▸ Hospital · IL · CCN 140288
Advocate Good Samaritan Hospital
3815 HIGHLAND AVENUE, DOWNERS GROVE, IL, 60515-
293 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
193
of 209 target codes
Payers
11
with negotiated rates
Rates published
35,019
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | — | — | $15,480 | $21,471 | $30,160 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | $795 | $397.5 | $242.85 | $620.5 | $1,556 |
| Psychiatric eval with medical services | CPT | 90792 | 11 | $525 | $262.5 | $206.85 | $409.77 | $1,556 |
| Psychotherapy 30 minutes | CPT | 90832 | 11 | $400 | $200 | $139.6 | $257.62 | $408.99 |
| Psychotherapy 45 minutes | CPT | 90834 | 5 | — | — | $242.85 | $321.57 | $592.31 |
| Psychotherapy 60 minutes | CPT | 90837 | 5 | — | — | $242.85 | $321.57 | $869.68 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | $590 | $295 | $205.91 | $358.72 | $489.11 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 11 | $390 | $195 | $49.25 | $209.06 | $796 |
| ED visit level 2 | CPT | 99282 | 11 | $535 | $267.5 | $210.79 | $417.57 | $1,214 |
| ED visit level 3 | CPT | 99283 | 11 | $1,160 | $580 | $418.52 | $880.59 | $2,071 |
| ED visit level 4 | CPT | 99284 | 11 | $2,510 | $1,255 | $643.63 | $1,574.22 | $3,426 |
| ED visit level 5 | CPT | 99285 | 11 | $4,080 | $2,040 | $926.71 | $2,253.24 | $4,020 |
| Critical care, first hour | CPT | 99291 | 11 | $4,760 | $2,380 | $1,273.61 | $2,521.61 | $11,010 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT head with contrast | CPT | 70460 | 11 | $1,780 | $890 | $269.08 | $941 | $1,488.08 |
| CT head with and without contrast | CPT | 70470 | 11 | $2,570 | $1,285 | $269.08 | $1,123.09 | $2,056 |
| CT neck with contrast | CPT | 70491 | 11 | $1,780 | $890 | $269.08 | $941 | $1,488.08 |
| MRI brain without contrast | CPT | 70551 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI brain with contrast | CPT | 70552 | 11 | $3,210 | $1,605 | $539.81 | $1,613 | $2,568 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| Chest X-ray single view | CPT | 71045 | 11 | $385 | $192.5 | $78.83 | $207.71 | $634 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $465 | $232.5 | $105.62 | $220 | $634 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $615 | $307.5 | $132.4 | $293 | $634 |
| CT chest without contrast | CPT | 71250 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT chest with contrast | CPT | 71260 | 11 | $1,780 | $890 | $269.08 | $941 | $1,488.08 |
| CT chest with and without contrast | CPT | 71270 | 11 | $2,570 | $1,285 | $269.08 | $1,123.09 | $2,056 |
| MRI chest without contrast | CPT | 71550 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI chest with contrast | CPT | 71551 | 11 | $3,210 | $1,605 | $1,096 | $1,613 | $2,568 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $905 | $452.5 | $130.42 | $293 | $724 |
| CT cervical spine without contrast | CPT | 72125 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| MRI cervical spine without contrast | CPT | 72141 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $3,210 | $1,605 | $539.81 | $1,613 | $2,568 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| CT pelvis without contrast | CPT | 72192 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT pelvis with contrast | CPT | 72193 | 11 | $1,780 | $890 | $269.08 | $941 | $1,488.08 |
| Shoulder X-ray | CPT | 73030 | 11 | $690 | $345 | $107.66 | $301.53 | $634 |
| Humerus X-ray | CPT | 73060 | 11 | $690 | $345 | $107.66 | $301.53 | $634 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $780 | $390 | $100.21 | $340.86 | $634 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $3,760 | $1,880 | $365.36 | $1,683.2 | $3,008 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $214.77 | $232.26 | $244.44 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $580 | $290 | $96.72 | $291.4 | $634 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $690 | $345 | $101.97 | $301.53 | $634 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $3,760 | $1,880 | $365.36 | $1,683.2 | $3,008 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $5,900 | $2,950 | $539.81 | $2,480.13 | $4,720 |
| CT abdomen without contrast | CPT | 74150 | 11 | $1,570 | $785 | $160.73 | $933.89 | $1,256 |
| CT abdomen with contrast | CPT | 74160 | 11 | $1,780 | $890 | $269.08 | $941 | $1,488.08 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $2,570 | $1,285 | $269.08 | $1,123.09 | $2,056 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $3,140 | $1,570 | $365.36 | $1,009.92 | $2,512 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $3,560 | $1,780 | $539.81 | $1,402.64 | $2,848 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $5,140 | $2,570 | $539.81 | $1,009.92 | $4,112 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $3,010 | $1,505 | $365.36 | $1,556.48 | $2,408 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $4,720 | $2,360 | $539.81 | $2,062.64 | $3,776 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $1,940 | $970 | $160.73 | $764.36 | $1,552 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $1,460 | $730 | $160.73 | $575.24 | $1,168 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,960 | $980 | $160.73 | $735.19 | $1,568 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $1,110 | $555 | $160.73 | $485.07 | $888 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,270 | $635 | $160.73 | $537 | $1,016 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $2,050 | $1,025 | $214 | $807.7 | $1,640 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $1,320 | $660 | $160.73 | $556.92 | $1,056 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,760 | $880 | $160.73 | $710.4 | $1,408 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,430 | $715 | $160.73 | $563.42 | $1,144 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $565 | $282.5 | $127.12 | $328.65 | $524 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $565 | $282.5 | $161.67 | $328.65 | $524 |
