Does Ascension St. John Nowata publish its standard charges and chargemaster?

Yes. Ascension St. John Nowata publishes a machine-readable file with 17,695 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Ascension St. John Nowata charge for procedures?

Ascension St. John Nowata (Nowata, OK) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · OK · CCN 371305

Ascension St. John Nowata

Nowata, OK, 74048-3660

25 bedsCritical Access Hospitals2

Compliance grade

100/100

Rates published

17,695

last crawl 2026-05-24

Procedures tracked

198

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All OK hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/ok-csv/731440267_jane-phillips-nowata-hospital-inc_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	15	—	—	$600	$2,375.36	0.19×	$18,736
Psychiatric diagnostic evaluation	CPT	90791	2	$335	$123.95	$142.4	$259.75	1.5×	$259.75
Psychiatric eval with medical services	CPT	90792	2	—	—	$159.8	$269.11	1.6×	$269.11
Psychotherapy 30 minutes	CPT	90832	1	—	—	$70.84	$70.84	0.48×	$70.84
Psychotherapy 45 minutes	CPT	90834	1	—	—	$94.45	$94.45	0.59×	$94.45
Psychotherapy 60 minutes	CPT	90837	1	—	—	$142.05	$142.05	0.75×	$142.05
Crisis psychotherapy 60 minutes	CPT	90839	1	—	—	$148.06	$148.06	0.93×	$148.06
emergency
ED visit level 1	CPT	99281	3	$382.75	$141.62	$23.74	$33	0.24×	$637
ED visit level 2	CPT	99282	3	$851.25	$314.96	$46.32	$65.42	0.28×	$849
ED visit level 3	CPT	99283	3	$1,431	$529.47	$69.41	$97.83	0.24×	$1,061
ED visit level 4	CPT	99284	3	$2,048.5	$757.95	$131.75	$186.98	0.28×	$1,591
ED visit level 5	CPT	99285	3	$3,114.75	$1,152.46	$194.56	$283.61	0.27×	$3,183
Critical care, first hour	CPT	99291	3	$3,275.5	$1,211.94	$248.97	$351.97	0.33×	$500
imaging
CT head without contrast	CPT	70450	3	$2,410.25	$891.79	$53.78	$337.76	1.6×	$337.76
CT head with contrast	CPT	70460	3	$2,387.25	$883.28	$71.19	$443.05	1.9×	$443.05
CT head with and without contrast	CPT	70470	3	$2,878.75	$1,065.14	$80.04	$448.51	1.7×	$448.51
CT neck with contrast	CPT	70491	3	$2,478.75	$917.14	$86.79	$548.35	2.0×	$548.35
MRI brain without contrast	CPT	70551	3	$2,354	$870.98	$92.97	$873.62	2.2×	$1,591
MRI brain with contrast	CPT	70552	3	$2,663.25	$985.4	$112.11	$977.37	2.0×	$1,591
MRI brain with and without contrast	CPT	70553	3	$3,456.5	$1,278.91	$148.26	$1,147.41	1.9×	$1,591
Chest X-ray single view	CPT	71045	2	$232.5	$86.03	$17.06	$17.71	0.19×	$18.98
Chest X-ray 2 views	CPT	71046	2	$320	$118.4	$23.34	$32.14	0.33×	$34.44
Chest X-ray 3 views	CPT	71047	2	$353.5	$130.8	$29.62	$40.67	0.42×	$43.58
CT chest without contrast	CPT	71250	3	$2,574.75	$952.66	$73	$429.02	2.0×	$429.02
CT chest with contrast	CPT	71260	3	$2,995.5	$1,108.34	$77.94	$535.87	1.9×	$535.87
CT chest with and without contrast	CPT	71270	3	$2,820.25	$1,043.49	$86.79	$648.2	2.2×	$648.2
MRI chest without contrast	CPT	71550	3	$2,437.75	$901.97	$91.34	$953.19	2.2×	$1,591
MRI chest with contrast	CPT	71551	3	$2,506.5	$927.41	$108.17	$1,060.05	1.3×	$1,591
