▸ Hospital · IN · CCN 151325
Ascension St. Vincent Warrick
1116 MILLIS AVE, BOONEVILLE, IN, 47601
25 bedsCritical Access Hospitals1
Compliance grade
A
100/100
Procedures tracked
198
of 209 target codes
Payers
30
with negotiated rates
Rates published
81,558
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 16 | — | — | $1,124 | $12,800 | $19,901 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 7 | $710 | $426 | $101.42 | $156.5 | $203.36 |
| Psychiatric eval with medical services | CPT | 90792 | 7 | — | — | $109.4 | $128.8 | $210.5 |
| Psychotherapy 30 minutes | CPT | 90832 | 7 | $328 | $196.8 | $49.13 | $66.81 | $85.78 |
| Psychotherapy 45 minutes | CPT | 90834 | 7 | $546 | $327.6 | $65.16 | $82.39 | $128.83 |
| Psychotherapy 60 minutes | CPT | 90837 | 7 | $655 | $393 | $97.58 | $124.27 | $194.22 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 7 | — | — | $22.72 | $121.83 | $283.38 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 7 | $259 | $155.4 | $3.45 | $26.06 | $33.3 |
| ED visit level 2 | CPT | 99282 | 7 | $802 | $481.2 | $6.73 | $49.16 | $60.5 |
| ED visit level 3 | CPT | 99283 | 7 | $1,294 | $776.4 | $10.08 | $78.77 | $102.81 |
| ED visit level 4 | CPT | 99284 | 7 | $2,174 | $1,304.4 | $19.14 | $146.03 | $174.23 |
| ED visit level 5 | CPT | 99285 | 7 | $3,623 | $2,173.8 | $28.23 | $235.33 | $252.81 |
| Critical care, first hour | CPT | 99291 | 7 | $4,658 | $2,794.8 | $36.28 | $301.25 | $330.48 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 20 | $1,475 | $885 | $23.94 | $66.53 | $1,027.34 |
| CT head with contrast | CPT | 70460 | 20 | $2,846 | $1,707.6 | $33.31 | $111.2 | $1,982.24 |
| CT head with and without contrast | CPT | 70470 | 20 | $2,871 | $1,722.6 | $39.5 | $111.2 | $1,999.65 |
| CT neck with contrast | CPT | 70491 | 20 | $2,801 | $1,680.6 | $40.71 | $119.1 | $1,950.9 |
| MRI brain without contrast | CPT | 70551 | 20 | $2,150 | $1,290 | $36.33 | $168.32 | $1,497.47 |
| MRI brain with contrast | CPT | 70552 | 20 | $3,627 | $2,176.2 | $50.29 | $250.13 | $2,526.21 |
| MRI brain with and without contrast | CPT | 70553 | 20 | $3,627 | $2,176.2 | $59.48 | $232.74 | $2,526.21 |
| Chest X-ray single view | CPT | 71045 | 18 | $419 | $251.4 | $2.74 | $18.46 | $291.83 |
| Chest X-ray 2 views | CPT | 71046 | 18 | $469 | $281.4 | $4.17 | $28.46 | $326.66 |
| Chest X-ray 3 views | CPT | 71047 | 7 | $518 | $310.8 | $5.33 | $22.96 | $242.27 |
| CT chest without contrast | CPT | 71250 | 20 | $1,475 | $885 | $36.28 | $94.83 | $1,027.34 |
| CT chest with contrast | CPT | 71260 | 20 | $2,846 | $1,707.6 | $43.3 | $119.58 | $1,982.24 |
| CT chest with and without contrast | CPT | 71270 | 20 | $2,801 | $1,680.6 | $49.1 | $148.65 | $1,950.9 |
| MRI chest without contrast | CPT | 71550 | 20 | $2,117 | $1,270.2 | $52.07 | $232.03 | $1,474.49 |
| MRI chest with contrast | CPT | 71551 | 20 | $4,551 | $2,730.6 | $61.83 | $335.35 | $3,169.77 |
| MRI chest with and without contrast | CPT | 71552 | 20 | $3,627 | $2,176.2 | $80.61 | $324.3 | $2,526.21 |
| Lumbosacral spine X-ray | CPT | 72100 | 10 | $469 | $281.4 | $4.83 | $24.05 | $312.73 |
| CT cervical spine without contrast | CPT | 72125 | 20 | $1,475 | $885 | $36.4 | $96.03 | $1,027.34 |
| CT thoracic spine without contrast | CPT | 72128 | 20 | $1,475 | $885 | $35.75 | $95.55 | $1,027.34 |
| CT lumbar spine without contrast | CPT | 72131 | 20 | $1,475 | $885 | $35.75 | $130.82 | $1,027.34 |
| MRI cervical spine without contrast | CPT | 72141 | 20 | $2,117 | $1,270.2 | $35.32 | $167.02 | $1,474.49 |
