Visits & medical services prices at Mayo Clinic Health System In Sparta

Sparta, WI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $10,172.70 $11,303 1.3×
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $172.80 $192 1.4×
Acoustic Reflex Testing (92568) $104.40 $116 2.9×
Actinotherapy Ultraviolet Light (96900) $87.30 $97 2.4×
Admn Sarscov2 Vacc 1 Dose (90480) $51.30 $57 1.3×
Advncd Care Plan 30 Min (99497) $207 $230 2.1×
Airway Inhalation Treatment (94640) $188.10 $209 0.9×
Ambulatory bp mntr w/sw 24 hr+ recording only (93786) $415.80 $462 3.2×
Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) $174.60 $194 1.4×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $75.60 $84 5.3×
Application Modality 1/> Areas Infrared (97026) $29.70 $33 4.4×
Application on-body injector (96377) $92.70 $103 2.0×
Arrhythmia Induction (93618) $3,953.70 $4,393 3.3×
Assessment of aphasia per hr (96105) $269.10 $299 2.8×
Audiometry Air & Bone (92553) $160.20 $178 1.3×
Auditory Function, 60 Min (92620) $309.60 $344 2.5×
Behavral qualit analys voice (92524) $417.60 $464 3.8×
Brief Emotional/Behav Assmt (96127) $77.40 $86 2.1×
C motor evoked upr&lwr limbs (95939) $4,958.10 $5,509 5.9×
Canalith repositioning proc (95992)
range across 2 matching MRF lines
$295.20–$355.50 $328–$395 varies
Car seat/bed test 60 min (94780) $206.10 $229 5.7×
Cardiac Stress Tst,Tracing Only (93017) $671.40 $746 3.2×
Cardiopulmonary resuscitation (92950)
range across 2 matching MRF lines
$2,043–$2,097.90 $2,270–$2,331 varies
Cardioversion (92960)
range across 2 matching MRF lines
$1,606.50–$1,629 $1,785–$1,810 varies
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $11,905.20 $13,228 3.8×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $12,884.40 $14,316 4.1×
Cbt 1st hour (94644) $359.10 $399 2.8×
Chemo Anti-Neopl Sq/Im (96401) $349.20 $388 5.0×
Chemo Hormon Antineopl Sq/Im (96402) $181.80 $202 2.6×
Chemo IV infusion addl hr (96415) $202.50 $225 2.9×
Chemo IV push addl drug (96411) $333 $370 4.8×
Chemother Prolong Infuse W/Pump (96416) $788.40 $876 2.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $403.20 $448 5.8×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $838.80 $932 2.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $584.10 $649 1.8×
Chest Wall Manipulation (94668) $155.70 $173 1.2×
Chron Care Mgmt Srvc 20 Min (99490) $117.90 $131 1.2×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $334.80 $372 1.9×
Comprehensive Hearing Test (92557) $264.60 $294 2.1×
Conditioning Play Audiometry (92582) $207.90 $231 1.7×
Cont gluc mntr physician/qhp provided equiptment (95250) $1,213.20 $1,348 9.4×
Cont Gluc Mntr Pt Prov Eqp (95249) $370.80 $412 6.5×
Continuous Pulse Ox (94762) $255.60 $284 2.0×
Coronary Art/Grft Angio S&I (93455) $9,751.50 $10,835 3.1×
Coronary Artery Angio S&I (93454) $7,107.30 $7,897 2.3×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $914.40 $1,016 4.3×
Cpt initial (94667) $272.70 $303 2.1×
Critical care first hour (99291)
range across 4 matching MRF lines
$1,430.10–$7,282.80 $1,589–$8,092 varies
Debridement Open Wound 20 Sq Cm< (97597) $257.40 $286 1.3×
Dialysis One Evaluation (90945)
range across 2 matching MRF lines
$1,216.80–$3,019.50 $1,352–$3,355 varies
ECG/monitoring and analysis (93271) $1,881 $2,090 20.4×
Echo Congenital Complete (93303) $2,138.40 $2,376 4.0×
Echo Heart Xthoracic,Limited (93308) $1,010.70 $1,123 4.4×
Echo transesophageal (93312) $2,293.20 $2,548 4.3×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $2,239.20 $2,488 4.2×
EEG cont rec w/video by tech min 8 channels (95700) $1,008.90 $1,121 4.8×
Eeg Sleep Only (95822) $1,523.70 $1,693 7.3×
Eeg W/O Vid 2-12 Hr Unmntr (95705) $1,056.60 $1,174 5.0×
EEG wo vid ea 12-26hr unmntr (95708) $1,756.80 $1,952 4.8×
