▸ Hospital · IA · CCN 161303
Grundy County Memorial Hospital
201 EAST J AVENUE, GRUNDY CENTER, IA, 50638
25 bedsCritical Access Hospitals9
Compliance grade
A
100/100
Procedures tracked
200
of 209 target codes
Payers
12
with negotiated rates
Rates published
48,108
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 | — | — | $10,050 | $10,832 | $20,078 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $405 | $324 | $133.18 | $182.8 | $437.86 |
| Psychiatric eval with medical services | CPT | 90792 | 10 | $453 | $362.4 | $133.18 | $191.22 | $437.86 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $245.42 | $196.34 | $67.55 | $142.14 | $437.86 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $326.42 | $261.14 | $89.14 | $151.1 | $437.86 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $392 | $313.6 | $131.89 | $182.64 | $437.86 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 12 | $409 | $327.2 | $127.19 | $177.2 | $437.86 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 10 | $196.15 | $156.92 | $10.3 | $46.37 | $239.96 |
| ED visit level 2 | CPT | 99282 | 12 | $401.24 | $321 | $25.91 | $97.08 | $431.54 |
| ED visit level 3 | CPT | 99283 | 12 | $748.94 | $599.16 | $25.91 | $145.66 | $754.56 |
| ED visit level 4 | CPT | 99284 | 12 | $1,208.35 | $966.68 | $25.91 | $266.24 | $1,160.42 |
| ED visit level 5 | CPT | 99285 | 12 | $1,759 | $1,407.2 | $25.91 | $386.61 | $1,670.8 |
| Critical care, first hour | CPT | 99291 | 12 | $2,796.09 | $2,236.88 | $194 | $698.42 | $2,296.25 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $1,627.13 | $1,301.71 | $37.24 | $102.51 | $1,052.75 |
| CT head with contrast | CPT | 70460 | 12 | $1,148.13 | $918.51 | $49.4 | $157.49 | $742.84 |
| CT head with and without contrast | CPT | 70470 | 12 | $2,248.72 | $1,798.98 | $55.55 | $166.83 | $1,454.92 |
| CT neck with contrast | CPT | 70491 | 12 | $1,353.71 | $1,082.97 | $60.29 | $172.34 | $875.85 |
| MRI brain without contrast | CPT | 70551 | 12 | $1,850.09 | $1,480.08 | $64.56 | $213.84 | $1,197.01 |
| MRI brain with contrast | CPT | 70552 | 12 | $1,914.33 | $1,531.47 | $77.96 | $315.94 | $1,238.57 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $2,526.36 | $2,021.09 | $100.21 | $320.62 | $1,634.55 |
| Chest X-ray single view | CPT | 71045 | 12 | $181.37 | $145.1 | $8.04 | $29.6 | $239.94 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $181.37 | $145.1 | $9.63 | $39.36 | $239.94 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $181.37 | $145.1 | $12.13 | $49.11 | $239.94 |
| CT chest without contrast | CPT | 71250 | 12 | $1,087.39 | $869.92 | $47.19 | $122.98 | $703.54 |
| CT chest with contrast | CPT | 71260 | 12 | $1,513.71 | $1,210.97 | $50.96 | $164.13 | $979.37 |
| CT chest with and without contrast | CPT | 71270 | 12 | $1,709.92 | $1,367.94 | $54.61 | $182.22 | $1,106.32 |
| MRI chest without contrast | CPT | 71550 | 12 | $1,744.96 | $1,395.97 | $63.91 | $290.06 | $1,392.56 |
| MRI chest with contrast | CPT | 71551 | 12 | $1,854.76 | $1,483.81 | $75.45 | $550.08 | $2,153.03 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $2,932.82 | $2,346.26 | $98.95 | $432.88 | $1,938.05 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $139 | $111.2 | $9.92 | $47.91 | $289.8 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $1,356.04 | $1,084.84 | $43.57 | $124.01 | $877.36 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $1,323 | $1,058.4 | $43.57 | $122.89 | $855.98 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $1,052.36 | $841.89 | $43.57 | $122.58 | $680.88 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $1,479.85 | $1,183.88 | $64.86 | $213.84 | $957.46 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $1,850.09 | $1,480.08 | $64.86 | $213.84 | $1,197.01 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $1,479.85 | $1,183.88 | $64.86 | $213.84 | $957.46 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $2,116.39 | $1,693.12 | $78.25 | $315.94 | $1,369.3 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $3,334.6 | $2,667.68 | $100.51 | $321.09 | $2,157.49 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $3,157.08 | $2,525.67 | $100.51 | $320.78 | $2,042.63 |
