▸ Hospital · IA · CCN 160146
St Lukes Regional Medical Center
2720 STONE PARK BLVD, SIOUX CITY, IA, 51104
179 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
200
of 209 target codes
Payers
12
with negotiated rates
Rates published
45,201
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 11 | — | — | $9,521.42 | $9,801.47 | $20,078 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $405 | $324 | $124.48 | $202.34 | $378.15 |
| Psychiatric eval with medical services | CPT | 90792 | 10 | $453 | $362.4 | $152.96 | $166.72 | $419.07 |
| Psychotherapy 30 minutes | CPT | 90832 | 10 | $210 | $168 | $67.55 | $107.22 | $170.59 |
| Psychotherapy 45 minutes | CPT | 90834 | 10 | $262 | $209.6 | $89.14 | $142.07 | $225.73 |
| Psychotherapy 60 minutes | CPT | 90837 | 10 | $392 | $313.6 | $131.89 | $157.46 | $333.11 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 10 | $409 | $327.2 | $127.19 | $157.46 | $342.39 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 10 | $249.06 | $199.25 | $10.3 | $50.36 | $239.1 |
| ED visit level 2 | CPT | 99282 | 12 | $494.54 | $395.64 | $17.38 | $80.4 | $474.76 |
| ED visit level 3 | CPT | 99283 | 12 | $910.72 | $728.58 | $17.38 | $120.63 | $874.29 |
| ED visit level 4 | CPT | 99284 | 12 | $1,460.6 | $1,168.48 | $17.38 | $230.52 | $1,402.18 |
| ED visit level 5 | CPT | 99285 | 12 | $2,119.68 | $1,695.75 | $17.38 | $341.78 | $2,034.89 |
| Critical care, first hour | CPT | 99291 | 12 | $3,157.64 | $2,526.12 | $194 | $813.97 | $3,031.33 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $1,679.95 | $1,343.96 | $37.24 | $104.21 | $1,612.75 |
| CT head with contrast | CPT | 70460 | 12 | $2,539.15 | $2,031.32 | $49.4 | $174.46 | $2,437.58 |
| CT head with and without contrast | CPT | 70470 | 12 | $2,846.09 | $2,276.88 | $55.55 | $174.46 | $2,732.25 |
| CT neck with contrast | CPT | 70491 | 12 | $2,651.63 | $2,121.31 | $60.29 | $176.48 | $2,545.56 |
| MRI brain without contrast | CPT | 70551 | 12 | $3,694.13 | $2,955.31 | $64.56 | $236.89 | $3,546.36 |
| MRI brain with contrast | CPT | 70552 | 12 | $4,093.58 | $3,274.87 | $77.96 | $349.99 | $3,929.84 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $4,827.1 | $3,861.68 | $100.21 | $349.99 | $4,634.02 |
| Chest X-ray single view | CPT | 71045 | 12 | $232.42 | $185.94 | $8.04 | $30.36 | $223.12 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $232.42 | $185.94 | $9.63 | $39.86 | $223.12 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $232.42 | $185.94 | $12.13 | $49.94 | $223.12 |
| CT chest without contrast | CPT | 71250 | 12 | $1,579.35 | $1,263.48 | $47.19 | $126.03 | $1,516.18 |
| CT chest with contrast | CPT | 71260 | 12 | $2,975.82 | $2,380.66 | $50.96 | $174.46 | $2,856.79 |
| CT chest with and without contrast | CPT | 71270 | 12 | $3,324.96 | $2,659.97 | $54.61 | $187.58 | $3,191.96 |
| MRI chest without contrast | CPT | 71550 | 10 | $1,215 | $972 | $63.91 | $240.5 | $1,392.56 |
| MRI chest with contrast | CPT | 71551 | 10 | $1,341 | $1,072.8 | $75.45 | $419.84 | $1,531.92 |
| MRI chest with and without contrast | CPT | 71552 | 10 | $1,697 | $1,357.6 | $98.95 | $355.33 | $1,938.05 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $422.36 | $337.89 | $9.92 | $51.01 | $405.47 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $2,058.61 | $1,646.89 | $43.57 | $124.97 | $1,976.27 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $1,543.7 | $1,234.96 | $43.57 | $124.67 | $1,481.95 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $1,960 | $1,568 | $43.57 | $124.35 | $1,881.6 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $3,855.43 | $3,084.35 | $64.86 | $236.89 | $3,701.21 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $3,700.12 | $2,960.1 | $64.86 | $236.89 | $3,552.12 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $3,679.01 | $2,943.21 | $64.86 | $236.89 | $3,531.85 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $6,028.33 | $4,822.67 | $78.25 | $349.99 | $5,787.2 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $5,794.67 | $4,635.74 | $100.51 | $349.99 | $5,562.88 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $6,028.33 | $4,822.67 | $100.51 | $349.99 | $5,787.2 |
