▸ Hospital · IA · CCN 160013
Trinity Muscatine
1518 MULBERRY, MUSCATINE, IA, 52761-
15 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
200
of 209 target codes
Payers
14
with negotiated rates
Rates published
59,290
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 12 | — | — | $7,813.88 | $15,630 | $20,078 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 14 | $451.25 | $361 | $103.79 | $161.33 | $645.32 |
| Psychiatric eval with medical services | CPT | 90792 | 12 | $453 | $362.4 | $138.76 | $215.72 | $726.79 |
| Psychotherapy 30 minutes | CPT | 90832 | 14 | $210 | $168 | $20.09 | $101.75 | $482.91 |
| Psychotherapy 45 minutes | CPT | 90834 | 14 | $262 | $209.6 | $36.27 | $134.5 | $482.91 |
| Psychotherapy 60 minutes | CPT | 90837 | 14 | $392 | $313.6 | $32.64 | $151.1 | $555.89 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 14 | $464.59 | $371.68 | $106.86 | $166.09 | $529.58 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $212.94 | $170.36 | $10.3 | $41.55 | $3,527.66 |
| ED visit level 2 | CPT | 99282 | 14 | $432.44 | $345.96 | $12.65 | $97.08 | $3,527.66 |
| ED visit level 3 | CPT | 99283 | 14 | $804.55 | $643.64 | $12.65 | $145.66 | $3,527.66 |
| ED visit level 4 | CPT | 99284 | 14 | $1,296.19 | $1,036.96 | $12.65 | $266.24 | $3,527.66 |
| ED visit level 5 | CPT | 99285 | 14 | $1,885.48 | $1,508.39 | $12.65 | $386.61 | $3,527.66 |
| Critical care, first hour | CPT | 99291 | 14 | $1,996.66 | $1,597.33 | $194 | $496.21 | $3,527.66 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 14 | $2,131.32 | $1,705.06 | $37.24 | $102.51 | $1,165.83 |
| CT head with contrast | CPT | 70460 | 14 | $2,432.15 | $1,945.72 | $49.4 | $167.42 | $1,330.39 |
| CT head with and without contrast | CPT | 70470 | 14 | $2,708.72 | $2,166.98 | $55.55 | $167.42 | $1,481.67 |
| CT neck with contrast | CPT | 70491 | 14 | $2,436.99 | $1,949.6 | $60.29 | $172.34 | $1,333.03 |
| MRI brain without contrast | CPT | 70551 | 14 | $2,542.54 | $2,034.04 | $64.56 | $227.32 | $1,390.77 |
| MRI brain with contrast | CPT | 70552 | 14 | $4,376.66 | $3,501.33 | $77.96 | $335.86 | $2,394.03 |
| MRI brain with and without contrast | CPT | 70553 | 14 | $5,970.59 | $4,776.48 | $100.21 | $335.86 | $3,265.91 |
| Chest X-ray single view | CPT | 71045 | 14 | $258.38 | $206.71 | $8.04 | $30.36 | $264.62 |
| Chest X-ray 2 views | CPT | 71046 | 14 | $385.75 | $308.6 | $9.63 | $39.86 | $264.62 |
| Chest X-ray 3 views | CPT | 71047 | 14 | $564.06 | $451.25 | $12.13 | $49.94 | $308.54 |
| CT chest without contrast | CPT | 71250 | 14 | $2,443.06 | $1,954.45 | $47.19 | $122.98 | $1,336.35 |
| CT chest with contrast | CPT | 71260 | 14 | $2,792.41 | $2,233.93 | $50.96 | $167.42 | $1,527.45 |
| CT chest with and without contrast | CPT | 71270 | 14 | $2,897.95 | $2,318.36 | $54.61 | $184.9 | $1,585.18 |
| MRI chest without contrast | CPT | 71550 | 14 | $3,412.28 | $2,729.83 | $63.91 | $294.33 | $1,866.52 |
| MRI chest with contrast | CPT | 71551 | 14 | $4,783.01 | $3,826.41 | $75.45 | $661.33 | $2,616.31 |
| MRI chest with and without contrast | CPT | 71552 | 14 | $5,650.34 | $4,520.28 | $98.95 | $439.25 | $3,090.74 |
| Lumbosacral spine X-ray | CPT | 72100 | 14 | $642.78 | $514.23 | $9.92 | $51.01 | $351.6 |
| CT cervical spine without contrast | CPT | 72125 | 14 | $2,660.19 | $2,128.16 | $43.57 | $124.97 | $1,455.12 |
| CT thoracic spine without contrast | CPT | 72128 | 14 | $2,701.44 | $2,161.16 | $43.57 | $124.67 | $1,477.69 |
