▸ Hospital · IL · CCN 140209
Methodist Medical Center Of Illinois
221 N E GLEN OAK, PEORIA, IL, 61636
215 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
200
of 209 target codes
Payers
12
with negotiated rates
Rates published
48,893
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 11 | — | — | $11,009 | $11,534 | $20,078 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $584.79 | $467.84 | $139.86 | $202.31 | $412.64 |
| Psychiatric eval with medical services | CPT | 90792 | 12 | $584.79 | $467.84 | $153.21 | $211.71 | $419.07 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $298.13 | $238.51 | $67.55 | $129.09 | $412.64 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $392.35 | $313.88 | $89.14 | $154.8 | $412.64 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $446.84 | $357.48 | $117.07 | $193.37 | $412.64 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 12 | $446.84 | $357.48 | $117.07 | $185.41 | $412.64 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 10 | $439.82 | $351.86 | $10.3 | $41.55 | $226.14 |
| ED visit level 2 | CPT | 99282 | 12 | $843.3 | $674.64 | $14.41 | $88.74 | $406.68 |
| ED visit level 3 | CPT | 99283 | 12 | $1,527.35 | $1,221.88 | $14.41 | $141.19 | $711.09 |
| ED visit level 4 | CPT | 99284 | 12 | $2,431.17 | $1,944.94 | $14.41 | $249.46 | $1,093.57 |
| ED visit level 5 | CPT | 99285 | 12 | $3,514.46 | $2,811.57 | $14.41 | $364.2 | $1,574.54 |
| Critical care, first hour | CPT | 99291 | 12 | $4,743.43 | $3,794.75 | $194 | $654.02 | $2,163.96 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $2,693.72 | $2,154.98 | $37.24 | $105.49 | $1,166.38 |
| CT head with contrast | CPT | 70460 | 12 | $2,784.86 | $2,227.89 | $49.4 | $171.51 | $1,205.84 |
| CT head with and without contrast | CPT | 70470 | 12 | $3,258.29 | $2,606.64 | $55.55 | $171.51 | $1,410.84 |
| CT neck with contrast | CPT | 70491 | 12 | $2,924.12 | $2,339.3 | $60.29 | $178.04 | $1,266.14 |
| MRI brain without contrast | CPT | 70551 | 12 | $5,061.19 | $4,048.96 | $64.56 | $232.88 | $2,191.5 |
| MRI brain with contrast | CPT | 70552 | 12 | $5,207.52 | $4,166.02 | $77.96 | $344.08 | $2,254.86 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $7,308.79 | $5,847.04 | $100.21 | $344.08 | $3,164.71 |
| Chest X-ray single view | CPT | 71045 | 12 | $366.73 | $293.39 | $8.04 | $26.96 | $226.11 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $423.26 | $338.61 | $9.63 | $35.33 | $226.11 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $437.87 | $350.3 | $12.13 | $44.04 | $226.11 |
| CT chest without contrast | CPT | 71250 | 12 | $2,598.28 | $2,078.63 | $47.19 | $124.2 | $1,125.06 |
| CT chest with contrast | CPT | 71260 | 12 | $3,449.76 | $2,759.81 | $50.96 | $171.51 | $1,493.75 |
| CT chest with and without contrast | CPT | 71270 | 12 | $3,947.56 | $3,158.05 | $54.61 | $187.25 | $1,709.29 |
| MRI chest without contrast | CPT | 71550 | 12 | $2,784.86 | $2,227.89 | $63.91 | $294.33 | $1,392.56 |
| MRI chest with contrast | CPT | 71551 | 12 | $3,481.09 | $2,784.88 | $75.45 | $529.79 | $2,028.99 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $5,473.64 | $4,378.92 | $98.95 | $439.25 | $2,370.09 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $570.89 | $456.72 | $9.92 | $46.11 | $273.11 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $3,493.5 | $2,794.8 | $43.57 | $124.97 | $1,512.69 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $2,807.15 | $2,245.72 | $43.57 | $124.67 | $1,215.5 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $3,034.43 | $2,427.55 | $43.57 | $124.35 | $1,313.91 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $4,468.84 | $3,575.08 | $64.86 | $232.88 | $1,935.01 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $3,863.24 | $3,090.6 | $64.86 | $232.88 | $1,672.78 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $5,123.91 | $4,099.13 | $64.86 | $232.88 | $2,218.65 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $5,213.43 | $4,170.75 | $78.25 | $344.08 | $2,257.42 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $6,332.78 | $5,066.23 | $100.51 | $344.08 | $2,742.09 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $6,675.33 | $5,340.27 | $100.51 | $344.08 | $2,890.42 |