| CT pelvis without contrast | CPT | 72192 | 12 | $1,183.17 | $946.54 | $47.51 | $124.23 | $765.51 |
| CT pelvis with contrast | CPT | 72193 | 12 | $1,448.31 | $1,158.65 | $50.66 | $210.13 | $937.06 |
| Shoulder X-ray | CPT | 73030 | 12 | $295.51 | $236.41 | $8.33 | $41.31 | $239.94 |
| Humerus X-ray | CPT | 73060 | 12 | $122.65 | $98.12 | $7.1 | $38.88 | $239.94 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $136.65 | $109.32 | $7.71 | $44.69 | $239.94 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $1,624.67 | $1,299.74 | $59.32 | $213.84 | $1,051.16 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $3,032.08 | $2,425.67 | $94.35 | $356.36 | $1,961.76 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $237.12 | $189.7 | $7.39 | $41.65 | $239.94 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $327.04 | $261.64 | $7.71 | $45.03 | $239.94 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $4,140.35 | $3,312.28 | $59.32 | $213.84 | $2,678.81 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $4,731.19 | $3,784.96 | $94.35 | $355.45 | $3,061.08 |
| CT abdomen without contrast | CPT | 74150 | 12 | $1,203.02 | $962.42 | $51.93 | $127.52 | $778.35 |
| CT abdomen with contrast | CPT | 74160 | 12 | $1,499.69 | $1,199.76 | $55.55 | $213.9 | $970.3 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $1,746.14 | $1,396.92 | $60.94 | $227.53 | $1,129.75 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $2,607.56 | $2,086.05 | $76.07 | $201.23 | $1,687.09 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $3,258.04 | $2,606.44 | $79.84 | $315.94 | $2,107.95 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $3,909.65 | $3,127.72 | $87.76 | $329.44 | $2,529.54 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $1,637.52 | $1,310.02 | $63.62 | $213.84 | $1,103.05 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $4,837.64 | $3,870.12 | $96.27 | $336.71 | $3,129.95 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,146.96 | $917.57 | $35.36 | $103.27 | $742.08 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $560.62 | $448.5 | $25.73 | $94.08 | $362.72 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $899.33 | $719.47 | $32.21 | $100.72 | $581.87 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $551.3 | $441.04 | $43.54 | $107.22 | $356.69 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $992.78 | $794.23 | $43.84 | $121.83 | $642.33 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 10 | $527 | $421.6 | $77.82 | $178.22 | $658.72 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $807.08 | $645.67 | $30.44 | $105.9 | $522.18 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $933.22 | $746.58 | $30.15 | $99.33 | $603.79 |
| Scrotal ultrasound | CPT | 76870 | 12 | $749.84 | $599.88 | $27.94 | $93.84 | $485.15 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $283 | $226.4 | $35.36 | $111.44 | $273.3 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $357 | $285.6 | $43.57 | $142.13 | $344.4 |
| Screening mammography bilateral | CPT | 77067 | 10 | $306.68 | $245.35 | $33.44 | $116.25 | $279.1 |
| EKG complete | CPT | 93000 | 8 | $47 | $37.6 | $12.88 | $28.7 | $42.87 |
| EKG tracing only | CPT | 93005 | 12 | $206.1 | $164.88 | $5.46 | $49.23 | $161.86 |
| EKG interpretation only | CPT | 93010 | 8 | $24 | $19.2 | $7.42 | $16 | $21.83 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $1,569 | $1,255.2 | $63.17 | $313.57 | $1,494.21 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $383 | $306.4 | $39.95 | $165.72 | $658.72 |
