▸ Hospital · IL · CCN 141309
Carle Eureka Hospital
101 SOUTH MAJOR STREET, EUREKA, IL, 61530
25 bedsCritical Access Hospitals1
Compliance grade
A
100/100
Procedures tracked
201
of 209 target codes
Payers
11
with negotiated rates
Rates published
52,684
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $12,941 | $18,048 | $28,159 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | $412 | $412 | $40.8 | $197.76 | $346.08 |
| Psychiatric eval with medical services | CPT | 90792 | 11 | $465 | $465 | $45.3 | $223.2 | $390.6 |
| Psychotherapy 30 minutes | CPT | 90832 | 11 | $208 | $208 | $20.4 | $111.12 | $190.21 |
| Psychotherapy 45 minutes | CPT | 90834 | 11 | $292 | $292 | $26.5 | $149.58 | $245.28 |
| Psychotherapy 60 minutes | CPT | 90837 | 11 | $397 | $397 | $34.7 | $190.56 | $333.48 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | $512 | $512 | $41.4 | $245.76 | $430.08 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 11 | $299 | $299 | $8.57 | $134.55 | $251.16 |
| ED visit level 2 | CPT | 99282 | 11 | $494 | $494 | $30.07 | $222.3 | $414.96 |
| ED visit level 3 | CPT | 99283 | 11 | $835 | $835 | $51.73 | $375.75 | $701.4 |
| ED visit level 4 | CPT | 99284 | 11 | $1,337 | $1,337 | $86.76 | $601.65 | $1,123.08 |
| ED visit level 5 | CPT | 99285 | 11 | $1,991 | $1,991 | $126.53 | $895.95 | $1,672.44 |
| Critical care, first hour | CPT | 99291 | 11 | $2,028 | $2,028 | $79.4 | $516.1 | $1,703.52 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 11 | $3,303 | $3,303 | $75.32 | $1,486.35 | $2,774.52 |
| CT head with contrast | CPT | 70460 | 11 | $3,077 | $3,077 | $99.72 | $1,384.65 | $2,584.68 |
| CT head with and without contrast | CPT | 70470 | 11 | $3,542 | $3,542 | $112.36 | $1,593.9 | $2,975.28 |
| CT neck with contrast | CPT | 70491 | 11 | $3,816 | $3,816 | $121.64 | $1,717.2 | $3,205.44 |
| MRI brain without contrast | CPT | 70551 | 11 | $4,197 | $4,197 | $130.58 | $1,888.65 | $3,525.48 |
| MRI brain with contrast | CPT | 70552 | 11 | $7,905 | $7,905 | $157.42 | $3,557.25 | $6,640.2 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $6,869 | $6,869 | $204 | $3,091.05 | $5,769.96 |
| Chest X-ray single view | CPT | 71045 | 11 | $340 | $340 | $16.34 | $153 | $285.6 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $340 | $340 | $19.44 | $153 | $285.6 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $375 | $375 | $24.36 | $168.75 | $315 |
| CT chest without contrast | CPT | 71250 | 11 | $3,399 | $3,399 | $95.38 | $1,529.55 | $2,855.16 |
| CT chest with contrast | CPT | 71260 | 11 | $4,317 | $4,317 | $102.78 | $1,942.65 | $3,626.28 |
| CT chest with and without contrast | CPT | 71270 | 11 | $4,865 | $4,865 | $110.52 | $2,189.25 | $4,086.6 |
| MRI chest without contrast | CPT | 71550 | 11 | $4,830 | $4,830 | $129.34 | $2,173.5 | $4,057.2 |
| MRI chest with contrast | CPT | 71551 | 11 | $5,569 | $5,569 | $152.52 | $2,506.05 | $4,677.96 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $7,905 | $7,905 | $201.52 | $3,557.25 | $6,640.2 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $632 | $632 | $20.04 | $284.4 | $530.88 |
| CT cervical spine without contrast | CPT | 72125 | 11 | $3,827 | $3,827 | $87.7 | $1,722.15 | $3,214.68 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $3,161 | $3,161 | $87.7 | $1,422.45 | $2,655.24 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $3,232 | $3,232 | $87.7 | $1,454.4 | $2,714.88 |
| MRI cervical spine without contrast | CPT | 72141 | 11 | $4,675 | $4,675 | $131.18 | $2,103.75 | $3,927 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $4,401 | $4,401 | $131.18 | $1,980.45 | $3,696.84 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $4,579 | $4,579 | $131.18 | $2,060.55 | $3,846.36 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $7,905 | $7,905 | $159.22 | $3,557.25 | $6,640.2 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $6,869 | $6,869 | $204.58 | $3,091.05 | $5,769.96 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $6,869 | $6,869 | $204.58 | $3,091.05 | $5,769.96 |