| MRI thoracic spine without contrast | CPT | 72146 | 20 | $2,117 | $1,270.2 | $35.32 | $166.62 | $1,474.49 |
| MRI lumbar spine without contrast | CPT | 72148 | 20 | $2,145 | $1,287 | $35.16 | $167.79 | $1,493.99 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 20 | $3,627 | $2,176.2 | $50.49 | $250.13 | $2,526.21 |
| MRI cervical spine with and without contrast | CPT | 72156 | 20 | $3,627 | $2,176.2 | $59.76 | $232.74 | $2,526.21 |
| MRI lumbar spine with contrast | CPT | 72158 | 20 | $3,627 | $2,176.2 | $59.65 | $232.74 | $2,526.21 |
| CT pelvis without contrast | CPT | 72192 | 20 | $1,475 | $885 | $30.12 | $84.07 | $1,027.34 |
| CT pelvis with contrast | CPT | 72193 | 20 | $2,801 | $1,680.6 | $41.27 | $119.58 | $1,950.9 |
| Shoulder X-ray | CPT | 73030 | 10 | $938 | $562.8 | $3.87 | $19.58 | $653.32 |
| Humerus X-ray | CPT | 73060 | 10 | $938 | $562.8 | $3.82 | $19.58 | $625.46 |
| Hand X-ray 3 views | CPT | 73130 | 10 | $938 | $562.8 | $3.88 | $18.91 | $625.46 |
| MRI upper extremity joint without contrast | CPT | 73221 | 20 | $4,234 | $2,540.4 | $37.14 | $174.39 | $2,948.98 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 20 | $7,254 | $4,352.4 | $73.57 | $330.92 | $5,052.41 |
| Hip X-ray 2 views | CPT | 73510 | 6 | — | — | $14.1 | $21.3 | $35.4 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $938 | $562.8 | $3.64 | $18.22 | $625.46 |
| Ankle X-ray 3 views | CPT | 73610 | 10 | $938 | $562.8 | $3.88 | $19.25 | $625.46 |
| MRI lower extremity joint without contrast | CPT | 73721 | 20 | $3,930 | $2,358 | $37.19 | $174.63 | $2,737.24 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 20 | $7,254 | $4,352.4 | $73.85 | $331.88 | $5,052.41 |
| CT abdomen without contrast | CPT | 74150 | 20 | $1,475 | $885 | $30.88 | $91.55 | $1,027.34 |
| CT abdomen with contrast | CPT | 74160 | 20 | $2,801 | $1,680.6 | $44.89 | $119.1 | $1,950.9 |
| CT abdomen with and without contrast | CPT | 74170 | 20 | $2,846 | $1,707.6 | $50.02 | $140.01 | $1,982.24 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 20 | $1,475 | $885 | $62.32 | $148.39 | $1,027.34 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 20 | $2,871 | $1,722.6 | $65.14 | $232.74 | $1,999.65 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 20 | $2,871 | $1,722.6 | $71.93 | $258.79 | $1,999.65 |
| MRI abdomen without contrast | CPT | 74181 | 20 | $2,117 | $1,270.2 | $52.07 | $178.45 | $1,474.49 |
| MRI abdomen with and without contrast | CPT | 74183 | 20 | $3,627 | $2,176.2 | $79.46 | $275.04 | $2,526.21 |
| Abdominal ultrasound complete | CPT | 76700 | 20 | $873 | $523.8 | $23.01 | $68.16 | $608.04 |
| Abdominal ultrasound limited | CPT | 76705 | 20 | $873 | $523.8 | $17.16 | $66.53 | $608.04 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 20 | $873 | $523.8 | $21.28 | $66.53 | $608.04 |
| Obstetric ultrasound first trimester | CPT | 76801 | 20 | $873 | $523.8 | $23.2 | $70.68 | $608.04 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 20 | $873 | $523.8 | $26.71 | $74.75 | $608.04 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 20 | — | — | $34.45 | $129.05 | $553 |
| Transvaginal ultrasound | CPT | 76830 | 20 | $907 | $544.2 | $22.28 | $71.81 | $631.73 |
| Pelvic ultrasound complete | CPT | 76856 | 20 | $907 | $544.2 | $20.59 | $66.53 | $631.73 |
| Scrotal ultrasound | CPT | 76870 | 10 | $873 | $523.8 | $12.73 | $51.12 | $608.04 |
| Diagnostic mammography unilateral | CPT | 77065 | 20 | — | — | $21.32 | $85.87 | $255.68 |
