Visits & medical services prices at Sarah D Culbertson Memorial Hospital
Rushville, IL · every code in this section with a posted price and a Medicare benchmark.
133 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) | $79.20 | $88 | 1.8× |
| Airway Inhalation Treatment (94640) | $47.70 | $53 | 0.2× |
| Analyze neurostim complex (95972) | $137.70 | $153 | 1.4× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $160.20 | $178 | 11.2× |
| Application on-body injector (96377) | $138.60 | $154 | 2.8× |
| Assessment of aphasia per hr (96105) | $419.40 | $466 | 4.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $670.50 | $745 | 1.7× |
| Canalith repositioning proc (95992) | $196.20 | $218 | 4.8× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,208.70 | $1,343 | 5.2× |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$461.70–$1,073.70 | $513–$1,193 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$872.10–$1,260 | $969–$1,400 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $79.20 | $88 | 1.0× |
| Chemo Hormon Antineopl Sq/Im (96402) range across 2 matching MRF lines |
$79.20–$129.60 | $88–$144 | varies |
| Chemo IV infusion addl hr (96415) | $159.30 | $177 | 2.1× |
| Chemo IV push addl drug (96411) | $45 | $50 | 0.6× |
| Chemother Prolong Infuse W/Pump (96416) | $690.30 | $767 | 2.0× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $159.30 | $177 | 2.1× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $690.30 | $767 | 2.0× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $396.90 | $441 | 1.1× |
| Chest Wall Manipulation (94668) | $31.50 | $35 | 0.2× |
| Chron Care Mgmt Srvc 20 Min (99490) | $70.20 | $78 | 0.6× |
| Color/duplex Doppler, limited (93976) range across 3 matching MRF lines |
$259.20–$1,737.90 | $288–$1,931 | varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $147.60 | $164 | 4.6× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $135.90 | $151 | 0.7× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $306 | $340 | 1.3× |
| Cpt initial (94667) | $64.80 | $72 | 0.5× |
| Critical care first hour (99291) | $1,277.10 | $1,419 | 1.4× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$148.50–$469.80 | $165–$522 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) range across 2 matching MRF lines |
$351.90–$796.50 | $391–$885 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) range across 3 matching MRF lines |
$217.80–$569.70 | $242–$633 | varies |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) range across 2 matching MRF lines |
$342.90–$1,691.10 | $381–$1,879 | varies |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 2 matching MRF lines |
$212.40–$1,324.80 | $236–$1,472 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 3 matching MRF lines |
$300.60–$2,247.30 | $334–$2,497 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) range across 3 matching MRF lines |
$189.90–$1,390.50 | $211–$1,545 | varies |
| Duplex up extrem art bilat (93930) range across 2 matching MRF lines |
$347.40–$1,695.60 | $386–$1,884 | varies |
| Duplex up extrem art unilat/ltd (93931) range across 2 matching MRF lines |
$212.40–$1,324.80 | $236–$1,472 | varies |
| Echo Heart Xthoracic,Limited (93308) range across 3 matching MRF lines |
$222.30–$1,362.60 | $247–$1,514 | varies |
| Electrical Stimulation Ea 15 Min (97032) | $164.70 | $183 | 11.2× |
| Electrocardiogram Tracing (93005) range across 4 matching MRF lines |
$54.90–$298.80 | $61–$332 | varies |
| Emergency Dept Visit Level 2 (99282) | $318.60 | $354 | 1.9× |
| Emergency Dept Visit Level 3 (99283) | $478.80 | $532 | 1.6× |
| Emergency Dept Visit Level 4 (99284) | $691.20 | $768 | 1.5× |
| Er level 1 (99281) | $207 | $230 | 2.3× |
| Er level v (99285) | $1,064.70 | $1,183 | 1.7× |
| Evaluate Swallowing Function (92610) | $446.40 | $496 | 5.3× |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$347.40–$1,548 | $386–$1,720 | varies |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$370.80–$1,210.50 | $412–$1,345 | varies |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $45 | $50 | 0.6× |
| Immunization administration (90471) | $79.20 | $88 | 1.0× |
| Iontophoresis 15 min (97033) | $174.60 | $194 | 9.2× |
| Irrig Drug Delivery Device (96523) | $147.60 | $164 | 2.3× |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$45–$187.20 | $50–$208 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 3 matching MRF lines |
$212.40–$447.30 | $236–$497 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) | $254.70 | $283 | 3.3× |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$45–$162 | $50–$180 | varies |
| IV push initial (96374) | $299.70 | $333 | 1.3× |
| Lwr Xtr Vasc Stdy Bilat (93924) range across 2 matching MRF lines |
$217.80–$713.70 | $242–$793 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 2 matching MRF lines |
$24.30–$81 | $27–$90 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$104.40–$106.20 | $116–$118 | varies |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $47.70 | $53 | 2.8× |
| Motion Fluoroscopy/Swallow (92611) | $584.10 | $649 | 6.4× |