| CT pelvis without contrast | CPT | 72192 | 12 | $1,718.54 | $1,374.84 | $47.51 | $126.06 | $1,649.8 |
| CT pelvis with contrast | CPT | 72193 | 12 | $2,872.18 | $2,297.75 | $50.66 | $216.31 | $2,757.29 |
| Shoulder X-ray | CPT | 73030 | 12 | $402.66 | $322.13 | $8.33 | $44 | $386.55 |
| Humerus X-ray | CPT | 73060 | 12 | $364.75 | $291.8 | $7.1 | $41.7 | $350.16 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $369.53 | $295.63 | $7.71 | $49.7 | $354.75 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $3,694.13 | $2,955.31 | $59.32 | $236.89 | $3,546.36 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $5,054.99 | $4,044 | $94.35 | $366.84 | $4,852.79 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $259.44 | $207.56 | $7.39 | $44.5 | $249.06 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $438.56 | $350.85 | $7.71 | $48.1 | $421.02 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $3,738.19 | $2,990.56 | $59.32 | $236.89 | $3,588.66 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $5,039.28 | $4,031.43 | $94.35 | $365.9 | $4,837.71 |
| CT abdomen without contrast | CPT | 74150 | 12 | $1,762.49 | $1,410 | $51.93 | $131.27 | $1,691.99 |
| CT abdomen with contrast | CPT | 74160 | 12 | $2,945.64 | $2,356.52 | $55.55 | $219.3 | $2,827.81 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $2,945.64 | $2,356.52 | $60.94 | $234.22 | $2,827.81 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $2,620.66 | $2,096.53 | $76.07 | $230.12 | $2,515.83 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $4,113.01 | $3,290.41 | $79.84 | $349.99 | $3,948.49 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $4,113.01 | $3,290.41 | $87.76 | $349.99 | $3,948.49 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $3,873.73 | $3,098.99 | $63.62 | $236.89 | $3,718.78 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $5,659.55 | $4,527.64 | $96.27 | $349.99 | $5,433.17 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,044.02 | $835.22 | $35.36 | $105.81 | $1,002.26 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $778.77 | $623.02 | $25.73 | $104.21 | $747.62 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $993.44 | $794.76 | $32.21 | $104.21 | $953.7 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $791.93 | $633.55 | $43.54 | $109.47 | $760.25 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $950.4 | $760.32 | $43.84 | $124.51 | $912.38 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $1,034.65 | $827.72 | $77.82 | $199.71 | $993.26 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $781.74 | $625.4 | $30.44 | $107.56 | $750.47 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $940.14 | $752.12 | $30.15 | $104.21 | $902.53 |
| Scrotal ultrasound | CPT | 76870 | 12 | $638.47 | $510.78 | $27.94 | $101.24 | $612.93 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $390.9 | $312.72 | $35.36 | $114.98 | $375.26 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $435.56 | $348.45 | $43.57 | $143.63 | $418.14 |
| Screening mammography bilateral | CPT | 77067 | 10 | $529.28 | $423.43 | $33.44 | $117.85 | $508.11 |
| EKG complete | CPT | 93000 | 8 | $47 | $37.6 | $12.88 | $28.7 | $42.87 |
| EKG tracing only | CPT | 93005 | 12 | $215.51 | $172.41 | $5.46 | $57.38 | $206.89 |
| EKG interpretation only | CPT | 93010 | 8 | $24 | $19.2 | $7.42 | $16 | $21.83 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $1,893.89 | $1,515.12 | $63.17 | $349.42 | $1,818.13 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $1,713.29 | $1,370.64 | $39.95 | $221.8 | $1,644.76 |