| CT pelvis without contrast | CPT | 72192 | 12 | $2,730.4 | $2,184.32 | $47.51 | $124.23 | $1,182.26 |
| CT pelvis with contrast | CPT | 72193 | 12 | $3,234.54 | $2,587.64 | $50.66 | $213.22 | $1,400.56 |
| Shoulder X-ray | CPT | 73030 | 12 | $513.81 | $411.05 | $8.33 | $39.98 | $226.11 |
| Humerus X-ray | CPT | 73060 | 12 | $464.63 | $371.71 | $7.1 | $37.75 | $226.11 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $487.34 | $389.88 | $7.71 | $42.06 | $226.11 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $4,345.23 | $3,476.19 | $59.32 | $232.88 | $1,881.48 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $4,942.1 | $3,953.68 | $94.35 | $366.84 | $2,139.93 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $421.92 | $337.54 | $7.39 | $40.32 | $226.11 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $499.91 | $399.93 | $7.71 | $42.06 | $226.11 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $4,466.27 | $3,573.02 | $59.32 | $232.88 | $1,933.89 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $5,208.26 | $4,166.61 | $94.35 | $365.9 | $2,255.18 |
| CT abdomen without contrast | CPT | 74150 | 12 | $2,780.69 | $2,224.56 | $51.93 | $129.4 | $1,204.04 |
| CT abdomen with contrast | CPT | 74160 | 12 | $3,229.05 | $2,583.24 | $55.55 | $216.6 | $1,398.18 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $4,085.9 | $3,268.72 | $60.94 | $228.82 | $1,769.19 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $5,929.24 | $4,743.4 | $76.07 | $201.5 | $2,567.36 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $6,540.71 | $5,232.57 | $79.84 | $344.08 | $2,832.13 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $7,567.87 | $6,054.3 | $87.76 | $344.08 | $3,276.89 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $4,441.86 | $3,553.49 | $63.62 | $246.55 | $1,923.33 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $6,462.28 | $5,169.83 | $96.27 | $344.08 | $2,798.17 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,486.72 | $1,189.38 | $35.36 | $108.62 | $643.75 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $1,110.42 | $888.34 | $25.73 | $102.46 | $480.81 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $1,189.63 | $951.71 | $32.21 | $102.46 | $515.11 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $1,000.55 | $800.44 | $43.54 | $110.38 | $433.24 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $1,164.8 | $931.84 | $43.84 | $123.03 | $504.36 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $1,310.31 | $1,048.25 | $77.82 | $181.75 | $620.77 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $1,023.45 | $818.76 | $30.44 | $109.6 | $443.15 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $1,132.88 | $906.31 | $30.15 | $102.46 | $490.54 |
| Scrotal ultrasound | CPT | 76870 | 12 | $1,093.35 | $874.68 | $27.94 | $93.84 | $473.42 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $417.53 | $334.03 | $35.36 | $111.44 | $273.3 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $516.63 | $413.31 | $43.57 | $142.13 | $344.4 |
| Screening mammography bilateral | CPT | 77067 | 10 | $408.82 | $327.06 | $33.44 | $116.25 | $279.1 |
| EKG complete | CPT | 93000 | 8 | $47 | $37.6 | $12.88 | $28.7 | $42.87 |
| EKG tracing only | CPT | 93005 | 12 | $255.11 | $204.09 | $5.46 | $39.34 | $152.54 |
| EKG interpretation only | CPT | 93010 | 8 | $24 | $19.2 | $7.42 | $16 | $21.83 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $2,526.39 | $2,021.12 | $63.17 | $298.58 | $1,408.12 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $1,162.63 | $930.11 | $39.95 | $184.88 | $620.77 |
