▸ Hospital · IL · CCN 141348
Red Bud Regional Hospital
ST. CLEMENT BLVD, RED BUD, IL, 141348
Compliance grade
A
100/100
Procedures tracked
201
of 209 target codes
Payers
19
with negotiated rates
Rates published
105,973
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 2 | — | — | $12,920 | $13,593 | $14,266 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 19 | $773.79 | $201.19 | $122.5 | $247.1 | $638.38 |
| Psychiatric eval with medical services | CPT | 90792 | 6 | $380 | $133 | $133 | $228 | $296.4 |
| Psychotherapy 30 minutes | CPT | 90832 | 19 | $610 | $158.6 | $55.65 | $173.85 | $503.25 |
| Psychotherapy 45 minutes | CPT | 90834 | 19 | $755 | $196.3 | $65.8 | $215.18 | $622.88 |
| Psychotherapy 60 minutes | CPT | 90837 | 19 | $770 | $200.2 | $104.3 | $232.44 | $635.25 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 6 | $295 | $103.25 | $103.25 | $177 | $230.1 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 19 | $1,132.08 | $294.35 | $13.71 | $225.65 | $942 |
| ED visit level 2 | CPT | 99282 | 19 | $1,214.11 | $315.67 | $45.5 | $361.2 | $1,004 |
| ED visit level 3 | CPT | 99283 | 19 | $1,456.94 | $378.81 | $74.2 | $433.44 | $1,239 |
| ED visit level 4 | CPT | 99284 | 19 | $1,763.12 | $458.42 | $110.25 | $524.53 | $1,454.57 |
| ED visit level 5 | CPT | 99285 | 19 | $2,247.88 | $584.45 | $164.15 | $668.75 | $2,079 |
| Critical care, first hour | CPT | 99291 | 19 | $4,340.89 | $1,128.64 | $225.75 | $1,291.42 | $3,581.23 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 19 | $4,596.25 | $1,195.03 | $47.08 | $919.25 | $3,791.91 |
| CT head with contrast | CPT | 70460 | 19 | $5,025.08 | $1,306.53 | $62.33 | $1,050.51 | $4,145.69 |
| CT head with and without contrast | CPT | 70470 | 19 | $5,777.55 | $1,502.17 | $70.23 | $1,155.51 | $4,766.48 |
| CT neck with contrast | CPT | 70491 | 19 | $4,323.5 | $1,124.11 | $76.03 | $864.7 | $3,566.89 |
| MRI brain without contrast | CPT | 70551 | 19 | $8,063.61 | $2,096.54 | $81.61 | $1,612.72 | $6,652.48 |
| MRI brain with contrast | CPT | 70552 | 19 | $9,859.93 | $2,563.59 | $98.39 | $2,169.19 | $8,134.44 |
| MRI brain with and without contrast | CPT | 70553 | 19 | $11,339 | $2,948.01 | $127.5 | $2,267.7 | $9,354.26 |
| Chest X-ray single view | CPT | 71045 | 19 | $818.59 | $212.84 | $10.21 | $163.72 | $675.34 |
| Chest X-ray 2 views | CPT | 71046 | 19 | $1,194.03 | $310.45 | $12.15 | $238.81 | $985.07 |
| Chest X-ray 3 views | CPT | 71047 | 19 | $1,719.07 | $446.96 | $15.23 | $429.77 | $1,418.23 |
| CT chest without contrast | CPT | 71250 | 19 | $5,049.79 | $1,312.95 | $59.61 | $1,009.96 | $4,166.08 |
| CT chest with contrast | CPT | 71260 | 19 | $5,942.67 | $1,545.1 | $64.24 | $1,188.53 | $4,902.7 |
| CT chest with and without contrast | CPT | 71270 | 19 | $6,368.08 | $1,655.71 | $69.08 | $1,273.62 | $5,253.67 |
| MRI chest without contrast | CPT | 71550 | 19 | $6,597.15 | $1,715.26 | $80.84 | $1,451.38 | $5,442.65 |
| MRI chest with contrast | CPT | 71551 | 19 | $7,006.06 | $1,821.58 | $95.33 | $1,541.33 | $5,780 |
| MRI chest with and without contrast | CPT | 71552 | 19 | $9,482.7 | $2,465.51 | $125.95 | $2,086.2 | $7,823.23 |
| Lumbosacral spine X-ray | CPT | 72100 | 19 | $2,842.03 | $738.93 | $12.53 | $710.51 | $2,344.67 |
| CT cervical spine without contrast | CPT | 72125 | 19 | $5,942.67 | $1,545.1 | $54.81 | $1,188.53 | $4,902.7 |
| CT thoracic spine without contrast | CPT | 72128 | 19 | $5,050.52 | $1,313.14 | $54.81 | $1,010.1 | $4,166.68 |
