Visits & medical services prices at Perkins County Health Services

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

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

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ProcedurePosted cashPosted gross× Medicare
Airway Inhalation Treatment (94640)
range across 5 matching MRF lines		 $44–$379 $44–$379 varies
Analyze neurostim complex (95972) $387 $387 3.9×
Analyze neurostim no prog (95970) $77 $77 0.6×
Analyze Neurostim Simple (95971) $146 $146 1.5×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035)
range across 7 matching MRF lines		 $85–$94 $85–$94 varies
Application on-body injector (96377) $212 $212 4.4×
Behavral qualit analys voice (92524) $322 $322 2.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $696 $696 1.8×
Cardiac Stress Tst,Tracing Only (93017) $1,152 $1,152 5.1×
Cardiopulmonary resuscitation (92950) $1,646 $1,646 7.3×
Cardioversion (92960) $2,440 $2,440 3.6×
Chemo Anti-Neopl Sq/Im (96401) $304 $304 4.1×
Chemo Hormon Antineopl Sq/Im (96402) $199 $199 2.7×
Chemo IV infusion addl hr (96415) $184 $184 2.5×
Chemo IV push addl drug (96411) $156 $156 2.1×
Chemother Prolong Infuse W/Pump (96416) $719 $719 2.1×
Chemotherapy Unspecified (96549) $136 $136 2.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $153 $153 2.0×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $454 $454 1.3×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $269 $269 0.8×
Color/duplex Doppler, complete (93975) $1,370 $1,370 5.5×
Color/duplex Doppler, limited (93976) $949 $949 8.7×
Computerized Ophthalmic Imaging Optic Nerve (92133) $178 $178 2.9×
Computerized Ophthalmic Imaging Retina (92134) $178 $178 2.9×
Critical care first hour (99291) $1,995 $1,995 2.3×
Debridement Open Wound 20 Sq Cm< (97597)
range across 2 matching MRF lines		 $367–$401 $367–$401 varies
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,542 $1,542 6.2×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $1,028 $1,028 9.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,719 $1,719 6.9×
Dup-scan xtr veins unilateral/limited study (93971) $1,225 $1,225 11.3×
Duplex up extrem art bilat (93930) $1,812 $1,812 7.3×
Duplex up extrem art unilat/ltd (93931) $1,207 $1,207 11.1×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines		 $1,079–$1,388.75 $1,079–$1,388.75 varies
Electrical Stimulation Ea 15 Min (97032) $94 $94 6.4×
Electrocardiogram Tracing (93005) $25 $25 0.4×
Emergency Dept Visit Level 2 (99282) $353 $353 2.2×
Emergency Dept Visit Level 3 (99283) $533 $533 1.9×
Emergency Dept Visit Level 4 (99284) $799 $799 1.8×
Er level 1 (99281) $202 $202 2.3×
Er level v (99285) $1,281 $1,281 2.1×
Evaluate Speech Production (92522) $322 $322 2.9×
Evaluate Swallowing Function (92610) $308 $308 3.6×
External ECG rec>48hr<7d recording (93242) $688 $688 17.7×
External ECG rec>7d<15d recording (93246) $688 $688 17.7×
Extracranial Bilat Study (93880) $1,707 $1,707 6.9×
Facial nerve function studies (92516) $337 $337 1.5×
Flexible endoscopic eval swallow c/v rec (92612) $726 $726 3.6×
Gonioscopy (92020) $171 $171 1.2×
Group Therapeutic Procedures (97150) $113 $113 6.3×
Holter monitor recording (93225)
range across 3 matching MRF lines		 $565–$688 $565–$688 varies
Icd Device Interrogate (93289) $172 $172 4.4×
Icd device progr eval dual (93283) $202 $202 5.2×
Icd Device Progr Eval Mult (93284) $231 $231 6.0×
Ilr Device Eval Progr (93285) $124 $124 3.2×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines		 $34–$35 $34–$35 varies
Immunization administration (90471)
range across 7 matching MRF lines		 $52–$108 $52–$108 varies
Inital newborn e/m (99460) $306 $306 2.2×
Iontophoresis 15 min (97033) $100 $100 5.3×
Irrig Drug Delivery Device (96523) $115 $115 1.9×
IV infusion hydration each additional hour (96361) $115 $115 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $399 $399 1.8×
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines		 $115–$180 $115–$180 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 2 matching MRF lines		 $115–$120 $115–$120 varies
IV push initial (96374) $229 $229 1.0×
