Does Ascension St. Vincent Williamsport publish its standard charges and chargemaster?

Yes. Ascension St. Vincent Williamsport publishes a machine-readable file with 74,033 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Ascension St. Vincent Williamsport charge for procedures?

Ascension St. Vincent Williamsport (Williamsport, IN) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · IN · CCN 151307

Ascension St. Vincent Williamsport

Williamsport, IN, 47993

16 bedsCritical Access Hospitals1

Compliance grade

100/100

Rates published

74,033

last crawl 2026-05-23

Procedures tracked

198

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IN hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/350784551_st-vincent-williamsport-hospital-inc_standardcharges.csv · CSV

Procedures & rates

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
behavioral
Psychoses	MS-DRG	885	16	—	—	$1,124	$13,400	1.0×	$19,901
Psychiatric diagnostic evaluation	CPT	90791	7	—	—	$101.42	$115.91	0.65×	$203.36
Psychiatric eval with medical services	CPT	90792	7	—	—	$109.4	$128.8	0.74×	$210.5
Psychotherapy 30 minutes	CPT	90832	7	—	—	$49.13	$66.81	0.45×	$85.78
Psychotherapy 45 minutes	CPT	90834	7	—	—	$65.16	$82.39	0.51×	$128.83
Psychotherapy 60 minutes	CPT	90837	7	—	—	$97.58	$124.27	0.65×	$194.22
Crisis psychotherapy 60 minutes	CPT	90839	7	—	—	$22.72	$121.83	0.77×	$283.38
emergency
ED visit level 1	CPT	99281	7	$531	$318.6	$3.45	$26.06	0.19×	$33.3
ED visit level 2	CPT	99282	7	$839	$503.4	$6.73	$49.16	0.21×	$60.5
ED visit level 3	CPT	99283	7	$1,526	$915.6	$10.08	$78.77	0.19×	$102.81
ED visit level 4	CPT	99284	7	$2,891	$1,734.6	$19.14	$146.03	0.22×	$174.23
ED visit level 5	CPT	99285	7	$3,888	$2,332.8	$28.23	$217.84	0.21×	$252.81
Critical care, first hour	CPT	99291	7	$4,961	$2,976.6	$36.28	$272.02	0.25×	$330.48
imaging
CT head without contrast	CPT	70450	20	$2,191	$1,314.6	$23.94	$66.53	0.32×	$1,460.96
CT head with contrast	CPT	70460	20	$2,738	$1,642.8	$33.31	$111.2	0.48×	$1,464.83
CT head with and without contrast	CPT	70470	20	$3,284	$1,970.4	$39.5	$111.2	0.42×	$1,756.94
CT neck with contrast	CPT	70491	20	$2,853	$1,711.8	$40.71	$119.1	0.44×	$1,902.38
MRI brain without contrast	CPT	70551	20	$3,430	$2,058	$36.33	$148.3	0.37×	$2,287.12
MRI brain with contrast	CPT	70552	20	$4,287	$2,572.2	$50.29	$250.13	0.52×	$2,858.57
MRI brain with and without contrast	CPT	70553	20	$5,144	$3,086.4	$59.48	$232.74	0.39×	$2,752.04
Chest X-ray single view	CPT	71045	18	$282	$169.2	$2.74	$19.01	0.20×	$250
Chest X-ray 2 views	CPT	71046	18	$414	$248.4	$4.17	$29.77	0.30×	$276.06
Chest X-ray 3 views	CPT	71047	7	$418	$250.8	$5.33	$22.96	0.24×	$242.27
CT chest without contrast	CPT	71250	20	$2,068	$1,240.8	$36.28	$94.83	0.44×	$1,378.94
CT chest with contrast	CPT	71260	20	$2,583	$1,549.8	$43.3	$119.58	0.42×	$1,722.34
CT chest with and without contrast	CPT	71270	20	$3,255	$1,953	$49.1	$148.65	0.51×	$2,170.43
MRI chest without contrast	CPT	71550	20	$3,404	$2,042.4	$52.07	$232.03	0.54×	$2,269.79