| CT lumbar spine without contrast | CPT | 72131 | 19 | $6,407.45 | $1,665.94 | $54.81 | $1,281.49 | $5,286.15 |
| MRI cervical spine without contrast | CPT | 72141 | 19 | $8,063.61 | $2,096.54 | $81.99 | $1,612.72 | $6,652.48 |
| MRI thoracic spine without contrast | CPT | 72146 | 19 | $8,063.61 | $2,096.54 | $81.99 | $1,612.72 | $6,652.48 |
| MRI lumbar spine without contrast | CPT | 72148 | 19 | $8,572.43 | $2,228.84 | $81.99 | $1,714.49 | $7,072.25 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 19 | $9,859.93 | $2,563.59 | $99.51 | $1,971.99 | $8,134.44 |
| MRI cervical spine with and without contrast | CPT | 72156 | 19 | $11,340 | $2,948.28 | $127.86 | $2,458.76 | $9,355.11 |
| MRI lumbar spine with contrast | CPT | 72158 | 19 | $11,337 | $2,947.68 | $127.86 | $2,267.44 | $9,353.2 |
| CT pelvis without contrast | CPT | 72192 | 19 | $5,095.29 | $1,324.78 | $60.01 | $1,019.06 | $4,203.61 |
| CT pelvis with contrast | CPT | 72193 | 19 | $5,777.55 | $1,502.17 | $63.86 | $1,155.51 | $4,766.48 |
| Shoulder X-ray | CPT | 73030 | 19 | $906.92 | $235.8 | $10.59 | $235.4 | $748.21 |
| Humerus X-ray | CPT | 73060 | 19 | $899.71 | $233.93 | $9.06 | $233.92 | $742.26 |
| Hand X-ray 3 views | CPT | 73130 | 19 | $1,251.19 | $325.31 | $9.83 | $312.8 | $1,032.23 |
| MRI upper extremity joint without contrast | CPT | 73221 | 19 | $8,063.61 | $2,096.54 | $74.85 | $1,612.72 | $6,652.48 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 19 | $12,281 | $3,193.12 | $119.96 | $2,568.12 | $10,132 |
| Hip X-ray 2 views | CPT | 73510 | 5 | $118 | $41.3 | $25.9 | $56.61 | $92.04 |
| Knee X-ray 1-2 views | CPT | 73560 | 19 | $2,720.23 | $707.26 | $9.43 | $544.05 | $2,244.19 |
| Ankle X-ray 3 views | CPT | 73610 | 19 | $1,518.99 | $394.94 | $9.83 | $379.75 | $1,253.17 |
| MRI lower extremity joint without contrast | CPT | 73721 | 19 | $8,063.61 | $2,096.54 | $74.85 | $1,612.72 | $6,652.48 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 19 | $12,281 | $3,193.12 | $119.96 | $2,568.12 | $10,132 |
| CT abdomen without contrast | CPT | 74150 | 19 | $5,095.29 | $1,324.78 | $65.41 | $1,019.06 | $4,203.61 |
| CT abdomen with contrast | CPT | 74160 | 19 | $5,859.74 | $1,523.54 | $70.23 | $1,171.95 | $4,834.29 |
| CT abdomen with and without contrast | CPT | 74170 | 19 | $6,738.44 | $1,752 | $76.81 | $1,347.69 | $5,559.21 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 19 | $10,190 | $2,649.3 | $96.09 | $2,037.92 | $8,406.42 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 19 | $11,636 | $3,025.45 | $101.45 | $2,327.26 | $9,599.96 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 19 | $13,013 | $3,383.34 | $111.13 | $2,602.56 | $10,736 |
| MRI abdomen without contrast | CPT | 74181 | 19 | $7,001.68 | $1,820.44 | $80.46 | $1,400.34 | $5,776.39 |
| MRI abdomen with and without contrast | CPT | 74183 | 19 | $12,665 | $3,292.81 | $122.3 | $2,532.92 | $10,448 |
| Abdominal ultrasound complete | CPT | 76700 | 19 | $4,234.07 | $1,100.86 | $44.76 | $846.81 | $3,493.11 |
| Abdominal ultrasound limited | CPT | 76705 | 19 | $3,467.5 | $901.55 | $32.61 | $693.5 | $2,860.69 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $3,688.69 | $959.06 | $40.9 | $922.18 | $3,043.17 |
| Obstetric ultrasound first trimester | CPT | 76801 | 19 | $1,998.2 | $519.54 | $54.79 | $506.77 | $1,648.52 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 19 | $4,020.86 | $1,045.43 | $55.15 | $1,005.22 | $3,317.21 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 19 | $4,623.16 | $1,202.03 | $95.55 | $1,155.79 | $3,814.11 |