Electrical Stimulation Ea 15 Min (97032) $53.10 $59 3.6×
Electrocardiogram Tracing (93005) $169.20 $188 3.0×
Electrophysiologic Follow-Up W/Pac/Rec W/Arrhyt (93624) $11,160 $12,400 1.5×
Electrophysiology Evaluation (93642) $1,640.70 $1,823 1.4×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
$276.30–$332.10 $307–$369 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines
$407.70–$601.20 $453–$668 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines
$618.30–$954 $687–$1,060 varies
Ep & ablate supravent arrhyt (93653) $28,771.20 $31,968 1.1×
Ep & ablate ventric tachy (93654) $30,948.30 $34,387 1.2×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $9,369 $10,410 1.2×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $12,218.40 $13,576 1.6×
Er level 1 (99281)
range across 2 matching MRF lines
$198–$265.50 $220–$295 varies
Er level v (99285)
range across 4 matching MRF lines
$1,107–$5,625.90 $1,230–$6,251 varies
Evaluate pt use of inhaler (94664) $161.10 $179 0.8×
Evaluate Speech Production (92522) $400.50 $445 3.6×
Evaluate Swallowing Function (92610) $766.80 $852 9.0×
Evaluation of speech fluency (92521) $493.20 $548 3.7×
External Ecg Scanning Analysis Report (93226) $1,269 $1,410 22.1×
F-up/limited tthrc echo congenital car anomaly (93304) $1,648.80 $1,832 3.1×
Flexible endoscopic eval swallow c/v rec (92612) $847.80 $942 4.2×
Fluorescein angiography (92235) $568.80 $632 2.7×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $1,232.10 $1,369 3.4×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $839.70 $933 4.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,731.60 $1,924 2.1×
Gi tract capsule endoscopy (91110) $3,078 $3,420 3.5×
Group Therapeutic Procedures (97150) $73.80 $82 4.1×
Health Behavior Assessment/Re-Assessment (96156) $322.20 $358 3.3×
Health behavior ivntj indiv f2f 1st 30 min (96158) $328.50 $365 1.9×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $14,187.60 $15,764 4.5×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935)
range across 2 matching MRF lines
$636.30–$2,754 $707–$3,060 varies
Holter monitor recording (93225) $664.20 $738 5.1×
Icd device progr eval dual (93283) $214.20 $238 5.9×
Icd Device Progr Eval Mult (93284) $104.40 $116 2.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $51.30 $57 0.7×
Immunization administration (90471) $51.30 $57 0.7×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $997.20 $1,108 2.8×
Insert/Place Heart Catheter (93503) $1,743.30 $1,937 1.1×
Interrogation vad in person (93750) $242.10 $269 2.6×
Intraventricular pacing (93612) $9,601.20 $10,668 1.3×
Iontophoresis 15 min (97033) $117.90 $131 6.2×
Irrig Drug Delivery Device (96523) $158.40 $176 2.8×
IV infusion hydration each additional hour (96361) $110.70 $123 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $281.70 $313 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $235.80 $262 3.4×
IV infusion therapy prophylaxis/dx ea hour (96366) $133.20 $148 2.9×
IV push initial (96374) $208.80 $232 1.0×
L Hrt Art/Grft Angio (93459) $14,919.30 $16,577 4.7×
Lung Function Test (Mbc/Mvv) (94200) $112.50 $125 2.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $61.20 $68 1.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $63 $70 1.7×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $40.50 $45 2.4×
Methacholine challenge (94070) $519.30 $577 1.4×
Motility study esophagus (91010) $1,049.40 $1,166 2.9×
Motion Fluoroscopy/Swallow (92611) $690.30 $767 7.5×
Multiple Family Group Psychotherapy (90849) $243 $270 1.4×
Multiple Sleep Latency Test (95805) $5,288.40 $5,876 6.3×
Muscle Test 2 Limbs (95861) $584.10 $649 4.5×
Muscle Test Nonparaspinal (95870) $252.90 $281 2.0×