MRI chest with and without contrast	CPT	71552	3	$3,194.75	$1,182.06	$142.78	$1,348.65	2.2×	$1,591
Lumbosacral spine X-ray	CPT	72100	3	$401.25	$148.46	$13.8	$259.34	2.5×	$259.34
CT cervical spine without contrast	CPT	72125	3	$2,233	$826.21	$73	$439.15	2.2×	$439.15
CT thoracic spine without contrast	CPT	72128	3	$2,280.25	$843.69	$73	$429.02	2.2×	$429.02
CT lumbar spine without contrast	CPT	72131	3	$2,280.25	$843.69	$73	$428.23	2.1×	$428.23
MRI cervical spine without contrast	CPT	72141	3	$2,602.75	$963.02	$100.19	$776.91	2.0×	$1,591
MRI thoracic spine without contrast	CPT	72146	3	$2,639.5	$976.62	$100.59	$778.45	2.1×	$1,591
MRI lumbar spine without contrast	CPT	72148	3	$2,499.5	$924.82	$92.97	$765.19	2.0×	$1,591
MRI lumbar spine with and without contrast	CPT	72149	3	$2,851	$1,054.87	$112.11	$963.32	2.1×	$1,591
MRI cervical spine with and without contrast	CPT	72156	3	$3,448.75	$1,276.04	$161.19	$1,150.53	2.1×	$1,591
MRI lumbar spine with contrast	CPT	72158	3	$3,775.25	$1,396.84	$147.87	$1,124	2.1×	$1,591
CT pelvis without contrast	CPT	72192	3	$2,550.5	$943.69	$68.92	$357.24	1.8×	$357.24
CT pelvis with contrast	CPT	72193	3	$2,625	$971.25	$73	$557.71	2.0×	$557.71
Shoulder X-ray	CPT	73030	3	$713	$263.81	$11.52	$259.34	2.8×	$259.34
Humerus X-ray	CPT	73060	3	$335.75	$124.23	$10.66	$259.34	2.9×	$259.34
Hand X-ray 3 views	CPT	73130	3	$710	$262.7	$10.66	$259.34	2.8×	$259.34
MRI upper extremity joint without contrast	CPT	73221	3	$5,544	$2,051.28	$84.59	$567.86	1.4×	$1,591
MRI upper extremity joint with and without contrast	CPT	73223	3	$2,894.25	$1,070.87	$134.83	$1,098.27	1.8×	$1,591
Hip X-ray 2 views	CPT	73510	3	—	—	$13.33	$259.34	3.4×	$259.34
Knee X-ray 1-2 views	CPT	73560	3	$560	$207.2	$10.66	$259.34	2.8×	$259.34
Ankle X-ray 3 views	CPT	73610	3	$729	$269.73	$10.66	$259.34	2.8×	$259.34
MRI lower extremity joint without contrast	CPT	73721	3	$5,280	$1,953.6	$84.59	$567.86	1.2×	$1,591
MRI lower extremity joint with and without contrast	CPT	73723	3	$2,894.25	$1,070.87	$135.23	$1,098.27	1.7×	$1,591
CT abdomen without contrast	CPT	74150	3	$2,581	$954.97	$74.8	$365.83	1.9×	$365.83
CT abdomen with contrast	CPT	74160	3	$2,756.25	$1,019.81	$80.44	$568.63	2.0×	$568.63
CT abdomen with and without contrast	CPT	74170	3	$2,954.5	$1,093.17	$88.13	$653.65	2.0×	$653.65
CT abdomen and pelvis without contrast	CPT	74176	2	$2,489	$920.93	$114.61	$474.26	1.3×	$474.26
CT abdomen and pelvis with contrast	CPT	74177	2	$3,209.75	$1,187.61	$222.39	$705.92	1.3×	$705.92
CT abdomen and pelvis with and without contrast	CPT	74178	2	$3,286.5	$1,216.01	$255.45	$825.26	1.4×	$825.26
MRI abdomen without contrast	CPT	74181	3	$2,646	$979.02	$91.74	$765.98	2.0×	$1,591
MRI abdomen with and without contrast	CPT	74183	3	$3,211.75	$1,188.35	$141.98	$1,177.84	2.1×	$1,591
Abdominal ultrasound complete	CPT	76700	3	$1,423.75	$526.79	$50.71	$289.39	1.9×	$289.39
Abdominal ultrasound limited	CPT	76705	3	$980	$362.6	$37.31	$222.31	1.5×	$222.31
