▸ Hospital · MN · CCN 240064
Grand Itasca Clinic And Hospital
1601 GOLF COURSE ROAD, GRAND RAPIDS, MN, 55744-3698
34 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
201
of 209 target codes
Payers
15
with negotiated rates
Rates published
185,678
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 10 | — | — | $7,668.43 | $11,288 | $22,587 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 15 | $905.69 | $384.92 | $122.33 | $308.66 | $1,961.89 |
| Psychiatric eval with medical services | CPT | 90792 | 10 | — | — | $139.13 | $161.68 | $1,961.89 |
| Psychotherapy 30 minutes | CPT | 90832 | 15 | $314 | $133.45 | $45.83 | $168.75 | $317.22 |
| Psychotherapy 45 minutes | CPT | 90834 | 15 | $438 | $186.15 | $54.59 | $214.42 | $442.47 |
| Psychotherapy 60 minutes | CPT | 90837 | 15 | $725 | $308.13 | $67.05 | $271.86 | $732.4 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 15 | $631 | $268.18 | $106.66 | $272.49 | $594 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 15 | $517 | $219.73 | $7.41 | $387.75 | $770 |
| ED visit level 2 | CPT | 99282 | 15 | $605 | $257.13 | $28.22 | $469.53 | $770 |
| ED visit level 3 | CPT | 99283 | 15 | $719 | $305.58 | $47.84 | $576.23 | $770 |
| ED visit level 4 | CPT | 99284 | 15 | $1,249 | $530.83 | $81.32 | $990.22 | $1,261.74 |
| ED visit level 5 | CPT | 99285 | 15 | $1,772 | $753.1 | $117.68 | $1,407.73 | $1,790.07 |
| Critical care, first hour | CPT | 99291 | 15 | $2,410 | $1,024.25 | $144.95 | $1,418.82 | $2,434.58 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 15 | $1,200.58 | $510.25 | $27.55 | $625.5 | $1,602 |
| CT head with contrast | CPT | 70460 | 10 | — | — | $36.74 | $144.07 | $585.23 |
| CT head with and without contrast | CPT | 70470 | 15 | $1,198 | $509.15 | $41.22 | $180.71 | $1,602 |
| CT neck with contrast | CPT | 70491 | 15 | $1,404 | $596.71 | $44.74 | $484.04 | $1,602 |
| MRI brain without contrast | CPT | 70551 | 15 | $1,604 | $681.7 | $47.81 | $227.36 | $1,620.36 |
| MRI brain with contrast | CPT | 70552 | 15 | $2,244 | $953.7 | $57.93 | $330.11 | $2,266.89 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $2,898 | $1,231.65 | $74.42 | $550.62 | $2,927.56 |
| Chest X-ray single view | CPT | 71045 | 15 | $323.04 | $137.3 | $5.89 | $171.33 | $329.22 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $357 | $151.73 | $7.06 | $87.74 | $418.58 |
| Chest X-ray 3 views | CPT | 71047 | 10 | — | — | $8.95 | $35.65 | $526.75 |
| CT chest without contrast | CPT | 71250 | 15 | $1,174 | $498.95 | $35.08 | $132.49 | $1,602 |
| CT chest with contrast | CPT | 71260 | 15 | $1,444 | $613.7 | $37.91 | $179.14 | $1,602 |
| CT chest with and without contrast | CPT | 71270 | 15 | $977 | $415.23 | $40.5 | $191.93 | $1,602 |
| MRI chest without contrast | CPT | 71550 | 15 | $1,552 | $659.6 | $47.34 | $269.15 | $1,567.83 |
| MRI chest with contrast | CPT | 71551 | 10 | — | — | $56.05 | $307.74 | $1,606.13 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $1,552 | $659.6 | $73.48 | $391.39 | $2,032.81 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $388 | $164.9 | $7.3 | $111.71 | $535.35 |
| CT cervical spine without contrast | CPT | 72125 | 15 | $1,178 | $500.65 | $32.26 | $127.24 | $1,602 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | $1,161 | $493.43 | $32.26 | $132.64 | $1,602 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | $1,174 | $498.95 | $32.26 | $274.13 | $1,602 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $1,878 | $798.15 | $48.05 | $243.25 | $1,897.16 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $1,801 | $765.43 | $48.05 | $243.25 | $1,819.37 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $1,895 | $805.38 | $48.05 | $243.25 | $1,914.33 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | $1,398 | $594.15 | $57.93 | $330.11 | $1,412.26 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $2,898 | $1,231.65 | $74.66 | $359.39 | $2,927.56 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $2,898 | $1,231.65 | $74.66 | $359.39 | $2,927.56 |