| Diagnostic mammography bilateral | CPT | 77066 | 20 | — | — | $27.03 | $109.51 | $327.17 |
| Screening mammography bilateral | CPT | 77067 | 20 | — | — | $21.77 | $100.4 | $270.19 |
| EKG complete | CPT | 93000 | 7 | — | — | $2.81 | $24.45 | $32.45 |
| EKG tracing only | CPT | 93005 | 7 | $458 | $274.8 | $1.36 | $15.78 | $19.71 |
| EKG interpretation only | CPT | 93010 | 7 | $110 | $66 | $1.45 | $8.67 | $12.74 |
| Transthoracic echocardiogram complete | CPT | 93306 | 7 | $5,534 | $3,320.4 | $45.57 | $156.02 | $557.6 |
| Transthoracic echocardiogram | CPT | 93307 | 7 | $2,100 | $1,260 | $26.63 | $90.45 | $377.78 |
| Stress echocardiogram | CPT | 93350 | 7 | — | — | $49.07 | $96.75 | $395.51 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| COPD w MCC | MS-DRG | 190 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| COPD w CC | MS-DRG | 191 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| COPD w/o CC/MCC | MS-DRG | 192 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| AMI discharged alive w MCC | MS-DRG | 280 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| AMI discharged alive w CC | MS-DRG | 281 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Heart failure & shock w MCC | MS-DRG | 291 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Heart failure & shock w CC | MS-DRG | 292 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| GI hemorrhage w CC | MS-DRG | 378 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Kidney/UTI w MCC | MS-DRG | 689 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Initial hospital care, low complexity | CPT | 99221 | 7 | — | — | $15.87 | $97.63 | $116.87 |
| Initial hospital care, moderate complexity | CPT | 99222 | 7 | — | — | $21.81 | $139.44 | $158.41 |
| Initial hospital care, high complexity | CPT | 99223 | 7 | — | — | $32.08 | $205.76 | $234.59 |
| Hospital discharge, <30 min | CPT | 99238 | 7 | — | — | $11.73 | $76.1 | $85.42 |
| Hospital discharge, >30 min | CPT | 99239 | 7 | — | — | $17.21 | $108.35 | $124.03 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $73 | $43.8 | $3.47 | $5.42 | $27.92 |
| General health panel | CPT | 80050 | 10 | $531 | $318.6 | $14.55 | $21.16 | $195.16 |
| Electrolyte panel | CPT | 80051 | 11 | $65 | $39 | $2.14 | $4.68 | $23.13 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $111 | $66.6 | $5 | $7.04 | $34.85 |
| Lipid panel | CPT | 80061 | 11 | $109 | $65.4 | $6.02 | $9.55 | $44.19 |
| Renal function panel | CPT | 80069 | 11 | $92 | $55.2 | $4.11 | $5.62 | $28.64 |
| Hepatic function panel | CPT | 80076 | 11 | $63 | $37.8 | $2.99 | $5.42 | $26.96 |
| Urinalysis non-automated | CPT | 81002 | 11 | $26 | $15.6 | $1.32 | $2.65 | $11.48 |
| Urinalysis automated | CPT | 81003 | 11 | $40 | $24 | $1.32 | $2.25 | $7.43 |
| Glucose quantitative | CPT | 82947 | 11 | $74 | $44.4 | $1.94 | $3.93 | $12.97 |
| Hemoglobin A1c | CPT | 83036 | 11 | $80 | $48 | $3.97 | $7.19 | $32.04 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $246 | $147.6 | $5.29 | $14.08 | $55.44 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $80 | $48 | $3.68 | $6.52 | $25.64 |
| Complete blood count without differential | CPT | 85027 | 11 | $70 | $42 | $3.06 | $5.42 | $21.35 |
| Urine culture bacterial | CPT | 87086 | 11 | $130 | $78 | $2.65 | $6.61 | $26.63 |
| Urine culture identification | CPT | 87088 | 11 | $61 | $36.6 | $3.97 | $6.79 | $26.7 |
