▸ Hospital · IL · CCN 141349
Sparta Community Hospital
818 EAST BROADWAY, SPARTA, IL, 62286
25 bedsCritical Access Hospitals11
Compliance grade
A
100/100
Procedures tracked
82
of 209 target codes
Payers
15
with negotiated rates
Rates published
4,536
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 15 | $4,501 | $4,501 | $323.35 | $2,415.78 | $4,275.95 |
| ED visit level 2 | CPT | 99282 | 15 | $4,265.75 | $4,265.75 | $132.3 | $1,000.74 | $4,052.46 |
| ED visit level 3 | CPT | 99283 | 15 | $4,265.75 | $4,265.75 | $33.95 | $365.82 | $4,052.46 |
| ED visit level 4 | CPT | 99284 | 15 | $4,507.75 | $4,507.75 | $329.7 | $2,543.92 | $4,282.36 |
| ED visit level 5 | CPT | 99285 | 15 | $4,517.75 | $4,517.75 | $375.68 | $2,723.65 | $4,291.86 |
| Critical care, first hour | CPT | 99291 | 15 | $3,788.5 | $3,788.5 | $305.83 | $2,408.03 | $3,599.08 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 15 | $2,566 | $2,566 | $256.6 | $1,448 | $2,437.7 |
| CT head with and without contrast | CPT | 70470 | 15 | $3,893 | $3,893 | $389.3 | $1,448 | $3,698.35 |
| CT neck with contrast | CPT | 70491 | 15 | $3,954.75 | $3,954.75 | $395.48 | $1,448 | $3,757.01 |
| MRI brain without contrast | CPT | 70551 | 15 | $3,713.75 | $3,713.75 | $371.38 | $1,298 | $3,528.06 |
| MRI brain with contrast | CPT | 70552 | 15 | $3,756.75 | $3,756.75 | $375.68 | $1,298 | $3,568.91 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $4,517.75 | $4,517.75 | $451.78 | $1,298 | $4,291.86 |
| Chest X-ray single view | CPT | 71045 | 15 | $250 | $250 | $21.73 | $157.29 | $237.5 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $365.5 | $365.5 | $36.55 | $244.89 | $347.23 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $345 | $345 | $34.5 | $231.15 | $327.75 |
| CT chest without contrast | CPT | 71250 | 15 | $3,382.75 | $3,382.75 | $338.28 | $1,448 | $3,213.61 |
| CT chest with contrast | CPT | 71260 | 15 | $4,089.5 | $4,089.5 | $408.95 | $1,448 | $3,885.03 |
| CT chest with and without contrast | CPT | 71270 | 15 | $4,829.5 | $4,829.5 | $482.95 | $1,448 | $4,588.03 |
| MRI chest without contrast | CPT | 71550 | 15 | $3,780.75 | $3,780.75 | $378.08 | $1,298 | $3,591.71 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $4,692.25 | $4,692.25 | $469.23 | $1,298 | $4,457.64 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $357.5 | $357.5 | $35.75 | $239.53 | $339.63 |
| CT cervical spine without contrast | CPT | 72125 | 15 | $3,387 | $3,387 | $338.7 | $1,448 | $3,217.65 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | $3,228.5 | $3,228.5 | $322.85 | $1,448 | $3,067.08 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | $3,215.25 | $3,215.25 | $321.53 | $1,448 | $3,054.49 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $3,552.25 | $3,552.25 | $355.23 | $1,298 | $3,374.64 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $3,058.25 | $3,058.25 | $305.83 | $1,298 | $2,905.34 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $3,747.75 | $3,747.75 | $374.78 | $1,298 | $3,560.36 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $4,501 | $4,501 | $450.1 | $1,298 | $4,275.95 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $4,435.25 | $4,435.25 | $443.53 | $1,298 | $4,213.49 |
| CT pelvis without contrast | CPT | 72192 | 15 | $3,028.75 | $3,028.75 | $302.88 | $1,448 | $2,877.31 |
| CT pelvis with contrast | CPT | 72193 | 15 | $2,819 | $2,819 | $281.9 | $1,448 | $2,678.05 |
| Shoulder X-ray | CPT | 73030 | 15 | $401.5 | $401.5 | $26.88 | $194.85 | $381.43 |
| Humerus X-ray | CPT | 73060 | 15 | $390.5 | $390.5 | $26.05 | $188.87 | $370.98 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $495 | $495 | $28.4 | $205.9 | $470.25 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $2,861.75 | $2,861.75 | $5.88 | $154.35 | $2,718.66 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $4,281.25 | $4,281.25 | $14.98 | $428.13 | $4,067.19 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $385.25 | $385.25 | $25.73 | $186.51 | $365.99 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $501.5 | $501.5 | $28.73 | $208.26 | $476.43 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $487.5 | $487.5 | $2.7 | $63.38 | $1,298 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $4,265.75 | $4,265.75 | $426.58 | $1,298 | $4,052.46 |
| CT abdomen without contrast | CPT | 74150 | 15 | $3,083 | $3,083 | $308.3 | $1,448 | $2,928.85 |