| CT pelvis without contrast | CPT | 72192 | 15 | $1,254 | $532.95 | $35.33 | $132.92 | $1,602 |
| CT pelvis with contrast | CPT | 72193 | 15 | $1,621 | $688.93 | $37.68 | $200.6 | $1,637.53 |
| Shoulder X-ray | CPT | 73030 | 15 | $556.5 | $236.52 | $6.12 | $103.37 | $562.18 |
| Humerus X-ray | CPT | 73060 | 15 | $459 | $195.08 | $5.17 | $88.61 | $535.35 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $535.5 | $227.59 | $5.64 | $107.99 | $540.96 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $3,079.5 | $1,308.79 | $44.04 | $706.34 | $3,110.91 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $2,773 | $1,178.53 | $69.94 | $376.54 | $2,801.28 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $10.84 | $37.06 | $67.16 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $573.14 | $243.59 | $5.41 | $215.96 | $578.98 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $544.5 | $231.42 | $5.64 | $109.08 | $550.05 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $3,015 | $1,281.38 | $44.04 | $1,020.98 | $3,045.75 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $4,288.5 | $1,822.62 | $69.94 | $673.95 | $4,332.24 |
| CT abdomen without contrast | CPT | 74150 | 15 | $1,174 | $498.95 | $38.62 | $139.05 | $1,602 |
| CT abdomen with contrast | CPT | 74160 | 15 | $1,556 | $661.3 | $41.22 | $220.15 | $1,602 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | $1,794 | $762.45 | $45.21 | $237.14 | $1,812.3 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $1,391.5 | $591.39 | $56.52 | $323.54 | $1,602 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | $1,832 | $778.6 | $59.12 | $479.72 | $1,850.69 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $2,038 | $866.15 | $65.01 | $346.81 | $2,058.79 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $2,075 | $881.88 | $47.11 | $243.25 | $2,096.17 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $3,126 | $1,328.55 | $71.36 | $359.39 | $3,157.89 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $694.11 | $295 | $26.14 | $251.73 | $984.26 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $543 | $230.78 | $19.08 | $286.04 | $984.26 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $573.62 | $243.79 | $23.79 | $228.53 | $984.26 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $664 | $282.2 | $32.76 | $169.63 | $1,117.99 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $683 | $290.28 | $33.01 | $207.13 | $1,117.99 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 15 | $884 | $375.7 | $63.38 | $221.16 | $1,117.99 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $557 | $236.73 | $22.6 | $113.47 | $984.26 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $590 | $250.75 | $22.37 | $108.77 | $984.26 |
| Scrotal ultrasound | CPT | 76870 | 15 | $619 | $263.08 | $20.72 | $107.01 | $984.26 |
| Diagnostic mammography unilateral | CPT | 77065 | 15 | $446 | $189.55 | $26.14 | $139.4 | $450.55 |
| Diagnostic mammography bilateral | CPT | 77066 | 15 | $576 | $244.8 | $32.26 | $161.96 | $581.88 |
| Screening mammography bilateral | CPT | 77067 | 15 | $469 | $199.33 | $24.73 | $217.75 | $473.78 |
| EKG complete | CPT | 93000 | 10 | — | — | $9.89 | $13.97 | $396.32 |
| EKG tracing only | CPT | 93005 | 15 | $223 | $94.78 | $4.23 | $117.66 | $396.32 |
| EKG interpretation only | CPT | 93010 | 15 | $37 | $15.73 | $5.41 | $25.92 | $396.32 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | $1,659 | $705.08 | $46.86 | $549.53 | $1,675.92 |
| Transthoracic echocardiogram | CPT | 93307 | 10 | — | — | $29.67 | $130.24 | $588.4 |
