▸ Hospital · IN · CCN 150102

Northwest Health- Starke

102 EAST CULVER RD, KNOX, IN, 46534

14 bedsAcute Care Hospitals4

Compliance grade

86/100

Rates published

2,620

last crawl 2026-05-23

Procedures tracked

134

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IN hospitals JSON

Source MRF: https://www.nwhealthstarke.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/272691760_northwest-health-starke_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—
emergency
ED visit level 1	CPT	99281	0	$363.95	$200.17	—	—	—
ED visit level 2	CPT	99282	0	$553.9	$304.65	—	—	—
ED visit level 3	CPT	99283	0	$1,972.98	$1,085.14	—	—	—
ED visit level 4	CPT	99284	0	$2,291.59	$1,260.37	—	—	—
ED visit level 5	CPT	99285	0	$3,063.23	$1,684.78	—	—	—
Critical care, first hour	CPT	99291	0	$4,076.02	$2,241.81	—	—	—
imaging
CT head without contrast	CPT	70450	0	$3,085.14	$1,696.83	—	—	—
CT head with contrast	CPT	70460	0	$3,679.96	$2,023.98	—	—	—
CT head with and without contrast	CPT	70470	0	$3,856.86	$2,121.27	—	—	—
CT neck with contrast	CPT	70491	0	$3,471.01	$1,909.06	—	—	—
MRI brain without contrast	CPT	70551	0	$3,856.86	$2,121.27	—	—	—
MRI brain with and without contrast	CPT	70553	0	$4,628.51	$2,545.68	—	—	—
Chest X-ray single view	CPT	71045	0	$347.8	$191.29	—	—	—
Chest X-ray 2 views	CPT	71046	0	$552.41	$303.83	—	—	—
Chest X-ray 3 views	CPT	71047	0	$581.67	$319.92	—	—	—
CT chest without contrast	CPT	71250	0	$3,085.14	$1,696.83	—	—	—
CT chest with contrast	CPT	71260	0	$3,471.01	$1,909.06	—	—	—
CT chest with and without contrast	CPT	71270	0	$3,856.86	$2,121.27	—	—	—
MRI chest without contrast	CPT	71550	0	$3,856.86	$2,121.27	—	—	—
MRI chest with contrast	CPT	71551	0	$4,628.51	$2,545.68	—	—	—
MRI chest with and without contrast	CPT	71552	0	$4,628.51	$2,545.68	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$593.38	$326.36	—	—	—
CT cervical spine without contrast	CPT	72125	0	$3,085.14	$1,696.83	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$3,085.14	$1,696.83	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$3,085.14	$1,696.83	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$3,856.86	$2,121.27	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$3,856.86	$2,121.27	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$3,856.86	$2,121.27	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$4,628.51	$2,545.68	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$4,628.51	$2,545.68	—	—	—
CT pelvis without contrast	CPT	72192	0	$3,085.14	$1,696.83	—	—	—
CT pelvis with contrast	CPT	72193	0	$3,471.01	$1,909.06	—	—	—
Shoulder X-ray	CPT	73030	0	$531.99	$292.59	—	—	—
Humerus X-ray	CPT	73060	0	$450.1	$247.56	—	—	—
Hand X-ray 3 views	CPT	73130	0	$429.69	$236.33	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$3,856.86	$2,121.27	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$4,628.51	$2,545.68	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$429.69	$236.33	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$470.6	$258.83	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$3,856.86	$2,121.27	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$4,628.51	$2,545.68	—	—	—
CT abdomen without contrast	CPT	74150	0	$3,085.14	$1,696.83	—	—	—
CT abdomen with contrast	CPT	74160	0	$3,471.01	$1,909.06	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$3,856.86	$2,121.27	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,085.14	$1,696.83	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$3,471.01	$1,909.06	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$3,856.86	$2,121.27	—	—	—
MRI abdomen without contrast	CPT	74181	0	$3,856.86	$2,121.27	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$4,628.51	$2,545.68	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,984.68	$1,091.57	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,588.63	$873.75	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,704.06	$937.23	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,753.75	$964.56	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,753.75	$964.56	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,768.38	$972.61	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,552.08	$853.64	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,759.6	$967.78	—	—	—
Scrotal ultrasound	CPT	76870	0	$1,549.15	$852.03	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$524.63	$288.55	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$666.41	$366.53	—	—	—
Screening mammography bilateral	CPT	77067	0	$511.51	$281.33	—	—	—
EKG tracing only	CPT	93005	0	$612.37	$336.8	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$3,207.95	$1,764.37	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$2,176.15	$1,196.88	—	—	—
Stress echocardiogram	CPT	93350	0	$2,746.13	$1,510.37	—	—	—
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	—	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$235.76	$129.67	—	—	—
General health panel	CPT	80050	0	$779	$428.45	—	—	—
Electrolyte panel	CPT	80051	0	$238.22	$131.02	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$397.51	$218.63	—	—	—
Lipid panel	CPT	80061	0	$419.42	$230.68	—	—	—
Renal function panel	CPT	80069	0	$306.92	$168.81	—	—	—
Hepatic function panel	CPT	80076	0	$534.92	$294.21	—	—	—
Urinalysis non-automated	CPT	81002	0	$64.79	$35.63	—	—	—
Urinalysis automated	CPT	81003	0	$143.22	$78.77	—	—	—
Glucose quantitative	CPT	82947	0	$70.17	$38.59	—	—	—
Hemoglobin A1c	CPT	83036	0	$143.4	$78.87	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$100.86	$55.47	—	—	—
Complete blood count with automated differential	CPT	85025	0	$267.44	$147.09	—	—	—
Complete blood count without differential	CPT	85027	0	$144.71	$79.59	—	—	—
Urine culture bacterial	CPT	87086	0	$163.68	$90.02	—	—	—
Urine culture identification	CPT	87088	0	$42.4	$23.32	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$362.44	$199.34	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$719.68	$395.82	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$16,078	$4,341.04	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$20,402	$5,508.55	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$20,444	$5,519.79	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$14,796	$3,995.04	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$18,028	$4,867.62	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$18,142	$4,898.23	—	—	—
surgery
Shoulder arthroscopy with decompression	CPT	29826	0	$71,665	$19,350	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$45,873	$12,386	—	—	—
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	—	—	—	—	—
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	—	—	—	—	—
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	—	—	—	—	—
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	—	—	—	—	—
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	—	—	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$25,059	$6,765.94	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—

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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