MRI chest with contrast	CPT	71551	20	$4,254	$2,552.4	$61.83	$335.35	0.41×	$2,836.57
MRI chest with and without contrast	CPT	71552	20	$5,106	$3,063.6	$80.61	$324.3	0.54×	$3,404.68
Lumbosacral spine X-ray	CPT	72100	10	$556	$333.6	$4.83	$24.05	0.23×	$370.74
CT cervical spine without contrast	CPT	72125	20	$2,827	$1,696.2	$36.4	$96.03	0.48×	$1,512.45
CT thoracic spine without contrast	CPT	72128	20	$2,607	$1,564.2	$35.75	$95.55	0.48×	$1,738.35
CT lumbar spine without contrast	CPT	72131	20	$2,594	$1,556.4	$35.75	$95.07	0.47×	$1,729.68
MRI cervical spine without contrast	CPT	72141	20	$3,328	$1,996.8	$35.32	$167.02	0.42×	$2,219.11
MRI thoracic spine without contrast	CPT	72146	20	$3,938	$2,362.8	$35.32	$166.62	0.45×	$2,625.86
MRI lumbar spine without contrast	CPT	72148	20	$3,412	$2,047.2	$35.16	$167.79	0.45×	$2,275.12
MRI lumbar spine with and without contrast	CPT	72149	20	$4,265	$2,559	$50.49	$250.13	0.55×	$2,843.9
MRI cervical spine with and without contrast	CPT	72156	20	$4,991	$2,994.6	$59.76	$232.74	0.43×	$3,328
MRI lumbar spine with contrast	CPT	72158	20	$5,117	$3,070.2	$59.65	$232.74	0.43×	$2,737.6
CT pelvis without contrast	CPT	72192	20	$2,176	$1,305.6	$30.12	$70.2	0.35×	$1,450.96
CT pelvis with contrast	CPT	72193	20	$2,719	$1,631.4	$41.27	$119.58	0.43×	$1,813.03
Shoulder X-ray	CPT	73030	10	$878	$526.8	$3.87	$19.58	0.21×	$585.45
Humerus X-ray	CPT	73060	10	$908	$544.8	$3.82	$19.58	0.22×	$605.45
Hand X-ray 3 views	CPT	73130	10	$1,042	$625.2	$3.88	$18.91	0.20×	$694.81
MRI upper extremity joint without contrast	CPT	73221	20	$6,180	$3,708	$37.14	$161.35	0.39×	$4,120.82
MRI upper extremity joint with and without contrast	CPT	73223	20	$9,266	$5,559.6	$73.57	$330.92	0.54×	$6,178.57
Hip X-ray 2 views	CPT	73510	6	—	—	$14.1	$21.3	0.28×	$35.4
Knee X-ray 1-2 views	CPT	73560	10	$792	$475.2	$3.64	$18.22	0.20×	$528.11
Ankle X-ray 3 views	CPT	73610	10	$1,012	$607.2	$3.88	$19.25	0.21×	$674.8
MRI lower extremity joint without contrast	CPT	73721	20	$5,992	$3,595.2	$37.19	$174.63	0.37×	$3,995.47
MRI lower extremity joint with and without contrast	CPT	73723	20	$8,984	$5,390.4	$73.85	$331.88	0.52×	$5,990.53
CT abdomen without contrast	CPT	74150	20	$2,219	$1,331.4	$30.88	$77.1	0.41×	$1,187.16
CT abdomen with contrast	CPT	74160	20	$2,774	$1,664.4	$44.89	$119.1	0.42×	$1,484.09
CT abdomen with and without contrast	CPT	74170	20	$3,329	$1,997.4	$50.02	$140.01	0.42×	$1,781.02
CT abdomen and pelvis without contrast	CPT	74176	20	$4,394	$2,636.4	$62.32	$147.3	0.40×	$2,929.92
CT abdomen and pelvis with contrast	CPT	74177	20	$5,495	$3,297	$65.14	$232.74	0.42×	$2,939.83
CT abdomen and pelvis with and without contrast	CPT	74178	20	$6,594	$3,956.4	$71.93	$232.74	0.40×	$4,396.88
MRI abdomen without contrast	CPT	74181	20	$2,430	$1,458	$52.07	$178.45	0.46×	$1,620.32
MRI abdomen with and without contrast	CPT	74183	20	$4,862	$2,917.2	$79.46	$275.04	0.49×	$2,601.17
Abdominal ultrasound complete	CPT	76700	20	$1,335	$801	$23.01	$68.16	0.46×	$890.18
