Visits & medical services prices at ProHealth Oconomowoc Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Actigraphy Testing Recording Analysis I&R (95803) $280.50 $510 4.8×
Actinotherapy Ultraviolet Light (96900) $51.70 $94 1.4×
Acupunct W/Stimul 15 Min (97813) $63.25 $115 2.2×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $36.85 $67 1.3×
Airway Inhalation Treatment (94640) $239.80 $436 1.1×
Airway resistance by oscillometry (94728) $544.50 $990 4.2×
Analyze neurostim complex (95972) $635.25 $1,155 6.7×
Analyze neurostim no prog (95970) $356.95 $649 2.7×
Analyze Neurostim Simple (95971) $481.25 $875 5.1×
Anrct mano rct sensation&rct balo expulsion test (91125) $1,244.65 $2,263 3.3×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $83.05 $151 5.8×
Application Modality 1/> Areas Infrared (97026) $11 $20 1.6×
Behavral qualit analys voice (92524) $278.30 $506 2.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $762.85 $1,387 2.1×
Canalith repositioning proc (95992) $140.80 $256 3.5×
Car seat/bed test 60 min (94780) $75.90 $138 2.0×
Cardiac Stress Tst,Tracing Only (93017) $1,075.80 $1,956 5.0×
Cardiopulmonary resuscitation (92950) $507.65 $923 2.4×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $44.55 $81 1.7×
Cbt 1st hour (94644) $233.20 $424 1.8×
Chemo Admin Peritoneal Cavity (96446) $554.95 $1,009 1.7×
Chemo Anti-Neopl Sq/Im (96401) $295.90 $538 4.1×
Chemo Hormon Antineopl Sq/Im (96402) $234.30 $426 3.3×
Chemo Ia Push (96420) $669.90 $1,218 2.0×
Chemo IV infusion addl hr (96415) $188.65 $343 2.6×
Chemo IV push addl drug (96411) $309.10 $562 4.3×
Chemother Prolong Infuse W/Pump (96416) $858.55 $1,561 2.6×
Chemotherapy Into Cns (96450) $1,530.10 $2,782 4.7×
Chemotherapy Unspecified (96549) $206.25 $375 4.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $311.85 $567 4.3×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $844.80 $1,536 2.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $453.75 $825 1.4×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $698.50 $1,270 2.1×
Chest Wall Manipulation (94668) $141.35 $257 1.1×
Color/duplex Doppler, complete (93975) $985.05 $1,791 4.1×
Color/duplex Doppler, limited (93976) $470.25 $855 4.5×
Community/Work Reintegration Trainj Ea 15 Min (97537) $99.55 $181 3.1×
Cont gluc mntr physician/qhp provided equiptment (95250) $389.95 $709 2.9×
Cont Gluc Mntr Pt Prov Eqp (95249) $195.80 $356 3.3×
Continuous Pulse Ox (94762) $352 $640 2.7×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $365.75 $665 1.7×
Cpt initial (94667) $211.75 $385 1.6×
Critical care first hour (99291) $2,309.45 $4,199 2.8×
Debridement Open Wound 20 Sq Cm< (97597) $354.75 $645 1.8×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $646.80 $1,176 2.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $616 $1,120 5.9×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,104.40 $2,008 4.6×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $646.25 $1,175 6.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $985.05 $1,791 4.1×
Dup-scan xtr veins unilateral/limited study (93971) $708.40 $1,288 6.8×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $985.05 $1,791 4.1×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $364.10 $662 3.5×
Duplex Scan Hemodialysis Access (93990) $492.80 $896 4.7×
Duplex up extrem art bilat (93930) $1,181.40 $2,148 5.0×
Duplex up extrem art unilat/ltd (93931) $646.25 $1,175 6.2×
ECG/monitoring and analysis (93271) $429 $780 4.5×
Echo Congenital Complete (93303) $1,481.70 $2,694 2.7×
Echo Heart Xthoracic,Limited (93308) $987.25 $1,795 4.2×