| Nasopharyngoscopy (92511) | $687.60 | $764 | 3.2× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $857.70 | $953 | 2.0× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $737.10 | $819 | 1.7× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$391.50–$505.80 | $435–$562 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $630.90 | $701 | 1.4× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$160.20–$174.60 | $178–$194 | varies |
| Nonphysician Telephone Assessment 11-20 Min (98967) | $112.50 | $125 | 4.5× |
| Nonphysician Telephone Assessment 21-30 Min (98968) | $163.80 | $182 | 4.7× |
| Nonphysician Telephone Assessment 5-10 Min (98966) | $90.90 | $101 | 6.6× |
| Ophth medical xm&eval intermediate estab pt (92012) | $382.50 | $425 | 2.7× |
| Oral Function Therapy (92526) | $340.20 | $378 | 4.0× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 2 matching MRF lines |
$147.60–$160.20 | $164–$178 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $118.80 | $132 | 5.1× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $75.60 | $84 | 3.3× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $95.40 | $106 | 4.1× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $118.80 | $132 | 5.1× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $143.10 | $159 | 6.2× |
| Ot eval high complexity (97167) | $424.80 | $472 | 4.2× |
| Ot Eval Low Complex (97165) | $360.90 | $401 | 3.6× |
| Ot Eval Moderate Complexity (97166) | $392.40 | $436 | 3.9× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$147.60–$160.20 | $164–$178 | varies |
| Ot paraffin bath (97018) | $170.10 | $189 | 28.3× |
| Ot Prosthetic Training, Each 15 Min (97761) | $147.60 | $164 | 3.7× |
| Ot Re-Eval Est Plan Care (97168) | $255.60 | $284 | 3.7× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $251.10 | $279 | 1.8× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $202.50 | $225 | 1.5× |
| Oxygen Uptake Rest Indirect (94690) range across 2 matching MRF lines |
$81.90–$100.80 | $91–$112 | varies |
| Percutaneous tests w/allergenic extracts (95004) | $13.50 | $15 | 0.0× |
| Phlebotomy therapeutic (99195) | $314.10 | $349 | 2.2× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $241.20 | $268 | 3.8× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $241.20 | $268 | 3.8× |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $240.30 | $267 | 2.2× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 2 matching MRF lines |
$41.40–$42.30 | $46–$47 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $60.30 | $67 | 1.2× |
| Psych diag eval w/med srvcs (90792) | $407.70 | $453 | 2.1× |
| Psychiatric diagnostic evaluation (90791) | $305.10 | $339 | 1.6× |
| Psytx Crisis Initial 60 Min (90839) | $305.10 | $339 | 1.6× |
| Pt Eval High Complex (97163) | $424.80 | $472 | 4.3× |
| Pt eval low complex 20 min (97161) | $360.90 | $401 | 3.7× |
| Pt Eval Mod Complex (97162) | $392.40 | $436 | 4.0× |
| Pt gait training 15 min (97116) | $162 | $180 | 5.6× |
| Pt mechanical traction (97012) | $228.60 | $254 | 15.9× |
| Pulmonary Stress Testing (94618) | $276.30 | $307 | 1.9× |
| Refill/Maint Portable Pump (96521) | $396.90 | $441 | 1.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $1,210.50 | $1,345 | 30.3× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 3 matching MRF lines |
$218.70–$369 | $243–$410 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $419.40 | $466 | 3.4× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $296.10 | $329 | 6.2× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$147.60–$174.60 | $164–$194 | varies |
| Sensory Integration Ea 15 Min (97533) range across 2 matching MRF lines |
$147.60–$174.60 | $164–$194 | varies |
| Speech sound lang comprehen (92523) | $531.90 | $591 | 2.3× |
| Spirometry (94010) | $288.90 | $321 | 1.2× |
| Standardized Cognitive Performance Testing (96125) | $419.40 | $466 | 4.1× |
| Temp transcutaneous pacing (92953) | $739.80 | $822 | 1.0× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $82.80 | $92 | 3.7× |
| Ther Ivntj Ea Addl 15 Min (97130) | $82.80 | $92 | 3.9× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $188.10 | $209 | 5.1× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $296.10 | $329 | 2.9× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $79.20 | $88 | 1.0× |
| Ther/Proph/Diag Iv Inf Init (96365) | $447.30 | $497 | 2.0× |
| Therapeutic Activities (97530) range across 3 matching MRF lines |
$147.60–$174.60 | $164–$194 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $62.10 | $69 | 1.5× |
| Trans Care Mgmt 14 Day Disch (99495) | $223.20 | $248 | 1.6× |
| Trans Care Mgmt 7 Day Disch (99496) | $303.30 | $337 | 2.1× |
| Tte w/doppler, complete (93306) range across 3 matching MRF lines |
$615.60–$3,270.60 | $684–$3,634 | varies |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $340.20 | $378 | 4.5× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$162–$266.40 | $180–$296 | varies |
| Tympanometry (92567) | $56.70 | $63 | 1.4× |
| Upr/L Xtremity Art 2 Levels (93922) range across 4 matching MRF lines |
$110.70–$741.60 | $123–$824 | varies |
| Vent Mgmt Inpat Init Day (94002) | $1,519.20 | $1,688 | 2.3× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $667.80 | $742 | 1.0× |
| Wheelchair Mgmt Ea 15 Min (97542) | $147.60 | $164 | 4.8× |
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.