Abdominal ultrasound limited	CPT	76705	20	$968	$580.8	$17.16	$66.53	0.45×	$645.46
Retroperitoneal ultrasound complete	CPT	76770	20	$1,062	$637.2	$21.28	$66.53	0.46×	$708.14
Obstetric ultrasound first trimester	CPT	76801	20	—	—	$23.2	$66.53	0.47×	$400
Obstetric ultrasound after first trimester	CPT	76805	20	—	—	$26.71	$66.53	0.44×	$400
Obstetric ultrasound with fetal anatomy	CPT	76811	20	—	—	$34.45	$129.05	0.55×	$400
Transvaginal ultrasound	CPT	76830	20	$850	$510	$22.28	$66.53	0.45×	$454.75
Pelvic ultrasound complete	CPT	76856	20	$1,004	$602.4	$20.59	$66.53	0.46×	$669.47
Scrotal ultrasound	CPT	76870	10	$983	$589.8	$12.73	$51.12	0.39×	$655.46
Diagnostic mammography unilateral	CPT	77065	20	$522	$313.2	$21.32	$85.87	0.57×	$255.68
Diagnostic mammography bilateral	CPT	77066	20	$632	$379.2	$27.03	$109.51	0.58×	$327.17
Screening mammography bilateral	CPT	77067	20	$514	$308.4	$21.77	$100.4	0.64×	$270.19
EKG complete	CPT	93000	7	—	—	$2.81	$24.45	1.0×	$32.45
EKG tracing only	CPT	93005	7	$491	$294.6	$1.36	$15.78	0.13×	$19.71
EKG interpretation only	CPT	93010	7	$94	$56.4	$1.45	$8.67	0.48×	$12.74
Transthoracic echocardiogram complete	CPT	93306	7	$4,388	$2,632.8	$45.57	$156.02	0.26×	$557.6
Transthoracic echocardiogram	CPT	93307	7	$2,254	$1,352.4	$26.63	$90.45	0.37×	$377.78
Stress echocardiogram	CPT	93350	7	—	—	$49.07	$110.96	0.22×	$395.51
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	16	—	—	$7,939.93	$13,833	0.90×	$19,901
COPD w MCC	MS-DRG	190	16	—	—	$7,939.93	$13,833	1.2×	$19,901
COPD w CC	MS-DRG	191	16	—	—	$7,939.93	$13,833	1.6×	$19,901
COPD w/o CC/MCC	MS-DRG	192	16	—	—	$7,939.93	$13,833	2.0×	$19,901
Simple pneumonia & pleurisy w CC	MS-DRG	194	16	—	—	$7,939.93	$13,833	1.6×	$19,901
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	16	—	—	$7,939.93	$13,833	2.1×	$19,901
AMI discharged alive w MCC	MS-DRG	280	16	—	—	$7,939.93	$13,833	0.88×	$19,901
AMI discharged alive w CC	MS-DRG	281	16	—	—	$7,939.93	$13,833	1.4×	$19,901
AMI discharged alive w/o CC/MCC	MS-DRG	282	16	—	—	$7,939.93	$13,833	1.8×	$19,901
Heart failure & shock w MCC	MS-DRG	291	16	—	—	$7,939.93	$13,833	1.1×	$19,901
Heart failure & shock w CC	MS-DRG	292	16	—	—	$7,939.93	$13,833	1.5×	$19,901
Heart failure & shock w/o CC/MCC	MS-DRG	293	16	—	—	$7,939.93	$13,833	2.2×	$19,901
Cardiac arrhythmia w MCC	MS-DRG	308	16	—	—	$7,939.93	$13,833	1.1×	$19,901
Cardiac arrhythmia w CC	MS-DRG	309	16	—	—	$7,939.93	$13,833	1.8×	$19,901
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	16	—	—	$7,939.93	$13,833	2.2×	$19,901
GI hemorrhage w CC	MS-DRG	378	16	—	—	$7,939.93	$13,833	1.4×	$19,901
GI hemorrhage w/o CC/MCC	MS-DRG	379	16	—	—	$7,939.93	$13,833	2.0×	$19,901
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	16	—	—	$7,939.93	$13,833	1.7×	$19,901
Fractures of femur w/o MCC	MS-DRG	533	16	—	—	$7,939.93	$13,833	0.91×	$19,901
Kidney/UTI w MCC	MS-DRG	689	16	—	—	$7,939.93	$13,833	1.2×	$19,901
Kidney/UTI w/o MCC	MS-DRG	690	16	—	—	$7,939.93	$13,833	1.7×	$19,901
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	16	—	—	$7,939.93	$13,833	0.74×	$19,901