Nasopharyngoscopy (92511) $633.60 $704 3.3×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines
$176.40–$189.90 $196–$211 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $291.60 $324 0.7×
Neurobehavioral Status Exam (96116) $307.80 $342 1.5×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $511.20 $568 4.1×
Neuromuscular Reeducation (97112) $113.40 $126 3.5×
Nitric oxide expired gas determination (95012) $132.30 $147 3.6×
Nonphysician Telephone Assessment 21-30 Min (98968) $160.20 $178 4.6×
O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) $853.20 $948 2.4×
Oph bmtry prtl coher intrfrmtry io lens pwr cal (92136) $288.90 $321 2.2×
Opscpy extnd optic nrv/macula drawing i&r uni/bi (92202) $73.80 $82 1.3×
Oral Function Therapy (92526) $366.30 $407 4.4×
Oral Speech Device Eval (92597) $556.20 $618 7.8×
Orthc/Prostc Mgmt Sbsq Enc (97763) $205.20 $228 4.1×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $193.50 $215 4.2×
Ot eval high complexity (97167) $370.80 $412 3.7×
Ot Eval Low Complex (97165) $333.90 $371 3.3×
Ot Eval Moderate Complexity (97166) $349.20 $388 3.5×
Ot manual therapy 15 min (97140) $134.10 $149 4.8×
Ot paraffin bath (97018) $53.10 $59 8.8×
Ot Re-Eval Est Plan Care (97168) $257.40 $286 3.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $346.50 $385 2.8×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $282.60 $314 2.3×
Patch/Application Test Specify Number Tests (95044) $51.30 $57 0.1×
Pdt dstr prmlg les skn illum/activj per day (96567) $1,055.70 $1,173 5.4×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $261 $290 1.2×
Peripheral arterial disease rehab per session (93668) $150.30 $167 2.6×
Perq Tcat Plmt Ntrac St 2+Les 2+St 2+C Segments (92930) $34,163.10 $37,959 1.9×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $9,268.20 $10,298 1.7×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $18,156.60 $20,174 1.6×
Phlebotomy therapeutic (99195)
range across 2 matching MRF lines
$161.10–$284.40 $179–$316 varies
Photochemotx Psoralens&Ultraviolet Puva (96912) $230.40 $256 4.0×
Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) $346.50 $385 6.0×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $326.70 $363 5.7×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $326.70 $363 5.7×
Physical Performance Test (97750) $154.80 $172 4.6×
Plethysmography (94726) $337.50 $375 0.9×
Pm device progr eval dual (93280) $122.40 $136 3.4×
Pm device progr eval multi (93281) $480.60 $534 13.3×
Pm Device Progr Eval Sngl (93279) $96.30 $107 2.7×
Pm/Icd Remote Tech Serv (93296) $381.60 $424 10.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $5,809.50 $6,455 7.0×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $239.40 $266 6.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $47.70 $53 1.0×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $72.90 $81 1.6×
Prq Card Angio/Athrect 1 Art (92924) $20,842.20 $23,158 1.9×
Prq Card Stent W/Angio 1 Vsl (92928) $19,905.30 $22,117 1.8×
Prq Card Stent/Ath/Angio (92933) $26,263.80 $29,182 1.5×
Prq Revasc Byp Graft 1 Vsl (92937) $11,218.50 $12,465 1.0×
Prq trl rvs ch occ ant&rtrgr (92945) $21,513.60 $23,904 1.9×
Psychiatric diagnostic evaluation (90791) $483.30 $537 2.8×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $203.40 $226 0.5×
Pt Eval High Complex (97163) $370.80 $412 3.8×
Pt eval low complex 20 min (97161) $333.90 $371 3.4×
Pt Eval Mod Complex (97162) $349.20 $388 3.6×
Pt gait training 15 min (97116) $128.70 $143 4.4×
Pt mechanical traction (97012) $53.10 $59 3.7×
Pt Re-Eval Est Plan Care (97164) $222.30 $247 3.3×
Pulmonary service/procedure (94799)
range across 3 matching MRF lines
$107.10–$384.30 $119–$427 varies
Pulmonary Stress Testing (94618) $351 $390 2.7×
Pure Tone Audiometry Air (92552) $149.40 $166 1.2×
