Visits & medical services prices at Tri Valley Health System
Cambridge, NE · every code in this section with a posted price and a Medicare benchmark.
140 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$70.20–$237.60 | $78–$264 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 2 matching MRF lines |
$112.50–$163.80 | $125–$182 | varies |
| Behavral qualit analys voice (92524) | $414 | $460 | 3.8× |
| Biofeedback training any modality (90901) | $153 | $170 | 3.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $847.80 | $942 | 2.2× |
| Canalith repositioning proc (95992) | $137.70 | $153 | 3.4× |
| Car seat/bed test 60 min (94780) | $297 | $330 | 7.7× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,348.20 | $1,498 | 6.0× |
| Cardiopulmonary resuscitation (92950) range across 3 matching MRF lines |
$722.70–$1,541.70 | $803–$1,713 | varies |
| Cardioversion (92960) | $2,613.60 | $2,904 | 3.8× |
| Cbt 1st hour (94644) | $254.70 | $283 | 1.8× |
| Chemo Anti-Neopl Sq/Im (96401) | $229.50 | $255 | 3.1× |
| Chemo Hormon Antineopl Sq/Im (96402) | $250.20 | $278 | 3.3× |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$180.90–$232.20 | $201–$258 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$344.70–$746.10 | $383–$829 | varies |
| Chest Wall Manipulation (94668) | $220.50 | $245 | 1.6× |
| Color/duplex Doppler, complete (93975) | $1,352.70 | $1,503 | 5.5× |
| Color/duplex Doppler, limited (93976) | $945.90 | $1,051 | 8.7× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $99.90 | $111 | 3.1× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $500.40 | $556 | 3.6× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $126.90 | $141 | 2.1× |
| Continuous Pulse Ox (94762) | $578.70 | $643 | 4.3× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 4 matching MRF lines |
$816.30–$1,145.70 | $907–$1,273 | varies |
| Cpt initial (94667) | $242.10 | $269 | 1.8× |
| Critical care first hour (99291) range across 3 matching MRF lines |
$337.50–$1,342.80 | $375–$1,492 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$307.80–$614.70 | $342–$683 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $1,527.30 | $1,697 | 6.2× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $1,323.90 | $1,471 | 12.2× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,643.40 | $1,826 | 6.6× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 2 matching MRF lines |
$1,197–$1,277.10 | $1,330–$1,419 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,798.20 | $1,998 | 7.3× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$1,323.90–$1,435.50 | $1,471–$1,595 | varies |
| Duplex Scan Hemodialysis Access (93990) | $1,117.80 | $1,242 | 10.3× |
| Duplex up extrem art bilat (93930) | $1,643.40 | $1,826 | 6.6× |
| Duplex up extrem art unilat/ltd (93931) | $1,181.70 | $1,313 | 10.9× |
| Echo Congenital Complete (93303) | $1,628.10 | $1,809 | 2.9× |
| Echo Heart Xthoracic,Limited (93308) | $1,055.70 | $1,173 | 4.3× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $2,208.60 | $2,454 | 3.9× |
| Electrocardiogram Tracing (93005) | $471.60 | $524 | 7.7× |
| Emergency Dept Visit Level 2 (99282) | $225 | $250 | 1.4× |
| Emergency Dept Visit Level 3 (99283) | $299.70 | $333 | 1.1× |
| Emergency Dept Visit Level 4 (99284) | $478.80 | $532 | 1.1× |
| Er level 1 (99281) | $174.60 | $194 | 2.0× |
| Er level v (99285) | $753.30 | $837 | 1.2× |
| Evaluate pt use of inhaler (94664) range across 3 matching MRF lines |
$237.60–$265.50 | $264–$295 | varies |
| Evaluate Speech Production (92522) | $395.10 | $439 | 3.5× |
| Evaluate Swallowing Function (92610) | $529.20 | $588 | 6.2× |
| Evaluation of speech fluency (92521) | $548.10 | $609 | 4.1× |
| External ECG rec>48hr<7d recording (93242) | $594 | $660 | 15.3× |
| External ECG rec>7d<15d recording (93246) | $594 | $660 | 15.3× |
| Extracranial Bilat Study (93880) | $1,848.60 | $2,054 | 7.5× |
| Extracranial Uni/Ltd Study (93882) | $1,409.40 | $1,566 | 13.0× |
| Holter monitor recording (93225) | $559.80 | $622 | 4.1× |
| Immunization administration (90471) range across 2 matching MRF lines |
$11.70–$34.20 | $13–$38 | varies |
| Inital newborn e/m (99460) | $470.70 | $523 | 3.4× |
| Intracutaneous tests w/allergenic extracts (95024) | $16.20 | $18 | 0.3× |
| Iontophoresis 15 min (97033) | $159.30 | $177 | 8.4× |
| Irrig Drug Delivery Device (96523) range across 2 matching MRF lines |
$179.10–$203.40 | $199–$226 | varies |
| IV infusion hydration each additional hour (96361) | $405 | $450 | 8.3× |
| IV infusion hydration initial 31 min-1 hour (96360) | $475.20 | $528 | 2.2× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $297.90 | $331 | 4.0× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $508.50 | $565 | 10.5× |
| IV push initial (96374) | $258.30 | $287 | 1.2× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $1,238.40 | $1,376 | 5.5× |
| Mechanical chest wall oscillation per session (94669) range across 2 matching MRF lines |
$220.50–$342 | $245–$380 | varies |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $53.10 | $59 | 1.7× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $40.50 | $45 | 1.1× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $58.50 | $65 | 3.4× |