| Screening mammography bilateral | CPT | 77067 | 11 | $475 | $237.5 | $133.37 | $300.75 | $524 |
| EKG complete | CPT | 93000 | 1 | — | — | $136.3 | $147.4 | $155.13 |
| EKG tracing only | CPT | 93005 | 11 | $465 | $232.5 | $78.47 | $222.51 | $372 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $57.82 | $62.53 | $65.81 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $2,340 | $1,170 | $781.76 | $1,406.82 | $1,964.99 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $1,780 | $890 | $365.36 | $1,044.82 | $1,877 |
| Stress echocardiogram | CPT | 93350 | 5 | — | — | $828.76 | $1,097.39 | $1,527.8 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $21,845 | $30,299 | $42,561 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $11,168 | $16,177 | $21,758 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $7,558.91 | $11,388 | $15,079 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $17,752 | $24,623 | $34,587 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $12,333 | $17,597 | $24,028 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $9,434.64 | $14,017 | $18,381 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $7,107.55 | $10,856 | $14,375 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $9,005.24 | $13,379 | $17,545 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $6,838.49 | $10,540 | $13,956 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $18,026 | $25,002 | $35,119 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $10,123 | $14,905 | $19,723 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $7,963.05 | $11,864 | $15,709 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $14,329 | $20,029 | $27,918 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $9,457.7 | $14,051 | $18,426 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $6,025.82 | $9,582.46 | $12,688 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $13,243 | $18,706 | $25,801 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $8,118.99 | $12,062 | $15,953 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $6,144.43 | $9,722.15 | $12,873 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $10,827 | $15,762 | $21,094 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $6,992.24 | $10,721 | $14,196 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $8,569.25 | $12,731 | $16,695 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $16,746 | $23,227 | $32,627 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $12,852 | $18,229 | $25,040 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $8,814.15 | $13,095 | $17,172 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $21,548 | $29,887 | $41,981 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $11,322 | $16,366 | $22,059 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $437.81 | $473.45 | $498.3 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $598.89 | $647.65 | $681.63 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $879.75 | $951.38 | $1,001.3 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $326.29 | $352.85 | $371.37 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $470.86 | $509.19 | $535.91 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $130 | $65 | $8.46 | $77.3 | $162.98 |
| General health panel | CPT | 80050 | 4 | — | — | $47.28 | $184.08 | $329.06 |
| Electrolyte panel | CPT | 80051 | 11 | $100 | $50 | $7.01 | $39.4 | $80 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $215 | $107.5 | $10.56 | $93.96 | $212.58 |
| Lipid panel | CPT | 80061 | 11 | $165 | $82.5 | $13.39 | $72.62 | $132 |
| Renal function panel | CPT | 80069 | 11 | $165 | $82.5 | $8.68 | $47.01 | $132 |
| Hepatic function panel | CPT | 80076 | 11 | $160 | $80 | $8.17 | $69.92 | $155.89 |
| Urinalysis non-automated | CPT | 81002 | 11 | $50 | $25 | $3.48 | $14.1 | $40 |
| Urinalysis automated | CPT | 81003 | 11 | $65 | $32.5 | $2.25 | $19.7 | $52 |
| Glucose quantitative | CPT | 82947 | 11 | $80 | $40 | $3.93 | $31.52 | $64 |
| Hemoglobin A1c | CPT | 83036 | 11 | $140 | $70 | $9.71 | $61.1 | $112 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $220 | $110 | $16.8 | $40 | $176 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $100 | $50 | $7.77 | $57.98 | $83.4 |
| Complete blood count without differential | CPT | 85027 | 11 | $100 | $50 | $6.47 | $42.31 | $80 |
| Urine culture bacterial | CPT | 87086 | 11 | $115 | $57.5 | $8.07 | $45.44 | $92 |
| Urine culture identification | CPT | 87088 | 11 | $95 | $47.5 | $8.09 | $43.88 | $76 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $475 | $237.5 | $49.47 | $287.74 | $446.59 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 11 | $900 | $450 | $304.07 | $547.2 | $746.1 |