| Tissue exam by pathologist level IV | CPT | 88305 | 10 | $476 | $285.6 | $10.55 | $45.66 | $277.37 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 18 | — | — | $8.25 | $26.4 | $61.67 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 5 | — | — | $307.69 | $2,263.19 | $2,381.76 |
| Vaginal delivery only | CPT | 59409 | 7 | — | — | $130.63 | $794.3 | $989.23 |
| Vaginal delivery with postpartum | CPT | 59410 | 5 | — | — | $159.53 | $1,089.77 | $1,189.65 |
| Routine obstetric care with C-section | CPT | 59510 | 5 | — | — | $348.34 | $2,263.19 | $2,637.16 |
| C-section delivery only | CPT | 59514 | 7 | — | — | $146.94 | $860.52 | $1,169.6 |
| C-section with postpartum | CPT | 59515 | 5 | — | — | $191.97 | $1,221.1 | $1,441.93 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | — | — | $7.89 | $65.72 | $73.29 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | — | — | $12.11 | $97.34 | $106.19 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | — | — | $20.23 | $156.17 | $162.17 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | — | — | $26.31 | $198.24 | $201.3 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $340 | $204 | $1.5 | $13.74 | $19.98 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $331 | $198.6 | $4.08 | $29.97 | $43 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $350 | $210 | $7.82 | $59.2 | $71.77 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $400 | $240 | $12.21 | $90.98 | $105.54 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $450 | $270 | $17.49 | $128.69 | $141.38 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 18 | — | — | $33.84 | $214.9 | $460.37 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 18 | — | — | $40.24 | $274.3 | $460.37 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 18 | — | — | $14.46 | $150.92 | $318.54 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 18 | — | — | $17.35 | $111.99 | $464.17 |
| Colonoscopy diagnostic | CPT | 45378 | 18 | — | — | $50.85 | $297.75 | $528.94 |
| Colonoscopy with biopsy | CPT | 45380 | 18 | — | — | $61.03 | $358.77 | $599.32 |
| Colonoscopy with polyp removal | CPT | 45385 | 18 | — | — | $72.43 | $425.99 | $725.61 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 18 | — | — | $285.69 | $1,673.9 | $13,700 |
| Hip hemiarthroplasty | CPT | 27125 | 7 | — | — | $221.89 | $1,461.9 | $2,043.94 |
| Total hip replacement | CPT | 27130 | 18 | — | — | $266 | $1,975 | $9,045.08 |
| Total knee replacement | CPT | 27447 | 18 | — | — | $265.93 | $2,089.4 | $8,859.71 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | — | — | $275.8 | $1,887.3 | $2,586.47 |
| Knee revision arthroplasty all components | CPT | 27487 | 7 | — | — | $345.06 | $2,439.3 | $3,268.72 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $34.65 | $940.3 | $1,224.04 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 18 | — | — | $207.73 | $1,294.1 | $3,321.81 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 18 | — | — | $105.81 | $791.7 | $1,487.08 |
| ACL reconstruction | CPT | 29888 | 18 | — | — | $193.11 | $1,381.2 | $4,403.04 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| CABG single arterial graft | CPT | 33533 | 7 | — | — | $457.57 | $2,187.05 | $3,552.71 |
| CABG 2 arterial grafts | CPT | 33534 | 7 | — | — | $538.42 | $2,829 | $4,097.66 |
| CABG 3 arterial grafts | CPT | 33535 | 7 | — | — | $600.5 | $3,090.2 | $4,517.63 |
| CABG 4+ arterial grafts | CPT | 33536 | 7 | — | — | $647.54 | $3,350.5 | $4,834.88 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Open appendectomy | CPT | 44950 | 7 | — | — | $143.8 | $685.7 | $1,734.57 |