| Transvaginal ultrasound | CPT | 76830 | 19 | $1,253.25 | $325.85 | $38.38 | $250.65 | $1,033.93 |
| Pelvic ultrasound complete | CPT | 76856 | 19 | $3,508.44 | $912.2 | $38.01 | $877.11 | $2,894.46 |
| Scrotal ultrasound | CPT | 76870 | 19 | $3,644.14 | $947.48 | $33.25 | $728.83 | $3,006.42 |
| Diagnostic mammography unilateral | CPT | 77065 | 19 | $664.87 | $172.87 | $44.76 | $181.18 | $548.52 |
| Diagnostic mammography bilateral | CPT | 77066 | 19 | $754.99 | $196.3 | $54.81 | $205.74 | $622.87 |
| Screening mammography bilateral | CPT | 77067 | 19 | $574.23 | $149.3 | $42.43 | $137.72 | $473.74 |
| EKG complete | CPT | 93000 | 6 | $82 | $28.7 | $16.65 | $49.2 | $63.96 |
| EKG tracing only | CPT | 93005 | 19 | $1,099.58 | $285.9 | $7.2 | $340.87 | $907.15 |
| EKG interpretation only | CPT | 93010 | 6 | $49 | $17.15 | $9.45 | $29.4 | $38.22 |
| Transthoracic echocardiogram complete | CPT | 93306 | 19 | $14,075 | $3,659.53 | $78.79 | $2,815.02 | $11,612 |
| Transthoracic echocardiogram | CPT | 93307 | 19 | $7,398.09 | $1,923.51 | $50 | $1,479.62 | $6,103.42 |
| Stress echocardiogram | CPT | 93350 | 19 | $2,140.98 | $556.66 | $78.79 | $452.12 | $1,766.31 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 2 | — | — | $18,602 | $19,570 | $20,538 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 2 | — | — | $9,345.28 | $9,831.74 | $10,318 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 2 | — | — | $6,330.7 | $6,660.24 | $6,989.78 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 2 | — | — | $14,455 | $15,207 | $15,960 |
| COPD w MCC | MS-DRG | 190 | 2 | — | — | $10,246 | $10,780 | $11,313 |
| COPD w CC | MS-DRG | 191 | 2 | — | — | $7,797.75 | $8,203.66 | $8,609.56 |
| COPD w/o CC/MCC | MS-DRG | 192 | 2 | — | — | $5,938.5 | $6,247.63 | $6,556.75 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 2 | — | — | $7,454.58 | $7,842.62 | $8,230.66 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 2 | — | — | $5,813.63 | $6,116.25 | $6,418.87 |
| AMI discharged alive w MCC | MS-DRG | 280 | 2 | — | — | $14,838 | $15,610 | $16,383 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | — | — | $8,501.68 | $8,944.23 | $9,386.77 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 2 | — | — | $6,688.68 | $7,036.85 | $7,385.02 |
| Heart failure & shock w MCC | MS-DRG | 291 | 2 | — | — | $11,875 | $12,493 | $13,111 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | — | — | $7,853.25 | $8,262.05 | $8,670.84 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 2 | — | — | $5,235.5 | $5,508.03 | $5,780.56 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 2 | — | — | $11,137 | $11,717 | $12,296 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 2 | — | — | $6,805.23 | $7,159.47 | $7,513.7 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | — | — | $5,236.43 | $5,509.01 | $5,781.58 |
| GI hemorrhage w CC | MS-DRG | 378 | 2 | — | — | $9,071.48 | $9,543.69 | $10,016 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 2 | — | — | $5,831.2 | $6,134.74 | $6,438.28 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 2 | — | — | $7,211.3 | $7,586.68 | $7,962.05 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 2 | — | — | $14,501 | $15,256 | $16,011 |
| Kidney/UTI w MCC | MS-DRG | 689 | 2 | — | — | $10,733 | $11,291 | $11,850 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 2 | — | — | $7,487.88 | $7,877.65 | $8,267.42 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 2 | — | — | $17,968 | $18,903 | $19,839 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 2 | — | — | $9,465.53 | $9,958.25 | $10,451 |