| Stress echocardiogram | CPT | 93350 | 15 | $2,165 | $920.13 | $46.86 | $271.91 | $2,187.08 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $11,040 | $16,004 | $32,024 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $5,546.55 | $8,320 | $16,648 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $3,757.36 | $5,817 | $11,640 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $8,579.22 | $12,562 | $25,137 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $6,081.27 | $9,068 | $18,145 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $4,628.07 | $7,035 | $14,077 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $3,524.58 | $5,492 | $10,989 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $4,424.39 | $6,750 | $13,507 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $3,450.47 | $5,388 | $10,781 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $8,806.51 | $12,880 | $25,773 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $5,045.86 | $7,620 | $15,248 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $3,969.82 | $6,114 | $12,234 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $7,048.06 | $10,420 | $20,850 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $4,661.01 | $7,081 | $14,169 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $3,107.34 | $4,908 | $9,820.91 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $6,609.96 | $9,807 | $19,624 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $4,038.99 | $6,211 | $12,428 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $3,107.89 | $4,909 | $9,822.91 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $5,384.04 | $8,093 | $16,194 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $3,460.9 | $5,403 | $10,811 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $4,280 | $6,548 | $13,103 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $8,606.67 | $12,600 | $25,213 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $6,370.05 | $9,472 | $18,953 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $4,444.16 | $6,778 | $13,563 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $10,664 | $15,478 | $30,971 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $5,617.92 | $8,420 | $16,848 |
| Initial hospital care, low complexity | CPT | 99221 | 15 | $372 | $158.1 | $56.21 | $261.28 | $1,345.1 |
| Initial hospital care, moderate complexity | CPT | 99222 | 15 | $582 | $247.35 | $89.45 | $465.94 | $1,815.42 |
| Initial hospital care, high complexity | CPT | 99223 | 15 | $775 | $329.38 | $119.35 | $629.1 | $2,680.8 |
| Hospital discharge, <30 min | CPT | 99238 | 15 | $362 | $153.85 | $56.21 | $262.77 | $968.85 |
| Hospital discharge, >30 min | CPT | 99239 | 15 | $510 | $216.75 | $79.41 | $372.3 | $1,420.35 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $188 | $79.9 | $8.32 | $139.6 | $189.92 |
| General health panel | CPT | 80050 | 7 | — | — | $40.61 | $50.13 | $124.22 |
| Electrolyte panel | CPT | 80051 | 15 | $84 | $35.7 | $6.9 | $18.67 | $124.22 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $209.09 | $88.87 | $10.39 | $28.98 | $211.22 |
| Lipid panel | CPT | 80061 | 15 | $96.3 | $40.93 | $13.18 | $34.66 | $124.22 |
| Renal function panel | CPT | 80069 | 15 | $182 | $77.35 | $8.54 | $22.14 | $183.86 |
| Hepatic function panel | CPT | 80076 | 15 | $120 | $51 | $8.04 | $21.37 | $124.22 |
| Urinalysis non-automated | CPT | 81002 | 10 | — | — | $2.09 | $3.63 | $9.32 |
| Urinalysis automated | CPT | 81003 | 15 | $70 | $29.75 | $1.51 | $31.06 | $70.71 |
| Glucose quantitative | CPT | 82947 | 15 | $46 | $19.55 | $3.87 | $12.88 | $80.24 |
| Hemoglobin A1c | CPT | 83036 | 15 | $66.19 | $28.13 | $9.55 | $28.86 | $137.04 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $98 | $41.65 | $16.53 | $53.06 | $135.27 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $109.14 | $46.39 | $3.37 | $23.34 | $110.26 |
| Complete blood count without differential | CPT | 85027 | 15 | $148.03 | $62.92 | $4.31 | $86.37 | $149.54 |
| Urine culture bacterial | CPT | 87086 | 15 | $85 | $36.13 | $7.94 | $23.85 | $103.23 |
