▸ Hospital · MN · CCN 241364

Community Memorial Hospital

512 SKYLINE BOULEVARD, CLOQUET, MN, 241364

Compliance grade

93/100

Rates published

79,821

last crawl 2026-05-24

Procedures tracked

129

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All MN hospitals JSON

Source MRF: https://cloquethospital.com/wp-content/uploads/2024/12/410743546_community-memorial-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	1	$254	$170.18	$112	$158.25	$254
ED visit level 2	CPT	99282	1	$372	$249.24	$198.5	$285.25	$372
ED visit level 3	CPT	99283	1	$587	$393.29	$248	$417.5	$587
ED visit level 4	CPT	99284	1	$943	$631.81	$369	$656	$943
ED visit level 5	CPT	99285	1	$1,377	$922.59	$596.5	$986.75	$1,377
Critical care, first hour	CPT	99291	1	$2,113	$1,415.71	$758	$1,435.5	$2,113
imaging
CT head without contrast	CPT	70450	1	$1,956	$1,310.52	$1,956	$1,956	$1,956
CT head with contrast	CPT	70460	1	$2,265	$1,517.55	$2,265	$2,265	$2,265
CT head with and without contrast	CPT	70470	1	$2,670	$1,788.9	$2,670	$2,670	$2,670
CT neck with contrast	CPT	70491	1	$3,114	$2,086.38	$3,114	$3,114	$3,114
MRI brain without contrast	CPT	70551	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI brain with contrast	CPT	70552	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI brain with and without contrast	CPT	70553	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
Chest X-ray single view	CPT	71045	1	$425	$284.75	$52.5	$238.75	$425
Chest X-ray 2 views	CPT	71046	1	$456	$305.52	$62.5	$259.25	$456
Chest X-ray 3 views	CPT	71047	1	$73	$48.91	$73	$73	$73
CT chest without contrast	CPT	71250	1	$1,952	$1,307.84	$1,952	$1,952	$1,952
CT chest with contrast	CPT	71260	1	$2,157	$1,445.19	$2,157	$2,157	$2,157
CT chest with and without contrast	CPT	71270	1	$2,605	$1,745.35	$2,605	$2,605	$2,605
MRI chest without contrast	CPT	71550	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI chest with and without contrast	CPT	71552	1	$5,491	$3,678.97	$3,909	$4,700	$5,491
Lumbosacral spine X-ray	CPT	72100	1	$679	$454.93	$62.5	$370.75	$679
CT cervical spine without contrast	CPT	72125	1	$3,325	$2,227.75	$3,325	$3,325	$3,325
CT thoracic spine without contrast	CPT	72128	1	$2,948	$1,975.16	$2,948	$2,948	$2,948
CT lumbar spine without contrast	CPT	72131	1	$3,325	$2,227.75	$3,325	$3,325	$3,325
MRI cervical spine without contrast	CPT	72141	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI thoracic spine without contrast	CPT	72146	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI lumbar spine without contrast	CPT	72148	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI lumbar spine with and without contrast	CPT	72149	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI cervical spine with and without contrast	CPT	72156	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
MRI lumbar spine with contrast	CPT	72158	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
CT pelvis without contrast	CPT	72192	1	$2,338	$1,566.46	$2,338	$2,338	$2,338
CT pelvis with contrast	CPT	72193	1	$2,338	$1,566.46	$2,338	$2,338	$2,338
Shoulder X-ray	CPT	73030	1	$468	$313.56	$52.5	$260.25	$468
Humerus X-ray	CPT	73060	1	$390	$261.3	$50.5	$220.25	$390
Hand X-ray 3 views	CPT	73130	1	$366	$245.22	$50.5	$208.25	$366
MRI upper extremity joint without contrast	CPT	73221	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI upper extremity joint with and without contrast	CPT	73223	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
Knee X-ray 1-2 views	CPT	73560	1	$460	$308.2	$52.5	$252	$460
Ankle X-ray 3 views	CPT	73610	1	$497	$332.99	$50.5	$273.75	$497