| Stress echocardiogram | CPT | 93350 | 12 | $1,319.63 | $1,055.71 | $63.17 | $272.59 | $1,408.12 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $15,521 | $15,977 | $27,695 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $7,942.03 | $8,523.39 | $14,918 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $5,375.65 | $6,004.22 | $10,600 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $12,625 | $13,120 | $22,797 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $8,770.67 | $9,336.78 | $16,312 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $6,709.61 | $7,313.62 | $12,844 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $5,054.66 | $5,689.12 | $10,060 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $6,404.23 | $7,013.87 | $12,331 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $4,863.31 | $5,501.27 | $9,737.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $12,819 | $13,311 | $23,124 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $7,199.29 | $7,794.3 | $13,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $5,663.06 | $6,286.33 | $11,084 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $10,191 | $10,731 | $18,701 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $6,726.01 | $7,329.75 | $12,872 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $4,285.37 | $4,933.97 | $8,765.54 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $9,418.13 | $9,972.32 | $17,402 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $5,773.96 | $6,395.19 | $11,270 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $4,369.72 | $5,016.78 | $8,907.5 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $7,699.92 | $8,285.72 | $14,511 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $4,972.65 | $5,608.61 | $9,921.97 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $6,094.17 | $6,709.51 | $11,809 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $11,910 | $12,418 | $21,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $9,140.09 | $9,699.42 | $16,934 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $6,268.34 | $6,880.47 | $12,102 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $15,319 | $15,770 | $27,338 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $8,052.15 | $8,631.48 | $15,103 |
| Initial hospital care, low complexity | CPT | 99221 | 8 | $227 | $181.6 | $74.73 | $135.5 | $226.16 |
| Initial hospital care, moderate complexity | CPT | 99222 | 8 | $308 | $246.4 | $118.66 | $213.8 | $307.11 |
| Initial hospital care, high complexity | CPT | 99223 | 8 | $453 | $362.4 | $158.4 | $284.9 | $452.74 |
| Hospital discharge, <30 min | CPT | 99238 | 8 | $185 | $148 | $73.92 | $133.3 | $162.91 |
| Hospital discharge, >30 min | CPT | 99239 | 8 | $262 | $209.6 | $104.69 | $188.4 | $239.49 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 9 | $85.7 | $68.56 | $5.08 | $9.94 | $37.11 |
| General health panel | CPT | 80050 | 7 | $88 | $70.4 | $17.48 | $32.61 | $53.61 |
| Electrolyte panel | CPT | 80051 | 9 | $85.7 | $68.56 | $4.21 | $8.24 | $37.11 |
| Comprehensive metabolic panel | CPT | 80053 | 9 | $85.7 | $68.56 | $6.34 | $12.41 | $37.11 |
| Lipid panel | CPT | 80061 | 9 | $85.7 | $68.56 | $8.03 | $15.74 | $37.11 |
| Renal function panel | CPT | 80069 | 9 | $85.7 | $68.56 | $5.21 | $10.2 | $37.11 |
| Hepatic function panel | CPT | 80076 | 9 | $85.7 | $68.56 | $4.9 | $9.6 | $37.11 |
| Urinalysis non-automated | CPT | 81002 | 9 | $32.14 | $25.72 | $3.48 | $4.09 | $13.92 |
| Urinalysis automated | CPT | 81003 | 9 | $32.14 | $25.72 | $2.25 | $2.65 | $13.92 |
| Glucose quantitative | CPT | 82947 | 9 | $41.96 | $33.57 | $3.93 | $4.62 | $18.17 |
| Hemoglobin A1c | CPT | 83036 | 9 | $41.96 | $33.57 | $5.83 | $10.6 | $19.42 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 9 | $68.75 | $55 | $10.08 | $17.83 | $33.6 |
| Complete blood count with automated differential | CPT | 85025 | 9 | $41.96 | $33.57 | $4.66 | $9.13 | $18.17 |
| Complete blood count without differential | CPT | 85027 | 9 | $41.96 | $33.57 | $3.88 | $7.6 | $18.17 |
| Urine culture bacterial | CPT | 87086 | 9 | $48.22 | $38.58 | $4.84 | $9.48 | $20.88 |
