Visits & medical services prices at Stewart Memorial Community Hospital

Lake City, IA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Actinotherapy Ultraviolet Light (96900) $68 $85 1.9×
Airway Inhalation Treatment (94640) $187 $234 0.9×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $68 $85 1.9×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $56 $71 3.9×
Application Modality 1/> Areas Infrared (97026) $36 $45 5.4×
Assessment of aphasia per hr (96105) $293 $367 3.0×
Behavral qualit analys voice (92524) $328 $411 3.0×
Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) $239 $299 2.9×
Bfb training ea addl 15 min (90913) $94 $118 2.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $360 $451 1.0×
Canalith repositioning proc (95992) $130 $163 3.2×
Car seat/bed test 60 min (94780) $150 $188 4.2×
Cardiac Stress Tst,Tracing Only (93017) $612 $766 2.9×
Cardiopulmonary resuscitation (92950) $542 $678 2.6×
Cardioversion (92960) $459 $574 0.7×
Cbt 1st hour (94644) $214 $268 1.7×
Chemo Anti-Neopl Sq/Im (96401) $232 $290 3.4×
Chemo Hormon Antineopl Sq/Im (96402) $140 $176 2.0×
Chemo IV infusion addl hr (96415) $124 $155 1.8×
Chemo IV push addl drug (96411) $242 $303 3.5×
Chemother Prolong Infuse W/Pump (96416) $561 $702 1.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $280 $351 4.0×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $573 $717 1.8×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $441 $552 1.4×
Chest Wall Manipulation (94668) $107 $134 0.8×
Color/duplex Doppler, complete (93975) $989 $1,237 4.3×
Color/duplex Doppler, limited (93976) $596 $746 5.9×
Community/Work Reintegration Trainj Ea 15 Min (97537) $101 $127 3.2×
Cont gluc mntr physician/qhp provided equiptment (95250) $479 $599 3.7×
Continuous Pulse Ox (94762) $240 $301 1.9×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 2 matching MRF lines		 $522–$745 $653–$932 varies
Cpt initial (94667) $136 $171 1.1×
Critical care first hour (99291) $1,572 $1,965 2.0×
Debridement Open Wound 20 Sq Cm< (97597) $278 $348 1.4×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $670 $838 2.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $417 $522 4.1×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $662 $828 2.9×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $431 $539 4.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $625 $782 2.7×
Dup-scan xtr veins unilateral/limited study (93971) $629 $787 6.3×
Duplex up extrem art bilat (93930) $652 $815 2.8×
Duplex up extrem art unilat/ltd (93931) $412 $516 4.1×
Ear and throat examination (92502) $1,070 $1,338 2.1×
ECG/monitoring and analysis (93271) $494 $618 5.4×
Echo Heart Xthoracic,Limited (93308) $712 $891 3.1×
EEG awake drowsy (95816) $589 $737 2.8×
Electrical Stimulation Ea 15 Min (97032) $61 $77 4.1×
Electrocardiogram Tracing (93005) $157 $197 2.8×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines		 $44–$304 $56–$381 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines		 $47–$486 $59–$608 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines		 $48–$776 $61–$970 varies
Emg 3 Extremities (95863) $540 $675 4.4×
Emg 4 Extremities (95864) $603 $754 4.9×
Er level 1 (99281)
range across 2 matching MRF lines		 $43–$182 $54–$228 varies
Er level v (99285)
range across 2 matching MRF lines		 $50–$1,150 $63–$1,438 varies
Evaluate pt use of inhaler (94664) $115 $144 0.5×
Evaluate Speech Production (92522) $333 $417 3.0×
Evaluate Swallowing Function (92610) $253 $317 3.0×
Evaluation of speech fluency (92521) $397 $497 3.0×
Evoked Auditory Test,Limited (92587) $209 $262 1.0×
Exercise test for bronchospasm (94617) $275 $344 2.2×
Exhaled Air Analysis O2 (94680) $213 $267 1.7×
External ECG rec>48hr<7d recording (93242) $318 $398 8.9×
External ECG rec>7d<15d recording (93246) $318 $398 8.9×
External Ecg Scanning Analysis Report (93226)
range across 2 matching MRF lines		 $346–$375 $433–$469 varies
Extracranial Bilat Study (93880) $860 $1,076 3.7×
Extracranial Uni/Ltd Study (93882) $536 $671 5.3×
Group Therapeutic Procedures (97150) $67 $84 3.7×
Holter monitor recording (93225)
range across 2 matching MRF lines		 $321–$440 $402–$550 varies
Immunization administration (90471)
range across 3 matching MRF lines		 $50–$79 $63–$99 varies
Iontophoresis 15 min (97033) $74 $93 3.9×
Irrig Drug Delivery Device (96523) $142 $178 2.5×
IV infusion hydration each additional hour (96361) $88 $110 2.0×
IV infusion hydration initial 31 min-1 hour (96360) $272 $340 1.3×
IV infusion ther proph addl sequential to 1 hr (96367) $140 $176 2.0×
IV infusion therapy prophylaxis/dx ea hour (96366) $98 $123 2.2×
IV push initial (96374) $148 $185 0.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $65 $82 2.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $77 $97 2.1×