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	16	—	—	$7,939.93	$13,833	1.3×	$19,901
Initial hospital care, low complexity	CPT	99221	7	—	—	$15.87	$97.63	1.1×	$116.87
Initial hospital care, moderate complexity	CPT	99222	7	—	—	$21.81	$139.44	0.83×	$158.41
Initial hospital care, high complexity	CPT	99223	7	—	—	$32.08	$205.76	0.91×	$234.59
Hospital discharge, <30 min	CPT	99238	7	—	—	$11.73	$76.1	0.89×	$85.42
Hospital discharge, >30 min	CPT	99239	7	—	—	$17.21	$108.35	0.89×	$124.03
lab
Basic metabolic panel (BMP)	CPT	80048	19	$286	$171.6	$3.47	$8.46	0.26×	$19.29
General health panel	CPT	80050	10	$542	$325.2	$14.55	$21.75	0.20×	$195.16
Electrolyte panel	CPT	80051	19	$250	$150	$2.14	$7.01	0.29×	$15.98
Comprehensive metabolic panel	CPT	80053	19	$439	$263.4	$5	$10.56	0.24×	$24.08
Lipid panel	CPT	80061	19	$359	$215.4	$6.02	$13.39	0.35×	$30.53
Renal function panel	CPT	80069	19	$421	$252.6	$4.11	$8.68	0.32×	$19.79
Hepatic function panel	CPT	80076	19	$324	$194.4	$2.99	$8.17	0.31×	$18.63
Urinalysis non-automated	CPT	81002	19	$80	$48	$1.32	$3.48	0.50×	$7.93
Urinalysis automated	CPT	81003	19	$138	$82.8	$1.32	$2.25	0.16×	$5.13
Glucose quantitative	CPT	82947	19	$96	$57.6	$1.94	$3.93	0.22×	$8.96
Hemoglobin A1c	CPT	83036	19	$252	$151.2	$3.97	$9.71	0.36×	$22.14
Thyroid stimulating hormone (TSH)	CPT	84443	19	$374	$224.4	$5.29	$16.8	0.36×	$38.3
Complete blood count with automated differential	CPT	85025	19	$189	$113.4	$3.68	$7.77	0.29×	$17.72
Complete blood count without differential	CPT	85027	19	$167	$100.2	$3.06	$6.47	0.30×	$14.75
Urine culture bacterial	CPT	87086	19	$279	$167.4	$2.65	$8.07	0.35×	$18.4
Urine culture identification	CPT	87088	19	$154	$92.4	$3.97	$8.09	0.36×	$18.45
Tissue exam by pathologist level IV	CPT	88305	10	$796	$477.6	$10.55	$45.95	0.45×	$277.37
maternity
Fetal non-stress test	CPT	59025	18	—	—	$8.25	$26.4	0.14×	$61.67
Routine obstetric care including vaginal delivery	CPT	59400	5	—	—	$307.69	$2,263.19	0.99×	$2,381.76
Vaginal delivery only	CPT	59409	7	—	—	$130.63	$794.3	0.36×	$989.23
Vaginal delivery with postpartum	CPT	59410	5	—	—	$159.53	$1,089.77	1.0×	$1,189.65
Routine obstetric care with C-section	CPT	59510	5	—	—	$348.34	$2,263.19	0.90×	$2,637.16
C-section delivery only	CPT	59514	7	—	—	$146.94	$860.52	0.90×	$1,169.6
C-section with postpartum	CPT	59515	5	—	—	$191.97	$1,221.1	0.96×	$1,441.93
office
Office visit, new patient, 15-29 min	CPT	99202	7	—	—	$7.89	$57.26	0.66×	$73.29
Office visit, new patient, 30-44 minutes	CPT	99203	7	—	—	$12.11	$87.49	0.71×	$106.19
Office visit, new patient, 45-59 min	CPT	99204	7	—	—	$20.23	$147.33	0.85×	$162.17
Office visit, new patient, 60-74 min	CPT	99205	7	—	—	$26.31	$191.56	0.87×	$201.3
Office visit, established patient, 5 min	CPT	99211	7	$378	$226.8	$1.5	$13.74	0.21×	$19.98
Office visit, established patient, 10-19 min	CPT	99212	7	$726	$435.6	$4.08	$29.97	0.37×	$43
Office visit, established patient, 20-29 minutes	CPT	99213	7	$899	$539.4	$7.82	$57.54	0.50×	$71.77
