Visits & medical services prices at Pawnee County Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $45 $56 0.3×
Acoustic Reflex Testing (92568) $42 $53 1.1×
Admn Sarscov2 Vacc 1 Dose (90480) $61 $76 1.4×
Advncd Care Plan 30 Min (99497) $145 $181 1.4×
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines		 $15–$200 $19–$250 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035)
range across 4 matching MRF lines		 $65–$66 $81–$83 varies
Application Modality 1/> Areas Diathermy (97024) $33 $41 4.5×
Application Modality 1/> Areas Infrared (97026) $60 $75 9.0×
Application on-body injector (96377) $128 $160 2.6×
Assessment of aphasia per hr (96105) $350 $437 3.6×
Assmt & care planning pt w/cognitive impairment (99483) $474 $593 4.5×
Audiometry Air & Bone (92553) $82 $102 0.6×
Behavral qualit analys voice (92524) $242 $303 2.2×
Brief Emotional/Behav Assmt (96127) $8 $10 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060)
range across 3 matching MRF lines		 $66–$562 $83–$703 varies
Canalith repositioning proc (95992) $95 $119 2.3×
Chemo Anti-Neopl Sq/Im (96401) $240 $300 3.2×
Chemo Hormon Antineopl Sq/Im (96402) $208 $260 2.8×
Chemo IV infusion addl hr (96415) $200 $250 2.7×
Chemo IV push addl drug (96411) $242 $303 3.2×
Chemother Prolong Infuse W/Pump (96416) $600 $750 1.7×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $272 $340 3.6×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $520 $650 1.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $360 $450 1.0×
Color/duplex Doppler, complete (93975) $952 $1,190 3.8×
Color/duplex Doppler, limited (93976) $562 $703 5.2×
Community/Work Reintegration Trainj Ea 15 Min (97537) $72 $90 2.2×
Comprehensive Hearing Test (92557) $150 $188 1.1×
Conditioning Play Audiometry (92582) $79 $99 0.6×
Debridement Open Wound 20 Sq Cm< (97597)
range across 2 matching MRF lines		 $175–$243 $219–$304 varies
Developmental tst admin phys/qhp 1st hour (96112) $108 $135 0.8×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $866 $1,082 3.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $441 $551 4.1×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $952 $1,190 3.8×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $778 $973 7.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,125 $1,406 4.5×
Dup-scan xtr veins unilateral/limited study (93971) $909 $1,136 8.4×
Duplex up extrem art bilat (93930) $930 $1,163 3.8×
Duplex up extrem art unilat/ltd (93931) $800 $1,000 7.4×
Echo Heart Xthoracic,Limited (93308) $634 $792 2.6×
EKG signal averaged (93278) $441 $551 7.2×
Electrical Stimulation Ea 15 Min (97032) $57 $71 3.9×
Electrocardiogram Tracing (93005) $229 $286 3.7×
Emergency Dept Visit Level 2 (99282) $294 $368 1.8×
Emergency Dept Visit Level 3 (99283) $458 $573 1.6×
Emergency Dept Visit Level 4 (99284) $692 $865 1.6×
Er level 1 (99281) $173 $216 2.0×
Er level v (99285) $1,168 $1,460 1.9×
Evaluate pt use of inhaler (94664) $100 $125 0.4×
Evaluate Speech Production (92522) $259 $324 2.3×
Evaluate Swallowing Function (92610) $277 $346 3.3×
Evaluation of speech fluency (92521) $249 $311 1.9×
Evoked Auditory Test,Limited (92587) $118 $147 0.5×
External ECG rec>48hr<7d recording (93242) $268 $335 6.9×
External ECG rec>7d<15d recording (93246) $346 $433 8.9×
Extracranial Bilat Study (93880) $1,120 $1,400 4.5×
Extracranial Uni/Ltd Study (93882) $653 $816 6.0×
Flexible endoscopic eval swallow c/v rec (92612) $390 $487 2.0×
Group Therapeutic Procedures (97150) $74 $92 4.1×
Holter monitor recording (93225) $318 $397 2.3×
Immunization administration (90471)
range across 3 matching MRF lines		 $4–$64 $5–$80 varies
Iontophoresis 15 min (97033) $95 $119 5.0×
Irrig Drug Delivery Device (96523) $153 $191 2.5×
IV infusion hydration each additional hour (96361) $128 $160 2.6×