| Stress echocardiogram | CPT | 93350 | 10 | $561 | $448.8 | $63.17 | $198.67 | $615.19 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $13,436 | $13,832 | $27,695 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $6,868.84 | $7,070.87 | $14,918 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $4,649.25 | $4,785.99 | $10,600 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $10,919 | $11,240 | $22,797 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $7,585.53 | $7,808.63 | $16,312 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $5,802.95 | $5,973.63 | $12,844 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $4,371.64 | $4,500.22 | $10,060 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $5,538.84 | $5,701.75 | $12,331 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $4,206.14 | $4,329.85 | $9,737.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $11,087 | $11,413 | $23,124 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $6,226.47 | $6,409.6 | $13,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $4,897.84 | $5,041.89 | $11,084 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $8,813.52 | $9,072.75 | $18,701 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $5,817.15 | $5,988.24 | $12,872 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $3,706.29 | $3,815.3 | $8,765.54 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $8,145.48 | $8,385.05 | $17,402 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $4,993.75 | $5,140.62 | $11,270 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $3,779.25 | $3,890.41 | $8,907.5 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $6,659.45 | $6,855.31 | $14,511 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $4,300.71 | $4,427.2 | $9,921.97 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $5,270.69 | $5,425.71 | $11,809 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $10,300 | $10,603 | $21,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $7,905.03 | $8,137.53 | $16,934 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $5,421.32 | $5,580.77 | $12,102 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $13,253 | $13,643 | $27,338 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $6,964.09 | $7,168.92 | $15,103 |
| Initial hospital care, low complexity | CPT | 99221 | 8 | $227 | $181.6 | $74.73 | $135.5 | $226.16 |
| Initial hospital care, moderate complexity | CPT | 99222 | 8 | $308 | $246.4 | $118.66 | $213.8 | $307.11 |
| Initial hospital care, high complexity | CPT | 99223 | 8 | $453 | $362.4 | $158.4 | $284.9 | $452.74 |
| Hospital discharge, <30 min | CPT | 99238 | 8 | $185 | $148 | $73.92 | $133.3 | $162.91 |
| Hospital discharge, >30 min | CPT | 99239 | 8 | $262 | $209.6 | $104.69 | $188.4 | $239.49 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 10 | $85.7 | $68.56 | $5.08 | $12.08 | $82.27 |
| General health panel | CPT | 80050 | 7 | $88 | $70.4 | $25.73 | $47.62 | $82.27 |
| Electrolyte panel | CPT | 80051 | 10 | $85.7 | $68.56 | $4.21 | $10.01 | $82.27 |
| Comprehensive metabolic panel | CPT | 80053 | 10 | $85.7 | $68.56 | $6.34 | $15.08 | $82.27 |
| Lipid panel | CPT | 80061 | 10 | $85.7 | $68.56 | $8.03 | $19.12 | $82.27 |
| Renal function panel | CPT | 80069 | 10 | $85.7 | $68.56 | $5.21 | $12.4 | $82.27 |
| Hepatic function panel | CPT | 80076 | 10 | $85.7 | $68.56 | $4.9 | $11.67 | $82.27 |
| Urinalysis non-automated | CPT | 81002 | 10 | $32.14 | $25.72 | $3.48 | $4.61 | $30.85 |
| Urinalysis automated | CPT | 81003 | 10 | $32.14 | $25.72 | $2.25 | $3.21 | $30.85 |
| Glucose quantitative | CPT | 82947 | 10 | $41.96 | $33.57 | $3.93 | $5.62 | $40.28 |
| Hemoglobin A1c | CPT | 83036 | 10 | $41.96 | $33.57 | $5.83 | $12.94 | $40.28 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 10 | $68.75 | $55 | $10.08 | $21.79 | $66 |
| Complete blood count with automated differential | CPT | 85025 | 10 | $41.96 | $33.57 | $4.66 | $11.09 | $40.28 |
| Complete blood count without differential | CPT | 85027 | 10 | $41.96 | $33.57 | $3.88 | $9.24 | $40.28 |
| Urine culture bacterial | CPT | 87086 | 10 | $48.22 | $38.58 | $4.84 | $11.53 | $46.29 |
