▸ Hospital · IL · CCN 140091
The Carle Foundation Hospital
611 W. PARK STREET, URBANA, IL, 61801-2595
469 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
11
with negotiated rates
Rates published
42,840
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 9 | — | — | $13,055 | $13,055 | $30,730 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | $599 | $599 | $59.9 | $190.21 | $509.15 |
| Psychiatric eval with medical services | CPT | 90792 | 11 | $672 | $672 | $67.2 | $201.6 | $571.2 |
| Psychotherapy 30 minutes | CPT | 90832 | 11 | $515 | $515 | $51.5 | $190.21 | $437.75 |
| Psychotherapy 45 minutes | CPT | 90834 | 11 | $599 | $599 | $59.9 | $190.21 | $509.15 |
| Psychotherapy 60 minutes | CPT | 90837 | 11 | $599 | $599 | $59.9 | $190.21 | $509.15 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | $599 | $599 | $59.9 | $190.21 | $509.15 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 11 | $410 | $410 | $8.57 | $146.4 | $348.5 |
| ED visit level 2 | CPT | 99282 | 11 | $746 | $746 | $30.07 | $287.52 | $634.1 |
| ED visit level 3 | CPT | 99283 | 11 | $1,292 | $1,292 | $51.73 | $408.48 | $1,098.2 |
| ED visit level 4 | CPT | 99284 | 11 | $2,027 | $2,027 | $86.76 | $608.1 | $1,722.95 |
| ED visit level 5 | CPT | 99285 | 11 | $2,877 | $2,877 | $126.53 | $863.1 | $2,445.45 |
| Critical care, first hour | CPT | 99291 | 11 | $3,780 | $3,780 | $151.72 | $1,134 | $3,213 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 11 | $3,812 | $3,812 | $112.03 | $762.4 | $3,240.2 |
| CT head with contrast | CPT | 70460 | 11 | $3,560 | $3,560 | $156.33 | $839.44 | $3,026 |
| CT head with and without contrast | CPT | 70470 | 11 | $4,095 | $4,095 | $183.83 | $919.69 | $3,480.75 |
| CT neck with contrast | CPT | 70491 | 11 | $4,400 | $4,400 | $187.96 | $965.44 | $3,740 |
| MRI brain without contrast | CPT | 70551 | 11 | $4,841 | $4,841 | $241.18 | $1,452.3 | $4,114.85 |
| MRI brain with contrast | CPT | 70552 | 11 | $9,093 | $9,093 | $332.97 | $2,727.9 | $7,729.05 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| Chest X-ray single view | CPT | 71045 | 11 | $609 | $609 | $22.16 | $239.52 | $517.65 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $609 | $609 | $28.59 | $182.7 | $517.65 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $735 | $735 | $35.87 | $220.5 | $624.75 |
| CT chest without contrast | CPT | 71250 | 11 | $3,906 | $3,906 | $112.03 | $1,171.8 | $3,320.1 |
| CT chest with contrast | CPT | 71260 | 11 | $4,977 | $4,977 | $176.07 | $1,493.1 | $4,230.45 |
| CT chest with and without contrast | CPT | 71270 | 11 | $5,618 | $5,618 | $187.96 | $1,685.4 | $4,775.3 |
| MRI chest without contrast | CPT | 71550 | 11 | $5,576 | $5,576 | $255.69 | $1,672.8 | $4,739.6 |
| MRI chest with contrast | CPT | 71551 | 11 | $6,416 | $6,416 | $458.86 | $1,924.8 | $5,453.6 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $9,093 | $9,093 | $373.86 | $2,727.9 | $7,729.05 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $840 | $840 | $33.81 | $252 | $714 |
| CT cervical spine without contrast | CPT | 72125 | 11 | $4,421 | $4,421 | $112.03 | $1,326.3 | $3,757.85 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $3,644 | $3,644 | $112.03 | $1,093.2 | $3,097.4 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $3,738 | $3,738 | $112.03 | $1,121.4 | $3,177.3 |
| MRI cervical spine without contrast | CPT | 72141 | 11 | $5,397 | $5,397 | $234.66 | $1,619.1 | $4,587.45 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $5,072 | $5,072 | $234.66 | $1,521.6 | $4,311.2 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $5,292 | $5,292 | $235.43 | $1,587.6 | $4,498.2 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $9,093 | $9,093 | $332.65 | $2,727.9 | $7,729.05 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| CT pelvis without contrast | CPT | 72192 | 11 | $4,148 | $4,148 | $112.03 | $1,244.4 | $3,525.8 |
| CT pelvis with contrast | CPT | 72193 | 11 | $5,061 | $5,061 | $187.96 | $1,518.3 | $4,301.85 |
| Shoulder X-ray | CPT | 73030 | 11 | $683 | $683 | $29.31 | $204.9 | $580.55 |
| Humerus X-ray | CPT | 73060 | 11 | $609 | $609 | $27.33 | $182.7 | $517.65 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $693 | $693 | $31.21 | $207.9 | $589.05 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $5,576 | $5,576 | $248.59 | $1,672.8 | $4,739.6 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $609 | $609 | $28.98 | $182.7 | $517.65 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $693 | $693 | $31.21 | $207.9 | $589.05 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $5,576 | $5,576 | $248.21 | $1,672.8 | $4,739.6 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| CT abdomen without contrast | CPT | 74150 | 11 | $4,158 | $4,158 | $112.03 | $1,247.4 | $3,534.3 |