| CT abdomen with contrast | CPT | 74160 | 15 | $4,247 | $4,247 | $424.7 | $1,448 | $4,034.65 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | $5,684.25 | $5,684.25 | $568.43 | $1,448 | $5,400.04 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $4,036.5 | $4,036.5 | $403.65 | $1,448 | $3,834.68 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | $5,561.25 | $5,561.25 | $556.13 | $1,448 | $5,283.19 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $7,105 | $7,105 | $710.5 | $1,666.83 | $6,749.75 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $2,981 | $2,981 | $298.1 | $1,298 | $2,831.95 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $4,596 | $4,596 | $459.6 | $1,298 | $4,366.2 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $568.5 | $568.5 | $56.85 | $380.9 | $540.08 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $321.5 | $321.5 | $27.1 | $196.48 | $305.43 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $407 | $407 | $25.1 | $200.8 | $386.65 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $330.75 | $330.75 | $33.08 | $221.6 | $314.21 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $330.75 | $330.75 | $33.08 | $221.6 | $314.21 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $167.75 | $167.75 | $16.78 | $112.39 | $159.36 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $167.75 | $167.75 | $16.78 | $112.39 | $159.36 |
| Scrotal ultrasound | CPT | 76870 | 15 | $337.5 | $337.5 | $33.75 | $226.13 | $320.63 |
| Diagnostic mammography unilateral | CPT | 77065 | 15 | $369 | $369 | $11.5 | $92 | $350.55 |
| Diagnostic mammography bilateral | CPT | 77066 | 15 | $369 | $369 | $36.9 | $247.23 | $350.55 |
| Screening mammography bilateral | CPT | 77067 | 15 | $356.75 | $356.75 | $12.43 | $90.09 | $338.91 |
| EKG tracing only | CPT | 93005 | 15 | $264.75 | $264.75 | $26.48 | $177.38 | $251.51 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | $1,323 | $1,323 | $132.3 | $886.41 | $1,256.85 |
| Stress echocardiogram | CPT | 93350 | 15 | $178 | $178 | $17.8 | $119.26 | $169.1 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $214.25 | $214.25 | $21.43 | $139.26 | $203.54 |
| General health panel | CPT | 80050 | 15 | $714.5 | $714.5 | $35 | $464.43 | $678.78 |
| Electrolyte panel | CPT | 80051 | 15 | $98.25 | $98.25 | $9.83 | $63.86 | $93.34 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $320.25 | $320.25 | $32.03 | $208.16 | $304.24 |
| Lipid panel | CPT | 80061 | 15 | $271.25 | $271.25 | $27.13 | $176.31 | $257.69 |
| Renal function panel | CPT | 80069 | 15 | $143.25 | $143.25 | $14.33 | $93.11 | $136.09 |
| Hepatic function panel | CPT | 80076 | 15 | $321.5 | $321.5 | $32.15 | $208.98 | $305.43 |
| Urinalysis automated | CPT | 81003 | 15 | $39.75 | $39.75 | $3.98 | $27.83 | $37.76 |
| Glucose quantitative | CPT | 82947 | 15 | $101.25 | $101.25 | $8.88 | $62.13 | $96.19 |
| Hemoglobin A1c | CPT | 83036 | 15 | $150.25 | $150.25 | $14.3 | $97.66 | $142.74 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $292 | $292 | $16.28 | $113.93 | $277.4 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $138.25 | $138.25 | $13.83 | $89.86 | $131.34 |
| Complete blood count without differential | CPT | 85027 | 15 | $57.75 | $57.75 | $5.78 | $37.54 | $54.86 |
| Urine culture bacterial | CPT | 87086 | 15 | $207.5 | $207.5 | $20.75 | $134.88 | $197.13 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $395 | $395 | $10.18 | $81.4 | $375.25 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 15 | $155 | $155 | $15.5 | $103.85 | $147.25 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 15 | $178 | $178 | $17.8 | $119.26 | $169.1 |
| Office visit, established patient, 5 min | CPT | 99211 | 15 | $679.25 | $679.25 | $15.5 | $124 | $645.29 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 15 | $155 | $155 | $15.5 | $103.85 | $147.25 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 15 | $178 | $178 | $17.8 | $119.26 | $169.1 |
Payer mix (top 15)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 82 | $257.2 |
| Blue Cross Blue Shield | 82 | $155.24 |
| Cigna | 82 | $282.85 |
| First Health | 82 | $301.7 |
| health alliance negotiated rate | 82 | $301.7 |
| healthlink hmo negotiated rate | 82 | $281.05 |
| healthlink ppo negotiated rate | 82 | $321.2 |
| healthsmart negotiated rate | 82 | $358.27 |
| Humana | 82 | $257.2 |
| Medicare Advantage | 82 | $87.59 |
| meridian negotiated rate | 82 | $37.72 |
| Molina | 82 | $44.93 |
| Multiplan | 82 | $301.7 |
| three rivers provider network negotiated rate | 82 | $301.7 |
| UnitedHealthcare | 82 | $258.71 |