| Urine culture identification | CPT | 87088 | 15 | $105 | $44.63 | $7.96 | $25.88 | $106.07 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $224.27 | $95.32 | $19.2 | $95.43 | $337.52 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 15 | $813 | $345.53 | $14.59 | $233.74 | $1,780.64 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 15 | $11,489 | $4,882.72 | $53.01 | $6,354.13 | $28,421 |
| Vaginal delivery only | CPT | 59409 | 15 | $3,766.33 | $1,600.7 | $53.01 | $2,434.32 | $12,357 |
| Vaginal delivery with postpartum | CPT | 59410 | 15 | $4,718.67 | $2,005.44 | $53.01 | $963.98 | $12,357 |
| Routine obstetric care with C-section | CPT | 59510 | 15 | $15,695 | $6,670.38 | $53.01 | $8,723.14 | $31,511 |
| C-section delivery only | CPT | 59514 | 15 | $4,329 | $1,839.83 | $507.93 | $870.61 | $12,383 |
| C-section with postpartum | CPT | 59515 | 15 | $6,216 | $2,641.8 | $53.01 | $1,992.15 | $17,120 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 15 | $326 | $138.55 | $32.29 | $79.7 | $672.55 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 15 | $504 | $214.2 | $55.97 | $132.31 | $1,011.18 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 15 | $747 | $317.48 | $91.85 | $214.51 | $1,711.95 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 10 | — | — | $124.62 | $173.18 | $2,234 |
| Office visit, established patient, 5 min | CPT | 99211 | 10 | — | — | $5.97 | $8.74 | $122.28 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 15 | $255 | $108.38 | $24.16 | $130.01 | $338.63 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 15 | $406 | $172.55 | $45.44 | $209.07 | $677.26 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 15 | $573 | $243.53 | $66.97 | $308.26 | $1,044.1 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 15 | $803 | $341.28 | $99.5 | $215.13 | $1,472.09 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | $2,038.05 | $866.18 | $53.01 | $943.48 | $2,058.84 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | $2,134 | $906.95 | $52.96 | $1,085.24 | $2,155.77 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | $2,024 | $860.2 | $38.38 | $763.05 | $2,044.64 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | $2,824 | $1,200.2 | $48.75 | $953.05 | $7,269.12 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | $2,640 | $1,122 | $52.97 | $972.52 | $3,418.48 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | $2,887.83 | $1,227.33 | $52.92 | $1,673.65 | $3,418.48 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | $2,939 | $1,249.08 | $52.87 | $1,728.77 | $2,968.98 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 15 | $6,525 | $2,773.13 | $53.01 | $4,106.31 | $36,309 |
| Hip hemiarthroplasty | CPT | 27125 | 10 | — | — | $761.47 | $1,072.64 | $15,384 |
| Total hip replacement | CPT | 27130 | 15 | $7,247.5 | $3,080.19 | $52.93 | $1,333.54 | $25,404 |
| Total knee replacement | CPT | 27447 | 15 | $5,791 | $2,461.18 | $52.92 | $3,403.94 | $25,404 |
| Knee revision arthroplasty single component | CPT | 27486 | 10 | — | — | $940.46 | $1,324.73 | $19,067 |
| Knee revision arthroplasty all components | CPT | 27487 | 10 | — | — | $1,166.58 | $1,643.37 | $23,859 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 15 | $772 | $328.1 | $112.11 | $454.71 | $1,831.33 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | $4,840 | $2,057 | $53.01 | $3,401.25 | $14,105 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | $2,467 | $1,048.48 | $52.73 | $1,538.74 | $6,406.13 |
| ACL reconstruction | CPT | 29888 | 10 | — | — | $658.06 | $3,015.13 | $14,105 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $25,235 | $35,858 | $71,752 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $13,161 | $18,970 | $37,959 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $9,239.12 | $13,485 | $26,983 |
| CABG single arterial graft | CPT | 33533 | 10 | — | — | $1,175.05 | $1,656.24 | $25,439 |
| CABG 2 arterial grafts | CPT | 33534 | 10 | — | — | $1,379.5 | $1,944.13 | $29,922 |
| CABG 3 arterial grafts | CPT | 33535 | 10 | — | — | $1,531.89 | $2,159.2 | $33,383 |