| CT abdomen with contrast | CPT | 74160 | 11 | $4,988 | $4,988 | $187.96 | $1,496.4 | $4,239.8 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $5,492 | $5,492 | $187.96 | $1,647.6 | $4,668.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $6,195 | $6,195 | $194.99 | $1,858.5 | $5,265.75 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $7,518 | $7,518 | $322.23 | $2,255.4 | $6,390.3 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $8,285 | $8,285 | $360.53 | $2,485.5 | $7,042.25 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $5,145 | $5,145 | $241.87 | $1,543.5 | $4,373.25 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $7,928 | $7,928 | $373.86 | $2,378.4 | $6,738.8 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $2,247 | $2,247 | $99.25 | $922.56 | $1,909.95 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $1,523 | $1,523 | $75.01 | $731.04 | $1,294.55 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,659 | $1,659 | $92.47 | $497.7 | $1,410.15 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $1,397 | $1,397 | $100.56 | $419.1 | $1,187.45 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,397 | $1,397 | $112.03 | $419.1 | $1,187.45 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $2,531 | $2,531 | $150.89 | $759.3 | $2,151.35 |
| Transvaginal ultrasound | CPT | 76830 | 11 | $1,397 | $1,397 | $101.68 | $419.1 | $1,187.45 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,397 | $1,397 | $89.86 | $419.1 | $1,187.45 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,397 | $1,397 | $85.87 | $419.1 | $1,187.45 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $777 | $777 | $77.7 | $233.1 | $660.45 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $924 | $924 | $92.4 | $277.2 | $785.4 |
| Screening mammography bilateral | CPT | 77067 | 11 | $924 | $924 | $92.4 | $277.2 | $785.4 |
| EKG complete | CPT | 93000 | 7 | — | — | $14.96 | $14.96 | $15.63 |
| EKG tracing only | CPT | 93005 | 11 | $462 | $462 | $6.48 | $138.6 | $392.7 |
| EKG interpretation only | CPT | 93010 | 7 | — | — | $8.33 | $8.33 | $8.95 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $4,851 | $4,851 | $201.38 | $2,313.6 | $4,123.35 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $2,037 | $2,037 | $140.29 | $611.1 | $1,731.45 |
| Stress echocardiogram | CPT | 93350 | 11 | $3,266 | $3,266 | $190.43 | $979.8 | $2,776.1 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 9 | — | — | $18,217 | $18,217 | $44,242 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 9 | — | — | $9,806.29 | $9,806.29 | $22,227 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 9 | — | — | $7,067.24 | $7,067.24 | $15,057 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $14,449 | $14,449 | $34,379 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $10,625 | $10,625 | $24,369 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $8,400.2 | $8,400.2 | $18,546 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $6,710.88 | $6,710.88 | $14,124 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $8,088.41 | $8,088.41 | $17,730 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $6,597.43 | $6,597.43 | $13,827 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $14,797 | $14,797 | $35,290 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $9,039.79 | $9,039.79 | $20,220 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $7,392.52 | $7,392.52 | $15,908 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $12,105 | $12,105 | $28,244 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $8,450.62 | $8,450.62 | $18,678 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $6,072.15 | $6,072.15 | $12,452 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $11,434 | $11,434 | $26,488 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $7,498.4 | $7,498.4 | $16,185 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $6,072.99 | $6,072.99 | $12,454 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $9,557.52 | $9,557.52 | $21,575 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $6,613.39 | $6,613.39 | $13,869 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $7,867.35 | $7,867.35 | $17,151 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $14,491 | $14,491 | $34,489 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $11,067 | $11,067 | $25,527 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $8,118.67 | $8,118.67 | $17,809 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $17,641 | $17,641 | $42,735 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $9,915.55 | $9,915.55 | $22,513 |
