▸ Hospital · IA · CCN 161350

Stewart Memorial Community Hospital

1200 WEST MONROE, LAKE CITY, IA, 51449-

20 bedsCritical Access Hospitals2

Compliance grade

86/100

Procedures tracked

119

of 209 target codes

Payers

with negotiated rates

Rates published

659

last crawl 2026-05-23

▸ Compare with other hospitals All IA hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://www.stewartmemorial.org/wp-content/uploads/2025/12/420860039_Stewart-Memorial-Community-Hospital_StandardCharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
emergency
ED visit level 1	CPT	99281	0	$228	$182	—	—	—
ED visit level 2	CPT	99282	0	$381	$304	—	—	—
ED visit level 3	CPT	99283	0	$608	$486	—	—	—
ED visit level 4	CPT	99284	0	$970	$776	—	—	—
ED visit level 5	CPT	99285	0	$1,438	$1,150	—	—	—
Critical care, first hour	CPT	99291	0	$1,965	$1,572	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,929	$1,543	—	—	—
CT head with contrast	CPT	70460	0	$2,301	$1,840	—	—	—
CT head with and without contrast	CPT	70470	0	$2,547	$2,037	—	—	—
CT neck with contrast	CPT	70491	0	$2,301	$1,840	—	—	—
MRI brain without contrast	CPT	70551	0	$2,467	$1,973	—	—	—
MRI brain with contrast	CPT	70552	0	$2,552	$2,041	—	—	—
MRI brain with and without contrast	CPT	70553	0	$2,480	$1,984	—	—	—
Chest X-ray single view	CPT	71045	0	$202	$161	—	—	—
Chest X-ray 2 views	CPT	71046	0	$263	$210	—	—	—
Chest X-ray 3 views	CPT	71047	0	$331	$264	—	—	—
CT chest without contrast	CPT	71250	0	$2,160	$1,728	—	—	—
CT chest with contrast	CPT	71260	0	$2,376	$1,900	—	—	—
CT chest with and without contrast	CPT	71270	0	$2,614	$2,091	—	—	—
MRI chest without contrast	CPT	71550	0	$2,544	$2,035	—	—	—
MRI chest with and without contrast	CPT	71552	0	$3,508	$2,806	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$311	$248	—	—	—
CT cervical spine without contrast	CPT	72125	0	$2,160	$1,728	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$2,182	$1,745	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$2,182	$1,745	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$2,362	$1,889	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$2,362	$1,889	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$2,375	$1,900	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$2,795	$2,236	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$3,331	$2,664	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$3,321	$2,656	—	—	—
CT pelvis without contrast	CPT	72192	0	$2,138	$1,710	—	—	—
CT pelvis with contrast	CPT	72193	0	$2,352	$1,881	—	—	—
Shoulder X-ray	CPT	73030	0	$269	$215	—	—	—
Humerus X-ray	CPT	73060	0	$247	$197	—	—	—
Hand X-ray 3 views	CPT	73130	0	$284	$227	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$2,297	$1,837	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$3,368	$2,694	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$266	$212	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$286	$228	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$2,432	$1,945	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$3,357	$2,685	—	—	—
CT abdomen without contrast	CPT	74150	0	$2,138	$1,710	—	—	—
CT abdomen with contrast	CPT	74160	0	$2,352	$1,881	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,587	$2,069	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$2,961	$2,368	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$4,274	$3,419	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$4,823	$3,858	—	—	—
MRI abdomen without contrast	CPT	74181	0	$2,498	$1,998	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$3,508	$2,806	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$842	$673	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$497	$397	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$832	$665	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$698	$558	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$800	$640	—	—	—
Transvaginal ultrasound	CPT	76830	0	$710	$568	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$628	$502	—	—	—
Scrotal ultrasound	CPT	76870	0	$597	$477	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$422	$337	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$534	$427	—	—	—
Screening mammography bilateral	CPT	77067	0	$383	$306	—	—	—
EKG complete	CPT	93000	0	$265	$212	—	—	—
EKG tracing only	CPT	93005	0	$197	$157	—	—	—
EKG interpretation only	CPT	93010	0	$131	$104	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$1,805	$1,444	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$1,261	$1,008	—	—	—
inpatient
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	$19,368	$15,494	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	$24,006	$19,204	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	$13,271	$10,616	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	$21,838	$17,470	—	—	—
Initial hospital care, low complexity	CPT	99221	0	$354	$283	—	—	—
Initial hospital care, moderate complexity	CPT	99222	0	$480	$384	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$706	$564	—	—	—
Hospital discharge, <30 min	CPT	99238	0	$245	$196	—	—	—
Hospital discharge, >30 min	CPT	99239	0	$375	$300	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$59	$47	—	—	—
Electrolyte panel	CPT	80051	0	$83	$66	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$100	$80	—	—	—
Lipid panel	CPT	80061	0	$116	$92	—	—	—
Renal function panel	CPT	80069	0	$50	$40	—	—	—
Hepatic function panel	CPT	80076	0	$59	$47	—	—	—
Urinalysis automated	CPT	81003	0	$51	$40	—	—	—
Glucose quantitative	CPT	82947	0	$171	$136	—	—	—
Hemoglobin A1c	CPT	83036	0	$100	$80	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$150	$120	—	—	—
Complete blood count with automated differential	CPT	85025	0	$42	$33	—	—	—
Complete blood count without differential	CPT	85027	0	$34	$27	—	—	—
Urine culture bacterial	CPT	87086	0	$86	$68	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$253	$202	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$456	$364	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$231	$184	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$370	$296	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$489	$391	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$593	$474	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$180	$144	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$227	$181	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$289	$231	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$409	$327	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$548	$438	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$4,254	$3,403	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$4,252	$3,401	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$3,979	$3,183	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$3,798	$3,038	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$4,253	$3,402	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$4,254	$3,403	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$4,254	$3,403	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	$11,940	$9,552	—	—	—
Total hip replacement	CPT	27130	0	$12,976	$10,380	—	—	—
Total knee replacement	CPT	27447	0	$11,094	$8,875	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$6,411	$5,128	—	—	—
ACL reconstruction	CPT	29888	0	$11,940	$9,552	—	—	—
Laparoscopic appendectomy	CPT	44970	0	$7,009	$5,607	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$7,702	$6,161	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	$7,009	$5,607	—	—	—
Umbilical hernia repair age 5+	CPT	49585	0	$1	—	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	$13,768	$11,014	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	$7,220	$5,776	—	—	—
Complex cataract surgery	CPT	66982	0	$4,382	$3,505	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$3,012	$2,409	—	—	—