Visits & medical services prices at Sauk Prairie Hospital
Prairie Du Sac, WI · every code in this section with a posted price and a Medicare benchmark.
178 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 1St psychiatric collab care mgmt 1st 70 mins (99492) | $524.85 | $959.50 | 5.3× |
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) | $178.33 | $326 | 1.4× |
| Acoustic Reflex Testing (92568) | $176.14 | $322 | 4.9× |
| Actinotherapy Ultraviolet Light (96900) | $61.27 | $112 | 1.7× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $30.36 | $55.50 | 0.8× |
| Airway Inhalation Treatment (94640) range across 6 matching MRF lines |
$38.57–$182.98 | $70.50–$334.50 | varies |
| Analyze Neurostim Simple (95971) | $164.10 | $300 | 1.8× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 7 matching MRF lines |
$108.04–$476.17 | $197.50–$870.50 | varies |
| Assessment of aphasia per hr (96105) | $514.18 | $940 | 5.3× |
| Audiometry Air & Bone (92553) | $143.87 | $263 | 1.2× |
| Basic vestibular evaluation (92540) | $213.88 | $391 | 1.0× |
| Behavral qualit analys voice (92524) | $441.71 | $807.50 | 4.0× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $165.22 | $302.03 | 2.0× |
| Bfb training ea addl 15 min (90913) range across 3 matching MRF lines |
$165.20–$494.77 | $302–$904.50 | varies |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) range across 3 matching MRF lines |
$155.90–$232.75 | $285–$425.50 | varies |
| Caloric Vstblr Test W/Rec (92537) | $57.99 | $106 | 0.5× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$138.40–$174.77 | $253–$319.49 | varies |
| Car seat/bed test 60 min (94780) | $137.85 | $252 | 3.8× |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$272.41–$553.02 | $498–$1,011 | varies |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$278.97–$531.69 | $510–$972 | varies |
| Cardioversion (92960) range across 3 matching MRF lines |
$859.34–$926.90 | $1,571–$1,694.50 | varies |
| Care mgmt services behavioral hlth cond 20 mins (99484) | $187.90 | $343.50 | 5.2× |
| Cbt 1st hour (94644) | $90.53 | $165.50 | 0.7× |
| Chemo Anti-Neopl Sq/Im (96401) range across 2 matching MRF lines |
$81.51–$96.55 | $149–$176.50 | varies |
| Chemo Hormon Antineopl Sq/Im (96402) | $102.29 | $187 | 1.5× |
| Chest Wall Manipulation (94668) | $51.15 | $93.50 | 0.4× |
| Chron Care Mgmt Srvc 20 Min (99490) | $198.02 | $362 | 2.0× |
| Color/duplex Doppler, complete (93975) | $577.64 | $1,056 | 2.5× |
| Color/duplex Doppler, limited (93976) | $399.86 | $731 | 3.9× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) range across 5 matching MRF lines |
$76.04–$303.32 | $139–$554.50 | varies |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $414.63 | $758 | 2.4× |
| Comprehensive Hearing Test (92557) | $210.33 | $384.50 | 1.7× |
| Conditioning Play Audiometry (92582) | $112.69 | $206 | 0.9× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $474.25 | $867 | 3.7× |
| Continuous Pulse Ox (94762) | $147.69 | $270 | 1.2× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 5 matching MRF lines |
$261.47–$424.75 | $478–$776.50 | varies |
| Cpt initial (94667) range across 3 matching MRF lines |
$68.93–$158.36 | $126–$289.50 | varies |
| Critical care first hour (99291) range across 2 matching MRF lines |
$669.53–$2,606.46 | $1,224–$4,765 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 6 matching MRF lines |
$25.17–$245.06 | $46–$448 | varies |
| Developmental tst admin phys/qhp 1st hour (96112) | $514.18 | $940 | 4.1× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $814.49 | $1,489 | 3.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) range across 2 matching MRF lines |
$3,048.16–$3,048.71 | $5,572.50–$5,573.50 | varies |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,529.42 | $2,796 | 15.1× |
| Duplex up extrem art bilat (93930) | $814.49 | $1,489 | 3.5× |
| ECG/monitoring and analysis (93271) | $80.41 | $147 | 0.9× |