| CT lumbar spine without contrast | CPT | 72131 | 14 | $2,701.44 | $2,161.16 | $43.57 | $124.35 | $1,477.69 |
| MRI cervical spine without contrast | CPT | 72141 | 14 | $3,412.28 | $2,729.83 | $64.86 | $227.32 | $1,866.52 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | $3,412.28 | $2,729.83 | $64.86 | $227.32 | $1,866.52 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | $3,412.28 | $2,729.83 | $64.86 | $227.32 | $1,866.52 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | $5,650.34 | $4,520.28 | $78.25 | $335.86 | $3,090.74 |
| MRI cervical spine with and without contrast | CPT | 72156 | 14 | $6,760.28 | $5,408.23 | $100.51 | $335.86 | $3,697.87 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | $6,760.28 | $5,408.23 | $100.51 | $335.86 | $3,697.87 |
| CT pelvis without contrast | CPT | 72192 | 14 | $2,337.52 | $1,870.02 | $47.51 | $123.1 | $1,278.62 |
| CT pelvis with contrast | CPT | 72193 | 14 | $2,610.47 | $2,088.38 | $50.66 | $213.22 | $1,427.93 |
| Shoulder X-ray | CPT | 73030 | 14 | $368.77 | $295.02 | $8.33 | $44 | $264.62 |
| Humerus X-ray | CPT | 73060 | 14 | $348.13 | $278.51 | $7.1 | $41.7 | $264.62 |
| Hand X-ray 3 views | CPT | 73130 | 14 | $328.73 | $262.99 | $7.71 | $49.7 | $264.62 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | $3,412.28 | $2,729.83 | $59.32 | $227.32 | $1,866.52 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 14 | $5,937.84 | $4,750.28 | $94.35 | $361.6 | $3,248 |
| Knee X-ray 1-2 views | CPT | 73560 | 14 | $260.8 | $208.64 | $7.39 | $44.5 | $264.62 |
| Ankle X-ray 3 views | CPT | 73610 | 14 | $348.13 | $278.51 | $7.71 | $48.1 | $264.62 |
| MRI lower extremity joint without contrast | CPT | 73721 | 14 | $3,412.28 | $2,729.83 | $59.32 | $227.32 | $1,866.52 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 14 | $6,176.81 | $4,941.45 | $94.35 | $360.68 | $3,378.72 |
| CT abdomen without contrast | CPT | 74150 | 14 | $2,406.69 | $1,925.36 | $51.93 | $131.24 | $1,316.46 |
| CT abdomen with contrast | CPT | 74160 | 14 | $2,696.58 | $2,157.27 | $55.55 | $216.6 | $1,475.03 |
| CT abdomen with and without contrast | CPT | 74170 | 14 | $2,731.77 | $2,185.42 | $60.94 | $230.88 | $1,494.28 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 14 | $4,927.38 | $3,941.91 | $76.07 | $215.82 | $2,695.28 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 14 | $5,373.78 | $4,299.03 | $79.84 | $335.86 | $2,939.46 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 14 | $5,751.04 | $4,600.84 | $87.76 | $335.86 | $3,145.82 |
| MRI abdomen without contrast | CPT | 74181 | 14 | $3,412.28 | $2,729.83 | $63.62 | $227.32 | $1,866.52 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | $6,526.16 | $5,220.93 | $96.27 | $336.29 | $3,569.81 |
| Abdominal ultrasound complete | CPT | 76700 | 14 | $1,325.85 | $1,060.68 | $35.36 | $103.58 | $725.24 |
| Abdominal ultrasound limited | CPT | 76705 | 14 | $820.01 | $656.01 | $25.73 | $100.01 | $448.55 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 14 | $917.06 | $733.65 | $32.21 | $101.42 | $501.63 |
| Obstetric ultrasound first trimester | CPT | 76801 | 14 | $826.07 | $660.86 | $43.54 | $108.69 | $451.86 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 14 | $883.09 | $706.48 | $43.84 | $121.83 | $483.05 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $527 | $421.6 | $77.82 | $178.7 | $726.49 |
| Transvaginal ultrasound | CPT | 76830 | 14 | $629.58 | $503.67 | $30.44 | $105.9 | $386.72 |