| CT pelvis without contrast | CPT | 72192 | 11 | $3,589 | $3,589 | $96.02 | $1,615.05 | $3,014.76 |
| CT pelvis with contrast | CPT | 72193 | 11 | $4,388 | $4,388 | $102.18 | $1,974.6 | $3,685.92 |
| Shoulder X-ray | CPT | 73030 | 11 | $412 | $412 | $16.94 | $185.4 | $346.08 |
| Humerus X-ray | CPT | 73060 | 11 | $412 | $412 | $14.5 | $185.4 | $346.08 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $483 | $483 | $15.72 | $217.35 | $405.72 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $4,830 | $4,830 | $119.76 | $2,173.5 | $4,057.2 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $6,869 | $6,869 | $191.94 | $3,091.05 | $5,769.96 |
| Hip X-ray 2 views | CPT | 73510 | 10 | $431 | $431 | $43.1 | $258.6 | $362.04 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $340 | $340 | $15.08 | $153 | $285.6 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $412 | $412 | $15.72 | $185.4 | $346.08 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $4,830 | $4,830 | $119.76 | $2,173.5 | $4,057.2 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $6,869 | $6,869 | $191.94 | $3,091.05 | $5,769.96 |
| CT abdomen without contrast | CPT | 74150 | 11 | $3,602 | $3,602 | $104.66 | $899.6 | $3,025.68 |
| CT abdomen with contrast | CPT | 74160 | 11 | $4,328 | $4,328 | $112.36 | $1,947.6 | $3,635.52 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $4,769 | $4,769 | $122.9 | $2,146.05 | $4,005.96 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $5,390 | $5,390 | $153.74 | $2,425.5 | $4,527.6 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $6,523 | $6,523 | $162.32 | $2,935.35 | $5,479.32 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $7,202 | $7,202 | $177.8 | $3,240.9 | $6,049.68 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $4,459 | $4,459 | $128.74 | $2,006.55 | $3,745.56 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $6,869 | $6,869 | $195.68 | $3,091.05 | $5,769.96 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $966 | $966 | $71.62 | $434.7 | $811.44 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $896 | $896 | $52.18 | $403.2 | $752.64 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,085 | $1,085 | $65.44 | $488.25 | $911.4 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $1,085 | $1,085 | $87.66 | $488.25 | $911.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,085 | $1,085 | $88.24 | $488.25 | $911.4 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $896 | $896 | $89.6 | $403.2 | $752.64 |
| Transvaginal ultrasound | CPT | 76830 | 11 | $1,085 | $1,085 | $61.4 | $488.25 | $911.4 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,085 | $1,085 | $60.82 | $488.25 | $911.4 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,085 | $1,085 | $56.5 | $488.25 | $911.4 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $328 | $328 | $32.8 | $147.6 | $275.52 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $465 | $465 | $46.5 | $209.25 | $390.6 |
| Screening mammography bilateral | CPT | 77067 | 11 | $530 | $530 | $53 | $238.5 | $445.2 |
| EKG complete | CPT | 93000 | 3 | — | — | $14.96 | $15.4 | $26.64 |
| EKG tracing only | CPT | 93005 | 11 | $245 | $245 | $6.48 | $110.25 | $205.8 |
| EKG interpretation only | CPT | 93010 | 11 | $44 | $44 | $4.4 | $19.8 | $82 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $1,705 | $1,705 | $82 | $642.37 | $1,432.2 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $1,503 | $1,503 | $80 | $676.35 | $1,262.52 |
| Stress echocardiogram | CPT | 93350 | 11 | $1,860 | $1,860 | $126.06 | $837 | $1,562.4 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 7 | — | — | $18,110 | $25,736 | $40,542 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 7 | — | — | $9,687.93 | $13,038 | $20,368 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 7 | — | — | $6,945.05 | $8,828.56 | $13,798 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 7 | — | — | $14,337 | $20,436 | $31,504 |
