Visits & medical services prices at SSM Health St. Clare Hospital - Baraboo
Baraboo, WI · every code in this section with a posted price and a Medicare benchmark.
156 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acoustic Reflex Testing (92568) | $45.65 | $83 | 1.3× |
| Actinotherapy Ultraviolet Light (96900) | $132 | $240 | 3.6× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $63.25 | $115 | 1.6× |
| Airway Inhalation Treatment (94640) | $241.45 | $439 | 1.1× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $125.40 | $228 | 8.7× |
| Assessment of aphasia per hr (96105) | $260.15 | $473 | 2.7× |
| Audiometry Air & Bone (92553) | $91.30 | $166 | 0.7× |
| Behavral qualit analys voice (92524) | $365.75 | $665 | 3.3× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $215.60 | $392 | 0.6× |
| Canalith repositioning proc (95992) | $99 | $180 | 2.4× |
| Car seat/bed test 60 min (94780) | $133.10 | $242 | 3.7× |
| Cardiac Stress Tst,Tracing Only (93017) | $648.45 | $1,179 | 3.1× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$559.90–$644.05 | $1,018–$1,171 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$795.85–$915.20 | $1,447–$1,664 | varies |
| Cbt 1st hour (94644) | $130.90 | $238 | 1.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $119.90 | $218 | 1.7× |
| Chemo IV infusion addl hr (96415) | $128.15 | $233 | 1.8× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $499.40 | $908 | 1.6× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $209 | $380 | 0.7× |
| Chest Wall Manipulation (94668) | $162.25 | $295 | 1.3× |
| Chron Care Mgmt Srvc 20 Min (99490) | $90.20 | $164 | 0.9× |
| Color/duplex Doppler, complete (93975) | $600.05 | $1,091 | 2.6× |
| Color/duplex Doppler, limited (93976) | $300.30 | $546 | 3.0× |
| Complex chronic care mgmt svc 1st 60 min cal mo (99487) | $165.55 | $301 | 1.0× |
| Comprehensive Hearing Test (92557) | $147.40 | $268 | 1.2× |
| Conditioning Play Audiometry (92582) | $81.40 | $148 | 0.7× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $362.45 | $659 | 2.8× |
| Continuous Pulse Ox (94762) | $364.65 | $663 | 2.9× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $282.70 | $514 | 1.3× |
| Cpt initial (94667) | $218.90 | $398 | 1.7× |
| Critical care first hour (99291) | $2,114.20 | $3,844 | 2.6× |
| Debridement Open Wound 20 Sq Cm< (97597) | $205.70 | $374 | 1.1× |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) | $51.70 | $94 | 0.1× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $690.80 | $1,256 | 6.8× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,547.15 | $2,813 | 6.7× |
| Dup-scan xtr veins unilateral/limited study (93971) | $772.75 | $1,405 | 7.6× |
| Duplex Scan Hemodialysis Access (93990) | $83.05 | $151 | 0.8× |
| Duplex up extrem art unilat/ltd (93931) | $772.75 | $1,405 | 7.6× |
| ECG/monitoring and analysis (93271) | $574.75 | $1,045 | 6.2× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$615.45–$773.30 | $1,119–$1,406 | varies |
| Echo transesophageal (93312) | $1,078.55 | $1,961 | 2.0× |
| EEG awake and asleep (95819) | $485.65 | $883 | 2.3× |
| EEG awake drowsy (95816) | $471.90 | $858 | 2.3× |
| Electrical Stimulation Ea 15 Min (97032) | $106.15 | $193 | 7.2× |
| Electrocardiogram Tracing (93005) | $188.10 | $342 | 3.3× |
| Emergency Dept Visit Level 2 (99282) | $276.10 | $502 | 1.9× |
| Emergency Dept Visit Level 3 (99283) | $498.85 | $907 | 1.9× |
| Emergency Dept Visit Level 4 (99284) | $1,046.10 | $1,902 | 2.6× |
| Er level 1 (99281) | $217.80 | $396 | 2.7× |
| Er level v (99285) | $1,650.55 | $3,001 | 2.9× |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $189.20 | $344 | 1.5× |
| Evaluate pt use of inhaler (94664) | $199.10 | $362 | 0.9× |