| Initial hospital care, low complexity | CPT | 99221 | 6 | $218 | $76.3 | $76.3 | $130.8 | $170.04 |
| Initial hospital care, moderate complexity | CPT | 99222 | 6 | $322 | $112.7 | $112.7 | $193.2 | $251.16 |
| Initial hospital care, high complexity | CPT | 99223 | 6 | $468 | $163.8 | $163.8 | $280.8 | $365.04 |
| Hospital discharge, <30 min | CPT | 99238 | 6 | $191 | $66.85 | $66.85 | $114.6 | $148.98 |
| Hospital discharge, >30 min | CPT | 99239 | 6 | $263 | $92.05 | $92.05 | $157.8 | $205.14 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 19 | $764.26 | $198.71 | $10.58 | $198.71 | $630.51 |
| General health panel | CPT | 80050 | 19 | $1,733.23 | $450.64 | $50.75 | $450.64 | $1,429.91 |
| Electrolyte panel | CPT | 80051 | 19 | $592.51 | $154.06 | $8.76 | $118.5 | $488.82 |
| Comprehensive metabolic panel | CPT | 80053 | 19 | $929.58 | $241.7 | $13.2 | $185.92 | $766.9 |
| Lipid panel | CPT | 80061 | 19 | $1,074.81 | $279.46 | $16.74 | $279.45 | $886.72 |
| Renal function panel | CPT | 80069 | 19 | $739.03 | $192.15 | $10.85 | $147.81 | $609.7 |
| Hepatic function panel | CPT | 80076 | 19 | $703.75 | $182.98 | $10.21 | $182.98 | $580.59 |
| Urinalysis non-automated | CPT | 81002 | 19 | $128.24 | $33.35 | $4.35 | $33.34 | $105.8 |
| Urinalysis automated | CPT | 81003 | 7 | $18 | $6.3 | $2.81 | $10.13 | $14.04 |
| Glucose quantitative | CPT | 82947 | 19 | $291.75 | $75.86 | $4.91 | $75.86 | $240.69 |
| Hemoglobin A1c | CPT | 83036 | 19 | $384.19 | $99.89 | $12.14 | $99.89 | $316.96 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 19 | $457.06 | $118.84 | $21 | $118.84 | $377.07 |
| Complete blood count with automated differential | CPT | 85025 | 19 | $439.04 | $114.16 | $9.71 | $114.15 | $362.21 |
| Complete blood count without differential | CPT | 85027 | 19 | $305.91 | $79.54 | $8.09 | $61.18 | $252.38 |
| Urine culture bacterial | CPT | 87086 | 19 | $340.67 | $88.58 | $10.09 | $88.57 | $281.05 |
| Urine culture identification | CPT | 87088 | 7 | $59 | $20.65 | $10.11 | $33.19 | $46.02 |
| Tissue exam by pathologist level IV | CPT | 88305 | 19 | $747.21 | $194.28 | $39.65 | $194.27 | $616.45 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 6 | $214 | $74.9 | $13.3 | $74.9 | $166.92 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 6 | $6,700 | $2,345 | $2,345 | $4,020 | $5,226 |
| Vaginal delivery only | CPT | 59409 | 6 | $3,200 | $1,120 | $992.69 | $1,920 | $2,496 |
| Vaginal delivery with postpartum | CPT | 59410 | 6 | $3,663 | $1,282.05 | $1,282.05 | $2,197.8 | $2,857.14 |
| Routine obstetric care with C-section | CPT | 59510 | 6 | $7,200 | $2,520 | $2,520 | $4,320 | $5,616 |
| C-section delivery only | CPT | 59514 | 6 | $3,268 | $1,143.8 | $1,132.58 | $1,960.8 | $2,549.04 |
| C-section with postpartum | CPT | 59515 | 6 | $3,524 | $1,233.4 | $1,233.4 | $2,114.4 | $2,748.72 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 6 | $172 | $60.2 | $55.21 | $103.2 | $134.16 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 6 | $249 | $87.15 | $87.15 | $149.4 | $194.22 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 6 | $369 | $129.15 | $129.15 | $221.4 | $287.82 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 6 | $451 | $157.85 | $157.85 | $270.6 | $351.78 |