| CABG 4+ arterial grafts | CPT | 33536 | 10 | — | — | $1,648.71 | $2,323.79 | $35,796 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $9,286.88 | $13,551 | $27,116 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $7,498.24 | $11,050 | $22,111 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $18,705 | $26,724 | $53,475 |
| Open appendectomy | CPT | 44950 | 10 | — | — | $417.59 | $1,959.92 | $12,320 |
| Laparoscopic appendectomy | CPT | 44970 | 15 | $2,727 | $1,158.98 | $52.67 | $587.23 | $11,519 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $16,652 | $23,853 | $47,730 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $10,590 | $15,374 | $30,763 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | $3,731.25 | $1,585.79 | $53.01 | $2,177.55 | $11,519 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 15 | $3,253 | $1,382.53 | $53.01 | $2,045.15 | $11,519 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $15,989 | $22,925 | $45,873 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $11,499 | $16,645 | $33,307 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $8,954.19 | $13,086 | $26,185 |
| Open umbilical hernia repair | CPT | 49560 | 2 | — | — | $706.91 | $2,649.11 | $10,055 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 2 | — | — | $433.71 | $1,625.3 | $6,348.61 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | $2,946 | $1,252.05 | $53.01 | $1,429.15 | $11,519 |
| Lap incisional hernia repair | CPT | 49652 | 2 | — | — | $712.84 | $2,671.34 | $9,156.66 |
| Total abdominal hysterectomy | CPT | 58150 | 10 | — | — | $679.74 | $957.73 | $13,686 |
| Vaginal hysterectomy | CPT | 58260 | 15 | $3,806 | $1,617.55 | $53.01 | $2,380.27 | $11,043 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | $3,993 | $1,697.03 | $53.01 | $1,996.3 | $11,519 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 15 | $4,443 | $1,888.28 | $53.01 | $2,247.04 | $20,556 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | $4,431 | $1,883.18 | $53.01 | $2,128.23 | $11,519 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $15,852 | $22,734 | $45,491 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $8,785.65 | $12,850 | $25,713 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $8,281.12 | $12,145 | $24,302 |
| Complex cataract surgery | CPT | 66982 | 10 | — | — | $512.75 | $2,072.95 | $4,883.55 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $374.96 | $1,649.61 | $15,756 |
| Intravitreal injection | CPT | 67028 | 10 | — | — | $62.88 | $286.51 | $3,504.26 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | — | $782.66 | $3,464.2 | $15,403 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $6,811.44 | $10,089 | $20,188 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $11,250 | $16,297 | $32,610 |
| PCI single major coronary artery | CPT | 92920 | 10 | — | — | $329.26 | $1,456.16 | $50,803 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | — | — | $366.01 | $1,619.72 | $50,803 |
| PCI bypass graft | CPT | 92937 | 10 | — | — | $365.78 | $1,618.84 | $50,803 |
| Left heart catheterization | CPT | 93452 | 10 | — | — | $149.09 | $721.93 | $18,766 |
| Coronary angiography with cath | CPT | 93455 | 10 | — | — | $175.46 | $849.77 | $18,766 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | — | — | $185.36 | $900.06 | $18,766 |
Payer mix (top 15)
| Payer | Codes covered | Median rate |
|---|---|---|
| health partners | 201 | $209.22 |
| Blue Cross Blue Shield | 200 | $278.04 |
| primewest | 197 | $126.59 |
| itasca medical care | 197 | $126.59 |
| medica | 197 | $171.62 |
| ucare | 197 | $188.75 |
| UnitedHealthcare | 197 | $239.61 |
| sanford health plan | 196 | $191.16 |
| WellCare | 196 | $152.79 |
| security health plan | 196 | $229.5 |
| wisconsin physician services | 124 | $332.72 |
| First Health | 124 | $302.97 |
| Multiplan | 124 | $314.37 |
| private healthcare systems | 124 | $314.37 |
| america's ppo | 124 | $339.92 |