Office visit, established patient, 30-39 minutes	CPT	99214	7	$1,076	$645.6	$12.21	$89.1	0.58×	$105.54
Office visit, established patient, 40-54 min	CPT	99215	7	$1,652	$991.2	$17.49	$126.82	0.67×	$141.38
preventive
Upper GI endoscopy diagnostic	CPT	43235	18	—	—	$33.84	$214.9	0.23×	$460.37
Upper GI endoscopy with biopsy	CPT	43239	18	—	—	$40.24	$274.3	0.28×	$460.37
Sigmoidoscopy diagnostic	CPT	45330	18	—	—	$14.46	$150.92	0.18×	$318.54
Sigmoidoscopy with biopsy	CPT	45331	18	—	—	$17.35	$111.99	0.13×	$464.17
Colonoscopy diagnostic	CPT	45378	18	—	—	$50.85	$297.75	0.34×	$528.94
Colonoscopy with biopsy	CPT	45380	18	—	—	$61.03	$358.77	0.30×	$599.32
Colonoscopy with polyp removal	CPT	45385	18	—	—	$72.43	$425.99	0.35×	$725.61
surgery
Total shoulder arthroplasty	CPT	23472	18	—	—	$285.69	$1,673.9	0.40×	$13,700
Hip hemiarthroplasty	CPT	27125	7	—	—	$221.89	$1,461.9	1.2×	$2,043.94
Total hip replacement	CPT	27130	18	—	—	$266	$1,975	0.46×	$9,045.08
Total knee replacement	CPT	27447	18	—	—	$265.93	$2,089.4	0.50×	$8,859.71
Knee revision arthroplasty single component	CPT	27486	7	—	—	$275.8	$1,887.3	1.1×	$2,586.47
Knee revision arthroplasty all components	CPT	27487	7	—	—	$345.06	$2,439.3	1.2×	$3,268.72
Shoulder arthroscopy with decompression	CPT	29826	7	—	—	$34.65	$940.3	2.9×	$1,224.04
Shoulder arthroscopy with rotator cuff repair	CPT	29827	18	—	—	$207.73	$1,294.1	0.39×	$3,321.81
Knee arthroscopy with meniscectomy	CPT	29881	18	—	—	$105.81	$791.7	0.39×	$1,487.08
ACL reconstruction	CPT	29888	18	—	—	$193.11	$1,381.2	0.41×	$4,403.04
Major small/large bowel procedures w MCC	MS-DRG	329	16	—	—	$7,939.93	$13,833	0.32×	$19,901
Major small/large bowel procedures w CC	MS-DRG	330	16	—	—	$7,939.93	$13,833	0.60×	$19,901
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	16	—	—	$7,939.93	$13,833	0.84×	$19,901
CABG single arterial graft	CPT	33533	7	—	—	$457.57	$2,187.05	1.2×	$3,552.71
CABG 2 arterial grafts	CPT	33534	7	—	—	$538.42	$2,829	1.3×	$4,097.66
CABG 3 arterial grafts	CPT	33535	7	—	—	$600.5	$3,090.2	1.4×	$4,517.63
CABG 4+ arterial grafts	CPT	33536	7	—	—	$647.54	$3,350.5	1.4×	$4,834.88
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	16	—	—	$7,939.93	$13,833	0.84×	$19,901
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	16	—	—	$7,939.93	$13,833	1.0×	$19,901
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	16	—	—	$7,939.93	$13,833	0.43×	$19,901
Open appendectomy	CPT	44950	7	—	—	$143.8	$685.7	0.60×	$1,734.57
Laparoscopic appendectomy	CPT	44970	7	—	—	$131.4	$673	0.43×	$1,620.38
Major joint replacement w MCC	MS-DRG	469	16	—	—	$7,939.93	$13,833	0.47×	$19,901
Major joint replacement w/o MCC	MS-DRG	470	16	—	—	$7,939.93	$13,833	0.73×	$19,901
Laparoscopic cholecystectomy	CPT	47562	18	—	—	$163.63	$892	0.50×	$2,648.76
Lap cholecystectomy with cholangiography	CPT	47563	18	—	—	$168.66	$965.28	0.51×	$10,581
Hip & femur procedures except major joint w MCC	MS-DRG	480	16	—	—	$7,939.93	$13,833	0.49×	$19,901
