Visits & medical services prices at St. Nicholas Hospital
Sheboygan, WI · every code in this section with a posted price and a Medicare benchmark.
222 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Ablate Heart Dysrhythm Focus (93650) | $8,764.14 | $13,279 | 1.1× |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $359.70 | $545 | 1.7× |
| Aep neurodiagnostic i&r (92653) | $539.88 | $818 | 2.6× |
| Aep threshold estimation mlt frequencies i&r (92652) | $537.24 | $814 | 2.5× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$79.20–$266.64 | $120–$404 | varies |
| Airway resistance by oscillometry (94728) | $209.22 | $317 | 1.7× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) | $267.30 | $405 | 2.1× |
| Analyze Pacemaker System (93724) | $1,801.80 | $2,730 | 6.0× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $62.70 | $95 | 4.4× |
| Behavral qualit analys voice (92524) | $184.14 | $279 | 1.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $654.72 | $992 | 1.8× |
| Bundle of his recording (93600) | $8,764.14 | $13,279 | 1.1× |
| C motor evoked uppr limbs (95928) | $1,174.80 | $1,780 | 1.4× |
| C motor evoked upr&lwr limbs (95939) range across 2 matching MRF lines |
$237.60–$1,034.88 | $360–$1,568 | varies |
| Canalith repositioning proc (95992) | $130.02 | $197 | 3.2× |
| Cardiac Stress Tst,Tracing Only (93017) range across 2 matching MRF lines |
$111.54–$990.66 | $169–$1,501 | varies |
| Cardiopulmonary resuscitation (92950) | $601.92 | $912 | 2.9× |
| Cardioversion (92960) | $1,704.78 | $2,583 | 2.6× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $51.48 | $78 | 2.0× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $7,684.38 | $11,643 | 2.4× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $8,833.44 | $13,384 | 2.8× |
| Cbt 1st hour (94644) | $240.90 | $365 | 1.9× |
| Chemo Hormon Antineopl Sq/Im (96402) | $194.70 | $295 | 2.8× |
| Chemo IV infusion addl hr (96415) | $203.28 | $308 | 2.9× |
| Chemo IV push addl drug (96411) | $287.76 | $436 | 4.1× |
| Chemotherapy Into Cns (96450) | $885.06 | $1,341 | 2.7× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $279.18 | $423 | 4.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $772.20 | $1,170 | 2.4× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $502.26 | $761 | 1.6× |
| Chest Wall Manipulation (94668) | $129.36 | $196 | 1.0× |
| Color/duplex Doppler, complete (93975) | $805.20 | $1,220 | 3.5× |
| Color/duplex Doppler, limited (93976) | $699.60 | $1,060 | 6.8× |
| Continuous Pulse Ox (94762) | $263.34 | $399 | 2.1× |
| Coronary Art/Grft Angio S&I (93455) | $8,833.44 | $13,384 | 2.8× |
| Coronary Artery Angio S&I (93454) | $9,716.52 | $14,722 | 3.1× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 3 matching MRF lines |
$273.24–$428.34 | $414–$649 | varies |
| Cpt initial (94667) | $137.94 | $209 | 1.1× |
| Critical care first hour (99291) | $2,028.84 | $3,074 | 2.5× |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) | $613.14 | $929 | 1.7× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$326.04–$615.78 | $494–$933 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $601.26 | $911 | 2.6× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $461.34 | $699 | 4.5× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,058.64 | $1,604 | 4.5× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $592.68 | $898 | 5.8× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,058.64 | $1,604 | 4.5× |
| Dup-scan xtr veins unilateral/limited study (93971) | $628.32 | $952 | 6.1× |
| Duplex Scan Hemodialysis Access (93990) | $489.72 | $742 | 4.8× |
| Duplex up extrem art bilat (93930) | $769.56 | $1,166 | 3.3× |
| Duplex up extrem art unilat/ltd (93931) | $531.30 | $805 | 5.2× |
| Echo Congenital Complete (93303) | $2,050.62 | $3,107 | 3.8× |
| Echo Heart Xthoracic,Limited (93308) | $766.92 | $1,162 | 3.3× |
| Echo transesophag congen probe plcmt only (93316) | $879.78 | $1,333 | 1.6× |
| Echo transesophageal (93312) | $2,113.98 | $3,203 | 4.0× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $2,050.62 | $3,107 | 3.8× |