| Office visit, established patient, 5 min | CPT | 99211 | 6 | $55 | $19.25 | $10.21 | $33 | $42.9 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 6 | $105 | $36.75 | $36.75 | $63 | $81.9 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $170 | $59.5 | $59.5 | $102 | $132.6 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $248 | $86.8 | $86.8 | $148.8 | $193.44 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $327 | $114.45 | $114.45 | $196.2 | $255.06 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 6 | $905 | $316.75 | $144.79 | $543 | $705.9 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 6 | $1,075 | $376.25 | $162.49 | $645 | $838.5 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 6 | $389 | $136.15 | $67.56 | $233.4 | $303.42 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 6 | $525 | $183.75 | $85.81 | $315 | $409.5 |
| Colonoscopy diagnostic | CPT | 45378 | 8 | $1,269 | $444.15 | $109.54 | $837.54 | $2,122 |
| Colonoscopy with biopsy | CPT | 45380 | 6 | $1,517 | $530.95 | $237.33 | $910.2 | $1,183.26 |
| Colonoscopy with polyp removal | CPT | 45385 | 6 | $1,698 | $594.3 | $298.64 | $1,018.8 | $1,324.44 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 6 | $5,450 | $1,907.5 | $1,748.9 | $3,270 | $4,251 |
| Hip hemiarthroplasty | CPT | 27125 | 6 | $5,080 | $1,778 | $1,373.34 | $3,048 | $3,962.4 |
| Total hip replacement | CPT | 27130 | 6 | $6,157 | $2,154.95 | $1,558.76 | $3,694.2 | $4,802.46 |
| Total knee replacement | CPT | 27447 | 6 | $6,094 | $2,132.9 | $1,556.73 | $3,656.4 | $4,753.32 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | $4,453 | $1,558.55 | $1,558.55 | $2,671.8 | $3,473.34 |
| Knee revision arthroplasty all components | CPT | 27487 | 6 | $6,529 | $2,285.15 | $2,124.83 | $3,917.4 | $5,092.62 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 6 | $3,876 | $1,356.6 | $208.38 | $2,325.6 | $3,023.28 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 6 | $4,850 | $1,697.5 | $1,292.61 | $2,910 | $3,783 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 6 | $3,400 | $1,190 | $186.55 | $657.01 | $2,652 |
| ACL reconstruction | CPT | 29888 | 6 | $6,870 | $2,404.5 | $1,177.96 | $4,122 | $5,358.6 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | — | — | $42,518 | $44,731 | $46,944 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 2 | — | — | $22,174 | $23,328 | $24,483 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | — | — | $15,567 | $16,377 | $17,187 |
| CABG single arterial graft | CPT | 33533 | 6 | $8,296 | $2,903.6 | $2,273.51 | $4,977.6 | $6,470.88 |
| CABG 2 arterial grafts | CPT | 33534 | 6 | $9,863 | $3,452.05 | $2,672.1 | $5,917.8 | $7,693.14 |
| CABG 3 arterial grafts | CPT | 33535 | 6 | $10,505 | $3,676.75 | $2,969.33 | $6,303 | $8,193.9 |
| CABG 4+ arterial grafts | CPT | 33536 | 6 | $5,992 | $2,097.2 | $2,097.2 | $3,595.2 | $4,673.76 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 2 | — | — | $15,647 | $16,462 | $17,276 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | — | — | $12,634 | $13,291 | $13,949 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 2 | — | — | $31,516 | $33,156 | $34,797 |
| Open appendectomy | CPT | 44950 | 6 | $2,310 | $808.5 | $790.56 | $1,386 | $1,801.8 |
| Laparoscopic appendectomy | CPT | 44970 | 6 | $1,950 | $682.5 | $682.5 | $1,170 | $1,521 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | — | — | $28,057 | $29,518 | $30,978 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | — | — | $17,842 | $18,771 | $19,700 |