| Pelvic ultrasound complete | CPT | 76856 | 14 | $629.58 | $503.67 | $30.15 | $100.01 | $419.54 |
| Scrotal ultrasound | CPT | 76870 | 14 | $883.09 | $706.48 | $27.94 | $94.5 | $483.05 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $502.2 | $401.76 | $35.36 | $112.73 | $386.72 |
| Diagnostic mammography bilateral | CPT | 77066 | 12 | $605.31 | $484.25 | $43.57 | $142.13 | $492.66 |
| Screening mammography bilateral | CPT | 77067 | 12 | $496.17 | $396.94 | $33.44 | $115.1 | $408.79 |
| EKG complete | CPT | 93000 | 10 | $47 | $37.6 | $12.88 | $28.7 | $90.91 |
| EKG tracing only | CPT | 93005 | 14 | $214.71 | $171.77 | $5.46 | $49.38 | $178.51 |
| EKG interpretation only | CPT | 93010 | 10 | $24 | $19.2 | $7.42 | $16 | $36.56 |
| Transthoracic echocardiogram complete | CPT | 93306 | 14 | $2,537.67 | $2,030.14 | $63.17 | $328.92 | $1,647.93 |
| Transthoracic echocardiogram | CPT | 93307 | 14 | $1,082.03 | $865.63 | $39.95 | $208.76 | $726.49 |
| Stress echocardiogram | CPT | 93350 | 14 | $1,684.31 | $1,347.45 | $63.17 | $300.44 | $1,647.93 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 12 | — | — | $11,027 | $22,057 | $27,695 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 12 | — | — | $5,637.01 | $11,276 | $14,918 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 12 | — | — | $3,815.47 | $7,632.09 | $10,600 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 12 | — | — | $8,960.79 | $17,924 | $22,797 |
| COPD w MCC | MS-DRG | 190 | 12 | — | — | $6,225.16 | $12,452 | $16,312 |
| COPD w CC | MS-DRG | 191 | 12 | — | — | $4,762.27 | $9,525.98 | $12,844 |
| COPD w/o CC/MCC | MS-DRG | 192 | 12 | — | — | $3,587.64 | $7,176.35 | $10,060 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 12 | — | — | $4,545.53 | $9,092.4 | $12,331 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 12 | — | — | $3,451.83 | $6,904.71 | $9,737.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 12 | — | — | $9,098.82 | $18,200 | $23,124 |
| AMI discharged alive w CC | MS-DRG | 281 | 12 | — | — | $5,109.84 | $10,221 | $13,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 12 | — | — | $4,019.47 | $8,040.13 | $11,084 |
| Heart failure & shock w MCC | MS-DRG | 291 | 12 | — | — | $7,232.94 | $14,468 | $18,701 |
| Heart failure & shock w CC | MS-DRG | 292 | 12 | — | — | $4,773.92 | $9,549.25 | $12,872 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 12 | — | — | $3,041.63 | $6,084.15 | $8,765.54 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 12 | — | — | $6,684.7 | $13,371 | $17,402 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 12 | — | — | $4,098.18 | $8,197.59 | $11,270 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 12 | — | — | $3,101.49 | $6,203.9 | $8,907.5 |
| GI hemorrhage w CC | MS-DRG | 378 | 12 | — | — | $5,465.17 | $10,932 | $14,511 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 12 | — | — | $3,529.44 | $7,059.92 | $9,921.97 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 12 | — | — | $4,325.46 | $8,652.22 | $11,809 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 12 | — | — | $8,453.02 | $16,909 | $21,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 12 | — | — | $6,487.36 | $12,977 | $16,934 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 12 | — | — | $4,449.08 | $8,899.49 | $12,102 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 12 | — | — | $10,877 | $21,756 | $27,338 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 12 | — | — | $5,715.17 | $11,432 | $15,103 |