| Stress echocardiogram | CPT | 93350 | 12 | $1,151.69 | $921.36 | $63.17 | $283.31 | $1,494.21 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $14,182 | $14,941 | $27,695 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $7,250.04 | $8,048.07 | $14,918 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $4,907.27 | $5,718.57 | $10,600 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $11,525 | $12,299 | $22,797 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $8,006.48 | $8,800.22 | $16,312 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $6,125 | $6,929.41 | $12,844 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $4,614.24 | $5,427.2 | $10,060 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $5,846.23 | $6,652.2 | $12,331 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $4,439.57 | $5,253.52 | $9,737.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $11,702 | $12,475 | $23,124 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $6,572.02 | $7,373.88 | $13,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $5,169.64 | $5,979.44 | $11,084 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $9,302.64 | $10,089 | $18,701 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $6,139.97 | $6,944.28 | $12,872 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $3,911.98 | $4,728.9 | $8,765.54 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $8,597.52 | $9,387.9 | $17,402 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $5,270.88 | $6,080.13 | $11,270 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $3,988.98 | $4,805.48 | $8,907.5 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $7,029.02 | $7,828.3 | $14,511 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $4,539.38 | $5,352.78 | $9,921.97 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $5,563.19 | $6,370.78 | $11,809 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $10,872 | $11,649 | $21,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $8,343.71 | $9,135.55 | $16,934 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $5,722.18 | $6,528.87 | $12,102 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $13,989 | $14,749 | $27,338 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $7,350.57 | $8,148.01 | $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 | $8.88 | $55.45 |
| General health panel | CPT | 80050 | 7 | $88 | $70.4 | $25.73 | $42.85 | $55.45 |
| Electrolyte panel | CPT | 80051 | 10 | $85.7 | $68.56 | $4.21 | $7.36 | $55.45 |
| Comprehensive metabolic panel | CPT | 80053 | 10 | $85.7 | $68.56 | $6.34 | $11.09 | $55.45 |
| Lipid panel | CPT | 80061 | 10 | $85.7 | $68.56 | $8.03 | $14.06 | $55.45 |
| Renal function panel | CPT | 80069 | 10 | $85.7 | $68.56 | $5.21 | $9.11 | $55.45 |
| Hepatic function panel | CPT | 80076 | 10 | $85.7 | $68.56 | $4.9 | $8.58 | $55.45 |
| Urinalysis non-automated | CPT | 81002 | 10 | $32.14 | $25.72 | $3.48 | $3.65 | $20.79 |
| Urinalysis automated | CPT | 81003 | 10 | $32.14 | $25.72 | $2.25 | $2.36 | $20.79 |
| Glucose quantitative | CPT | 82947 | 10 | $41.96 | $33.57 | $3.93 | $4.13 | $27.15 |
| Hemoglobin A1c | CPT | 83036 | 10 | $41.96 | $33.57 | $5.83 | $10.2 | $27.15 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 10 | $68.75 | $55 | $10.08 | $17.64 | $44.48 |
| Complete blood count with automated differential | CPT | 85025 | 10 | $41.96 | $33.57 | $4.66 | $8.16 | $27.15 |
| Complete blood count without differential | CPT | 85027 | 10 | $41.96 | $33.57 | $3.88 | $6.79 | $27.15 |
| Urine culture bacterial | CPT | 87086 | 10 | $48.22 | $38.58 | $4.84 | $8.47 | $31.2 |
| Urine culture identification | CPT | 87088 | 10 | $48.22 | $38.58 | $4.85 | $8.49 | $31.2 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $205 | $164 | $28.96 | $62.79 | $182.28 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 12 | $476.55 | $381.24 | $17.87 | $66.15 | $548.23 |
| 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 | 12 | $3,092.73 | $2,474.19 | $691.99 | $2,001 | $8,664.72 |
| 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 | 12 | $2,189.57 | $1,751.66 | $109.69 | $777.12 | $2,555 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | $1,143 | $914.4 | $123.53 | $435.4 | $2,555 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | $534 | $427.2 | $50.95 | $174.48 | $2,484.55 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | $840 | $672 | $64.93 | $224.58 | $2,484.55 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | $1,017 | $813.6 | $82.56 | $426.74 | $2,484.55 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | $1,309 | $1,047.2 | $179.1 | $664.1 | $3,213.19 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | $1,371 | $1,096.8 | $226.39 | $814.61 | $3,213.19 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 10 | $8,950 | $7,160 | $1,290.01 | $4,475 | $50,116 |
