Geneseo, IL, 61254-1099
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vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | vs nat'l | Neg max |
|---|---|---|---|---|---|---|---|---|---|
| emergency | |||||||||
| ED visit level 1 | CPT | 99281 | 5 | — | — | $50 | $103.5 | 0.74× | $204 |
| ED visit level 2 | CPT | 99282 | 5 | — | — | $50 | $190 | 0.80× | $395 |
| ED visit level 3 | CPT | 99283 | 5 | — | — | $50 | $279 | 0.69× | $465 |
| ED visit level 4 | CPT | 99284 | 5 | — | — | $50 | $432 | 0.65× | $780 |
| ED visit level 5 | CPT | 99285 | 5 | — | — | $50 | $675 | 0.65× | $971 |
| Critical care, first hour | CPT | 99291 | 5 | — | — | $50 | $795 | 0.74× | $1,590 |
| imaging | |||||||||
| EKG complete | CPT | 93000 | 5 | — | — | $50 | $95 | 3.9× | $260 |
| EKG tracing only | CPT | 93005 | 5 | — | — | $50 | $90 | 0.76× | $171.6 |
| EKG interpretation only | CPT | 93010 | 5 | — | — | $79.56 | $79.56 | 4.4× | $90 |
| inpatient | |||||||||
| Initial hospital care, low complexity | CPT | 99221 | 5 | — | — | $90 | $274.5 | 3.0× | $305 |
| Initial hospital care, moderate complexity | CPT | 99222 | 5 | — | — | $90 | $378 | 2.2× | $420 |
| Initial hospital care, high complexity | CPT | 99223 | 5 | — | — | $90 | $454.5 | 2.0× | $505 |
| Hospital discharge, <30 min | CPT | 99238 | 5 | — | — | $90 | $198 | 2.3× | $220 |
| Hospital discharge, >30 min | CPT | 99239 | 5 | — | — | $90 | $279 | 2.3× | $310 |
| lab | |||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 5 | — | — | $50 | $90 | 2.8× | $166.4 |
| General health panel | CPT | 80050 | 5 | — | — | $50 | $130 | 1.2× | $260 |
| Electrolyte panel | CPT | 80051 | 5 | — | — | $50 | $90 | 3.8× | $134.16 |
| Comprehensive metabolic panel | CPT | 80053 | 5 | — | — | $50 | $104 | 2.3× | $208 |
| Lipid panel | CPT | 80061 | 5 | — | — | $50 | $90 | 2.4× | $166.4 |
| Renal function panel | CPT | 80069 | 5 | — | — | $50 | $122.2 | 4.5× | $244.4 |
| Hepatic function panel | CPT | 80076 | 5 | — | — | $50 | $90 | 3.4× | $156 |
| Urinalysis automated | CPT | 81003 | 5 | — | — | $20.8 | $37.44 | 2.7× | $90 |
| Glucose quantitative | CPT | 82947 | 5 | — | — | $19.01 | $34.21 | 1.9× | $90 |
| Hemoglobin A1c | CPT | 83036 | 5 | — | — | $50 | $87.36 | 3.2× | $124.8 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 5 | — | — | $50 | $91 | 1.9× | $182 |
| Complete blood count with automated differential | CPT | 85025 | 5 | — | — | $50 | $76.44 | 2.9× | $109.2 |
| Complete blood count without differential | CPT | 85027 | 5 | — | — | $50 | $75 | 3.5× | $104 |
| Urine culture bacterial | CPT | 87086 | 5 | — | — | $50 | $80.08 | 3.4× | $114.4 |
| Urine culture identification | CPT | 87088 | 5 | — | — | $50 | $87.36 | 3.9× | $124.8 |
| office | |||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 5 | — | — | $69.3 | $128.7 | 1.5× | $220 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 5 | — | — | $90 | $201.6 | 1.6× | $340 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 5 | — | — | $90 | $240.3 | 1.4× | $410 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 5 | — | — | $90 | $286.65 | 1.3× | $490 |
| Office visit, established patient, 5 min | CPT | 99211 | 5 | — | — | $23.4 | $67.5 | 1.0× | $148.75 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 5 | — | — | $33.08 | $64.8 | 0.81× | $110 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 5 | — | — | $45.9 | $85.5 | 0.75× | $145 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 5 | — | — | $69.3 | $128.7 | 0.84× | $220 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 5 | — | — | $90 | $175.5 | 0.93× | $300 |
| preventive | |||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | — | — | $90 | $945 | 1.0× | $1,050 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | — | $90 | $990 | 1.0× | $1,100 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 5 | — | — | $90 | $405 | 0.48× | $450 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | — | — | $90 | $648 | 0.73× | $720 |
| Colonoscopy diagnostic | CPT | 45378 | 5 | — | — | $90 | $1,170 | 1.3× | $1,300 |
| Colonoscopy with biopsy | CPT | 45380 | 5 | — | — | $90 | $1,170 | 0.96× | $1,300 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | — | $90 | $1,620 | 1.3× | $1,800 |
| surgery | |||||||||
| Open appendectomy | CPT | 44950 | 5 | — | — | $90 | $2,520 | 2.2× | $2,800 |
| Laparoscopic appendectomy | CPT | 44970 | 5 | — | — | $90 | $2,700 | 1.7× | $3,000 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $90 | $2,250 | 1.3× | $2,500 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $90 | $3,168 | 1.7× | $3,520 |
| Open umbilical hernia repair | CPT | 49560 | 5 | — | — | $90 | $2,898 | 1.5× | $3,220 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 5 | — | — | $90 | $1,728 | 1.3× | $1,920 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $90 | $1,620 | 1.4× | $1,800 |
| Lap incisional hernia repair | CPT | 49652 | 5 | — | — | $90 | $2,790 | 1.0× | $3,100 |
| Total abdominal hysterectomy | CPT | 58150 | 5 | — | — | $90 | $3,690 | 3.8× | $4,100 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $90 | $2,250 | 1.1× | $2,500 |
| Payer | Codes covered | Median rate |
|---|---|---|
| deidentifiedhigher | 55 | $198.45 |
| deidentifiedlower | 55 | $186.5 |
| grosschargerate | 55 | $220.5 |
| paymentrate | 55 | $144.2 |
| paymentratepercent | 55 | $75 |