| Initial hospital care, low complexity | CPT | 99221 | 10 | $227 | $181.6 | $74.73 | $135.5 | $279.06 |
| Initial hospital care, moderate complexity | CPT | 99222 | 10 | $308 | $246.4 | $118.66 | $213.8 | $430.74 |
| Initial hospital care, high complexity | CPT | 99223 | 10 | $453 | $362.4 | $158.4 | $284.9 | $570.72 |
| Hospital discharge, <30 min | CPT | 99238 | 10 | $185 | $148 | $73.92 | $122.48 | $260.05 |
| Hospital discharge, >30 min | CPT | 99239 | 10 | $262 | $209.6 | $104.66 | $178.89 | $370.12 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 12 | $85.7 | $68.56 | $3.5 | $11 | $46.88 |
| General health panel | CPT | 80050 | 8 | $88 | $70.4 | $3.5 | $31.37 | $103.95 |
| Electrolyte panel | CPT | 80051 | 12 | $85.7 | $68.56 | $3.5 | $9.11 | $46.88 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $85.7 | $68.56 | $6.34 | $15.08 | $46.88 |
| Lipid panel | CPT | 80061 | 12 | $85.7 | $68.56 | $8.03 | $18.56 | $46.88 |
| Renal function panel | CPT | 80069 | 12 | $85.7 | $68.56 | $3.5 | $11.28 | $46.88 |
| Hepatic function panel | CPT | 80076 | 12 | $85.7 | $68.56 | $3.5 | $10.62 | $46.88 |
| Urinalysis non-automated | CPT | 81002 | 12 | $32.14 | $25.72 | $2.94 | $4.52 | $17.58 |
| Urinalysis automated | CPT | 81003 | 12 | $32.14 | $25.72 | $2.25 | $3.49 | $17.58 |
| Glucose quantitative | CPT | 82947 | 12 | $41.96 | $33.57 | $3.3 | $5.11 | $22.95 |
| Hemoglobin A1c | CPT | 83036 | 12 | $41.96 | $33.57 | $3.5 | $10.2 | $28.84 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $68.75 | $55 | $10.08 | $18.31 | $49.9 |
| Complete blood count with automated differential | CPT | 85025 | 12 | $41.96 | $33.57 | $3.5 | $9.65 | $23.08 |
| Complete blood count without differential | CPT | 85027 | 12 | $41.96 | $33.57 | $3.5 | $8.41 | $22.95 |
| Urine culture bacterial | CPT | 87086 | 12 | $48.22 | $38.58 | $3.5 | $10.49 | $26.38 |
| Urine culture identification | CPT | 87088 | 12 | $48.22 | $38.58 | $3.5 | $10.52 | $26.38 |
| Tissue exam by pathologist level IV | CPT | 88305 | 14 | $205 | $164 | $28.34 | $60.7 | $379.3 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | $405.15 | $324.12 | $17.87 | $67.41 | $604.63 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 10 | $5,690 | $4,552 | $2,106.28 | $3,049.25 | $9,959.3 |
| Vaginal delivery only | CPT | 59409 | 14 | $3,870.81 | $3,096.65 | $691.99 | $1,605.05 | $9,556.16 |
| Vaginal delivery with postpartum | CPT | 59410 | 10 | $2,641 | $2,112.8 | $936.78 | $1,377.81 | $5,444.16 |
| Routine obstetric care with C-section | CPT | 59510 | 10 | $5,924 | $4,739.2 | $2,322.97 | $3,393.26 | $10,758 |
| C-section delivery only | CPT | 59514 | 10 | $2,305 | $1,844 | $778.91 | $1,333.3 | $5,131.77 |
| C-section with postpartum | CPT | 59515 | 10 | $3,196 | $2,556.8 | $1,153.4 | $1,709.06 | $6,760.82 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 10 | $167 | $133.6 | $42.93 | $66.3 | $159.96 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 10 | $237 | $189.6 | $74.5 | $116 | $279.06 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 10 | $362 | $289.6 | $121.61 | $188.8 | $444.52 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 10 | $459 | $367.2 | $165.2 | $241.22 | $603.47 |
