▸ Hospital · IN · CCN 150006

Northwest Health-la Porte

STATE & MADISON STREETS, LAPORTE, IN, 46350-

80 bedsAcute Care Hospitals4

Compliance grade

86/100

Rates published

9,569

last crawl 2026-05-23

Procedures tracked

193

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IN hospitals JSON

Source MRF: https://www.nwhealthlaporte.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/810722737_northwest-health-laporte_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—
Psychiatric diagnostic evaluation	CPT	90791	0	$353	$190.62	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$394	$212.76	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$172	$92.88	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$229	$123.66	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$343	$185.22	—	—	—
emergency
ED visit level 1	CPT	99281	0	$363.95	$196.53	—	—	—
ED visit level 2	CPT	99282	0	$553.9	$299.11	—	—	—
ED visit level 3	CPT	99283	0	$1,972.98	$1,065.41	—	—	—
ED visit level 4	CPT	99284	0	$2,291.59	$1,237.46	—	—	—
ED visit level 5	CPT	99285	0	$3,063.23	$1,654.14	—	—	—
Critical care, first hour	CPT	99291	0	$4,076.02	$2,201.05	—	—	—
imaging
CT head without contrast	CPT	70450	0	$3,085.14	$1,665.98	—	—	—
CT head with contrast	CPT	70460	0	$3,679.96	$1,987.18	—	—	—
CT head with and without contrast	CPT	70470	0	$3,856.86	$2,082.7	—	—	—
CT neck with contrast	CPT	70491	0	$3,471.01	$1,874.35	—	—	—
MRI brain without contrast	CPT	70551	0	$3,856.86	$2,082.7	—	—	—
MRI brain with contrast	CPT	70552	0	$4,628.51	$2,499.4	—	—	—
MRI brain with and without contrast	CPT	70553	0	$4,628.51	$2,499.4	—	—	—
Chest X-ray single view	CPT	71045	0	$347.8	$187.81	—	—	—
Chest X-ray 2 views	CPT	71046	0	$552.41	$298.3	—	—	—
Chest X-ray 3 views	CPT	71047	0	$581.67	$314.1	—	—	—
CT chest without contrast	CPT	71250	0	$3,085.14	$1,665.98	—	—	—
CT chest with contrast	CPT	71260	0	$3,471.01	$1,874.35	—	—	—
CT chest with and without contrast	CPT	71270	0	$3,856.86	$2,082.7	—	—	—
MRI chest without contrast	CPT	71550	0	$3,856.86	$2,082.7	—	—	—
MRI chest with contrast	CPT	71551	0	$4,628.51	$2,499.4	—	—	—
MRI chest with and without contrast	CPT	71552	0	$4,628.51	$2,499.4	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$593.38	$320.43	—	—	—
CT cervical spine without contrast	CPT	72125	0	$3,085.14	$1,665.98	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$3,085.14	$1,665.98	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$3,085.14	$1,665.98	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$3,856.86	$2,082.7	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$3,856.86	$2,082.7	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$3,856.86	$2,082.7	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$4,628.51	$2,499.4	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$4,628.51	$2,499.4	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$4,628.51	$2,499.4	—	—	—
CT pelvis without contrast	CPT	72192	0	$3,085.14	$1,665.98	—	—	—
CT pelvis with contrast	CPT	72193	0	$3,471.01	$1,874.35	—	—	—
Shoulder X-ray	CPT	73030	0	$531.99	$287.27	—	—	—
Humerus X-ray	CPT	73060	0	$450.1	$243.05	—	—	—
Hand X-ray 3 views	CPT	73130	0	$429.69	$232.03	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$3,856.86	$2,082.7	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$4,628.51	$2,499.4	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$429.69	$232.03	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$470.6	$254.12	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$3,856.86	$2,082.7	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$4,628.51	$2,499.4	—	—	—
CT abdomen without contrast	CPT	74150	0	$3,085.14	$1,665.98	—	—	—
CT abdomen with contrast	CPT	74160	0	$3,471.01	$1,874.35	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$3,856.86	$2,082.7	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,085.14	$1,665.98	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$3,471.01	$1,874.35	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$3,856.86	$2,082.7	—	—	—