MRI lower extremity joint without contrast	CPT	73721	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI lower extremity joint with and without contrast	CPT	73723	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
CT abdomen without contrast	CPT	74150	1	$2,338	$1,566.46	$2,338	$2,338	$2,338
CT abdomen with contrast	CPT	74160	1	$2,587	$1,733.29	$2,587	$2,587	$2,587
CT abdomen with and without contrast	CPT	74170	1	$2,660	$1,782.2	$2,660	$2,660	$2,660
CT abdomen and pelvis without contrast	CPT	74176	1	$4,671	$3,129.57	$624	$2,647.5	$4,671
CT abdomen and pelvis with contrast	CPT	74177	1	$4,917	$3,294.39	$667.5	$2,792.25	$4,917
CT abdomen and pelvis with and without contrast	CPT	74178	1	$4,992	$3,344.64	$703.5	$2,847.75	$4,992
MRI abdomen without contrast	CPT	74181	1	$3,909	$2,619.03	$3,909	$3,909	$3,909
MRI abdomen with and without contrast	CPT	74183	1	$5,491	$3,678.97	$5,491	$5,491	$5,491
Abdominal ultrasound complete	CPT	76700	1	$1,541	$1,032.47	$1,541	$1,541	$1,541
Abdominal ultrasound limited	CPT	76705	1	$1,439	$964.13	$959	$1,199	$1,439
Retroperitoneal ultrasound complete	CPT	76770	1	$959	$642.53	$959	$959	$959
Obstetric ultrasound first trimester	CPT	76801	1	$1,255	$840.85	$275.5	$765.25	$1,255
Obstetric ultrasound after first trimester	CPT	76805	1	$1,541	$1,032.47	$1,541	$1,541	$1,541
Transvaginal ultrasound	CPT	76830	1	$819	$548.73	$819	$819	$819
Pelvic ultrasound complete	CPT	76856	1	$1,255	$840.85	$1,255	$1,255	$1,255
Scrotal ultrasound	CPT	76870	1	$959	$642.53	$959	$959	$959
Diagnostic mammography unilateral	CPT	77065	1	$559	$374.53	$114	$435	$559
Diagnostic mammography bilateral	CPT	77066	1	$595	$398.65	$152.5	$471	$595
Screening mammography bilateral	CPT	77067	1	$595	$398.65	$100	$471	$595
EKG tracing only	CPT	93005	1	$351	$235.17	$341	$346	$351
EKG interpretation only	CPT	93010	1	$110	$73.7	$110	$110	$110
Transthoracic echocardiogram complete	CPT	93306	1	$2,233	$1,496.11	$2,233	$2,233	$2,233
Stress echocardiogram	CPT	93350	1	$1,802	$1,207.34	$1,802	$1,802	$1,802
inpatient
Initial hospital care, low complexity	CPT	99221	1	$155	$103.85	$155	$155	$155
Initial hospital care, moderate complexity	CPT	99222	1	$255	$170.85	$255	$255	$255
Initial hospital care, high complexity	CPT	99223	1	$360	$241.2	$360	$360	$360
Hospital discharge, <30 min	CPT	99238	1	$165	$110.55	$165	$165	$165
Hospital discharge, >30 min	CPT	99239	1	$200	$134	$200	$200	$200
lab
Basic metabolic panel (BMP)	CPT	80048	1	$315	$211.05	$315	$315	$315
General health panel	CPT	80050	1	$563	$377.21	$563	$563	$563
Electrolyte panel	CPT	80051	1	$205	$137.35	$205	$205	$205
Comprehensive metabolic panel	CPT	80053	1	$377	$252.59	$377	$377	$377
Lipid panel	CPT	80061	1	$330	$221.1	$330	$330	$330
Renal function panel	CPT	80069	1	$205	$137.35	$205	$205	$205
Hepatic function panel	CPT	80076	1	$250	$167.5	$250	$250	$250
Urinalysis non-automated	CPT	81002	1	$162	$108.54	$162	$162	$162
Urinalysis automated	CPT	81003	1	$66	$44.22	$58	$62	$66
Glucose quantitative	CPT	82947	1	$163	$109.21	$163	$163	$163
Hemoglobin A1c	CPT	83036	1	$285	$190.95	$285	$285	$285
Thyroid stimulating hormone (TSH)	CPT	84443	1	$289	$193.63	$90	$189.5	$289
Complete blood count with automated differential	CPT	85025	1	$187	$125.29	$26	$106.5	$187
Complete blood count without differential	CPT	85027	1	$187	$125.29	$187	$187	$187
Urine culture bacterial	CPT	87086	1	$195	$130.65	$14	$104.5	$195
Tissue exam by pathologist level IV	CPT	88305	1	$200	$134	$200	$200	$200
maternity
Fetal non-stress test	CPT	59025	1	$1,089	$729.63	$160.5	$548	$1,089