| Evaluate Speech Production (92522) | $365.75 | $665 | 3.3× |
| Evaluate Swallowing Function (92610) | $575.30 | $1,046 | 6.8× |
| Evaluation of speech fluency (92521) | $365.75 | $665 | 2.7× |
| Evoked Auditory Test,Limited (92587) | $39.60 | $72 | 0.2× |
| Exercise test for bronchospasm (94617) | $112.75 | $205 | 0.9× |
| External Ecg Scanning Analysis Report (93226) | $532.40 | $968 | 9.3× |
| Extracranial Bilat Study (93880) | $1,324.40 | $2,408 | 5.7× |
| Group Therapeutic Procedures (97150) | $120.45 | $219 | 6.7× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $1,227.05 | $2,231 | 1.8× |
| Holter monitor recording (93225) | $391.60 | $712 | 3.0× |
| Immunization administration (90471) | $61.05 | $111 | 0.9× |
| Iontophoresis 15 min (97033) | $119.90 | $218 | 6.3× |
| Irrig Drug Delivery Device (96523) | $91.30 | $166 | 1.6× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$74.80–$85.80 | $136–$156 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$349.25–$402.05 | $635–$731 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$74.80–$85.80 | $136–$156 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$79.20–$90.75 | $144–$165 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$150.70–$173.25 | $274–$315 | varies |
| Mechanical chest wall oscillation per session (94669) | $223.30 | $406 | 1.0× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $46.20 | $84 | 1.5× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $46.20 | $84 | 1.3× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $101.75 | $185 | 6.0× |
| Motion Fluoroscopy/Swallow (92611) | $610.50 | $1,110 | 6.7× |
| Multiple Sleep Latency Test (95805) | $1,482.25 | $2,695 | 1.8× |
| Nasopharyngoscopy (92511) range across 2 matching MRF lines |
$189.75–$217.80 | $345–$396 | varies |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $205.70 | $374 | 0.5× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $205.70 | $374 | 1.1× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $268.40 | $488 | 0.7× |
| Neuromuscular Reeducation (97112) | $106.15 | $193 | 3.2× |
| Oral Function Therapy (92526) | $246.95 | $449 | 2.9× |
| Oral Speech Device Eval (92597) | $508.75 | $925 | 7.2× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $103.40 | $188 | 2.1× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $106.15 | $193 | 2.3× |
| Ot eval high complexity (97167) | $321.20 | $584 | 3.2× |
| Ot Eval Low Complex (97165) | $160.60 | $292 | 1.6× |
| Ot Eval Moderate Complexity (97166) | $241.45 | $439 | 2.4× |
| Ot manual therapy 15 min (97140) | $122.65 | $223 | 4.4× |
| Ot paraffin bath (97018) | $102.85 | $187 | 17.1× |
| Ot Prosthetic Training, Each 15 Min (97761) | $102.85 | $187 | 2.5× |
| Ot Re-Eval Est Plan Care (97168) | $104.50 | $190 | 1.5× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 2 matching MRF lines |
$207.90–$220 | $378–$400 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $166.10 | $302 | 1.3× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $425.15 | $773 | 2.0× |
| Peripheral arterial disease rehab per session (93668) | $50.05 | $91 | 0.9× |
| Phlebotomy therapeutic (99195) | $193.60 | $352 | 1.5× |
| Photochemotx Psoralens&Ultraviolet Puva (96912) | $189.20 | $344 | 3.3× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $177.10 | $322 | 3.1× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $172.70 | $314 | 3.0× |
| Physical Performance Test (97750) | $99.55 | $181 | 3.0× |
| Plethysmography (94726) | $191.40 | $348 | 0.5× |
| Pm device eval in person (93288) | $115.50 | $210 | 3.2× |
| Pm/Icd Remote Tech Serv (93296) | $167.20 | $304 | 4.6× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 3 matching MRF lines |