| Eeg 41-60 Minutes (95812) | $774.18 | $1,173 | 3.7× |
| EEG awake and asleep (95819) | $1,351.02 | $2,047 | 6.4× |
| EEG awake drowsy (95816) | $787.38 | $1,193 | 3.7× |
| EEG cerebral death evaluation (95824) | $864.60 | $1,310 | 2.4× |
| EEG cont rec w/video by tech min 8 channels (95700) | $2,522.52 | $3,822 | 11.9× |
| EEG extended monitoring 61-119 minutes (95813) | $1,404.48 | $2,128 | 6.7× |
| Eeg Sleep Only (95822) | $1,081.08 | $1,638 | 5.1× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $2,432.76 | $3,686 | 11.5× |
| EEG w/o vid 2-12hr cont mntr (95707) | $3,153.48 | $4,778 | 14.9× |
| EEG w/o vid ea 12-26hr intmt (95709) | $4,775.10 | $7,235 | 13.1× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $2,702.70 | $4,095 | 12.8× |
| EEG wo vid ea 12-26hr unmntr (95708) | $4,505.16 | $6,826 | 12.3× |
| Electrical Stimulation Ea 15 Min (97032) | $62.70 | $95 | 4.3× |
| Electrocardiogram Tracing (93005) | $186.78 | $283 | 3.2× |
| Electrophysiology Evaluation (93642) | $1,981.98 | $3,003 | 1.7× |
| Emergency Dept Visit Level 2 (99282) | $273.24 | $414 | 1.8× |
| Emergency Dept Visit Level 3 (99283) | $839.52 | $1,272 | 3.1× |
| Emergency Dept Visit Level 4 (99284) | $1,259.28 | $1,908 | 3.1× |
| Emg 3 Extremities (95863) | $592.68 | $898 | 4.7× |
| Emg 4 Extremities (95864) | $711.48 | $1,078 | 5.7× |
| Ep & ablate supravent arrhyt (93653) | $17,666.22 | $26,767 | 0.7× |
| Ep & ablate ventric tachy (93654) | $17,666.22 | $26,767 | 0.7× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $8,764.14 | $13,279 | 1.1× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) | $8,764.14 | $13,279 | 1.1× |
| Er level 1 (99281) | $136.62 | $207 | 1.7× |
| Er level v (99285) | $1,723.92 | $2,612 | 3.0× |
| Evaluate Speech Production (92522) | $181.50 | $275 | 1.6× |
| Evaluate Swallowing Function (92610) | $273.24 | $414 | 3.2× |
| Evaluation of speech fluency (92521) | $181.50 | $275 | 1.4× |
| Evoked Auditory Test,Limited (92587) | $359.70 | $545 | 1.7× |
| Exercise test for bronchospasm (94617) | $247.50 | $375 | 1.9× |
| External ECG rec>48hr<7d recording (93242) | $105.60 | $160 | 2.9× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $157.08 | $238 | 1.2× |
| External ECG rec>7d<15d recording (93246) | $149.82 | $227 | 4.1× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $316.80 | $480 | 2.4× |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$554.40–$582.12 | $840–$882 | varies |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$67.98–$1,024.32 | $103–$1,552 | varies |
| Extracranial Uni/Ltd Study (93882) | $498.30 | $755 | 4.9× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,530.54 | $2,319 | 2.9× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) | $790.68 | $1,198 | 2.2× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $1,325.28 | $2,008 | 1.6× |
| Group Therapeutic Procedures (97150) | $69.96 | $106 | 3.9× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $8,234.16 | $12,476 | 2.6× |
| Holter monitor recording (93225) | $396 | $600 | 3.0× |
| Ilr Device Eval Progr (93285) | $95.04 | $144 | 2.6× |
| Immunization administration (90471) range across 2 matching MRF lines |
$73.26–$120.12 | $111–$182 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $613.14 | $929 | 1.7× |
| Insert/Place Heart Catheter (93503) | $1,871.10 | $2,835 | 1.2× |
| Interrogate Subq Defib (93261) | $78.54 | $119 | 2.2× |
| Intra-atrial recording (93602) | $8,764.14 | $13,279 | 1.1× |
| Intraventricular pacing (93612) | $8,764.14 | $13,279 | 1.1× |
| Iontophoresis 15 min (97033) | $77.22 | $117 | 4.1× |
| Irrig Drug Delivery Device (96523) | $127.38 | $193 | 2.2× |
| IV infusion hydration each additional hour (96361) | $143.88 | $218 | 3.1× |
| IV infusion hydration initial 31 min-1 hour (96360) | $375.54 | $569 | 1.8× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $145.86 | $221 | 2.1× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $143.88 | $218 | 3.1× |
| IV push initial (96374) | $205.92 | $312 | 1.0× |