| Motion Fluoroscopy/Swallow (92611) | $700.20 | $778 | 7.7× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $1,124.10 | $1,249 | 2.7× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $614.70 | $683 | 3.0× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $711.90 | $791 | 1.7× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$135.90–$159.30 | $151–$177 | varies |
| Newborn resuscitation (99465) | $560.70 | $623 | 0.8× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $207.90 | $231 | 0.5× |
| Oral Function Therapy (92526) | $424.80 | $472 | 5.0× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $180.90 | $201 | 3.6× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 3 matching MRF lines |
$116.10–$207.90 | $129–$231 | varies |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $58.50 | $65 | 2.6× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $81 | $90 | 3.6× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $108 | $120 | 4.8× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $130.50 | $145 | 5.8× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $153 | $170 | 6.8× |
| Ot Contrast Bath Ea 15 Min (97034) | $99.90 | $111 | 7.1× |
| Ot eval high complexity (97167) | $417.60 | $464 | 4.2× |
| Ot Eval Low Complex (97165) | $353.70 | $393 | 3.5× |
| Ot Eval Moderate Complexity (97166) | $387.90 | $431 | 3.9× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$112.50–$181.80 | $125–$202 | varies |
| Ot paraffin bath (97018) range across 2 matching MRF lines |
$96.30–$112.50 | $107–$125 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) | $152.10 | $169 | 3.8× |
| Ot Re-Eval Est Plan Care (97168) | $262.80 | $292 | 3.8× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $287.10 | $319 | 2.1× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $248.40 | $276 | 1.9× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $318.60 | $354 | 1.4× |
| Percutaneous tests w/allergenic extracts (95004) | $17.10 | $19 | 0.0× |
| Peripheral arterial disease rehab per session (93668) | $287.10 | $319 | 4.7× |
| Phlebotomy therapeutic (99195) | $155.70 | $173 | 1.1× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $538.20 | $598 | 8.8× |
| Plethysmography (94726) | $485.10 | $539 | 1.3× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $5,434.20 | $6,038 | 6.1× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $23.40 | $26 | 0.5× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $27.77 | $30.86 | 0.6× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $38.91 | $43.23 | 0.8× |
| Pt Eval High Complex (97163) | $301.50 | $335 | 3.1× |
| Pt eval low complex 20 min (97161) | $235.80 | $262 | 2.4× |
| Pt Eval Mod Complex (97162) | $268.20 | $298 | 2.7× |
| Pt gait training 15 min (97116) | $138.60 | $154 | 4.8× |
| Pt mechanical traction (97012) | $106.20 | $118 | 7.4× |
| Pt Re-Eval Est Plan Care (97164) | $133.20 | $148 | 2.0× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$311.40–$526.50 | $346–$585 | varies |
| Pulmonary Stress Testing (94618) | $627.30 | $697 | 4.5× |
| Remote 30 Day Ecg Rev/Report (93270) | $429.30 | $477 | 11.1× |
| Respiratory flow volume loop (94375) | $375.30 | $417 | 1.7× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$218.70–$579.60 | $243–$644 | varies |
| Same day nb discharge (99463) | $757.80 | $842 | 5.5× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$112.50–$155.70 | $125–$173 | varies |
| Sensory Integration Ea 15 Min (97533) | $116.10 | $129 | 1.9× |
| Sleep study unattended (95806) | $716.40 | $796 | 3.2× |
| Speech sound lang comprehen (92523) | $505.80 | $562 | 2.2× |
| Spirometry (94010) | $364.50 | $405 | 1.6× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $112.50 | $125 | 3.0× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $88.20 | $98 | 3.0× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$39.60–$194.40 | $44–$216 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $595.80 | $662 | 2.7× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$133.20–$156.60 | $148–$174 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $76.50 | $85 | 2.0× |
| Trans Care Mgmt 14 Day Disch (99495) | $446.40 | $496 | 3.2× |
| Trans Care Mgmt 7 Day Disch (99496) | $603.90 | $671 | 4.4× |
| Tte w/doppler, complete (93306) | $2,623.50 | $2,915 | 4.6× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 2 matching MRF lines |
$320.40–$463.50 | $356–$515 | varies |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $203.40 | $226 | 4.2× |
| Tympanometry (92567) | $95.40 | $106 | 2.5× |
| Upr/L Xtremity Art 2 Levels (93922) | $701.10 | $779 | 5.1× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $1,238.40 | $1,376 | 5.5× |
| Vasopneumatic device (97016) | $138.60 | $154 | 11.5× |
| Vent Mgmt Inpat Init Day (94002) | $1,485 | $1,650 | 2.3× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,350 | $1,500 | 2.1× |
| Vital capacity, total (94150) | $127.80 | $142 | 1.0× |
| Wheelchair Mgmt Ea 15 Min (97542) | $116.10 | $129 | 3.7× |
| Whirlpool Therapy (97022) range across 2 matching MRF lines |
$133.20–$135.90 | $148–$151 | varies |
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.