Visits & medical services prices at Republic County Hospital

Belleville, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $35.62 $47.50 0.2×
Behavioral and qualitative analysis of voice and resonance (92524) $179.25 $239 1.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $189 $252 0.6×
Canalith Repositioning (95992) $54 $72 1.3×
Car seat/bed test 60 min (94780) $37.50 $50 1.1×
Cardiac Stress Tst,Tracing Only (93017) $236.25 $315 1.2×
Cardiopulmonary exercise testing (94621) $255.75 $341 0.7×
Cardiopulmonary resuscitation (92950) $298.50 $398 1.5×
Cardioversion (92960) $568.50 $758 0.9×
Cbt 1st hour (94644) $78.75 $105 0.6×
Chemo Hormon Antineopl Sq/Im (96402) $39.75 $53 0.6×
Chemo prolong 8+ hrs infuse w/pump (96416) $231 $308 0.8×
Chemother, IV infusion, 1 hr (96413) $231 $308 0.8×
Chemother, IV infusion, ea add hr (96415) $231 $308 3.5×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $39 $52 0.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $39 $52 0.6×
Color/duplex Doppler, complete (93975) $472.50 $630 2.2×
Cpap initiation and management (94660) $51 $68 0.3×
Cpt initial (94667) $48 $64 0.4×
Critical care (99291) $252 $336 0.3×
Debridement Open Wound 20 Sq Cm< (97597) $138 $184 0.7×
Demo &/or eval,pt use,aerosol device (94664) $51 $68 0.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $472.50 $630 2.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $630 $840 2.9×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $472.50 $630 4.9×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $472.50 $630 2.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $472.50 $630 4.9×
Dup-scan xtr veins unilateral/limited study (93971) $472.50 $630 4.9×
Duplex scan extracranial art compl bi study (93880) $472.50 $630 2.2×
Echo Heart Xthoracic,Limited (93308) $708.75 $945 3.2×
Echo transesophageal (93312) $449.25 $599 0.9×
Echo Transthoracic - Congenital Tte Complete (93303) $468.75 $625 0.9×
EEG awake asleep (95819) $292.50 $390 1.5×
EEG awake drowsy (95816) $329.25 $439 1.7×
EKG (93005) $118.50 $158 2.2×
EKG rhythm strip (93041) $31.50 $42 0.6×
Er level 1 (99281) $27.75 $37 0.4×
Er level ii (99282) $53.16 $70.88 0.4×
Er level iii (99283) $114.10 $152.13 0.5×
Er level IV (99284) $163.34 $217.78 0.4×
Er level v (99285) $221.16 $294.88 0.4×
Evaluation of speech fluency (92521) $179.25 $239 1.3×
Evaluation of speech sound production (92522) $179.25 $239 1.6×
Evaluation of swallowing function (92610) $172.50 $230 2.0×
Evoked auditory test,limited (92587) $47.25 $63 0.2×
Exercise tst brncspsm (94617) $330.75 $441 2.7×
External ECG rec>48hr<7d recording (93242) $106.12 $141.50 3.1×
External ECG rec>7d<15d recording (93246) $165 $220 4.8×
External ECG rec>7d<15d scanning alys w/report (93247) $165 $220 1.3×
External Ecg Scanning Analysis Report (93226) $165 $220 3.0×
Eye exam w anesth; limited (92019) $443.25 $591 0.2×
Flow volume loop (94375) $30 $40 0.2×
Group Therapeutic Procedures (97150) $35.25 $47 2.0×
Holter Monitor Recording (93225) $165 $220 1.3×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $19.88 $26.50 0.5×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $26.25 $35 0.4×
Immunization Admin (90471) $26.62 $35.50 0.4×
Immunotherapy, 2+ Injections (95117) $47.25 $63 1.1×
Inital newborn e/m (99460) $118.75 $158.33 1.0×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $76.50 $102 1.4×
IV infusion hydration each additional hour (96361) $95.25 $127 2.2×
IV infusion hydration initial 31 min-1 hour (96360) $170.62 $227.50 0.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $170.62 $227.50 2.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $170.62 $227.50 0.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $116.25 $155 2.7×
IV push initial (96374) $53.62 $71.50 0.3×
Manual therapy 15 min (97140) $64.50 $86 2.3×
Massage 15 min (97124) $57.38 $76.50 1.9×
Maximum voluntary ventilation (94200) $80.25 $107 1.5×
Mechanical chest wall oscillation (94669) $47.25 $63 0.2×
Mechanical traction (97012) $57 $76 4.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $12 $16 0.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $15.75 $21 0.4×