Retroperitoneal ultrasound complete	CPT	76770	3	$1,081.5	$400.16	$46.34	$273.02	1.9×	$273.02
Obstetric ultrasound first trimester	CPT	76801	3	$1,321	$488.77	$61.54	$420.03	3.0×	$420.03
Obstetric ultrasound after first trimester	CPT	76805	3	$1,530.5	$566.29	$61.14	$420.03	2.8×	$420.03
Obstetric ultrasound with fetal anatomy	CPT	76811	3	$1,297	$479.89	$87.32	$420.03	1.8×	$420.03
Transvaginal ultrasound	CPT	76830	3	$1,024	$378.88	$42.8	$156.78	1.1×	$156.78
Pelvic ultrasound complete	CPT	76856	3	$1,311.75	$485.35	$43.2	$256.62	1.8×	$256.62
Scrotal ultrasound	CPT	76870	3	$808.5	$299.15	$36.65	$255.85	2.0×	$255.85
Diagnostic mammography unilateral	CPT	77065	2	$437	$161.69	$95.22	$223.66	1.5×	$239.64
Diagnostic mammography bilateral	CPT	77066	2	$564.5	$208.87	$121.8	$284	1.5×	$304.29
Screening mammography bilateral	CPT	77067	2	$380	$140.6	$100.61	$228.91	1.5×	$245.26
EKG complete	CPT	93000	3	—	—	$18.08	$30.48	1.2×	$32.66
EKG tracing only	CPT	93005	3	$186	$68.82	$8.63	$16.51	0.14×	$124.62
EKG interpretation only	CPT	93010	3	$34.75	$12.86	$9.44	$14.6	0.81×	$23.28
Transthoracic echocardiogram complete	CPT	93306	3	$2,314.5	$856.37	$88.03	$386.11	0.64×	$1,550.72
Transthoracic echocardiogram	CPT	93307	3	$1,447	$535.39	$61.15	$234.01	0.95×	$969.49
Stress echocardiogram	CPT	93350	3	—	—	$98.62	$408.72	0.81×	$408.72
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	13	—	—	$1,506	$5,674.5	0.37×	$18,736
COPD w MCC	MS-DRG	190	13	—	—	$1,506	$5,674.5	0.51×	$18,736
COPD w CC	MS-DRG	191	13	—	—	$1,506	$5,674.5	0.64×	$18,736
COPD w/o CC/MCC	MS-DRG	192	13	—	—	$1,506	$5,674.5	0.81×	$18,736
Simple pneumonia & pleurisy w CC	MS-DRG	194	13	—	—	$1,506	$5,674.5	0.67×	$18,736
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	13	—	—	$1,506	$5,674.5	0.85×	$18,736
AMI discharged alive w MCC	MS-DRG	280	13	—	—	$1,506	$5,674.5	0.36×	$18,736
AMI discharged alive w CC	MS-DRG	281	13	—	—	$1,506	$5,674.5	0.59×	$18,736
AMI discharged alive w/o CC/MCC	MS-DRG	282	13	—	—	$1,506	$5,674.5	0.73×	$18,736
Heart failure & shock w MCC	MS-DRG	291	13	—	—	$1,506	$5,674.5	0.44×	$18,736
Heart failure & shock w CC	MS-DRG	292	13	—	—	$1,506	$5,674.5	0.63×	$18,736
Heart failure & shock w/o CC/MCC	MS-DRG	293	13	—	—	$1,506	$5,674.5	0.91×	$18,736
Cardiac arrhythmia w MCC	MS-DRG	308	13	—	—	$1,506	$5,674.5	0.47×	$18,736
Cardiac arrhythmia w CC	MS-DRG	309	13	—	—	$1,506	$5,674.5	0.73×	$18,736
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	13	—	—	$1,506	$5,674.5	0.91×	$18,736
GI hemorrhage w CC	MS-DRG	378	13	—	—	$1,506	$5,674.5	0.57×	$18,736
GI hemorrhage w/o CC/MCC	MS-DRG	379	13	—	—	$1,506	$5,674.5	0.83×	$18,736
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	13	—	—	$1,506	$5,674.5	0.71×	$18,736
Fractures of femur w/o MCC	MS-DRG	533	13	—	—	$1,506	$5,674.5	0.37×	$18,736
Kidney/UTI w MCC	MS-DRG	689	13	—	—	$1,506	$5,674.5	0.49×	$18,736
Kidney/UTI w/o MCC	MS-DRG	690	13	—	—	$1,506	$5,674.5	0.68×	$18,736