| COPD w MCC | MS-DRG | 190 | 7 | — | — | $10,508 | $14,345 | $22,331 |
| COPD w CC | MS-DRG | 191 | 7 | — | — | $8,279.87 | $10,944 | $16,995 |
| COPD w/o CC/MCC | MS-DRG | 192 | 7 | — | — | $6,588.19 | $8,291.13 | $12,943 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | — | — | $7,967.63 | $10,455 | $16,247 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 7 | — | — | $6,474.57 | $8,049.52 | $12,671 |
| AMI discharged alive w MCC | MS-DRG | 280 | 7 | — | — | $14,686 | $20,866 | $32,339 |
| AMI discharged alive w CC | MS-DRG | 281 | 7 | — | — | $8,920.36 | $11,840 | $18,529 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 7 | — | — | $7,270.77 | $9,314.68 | $14,578 |
| Heart failure & shock w MCC | MS-DRG | 291 | 7 | — | — | $11,990 | $16,645 | $25,881 |
| Heart failure & shock w CC | MS-DRG | 292 | 7 | — | — | $8,330.37 | $10,997 | $17,116 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 7 | — | — | $5,948.57 | $7,174.45 | $11,411 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 7 | — | — | $11,318 | $15,501 | $24,273 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 7 | — | — | $7,376.81 | $9,486.65 | $14,832 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 7 | — | — | $5,949.41 | $7,241.83 | $11,413 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | — | — | $9,438.79 | $12,648 | $19,771 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 7 | — | — | $6,490.57 | $8,148.7 | $12,709 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 7 | — | — | $7,746.28 | $10,033 | $15,717 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $14,379 | $19,903 | $31,605 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $10,950 | $14,988 | $23,392 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $7,997.93 | $10,371 | $16,320 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $17,534 | $25,110 | $39,161 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $9,797.32 | $13,212 | $20,630 |
| Initial hospital care, low complexity | CPT | 99221 | 11 | $292 | $292 | $9.8 | $64.24 | $245.28 |
| Initial hospital care, moderate complexity | CPT | 99222 | 11 | $397 | $397 | $39.7 | $178.65 | $333.48 |
| Initial hospital care, high complexity | CPT | 99223 | 11 | $573 | $573 | $57.3 | $257.85 | $481.32 |
| Hospital discharge, <30 min | CPT | 99238 | 11 | $210 | $210 | $21 | $94.5 | $176.4 |
| Hospital discharge, >30 min | CPT | 99239 | 11 | $309 | $309 | $30.9 | $139.05 | $259.56 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $107 | $107 | $7.28 | $49.76 | $89.88 |
| General health panel | CPT | 80050 | 10 | $352 | $352 | $31.89 | $168.96 | $295.68 |
| Electrolyte panel | CPT | 80051 | 11 | $125 | $125 | $6.03 | $52.88 | $105 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $322 | $322 | $9.08 | $71.5 | $270.48 |
| Lipid panel | CPT | 80061 | 11 | $144 | $144 | $11.52 | $66.96 | $120.96 |
| Renal function panel | CPT | 80069 | 11 | $131 | $131 | $7.46 | $60.92 | $110.04 |
| Hepatic function panel | CPT | 80076 | 11 | $110 | $110 | $7.03 | $51.15 | $92.4 |
| Urinalysis non-automated | CPT | 81002 | 11 | $110 | $110 | $2.6 | $28.52 | $92.4 |
| Urinalysis automated | CPT | 81003 | 11 | $71 | $71 | $1.94 | $31.07 | $59.64 |
| Glucose quantitative | CPT | 82947 | 11 | $193 | $193 | $1.2 | $35.26 | $162.12 |
| Hemoglobin A1c | CPT | 83036 | 11 | $180 | $180 | $2.6 | $36 | $151.2 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $149 | $149 | $6.7 | $57.62 | $125.16 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $83 | $83 | $6.1 | $37.4 | $69.72 |
| Complete blood count without differential | CPT | 85027 | 11 | $125 | $125 | $4.9 | $31.85 | $105 |
| Urine culture bacterial | CPT | 87086 | 11 | $70 | $70 | $6.94 | $32.55 | $58.8 |