| Echo Congenital Complete (93303) | $1,490.31 | $2,724.50 | 2.8× |
| Echo Heart Xthoracic,Limited (93308) range across 4 matching MRF lines |
$661.60–$762.25 | $1,209.50–$1,393.50 | varies |
| Electrical Stimulation Ea 15 Min (97032) range across 9 matching MRF lines |
$108.04–$476.17 | $197.50–$870.50 | varies |
| Electrocardiogram Tracing (93005) range across 3 matching MRF lines |
$66.74–$154.26 | $122–$282 | varies |
| Emergency Dept Visit Level 2 (99282) range across 2 matching MRF lines |
$231.93–$637.81 | $424–$1,166 | varies |
| Emergency Dept Visit Level 3 (99283) range across 2 matching MRF lines |
$323.56–$1,160.74 | $591.50–$2,122 | varies |
| Emergency Dept Visit Level 4 (99284) range across 2 matching MRF lines |
$437.06–$1,958.54 | $799–$3,580.50 | varies |
| Er level 1 (99281) range across 2 matching MRF lines |
$145.78–$314.53 | $266.50–$575 | varies |
| Er level v (99285) range across 2 matching MRF lines |
$588.58–$2,933.84 | $1,076–$5,363.50 | varies |
| Esophgl funcj g-esop rflx impd eltrd prolng (91038) range across 2 matching MRF lines |
$158.36–$1,431.23 | $289.50–$2,616.50 | varies |
| Evaluate pt use of inhaler (94664) range across 3 matching MRF lines |
$41.58–$158.36 | $76–$289.50 | varies |
| Evaluate Speech Production (92522) | $441.71 | $807.50 | 3.9× |
| Evaluate Swallowing Function (92610) | $441.71 | $807.50 | 5.2× |
| Evaluation of speech fluency (92521) | $441.71 | $807.50 | 3.3× |
| Evoked Auditory Test,Limited (92587) | $122.53 | $224 | 0.6× |
| Exercise test for bronchospasm (94617) | $242.60 | $443.50 | 1.9× |
| External ECG rec>48hr<7d recording (93242) | $80.41 | $147 | 2.2× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $698.52 | $1,277 | 5.4× |
| External ECG rec>7d<15d recording (93246) | $80.41 | $147 | 2.2× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $759.24 | $1,388 | 5.9× |
| Extracranial Bilat Study (93880) | $1,126.82 | $2,060 | 4.9× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,069.12 | $1,954.50 | 2.0× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) | $137.85 | $252 | 0.4× |
| Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) range across 4 matching MRF lines |
$131.28–$463.31 | $240–$847 | varies |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $227.28 | $415.50 | 0.3× |
| Group Therapeutic Procedures (97150) | $92.45 | $169 | 5.1× |
| Immunization administration (90471) | $49.78 | $91 | 0.7× |
| Insert/Place Heart Catheter (93503) | $405.33 | $741 | 0.3× |
| Iontophoresis 15 min (97033) range across 3 matching MRF lines |
$171.22–$188.72 | $313–$345 | varies |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$76.86–$98.19 | $140.50–$179.50 | varies |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$59.63–$82.05 | $109–$150 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 3 matching MRF lines |
$175.32–$278.43 | $320.50–$509 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) | $86.16 | $157.50 | 1.2× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $82.05 | $150 | 1.8× |
| IV push initial (96374) range across 2 matching MRF lines |
$65.64–$158.09 | $120–$289 | varies |
| Lung Function Test (Mbc/Mvv) (94200) | $99.29 | $181.50 | 1.7× |
| Mechanical chest wall oscillation per session (94669) range across 2 matching MRF lines |
$61.82–$94.91 | $113–$173.50 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) range across 5 matching MRF lines |
$35.01–$139.76 | $64–$255.50 | varies |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 5 matching MRF lines |
$39.94–$158.91 | $73–$290.50 | varies |
| Motility study esophagus (91010) range across 4 matching MRF lines |
$173.40–$1,431.23 | $317–$2,616.50 | varies |
| Motion Fluoroscopy/Swallow (92611) | $498.05 | $910.50 | 5.4× |
| Motor &/sens nrv cndj preconf eltrd array limb (95905) | $190.36 | $348 | 0.4× |
| Multiple Sleep Latency Test (95805) range across 4 matching MRF lines |
$1,110.69–$4,557.61 | $2,030.50–$8,332 | varies |