Echo transesophag montr cardiac pump functj (93318) $1,899.70 $3,454 3.5×
Echo transesophageal (93312) $2,011.90 $3,658 3.7×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $2,242.35 $4,077 4.1×
Eeg 41-60 Minutes (95812) $1,096.15 $1,993 5.1×
EEG awake and asleep (95819) $1,009.80 $1,836 4.7×
EEG awake drowsy (95816) $797.50 $1,450 3.7×
EEG cont rec w/video by tech min 8 channels (95700) $859.65 $1,563 4.0×
EEG extended monitoring 61-119 minutes (95813) $1,315.05 $2,391 6.1×
EKG signal averaged (93278) $255.20 $464 4.3×
Electrical Stimulation Ea 15 Min (97032) $91.85 $167 6.2×
Electrocardiogram Tracing (93005) $175.45 $319 3.0×
Electroconvulsive Therapy (90870) $1,310.65 $2,383 1.5×
Emergency Dept Visit Level 2 (99282) $498.30 $906 3.3×
Emergency Dept Visit Level 3 (99283) $623.15 $1,133 2.3×
Emergency Dept Visit Level 4 (99284) $1,081.30 $1,966 2.6×
Emg 3 Extremities (95863) $594 $1,080 4.6×
Emg 4 Extremities (95864) $653.40 $1,188 5.1×
Endomyocardial Biopsy (93505) $5,699.10 $10,362 1.8×
Er level 1 (99281) $255.75 $465 3.0×
Er level v (99285) $1,649.45 $2,999 2.8×
Evaluate pt use of inhaler (94664) $154 $280 0.7×
Evaluate Speech Production (92522) $278.30 $506 2.5×
Evaluate Swallowing Function (92610) $254.10 $462 3.0×
Evaluation of speech fluency (92521) $393.25 $715 3.0×
Exercise test for bronchospasm (94617) $281.60 $512 2.1×
External ECG rec>48hr<7d recording (93242) $113.85 $207 3.1×
External ECG rec>48hr<7d scanning alys w/report (93243) $351.45 $639 2.7×
External ECG rec>7d<15d recording (93246) $175.45 $319 4.7×
External ECG rec>7d<15d scanning alys w/report (93247) $351.45 $639 2.7×
External Ecg Scanning Analysis Report (93226) $403.15 $733 6.9×
Extracranial Bilat Study (93880) $985.05 $1,791 4.1×
Extracranial Uni/Ltd Study (93882) $646.25 $1,175 6.2×
Flexible endoscopic eval swallow c/v rec (92612) $316.80 $576 1.6×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,396.45 $2,539 1.6×
Gi tract capsule endoscopy (91110) $1,986.60 $3,612 2.2×
Gi tract imaging intraluminal colon i&r (91113) $1,999.25 $3,635 2.2×
Group Therapeutic Procedures (97150) $31.90 $58 1.8×
Health Behavior Assessment/Re-Assessment (96156) $184.80 $336 1.8×
Holter monitor recording (93225) $498.30 $906 3.8×
Icd Device Interrogate (93289) $177.65 $323 4.8×
Icd device progr eval dual (93283) $128.70 $234 3.5×
Icd Device Progr Eval Mult (93284) $128.70 $234 3.5×
Icm Device Eval (93290) $128.70 $234 3.5×
Ilr Device Eval Progr (93285) $128.70 $234 3.5×
Ilr Device Interrogate (93291) $78.65 $143 2.7×
Im Adm Intransl/Oral 1 Vaccine (90473)
range across 2 matching MRF lines
$11.55–$42.90 $21–$78 varies
Immunization administration (90471)
range across 2 matching MRF lines
$11.55–$79.75 $21–$145 varies
Insert/Place Heart Catheter (93503) $5,387.25 $9,795 3.4×
Interrogate Subq Defib (93261) $128.70 $234 3.5×
Interrogation eval in person wr defibrillator (93292) $128.70 $234 3.5×
Intracranial Complete Study (93886) $985.05 $1,791 4.1×
Iontophoresis 15 min (97033) $113.85 $207 6.0×
Irrig Drug Delivery Device (96523) $127.05 $231 2.2×
IV infusion hydration each additional hour (96361) $106.70 $194 2.3×
IV infusion hydration initial 31 min-1 hour (96360) $432.85 $787 2.0×
IV infusion ther proph addl sequential to 1 hr (96367) $189.75 $345 2.6×
IV infusion therapy prophylaxis/dx ea hour (96366) $83.05 $151 1.8×
IV push initial (96374) $233.75 $425 1.1×
Low frequency non-thermal us (97610) $287.10 $522 1.4×
Lwr Xtr Vasc Stdy Bilat (93924) $1,096.70 $1,994 5.1×
Mechanical chest wall oscillation per session (94669) $292.60 $532 1.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $78.10 $142 2.5×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $66.55 $121 1.8×