| Urine culture identification | CPT | 87088 | 10 | $48.22 | $38.58 | $4.85 | $11.56 | $46.29 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $205 | $164 | $28.96 | $61 | $182.28 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 12 | $621.05 | $496.84 | $17.87 | $74.1 | $596.21 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 8 | $5,690 | $4,552 | $2,106.28 | $3,033 | $5,372.16 |
| Vaginal delivery only | CPT | 59409 | 10 | $2,051 | $1,640.8 | $691.99 | $1,623.07 | $3,163.52 |
| Vaginal delivery with postpartum | CPT | 59410 | 8 | $2,641 | $2,112.8 | $936.78 | $1,353.2 | $2,640.42 |
| Routine obstetric care with C-section | CPT | 59510 | 8 | $5,924 | $4,739.2 | $2,322.97 | $3,369.1 | $5,923.56 |
| C-section delivery only | CPT | 59514 | 8 | $2,305 | $1,844 | $778.91 | $1,133.3 | $2,304.69 |
| C-section with postpartum | CPT | 59515 | 8 | $3,196 | $2,556.8 | $1,153.4 | $1,678.5 | $3,195.11 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $167 | $133.6 | $42.93 | $66.3 | $112.29 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 8 | $237 | $189.6 | $74.5 | $116 | $168.46 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $362 | $289.6 | $121.61 | $188.8 | $288.21 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 8 | $459 | $367.2 | $165.2 | $257 | $376.67 |
| Office visit, established patient, 5 min | CPT | 99211 | 8 | $51 | $40.8 | $8.04 | $12.3 | $20.76 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 8 | $104 | $83.2 | $32.24 | $49.59 | $66.6 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 8 | $201 | $160.8 | $60.36 | $93.2 | $124.66 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 8 | $240 | $192 | $88.83 | $137.3 | $184.05 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 8 | $332 | $265.6 | $131.48 | $203 | $272.53 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 10 | $859 | $687.2 | $109.69 | $294.87 | $932.84 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | $1,143 | $914.4 | $123.53 | $331.06 | $932.84 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | $534 | $427.2 | $50.95 | $140.73 | $907.12 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | $840 | $672 | $64.93 | $172.99 | $907.12 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | $1,017 | $813.6 | $82.56 | $351.7 | $907.12 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | $1,309 | $1,047.2 | $179.1 | $572.3 | $1,173.14 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | $1,371 | $1,096.8 | $226.39 | $678.17 | $1,173.14 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 10 | $8,950 | $7,160 | $1,290.01 | $3,434.4 | $18,297 |
| Hip hemiarthroplasty | CPT | 27125 | 8 | $6,968 | $5,574.4 | $1,013.18 | $2,208.3 | $3,483.37 |
| Total hip replacement | CPT | 27130 | 10 | $8,344 | $6,675.2 | $1,146 | $3,048.88 | $12,802 |
| Total knee replacement | CPT | 27447 | 10 | $8,336 | $6,668.8 | $1,144.67 | $3,044.93 | $12,802 |
| Knee revision arthroplasty single component | CPT | 27486 | 8 | $8,660 | $6,928 | $1,254.09 | $2,733.9 | $11,191 |
| Knee revision arthroplasty all components | CPT | 27487 | 8 | $10,830 | $8,664 | $1,560.09 | $3,401.3 | $14,049 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 8 | $1,326 | $1,060.8 | $151.83 | $330.5 | $538.56 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 10 | $6,590 | $5,272 | $958.1 | $2,551.95 | $7,107.76 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | $3,324 | $2,659.2 | $490.7 | $1,304.86 | $3,228.27 |
| ACL reconstruction | CPT | 29888 | 10 | $6,040 | $4,832 | $874.13 | $2,329.09 | $7,107.76 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $31,017 | $31,929 | $61,895 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $15,966 | $16,436 | $32,616 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $11,152 | $11,480 | $23,250 |
| CABG single arterial graft | CPT | 33533 | 8 | $5,709 | $4,567.2 | $1,610.12 | $3,690.6 | $5,708.4 |
| CABG 2 arterial grafts | CPT | 33534 | 8 | $6,708 | $5,366.4 | $1,891.26 | $4,335.1 | $6,707.71 |
| CABG 3 arterial grafts | CPT | 33535 | 8 | $7,481 | $5,984.8 | $2,102.11 | $4,815.5 | $7,480.06 |