| Urine culture identification | CPT | 87088 | 9 | $48.22 | $38.58 | $4.85 | $9.51 | $20.88 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $205 | $164 | $28.96 | $61 | $182.28 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 12 | $796.83 | $637.47 | $17.87 | $61.37 | $516.65 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 8 | $5,690 | $4,552 | $2,106.28 | $3,033 | $5,372.16 |
| Vaginal delivery only | CPT | 59409 | 12 | $5,240.66 | $4,192.53 | $691.99 | $1,900.69 | $8,165.52 |
| Vaginal delivery with postpartum | CPT | 59410 | 8 | $2,641 | $2,112.8 | $936.78 | $1,353.2 | $2,640.42 |
| Routine obstetric care with C-section | CPT | 59510 | 8 | $5,924 | $4,739.2 | $2,322.97 | $3,369.1 | $5,923.56 |
| C-section delivery only | CPT | 59514 | 10 | $8,122.89 | $6,498.32 | $778.91 | $1,752.41 | $3,980.22 |
| C-section with postpartum | CPT | 59515 | 8 | $3,196 | $2,556.8 | $1,153.4 | $1,678.5 | $3,195.11 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $167 | $133.6 | $42.93 | $66.3 | $112.29 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 8 | $237 | $189.6 | $74.5 | $116 | $168.46 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $362 | $289.6 | $121.61 | $188.8 | $288.21 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 8 | $459 | $367.2 | $165.2 | $257 | $376.67 |
| Office visit, established patient, 5 min | CPT | 99211 | 8 | $51 | $40.8 | $8.04 | $12.3 | $20.76 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 8 | $104 | $83.2 | $32.24 | $49.59 | $66.6 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 8 | $201 | $160.8 | $60.36 | $93.2 | $124.66 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 8 | $240 | $192 | $88.83 | $137.3 | $184.05 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 8 | $332 | $265.6 | $131.48 | $203 | $272.53 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $2,012.96 | $1,610.37 | $109.69 | $456.35 | $2,407.8 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $4,995.68 | $3,996.55 | $123.53 | $669.35 | $2,407.8 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | $534 | $427.2 | $50.95 | $173.02 | $2,341.41 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | $840 | $672 | $64.93 | $214.15 | $2,341.41 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | $1,017 | $813.6 | $82.56 | $409.12 | $2,341.41 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | $1,309 | $1,047.2 | $179.1 | $632.6 | $3,028.07 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | $1,371 | $1,096.8 | $226.39 | $803.6 | $3,028.07 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 10 | $8,950 | $7,160 | $1,290.01 | $4,214.42 | $47,229 |
| Hip hemiarthroplasty | CPT | 27125 | 8 | $6,968 | $5,574.4 | $1,013.18 | $2,208.3 | $3,483.37 |
| Total hip replacement | CPT | 27130 | 10 | $8,344 | $6,675.2 | $1,146 | $3,927.16 | $33,044 |
| Total knee replacement | CPT | 27447 | 10 | $8,336 | $6,668.8 | $1,144.67 | $3,925.06 | $33,044 |
| Knee revision arthroplasty single component | CPT | 27486 | 8 | $8,660 | $6,928 | $1,254.09 | $2,733.9 | $11,191 |
| Knee revision arthroplasty all components | CPT | 27487 | 8 | $10,830 | $8,664 | $1,560.09 | $3,401.3 | $14,049 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 8 | $1,326 | $1,060.8 | $151.83 | $330.5 | $538.56 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 10 | $6,590 | $5,272 | $958.1 | $3,073.52 | $18,346 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | $3,324 | $2,659.2 | $490.7 | $1,564.1 | $8,332.67 |
| ACL reconstruction | CPT | 29888 | 10 | $6,040 | $4,832 | $874.13 | $2,845.38 | $18,346 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $34,904 | $35,931 | $61,895 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $18,310 | $18,848 | $32,616 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $12,894 | $13,385 | $23,250 |
| CABG single arterial graft | CPT | 33533 | 8 | $5,709 | $4,567.2 | $1,610.12 | $3,690.6 | $5,708.4 |
| CABG 2 arterial grafts | CPT | 33534 | 8 | $6,708 | $5,366.4 | $1,891.26 | $4,335.1 | $6,707.71 |
