Visits & medical services prices at Thayer County Health Services

Hebron, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $161 $201 1.5×
Airway inhalation treatment (94640) $189 $236 0.8×
Assessment of aphasia (96105) $192 $240 2.0×
Behavioral and qualitative analysis of voice and resonance (92524) $287 $359 2.6×
Canalith Repositioning (95992) $94 $117 2.3×
Cardiac Stress Tst,Tracing Only (93017) $730 $913 3.3×
Cardioversion (92960) $1,170 $1,463 1.7×
Chemo IV push addl drug (96411) $218 $273 2.9×
Chemo Iv Push Sngl Drug (96409) $396 $495 1.2×
Chemother, IV infusion, 1 hr (96413) $740 $925 2.2×
Chemother, IV infusion, ea add hr (96415) $175 $219 2.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $308 $308 4.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $270 $338 3.6×
Color/duplex Doppler, complete (93975) $930 $1,162 3.8×
Debridement Open Wound 20 Sq Cm< (97597) $158.50 $198 0.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $966 $1,208 3.9×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $771 $964 7.1×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,010 $1,263 4.1×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $834 $1,042 7.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $944 $1,180 3.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $763 $954 7.0×
Dup-scan xtr veins unilateral/limited study (93971) $894 $1,117 8.2×
Duplex hemodialysis access (93990) $830 $1,038 7.6×
Duplex scan extracranial art compl bi study (93880) $1,193 $1,491 4.8×
Echo Heart Xthoracic,Limited (93308) $879 $923 3.5×
EKG (93005) $285 $308 4.7×
Er level 1 (99281) $186 $233 2.1×
Er level ii (99282) $282 $352 1.8×
Er level iii (99283) $483 $581 1.7×
Er level IV (99284) $725 $871 1.7×
Er level v (99285) $1,073 $1,291 1.7×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $134 $167 1.9×
Evaluation of speech fluency (92521) $266 $333 2.0×
Evaluation of speech sound production (92522) $318 $397 2.8×
Evaluation of swallowing function (92610) $285 $356 3.4×
Evaluation with prescription of speech-generating alternative (92607) $239 $299 2.0×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $75 $94 1.0×
Immunization Admin (90471) $70 $84 0.9×
Immunotherapy, 2+ Injections (95117) $34 $43 0.7×
IV infusion hydration each additional hour (96361) $97 $189 2.0×
IV infusion hydration initial 31 min-1 hour (96360) $299 $374 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $181 $226 2.4×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $396 $396 1.8×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $172 $215 3.5×
IV push initial (96374) $196.50 $217.50 0.9×
Manual therapy 15 min (97140) $86 $108 3.1×
Mechanical traction (97012) $71 $89 4.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $57 $71 1.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $58 $72 1.6×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $443 $554 4.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $190 $237 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $303 $379 0.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $534 $667 3.9×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $704 $880 3.1×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $87 $108.50 1.9×
Osteopathic manipulative tx 3-4 body regions (98926) $206 $258 9.2×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $60 $75 1.9×
Ot Prosthetic Training, Each 15 Min (97761) $75 $94 1.9×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $232 $290 1.7×
Paraffin bath (97018) $60.50 $75.50 10.1×
Pm device progr eval dual (93280) $306 $382 7.9×
Pm device progr eval multi (93281) $330 $412 8.5×
Pm device progr eval sngl (93279) $250 $313 6.5×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,350 $4,187 3.8×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $29 $36 0.6×
Programming of dual lead implantable defibrillator system (93283) $402 $502 10.4×
Programming of single lead implantable defibrillator system (93282) $306 $382 7.9×
Psych diag eval w/med srvcs (90792) $720 $900 3.9×
Psychiatric diagnostic evaluation (90791) $301 $376 1.6×
Pt Aquatic Therapy/Exercises (97113) $113.50 $142 3.1×
Pt Electric Current Therapy (97033) $95.50 $119 5.0×
Pt Electrical Stimulation (97032) $72.50 $90.50 4.9×
Pt Gait Training Therapy (97116) $77.50 $97 2.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $91 $114 2.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $90 $113 2.8×
Pt Ultrasound Therapy (97035) $65 $81 4.5×
Pure Tone Audiometry Air & Bone (92553) $123 $154 0.9×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $202 $253 1.0×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $96 $120 2.0×
Sensory Integration Ea 15 Min (97533) $194 $243 3.2×
Smoking cessation > 10 min (99407) $54 $67 1.4×
Speech sound lang comprehen (92523) $354 $443 1.6×
Standardized Cognitive Performance Testing (96125) $344 $430 3.3×
Ther/Proph/Diag Inj Sc/Im (96372) $104.50 $139.50 1.4×
Therapeutic Activities (97530) $85 $106 2.4×
Therapeutic phlebotomy (99195) $170 $213 1.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,866 $2,332 3.3×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,434 $1,793 5.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $258 $322 3.4×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $235 $294 2.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $162 $176 3.3×
Tympanometry (92567) $33 $41 0.9×
Vasc Duplex Extrem Venous,Bilat (93970) $1,105 $1,381 4.5×
Vasc Duplex Scan Extracranial,Limited (93882) $600 $750 5.5×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $847 $1,059 3.8×
Vasopneumatic device (97016) $80 $100 6.7×
Vital capacity total (94150) $123 $154 0.9×
Wheelchair Mgmt Ea 15 Min (97542) $115 $115 3.7×