| Urine culture identification | CPT | 87088 | 11 | $172 | $172 | $6.96 | $79.98 | $144.48 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $585 | $585 | $26.9 | $176.33 | $491.4 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 11 | $846 | $846 | $24.8 | $165.05 | $710.64 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 11 | $11,201 | $11,201 | $82 | $5,040.45 | $9,408.84 |
| Vaginal delivery only | CPT | 59409 | 11 | $4,344 | $4,344 | $82 | $1,954.8 | $3,648.96 |
| Vaginal delivery with postpartum | CPT | 59410 | 11 | $5,579 | $5,579 | $82 | $2,510.55 | $4,686.36 |
| Routine obstetric care with C-section | CPT | 59510 | 11 | $12,458 | $12,458 | $82 | $5,606.1 | $10,465 |
| C-section delivery only | CPT | 59514 | 11 | $4,929 | $4,929 | $82 | $2,218.05 | $4,140.36 |
| C-section with postpartum | CPT | 59515 | 11 | $6,803 | $6,803 | $82 | $3,061.35 | $5,714.52 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 11 | $316 | $316 | $21.5 | $132.01 | $265.44 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 11 | $405 | $405 | $30.3 | $182.25 | $340.2 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 11 | $530 | $530 | $46.3 | $238.5 | $445.2 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 11 | $656 | $656 | $58.5 | $295.2 | $551.04 |
| Office visit, established patient, 5 min | CPT | 99211 | 11 | $131 | $131 | $6.18 | $39.49 | $110.04 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 11 | $250 | $250 | $13.2 | $81.44 | $210 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 11 | $299 | $299 | $21 | $128.94 | $251.16 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 11 | $347 | $347 | $30.9 | $156.15 | $291.48 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 11 | $408 | $408 | $39.4 | $189.12 | $342.72 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | $1,478 | $1,478 | $82 | $666.72 | $1,241.52 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | $2,170 | $2,170 | $82 | $976.5 | $1,822.8 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | $1,634 | $1,634 | $54.21 | $559 | $1,372.56 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | $1,944 | $1,944 | $69.26 | $874.25 | $1,632.96 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | $2,409 | $2,409 | $82 | $1,020.52 | $2,023.56 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | $3,172 | $3,172 | $82 | $1,306.19 | $2,664.48 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | $3,232 | $3,232 | $82 | $1,374.06 | $2,714.88 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | $7,575 | $7,575 | $82 | $3,408.75 | $18,790 |
| Hip hemiarthroplasty | CPT | 27125 | 3 | — | — | $1,058.52 | $1,090.28 | $13,758 |
| Total hip replacement | CPT | 27130 | 11 | $7,090 | $7,090 | $82 | $3,190.5 | $13,758 |
| Total knee replacement | CPT | 27447 | 11 | $7,078 | $7,078 | $82 | $3,185.1 | $13,758 |
| Knee revision arthroplasty single component | CPT | 27486 | 11 | $7,343 | $7,343 | $82 | $3,304.35 | $13,758 |
| Knee revision arthroplasty all components | CPT | 27487 | 11 | $9,206 | $9,206 | $82 | $4,142.7 | $18,790 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 11 | $926 | $926 | $82 | $416.7 | $777.84 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 11 | $5,568 | $5,568 | $82 | $2,505.6 | $7,775.89 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | $2,790 | $2,790 | $82 | $1,255.5 | $3,506.34 |
| ACL reconstruction | CPT | 29888 | 11 | $5,105 | $5,105 | $82 | $2,297.25 | $7,775.89 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 7 | — | — | $39,870 | $59,103 | $92,665 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | — | — | $21,360 | $30,632 | $48,328 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 7 | — | — | $15,349 | $21,453 | $33,927 |
| CABG single arterial graft | CPT | 33533 | 11 | $9,967 | $9,967 | $82 | $4,485.15 | $8,372.28 |
| CABG 2 arterial grafts | CPT | 33534 | 11 | $11,720 | $11,720 | $82 | $5,274 | $9,844.8 |
| CABG 3 arterial grafts | CPT | 33535 | 3 | — | — | $2,446.3 | $2,740.79 | $4,750.92 |