| Nasopharyngoscopy (92511) | $77.13 | $141 | 0.4× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) range across 4 matching MRF lines |
$67.01–$871.92 | $122.50–$1,594 | varies |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) range across 5 matching MRF lines |
$74.94–$874.66 | $137–$1,599 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 6 matching MRF lines |
$22.98–$202.67 | $42–$370.50 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 4 matching MRF lines |
$27.08–$206.22 | $49.50–$377 | varies |
| Neuromuscular Reeducation (97112) range across 4 matching MRF lines |
$141.95–$566.70 | $259.50–$1,036 | varies |
| Newborn resuscitation (99465) | $469.33 | $858 | 0.7× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $376.61 | $688.50 | 1.0× |
| Ophth medical xm&eval intermediate estab pt (92012) | $205.68 | $376 | 1.6× |
| Oral Function Therapy (92526) | $217.44 | $397.50 | 2.6× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 5 matching MRF lines |
$74.40–$297.30 | $136–$543.50 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 4 matching MRF lines |
$110.23–$440.07 | $201.50–$804.50 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $81.78 | $149.50 | 3.9× |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$64.28–$117.88 | $117.50–$215.50 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) | $153.44 | $280.50 | 7.3× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $189.54 | $346.50 | 9.0× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $227.01 | $415 | 10.8× |
| Ot eval high complexity (97167) | $342.97 | $627 | 3.4× |
| Ot Eval Low Complex (97165) | $193.10 | $353 | 1.9× |
| Ot Eval Moderate Complexity (97166) | $252.99 | $462.50 | 2.5× |
| Ot manual therapy 15 min (97140) range across 4 matching MRF lines |
$141.95–$566.70 | $259.50–$1,036 | varies |
| Ot paraffin bath (97018) | $96.28 | $176 | 16.0× |
| Ot Re-Eval Est Plan Care (97168) | $140.58 | $257 | 2.1× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 2 matching MRF lines |
$237.68–$263.11 | $434.50–$481 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) range across 3 matching MRF lines |
$186.86–$187.08 | $341.60–$342 | varies |
| Peripheral arterial disease rehab per session (93668) range across 2 matching MRF lines |
$187.08–$212.24 | $342–$388 | varies |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$83.97–$123.08 | $153.50–$225 | varies |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) range across 3 matching MRF lines |
$160.55–$370.05 | $293.50–$676.50 | varies |
| Physical Performance Test (97750) range across 4 matching MRF lines |
$83.15–$332.31 | $152–$607.50 | varies |
| Plethysmography (94726) range across 2 matching MRF lines |
$99.29–$190.91 | $181.50–$349 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 2 matching MRF lines |
$4,179.08–$5,145.63 | $7,640–$9,407 | varies |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $195.83 | $358 | 2.0× |
| Psychiatric diagnostic evaluation (90791) | $586.94 | $1,073 | 3.4× |
| Psycl/nrpsycl tst tech 2+ tst 1st 30 min (96138) | $100.93 | $184.50 | 0.2× |
| Psytx Crisis Initial 60 Min (90839) | $522.12 | $954.50 | 3.0× |
| Pt Eval High Complex (97163) | $342.97 | $627 | 3.5× |
| Pt eval low complex 20 min (97161) | $182.43 | $333.50 | 1.9× |
| Pt Eval Mod Complex (97162) | $249.98 | $457 | 2.6× |
| Pt gait training 15 min (97116) range across 5 matching MRF lines |
$119.25–$476.17 | $218–$870.50 | varies |
| Pt mechanical traction (97012) | $119.25 | $218 | 8.3× |
| Pt Re-Eval Est Plan Care (97164) | $146.60 | $268 | 2.2× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$93.54–$148.52 | $171–$271.50 | varies |
| Pulmonary Stress Testing (94618) | $106.94 | $195.50 | 0.8× |
| Pure Tone Audiometry Air (92552) range across 2 matching MRF lines |
$51.42–$81.78 | $94–$149.50 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $698.52 | $1,277 | 19.3× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $53.34 | $97.50 | 0.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 3 matching MRF lines |
