Visits & medical services prices at West Holt Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $274.50 $343 1.2×
Behavioral and qualitative analysis of voice and resonance (92524) $351 $439 3.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $774 $967 2.0×
Canalith Repositioning (95992) $103 $129 2.5×
Cardiac Stress Tst,Tracing Only (93017) $1,216 $1,520 5.4×
Cardiopulmonary resuscitation (92950) $550 $688 2.5×
Cardioversion (92960) $1,330 $1,663 1.9×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $54 $67 0.5×
Color/duplex Doppler, complete (93975) $1,037 $1,296 4.2×
Color/duplex Doppler, limited (93976) $800 $1,000 7.4×
Cpap initiation and management (94660) $823 $1,029 3.6×
Cpt initial (94667) $277 $346 2.0×
Critical care (99291) $3,042 $3,803 3.5×
Debridement Open Wound 20 Sq Cm< (97597) $318 $397 1.5×
Demo &/or eval,pt use,aerosol device (94664) $197 $246 0.9×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $1,559 $1,949 6.3×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $827 $1,034 7.6×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,076 $1,345 4.3×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $878 $1,097 8.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,076 $1,345 4.3×
Dup-scan xtr veins unilateral/limited study (93971) $1,037 $1,296 9.6×
Duplex scan extracranial art compl bi study (93880) $1,559 $1,949 6.3×
Echo Heart Xthoracic,Limited (93308) $914 $1,142.50 3.7×
EKG (93005) $349.50 $437 5.7×
Elec alys nstim pls gen smpl sc/perph w/prgrmg (95971) $125 $156 1.3×
Er level 1 (99281) $188 $235 2.1×
Er level ii (99282) $319 $399 2.0×
Er level iii (99283) $509 $636 1.8×
Er level IV (99284) $740 $925 1.7×
Er level v (99285) $1,165 $1,456 1.9×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $269 $336 3.8×
Evaluation of speech fluency (92521) $419 $524 3.1×
Evaluation of speech sound production (92522) $344 $430 3.1×
Evaluation of swallowing function (92610) $318 $397 3.7×
Evaluation with prescription of speech-generating alternative (92607) $470 $587 3.8×
External ECG rec>48hr<7d recording (93242) $477 $596 12.3×
External ECG rec>48hr<7d scanning alys w/report (93243) $877 $1,096 6.3×
External ECG rec>7d<15d recording (93246) $597 $746 15.4×
External ECG rec>7d<15d scanning alys w/report (93247) $998 $1,248 7.2×
External Ecg Scanning Analysis Report (93226) $707 $884 11.5×
Holter Monitor Recording (93225) $526.50 $658.50 3.8×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $39 $49 0.9×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $39 $49 0.5×
Immunization Admin (90471) $39 $49 0.5×
Immunotherapy, 2+ Injections (95117) $46 $57 0.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $166 $208 2.7×
IV infusion hydration each additional hour (96361) $117 $146 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $420 $525 1.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $208 $260 2.8×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $414 $517 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $140 $175 2.9×
IV push initial (96374) $163.50 $204.50 0.7×
Manual therapy 15 min (97140) $107 $134 3.9×
Maximum voluntary ventilation (94200) $146 $182 2.4×
Mechanical chest wall oscillation (94669) $197 $246 0.9×
Mechanical traction (97012) $86 $107 6.0×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $63 $79 2.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $105 $131 2.9×
Mnt Group Ea 30 Min (97804) $63 $79 3.7×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $494 $617 5.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $420 $525 2.0×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $525 $656 1.2×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $663 $829 4.8×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $901 $1,126 4.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $446 $557 3.3×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $119 $149 2.6×
Ot Contrast Bath Ea 15 Min (97034) $70 $87 5.0×
Ot eval high complex 60 min (97167) $361 $451 3.6×
Ot eval low complex 30 min (97165) $258 $323 2.6×
Ot eval mod complex 45 min (97166) $309 $386 3.1×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $119 $149 2.4×
Ot Prosthetic Training, Each 15 Min (97761) $119 $149 2.9×
Ot Range Motion Measure,Each Extrem (95851) $71 $89 2.7×
Ot re-eval est plan care (97168) $161 $201 2.4×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $259 $324 1.9×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $259 $324 1.9×
Paraffin bath (97018) $79 $99 13.1×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $197 $246 0.9×
Percutaneous tests w/allergenic extracts (95004) $6 $8 0.0×
Phy/qhp op pulm rhb w/mntr (94626) $306 $383 5.0×
Phy/qhp op pulm rhb w/o mntr (94625) $231 $289 3.8×
Plethysmography (94726) $867 $1,084 2.2×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $42.50 $53 0.9×
Pt Electric Current Therapy (97033) $149 $186 7.8×
Pt Electrical Stimulation (97032) $103 $129 7.0×
Pt eval high complex 45 min (97163) $334 $418 3.4×
Pt eval low complex 20 min (97161) $232 $290 2.4×
Pt Gait Training Therapy (97116) $102 $128 3.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $105 $131 3.2×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $283 $354 2.9×
Pt re-evaluation (97164) $131 $164 1.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $109 $136 3.4×
Pt Ultrasound Therapy (97035) $90 $112 6.3×
Pt Whirlpool Therapy (97022) $124 $155 7.9×
Pulmonary stress testing (94618) $519 $649 3.8×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $333 $416 8.6×
Rom meas&reprt hand w/wo comparison normal sid (95852) $53 $66 2.5×
Rt Chest Wall Manipulation,Subsequent (94668) $120 $150 0.9×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $205 $256 4.3×
Sensory Integration Ea 15 Min (97533) $95 $119 1.6×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $528 $660 2.4×
Speech sound lang comprehen (92523) $586 $733 2.6×
Spirometry (94010) $350 $437 1.6×
Stress Tte Complete (93351) $1,667 $2,084 2.9×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $102 $128 4.6×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $100 $125.50 4.8×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $409 $511 4.0×
Ther/Proph/Diag Inj Sc/Im (96372) $124 $155 1.7×
Therapeutic Activities (97530) $109 $136 3.1×
Therapeutic phlebotomy (99195) $277 $346 2.0×
Trans Care Mgmt 14 Day Disch (99495) $356 $445 2.6×
Trans Care Mgmt 7 Day Disch (99496) $485 $606 3.5×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,990 $2,487 3.5×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $1,978 $2,472 8.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $304 $380 4.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $320 $400 3.8×
Tx/Pro/Dx Inj New Drug Addon (96375) $178 $223 3.7×
Tympanometry (92567) $62 $78 1.6×
Vasc Duplex Extrem Venous,Bilat (93970) $1,444 $1,805 5.8×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,042 $1,303 4.6×
Vasopneumatic device (97016) $68 $85 5.7×
Ventilation assist & mgmt inpatient 1st day (94002) $1,241 $1,551 1.9×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $857 $1,071 1.3×
Wheelchair Mgmt Ea 15 Min (97542) $97 $121 3.1×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $624 $780 6.3×