| 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 | $4,171.24 | $35,064 |
| Total knee replacement | CPT | 27447 | 10 | $8,336 | $6,668.8 | $1,144.67 | $4,167.04 | $35,064 |
| 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 | $3,294.92 | $19,468 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | $3,324 | $2,659.2 | $490.7 | $1,661.93 | $8,842.09 |
| ACL reconstruction | CPT | 29888 | 10 | $6,040 | $4,832 | $874.13 | $3,019.58 | $19,468 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $32,376 | $33,392 | $61,895 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $16,852 | $17,596 | $32,616 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $11,771 | $12,543 | $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 | — | — | $11,824 | $12,596 | $23,348 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $9,393.9 | $10,180 | $18,869 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $25,074 | $25,860 | $47,935 |
| Open appendectomy | CPT | 44950 | 10 | $1,971 | $1,576.8 | $565.44 | $1,970.89 | $17,004 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | $1,841 | $1,472.8 | $532.67 | $1,840.94 | $15,900 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $23,281 | $24,011 | $44,508 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $13,443 | $14,206 | $26,332 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | $2,018 | $1,614.4 | $583.24 | $2,017.34 | $15,900 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | $2,196 | $1,756.8 | $633.75 | $2,195.8 | $15,900 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $20,968 | $21,688 | $40,202 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $14,793 | $15,548 | $28,821 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $11,310 | $12,085 | $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 | $1,315.76 | $15,900 |
| 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 | $2,608.44 | $13,453 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | $2,758 | $2,206.4 | $791.18 | $2,757.27 | $15,900 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | $3,073 | $2,458.4 | $879.56 | $3,072.25 | $28,372 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | $4,064 | $3,251.2 | $584.08 | $2,031.54 | $15,900 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $19,439 | $20,168 | $37,383 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $11,386 | $12,160 | $22,541 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $10,422 | $11,202 | $20,764 |
| Complex cataract surgery | CPT | 66982 | 10 | $4,656 | $3,724.8 | $669.56 | $2,002.71 | $6,215.36 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | $3,394 | $2,715.2 | $488.93 | $1,699.34 | $6,215.36 |
| Intravitreal injection | CPT | 67028 | 10 | $630 | $504 | $83.2 | $274.93 | $903.91 |
| Vitrectomy mechanical | CPT | 67042 | 10 | $7,152 | $5,721.6 | $1,024.83 | $3,334.45 | $10,963 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $8,546.19 | $9,336.87 | $17,307 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $13,931 | $14,691 | $27,232 |
| PCI single major coronary artery | CPT | 92920 | 12 | $14,331 | $11,465 | $452.43 | $4,725.85 | $15,538 |
| PCI with drug-eluting stent | CPT | 92928 | 12 | $18,138 | $14,511 | $502.96 | $8,971.51 | $30,905 |
| PCI bypass graft | CPT | 92937 | 12 | $18,138 | $14,511 | $502.63 | $8,971.51 | $30,905 |
| Left heart catheterization | CPT | 93452 | 12 | $9,904.84 | $7,923.88 | $203.9 | $1,436.65 | $8,765.25 |
| Coronary angiography with cath | CPT | 93455 | 12 | $9,904.84 | $7,923.88 | $240.23 | $1,641.71 | $8,765.25 |
| Coronary angiography with bypass cath | CPT | 93458 | 12 | $12,851 | $10,281 | $253.81 | $1,676.56 | $8,765.25 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 200 | $188.9 |
| Aetna | 197 | $284.37 |
| health partners open network | 197 | $274.58 |
| UnitedHealthcare | 197 | $239.49 |
| amerivantage | 196 | $155.54 |
| Humana | 196 | $155.54 |
| Molina | 196 | $151.1 |
| Cigna | 154 | $249.86 |
| amerigroup | 147 | $755.69 |
| iowa total care | 147 | $755.69 |
| medica exchange insure | 140 | $910.36 |
| medica exchange inspire | 140 | $813.63 |