Visits & medical services prices at Ridgeview Le Sueur Medical Center

Le Sueur, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acoustic reflex testing (92568) $36.40 $51.50 0.9×
Advance care planning first 30 mins (99497) $189.35 $270.50 1.8×
Airway inhalation treatment (94640) $127.40 $182 0.6×
Analyze neurostim complex (95972) $137.20 $166.50 1.4×
Analyze neurostim no prog (95970) $45.50 $64 0.3×
Analyze neurostim simple (95971) $33
Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed Facility (99170) $202.30 $289 1.0×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $93.80 $134 6.5×
Assessment of aphasia per hr (96105) $371 $530 3.8×
Basic vestibular evaluation (92540) $166.25 $237.50 0.7×
Bedside Swallowing Eval (92610) $126 $180 1.5×
Behavioral and qualitative analysis of voice and resonance (92524) $317.10 $453 2.9×
Brief Emotional/Behavioral Assessment (96127) $11.90 $17 0.3×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $81.20 $116 0.2×
Caloric vestibular test w/rec bi bithermal (92537) $23.10 $33 0.2×
Caloric vestibular test w/rec bi monothermal (92538) $16.10 $23 0.1×
Canalith Repositioning Procedure (95992) $159.60 $228 3.9×
Cardiac Stress Tst,Tracing Only (93017) $856.80 $1,224 3.8×
Cardiopulmonary resuscitation (92950) $741.30 $1,059 3.3×
Cardioversion (92960) $369.60 $447 0.5×
Caregiver hlth risk assmt score doc stnd instrm (96161) $7.70 $11 0.2×
Chemo Hormon Antineopl Sq/Im (96402) $85.40 $122 1.1×
Chemo IV push addl drug (96411) $131.60 $188 1.7×
Chemo prolong 8+ hrs infuse w/pump (96416) $308 $440 0.9×
Chemother, IV infusion, 1 hr (96413) $312.90 $447 0.9×
Chemother, IV infusion, ea add hr (96415) $67.20 $96 0.9×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $258.30 $369 3.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $154 $220 2.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $241.50 $345 0.7×
Chronic care management services 1st 20 min (99490) $136.15 $194.50 1.3×
Color Vision Examination (92283) $111.30 $159 1.8×
Color/duplex Doppler, complete (93975) $1,004.50 $1,435 4.0×
Color/duplex Doppler, limited (93976) $730.10 $1,043 6.7×
Comprehensive Hearing Test (92557) $88.20 $117.50 0.7×
Computerized dynamic posturography (92548) $34.30 $49 0.2×
Conditioning Play Audiometry (92582) $209.30 $299 1.6×
Cont Gluc Monitoring Patient Provided Equipment (95249) $158.20 $226 2.6×
Continuous Glucose Monitoring (95250) $357 $510 2.6×
Cpap/bipap (94660) $493.15 $704.50 2.2×
Critical care (99291) $658.70 $941 0.8×
Dbrdmt prmlg les w/pdt (96574) $670.60 $958 3.2×
Debridement Open Wound 20 Sq Cm< (97597) $228.90 $273 1.1×
Distort Product Evoked Otoacoustic Emisns Limitd (92587) $9.10 $13 0.0×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $12.60 $18 0.0×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $497.70 $711 4.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $680.40 $972 6.2×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $333.20 $476 3.0×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,124.20 $1,606 4.5×
Dup-scan xtr veins unilateral/limited study (93971) $873.60 $1,248 8.0×
Duplex scan extracranial art compl bi study (93880) $781.20 $1,116 3.1×
Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) $191.10 $273 1.4×
Ear and throat examination (92502) $229.60 $328 0.4×
Echo Heart Xthoracic,Limited (93308) $388.15 $554.50 1.6×
EEG awake and asleep (95819) $549.85 $785.50 2.4×
EEG awake drowsy (95816) $819.70 $1,171 3.6×
EEG coma or sleep only (95822) $931 $1,330 4.1×
EEG greater than 1 hour (95813) $868 $1,240 3.8×
Electrocardiogram Tracing (93005) $152.60 $218 2.5×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $712.60 $1,018 3.2×
EMG one extremity (95860) $136.15 $194.50 1.0×
EMG three extremities (95863) $367.15 $381 2.7×
EMG two extremities (95861) $385 $550 2.8×
Er level 1 (99281) $28 $40 0.3×
Er level ii (99282) $100.10 $143 0.6×
Er level iii (99283) $170.10 $243 0.6×
Er level IV (99284) $289.10 $413 0.7×