Laryngeal Function Studies (92520) $349 $349 2.5×
Lung Function Test (Mbc/Mvv) (94200) $194 $194 3.2×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $56 $56 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $56 $56 1.5×
Nasal function studies (92512) $320 $320 1.4×
Nasopharyngoscopy (92511) $304 $304 1.5×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $467 $467 1.1×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $522 $522 1.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605)
range across 2 matching MRF lines		 $66–$272 $66–$272 varies
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $362 $362 0.9×
Neuromuscular Reeducation (97112)
range across 4 matching MRF lines		 $94–$98 $94–$98 varies
Newborn resuscitation (99465) $727 $727 1.1×
Oral Function Therapy (92526) $234 $234 2.8×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $124 $124 2.7×
Ot eval high complexity (97167) $228 $228 2.3×
Ot Eval Low Complex (97165) $228 $228 2.3×
Ot Eval Moderate Complexity (97166) $228 $228 2.3×
Ot manual therapy 15 min (97140) $98 $98 3.5×
Ot paraffin bath (97018) $66 $66 11.0×
Ot Re-Eval Est Plan Care (97168) $100 $100 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $331 $331 2.5×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $225 $225 1.7×
Peripheral arterial disease rehab per session (93668) $239 $239 3.9×
Phlebotomy therapeutic (99195) $194 $194 1.4×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $331 $331 5.4×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $225 $225 3.7×
Physical Performance Test (97750) $124 $124 3.7×
Pm device eval in person (93288) $141 $141 3.6×
Pm device progr eval dual (93280) $172 $172 4.4×
Pm Device Progr Eval Sngl (93279) $147 $147 3.8×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $177 $177 4.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $33 $33 0.7×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $46 $46 0.9×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $72 $72 0.2×
Pt Eval High Complex (97163) $175 $175 1.8×
Pt eval low complex 20 min (97161) $175 $175 1.8×
Pt Eval Mod Complex (97162) $175 $175 1.8×
Pt gait training 15 min (97116) $94 $94 3.2×
Pt mechanical traction (97012) $90 $90 6.3×
Pt Re-Eval Est Plan Care (97164) $100 $100 1.5×
Pulmonary Stress Testing (94618) $355 $355 2.6×
Refill/Maint Portable Pump (96521) $436 $436 2.0×
Respiratory flow volume loop (94375) $177 $177 0.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602)
range across 2 matching MRF lines		 $64–$204 $64–$204 varies
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $322 $322 2.6×
Self Care Mngment Training (97535) $94 $94 2.9×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $803 $803 3.6×
Speech sound lang comprehen (92523) $322 $322 1.4×
Spirometry (94010) $337 $337 1.5×
Stress Tte Only (93350) $2,153 $2,153 3.8×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $130 $130 5.8×
Ther Ivntj Ea Addl 15 Min (97130) $100 $100 4.8×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $127 $127 3.4×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $98 $98 3.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $234 $234 2.3×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines		 $57–$160 $57–$160 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 2 matching MRF lines		 $307–$401 $307–$401 varies
Therapeutic Activities (97530) $94 $94 2.7×
Tobacco Use Cessation Intensive >10 Minutes (99407) $109 $109 2.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $55 $55 1.4×
Tte w/doppler, complete (93306) $2,564 $2,564 4.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $282 $282 3.7×
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $124 $124 5.2×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines		 $97–$190 $97–$190 varies
Upr/L Xtremity Art 2 Levels (93922) $556 $556 4.0×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $1,088 $1,088 4.9×
Vasopneumatic device (97016) $90 $90 7.5×
Wheelchair Mgmt Ea 15 Min (97542) $75 $75 2.4×
Whirlpool Therapy (97022)
range across 9 matching MRF lines		 $90–$127 $90–$127 varies

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.