| L Hrt Art/Grft Angio (93459) | $7,242.84 | $10,974 | 2.3× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $1,049.40 | $1,590 | 5.0× |
| Mechanical chest wall oscillation per session (94669) range across 2 matching MRF lines |
$520.08–$526.02 | $788–$797 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $79.86 | $121 | 2.5× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $94.38 | $143 | 2.6× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $64.02 | $97 | 3.8× |
| Methacholine challenge (94070) | $925.32 | $1,402 | 2.5× |
| Motion Fluoroscopy/Swallow (92611) | $282.48 | $428 | 3.1× |
| Multiple Sleep Latency Test (95805) | $2,968.02 | $4,497 | 3.5× |
| Muscle Test 2 Limbs (95861) range across 2 matching MRF lines |
$297–$533.94 | $450–$809 | varies |
| Muscle Test Nonparaspinal (95870) range across 2 matching MRF lines |
$124.08–$207.24 | $188–$314 | varies |
| Muscle Test One Limb (95860) | $413.82 | $627 | 3.2× |
| Nasopharyngoscopy (92511) | $248.82 | $377 | 1.3× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) range across 2 matching MRF lines |
$297–$543.84 | $450–$824 | varies |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) range across 2 matching MRF lines |
$231–$413.82 | $350–$627 | varies |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) | $592.68 | $898 | 2.8× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $199.32 | $302 | 1.0× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $401.28 | $608 | 1.0× |
| Neuromuscular Reeducation (97112) | $93.72 | $142 | 2.9× |
| Newborn resuscitation (99465) | $755.70 | $1,145 | 1.2× |
| O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) | $677.16 | $1,026 | 1.9× |
| Oral Function Therapy (92526) | $224.40 | $340 | 2.7× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $85.14 | $129 | 1.8× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $66 | $100 | 3.1× |
| Ot eval high complexity (97167) range across 5 matching MRF lines |
$98.34–$155.76 | $149–$236 | varies |
| Ot Eval Low Complex (97165) range across 5 matching MRF lines |
$98.34–$155.76 | $149–$236 | varies |
| Ot Eval Moderate Complexity (97166) range across 5 matching MRF lines |
$98.34–$155.76 | $149–$236 | varies |
| Ot manual therapy 15 min (97140) | $80.52 | $122 | 2.9× |
| Ot Prosthetic Training, Each 15 Min (97761) | $69.96 | $106 | 1.7× |
| Ot Re-Eval Est Plan Care (97168) range across 2 matching MRF lines |
$91.08–$104.94 | $138–$159 | varies |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) range across 3 matching MRF lines |
$321.42–$374.22 | $487–$567 | varies |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $145.20 | $220 | 1.2× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $234.96 | $356 | 1.1× |
| Peripheral arterial disease rehab per session (93668) | $92.40 | $140 | 1.6× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $6,270.66 | $9,501 | 1.1× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) | $13,098.36 | $19,846 | 1.2× |
| Phlebotomy therapeutic (99195) | $227.70 | $345 | 1.8× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $137.94 | $209 | 2.4× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $137.94 | $209 | 2.4× |
| Physical Performance Test (97750) | $80.52 | $122 | 2.4× |
| Plethysmography (94726) | $476.52 | $722 | 1.3× |
| Pm device eval in person (93288) | $113.52 | $172 | 3.1× |
| Pm device progr eval dual (93280) | $93.06 | $141 | 2.5× |
| Pm device progr eval multi (93281) | $126.06 | $191 | 3.5× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $4,039.86 | $6,121 | 4.8× |
| Prq Card Angio/Athrect 1 Art (92924) | $10,479.48 | $15,878 | 0.9× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $13,098.36 | $19,846 | 1.2× |
| Prq Card Stent/Ath/Angio (92933) | $20,739.84 | $31,424 | 1.2× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $13,098.36 | $19,846 | 1.2× |
| Pt Eval High Complex (97163) range across 5 matching MRF lines |
$95.70–$155.10 | $145–$235 | varies |
| Pt eval low complex 20 min (97161) range across 5 matching MRF lines |
$95.70–$155.10 | $145–$235 | varies |
| Pt Eval Mod Complex (97162) range across 5 matching MRF lines |