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	13	—	—	$1,506	$5,674.5	0.30×	$18,736
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	13	—	—	$1,506	$5,674.5	0.55×	$18,736
Initial hospital care, low complexity	CPT	99221	2	—	—	$111.73	$112.11	1.2×	$112.48
Initial hospital care, moderate complexity	CPT	99222	2	—	—	$151.74	$152.1	0.90×	$152.46
Initial hospital care, high complexity	CPT	99223	2	—	—	$224.49	$224.56	1.00×	$224.63
Hospital discharge, <30 min	CPT	99238	2	—	—	$79.86	$80.84	0.94×	$81.81
Hospital discharge, >30 min	CPT	99239	2	—	—	$118.44	$118.74	0.98×	$119.04
lab
Basic metabolic panel (BMP)	CPT	80048	5	$85.75	$31.73	$8.86	$42.88	1.3×	$109.05
General health panel	CPT	80050	4	$435.5	$161.14	$29.19	$109.05	1.0×	$435.5
Electrolyte panel	CPT	80051	5	$75	$27.75	$7.3	$60.18	2.5×	$75
Comprehensive metabolic panel	CPT	80053	5	$110.25	$40.79	$11.2	$109.05	2.5×	$110.25
Lipid panel	CPT	80061	5	$179.5	$66.42	$16.63	$74.6	2.0×	$179.5
Renal function panel	CPT	80069	5	$71.75	$26.55	$9.12	$35.88	1.3×	$109.05
Hepatic function panel	CPT	80076	5	$119.75	$44.31	$8.6	$109.05	4.1×	$119.75
Urinalysis non-automated	CPT	81002	5	$50.25	$18.59	$2.61	$20.23	2.9×	$50.25
Urinalysis automated	CPT	81003	5	$58	$21.46	$2.35	$20.23	1.5×	$58
Glucose quantitative	CPT	82947	3	$68.5	$25.35	$4.17	$33.65	1.9×	$34.25
Hemoglobin A1c	CPT	83036	5	$370.5	$137.09	$10.16	$60.18	2.2×	$370.5
Thyroid stimulating hormone (TSH)	CPT	84443	5	$224.5	$83.07	$17.72	$85.28	1.8×	$224.5
Complete blood count with automated differential	CPT	85025	3	$122.5	$45.33	$8.08	$51.91	2.0×	$61.25
Complete blood count without differential	CPT	85027	3	$80	$29.6	$6.78	$51.91	2.4×	$51.91
Urine culture bacterial	CPT	87086	3	$129.25	$47.82	$8.6	$56.64	2.4×	$64.63
Urine culture identification	CPT	87088	3	$47.25	$17.48	$7.62	$14.96	0.67×	$56.64
Tissue exam by pathologist level IV	CPT	88305	3	$185	$68.45	$29.83	$113.79	1.1×	$119.32
maternity
Fetal non-stress test	CPT	59025	3	—	—	$16.93	$101.41	0.54×	$101.41
Routine obstetric care including vaginal delivery	CPT	59400	3	—	—	$2,004.5	$3,660.2	1.6×	$3,921.64
Vaginal delivery only	CPT	59409	3	$2,618	$968.66	$897.66	$1,764.41	0.80×	$1,764.41
Vaginal delivery with postpartum	CPT	59410	3	—	—	$1,039.17	$2,247.23	2.1×	$2,247.23
Routine obstetric care with C-section	CPT	59510	3	—	—	$2,269.84	$4,044.32	1.6×	$4,333.2
C-section delivery only	CPT	59514	3	—	—	$1,035.38	$1,984.36	2.1×	$1,984.36
C-section with postpartum	CPT	59515	2	—	—	$1,250.16	$1,335.96	1.1×	$1,421.75
office
Office visit, new patient, 15-29 min	CPT	99202	3	$354.25	$131.07	$55.48	$78.74	0.91×	$84.36
Office visit, new patient, 30-44 minutes	CPT	99203	3	$447	$165.39	$83.81	$120.41	0.98×	$129.01
Office visit, new patient, 45-59 min	CPT	99204	3	$616.75	$228.2	$140.86	$205.51	1.2×	$220.19
Office visit, new patient, 60-74 min	CPT	99205	3	$750.5	$277.69	$183.33	$264.56	1.2×	$283.45
Office visit, established patient, 5 min	CPT	99211	3	$251	$92.87	$10.21	$14.48	0.22×	$15.51