MRI abdomen without contrast	CPT	74181	0	$3,856.86	$2,082.7	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$4,628.51	$2,499.4	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,984.68	$1,071.73	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,588.63	$857.86	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,704.06	$920.19	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,753.75	$947.03	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,753.75	$947.03	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,768.38	$954.93	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,552.08	$838.12	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,759.6	$950.18	—	—	—
Scrotal ultrasound	CPT	76870	0	$1,549.15	$836.54	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$524.63	$283.3	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$666.41	$359.86	—	—	—
Screening mammography bilateral	CPT	77067	0	$511.51	$276.22	—	—	—
EKG complete	CPT	93000	0	$44	$23.76	—	—	—
EKG tracing only	CPT	93005	0	$612.37	$330.68	—	—	—
EKG interpretation only	CPT	93010	0	$23	$12.42	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$3,207.95	$1,732.29	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$2,176.15	$1,175.12	—	—	—
Stress echocardiogram	CPT	93350	0	$2,746.13	$1,482.91	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—
COPD w MCC	MS-DRG	190	0	—	—	—	—	—
COPD w CC	MS-DRG	191	0	—	—	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	—	—	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	—	—	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	—	—	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	—	—	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	—	—	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	—	—	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	—	—	—	—	—
Heart failure & shock w/o CC/MCC	MS-DRG	293	0	—	—	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	—	—	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	—	—	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	—	—	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	—	—	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	—	—	—	—	—
Fractures of femur w/o MCC	MS-DRG	533	0	—	—	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	—	—	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	—	—	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	—	—	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	—	—	—	—	—
Initial hospital care, low complexity	CPT	99221	0	$268	$144.72	—	—	—
Initial hospital care, moderate complexity	CPT	99222	0	$363	$196.02	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$539	$291.06	—	—	—
Hospital discharge, <30 min	CPT	99238	0	$193	$104.22	—	—	—
Hospital discharge, >30 min	CPT	99239	0	$286	$154.44	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$235.76	$127.31	—	—	—
General health panel	CPT	80050	0	$779	$420.66	—	—	—
Electrolyte panel	CPT	80051	0	$238.22	$128.64	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$397.51	$214.66	—	—	—
Lipid panel	CPT	80061	0	$419.42	$226.49	—	—	—
Renal function panel	CPT	80069	0	$306.92	$165.74	—	—	—
Hepatic function panel	CPT	80076	0	$534.92	$288.86	—	—	—
Urinalysis non-automated	CPT	81002	0	$64.79	$34.99	—	—	—
Urinalysis automated	CPT	81003	0	$143.22	$77.34	—	—	—
Glucose quantitative	CPT	82947	0	$70.17	$37.89	—	—	—
Hemoglobin A1c	CPT	83036	0	$143.4	$77.44	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$100.86	$54.46	—	—	—
Complete blood count with automated differential	CPT	85025	0	$267.44	$144.42	—	—	—
Complete blood count without differential	CPT	85027	0	$144.71	$78.14	—	—	—
Urine culture bacterial	CPT	87086	0	$163.68	$88.39	—	—	—
Urine culture identification	CPT	87088	0	$42.4	$22.9	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$362.44	$195.72	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$1,081.17	$388.63	—	—	—
Routine obstetric care including vaginal delivery	CPT	59400	0	$6,759	$3,649.86	—	—	—
Vaginal delivery only	CPT	59409	0	$2,642	$1,426.68	—	—	—
Vaginal delivery with postpartum	CPT	59410	0	$3,370	$1,819.8	—	—	—
Routine obstetric care with C-section	CPT	59510	0	$7,475	$4,036.5	—	—	—
