Visits & medical services prices at Phelps Memorial Health Center

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

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $167.40 $186 1.6×
Airway inhalation treatment (94640) $144.90 $161 0.6×
Appl on-body injector for timed subq injection (96377) $155.70 $173 3.2×
Behavioral and qualitative analysis of voice and resonance (92524) $299.25 $332.50 2.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $688.50 $765 1.8×
Capsule endoscopy (91110) $2,722.05 $3,024.50 2.9×
Cardiac Stress Tst,Tracing Only (93017) $1,278.90 $1,421 5.7×
Cardiopulmonary resuscitation (92950) $626.40 $696 2.8×
Cardioversion (92960) $1,045.80 $1,162 1.5×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $10,261.35 $11,401.50 3.0×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $16,491.60 $18,324 4.9×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $14,745.15 $16,383.50 4.4×
Chemo Hormon Antineopl Sq/Im (96402) $255.60 $284 3.4×
Chemo IV push addl drug (96411) $311.40 $346 4.2×
Chemo Iv Push Sngl Drug (96409) $501.30 $557 1.5×
Chemo prolong 8+ hrs infuse w/pump (96416) $677.70 $753 2.0×
Chemother, IV infusion, 1 hr (96413) $593.55 $659.50 1.7×
Chemother, IV infusion, ea add hr (96415) $230.40 $256 3.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $308.70 $343 4.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $324 $360 4.3×
Color/duplex Doppler, complete (93975) $1,202.40 $1,336 4.9×
Color/duplex Doppler, limited (93976) $1,464.30 $1,627 13.5×
Cont Gluc Monitoring Patient Provided Equipment (95249) $232.20 $258 3.8×
Continuous Glucose Monitoring (95250) $510.30 $567 3.7×
Coronary artery angio s&i (93454) $10,075.50 $11,195 3.0×
Cpap initiation and management (94660) $909.90 $1,011 4.0×
Cpt initial (94667) $206.10 $229 1.5×
Critical care (99291) $513.90 $571 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $184.50 $205 0.9×
Demo &/or eval,pt use,aerosol device (94664) $174.60 $194 0.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $936 $1,040 3.8×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,278.90 $1,421 5.2×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $1,023.30 $1,137 9.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,211.40 $1,346 4.9×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,092.60 $1,214 10.1×
Dup-scan xtr veins unilateral/limited study (93971) $1,196.10 $1,329 11.0×
Duplex scan extracranial art compl bi study (93880) $1,558.80 $1,732 6.3×
Echo Heart Xthoracic,Limited (93308) $947.70 $1,053 3.8×
Echo transesophageal (93312) $1,746.45 $1,940.50 3.1×
EKG (93005) $19.80 $22 0.3×
Er level 1 (99281) $45 $50 0.5×
Er level ii (99282) $80.55 $89.50 0.5×
Er level iii (99283) $137.70 $153 0.5×
Er level IV (99284) $235.35 $261.50 0.5×
Er level v (99285) $397.35 $441.50 0.6×
Evaluation of speech fluency (92521) $284.40 $316 2.1×
Evaluation of swallowing function (92610) $373.95 $415.50 4.4×
External ECG rec>48hr<7d recording (93242) $27.90 $31 0.7×
External ECG rec>7d<15d recording (93246) $40.50 $45 1.0×
Flow volume loop (94375) $207 $230 0.9×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $2,594.70 $2,883 2.9×
Holter Monitor Recording (93225) $613.80 $682 4.4×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $32.40 $36 0.8×
Immunization Admin (90471) $83.70 $93 1.1×
Immunotherapy, 2+ Injections (95117) $20.70 $23 0.4×
Inital newborn e/m (99460) $179.10 $199 1.3×
Initial normal newborn care, same day discharge (99463) $207 $230 1.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $178.20 $198 2.9×
IV infusion hydration each additional hour (96361) $109.80 $122 2.3×
IV infusion hydration initial 31 min-1 hour (96360) $400.50 $445 1.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $199.80 $222 2.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $419.40 $466 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $134.10 $149 2.8×
IV push initial (96374) $250.20 $278 1.1×
Manual therapy 15 min (97140) $123.30 $137 4.4×
Mechanical traction (97012) $97.20 $108 6.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $63.90 $71 2.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $52.20 $58 1.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $487.80 $542 5.3×
Nasopharyngoscopy (92511) $300.60 $334 1.5×
Neg press wnd tx </=50 sq cm (97607) $513 $570 1.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $78.75 $87.50 0.4×
Newborn resuscitation (99465) $272.70 $303 0.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $574.20 $638 4.2×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $861.30 $957 3.8×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $467.10 $519 3.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $105.75 $117.50 2.3×
