Visits & medical services prices at St. Francis Hospital

Litchfield, IL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Airway Inhalation Treatment (94640)
range across 2 matching MRF lines
$382.32–$439.20 $531–$610 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $212.40 $295 14.8×
Bioimpedance Cv Analysis (93701) $278.64 $387 2.0×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $822.24 $1,142 2.1×
Canalith repositioning proc (95992) $159.12 $221 3.9×
Cardiac Stress Tst,Tracing Only (93017) $1,052.64 $1,462 4.5×
Cardiopulmonary resuscitation (92950) $856.08 $1,189 3.7×
Cardioversion (92960) $1,594.08 $2,214 2.3×
Cbt 1st hour (94644) $601.92 $836 4.2×
Chemo Admin Peritoneal Cavity (96446) $716.40 $995 2.0×
Chemo Anti-Neopl Sq/Im (96401) $260.64 $362 3.4×
Chemo Hormon Antineopl Sq/Im (96402) $269.28 $374 3.5×
Chemo Ia Push (96420) $716.40 $995 2.0×
Chemo Intralesional Over 7 (96406) $511.20 $710 2.2×
Chemo intralesional up to 7 (96405) $548.64 $762 7.1×
Chemo IV infusion addl hr (96415) $344.16 $478 4.5×
Chemo IV push addl drug (96411) $330.48 $459 4.3×
Chemother Prolong Infuse W/Pump (96416) $2,733.84 $3,797 7.7×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $716.40 $995 2.0×
Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) $344.16 $478 6.9×
Chemotherapy Into Cns (96450) $1,108.80 $1,540 3.1×
Chemotherapy Intracavitary (96440) $716.40 $995 2.0×
Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) $1,025.28 $1,424 2.9×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $344.16 $478 4.5×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $716.40 $995 2.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $716.40 $995 2.0×
Chest Wall Manipulation (94668) $278.64 $387 2.0×
Color/duplex Doppler, complete (93975) $1,324.08 $1,839 5.2×
Color/duplex Doppler, limited (93976)
range across 2 matching MRF lines
$851.76–$2,389.68 $1,183–$3,319 varies
Cpap Ventilation Cpap Initiation&Mgmt (94660) $566.64 $787 2.4×
Cpt initial (94667) $278.64 $387 2.0×
Critical care first hour (99291) $1,993.68 $2,769 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $372.96 $518 1.7×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,191.60 $1,655 4.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $252 $350 2.2×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,180.80 $1,640 4.6×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $640.08 $889 5.7×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,432.80 $1,990 5.6×
Dup-scan xtr veins unilateral/limited study (93971) $789.84 $1,097 7.1×
Duplex up extrem art bilat (93930) $1,004.40 $1,395 3.9×
Duplex up extrem art unilat/ltd (93931) $599.04 $832 5.3×
Echo Heart Xthoracic,Limited (93308) $454.32 $631 1.8×
EEG awake and asleep (95819) $696.96 $968 3.0×
EEG awake drowsy (95816) $696.96 $968 3.0×
Electrical Stimulation Ea 15 Min (97032) $137.52 $191 9.4×
Electrocardiogram Tracing (93005) $257.76 $358 4.1×
Emergency Dept Visit Level 2 (99282) $429.84 $597 2.6×
Emergency Dept Visit Level 3 (99283) $629.28 $874 2.2×
Emergency Dept Visit Level 4 (99284) $849.60 $1,180 1.9×
Er level 1 (99281) $246.24 $342 2.7×
Er level v (99285)
range across 2 matching MRF lines
$1,551.60–$1,707.12 $2,155–$2,371 varies
Evaluate Swallowing Function (92610)
range across 5 matching MRF lines
$244.08–$441.36 $339–$613 varies
External Ecg Scanning Analysis Report (93226) $884.88 $1,229 14.0×
Extracranial Bilat Study (93880) $1,227.60 $1,705 4.8×
Extracranial Uni/Ltd Study (93882) $613.44 $852 5.5×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $2,905.92 $4,036 3.2×
Gi tract capsule endoscopy (91110) $2,025.36 $2,813 2.1×
Holter monitor recording (93225) $677.52 $941 4.8×
Immunization administration (90471) $133.92 $186 1.7×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $1,146.24 $1,592 2.9×
Iontophoresis 15 min (97033) $147.60 $205 7.8×
Irrig Drug Delivery Device (96523) $206.64 $287 3.3×
IV infusion hydration each additional hour (96361) $223.92 $311 4.5×
IV infusion hydration initial 31 min-1 hour (96360) $413.28 $574 1.8×
IV infusion ther proph addl sequential to 1 hr (96367) $223.92 $311 2.9×
IV infusion therapy prophylaxis/dx ea hour (96366) $223.92 $311 4.5×
IV push initial (96374) $396 $550 1.7×