$2,082.85–$2,532.75 | $3,787–$4,605 | varies |
| Principal care management services, for a single high-risk disease, with the following required elements: one complex… (99426) | $90.20 | $164 | 0.9× |
| Pt Eval High Complex (97163) | $245.85 | $447 | 2.5× |
| Pt eval low complex 20 min (97161) | $81.95 | $149 | 0.8× |
| Pt Eval Mod Complex (97162) | $163.90 | $298 | 1.7× |
| Pt gait training 15 min (97116) | $129.25 | $235 | 4.4× |
| Pt mechanical traction (97012) | $102.85 | $187 | 7.2× |
| Pt Re-Eval Est Plan Care (97164) | $158.40 | $288 | 2.3× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$126.50–$253 | $230–$460 | varies |
| Pulmonary Stress Testing (94618) | $116.05 | $211 | 0.9× |
| Pure Tone Audiometry Air (92552) | $48.40 | $88 | 0.4× |
| Rem mntr physiol param 1st dev supply ea 30 d (99454) | $85.80 | $156 | 2.4× |
| Rem mntr physiol param 1st set up pt educaj eqp (99453) | $165 | $300 | 1.3× |
| Remote 30 Day Ecg Rev/Report (93270) | $287.10 | $522 | 7.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $205.70 | $374 | 1.1× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $322.30 | $586 | 2.6× |
| Self Care Mngment Training (97535) | $125.40 | $228 | 3.9× |
| Self-meas bp pt educaj/traing & dev calibration (99473) | $33 | $60 | 1.2× |
| Sleep study attended (95807) | $951.50 | $1,730 | 2.6× |
| Sleep study unattended (95806) | $697.40 | $1,268 | 3.3× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $640.20 | $1,164 | 3.1× |
| Speech Audiometry Complete (92556) | $57.75 | $105 | 1.0× |
| Speech audiometry threshold (92555) | $36.85 | $67 | 0.6× |
| Speech sound lang comprehen (92523) | $365.75 | $665 | 1.6× |
| Spirometry (94010) | $81.95 | $149 | 0.4× |
| Standardized Cognitive Performance Testing (96125) | $341 | $620 | 3.3× |
| Stenger Test Speech (92577) | $68.20 | $124 | 0.2× |
| Stenger Test, Pure Tone (92565) | $68.20 | $124 | 1.2× |
| Stress Tte Only (93350) | $821.15 | $1,493 | 1.5× |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$614.35–$706.20 | $1,117–$1,284 | varies |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $99.55 | $181 | 4.4× |
| Ther Ivntj Ea Addl 15 Min (97130) | $99.55 | $181 | 4.7× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $102.85 | $187 | 2.8× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $106.15 | $193 | 3.6× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $218.35 | $397 | 2.1× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$113.85–$130.35 | $207–$237 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$363.55–$417.45 | $661–$759 | varies |
| Therapeutic Activities (97530) | $108.35 | $197 | 3.1× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $41.80 | $76 | 1.1× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$38.50–$44 | $70–$80 | varies |
| Tte w/doppler, complete (93306) | $1,404.15 | $2,553 | 2.6× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $201.85 | $367 | 2.7× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$110.55–$126.50 | $201–$230 | varies |
| Tympanometry (92567) | $62.70 | $114 | 1.7× |
| Tympanometry and reflex threshold measurements (92550) | $88 | $160 | 0.4× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $622.05 | $1,131 | 3.0× |
| Vasopneumatic device (97016) | $102.85 | $187 | 8.6× |
| Vent Mgmt Inpat Init Day (94002) | $617.65 | $1,123 | 1.0× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $600.05 | $1,091 | 1.0× |
| Visual reinforcement audiometry (vra) (92579) | $77 | $140 | 0.4× |
| Vital capacity, total (94150) | $177.10 | $322 | 1.4× |
| Whirlpool Therapy (97022) | $102.85 | $187 | 6.6× |
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.