| Laparoscopic cholecystectomy | CPT | 47562 | 7 | $2,906 | $1,017.1 | $814.8 | $1,917.96 | $2,800 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 7 | $3,421 | $1,197.35 | $886.88 | $2,257.86 | $2,800 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | — | — | $26,939 | $28,341 | $29,743 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | — | — | $19,374 | $20,383 | $21,391 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 2 | — | — | $15,087 | $15,872 | $16,657 |
| Open umbilical hernia repair | CPT | 49560 | 5 | $2,558 | $895.3 | $895.3 | $1,688.28 | $1,995.24 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 5 | $1,828 | $639.8 | $639.8 | $1,206.48 | $1,425.84 |
| Lap inguinal hernia repair | CPT | 49650 | 6 | $1,889 | $661.15 | $533.06 | $1,133.4 | $1,473.42 |
| Lap incisional hernia repair | CPT | 49652 | 5 | $2,800 | $980 | $980 | $1,848 | $2,184 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | $4,520 | $1,582 | $1,229.05 | $2,712 | $3,525.6 |
| Vaginal hysterectomy | CPT | 58260 | 6 | $4,413 | $1,544.55 | $1,010.16 | $2,647.8 | $3,442.14 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 6 | $4,250 | $1,487.5 | $1,064.91 | $2,550 | $3,315 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 6 | $4,381 | $1,533.35 | $1,184.51 | $2,628.6 | $3,417.18 |
| Lap salpingo-oophorectomy | CPT | 58661 | 6 | $4,000 | $1,400 | $788.35 | $2,400 | $3,120 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 2 | — | — | $26,708 | $28,099 | $29,489 |
| OR procedure for obesity w CC | MS-DRG | 620 | 2 | — | — | $14,803 | $15,573 | $16,344 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 2 | — | — | $13,953 | $14,679 | $15,405 |
| Complex cataract surgery | CPT | 66982 | 6 | $3,938 | $1,378.3 | $854.41 | $2,362.8 | $3,071.64 |
| Cataract surgery with lens implant | CPT | 66984 | 6 | $3,841 | $1,344.35 | $623.05 | $2,304.6 | $2,995.98 |
| Intravitreal injection | CPT | 67028 | 6 | $790 | $276.5 | $106.81 | $474 | $616.2 |
| Vitrectomy mechanical | CPT | 67042 | 6 | $4,421 | $1,547.35 | $1,309.34 | $2,652.6 | $3,448.38 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 2 | — | — | $11,476 | $12,074 | $12,671 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 2 | — | — | $18,954 | $19,941 | $20,927 |
| PCI single major coronary artery | CPT | 92920 | 6 | $1,446 | $506.1 | $506.1 | $867.6 | $1,127.88 |
| PCI with drug-eluting stent | CPT | 92928 | 6 | $1,650 | $577.5 | $577.5 | $990 | $1,287 |
| PCI bypass graft | CPT | 92937 | 6 | $1,650 | $577.5 | $577.5 | $990 | $1,287 |
| Left heart catheterization | CPT | 93452 | 6 | $2,215 | $775.25 | $246.4 | $805.88 | $1,727.7 |
| Coronary angiography with cath | CPT | 93455 | 6 | $2,627 | $919.45 | $331.59 | $967.58 | $2,049.06 |
| Coronary angiography with bypass cath | CPT | 93458 | 6 | $2,708 | $947.8 | $349.7 | $987 | $2,112.24 |
Payer mix (top 19)
| Payer | Codes covered | Median rate |
|---|---|---|
| Humana | 158 | $706.65 |
| Multiplan | 158 | $624 |
| prime health services | 158 | $680.19 |
| Self-Pay (Cash) | 158 | $283.82 |
| Cigna | 158 | $482.08 |
| claimdoc | 154 | $158.2 |
| healthlink | 131 | $3,814.11 |
| UnitedHealthcare | 131 | $1,096 |
| deaconess onecare | 87 | $735.16 |
| dhp | 87 | $839.9 |
| WellCare | 86 | $697.6 |
| alliance coal | 86 | $1,151.04 |
| Blue Cross Blue Shield | 86 | $1,080.13 |
| hope trust | 86 | $1,220.79 |
| meridian | 86 | $697.6 |
| Molina | 86 | $697.6 |
| mytruadvantage (dhp) | 86 | $697.6 |
| umwa | 86 | $697.6 |
| Aetna | 86 | $738.93 |