| CABG 4+ arterial grafts | CPT | 33536 | 8 | $8,063 | $6,450.4 | $2,263.84 | $5,187.2 | $8,062.01 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 11 | — | — | $11,202 | $11,531 | $23,348 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $8,899.98 | $9,161.74 | $18,869 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $23,841 | $24,542 | $47,935 |
| Open appendectomy | CPT | 44950 | 10 | $1,971 | $1,576.8 | $565.44 | $1,507.35 | $6,208.33 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | $1,841 | $1,472.8 | $532.67 | $1,419.02 | $5,804.99 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $22,079 | $22,728 | $44,508 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $12,736 | $13,111 | $26,332 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | $2,018 | $1,614.4 | $583.24 | $1,552.71 | $5,804.99 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | $2,196 | $1,756.8 | $633.75 | $1,687.41 | $5,804.99 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $19,866 | $20,450 | $40,202 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $14,015 | $14,428 | $28,821 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $10,716 | $11,031 | $22,402 |
| Open umbilical hernia repair | CPT | 49560 | 1 | — | — | $1,405 | $1,405 | $1,652 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $854 | $854 | $1,005 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | $2,632 | $2,105.6 | $384.86 | $1,023.72 | $5,804.99 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $1,356 | $1,356 | $1,596 |
| Total abdominal hysterectomy | CPT | 58150 | 8 | $3,151 | $2,520.8 | $912.58 | $1,935.5 | $7,412.9 |
| Vaginal hysterectomy | CPT | 58260 | 10 | $2,609 | $2,087.2 | $751.29 | $2,018.19 | $4,911.59 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | $2,758 | $2,206.4 | $791.18 | $2,120.82 | $5,804.99 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | $3,073 | $2,458.4 | $879.56 | $2,355.93 | $10,359 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | $4,064 | $3,251.2 | $584.08 | $1,566.44 | $5,804.99 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $18,417 | $18,958 | $37,383 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $10,787 | $11,105 | $22,541 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $9,874.01 | $10,164 | $20,764 |
| Complex cataract surgery | CPT | 66982 | 10 | $4,656 | $3,724.8 | $669.56 | $1,797.73 | $2,327.87 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | $3,394 | $2,715.2 | $488.93 | $1,397.91 | $2,269.24 |
| Intravitreal injection | CPT | 67028 | 10 | $630 | $504 | $83.2 | $221.22 | $330.02 |
| Vitrectomy mechanical | CPT | 67042 | 10 | $7,152 | $5,721.6 | $1,024.83 | $2,751.15 | $4,002.6 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $8,096.85 | $8,334.99 | $17,307 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $13,199 | $13,587 | $27,232 |
| PCI single major coronary artery | CPT | 92920 | 10 | $1,434 | $1,147.2 | $452.43 | $1,223.67 | $5,672.81 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | $1,594 | $1,275.2 | $502.96 | $1,357.7 | $11,283 |
| PCI bypass graft | CPT | 92937 | 10 | $1,592 | $1,273.6 | $502.63 | $1,356.37 | $11,283 |
| Left heart catheterization | CPT | 93452 | 10 | $2,434 | $1,947.2 | $203.9 | $795.51 | $3,200.22 |
| Coronary angiography with cath | CPT | 93455 | 10 | $2,771 | $2,216.8 | $240.23 | $894.14 | $3,200.22 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | $2,855 | $2,284 | $253.81 | $922.8 | $3,200.22 |
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 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 200 | $188.9 |
| Aetna | 197 | $268.07 |
| health partners open network | 197 | $269.77 |
| UnitedHealthcare | 197 | $187.58 |
| amerivantage | 196 | $157.46 |
| Humana | 196 | $157.46 |
| Molina | 196 | $152.96 |
| Cigna | 154 | $251.94 |
| amerigroup | 147 | $907.12 |
| iowa total care | 147 | $907.12 |
| medica exchange insure | 125 | $1,172.29 |
| medica exchange inspire | 125 | $1,047.21 |