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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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $379 $379 1.7×
Analyze Neurostim Complex (95972) $387 $387 3.9×
Analyze neurostim no prog (95970) $77 $77 0.6×
Appl on-body injector for timed subq injection (96377) $212 $212 4.4×
Behavioral and qualitative analysis of voice and resonance (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 Hormon Antineopl Sq/Im (96402) $199 $199 2.7×
Chemo IV push addl drug (96411) $156 $156 2.1×
Chemo Iv Push Sngl Drug (96409) $269 $269 0.8×
Chemo prolong 8+ hrs infuse w/pump (96416) $719 $719 2.1×
Chemother, IV infusion, 1 hr (96413) $454 $454 1.3×
Chemother, IV infusion, ea add hr (96415) $184 $184 2.5×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $304 $304 4.1×
Chemotherapy, unspecified procedure (96549) $136 $136 2.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $153 $153 2.0×
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×
Cptrized oph dx img pst segment uni/bi retina (92134) $178 $178 2.9×
Critical care (99291) $1,995 $1,995 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $384 $384 1.8×
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 Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,812 $1,812 7.3×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,207 $1,207 11.1×
Dup-scan xtr veins unilateral/limited study (93971) $1,225 $1,225 11.3×
Duplex scan extracranial art compl bi study (93880) $1,707 $1,707 6.9×
Echo Heart Xthoracic,Limited (93308) $1,233.88 $1,233.88 5.0×
EKG (93005) $25 $25 0.4×
Elec alys nstim pls gen smpl sc/perph w/prgrmg (95971) $146 $146 1.5×
Er level 1 (99281) $202 $202 2.3×
Er level ii (99282) $353 $353 2.2×
Er level iii (99283) $533 $533 1.9×
Er level IV (99284) $799 $799 1.8×
Er level v (99285) $1,281 $1,281 2.1×
Evaluation of speech sound production (92522) $322 $322 2.9×
Evaluation of swallowing function (92610) $308 $308 3.6×
Evaluation with prescription of speech-generating alternative (92607) $322 $322 2.6×
External ECG rec>48hr<7d recording (93242) $688 $688 17.7×
External ECG rec>7d<15d recording (93246) $688 $688 17.7×
Facial nerve function studies (92516) $337 $337 1.5×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $726 $726 3.6×
Flow volume loop (94375) $177 $177 0.8×
Gonioscopy (92020) $171 $171 1.2×
Group Therapeutic Procedures (97150) $113 $113 6.3×
Holter Monitor Recording (93225) $688 $688 5.0×
Icd Device Interrogate (93289) $172 $172 4.4×
Ilr Device Eval Progr (93285) $124 $124 3.2×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $34.50 $34.50 0.5×
Immunization Admin (90471) $52 $52 0.7×
Immunotherapy, 2+ Injections (95117) $46 $46 0.9×
Inital newborn e/m (99460) $306 $306 2.2×
Irrigaj Implntd Venous Access Drug Delivery Syst (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, therap/proph/diagnost,add infusion,1st hour (96367) $147.50 $147.50 2.0×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $354 $354 1.6×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $117.50 $117.50 2.4×
IV push initial (96374) $229 $229 1.0×
Laryngeal Function Studies (92520) $349 $349 2.5×
Manual therapy 15 min (97140) $98 $98 3.5×
Massage 15 min (97124) $98 $98 3.3×
Maximum voluntary ventilation (94200) $194 $194 3.2×
Mechanical traction (97012) $90 $90 6.3×
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 press wnd tx </=50 sq cm (97607) $467 $467 1.1×
Neg press wound tx >50 cm (97608) $522 $522 1.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $169 $169 0.8×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $362 $362 0.9×
Newborn resuscitation (99465) $727 $727 1.1×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $556 $556 4.0×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $1,088 $1,088 4.9×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $124 $124 2.7×
Ot eval high complex 60 min (97167) $228 $228 2.3×
Ot eval low complex 30 min (97165) $228 $228 2.3×
Ot eval mod complex 45 min (97166) $228 $228 2.3×
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×
Paraffin bath (97018) $66 $66 11.0×
Peripheral arterial disease rehab per session (93668) $239 $239 3.9×
Phy/qhp op pulm rhb w/mntr (94626) $331 $331 5.4×
Phy/qhp op pulm rhb w/o mntr (94625) $225 $225 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×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $231 $231 6.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $33 $33 0.7×
Programming of dual lead implantable defibrillator system (93283) $202 $202 5.2×
Programming of single lead implantable defibrillator system (93282) $177 $177 4.6×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $72 $72 0.2×
Pt Aquatic Therapy/Exercises (97113) $127 $127 3.4×
Pt Electric Current Therapy (97033) $100 $100 5.3×
Pt Electrical Stimulation (97032) $94 $94 6.4×
Pt eval high complex 45 min (97163) $175 $175 1.8×
Pt eval low complex 20 min (97161) $175 $175 1.8×
Pt Gait Training Therapy (97116) $94 $94 3.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $94 $94 2.9×
Pt Physical Performance Test (97750) $124 $124 3.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $175 $175 1.8×
Pt re-evaluation (97164) $100 $100 1.5×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $94 $94 2.9×
Pt Ultrasound Therapy (97035) $85 $85 5.9×
Pt Whirlpool Therapy (97022) $108 $108 6.9×
Pulmonary stress testing (94618) $355 $355 2.6×
Refill/maint, portable pump (96521) $436 $436 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $134 $134 0.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $803 $803 3.6×
Smoking cessation > 10 min (99407) $109 $109 2.8×
Speech group therapy (92508) $124 $124 5.2×
Speech sound lang comprehen (92523) $322 $322 1.4×
Spirometry (94010) $337 $337 1.5×
Stress echo (93350) $2,153 $2,153 3.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $130 $130 5.8×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $100 $100 4.8×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $234 $234 2.3×
Ther/Proph/Diag Inj Sc/Im (96372) $57 $57 0.8×
Therapeutic Activities (97530) $94 $94 2.7×
Therapeutic phlebotomy (99195) $194 $194 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $55 $55 1.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,564 $2,564 4.5×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $282 $282 3.7×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $234 $234 2.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $143.50 $143.50 3.0×
Vasc Duplex Extrem Venous,Bilat (93970) $1,719 $1,719 6.9×
Vasopneumatic device (97016) $90 $90 7.5×
Wheelchair Mgmt Ea 15 Min (97542) $75 $75 2.4×