Methacholine challenge (94070) $809.60 $1,472 2.2×
Motion Fluoroscopy/Swallow (92611) $328.90 $598 3.6×
Multiple Sleep Latency Test (95805) $2,875.95 $5,229 3.4×
Muscle Test 2 Limbs (95861) $540.10 $982 4.1×
Muscle Test One Limb (95860) $491.15 $893 3.7×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $503.80 $916 2.3×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $271.70 $494 1.3×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $497.75 $905 1.2×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $674.85 $1,227 1.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $327.80 $596 1.6×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $455.40 $828 1.1×
Nerve Conduction Studies 1-2 Studies (95907) $503.80 $916 2.3×
Nerve Conduction Studies 11-12 Studies (95912) $1,882.65 $3,423 5.1×
Nerve conduction studies 13 or more studies (95913) $2,334.75 $4,245 6.3×
Nerve Conduction Studies 3-4 Studies (95908) $737 $1,340 3.4×
Nerve conduction studies 5-6 studies (95909) $1,067 $1,940 5.0×
Nerve conduction studies 7-8 studies (95910) $1,240.80 $2,256 3.3×
Nerve Conduction Studies 9-10 Studies (95911) $1,663.75 $3,025 4.5×
Neurobehavioral Status Exam (96116) $306.90 $558 1.4×
Neuromuscular Reeducation (97112) $152.35 $277 4.7×
Newborn resuscitation (99465) $641.30 $1,166 1.0×
Nonphysician Telephone Assessment 11-20 Min (98967) $27.50 $50 1.1×
Nonphysician Telephone Assessment 21-30 Min (98968) $41.25 $75 1.2×
Nonphysician Telephone Assessment 5-10 Min (98966) $16.50 $30 1.2×
Nrpsyc tst eval phys/qhp 1st (96132) $299.75 $545 0.8×
Oral Function Therapy (92526) $255.75 $465 3.0×
Orthc/Prostc Mgmt Sbsq Enc (97763) $133.10 $242 2.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $139.70 $254 3.0×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $33.55 $61 1.6×
Osteopathic manipulative tx 3-4 body regions (98926) $40.70 $74 1.9×
Osteopathic manipulative tx 5-6 body regions (98927) $44.55 $81 2.1×
Osteopathic manipulative tx 7-8 body regions (98928) $51.70 $94 2.4×
Osteopathic manipulative tx 9-10 body regions (98929) $57.75 $105 2.7×
Ot eval high complexity (97167) $339.90 $618 3.4×
Ot Eval Low Complex (97165) $254.10 $462 2.5×
Ot Eval Moderate Complexity (97166) $295.90 $538 2.9×
Ot manual therapy 15 min (97140) $155.65 $283 5.6×
Ot paraffin bath (97018) $53.35 $97 8.9×
Ot Prosthetic Training, Each 15 Min (97761) $121.55 $221 3.0×
Ot Re-Eval Est Plan Care (97168) $184.25 $335 2.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $288.75 $525 2.2×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $227.15 $413 1.8×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $235.40 $428 1.1×
Peripheral arterial disease rehab per session (93668) $144.65 $263 2.5×
Phlebotomy therapeutic (99195) $294.25 $535 2.2×
Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) $174.35 $317 3.0×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $167.75 $305 2.9×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $168.30 $306 2.9×
Physical Performance Test (97750) $121.55 $221 3.6×
Plethysmography (94726) $520.30 $946 1.4×
Pm device eval in person (93288) $107.80 $196 2.9×
Pm device progr eval dual (93280) $128.70 $234 3.5×
Pm device progr eval multi (93281) $128.70 $234 3.5×
Pm Device Progr Eval Sngl (93279) $128.70 $234 3.5×
Pm/Icd Remote Tech Serv (93296) $128.70 $234 3.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,911.05 $7,111 4.6×
Prgrmg Dev Eval Implantable Subq Lead Dfb System (93260) $145.75 $265 3.9×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $128.70 $234 3.5×