$95.70–$155.10 | $145–$235 | varies |
| Pt gait training 15 min (97116) | $80.52 | $122 | 2.8× |
| Pt group caregiver training (97552) | $43.56 | $66 | 2.0× |
| Pt mechanical traction (97012) | $69.96 | $106 | 4.9× |
| Pt Re-Eval Est Plan Care (97164) range across 2 matching MRF lines |
$77.22–$89.10 | $117–$135 | varies |
| Pulm function test by gas (94727) | $276.54 | $419 | 1.3× |
| Pulmonary service/procedure (94799) range across 2 matching MRF lines |
$180.84–$357.72 | $274–$542 | varies |
| Pulmonary Stress Testing (94618) | $447.48 | $678 | 3.4× |
| R Hrt Art/Grft Angio (93457) | $7,260.66 | $11,001 | 2.3× |
| R hrt coronary artery angio (93456) | $6,586.80 | $9,980 | 2.1× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $5,838.36 | $8,846 | 1.8× |
| Remote 30 Day Ecg Rev/Report (93270) | $231 | $350 | 6.3× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $134.64 | $204 | 2.3× |
| Right Heart Cath (93451) | $4,769.16 | $7,226 | 1.5× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $229.68 | $348 | 1.2× |
| Self Care Mngment Training (97535) | $89.10 | $135 | 2.8× |
| Sensory Integration Ea 15 Min (97533) | $67.32 | $102 | 1.1× |
| Short-latency somatosens ep std upr limbs (95925) | $906.18 | $1,373 | 4.3× |
| Sleep study unattended (95806) | $518.76 | $786 | 2.5× |
| Slp caregiver training 1st 30 min (97550) | $102.96 | $156 | 2.0× |
| Slp Stdy Unatnd W/Anal (95801) | $296.34 | $449 | 5.1× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $345.18 | $523 | 1.6× |
| Somatosensory Testing (95938) range across 2 matching MRF lines |
$537.90–$1,431.54 | $815–$2,169 | varies |
| Speech sound lang comprehen (92523) | $345.18 | $523 | 1.5× |
| Spirometry (94010) | $363 | $550 | 1.7× |
| Ssep lower limbs (95926) | $906.18 | $1,373 | 4.3× |
| Stress Tte Only (93350) | $1,606.44 | $2,434 | 3.0× |
| Temp transcutaneous pacing (92953) | $1,087.02 | $1,647 | 1.7× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $71.94 | $109 | 3.2× |
| Ther Ivntj Ea Addl 15 Min (97130) | $71.94 | $109 | 3.4× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $69.96 | $106 | 2.4× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $105.60 | $160 | 1.5× |
| Ther/Proph/Diag Iv Inf Init (96365) | $439.56 | $666 | 2.1× |
| Therapeutic Activities (97530) | $95.70 | $145 | 2.7× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,745.04 | $2,644 | 4.8× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $52.80 | $80 | 1.4× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $36.96 | $56 | 1.0× |
| Transcath Closure of Asd (93580) | $18,034.50 | $27,325 | 1.0× |
| Tte w/doppler, complete (93306) | $1,709.40 | $2,590 | 3.2× |
| Tte W/O Doppler Complete (93307) | $1,453.98 | $2,203 | 6.2× |
| Tx atrial fib pulm vein isol (93656) | $17,666.22 | $26,767 | 0.7× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $224.40 | $340 | 2.9× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $143.88 | $218 | 3.1× |
| Unlis neurological/neuromuscular dx px (95999) | $394.02 | $597 | 3.1× |
| Upr/L Xtremity Art 2 Levels (93922) | $410.52 | $622 | 3.2× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $582.12 | $882 | 2.8× |
| Valvuloplasty aortic valve (92986) | $6,585.48 | $9,978 | 1.2× |
| Valvuloplasty mitral valve (92987) | $13,098.36 | $19,846 | 1.2× |
| Vasopneumatic device (97016) | $62.70 | $95 | 5.2× |
| Veeg 2-12 Hr Cont Mntr (95713) | $3,153.48 | $4,778 | 8.6× |
| Veeg 2-12 hr intmt mntr (95712) | $2,702.70 | $4,095 | 7.4× |
| Veeg 2-12 hr unmonitored (95711) | $2,432.76 | $3,686 | 11.5× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $4,775.10 | $7,235 | 13.1× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $4,505.16 | $6,826 | 12.3× |
| Veeg ea 12-26hr cont mntr (95716) | $4,224 | $6,400 | 5.0× |
| Visual Evoked Potential Test (95930) | $1,431.54 | $2,169 | 6.8× |
| Vital capacity, total (94150) | $180.84 | $274 | 1.4× |
| Wheelchair Mgmt Ea 15 Min (97542) | $56.10 | $85 | 1.8× |
| Whirlpool Therapy (97022) | $77.22 | $117 | 4.9× |
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.