C-section delivery only	CPT	59514	0	$2,969	$1,603.26	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$196	$105.84	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$282	$152.28	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$430	$232.2	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$1,715.77	$926.52	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$53	$28.62	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$114	$61.56	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$239.75	$129.47	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$283	$152.82	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$381	$205.74	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$12,339	$4,071.72	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$18,107	$5,975.26	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$16,292	$5,376.45	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$16,024	$5,287.95	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$12,926	$4,265.45	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$18,789	$6,200.24	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$23,025	$7,598.39	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	$128,810	$42,507	—	—	—
Hip hemiarthroplasty	CPT	27125	0	$4,440	$2,397.6	—	—	—
Total hip replacement	CPT	27130	0	$130,811	$43,168	—	—	—
Total knee replacement	CPT	27447	0	$125,945	$41,562	—	—	—
Shoulder arthroscopy with decompression	CPT	29826	0	$66,611	$21,982	—	—	—
Shoulder arthroscopy with rotator cuff repair	CPT	29827	0	$81,293	$26,827	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$52,176	$17,218	—	—	—
ACL reconstruction	CPT	29888	0	$83,004	$27,391	—	—	—
Major small/large bowel procedures w MCC	MS-DRG	329	0	—	—	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	—	—	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	—	—	—	—	—
CABG single arterial graft	CPT	33533	0	$6,093	$3,290.22	—	—	—
CABG 2 arterial grafts	CPT	33534	0	$7,167	$3,870.18	—	—	—
CABG 3 arterial grafts	CPT	33535	0	$8,000	$4,320	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	—	—	—	—	—
Open appendectomy	CPT	44950	0	$2,087	$1,126.98	—	—	—
Laparoscopic appendectomy	CPT	44970	0	$71,801	$23,694	—	—	—
Spinal fusion (non-cervical) w MCC	MS-DRG	459	0	—	—	—	—	—
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	0	—	—	—	—	—
Major joint replacement w MCC	MS-DRG	469	0	—	—	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	—	—	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$75,034	$24,761	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	$103,688	$34,217	—	—	—
Hip & femur procedures except major joint w MCC	MS-DRG	480	0	—	—	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	—	—	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	—	—	—	—	—
Open umbilical hernia repair	CPT	49560	0	$2,876	$1,553.04	—	—	—
Umbilical hernia repair age 5+	CPT	49585	0	$1,444	$779.76	—	—	—
Lap inguinal hernia repair	CPT	49650	0	$78,903	$26,038	—	—	—
Lap incisional hernia repair	CPT	49652	0	$2,897	$1,564.38	—	—	—
Total abdominal hysterectomy	CPT	58150	0	$3,325	$1,795.5	—	—	—
Vaginal hysterectomy	CPT	58260	0	$84,565	$27,906	—	—	—
Lap-assisted vaginal hysterectomy	CPT	58550	0	$69,103	$22,804	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	$75,797	$25,013	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	$63,566	$20,977	—	—	—
OR procedure for obesity w MCC	MS-DRG	619	0	—	—	—	—	—
OR procedure for obesity w CC	MS-DRG	620	0	—	—	—	—	—
OR procedure for obesity w/o CC/MCC	MS-DRG	621	0	—	—	—	—	—
Complex cataract surgery	CPT	66982	0	$28,157	$9,291.65	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$26,598	$8,777.19	—	—	—
Intravitreal injection	CPT	67028	0	$404	$218.16	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	$20,509	$11,075	—	—	—
PCI with drug-eluting stent	CPT	92928	0	$41,564	$22,445	—	—	—
PCI bypass graft	CPT	92937	0	$41,564	$22,445	—	—	—
Left heart catheterization	CPT	93452	0	$16,163	$8,728.08	—	—	—
Coronary angiography with cath	CPT	93455	0	$18,150	$9,800.93	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$22,577	$12,192	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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