| Laparoscopic appendectomy | CPT | 44970 | 7 | — | — | $131.4 | $673 | $1,620.38 |
| Major joint replacement w MCC | MS-DRG | 469 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Laparoscopic cholecystectomy | CPT | 47562 | 18 | — | — | $163.63 | $892 | $2,648.76 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 18 | — | — | $168.66 | $965.28 | $10,581 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Open umbilical hernia repair | CPT | 49560 | 7 | — | — | $165.01 | $782.3 | $1,988.48 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 7 | — | — | $96.3 | $472.8 | $1,196.31 |
| Lap inguinal hernia repair | CPT | 49650 | 18 | — | — | $94.14 | $516.4 | $2,648.76 |
| Lap incisional hernia repair | CPT | 49652 | 7 | — | — | $194.34 | $1,191.29 | $2,006.09 |
| Total abdominal hysterectomy | CPT | 58150 | 7 | — | — | $199.64 | $1,202.18 | $1,616.16 |
| Vaginal hysterectomy | CPT | 58260 | 18 | — | — | $162.85 | $1,039.67 | $2,090.81 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 18 | — | — | $173.88 | $1,213.6 | $2,648.76 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 18 | — | — | $194.63 | $1,327.01 | $4,445.47 |
| Lap salpingo-oophorectomy | CPT | 58661 | 18 | — | — | $128.06 | $856.61 | $2,648.76 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 17 | — | — | $7,939.93 | $13,700 | $19,901 |
| OR procedure for obesity w CC | MS-DRG | 620 | 17 | — | — | $7,939.93 | $13,700 | $19,901 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 17 | — | — | $7,939.93 | $13,700 | $19,901 |
| Complex cataract surgery | CPT | 66982 | 18 | — | — | $149.37 | $1,085.3 | $1,768.72 |
| Cataract surgery with lens implant | CPT | 66984 | 18 | — | — | $119.97 | $766.16 | $1,257.21 |
| Intravitreal injection | CPT | 67028 | 18 | — | — | $18.84 | $72.77 | $283.93 |
| Vitrectomy mechanical | CPT | 67042 | 18 | — | — | $216.77 | $1,559.34 | $2,464.05 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 16 | — | — | $7,939.93 | $13,590 | $19,901 |
| PCI single major coronary artery | CPT | 92920 | 18 | — | — | $113.54 | $796.79 | $9,845.53 |
| PCI with drug-eluting stent | CPT | 92928 | 18 | — | — | $126.02 | $884.66 | $15,991 |
| PCI bypass graft | CPT | 92937 | 7 | — | — | $125.94 | $763.59 | $15,991 |
| Left heart catheterization | CPT | 93452 | 19 | — | — | $178.63 | $835.69 | $14,592 |
| Coronary angiography with cath | CPT | 93455 | 18 | — | — | $208.63 | $711.57 | $2,261.57 |
| Coronary angiography with bypass cath | CPT | 93458 | 18 | — | — | $217.44 | $752.13 | $2,340.29 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 198 | $180 |
| encore exclusive | 198 | $311.13 |
| UnitedHealthcare | 197 | $122.6 |
| patoka valley tier 1 | 158 | $201.16 |
| patoka valley tier 2 | 158 | $201.16 |
| mhs care connect | 153 | $97.35 |
| Medicaid | 153 | $97.35 |
| Aetna | 141 | $400 |
| Humana | 136 | $1,487.08 |
| smarthealth ppo/hdhp 20161001 | 109 | $232.77 |
| CareSource | 79 | $167.79 |
| Ambetter | 79 | $167.79 |
| personalized care | 79 | $167.79 |
| Medicare | 79 | $167.02 |
| Medicare Advantage | 79 | $200.27 |
| ascension complete mcr | 76 | $232.74 |
| secure horizons-pacificare | 76 | $232.74 |
| corizon | 76 | $232.74 |
| immergrun | 76 | $232.74 |
| smarthealth ppo | 72 | $74.75 |
| unified group services | 41 | $18,572 |
| advantage 360 | 40 | $11,850 |
| Cigna | 40 | $17,562 |
| encore | 40 | $13,400 |
| 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 |