Visits & medical services prices at Ridgeview Sibley Medical Center
Arlington, MN · every code in this section with a posted price and a Medicare benchmark.
120 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) range across 3 matching MRF lines |
$37.05 | $21.22–$72 | 0.9× |
| Advncd Care Plan 30 Min (99497) | — | $283 | — |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$42.10–$118.30 | $33–$182 | varies |
| Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) | $187.85 | $289 | 0.9× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $87.10 | $134 | 6.1× |
| Application on-body injector (96377) | $58.50 | $90 | 1.2× |
| Assessment of aphasia per hr (96105) | $344.50 | $530 | 3.5× |
| Basic vestibular evaluation (92540) | $239.20 | $368 | 1.1× |
| Brief Emotional/Behav Assmt (96127) | — | $17 | — |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 3 matching MRF lines |
$87.75 | $35–$135 | 0.2× |
| Canalith repositioning proc (95992) | $148.20 | $228 | 3.6× |
| Cardiac Stress Tst,Tracing Only (93017) | $650 | $1,000 | 2.9× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$404.95–$688.35 | $623–$1,059 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$237.90–$1,188.85 | $366–$1,829 | varies |
| Chemo Anti-Neopl Sq/Im (96401) range across 2 matching MRF lines |
$84.39–$239.85 | $129.83–$369 | varies |
| Chemo Hormon Antineopl Sq/Im (96402) range across 2 matching MRF lines |
$84.39–$135.20 | $129.83–$208 | varies |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$109.94–$321.10 | $169.14–$494 | varies |
| Chemo IV push addl drug (96411) range across 2 matching MRF lines |
$170.37–$250.25 | $262.11–$385 | varies |
| Chemother Prolong Infuse W/Pump (96416) | $495.10 | $761.69 | 1.4× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) range across 2 matching MRF lines |
$170.37–$286 | $262.11–$440 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$214.50–$495.10 | $330–$761.69 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $285.43 | $439.12 | 0.8× |
| Chron Care Mgmt Srvc 20 Min (99490) range across 2 matching MRF lines |
$111.80 | $172–$217 | 1.1× |
| Color/duplex Doppler, complete (93975) | $897 | $1,380 | 3.6× |
| Color/duplex Doppler, limited (93976) | $677.95 | $1,043 | 6.3× |
| Continuous Pulse Ox (94762) | $250.90 | $386 | 1.9× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $590.20 | $908 | 2.6× |
| Critical care first hour (99291) range across 2 matching MRF lines |
$471.90–$1,790.75 | $726–$2,755 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$78.65–$277.55 | $121–$427 | varies |
| Debridement Prmlg Hyperkeratotic Les W/Pdt (96574) | $622.70 | $958 | 3.0× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $462.15 | $711 | 4.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $631.80 | $972 | 5.8× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $744.90 | $1,146 | 3.0× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$618.80–$635.05 | $952–$977 | varies |
| Duplex up extrem art unilat/ltd (93931) | $52 | $80 | 0.5× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$54.60–$666.25 | $84–$1,025 | varies |
| EEG awake and asleep (95819) | $125.45 | $193 | 0.6× |
| Electrical Stimulation Ea 15 Min (97032) | $46.80 | $72 | 3.2× |
| Electrocardiogram Tracing (93005) | $166.40 | $256 | 2.7× |
| Emergency Dept Visit Level 2 (99282) range across 3 matching MRF lines |
$92.95–$365.30 | $143–$562 | varies |
| Emergency Dept Visit Level 3 (99283) range across 3 matching MRF lines |
$157.95–$569.40 | $243–$876 | varies |
| Emergency Dept Visit Level 4 (99284) range across 3 matching MRF lines |
$268.45–$941.85 | $413–$1,449 | varies |
| Er level 1 (99281) range across 3 matching MRF lines |
$26–$214.50 | $40–$330 | varies |
| Er level v (99285) range across 3 matching MRF lines |
$388.70–$1,303.90 | $598–$2,006 | varies |
| Evaluate pt use of inhaler (94664) | $94.25 | $145 | 0.4× |
| Evaluate Speech Production (92522) | $305.50 | $470 | 2.7× |
| Evaluate Swallowing Function (92610) | $315.90 | $486 | 3.7× |
| External ECG rec>48hr<7d recording (93242) range across 2 matching MRF lines |
$193.70 | $42–$298 | 5.0× |
| External ECG rec>7d<15d recording (93246) range across 2 matching MRF lines |
$193.70 | $42–$298 | 5.0× |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$790.40–$811.20 | $1,216–$1,248 | varies |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $178.75 | $275 | 0.2× |
| Im Adm Intransl/Oral 1 Vaccine (90473) range across 2 matching MRF lines |
— | $21.22–$58 | — |
| Immunization administration (90471) | — | $72 | — |
| Inital newborn e/m (99460) | $206.05 | $317 | 1.5× |
