37.84 $43 2.6×
Pt Re-Eval Est Plan Care (97164) $152.24 $173 2.3×
Pulm function test by gas (94727) $249.92 $284 1.1×
Pulmonary service/procedure (94799)
range across 3 matching MRF lines
$36.96–$497.20 $42–$565 varies
Pulmonary Stress Testing (94618) $219.12 $249 1.5×
Pure Tone Audiometry Air (92552) $95.92 $109 0.7×
R Hrt Art/Grft Angio (93457) $10,322.40 $11,730 2.9×
R hrt coronary artery angio (93456) $10,676.16 $12,132 3.0×
R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) $10,176.32 $11,564 2.9×
R&L Hrt Cath W/Ventriclgrphy (93453) $12,223.20 $13,890 3.5×
Rapid Desensitization Procedure Each Hour (95180) $437.36 $497 0.9×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $532.40 $605 1.5×
Refill/Maint Portable Pump (96521) $364.32 $414 1.6×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $168.08 $191 4.2×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $54.56 $62 0.4×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $168.08 $191 4.2×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $160.16 $182 4.0×
Remote 30 Day Ecg Rev/Report (93270) $250.80 $285 6.2×
Remote 30 Day Ecg Tech Supp (93229) $6,023.60 $6,845 14.9×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $61.60 $70 0.4×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981) $132 $150 3.2×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980) $139.92 $159 2.6×
Right Heart Cath (93451) $4,477.44 $5,088 1.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $139.92 $159 0.6×
Rtm dev sply data muscskel sys 2-15 d in 30d pd (98985) $80.08 $91 2.0×
Rtm tx mgmt 1 r-t ia comunicaj cal mo 1st 10 min (98979) $70.40 $80 2.7×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $482.24 $548 3.9×
Sbsq Psyc Collab Care Mgmt (99493) $304.48 $346 2.8×
Self Care Mngment Training (97535) $95.04 $108 2.9×
Sensory Integration Ea 15 Min (97533) $104.72 $119 1.7×
Sleep study unattended (95806) $1,120.24 $1,273 4.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800)
range across 2 matching MRF lines
$855.36–$1,158.96 $972–$1,317 varies
Somatosensory Testing (95938) $1,088.56 $1,237 1.2×
Speech Audiometry Complete (92556) $146.08 $166 2.3×
Speech audiometry threshold (92555) $83.60 $95 1.3×
Speech sound lang comprehen (92523) $637.12 $724 2.8×
Spirometry (94010) $212.96 $242 0.9×
Standardized Cognitive Performance Testing (96125) $414.48 $471 4.0×
Stenger Test, Pure Tone (92565) $61.60 $70 1.0×
Temp transcutaneous pacing (92953)
range across 2 matching MRF lines
$50.16–$995.28 $57–$1,131 varies
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $112.64 $128 5.0×
Ther Ivntj Ea Addl 15 Min (97130) $95.92 $109 4.6×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $107.36 $122 2.9×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $55.44 $63 1.9×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $247.28 $281 2.4×
Ther/Prop/Diag Inj/Inf Proc (96379) $84.48 $96 1.7×
Ther/Proph/Diag Inj Sc/Im (96372) $70.40 $80 0.9×
Ther/Proph/Diag Iv Inf Init (96365) $282.48 $321 1.2×
Therapeutic Activities (97530) $100.32 $114 2.9×
Tobacco Use Cessation Intensive >10 Minutes (99407) $97.68 $111 2.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $23.76 $27 0.6×
Trans Care Mgmt 7 Day Disch (99496) $540.32 $614 3.7×
Tx atrial fib pulm vein isol (93656) $35,867.04 $40,758 1.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $182.16 $207 2.4×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $190.08 $216 7.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $119.68 $136 2.4×
Tympanometry (92567) $83.60 $95 2.1×
Tympanometry and reflex threshold measurements (92550) $140.80 $160 0.6×
Unlisted cardiovascular service/procedure (93799) $2,755.28 $3,131 19.8×
Unlisted Diagnostic Gastroenterology Procedure (91299) $1,538.24 $1,748 11.0×
Vasopneumatic device (97016) $48.40 $55 4.0×
Veeg 2-12 Hr Cont Mntr (95713) $4,856.72 $5,519 12.0×
Vent Mgmt Inpat Init Day (94002) $2,112 $2,400 3.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,726.56 $1,962 2.6×
Visual reinforcement audiometry (vra) (92579) $182.16 $207 0.8×
Vital capacity, total (94150) $178.64 $203 1.3×
Wheelchair Mgmt Ea 15 Min (97542) $52.80 $60 1.7×
Whirlpool Therapy (97022) $37.84 $43 2.4×

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.