Medical nutrition therapy grp2/ indiv ea 30 mi (97804) $51 $64 3.0×
Multiple Sleep Latency Test (95805) $2,400 $3,001 2.9×
Muscle Test 2 Limbs (95861) $414 $518 3.2×
Muscle Test One Limb (95860) $284 $355 2.2×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $964 $1,205 2.5×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $952 $1,190 2.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $403 $504 2.1×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $475 $594 1.2×
Nerve Conduction Studies 1-2 Studies (95907) $209 $262 1.0×
Nerve Conduction Studies 11-12 Studies (95912) $576 $720 1.6×
Nerve conduction studies 13 or more studies (95913) $669 $837 1.9×
Nerve Conduction Studies 3-4 Studies (95908) $264 $330 1.3×
Nerve conduction studies 5-6 studies (95909) $317 $397 1.5×
Nerve conduction studies 7-8 studies (95910) $413 $517 1.2×
Nerve Conduction Studies 9-10 Studies (95911) $497 $622 1.4×
Neuromuscular Reeducation (97112) $116 $145 3.5×
Oral Function Therapy (92526) $254 $318 3.0×
Orthc/Prostc Mgmt Sbsq Enc (97763) $159 $199 3.2×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $105 $132 2.3×
Ot eval high complexity (97167) $240 $300 2.4×
Ot Eval Low Complex (97165) $240 $300 2.4×
Ot Eval Moderate Complexity (97166) $240 $300 2.4×
Ot manual therapy 15 min (97140) $103 $129 3.7×
Ot paraffin bath (97018) $48 $60 8.0×
Ot Prosthetic Training, Each 15 Min (97761) $124 $155 3.1×
Ot Re-Eval Est Plan Care (97168) $124 $155 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $322 $403 2.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $155 $194 1.3×
Patient-initiated spirometric phys/qhp r&i only (94016) $93 $117 3.8×
Peripheral arterial disease rehab per session (93668) $130 $163 2.3×
Phlebotomy therapeutic (99195)
range across 2 matching MRF lines		 $41–$250 $52–$313 varies
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $186 $233 3.3×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $173 $217 3.1×
Physical Performance Test (97750) $100 $125 3.0×
Plethysmography (94726) $646 $808 1.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,984 $3,731 3.6×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $27 $34 0.6×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $32 $41 0.7×
Psycl/Nrpsyc Tst Auto Result (96146) $17 $22 0.6×
Pt Eval High Complex (97163) $240 $300 2.5×
Pt eval low complex 20 min (97161) $240 $300 2.5×
Pt Eval Mod Complex (97162) $240 $300 2.5×
Pt gait training 15 min (97116) $93 $117 3.2×
Pt mechanical traction (97012) $63 $79 4.4×
Pt Re-Eval Est Plan Care (97164) $124 $155 1.8×
Pt ultraviolet (97028) $25 $32 3.0×
Pulmonary service/procedure (94799) $174 $218 1.4×
Pulmonary Stress Testing (94618) $184 $230 1.4×
Remote 30 Day Ecg Rev/Report (93270) $266 $333 7.4×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $131 $164 2.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $432 $540 2.2×
Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) $68 $85 2.6×
Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) $369 $462 3.0×
Self Care Mngment Training (97535) $98 $123 3.0×
Sensory Integration Ea 15 Min (97533) $152 $190 2.5×
Sleep study unattended (95806) $483 $604 2.3×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $572 $716 2.8×
Speech audiometry threshold (92555) $164 $205 2.9×
Speech sound lang comprehen (92523) $545 $682 2.4×
Spirometry (94010) $207 $259 1.0×
Standardized Cognitive Performance Testing (96125) $309 $387 3.0×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $87 $109 3.9×
Ther Ivntj Ea Addl 15 Min (97130) $89 $112 4.2×
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $116 $146 3.1×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $94 $118 3.2×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $309 $387 3.0×
Ther/Proph/Diag Inj Sc/Im (96372) $107 $134 1.5×
Ther/Proph/Diag Iv Inf Init (96365) $438 $548 2.1×
Therapeutic Activities (97530) $110 $138 3.1×
Tobacco Use Cessation Intensive >10 Minutes (99407) $75 $94 2.1×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $35 $44 1.0×
Trans Care Mgmt 14 Day Disch (99495) $423 $529 3.3×
Trans Care Mgmt 7 Day Disch (99496) $574 $718 4.5×
Tte w/doppler, complete (93306) $1,444 $1,805 2.7×
Tte W/O Doppler Complete (93307) $1,008 $1,261 4.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $229 $287 3.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $130 $163 2.9×
Upr/L Xtremity Art 2 Levels (93922) $301 $377 2.4×
Upr/Lxtr Art Stdy 3+ Lvls (93923) $496 $621 2.4×
Vent Mgmt Inpat Init Day (94002) $873 $1,092 1.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $615 $769 1.0×
Wheelchair Mgmt Ea 15 Min (97542) $57 $72 1.8×

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.