| Office visit, established patient, 5 min | CPT | 99211 | 10 | $51 | $40.8 | $8.04 | $12.3 | $28.81 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 10 | $104 | $83.2 | $32.24 | $49.59 | $118.32 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 10 | $201 | $160.8 | $60.36 | $93.2 | $218.65 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 10 | $240 | $192 | $88.83 | $137.3 | $322.19 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 10 | $332 | $265.6 | $131.48 | $203 | $472.73 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $859 | $687.2 | $109.69 | $399.8 | $2,817.86 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $1,143 | $914.4 | $123.53 | $499.91 | $2,817.86 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $534 | $427.2 | $50.95 | $202.92 | $2,740.17 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $840 | $672 | $64.93 | $259.14 | $2,740.17 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $1,017 | $813.6 | $82.56 | $426.74 | $2,740.17 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $1,309 | $1,047.2 | $179.1 | $709.61 | $3,543.76 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $1,371 | $1,096.8 | $226.39 | $814.61 | $3,543.76 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | $8,950 | $7,160 | $1,290.01 | $4,475 | $55,272 |
| Hip hemiarthroplasty | CPT | 27125 | 10 | $6,968 | $5,574.4 | $1,013.18 | $2,208.3 | $5,621.94 |
| Total hip replacement | CPT | 27130 | 12 | $8,344 | $6,675.2 | $1,146 | $4,171.24 | $38,672 |
| Total knee replacement | CPT | 27447 | 12 | $8,336 | $6,668.8 | $1,144.67 | $4,167.04 | $38,672 |
| Knee revision arthroplasty single component | CPT | 27486 | 10 | $8,660 | $6,928 | $1,254.09 | $2,733.9 | $11,191 |
| Knee revision arthroplasty all components | CPT | 27487 | 10 | $10,830 | $8,664 | $1,560.09 | $3,401.3 | $14,049 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 10 | $1,326 | $1,060.8 | $151.83 | $330.5 | $857.17 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | $6,590 | $5,272 | $958.1 | $3,294.92 | $21,471 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | $3,324 | $2,659.2 | $490.7 | $1,661.93 | $9,751.77 |
| ACL reconstruction | CPT | 29888 | 12 | $6,040 | $4,832 | $874.13 | $3,019.58 | $21,471 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 12 | — | — | $25,454 | $50,916 | $63,039 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 12 | — | — | $13,103 | $26,209 | $32,616 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 12 | — | — | $9,152.04 | $18,307 | $23,250 |
| CABG single arterial graft | CPT | 33533 | 10 | $5,709 | $4,567.2 | $1,610.12 | $3,623.81 | $8,116.27 |
| CABG 2 arterial grafts | CPT | 33534 | 10 | $6,708 | $5,366.4 | $1,891.26 | $4,246.72 | $9,526.87 |
| CABG 3 arterial grafts | CPT | 33535 | 10 | $7,481 | $5,984.8 | $2,102.11 | $4,724.76 | $10,594 |
| CABG 4+ arterial grafts | CPT | 33536 | 10 | $8,063 | $6,450.4 | $2,263.84 | $5,087.85 | $11,402 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 12 | — | — | $9,193.06 | $18,389 | $23,348 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 12 | — | — | $7,303.89 | $14,610 | $18,869 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 12 | — | — | $19,565 | $39,136 | $48,454 |
| Open appendectomy | CPT | 44950 | 12 | $1,971 | $1,576.8 | $565.44 | $1,970.89 | $18,754 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | $1,841 | $1,472.8 | $532.67 | $1,840.94 | $17,535 |