Lwr Xtr Vasc Stdy Bilat (93924) $1,664.64 $2,312 7.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $79.20 $110 2.2×
Methacholine challenge (94070) $672.48 $934 1.7×
Motion Fluoroscopy/Swallow (92611) $232.56 $323 2.5×
Multiple Sleep Latency Test (95805) $2,440.08 $3,389 2.7×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $863.28 $1,199 2.0×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $863.28 $1,199 2.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $429.12 $596 2.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $784.08 $1,089 1.8×
Nerve conduction studies 13 or more studies (95913) $1,550.16 $2,153 3.9×
Nerve Conduction Studies 3-4 Studies (95908) $672.48 $934 2.9×
Nerve conduction studies 5-6 studies (95909) $730.80 $1,015 3.2×
Nerve conduction studies 7-8 studies (95910) $956.16 $1,328 2.4×
Nerve Conduction Studies 9-10 Studies (95911) $1,149.12 $1,596 2.9×
Neuromuscular Reeducation (97112) $108 $150 3.3×
Oral Function Therapy (92526)
range across 2 matching MRF lines
$151.20–$679.68 $210–$944 varies
Oral Speech Device Eval (92597) $149.04 $207 2.1×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $144 $200 3.1×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $63.36 $88 2.7×
Ot Eval Low Complex (97165) $255.60 $355 2.5×
Ot Eval Moderate Complexity (97166) $280.80 $390 2.8×
Ot manual therapy 15 min (97140) $150.48 $209 5.4×
Ot paraffin bath (97018) $85.68 $119 14.3×
Ot Prosthetic Training, Each 15 Min (97761) $164.88 $229 4.1×
Ot Re-Eval Est Plan Care (97168) $159.84 $222 2.3×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $262.80 $365 1.9×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $246.96 $343 1.8×
Peripheral arterial disease rehab per session (93668) $136.80 $190 2.2×
Phlebotomy therapeutic (99195) $256.32 $356 1.8×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $128.16 $178 2.0×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $141.12 $196 2.2×
Physical Performance Test (97750) $69.84 $97 2.1×
Plethysmography (94726) $627.12 $871 1.6×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,697.28 $6,524 5.1×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $99.36 $138 2.0×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $99.36 $138 2.0×
Pt eval low complex 20 min (97161) $218.88 $304 2.2×
Pt Eval Mod Complex (97162) $273.60 $380 2.8×
Pt gait training 15 min (97116) $115.92 $161 4.0×
Pt mechanical traction (97012) $110.88 $154 7.7×
Pt Re-Eval Est Plan Care (97164) $165.60 $230 2.5×
Pulmonary service/procedure (94799) $337.68 $469 2.4×
Pulmonary Stress Testing (94618) $478.80 $665 3.4×
Refill/Maint Portable Pump (96521) $586.08 $814 2.6×
Refill/Maint Pump/Resvr Syst (96522) $586.08 $814 2.6×
Remote 30 Day Ecg Rev/Report (93270) $743.04 $1,032 18.6×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $128.16 $178 2.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $428.40 $595 2.0×
Self Care Mngment Training (97535) $131.76 $183 4.1×
Sleep study unattended (95806) $1,259.28 $1,749 5.4×
Speech sound lang comprehen (92523) $408.24 $567 1.8×
Spirometry (94010) $302.40 $420 1.3×
Subcutaneous Infusion Each Additional Hour (96370) $162.72 $226 3.2×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $455.04 $632 2.0×
Subq Infusion Additional Pump Infusion Site (96371) $203.76 $283 2.6×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $156.24 $217 7.0×
Ther Ivntj Ea Addl 15 Min (97130) $108 $150 5.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $142.56 $198 4.8×
Ther/Proph/Diag Inj Ia (96373) $455.04 $632 2.0×
Ther/Proph/Diag Inj Sc/Im (96372) $178.56 $248 2.3×
Ther/Proph/Diag Iv Inf Init (96365) $405.36 $563 1.8×
Therapeutic Activities (97530) $149.76 $208 4.3×
Tte w/doppler, complete (93306) $2,491.20 $3,460 4.3×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $205.92 $286 2.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $189.36 $263 3.8×
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines
$487.44–$555.12 $677–$771 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923)
range across 2 matching MRF lines
$446.40–$1,216.08 $620–$1,689 varies
Vasopneumatic device (97016) $106.56 $148 8.9×
Wheelchair Mgmt Ea 15 Min (97542) $134.64 $187 4.3×

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.