Routine obstetric care including vaginal delivery	CPT	59400	1	$3,750	$2,512.5	$3,750	$3,750	$3,750
Vaginal delivery only	CPT	59409	1	$2,060	$1,380.2	$2,060	$2,060	$2,060
Vaginal delivery with postpartum	CPT	59410	1	$2,350	$1,574.5	$2,350	$2,350	$2,350
Routine obstetric care with C-section	CPT	59510	1	$4,705	$3,152.35	$4,705	$4,705	$4,705
C-section delivery only	CPT	59514	1	$3,860	$2,586.2	$3,860	$3,860	$3,860
C-section with postpartum	CPT	59515	1	$2,800	$1,876	$2,800	$2,800	$2,800
office
Office visit, new patient, 15-29 min	CPT	99202	1	$219	$146.73	$50	$153.5	$219
Office visit, new patient, 30-44 minutes	CPT	99203	1	$289	$193.63	$72.25	$249.38	$289
Office visit, new patient, 45-59 min	CPT	99204	1	$376	$251.92	$79.25	$277.38	$376
Office visit, new patient, 60-74 min	CPT	99205	1	$500	$335	$96	$288	$500
Office visit, established patient, 5 min	CPT	99211	1	$343	$229.81	$12.5	$48	$343
Office visit, established patient, 10-19 min	CPT	99212	1	$219	$146.73	$29	$101.5	$219
Office visit, established patient, 20-29 minutes	CPT	99213	1	$233	$156.11	$48.75	$170.63	$233
Office visit, established patient, 30-39 minutes	CPT	99214	1	$304	$203.68	$76	$255	$304
Office visit, established patient, 40-54 min	CPT	99215	1	$429	$287.43	$107.25	$321.75	$429
preventive
Upper GI endoscopy diagnostic	CPT	43235	1	$790.5	$529.64	$790.5	$790.5	$790.5
Upper GI endoscopy with biopsy	CPT	43239	1	$849.5	$569.17	$849.5	$849.5	$849.5
Sigmoidoscopy diagnostic	CPT	45330	1	$1,529	$1,024.43	$293.5	$911.25	$1,529
Sigmoidoscopy with biopsy	CPT	45331	1	$341	$228.47	$341	$341	$341
Colonoscopy diagnostic	CPT	45378	1	$1,130	$757.1	$1,130	$1,130	$1,130
Colonoscopy with biopsy	CPT	45380	1	$1,202	$805.34	$1,202	$1,202	$1,202
Colonoscopy with polyp removal	CPT	45385	1	$1,480	$991.6	$1,480	$1,480	$1,480
surgery
Total shoulder arthroplasty	CPT	23472	1	$4,745	$3,179.15	$4,745	$4,745	$4,745
Hip hemiarthroplasty	CPT	27125	1	$3,756.5	$2,516.86	$3,756.5	$3,756.5	$3,756.5
Total hip replacement	CPT	27130	1	$4,896	$3,280.32	$4,896	$4,896	$4,896
Total knee replacement	CPT	27447	1	$5,564.5	$3,728.22	$5,564.5	$5,564.5	$5,564.5
Knee revision arthroplasty single component	CPT	27486	1	$5,405	$3,621.35	$5,405	$5,405	$5,405
Knee revision arthroplasty all components	CPT	27487	1	$7,273	$4,872.91	$7,273	$7,273	$7,273
Shoulder arthroscopy with decompression	CPT	29826	1	$1,150	$770.5	$1,150	$1,150	$1,150
Shoulder arthroscopy with rotator cuff repair	CPT	29827	1	$3,030	$2,030.1	$3,030	$3,030	$3,030
Knee arthroscopy with meniscectomy	CPT	29881	1	$1,949.5	$1,306.17	$1,949.5	$1,949.5	$1,949.5
ACL reconstruction	CPT	29888	1	$4,590	$3,075.3	$4,590	$4,590	$4,590
Open appendectomy	CPT	44950	1	$1,658	$1,110.86	$1,658	$1,658	$1,658
Laparoscopic appendectomy	CPT	44970	1	$1,606	$1,076.02	$1,606	$1,606	$1,606
Laparoscopic cholecystectomy	CPT	47562	1	$2,063	$1,382.21	$2,063	$2,063	$2,063
Lap cholecystectomy with cholangiography	CPT	47563	1	$2,223.5	$1,489.75	$2,223.5	$2,223.5	$2,223.5
Lap inguinal hernia repair	CPT	49650	1	$1,862.5	$1,247.88	$1,862.5	$1,862.5	$1,862.5
Total abdominal hysterectomy	CPT	58150	1	$4,868.5	$3,261.9	$4,868.5	$4,868.5	$4,868.5
Vaginal hysterectomy	CPT	58260	1	$4,485	$3,004.95	$4,485	$4,485	$4,485
Lap-assisted vaginal hysterectomy	CPT	58550	1	$3,050	$2,043.5	$3,050	$3,050	$3,050
Lap-assisted vaginal hysterectomy >250g	CPT	58552	1	$4,491	$3,008.97	$4,491	$4,491	$4,491
Lap salpingo-oophorectomy	CPT	58661	1	$3,727	$2,497.09	$2,519	$3,123	$3,727

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 1)

Payer	Codes covered	Median rate
hp	129	$445.5

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