R Hrt Art/Grft Angio (93457) $14,589.90 $16,211 4.6×
R hrt coronary artery angio (93456) $12,484.80 $13,872 4.0×
R&L Hrt Cath W/Ventriclgrphy (93453) $9,361.80 $10,402 3.0×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $171.90 $191 4.7×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $55.80 $62 0.4×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $171.90 $191 4.7×
Rem ther mntr dev sply data muscskel sys ea 30 d (98977) $237.60 $264 6.6×
Remote 30 Day Ecg Rev/Report (93270) $445.50 $495 12.3×
Remote 30 Day Ecg Tech Supp (93229) $6,398.10 $7,109 17.7×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $90.90 $101 0.7×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98981) $191.70 $213 4.6×
Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time… (98980) $201.60 $224 3.7×
Right Heart Cath (93451) $5,487.30 $6,097 1.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $151.20 $168 0.8×
Rtm dev sply data muscskel sys 2-15 d in 30d pd (98985) $118.80 $132 3.3×
Rtm tx mgmt 1 r-t ia comunicaj cal mo 1st 10 min (98979) $100.80 $112 3.8×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $733.50 $815 6.0×
Select picture audiometry (92583) $139.50 $155 2.4×
Self Care Mngment Training (97535) $138.60 $154 4.3×
Sensory Integration Ea 15 Min (97533) $97.20 $108 1.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800)
range across 2 matching MRF lines
$477.90–$1,188 $531–$1,320 varies
Somatosensory Testing (95938) $3,590.10 $3,989 4.3×
Speech Audiometry Complete (92556) $126.90 $141 2.2×
Speech audiometry threshold (92555) $93.60 $104 1.6×
Speech sound lang comprehen (92523) $830.70 $923 3.7×
Spirometry (94010) $248.40 $276 1.2×
Standardized Cognitive Performance Testing (96125)
range across 2 matching MRF lines
$597.60–$613.80 $664–$682 varies
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $887.40 $986 4.3×
Temp transcutaneous pacing (92953) $157.50 $175 0.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $128.70 $143 5.8×
Ther Ivntj Ea Addl 15 Min (97130) $128.70 $143 6.1×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $134.10 $149 3.6×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $61.20 $68 2.1×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $335.70 $373 3.3×
Ther/Proph/Diag Inj Ia (96373) $74.70 $83 0.4×
Ther/Proph/Diag Inj Sc/Im (96372) $128.70 $143 1.8×
Ther/Proph/Diag Iv Inf Init (96365) $365.40 $406 1.8×
Therapeutic Activities (97530) $134.10 $149 3.8×
Tobacco Use Cessation Intensive >10 Minutes (99407) $108.90 $121 3.0×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $264.60 $294 7.3×
Tte w/doppler, complete (93306) $3,093.30 $3,437 5.8×
Tx atrial fib pulm vein isol (93656) $33,978.60 $37,754 1.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $341.10 $379 4.5×
Tx/Pro/Dx Inj New Drug Addon (96375) $111.60 $124 2.5×
Tympanometry (92567) $117 $130 3.2×
Tympanometry and reflex threshold measurements (92550) $128.70 $143 0.6×
Unlisted cardiovascular service/procedure (93799)
range across 2 matching MRF lines
$245.70–$996.30 $273–$1,107 varies
Unlisted Diagnostic Gastroenterology Procedure (91299) $1,049.40 $1,166 8.4×
Vasopneumatic device (97016) $78.30 $87 6.5×
Veeg 2-12 Hr Cont Mntr (95713) $4,998.60 $5,554 13.8×
Veeg 2-12 hr unmonitored (95711) $1,468.80 $1,632 7.0×
Veeg Ea 12-26 Hr Unmntr (95714) $2,952 $3,280 8.1×
Vent Mgmt Inpat Init Day (94002) $2,088 $2,320 3.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,940.40 $2,156 3.2×
Visual reinforcement audiometry (vra) (92579) $252 $280 1.2×
Vital capacity, total (94150) $143.10 $159 1.1×
Wheelchair Mgmt Ea 15 Min (97542) $66.60 $74 2.1×
Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) $203.40 $226 5.6×

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.