$22.98–$114.33 | $42–$209 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $441.71 | $807.50 | 3.6× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) range across 3 matching MRF lines |
$207.32–$621.12 | $379–$1,135.50 | varies |
| Sbsq Psyc Collab Care Mgmt (99493) | $477.54 | $873 | 4.8× |
| Select picture audiometry (92583) | $55.53 | $101.50 | 1.0× |
| Self Care Mngment Training (97535) range across 4 matching MRF lines |
$89.44–$356.38 | $163.50–$651.50 | varies |
| Sensory Integration Ea 15 Min (97533) range across 4 matching MRF lines |
$108.04–$430.77 | $197.50–$787.50 | varies |
| Sleep study unattended (95806) range across 2 matching MRF lines |
$927.44–$1,095.37 | $1,695.50–$2,002.50 | varies |
| Speech Audiometry Complete (92556) | $109.68 | $200.50 | 1.9× |
| Speech audiometry threshold (92555) | $50.88 | $93 | 0.9× |
| Speech sound lang comprehen (92523) | $441.71 | $807.50 | 2.0× |
| Spirometry (94010) range across 3 matching MRF lines |
$102.84–$148.52 | $188–$271.50 | varies |
| Standardized Cognitive Performance Testing (96125) | $441.71 | $807.50 | 4.3× |
| Stenger Test, Pure Tone (92565) | $50.06 | $91.50 | 0.9× |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$25.17–$50.33 | $46–$92 | varies |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $108.04 | $197.50 | 4.8× |
| Ther Ivntj Ea Addl 15 Min (97130) range across 4 matching MRF lines |
$108.04–$323.28 | $197.50–$591 | varies |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) range across 5 matching MRF lines |
$157.27–$627.96 | $287.50–$1,148 | varies |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $256.27 | $468.50 | 2.5× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $58.26 | $106.50 | 0.8× |
| Ther/Proph/Diag Iv Inf Init (96365) range across 4 matching MRF lines |
$281.44–$372.51 | $514.50–$681 | varies |
| Therapeutic Activities (97530) range across 7 matching MRF lines |
$121.17–$484.37 | $221.50–$885.50 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $537.16 | $982 | 1.5× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$49.51–$86.16 | $90.50–$157.50 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$26.53–$44.31 | $48.50–$81 | varies |
| Tone Decay Test (92563) | $48.14 | $88 | 1.3× |
| Trans Care Mgmt 14 Day Disch (99495) | $493.95 | $903 | 3.8× |
| Trans Care Mgmt 7 Day Disch (99496) | $697.70 | $1,275.50 | 5.4× |
| Tte w/doppler, complete (93306) | $1,708.01 | $3,122.50 | 3.2× |
| Tte W/O Doppler Complete (93307) | $1,005.39 | $1,838 | 4.3× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $218.53 | $399.50 | 2.9× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $199.39 | $364.50 | 8.3× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 3 matching MRF lines |
$65.64–$69.20 | $120–$126.50 | varies |
| Tympanometry (92567) range across 2 matching MRF lines |
$62.09–$91.35 | $113.50–$167 | varies |
| Tympanometry and reflex threshold measurements (92550) | $135.39 | $247.50 | 0.6× |
| Unlisted otorhinolaryngological service (92700) | $54.16 | $99 | 1.9× |
| Upr/L Xtremity Art 2 Levels (93922) range across 6 matching MRF lines |
$16.96–$220.72 | $31–$403.50 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) range across 4 matching MRF lines |
$58.26–$973.12 | $106.50–$1,779 | varies |
| Vasopneumatic device (97016) range across 2 matching MRF lines |
$127.18–$140.58 | $232.50–$257 | varies |
| Vent Mgmt Inpat Init Day (94002) range across 3 matching MRF lines |
$64.28–$1,089.63 | $117.50–$1,992 | varies |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $962.72 | $1,760 | 1.6× |
| Visual reinforcement audiometry (vra) (92579) | $100.93 | $184.50 | 0.5× |
| Vital capacity, total (94150) | $59.90 | $109.50 | 0.5× |
| Whirlpool Therapy (97022) | $108.04 | $197.50 | 6.9× |
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.