| CABG 3 arterial grafts | CPT | 33535 | 8 | $7,481 | $5,984.8 | $2,102.11 | $4,815.5 | $7,480.06 |
| CABG 4+ arterial grafts | CPT | 33536 | 8 | $8,063 | $6,450.4 | $2,263.84 | $5,187.2 | $8,062.01 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 11 | — | — | $12,952 | $13,441 | $23,348 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $10,291 | $10,829 | $18,869 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $26,992 | $27,786 | $47,935 |
| Open appendectomy | CPT | 44950 | 10 | $1,971 | $1,576.8 | $565.44 | $1,857.98 | $16,025 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | $1,841 | $1,472.8 | $532.67 | $1,736.04 | $14,984 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $25,050 | $25,787 | $44,508 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $14,726 | $15,182 | $26,332 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | $2,018 | $1,614.4 | $583.24 | $1,901.97 | $14,984 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | $2,196 | $1,756.8 | $633.75 | $2,067.59 | $14,984 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $22,609 | $23,274 | $40,202 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $16,159 | $16,634 | $28,821 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $12,390 | $12,889 | $22,402 |
| Open umbilical hernia repair | CPT | 49560 | 1 | — | — | $1,405 | $1,405 | $1,652 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $854 | $854 | $1,005 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | $2,632 | $2,105.6 | $384.86 | $1,238.22 | $14,984 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $1,356 | $1,356 | $1,596 |
| Total abdominal hysterectomy | CPT | 58150 | 8 | $3,151 | $2,520.8 | $912.58 | $1,935.5 | $7,412.9 |
| Vaginal hysterectomy | CPT | 58260 | 10 | $2,609 | $2,087.2 | $751.29 | $2,408.61 | $12,678 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | $2,758 | $2,206.4 | $791.18 | $2,557.43 | $14,984 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | $3,073 | $2,458.4 | $879.56 | $2,859.66 | $26,738 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | $4,064 | $3,251.2 | $584.08 | $1,885.62 | $14,984 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $21,012 | $21,630 | $37,383 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $12,473 | $12,971 | $22,541 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $11,417 | $11,934 | $20,764 |
| Complex cataract surgery | CPT | 66982 | 10 | $4,656 | $3,724.8 | $669.56 | $2,156.17 | $5,857.27 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | $3,394 | $2,715.2 | $488.93 | $1,696.53 | $5,857.27 |
| Intravitreal injection | CPT | 67028 | 10 | $630 | $504 | $83.2 | $286.76 | $851.83 |
| Vitrectomy mechanical | CPT | 67042 | 10 | $7,152 | $5,721.6 | $1,024.83 | $3,321.7 | $10,331 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $9,361.89 | $9,917.13 | $17,307 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $15,259 | $15,708 | $27,232 |
| PCI single major coronary artery | CPT | 92920 | 12 | $11,585 | $9,268.08 | $452.43 | $2,262.18 | $14,642 |
| PCI with drug-eluting stent | CPT | 92928 | 12 | $15,983 | $12,786 | $502.96 | $2,920 | $29,124 |
| PCI bypass graft | CPT | 92937 | 12 | $19,905 | $15,924 | $502.63 | $3,433.15 | $29,124 |
| Left heart catheterization | CPT | 93452 | 12 | $11,392 | $9,113.86 | $203.9 | $1,312.43 | $8,260.26 |
| Coronary angiography with cath | CPT | 93455 | 12 | $14,279 | $11,423 | $240.23 | $1,531.29 | $8,260.26 |
| Coronary angiography with bypass cath | CPT | 93458 | 12 | $17,828 | $14,262 | $253.81 | $1,562.52 | $8,260.26 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 200 | $196.89 |
| Aetna | 197 | $286.83 |
| health partners open network | 197 | $269.77 |
| UnitedHealthcare | 197 | $233.29 |
| amerivantage | 196 | $163.11 |
| Molina | 196 | $158.45 |
| Humana | 181 | $169.5 |
| Cigna | 154 | $254.6 |
| amerigroup | 147 | $878.39 |
| iowa total care | 147 | $878.39 |
| medica exchange insure | 144 | $1,084.52 |
| medica exchange inspire | 144 | $966.48 |