Psych diag eval w/med srvcs (90792) $216.15 $393 1.2×
Psychiatric diagnostic evaluation (90791) $263.45 $479 1.5×
Psychological tst eval svc phys/qhp first hour (96130) $299.75 $545 1.4×
Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) $126.50 $230 0.3×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $154 $280 1.2×
Pt Eval High Complex (97163) $323.95 $589 3.3×
Pt eval low complex 20 min (97161) $246.95 $449 2.5×
Pt Eval Mod Complex (97162) $282.15 $513 2.9×
Pt gait training 15 min (97116) $108.35 $197 3.7×
Pt group caregiver training (97552) $19.80 $36 0.9×
Pt mechanical traction (97012) $83.60 $152 5.8×
Pt Re-Eval Est Plan Care (97164) $139.70 $254 2.1×
Pt ultraviolet (97028) $41.25 $75 4.9×
Pulm function test by gas (94727) $352 $640 1.6×
Pulmonary service/procedure (94799) $109.45 $199 0.9×
Pulmonary Stress Testing (94618) $285.45 $519 2.2×
Pure Tone Audiometry Air (92552) $148.50 $270 1.1×
Rectal sensation tone&compliance study (91124) $819.50 $1,490 3.8×
Refill/Maint Portable Pump (96521) $375.10 $682 1.8×
Rem mntr physiol param 1st dev supply ea 30 d (99454) $119.90 $218 3.2×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $282.15 $513 2.1×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $71.50 $130 1.9×
Remote 30 Day Ecg Rev/Report (93270) $514.80 $936 13.8×
Remote 30 Day Ecg Tech Supp (93229) $682.55 $1,241 1.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $268.40 $488 1.3×
Self Care Mngment Training (97535) $118.25 $215 3.6×
Self-meas bp pt educaj/traing & dev calibration (99473) $80.30 $146 2.8×
Sleep study unattended (95806) $948.75 $1,725 4.4×
Slp caregiver training 1st 30 min (97550) $92.95 $169 1.8×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $750.20 $1,364 3.5×
Speech sound lang comprehen (92523) $380.05 $691 1.7×
Spin/Brain Pump Refil & Main (95991) $488.40 $888 1.6×
Spirometry (94010) $443.85 $807 2.1×
Temp transcutaneous pacing (92953) $1,062.05 $1,931 1.6×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $146.30 $266 6.5×
Ther Ivntj Ea Addl 15 Min (97130) $96.80 $176 4.6×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $146.85 $267 4.0×
Ther/Proph/Diag Inj Sc/Im (96372) $150.70 $274 2.1×
Ther/Proph/Diag Iv Inf Init (96365) $413.60 $752 2.0×
Therapeutic Activities (97530) $156.75 $285 4.5×
Tobacco Use Cessation Intensive >10 Minutes (99407) $68.75 $125 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $48.95 $89 1.3×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $460.35 $837 4.4×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $128.70 $234 3.5×
Tte w/doppler, complete (93306) $2,083.95 $3,789 3.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $271.70 $494 3.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $137.50 $250 2.9×
Unlis neurological/neuromuscular dx px (95999) $585.20 $1,064 4.6×
Unlisted cardiovascular service/procedure (93799) $1,201.75 $2,185 9.4×
Unlisted Diagnostic Gastroenterology Procedure (91299) $914.65 $1,663 7.1×
Upr/L Xtremity Art 2 Levels (93922) $382.25 $695 2.9×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $525.25 $955 2.4×
Vasopneumatic device (97016) $75.90 $138 6.3×
Veeg 2-12 hr intmt mntr (95712) $1,252.35 $2,277 3.4×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $1,991 $3,620 5.4×
Vent Mgmt Inpat Init Day (94002) $1,005.95 $1,829 1.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $998.80 $1,816 1.6×
Vital capacity, total (94150) $151.80 $276 1.2×
Wheelchair Mgmt Ea 15 Min (97542) $101.75 $185 3.3×
Whirlpool Therapy (97022) $97.35 $177 6.2×

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.