| Iontophoresis 15 min (97033) | $122.85 | $189 | 6.5× |
| Irrig Drug Delivery Device (96523) range across 2 matching MRF lines |
$102.05–$107.64 | $157–$165.60 | varies |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$75.40–$214.91 | $116–$330.63 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$182.65–$261.78 | $281–$402.74 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$161.20–$214.91 | $248–$330.63 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$104–$252.83 | $160–$388.97 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$106.69–$157.30 | $164.14–$242 | varies |
| Motion Fluoroscopy/Swallow (92611) | $203.45 | $313 | 2.2× |
| Multiple Sleep Latency Test (95805) | $126.10 | $194 | 0.1× |
| Muscle Test One Limb (95860) | $111.80 | $172 | 0.8× |
| Nasopharyngoscopy (92511) | $84.50 | $130 | 0.4× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $47.45 | $73 | 0.1× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $55.90 | $86 | 0.1× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$53.95–$268.45 | $83–$413 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 2 matching MRF lines |
$59.15–$336.70 | $91–$518 | varies |
| Neuromuscular Reeducation (97112) | $89.70 | $138 | 2.7× |
| Newborn resuscitation (99465) | $315.25 | $485 | 0.5× |
| Oral Function Therapy (92526) | $158.60 | $244 | 1.9× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $94.90 | $146 | 1.9× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $105.95 | $163 | 2.3× |
| Ot eval high complexity (97167) | $297.70 | $458 | 3.0× |
| Ot Eval Low Complex (97165) | $230.75 | $355 | 2.3× |
| Ot Eval Moderate Complexity (97166) | $258.70 | $398 | 2.6× |
| Ot manual therapy 15 min (97140) | $94.25 | $145 | 3.4× |
| Ot Re-Eval Est Plan Care (97168) | $175.50 | $270 | 2.6× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $230.10 | $354 | 1.7× |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$63.58–$162.50 | $97.81–$250 | varies |
| Physical Performance Test (97750) | $102.70 | $158 | 3.0× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $270.40 | $416 | 0.3× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | — | $36 | — |
| Psych diag eval w/med srvcs (90792) | $380.25 | $585 | 2.1× |
| Psychiatric diagnostic evaluation (90791) | $331.50 | $510 | 1.8× |
| Psychological tst eval svc phys/qhp first hour (96130) | $243.10 | $374 | 1.1× |
| Psytx Crisis Initial 60 Min (90839) | $289.90 | $446 | 1.6× |
| Pt Eval High Complex (97163) | $270.40 | $416 | 2.8× |
| Pt eval low complex 20 min (97161) | $203.45 | $313 | 2.1× |
| Pt Eval Mod Complex (97162) | $215.80 | $332 | 2.2× |
| Pt gait training 15 min (97116) | $90.35 | $139 | 3.1× |
| Pt mechanical traction (97012) | $90.35 | $139 | 6.3× |
| Pt Re-Eval Est Plan Care (97164) | $113.75 | $175 | 1.7× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) | $7.15 | $11 | 0.2× |
| Rem mntr physiol param 1st dev supply ea 30 d (99454) | $106.60 | $164 | 2.8× |
| Rem mntr physiol param 1st set up pt educaj eqp (99453) | $44.85 | $69 | 0.3× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $258.05 | $397 | 1.2× |
| Same day nb discharge (99463) | $240.50 | $370 | 1.7× |
| Self Care Mngment Training (97535) | $90.35 | $139 | 2.8× |
| Speech sound lang comprehen (92523) | $305.50 | $470 | 1.3× |
| Spirometry (94010) | $61.75 | $95 | 0.3× |
| Standardized Cognitive Performance Testing (96125) | $338.65 | $521 | 3.3× |
| Temp transcutaneous pacing (92953) | $2.60 | $4 | 0.0× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $99.45 | $153 | 4.4× |
| Ther Ivntj Ea Addl 15 Min (97130) | $99.45 | $153 | 4.7× |
| Ther/Prop/Diag Inj/Inf Proc (96379) | $167.70 | $258 | 3.5× |
| Ther/Proph/Diag Inj Sc/Im (96372) | — | $50 | — |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$215.15–$353.91 | $331–$544.47 | varies |
| Therapeutic Activities (97530) | $90.35 | $139 | 2.6× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $55.90 | $86 | 1.4× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $26.65 | $41 | 0.7× |
| Trans Care Mgmt 14 Day Disch (99495) | — | $715 | — |
| Trans Care Mgmt 7 Day Disch (99496) | — | $966 | — |
| Tte w/doppler, complete (93306) | $1,705.60 | $2,624 | 3.0× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $268.45 | $413 | 3.5× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$94.90–$110.90 | $146–$170.62 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $26.65 | $41 | 0.2× |
| Vasopneumatic device (97016) | $106.60 | $164 | 8.9× |
| Vent Mgmt Inpat Init Day (94002) | $632.45 | $973 | 1.0× |
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.