Er level v (99285) $418.60 $598 0.7×
Esophgl funcj g-esop rflx impd eltrd prolng (91038) $907.20 $1,296 2.3×
Eval speech sound production (92522) $329 $470 2.9×
Evaluate Pt Use Of Inhaler (94664) $44.10 $63 0.2×
External ECG rec>48hr<7d recording (93242) $208.60 $298 5.3×
External ECG rec>48hr<7d scanning alys w/report (93243) $540.40 $772 3.9×
External ECG rec>7d<15d recording (93246) $208.60 $298 5.3×
External ECG rec>7d<15d scanning alys w/report (93247) $567 $810 4.1×
External Ecg Scanning Analysis Report (93226) $86.80 $124 1.4×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $345.10 $493 0.9×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $292.60 $418 1.3×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $192.50 $275 0.2×
Gastrointestinal Tract Imaging Esophagus W/I&R (91111) $2,059.05 $2,941.50 2.2×
Gi tract capsule endoscopy (91110) $1,497.30 $2,139 1.6×
Holter Monitor (93225) $44.80 $64 0.3×
Imm admn sarscov2 vaccine single dose (90480) $27.38 $39.11 0.6×
Immune Admin Oral/Nasal (90473) $40.60 $58 0.5×
Immunization Admin (90471) $50.40 $72 0.7×
Inhalation bronchial challenge testing (95070) $84.70 $121 0.2×
Inital newborn e/m (99460) $221.90 $317 1.6×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) $259 $370 1.9×
Injection intra arterial (96373) $45.50 $65 0.2×
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) $24
Iontophoresis 15 min (97033) $149.10 $213 7.8×
Irrig drug delivery device (96523) $129.50 $185 2.1×
IV infusion hydration each additional hour (96361) $116.20 $166 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $831.60 $1,188 3.7×
IV infusion ther proph addl sequential to 1 hr (96367) $158.20 $226 2.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $831.60 $1,188 3.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $128.10 $183 2.6×
IV push ea addl new drug (96375) $138.60 $198 2.8×
IV push initial (96374) $169.40 $242 0.8×
Liver Elastography W/O Imag W/I&R (91200) $37.45 $53.50 0.3×
Manual therapy 15 min (97140) $127.40 $182 4.6×
Maximum voluntary ventilation (94200) $30.10 $43 0.5×
Mechanical traction (97012) $97.30 $139 6.8×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $77 $102 2.4×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $88.20 $118 2.4×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $40.60 $55.50 2.4×
Methacholine challenge (94070) $87.50 $125 0.2×
Motility study esophagus (91010) $380.80 $544 1.0×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $222.60 $318 2.4×
Multiple Sleep Latency Test (95805) $522.20 $746 0.6×
Nasopharyngoscopy (92511) $283.50 $202.50 1.4×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $207.90 $297 0.9×
Neg press wound tx >50 cm (97608) $60.20 $86 0.1×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $51.10 $73 0.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $58.10 $83 0.3×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $63.70 $91 0.1×
Nerve Conduction Studies 11-12 Studies (95912) $224.70 $321 0.6×
Nerve conduction studies 13/> studies (95913) $249.20 $356 0.6×
Nerve Conduction Studies 3-4 Studies (95908) $114.10 $163 0.5×
Nerve Conduction Studies 5-6 Studies (95909) $137.20 $196 0.6×
Nerve Conduction Studies 7-8 Studies (95910) $174.30 $249 0.4×
Nerve Conduction Studies 9-10 Studies (95911) $199.50 $285 0.5×
Nerve conduction studies; 1-2 studies (95907) $155.40 $222 0.7×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $170.10 $243 1.3×
Newborn resuscitation (99465) $339.50 $485 0.5×
Nitric oxide expired gas determination (95012) $46.20 $66 1.2×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $232.40 $332 1.7×
Nrpsyc tst eval phys/qhp 1st (96132) $310.10 $362 0.8×
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording Non-Facility (92544) $9.10 $13 0.1×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $114.10 $163 2.5×
Oscillating Tracking Test (92545) $9.10 $13 0.0×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $76.30 $94 3.4×
