Visits & medical services prices at CHI St. Francis Health

Breckenridge, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $85.80 $143 0.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $67.20 $112 0.2×
Canalith Repositioning Procedure (95992) $142.20 $237 3.5×
Car seat/bed test 60 min (94780) $80.70 $134.50 2.1×
Cardiopulmonary resuscitation (92950) $780 $1,300 3.5×
Cardioversion (92960) $232.80 $388 0.3×
Chemother, IV infusion, 1 hr (96413) $675 $1,125 2.0×
Chemother, IV infusion, ea add hr (96415) $126.60 $211 1.7×
Color/duplex Doppler, complete (93975) $626.70 $1,044.50 2.5×
Color/duplex Doppler, limited (93976) $481.20 $802 4.5×
Cpap/bipap (94660) $111.60 $186 0.5×
Cpt initial (94667) $99.60 $166 0.7×
Critical care (99291) $513 $855 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $224.40 $374 1.1×
Distort Product Evoked Otoacoustic Emisns Limitd (92587) $14.40 $24 0.1×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $758.40 $1,264 3.1×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $624 $1,040 5.8×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $609.60 $1,016 2.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,264.20 $2,107 5.1×
Duplex scan extracranial art compl bi study (93880) $969.60 $1,616 3.9×
Echo Heart Xthoracic,Limited (93308) $400.20 $667 1.6×
EEG awake and asleep (95819) $1,498.20 $2,497 6.7×
EEG coma or sleep only (95822) $1,362.60 $2,271 6.1×
Electrocardiogram Tracing (93005) $90.60 $151 1.5×
Er level 1 (99281) $127.20 $212 1.5×
Er level ii (99282) $195.60 $326 1.2×
Er level iii (99283) $337.20 $562 1.2×
Er level IV (99284) $597.30 $995.50 1.4×
Er level v (99285) $882.30 $1,470.50 1.4×
Evaluate Pt Use Of Inhaler (94664) $64.80 $108 0.3×
Exhaled air analysis o2 (94680) $127.80 $213 1.0×
External ECG rec>48hr<7d recording (93242) $20.40 $34 0.5×
External ECG rec>7d<15d recording (93246) $20.40 $34 0.5×
Imm admn sarscov2 vaccine single dose (90480) $48.60 $81 1.2×
Immune Admin Oral/Nasal (90473) $28.80 $48 0.4×
Immunization Admin (90471) $53.10 $88.50 0.7×
Irrig drug delivery device (96523) $129.60 $216 2.1×
IV infusion hydration each additional hour (96361) $102 $170 2.1×
IV infusion hydration initial 31 min-1 hour (96360) $414.60 $691 1.9×
IV infusion ther proph addl sequential to 1 hr (96367) $135 $225 1.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $425.10 $708.50 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $105.60 $176 2.2×
IV push ea addl new drug (96375) $94.80 $158 2.0×
IV push initial (96374) $403.80 $673 1.8×
Mechanical chest wall oscillation (94669) $104.40 $174 0.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $129.60 $216 4.1×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $150 $250 4.1×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $68.40 $114 4.0×
Methacholine challenge (94070) $108.60 $181 0.3×
Multiple Sleep Latency Test (95805) $1,430.40 $2,384 1.6×
Newborn resuscitation (99465) $753.60 $1,256 1.1×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $120 $200 0.9×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $34.50 $57.50 1.5×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $185.40 $309 1.4×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $93 $155 0.7×
Peripheral arterial disease rehab per session (93668) $73.20 $122 1.2×
Phlebotomy therapeutic (99195) $409.20 $682 3.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,785.90 $2,976.50 2.0×
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $1,944 $3,240 2.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $18.60 $31 0.4×
Psych diag eval w/med srvcs (90792) $246.60 $411 1.3×
Psychiatric diagnostic evaluation (90791) $219.60 $366 1.2×
Pt Aquatic Therapy/Exercises (97113) $12 $20 0.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $210.60 $351 1.0×
Rt Chest Wall Manipulation,Subsequent (94668) $120 $200 0.9×
Spirometry (94010) $73.20 $122 0.3×
Temp transcutaneous pacing (92953) $86.10 $143.50 0.1×
Ther/prop/diag inj/inf proc (96379) $56.70 $94.50 1.2×
Therapeutic prophylactic/dx injection subq/im (96372) $129.60 $216 1.7×
Tte w/doppler, complete (93306) $1,055.40 $1,759 1.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $303 $505 1.2×
Ultraviolet Light Therapy (96900) $89.40 $149 2.3×
Unlisted Cardiovascular Service/Procedure (93799) $21.60 $36 0.2×
Upr/lxtr art stdy 3+ lvls (93923) $454.20 $757 2.0×
Vent mgmt inpat init day (94002) $355.20 $592 0.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $256.20 $427 0.4×
Vital capacity, total (94150) $99 $165 0.7×