| CABG 4+ arterial grafts | CPT | 33536 | 3 | — | — | $2,636.71 | $2,950.51 | $5,120.84 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 7 | — | — | $15,422 | $21,557 | $34,103 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | — | — | $12,680 | $17,273 | $27,535 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 7 | — | — | $29,860 | $44,587 | $68,687 |
| Open appendectomy | CPT | 44950 | 3 | — | — | $644.12 | $663.44 | $6,937.47 |
| Laparoscopic appendectomy | CPT | 44970 | 11 | $3,197 | $3,197 | $82 | $1,438.65 | $6,478.5 |
| Major joint replacement w MCC | MS-DRG | 469 | 7 | — | — | $26,713 | $40,475 | $61,149 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 7 | — | — | $17,419 | $24,546 | $38,887 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | $3,506 | $3,506 | $82 | $1,577.7 | $6,478.5 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 11 | $3,815 | $3,815 | $82 | $1,716.75 | $6,478.5 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 7 | — | — | $25,696 | $37,643 | $58,712 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | — | — | $18,813 | $26,824 | $42,225 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 7 | — | — | $14,912 | $20,707 | $32,881 |
| Open umbilical hernia repair | CPT | 49560 | 10 | $3,925 | $3,925 | $82 | $1,884 | $3,297 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 10 | $2,349 | $2,349 | $82 | $1,127.52 | $1,973.16 |
| Lap inguinal hernia repair | CPT | 49650 | 11 | $2,271 | $2,271 | $82 | $1,021.95 | $6,478.5 |
| Lap incisional hernia repair | CPT | 49652 | 10 | $3,959 | $3,959 | $82 | $1,900.32 | $3,325.56 |
| Total abdominal hysterectomy | CPT | 58150 | 11 | $5,304 | $5,304 | $82 | $2,386.8 | $4,455.36 |
| Vaginal hysterectomy | CPT | 58260 | 3 | — | — | $731.08 | $753.01 | $5,360.72 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 3 | — | — | $768.47 | $791.52 | $6,478.5 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 3 | — | — | $855.39 | $881.05 | $11,391 |
| Lap salpingo-oophorectomy | CPT | 58661 | 11 | $3,429 | $3,429 | $82 | $1,543.05 | $6,478.5 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $25,486 | $36,151 | $58,210 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $14,654 | $20,567 | $32,262 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $13,880 | $19,117 | $30,409 |
| Complex cataract surgery | CPT | 66982 | 11 | $3,749 | $3,749 | $82 | $1,687.05 | $3,149.16 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | $2,734 | $2,734 | $82 | $1,230.3 | $2,473.11 |
| Intravitreal injection | CPT | 67028 | 11 | $1,217 | $1,217 | $51.2 | $332.8 | $1,022.28 |
| Vitrectomy mechanical | CPT | 67042 | 11 | $5,755 | $5,755 | $82 | $2,589.75 | $4,834.2 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $11,627 | $15,702 | $25,013 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $18,431 | $25,773 | $41,310 |
| PCI single major coronary artery | CPT | 92920 | 11 | $18,195 | $18,195 | $82 | $1,892.68 | $15,284 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $13,474 | $13,474 | $82 | $2,106.31 | $12,371 |
| PCI bypass graft | CPT | 92937 | 11 | $37,226 | $37,226 | $82 | $2,247.15 | $31,270 |
| Left heart catheterization | CPT | 93452 | 11 | $11,363 | $11,363 | $449.16 | $5,113.35 | $9,544.92 |
| Coronary angiography with cath | CPT | 93455 | 11 | $10,981 | $10,981 | $507.2 | $3,296.8 | $9,224.04 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $14,618 | $14,618 | $522.6 | $3,396.9 | $12,279 |
Payer mix (top 11)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 201 | $316.82 |
| WellCare | 196 | $373.86 |
| Cigna | 193 | $255.44 |
| community partners health plan (cphp) | 193 | $1,166.4 |
| Multiplan | 193 | $1,458 |
| UnitedHealthcare | 193 | $583.68 |
| Blue Cross Blue Shield | 193 | $1,425.3 |
| Humana | 158 | $194.2 |
| Molina | 150 | $217 |
| healthlink | 150 | $592.15 |
| meridian | 150 | $198.91 |