Methacholine challenge (94070) $295.50 $394 0.9×
Mnt Group Ea 30 Min (97804) $6 $8 0.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $294.75 $393 3.2×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $74.25 $99 0.4×
Nitric oxide expired gas determination (95012) $30 $40 0.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $472.50 $630 3.9×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $80.25 $107 0.7×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $60.75 $81 1.3×
Osteopathic manipulative tx 1-2 body regions (98925) $39.75 $53 2.0×
Osteopathic manipulative tx 3-4 body regions (98926) $51.38 $68.50 2.6×
Osteopathic manipulative tx 5-6 body regions (98927) $59.25 $79 3.0×
Osteopathic manipulative tx 7-8 body regions (98928) $26.25 $35 1.3×
Ot Contrast Bath Ea 15 Min (97034) $59.25 $79 4.2×
Ot eval high complex 60 min (97167) $174 $232 1.7×
Ot eval low complex 30 min (97165) $104.25 $139 1.0×
Ot eval mod complex 45 min (97166) $134.25 $179 1.3×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $41.25 $55 0.8×
Ot Prosthetic Training, Each 15 Min (97761) $51.75 $69 1.3×
Ot re-eval est plan care (97168) $170.25 $227 2.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $207 $276 1.7×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $207 $276 1.7×
Paraffin bath (97018) $57.38 $76.50 9.5×
Peripheral arterial disease rehab per session (93668) $93.75 $125 1.7×
Phy/qhp op pulm rhb w/mntr (94626) $596.25 $795 11.0×
Phy/qhp op pulm rhb w/o mntr (94625) $420 $560 7.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,725 $2,300 2.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $47.25 $63 1.1×
Pt Electric Current Therapy (97033) $81.75 $109 4.3×
Pt Electrical Stimulation (97032) $88.50 $118 6.0×
Pt eval high complex 45 min (97163) $170.25 $227 1.7×
Pt eval low complex 20 min (97161) $104.25 $139 1.1×
Pt Gait Training Therapy (97116) $57 $76 2.0×
Pt Infrared Therapy (97026) $21.75 $29 3.3×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $64.50 $86 2.0×
Pt Physical Performance Test (97750) $85.88 $114.50 2.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $134.25 $179 1.4×
Pt re-evaluation (97164) $84 $112 1.2×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $57.75 $77 1.8×
Pt Ultrasound Therapy (97035) $57.38 $76.50 4.0×
Pulm function test by gas (94727) $82.50 $110 0.4×
Pulmonary stress testing (94618) $160.50 $214 1.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $138 $184 4.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $131.25 $175 0.7×
Rt Chest Wall Manipulation,Subsequent (94668) $37.50 $50 0.3×
Sensory Integration Ea 15 Min (97533) $58.50 $78 1.0×
Sleep study unattended (95806) $450 $600 2.3×
Smoking cessation > 10 min (99407) $37.50 $50 1.1×
Speech sound lang comprehen (92523) $136.50 $182 0.6×
Spirometry (94010) $283.50 $378 1.4×
Ther/Proph/Diag Inj Sc/Im (96372) $39.75 $53 0.6×
Therapeutic Activities (97530) $59.25 $79 1.7×
Therapeutic phlebotomy (99195) $75.38 $100.50 0.6×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $19.50 $26 0.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,417.50 $1,890 2.8×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $449.25 $599 2.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $119.25 $159 1.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $119.25 $159 1.4×
Tx/Pro/Dx Inj New Drug Addon (96375) $53.62 $71.50 1.2×
Unlisted Cardiovascular Service/Procedure (93799) $738.75 $985 6.2×
Unlisted pulmonary service/procedure (94799) $48 $64 0.4×
Vasc Duplex Extrem Venous,Bilat (93970) $630 $840 2.9×
Vasc Duplex Scan Extracranial,Limited (93882) $472.50 $630 4.9×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $472.50 $630 2.4×
Vasopneumatic device (97016) $57 $76 4.7×
Ventilation assist & mgmt inpatient 1st day (94002) $348 $464 0.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $250.50 $334 0.4×
Vital capacity total (94150) $15 $20 0.1×
Wheelchair Mgmt Ea 15 Min (97542) $58.50 $78 1.9×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $197.25 $263 2.3×