Hip & femur procedures except major joint w CC	MS-DRG	481	16	—	—	$7,939.93	$13,833	0.68×	$19,901
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	16	—	—	$7,939.93	$13,833	0.87×	$19,901
Open umbilical hernia repair	CPT	49560	7	—	—	$165.01	$782.3	0.41×	$1,988.48
Umbilical hernia repair age 5+	CPT	49585	7	—	—	$96.3	$472.8	0.36×	$1,196.31
Lap inguinal hernia repair	CPT	49650	18	—	—	$94.14	$516.4	0.46×	$2,648.76
Lap incisional hernia repair	CPT	49652	7	—	—	$194.34	$1,191.29	0.44×	$2,006.09
Total abdominal hysterectomy	CPT	58150	7	—	—	$199.64	$1,202.18	1.2×	$1,616.16
Vaginal hysterectomy	CPT	58260	18	—	—	$162.85	$1,039.67	0.57×	$2,090.81
Lap-assisted vaginal hysterectomy	CPT	58550	18	—	—	$173.88	$1,213.6	0.82×	$2,648.76
Lap-assisted vaginal hysterectomy >250g	CPT	58552	18	—	—	$194.63	$1,327.01	0.60×	$4,445.47
Lap salpingo-oophorectomy	CPT	58661	18	—	—	$128.06	$856.61	0.42×	$2,648.76
OR procedure for obesity w MCC	MS-DRG	619	17	—	—	$7,939.93	$13,965	0.51×	$19,901
OR procedure for obesity w CC	MS-DRG	620	17	—	—	$7,939.93	$13,965	0.86×	$19,901
OR procedure for obesity w/o CC/MCC	MS-DRG	621	17	—	—	$7,939.93	$13,965	0.92×	$19,901
Complex cataract surgery	CPT	66982	18	—	—	$149.37	$1,085.3	0.49×	$1,768.72
Cataract surgery with lens implant	CPT	66984	18	—	—	$119.97	$766.16	0.35×	$1,257.21
Intravitreal injection	CPT	67028	18	—	—	$18.84	$72.77	0.21×	$283.93
Vitrectomy mechanical	CPT	67042	18	—	—	$216.77	$1,559.34	0.62×	$2,464.05
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	16	—	—	$7,939.93	$13,833	1.1×	$19,901
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	16	—	—	$7,939.93	$13,833	0.72×	$19,901
PCI single major coronary artery	CPT	92920	18	—	—	$113.54	$796.79	0.14×	$9,845.53
PCI with drug-eluting stent	CPT	92928	18	—	—	$126.02	$884.66	0.09×	$15,991
PCI bypass graft	CPT	92937	7	—	—	$125.94	$763.59	0.07×	$15,991
Left heart catheterization	CPT	93452	19	—	—	$178.63	$611.42	0.20×	$14,592
Coronary angiography with cath	CPT	93455	18	—	—	$208.63	$711.57	0.23×	$2,261.57
Coronary angiography with bypass cath	CPT	93458	18	—	—	$217.44	$752.13	0.24×	$2,340.29

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

Payer mix (top 30)

Payer	Codes covered	Median rate
encore exclusive	198	$311.13
Anthem BCBS	198	$176.17
UnitedHealthcare	197	$126.7
patoka valley tier 2	158	$201.16
patoka valley tier 1	158	$201.16
mhs care connect	153	$97.35
Medicaid	153	$97.35
Aetna	141	$250.13
Humana	136	$464.17
smarthealth ppo/hdhp 20161001	109	$232.77
personalized care	94	$148.3
immergrun	94	$148.3
secure horizons-pacificare	94	$148.3
Medicare	94	$148.3
Medicare Advantage	94	$148.3
corizon	94	$148.3
CareSource	79	$167.79
Ambetter	79	$167.79
ascension complete mcr	76	$232.74
smarthealth ppo	72	$34.97
unified group services	41	$18,572
Cigna	40	$17,562
encore	40	$13,400
advantage 360	40	$11,850
one health plan	40	$11,500
prohealth	40	$7,939.93
sagamore plus drg	40	$19,607
siho ppo	40	$15,000
suburban/sho	40	$7,939.93
unified zionsville	40	$14,464

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