| Initial hospital care, low complexity | CPT | 99221 | 11 | $168 | $168 | $16.8 | $76.87 | $142.8 |
| Initial hospital care, moderate complexity | CPT | 99222 | 7 | — | — | $91.94 | $119.28 | $121.67 |
| Initial hospital care, high complexity | CPT | 99223 | 7 | — | — | $122.29 | $158.97 | $162.15 |
| Hospital discharge, <30 min | CPT | 99238 | 7 | — | — | $56.6 | $75.27 | $76.78 |
| Hospital discharge, >30 min | CPT | 99239 | 7 | — | — | $80.45 | $107 | $109.14 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $163 | $163 | $3.6 | $22.84 | $138.55 |
| General health panel | CPT | 80050 | 10 | $425 | $425 | $31.89 | $165.75 | $361.25 |
| Electrolyte panel | CPT | 80051 | 11 | $215 | $215 | $6.03 | $22.78 | $182.75 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $509 | $509 | $4.4 | $71.76 | $432.65 |
| Lipid panel | CPT | 80061 | 11 | $389 | $389 | $11.52 | $43.52 | $330.65 |
| Renal function panel | CPT | 80069 | 11 | $310 | $310 | $7.46 | $31 | $263.5 |
| Hepatic function panel | CPT | 80076 | 11 | $320 | $320 | $7.03 | $32 | $272 |
| Urinalysis non-automated | CPT | 81002 | 11 | $184 | $184 | $2.99 | $55.68 | $156.4 |
| Urinalysis automated | CPT | 81003 | 11 | $116 | $116 | $1.94 | $40.44 | $98.6 |
| Glucose quantitative | CPT | 82947 | 11 | $194 | $194 | $3.38 | $81.09 | $164.9 |
| Hemoglobin A1c | CPT | 83036 | 11 | $263 | $263 | $3 | $24 | $223.55 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $389 | $389 | $1.8 | $38.9 | $330.65 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $263 | $263 | $6.68 | $73.13 | $223.55 |
| Complete blood count without differential | CPT | 85027 | 11 | $200 | $200 | $5.56 | $72.96 | $170 |
| Urine culture bacterial | CPT | 87086 | 11 | $215 | $215 | $6.94 | $26.23 | $182.75 |
| Urine culture identification | CPT | 87088 | 11 | $184 | $184 | $6.96 | $26.29 | $156.4 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $924 | $924 | $22.6 | $203.15 | $785.4 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 11 | $861 | $861 | $36.25 | $312.48 | $731.85 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 7 | — | — | $1,791.18 | $2,358.17 | $2,405.33 |
| Vaginal delivery only | CPT | 59409 | 7 | — | — | $623.52 | $3,468.96 | $3,538.34 |
| Vaginal delivery with postpartum | CPT | 59410 | 7 | — | — | $823.17 | $1,061.82 | $1,083.05 |
| Routine obstetric care with C-section | CPT | 59510 | 7 | — | — | $1,991.74 | $2,659.68 | $2,712.87 |
| C-section delivery only | CPT | 59514 | 7 | — | — | $708.83 | $907.65 | $925.8 |
| C-section with postpartum | CPT | 59515 | 7 | — | — | $1,016.31 | $1,342.1 | $1,368.94 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 11 | $163 | $163 | $16.3 | $72.84 | $138.55 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 11 | $215 | $215 | $21.5 | $115.47 | $182.75 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 11 | $315 | $315 | $31.5 | $174.69 | $267.75 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 11 | $362 | $362 | $36.2 | $234.2 | $307.7 |
| Office visit, established patient, 5 min | CPT | 99211 | 11 | $85 | $85 | $6.18 | $25.5 | $72.25 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 11 | $163 | $163 | $16.3 | $57.62 | $138.55 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 11 | $215 | $215 | $21.5 | $92.64 | $182.75 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 11 | $1,134 | $1,134 | $31.5 | $204.75 | $963.9 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 11 | $362 | $362 | $36.2 | $188.35 | $307.7 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | $2,079 | $2,079 | $118.34 | $971.94 | $1,767.15 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | $3,045 | $3,045 | $133.51 | $971.94 | $2,588.25 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | $2,289 | $2,289 | $54.21 | $996.56 | $1,945.65 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | $2,720 | $2,720 | $69.26 | $996.56 | $2,312 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | $3,371 | $3,371 | $178.84 | $1,011.3 | $2,865.35 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | $4,431 | $4,431 | $194.2 | $1,329.3 | $3,766.35 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | $4,526 | $4,526 | $245.75 | $1,357.8 | $3,847.1 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 7 | — | — | $1,352.64 | $18,790 | $19,165 |
| Hip hemiarthroplasty | CPT | 27125 | 7 | — | — | $1,058.52 | $13,758 | $14,033 |
| Total hip replacement | CPT | 27130 | 7 | — | — | $1,203.7 | $13,758 | $14,033 |