Osteopathic manipulative tx 3-4 body regions (98926) $109.20 $137.50 4.8×
Osteopathic manipulative tx 5-6 body regions (98927) $142.10 $180.50 6.3×
Osteopathic manipulative tx 7-8 body regions (98928) $173.60 $223.50 7.7×
Osteopathic manipulative tx 9-10 body regions (98929) $203.70 $265 9.0×
Ot eval high complex 60 min (97167) $320.60 $458 3.2×
Ot eval low complex 30 min (97165) $248.50 $355 2.5×
Ot eval mod complex 45 min (97166) $222.60 $318 2.2×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $102.20 $146 2.0×
Ot re-evaluation (97168) $189 $270 2.8×
Ot therapeutic activity 15 min (97530) $97.30 $139 2.8×
Paraffin bath pt (97018) $74.20 $106 12.3×
Patch/Application Test Specify Number Tests (95044) $12.60 $18 0.0×
Pdt dstr prmlg les skn illum/activj per day (96567) $331.10 $473 1.6×
Percutaneous tests w/allergenic extracts (95004) $9.10 $13 0.0×
Phlebotomy therapeutic (99195) $231.70 $331 1.7×
Photo patch test(s) (specify number of tests) Facility (95052) $15.40 $22 0.2×
Plethysmography (94726) $107.10 $153 0.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $788.20 $1,126 0.9×
Positional Nystagmus Test (92542) $10.50 $15 0.1×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $35.70 $31.50 0.7×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $25.20 $36 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $30.10 $43 0.6×
Psych diag eval w/med srvcs (90792) $409.50 $585 2.2×
Psychiatric diagnostic evaluation (90791) $416.50 $510 2.2×
Psycl tst eval phys/qhp 1st (96130) $261.80 $374 1.2×
Psytx crisis initial 60 min (90839) $354.20 $446 1.9×
Pt Electrical Stimulation (97032) $119.70 $171 8.1×
Pt eval high complex 45 min (97163) $165.90 $237 1.7×
Pt eval low complex 20 min (97161) $161.70 $231 1.7×
Pt eval mod complex 30 min (97162) $161.70 $231 1.7×
Pt gait training 15 min (97116) $98 $140 3.4×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $120.40 $172 3.7×
Pt re-evaluation (97164) $155.40 $222 2.3×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $100.80 $144 3.1×
Pt-focused hlth risk assmt (96160) $7.70 $11 0.2×
Pulmonary Service/Procedure (94799) $56.70 $81 0.4×
Pure Tone Audiometry Air & Bone (92553) $111.30 $159 0.8×
Pure Tone Audiometry Air Only (92552) $92.40 $132 0.7×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $48.30 $69 0.3×
Rem mntr physiol param dev (99454) $114.80 $164 2.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $20.30 $29 0.5×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $277.90 $397 1.3×
Sleep study attended (95807) $850.50 $1,215 2.2×
Sleep study unattended (95806) $124.60 $178 0.6×
Smoking cessation > 10 min (99407) $66.50 $86 1.7×
Speech Audiometry Complete (92556) $109.20 $156 1.8×
Speech audiometry threshold (92555) $70.70 $101 1.1×
Speech sound lang comprehen (92523) $329 $470 1.5×
Spirometry (94010) $46.90 $67 0.2×
Spontaneous nystagmus test (92541) $10.50 $15 0.1×
Standardized Cognitive Performance Testing (96125) $364.70 $521 3.5×
Temp transcutaneous pacing (92953) $2.80 $4 0.0×
Ther/prop/diag inj/inf proc (96379) $1,011.50 $1,445 20.6×
Therapeutic prophylactic/dx injection subq/im (96372) $133 $190 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $35.70 $41 0.9×
Trans Care Mgmt 14 Day Disch (99495) $500.50 $475.50 3.6×
Trans Care Mgmt 7 Day Disch (99496) $455 $483 3.3×
Tte w/doppler, complete (93306) $1,836.80 $2,624 3.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $305.90 $437 4.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $109.20 $156 1.3×
Tympanometry (92567) $39.90 $47 1.0×
Tympanometry And Reflex Threshold Measurements (92550) $52.50 $75 0.2×
Ultraviolet Light Therapy (96900) $60.90 $87 1.6×
Unlisted otorhinolaryngological service (92700) $369.60 $528 12.2×
Vasc Duplex Scan Extracranial,Limited (93882) $245 $350 2.2×
Vasopneumatic device (97016) $114.80 $164 9.6×
Vent mgmt inpat init day (94002) $681.10 $973 1.1×
Visual reinforcement audiometry (vra) (92579) $106.40 $139 0.5×
Wheelchair Mgmt Ea 15 Min (97542) $90.30 $129 2.9×