Osteopathic manipulative tx 1-2 body regions (98925) $61.20 $68 2.7×
Osteopathic manipulative tx 3-4 body regions (98926) $89.10 $99 4.0×
Osteopathic manipulative tx 5-6 body regions (98927) $116.10 $129 5.2×
Osteopathic manipulative tx 7-8 body regions (98928) $143.10 $159 6.4×
Osteopathic manipulative tx 9-10 body regions (98929) $165.60 $184 7.4×
Ot eval high complex 60 min (97167) $265.50 $295 2.6×
Ot eval low complex 30 min (97165) $220.50 $245 2.2×
Ot eval mod complex 45 min (97166) $245.70 $273 2.4×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $89.10 $99 1.8×
Ot Range Motion Measure,Each Extrem (95851) $43.20 $48 1.7×
Ot re-eval est plan care (97168) $220.50 $245 3.2×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $278.10 $309 2.1×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $245.70 $273 1.8×
Paraffin bath (97018) $87.30 $97 14.5×
Peripheral arterial disease rehab per session (93668) $204.30 $227 3.3×
Phy/qhp op pulm rhb w/mntr (94626) $182.70 $203 3.0×
Phy/qhp op pulm rhb w/o mntr (94625) $172.80 $192 2.8×
Plethysmography (94726) $578.70 $643 1.5×
Pm device progr eval dual (93280) $172.80 $192 4.5×
Pm device progr eval multi (93281) $112.50 $125 2.9×
Pm device progr eval sngl (93279) $148.50 $165 3.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,647.60 $5,164 5.2×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $241.20 $268 6.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $18 $20 0.4×
Programming of dual lead implantable defibrillator system (93283) $238.50 $265 6.2×
Programming of single lead implantable defibrillator system (93282) $140.40 $156 3.6×
Prq card revasc chronic 1vsl (92943) $13,876.20 $15,418 1.2×
Prq Card Stent W/Angio 1 Vsl (92928) $13,394.70 $14,883 1.1×
Prq trluml coronary angioplasty one art/branch (92920) $10,716.30 $11,907 1.8×
Psych diag eval w/med srvcs (90792) $333 $370 1.8×
Psychiatric diagnostic evaluation (90791) $298.80 $332 1.6×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $90.90 $101 0.7×
Pt Aquatic Therapy/Exercises (97113) $128.70 $143 3.5×
Pt Electric Current Therapy (97033) $132.30 $147 6.9×
Pt eval high complex 45 min (97163) $245.70 $273 2.5×
Pt eval low complex 20 min (97161) $207.90 $231 2.1×
Pt Gait Training Therapy (97116) $107.10 $119 3.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $112.50 $125 3.4×
Pt Physical Performance Test (97750) $134.10 $149 4.0×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $220.50 $245 2.3×
Pt re-evaluation (97164) $207.90 $231 3.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $123.30 $137 3.8×
Pt Ultrasound Therapy (97035) $95.40 $106 6.6×
Pt Whirlpool Therapy (97022) $121.05 $134.50 7.7×
Pulm function test by gas (94727) $545.40 $606 2.4×
Pulmonary stress testing (94618) $409.50 $455 3.0×
R & l hrt cath w/njx l ventriculog img s&i (93453) $15,405.30 $17,117 4.6×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $18,361.35 $20,401.50 5.5×
Refill/Maint Pump/Resvr Syst (96522) $909 $1,010 4.1×
Refill/maint, portable pump (96521) $407.70 $453 1.8×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $524.70 $583 13.5×
Right heart cath (93451) $6,693.30 $7,437 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $157.50 $175 0.8×
Rt Chest Wall Manipulation,Subsequent (94668) $113.40 $126 0.8×
Sleep study unattended (95806) $602.10 $669 2.7×
Speech sound lang comprehen (92523) $313.65 $348.50 1.4×
Spirometry (94010) $343.80 $382 1.5×
Stress echo (93350) $1,859.40 $2,066 3.3×
Stress Tte Complete (93351) $3,200.40 $3,556 5.6×
Ther/Proph/Diag Inj Sc/Im (96372) $94.50 $105 1.3×
Therapeutic Activities (97530) $182.46 $202.74 5.2×
Therapeutic phlebotomy (99195) $192.60 $214 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $49.50 $55 1.3×
Trans Care Mgmt 14 Day Disch (99495) $356.40 $396 2.6×
Trans Care Mgmt 7 Day Disch (99496) $467.10 $519 3.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,416.50 $2,685 4.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $308.70 $343 4.1×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $294.30 $327 3.5×
Tx/Pro/Dx Inj New Drug Addon (96375) $191.70 $213 3.9×
Tympanometry (92567) $60.30 $67 1.6×
Unlisted pulmonary service/procedure (94799) $294.75 $327.50 2.2×
Vasc Duplex Extrem Venous,Bilat (93970) $1,499.40 $1,666 6.1×
Vasc Duplex Scan Extracranial,Limited (93882) $1,153.80 $1,282 10.6×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,013.40 $1,126 4.5×
Vasopneumatic device (97016) $100.80 $112 8.4×
Ventilation assist & mgmt inpatient 1st day (94002) $1,632.60 $1,814 2.5×
Wheelchair Mgmt Ea 15 Min (97542) $105.30 $117 3.4×