| Major joint replacement w MCC | MS-DRG | 469 | 12 | — | — | $18,119 | $36,244 | $44,874 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 12 | — | — | $10,452 | $20,907 | $26,332 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | $2,018 | $1,614.4 | $583.24 | $2,017.34 | $17,535 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $2,196 | $1,756.8 | $633.75 | $2,195.8 | $17,535 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 12 | — | — | $16,303 | $32,611 | $40,375 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 12 | — | — | $11,502 | $23,007 | $28,821 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 12 | — | — | $8,793.94 | $17,591 | $22,402 |
| Open umbilical hernia repair | CPT | 49560 | 2 | — | — | $1,405 | $1,652 | $11,411 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $854 | $854 | $1,005 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | $2,632 | $2,105.6 | $384.86 | $1,315.76 | $17,535 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $1,356 | $1,356 | $1,596 |
| Total abdominal hysterectomy | CPT | 58150 | 10 | $3,151 | $2,520.8 | $912.58 | $1,935.5 | $11,411 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $2,609 | $2,087.2 | $751.29 | $2,608.44 | $14,837 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | $2,758 | $2,206.4 | $791.18 | $2,757.27 | $17,535 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | $3,073 | $2,458.4 | $879.56 | $3,072.25 | $31,291 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | $4,064 | $3,251.2 | $584.08 | $2,031.54 | $17,535 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 12 | — | — | $15,114 | $30,232 | $37,430 |
| OR procedure for obesity w CC | MS-DRG | 620 | 12 | — | — | $8,852.7 | $17,708 | $22,541 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 12 | — | — | $8,103.24 | $16,209 | $20,764 |
| Complex cataract surgery | CPT | 66982 | 12 | $4,656 | $3,724.8 | $669.56 | $1,969.73 | $6,854.8 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | $3,394 | $2,715.2 | $488.93 | $1,696.53 | $6,854.8 |
| Intravitreal injection | CPT | 67028 | 12 | $630 | $504 | $83.2 | $276.6 | $996.91 |
| Vitrectomy mechanical | CPT | 67042 | 12 | $7,152 | $5,721.6 | $1,024.83 | $3,474.31 | $12,091 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 12 | — | — | $6,644.79 | $13,292 | $17,307 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 12 | — | — | $10,832 | $21,667 | $27,232 |
| PCI single major coronary artery | CPT | 92920 | 14 | $10,939 | $8,751.37 | $452.43 | $2,767.62 | $17,136 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | $18,660 | $14,928 | $502.96 | $4,291.85 | $34,084 |
| PCI bypass graft | CPT | 92937 | 14 | $18,660 | $14,928 | $502.63 | $4,291.85 | $34,084 |
| Left heart catheterization | CPT | 93452 | 14 | $9,607.27 | $7,685.82 | $203.9 | $1,482.54 | $21,945 |
| Coronary angiography with cath | CPT | 93455 | 14 | $12,374 | $9,899.38 | $240.23 | $1,652.36 | $21,945 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | $14,276 | $11,421 | $253.81 | $1,692.35 | $21,945 |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 200 | $183.92 |
| bc illinois community | 198 | $430.74 |
| Aetna | 197 | $286.83 |
| UnitedHealthcare | 197 | $239.49 |
| Ambetter | 196 | $157.82 |
| meridian health plan | 196 | $155.54 |
| health alliance | 196 | $151.1 |
| Humana | 196 | $155.54 |
| health partners open network | 154 | $228 |
| Cigna | 154 | $259.56 |
| amerigroup | 147 | $787.39 |
| iowa total care | 147 | $787.39 |
| medica exchange insure | 139 | $1,132.46 |
| medica exchange inspire | 139 | $1,010.93 |