IV infusion hydration initial 31 min-1 hour (96360) $320 $400 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $160 $200 2.1×
IV infusion therapy prophylaxis/dx ea hour (96366) $144 $180 3.0×
IV push initial (96374) $208 $260 0.9×
Lwr Xtr Vasc Stdy Bilat (93924) $649 $811 2.9×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $96 $120 2.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $200 $250 1.0×
Neuromuscular Reeducation (97112) $86 $108 2.6×
Nrpsyc tst eval phys/qhp 1st (96132) $231 $289 0.6×
Oral Function Therapy (92526) $242 $303 2.9×
Orthc/Prostc Mgmt Sbsq Enc (97763) $90 $113 1.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $82 $103 1.8×
Ot Contrast Bath Ea 15 Min (97034) $53 $66 3.8×
Ot eval high complexity (97167) $208 $260 2.1×
Ot Eval Low Complex (97165) $151 $189 1.5×
Ot Eval Moderate Complexity (97166) $178 $222 1.8×
Ot manual therapy 15 min (97140) $86 $108 3.1×
Ot paraffin bath (97018) $57 $71 9.5×
Ot Prosthetic Training, Each 15 Min (97761) $64 $80 1.6×
Ot Re-Eval Est Plan Care (97168) $122 $152 1.8×
Ot rom hand (95852) $63 $79 2.9×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $108 $135 0.8×
Phlebotomy therapeutic (99195)
range across 2 matching MRF lines		 $129–$174 $161–$217 varies
Physical Performance Test (97750) $78 $98 2.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,912 $3,640 3.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $17 $21 0.3×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $19 $24 0.4×
Pt Eval High Complex (97163) $242 $303 2.5×
Pt eval low complex 20 min (97161) $138 $173 1.4×
Pt Eval Mod Complex (97162) $173 $216 1.8×
Pt gait training 15 min (97116) $78 $98 2.7×
Pt mechanical traction (97012) $65 $81 4.5×
Pt Re-Eval Est Plan Care (97164) $104 $130 1.5×
Pt ultraviolet (97028)
range across 2 matching MRF lines		 $34–$65 $43–$81 varies
Pure Tone Audiometry Air (92552) $56 $70 0.4×
Refill/Maint Portable Pump (96521) $286 $358 1.3×
Remote 30 Day Ecg Rev/Report (93270) $242 $302 6.2×
Remote 30 Day Ecg Tech Supp (93229) $630 $788 1.6×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $137 $171 2.2×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $63 $79 2.4×
Select picture audiometry (92583) $110 $137 1.8×
Self Care Mngment Training (97535) $86 $108 2.7×
Speech Audiometry Complete (92556) $71 $89 1.2×
Speech audiometry threshold (92555) $42 $53 0.7×
Speech sound lang comprehen (92523) $308 $385 1.4×
Spirometry (94010)
range across 3 matching MRF lines		 $46–$259 $57–$324 varies
Standardized Cognitive Performance Testing (96125) $259 $324 2.5×
Stress Tte Only (93350) $1,077 $1,346 1.9×
Test to assess hearing loss using different tone pitches (92575) $34 $42 0.9×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $86 $108 3.8×
Ther Ivntj Ea Addl 15 Min (97130) $69 $86 3.3×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $51 $64 1.7×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines		 $25–$120 $31–$150 varies
Ther/Proph/Diag Iv Inf Init (96365) $320 $400 1.4×
Therapeutic Activities (97530) $82 $103 2.3×
Tobacco Use Cessation Intensive >10 Minutes (99407) $48 $60 1.2×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $26 $32 0.7×
Tte w/doppler, complete (93306) $1,638 $2,048 2.9×
Tte W/O Doppler Complete (93307) $798 $997 3.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $242 $303 3.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $184 $230 3.8×
Tympanometry (92567)
range across 2 matching MRF lines		 $29–$59 $36–$74 varies
Upr/L Xtremity Art 2 Levels (93922) $454 $568 3.3×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $600 $750 2.7×
Vasopneumatic device (97016) $62 $77 5.2×
Wheelchair Mgmt Ea 15 Min (97542)
range across 2 matching MRF lines		 $74–$182 $93–$228 varies
Whirlpool Therapy (97022) $82 $103 5.2×

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.