St Francis Medical Center
2400 St Francis Drive
Breckenridge, MN 56520
Critical Access Hospitals
Overview
- CCN241377
Procedures & prices
- FOSPHENYTOIN INJ PEQ2009$10cashGross $170 payers
- Flutamide 125 mgS0175$10cashGross $170 payers
- Inj theophylline per 40 mgJ2810$11cashGross $180 payers
- CYCLOPHOSPHAMIDE ORAL 25 MGJ8530$11cashGross $180 payers
- Normal saline solution infusJ7040$11cashGross $180 payers
- CYCLOSPORINE ORAL 100 MGJ7502$12cashGross $190 payers
- DIGOXIN INJECTIONJ1160$12cashGross $190 payers
- HC OT AQUATIC THERAPY/EXERCISES GO97113$12cashGross $200 payers
- Furosemide injectionJ1940$12cashGross $200 payers
- NORMAL SALINE SOLUTION INFUSJ7050$12cashGross $210 payers
| Procedure | Code | Cash↑ | Gross | Negotiated range | Payers |
|---|---|---|---|---|---|
| FOSPHENYTOIN INJ PE | Q2009 | $10 | $17 | — | 0 |
| Flutamide 125 mg | S0175 | $10 | $17 | — | 0 |
| Inj theophylline per 40 mg | J2810 | $11 | $18 | — | 0 |
| CYCLOPHOSPHAMIDE ORAL 25 MG | J8530 | $11 | $18 | — | 0 |
| Normal saline solution infus | J7040 | $11 | $18 | — | 0 |
| CYCLOSPORINE ORAL 100 MG | J7502 | $12 | $19 | — | 0 |
| DIGOXIN INJECTION | J1160 | $12 | $19 | — | 0 |
| HC OT AQUATIC THERAPY/EXERCISES GO | 97113 | $12 | $20 | — | 0 |
| Furosemide injection | J1940 | $12 | $20 | — | 0 |
| NORMAL SALINE SOLUTION INFUS | J7050 | $12 | $21 | — | 0 |
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