| Vaginal delivery only | CPT | 59409 | 10 | $4,280 | $2,140 | $1,686.32 | $3,372.64 | $6,363.66 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $230 | $115 | $80.27 | $125.12 | $184 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $295 | $147.5 | $84 | $148.7 | $236 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $355 | $177.5 | $84 | $160.57 | $284 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $415 | $207.5 | $84 | $174.51 | $332 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $180 | $90 | $62.82 | $111.3 | $166 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $240 | $120 | $22.69 | $104.88 | $192 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $295 | $147.5 | $84 | $148.7 | $236 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $355 | $177.5 | $84 | $160.57 | $284 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $415 | $207.5 | $84 | $174.51 | $332 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | — | — | $1,417.13 | $2,501.24 | $6,181 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | — | $1,417.13 | $2,501.24 | $6,181 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 5 | — | — | $1,378.06 | $2,447.37 | $6,071 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | — | — | $1,378.06 | $2,447.37 | $6,071 |
| Colonoscopy diagnostic | CPT | 45378 | 7 | — | — | $1,378.06 | $1,878 | $6,181 |
| Colonoscopy with biopsy | CPT | 45380 | 5 | — | — | $1,782.19 | $2,742.94 | $6,181 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | — | $1,782.19 | $2,742.94 | $6,181 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $24,003 | $28,284 | $47,462 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $12,700 | $18,206 | $25,111 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $19,448 | $24,878 | $47,462 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $19,448 | $24,878 | $47,462 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $24,003 | $34,410 | $47,462 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $24,003 | $34,410 | $47,462 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $3,181 | $4,561.5 | $6,291 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $10,798 | $13,499 | $25,111 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $4,904.26 | $7,657.46 | $17,439 |
| ACL reconstruction | CPT | 29888 | 5 | — | — | $10,798 | $13,499 | $25,111 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $50,428 | $69,944 | $98,248 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $25,958 | $36,004 | $50,574 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $18,131 | $25,148 | $35,325 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $3,181 | $4,561.5 | $6,291 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $3,181 | $4,561.5 | $6,291 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $3,181 | $4,561.5 | $6,291 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $3,181 | $4,561.5 | $6,291 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $18,213 | $25,261 | $35,483 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $14,470 | $20,200 | $28,191 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $38,761 | $53,761 | $75,517 |
| Open appendectomy | CPT | 44950 | 5 | — | — | $8,821 | $9,987.83 | $17,439 |
| Laparoscopic appendectomy | CPT | 44970 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $35,897 | $49,789 | $69,937 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $20,707 | $28,720 | $40,342 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $32,298 | $44,797 | $62,926 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $22,787 | $31,605 | $44,395 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $17,422 | $24,164 | $33,943 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $8,821 | $12,644 | $17,439 |
| Vaginal hysterectomy | CPT | 58260 | 5 | — | — | $7,461.49 | $9,350.52 | $17,439 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 5 | — | — | $12,700 | $16,008 | $25,111 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $8,818.69 | $12,189 | $25,111 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $13,685 | $37,749 | $58,336 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $13,685 | $23,140 | $34,169 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $13,685 | $22,130 | $31,277 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $3,447.34 | $5,430.38 | $12,362 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $3,447.34 | $5,430.38 | $12,362 |
| Intravitreal injection | CPT | 67028 | 5 | — | — | $501.35 | $1,922.43 | $6,291 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | — | $6,080.59 | $8,603.27 | $18,102 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $13,164 | $18,609 | $25,647 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $21,459 | $29,763 | $41,808 |
| PCI single major coronary artery | CPT | 92920 | 11 | $18,930 | $9,465 | $7,336.28 | $11,659 | $25,111 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $33,610 | $16,805 | $9,538.74 | $17,605 | $27,291 |
| PCI bypass graft | CPT | 92937 | 11 | $28,020 | $14,010 | $9,538.74 | $17,202 | $25,111 |
| Left heart catheterization | CPT | 93452 | 11 | $11,370 | $5,685 | $4,479.78 | $7,060.77 | $18,102 |
| Coronary angiography with cath | CPT | 93455 | 11 | $10,350 | $5,175 | $4,077.9 | $6,437.59 | $18,102 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $10,920 | $5,460 | $4,302.48 | $6,781.32 | $18,102 |
Payer mix (top 11)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 181 | $3,126 |
| Ambetter | 166 | $539.81 |
| hstechnology | 166 | $714.78 |
| Molina | 166 | $539.81 |
| Oscar Health | 166 | $558.42 |
| Blue Cross Blue Shield | 159 | $1,381.41 |
| Cigna | 148 | $1,096 |
| Aetna | 146 | $960.31 |
| advocate employee | 103 | $559.21 |
| private healthcare systems | 103 | $916.6 |
| Multiplan | 103 | $1,060 |