| Total knee replacement | CPT | 27447 | 7 | — | — | $1,202.43 | $13,758 | $14,033 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | — | — | $1,313.78 | $13,758 | $14,033 |
| Knee revision arthroplasty all components | CPT | 27487 | 7 | — | — | $1,641.41 | $18,790 | $19,165 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $155.89 | $155.89 | $166.81 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 7 | — | — | $999.51 | $7,775.89 | $7,931.41 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 7 | — | — | $504.71 | $3,506.34 | $3,576.46 |
| ACL reconstruction | CPT | 29888 | 7 | — | — | $911.67 | $7,775.89 | $7,931.41 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $39,947 | $39,947 | $101,123 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $21,463 | $21,463 | $52,738 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $15,459 | $15,459 | $37,024 |
| CABG single arterial graft | CPT | 33533 | 7 | — | — | $1,877.09 | $1,877.09 | $2,128.94 |
| CABG 2 arterial grafts | CPT | 33534 | 7 | — | — | $2,203.47 | $2,203.47 | $2,499.89 |
| CABG 3 arterial grafts | CPT | 33535 | 7 | — | — | $2,446.3 | $2,446.3 | $2,781.29 |
| CABG 4+ arterial grafts | CPT | 33536 | 7 | — | — | $2,636.71 | $2,636.71 | $2,994.11 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $15,532 | $15,532 | $37,215 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $12,794 | $12,794 | $30,048 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $29,950 | $29,950 | $74,956 |
| Open appendectomy | CPT | 44950 | 7 | — | — | $644.12 | $6,937.47 | $7,076.22 |
| Laparoscopic appendectomy | CPT | 44970 | 7 | — | — | $602.74 | $6,478.5 | $6,608.07 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $26,808 | $26,808 | $66,730 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $17,527 | $17,527 | $42,436 |
| Laparoscopic cholecystectomy | CPT | 47562 | 7 | — | — | $660.53 | $6,478.5 | $6,608.07 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 7 | — | — | $720.68 | $6,478.5 | $6,608.07 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $25,792 | $25,792 | $64,071 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $18,918 | $18,918 | $46,079 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $15,023 | $15,023 | $35,882 |
| Lap inguinal hernia repair | CPT | 49650 | 7 | — | — | $431.49 | $6,478.5 | $6,608.07 |
| Total abdominal hysterectomy | CPT | 58150 | 7 | — | — | $882.15 | $975.12 | $994.62 |
| Vaginal hysterectomy | CPT | 58260 | 7 | — | — | $731.08 | $5,360.72 | $5,467.93 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 7 | — | — | $768.47 | $6,478.5 | $6,608.07 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 7 | — | — | $855.39 | $11,391 | $11,619 |
| Lap salpingo-oophorectomy | CPT | 58661 | 7 | — | — | $569.47 | $6,478.5 | $6,608.07 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $25,582 | $25,582 | $63,523 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $14,765 | $14,765 | $35,207 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $13,993 | $13,993 | $33,185 |
| Complex cataract surgery | CPT | 66982 | 7 | — | — | $738.24 | $2,473.11 | $2,522.57 |
| Cataract surgery with lens implant | CPT | 66984 | 7 | — | — | $538.68 | $2,473.11 | $2,522.57 |
| Intravitreal injection | CPT | 67028 | 11 | $1,722 | $1,722 | $91.47 | $516.6 | $1,463.7 |
| Vitrectomy mechanical | CPT | 67042 | 7 | — | — | $1,133.45 | $4,429.45 | $4,518.04 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $11,743 | $11,743 | $27,295 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $18,537 | $18,537 | $45,080 |
| PCI single major coronary artery | CPT | 92920 | 11 | $23,237 | $23,237 | $526.77 | $6,971.1 | $19,751 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $17,955 | $17,955 | $587.67 | $11,868 | $15,262 |
| PCI bypass graft | CPT | 92937 | 11 | $49,571 | $49,571 | $587.03 | $14,871 | $42,135 |
| Left heart catheterization | CPT | 93452 | 11 | $15,152 | $15,152 | $927.06 | $4,545.6 | $12,879 |
| Coronary angiography with cath | CPT | 93455 | 11 | $14,627 | $14,627 | $1,038.72 | $4,388.1 | $12,433 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $19,488 | $19,488 | $1,072.24 | $5,846.4 | $16,565 |
Payer mix (top 11)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 197 | $429.58 |
| Blue Cross Blue Shield | 197 | $1,070.09 |
| Humana | 197 | $194.6 |
| meridian | 197 | $165.22 |
| Molina | 197 | $316.37 |
| UnitedHealthcare | 197 | $840.06 |
| WellCare | 196 | $373.86 |
| Cigna | 158 | $2,960.88 |
| community partners health plan (cphp) | 158 | $1,544.85 |
| Multiplan | 115 | $739.2 |
| healthlink | 115 | $785.4 |