Office visit, established patient, 10-19 min	CPT	99212	3	$354.25	$131.07	$28.2	$39.37	0.49×	$42.18
Office visit, established patient, 20-29 minutes	CPT	99213	3	$447	$165.39	$55.58	$79.88	0.70×	$85.59
Office visit, established patient, 30-39 minutes	CPT	99214	3	$576.25	$213.21	$85.98	$123.31	0.81×	$132.12
Office visit, established patient, 40-54 min	CPT	99215	3	$714.75	$264.46	$122.03	$173.67	0.92×	$186.07
preventive
Upper GI endoscopy diagnostic	CPT	43235	3	—	—	$139.96	$313.57	0.34×	$313.57
Upper GI endoscopy with biopsy	CPT	43239	3	—	—	$158.31	$370.51	0.38×	$370.51
Sigmoidoscopy diagnostic	CPT	45330	3	—	—	$63.05	$137.29	0.16×	$137.29
Sigmoidoscopy with biopsy	CPT	45331	3	—	—	$81.39	$163.81	0.18×	$163.81
Colonoscopy diagnostic	CPT	45378	3	—	—	$71.28	$468.79	0.53×	$468.79
Colonoscopy with biopsy	CPT	45380	3	—	—	$229.43	$559.28	0.46×	$559.28
Colonoscopy with polyp removal	CPT	45385	3	—	—	$291.15	$664.57	0.55×	$664.57
surgery
Total shoulder arthroplasty	CPT	23472	3	—	—	$1,617.69	$3,101.37	0.75×	$3,101.37
Hip hemiarthroplasty	CPT	27125	3	—	—	$1,251.63	$2,400.12	1.9×	$2,400.12
Total hip replacement	CPT	27130	3	—	—	$1,507.65	$3,058.45	0.71×	$3,058.45
Total knee replacement	CPT	27447	3	—	—	$1,506.93	$3,265.16	0.78×	$3,265.16
Knee revision arthroplasty single component	CPT	27486	3	—	—	$1,561.73	$2,986.69	1.8×	$2,986.69
Knee revision arthroplasty all components	CPT	27487	3	—	—	$1,956.75	$3,735.51	1.9×	$3,735.51
Shoulder arthroscopy with decompression	CPT	29826	3	—	—	$198.08	$374.41	1.1×	$735.71
Shoulder arthroscopy with rotator cuff repair	CPT	29827	3	—	—	$1,167.55	$2,277.66	0.69×	$2,277.66
Knee arthroscopy with meniscectomy	CPT	29881	3	—	—	$593.82	$1,148.19	0.56×	$1,148.19
ACL reconstruction	CPT	29888	3	—	—	$1,090.38	$2,096.7	0.63×	$2,096.7
Major small/large bowel procedures w MCC	MS-DRG	329	13	—	—	$1,506	$5,674.5	0.13×	$18,736
Major small/large bowel procedures w CC	MS-DRG	330	13	—	—	$1,506	$5,674.5	0.24×	$18,736
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	13	—	—	$1,506	$5,674.5	0.35×	$18,736
CABG single arterial graft	CPT	33533	3	—	—	$2,115.74	$4,042.84	2.2×	$4,042.84
CABG 2 arterial grafts	CPT	33534	3	—	—	$2,490.43	$4,779.97	2.2×	$4,779.97
CABG 3 arterial grafts	CPT	33535	3	—	—	$2,781.22	$5,328.32	2.3×	$5,328.32
CABG 4+ arterial grafts	CPT	33536	3	—	—	$2,998.86	$5,708.97	2.3×	$5,708.97
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	13	—	—	$1,506	$5,674.5	0.34×	$18,736
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	13	—	—	$1,506	$5,674.5	0.42×	$18,736
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	13	—	—	$1,506	$5,674.5	0.18×	$18,736
Open appendectomy	CPT	44950	3	—	—	$700.74	$1,365.04	1.2×	$1,365.04
Laparoscopic appendectomy	CPT	44970	3	—	—	$642.08	$1,276.89	0.82×	$1,276.89
Major joint replacement w MCC	MS-DRG	469	13	—	—	$1,506	$5,674.5	0.19×	$18,736
Major joint replacement w/o MCC	MS-DRG	470	13	—	—	$1,506	$5,674.5	0.30×	$18,736
Laparoscopic cholecystectomy	CPT	47562	3	—	—	$735.82	$1,397.79	0.79×	$1,397.79
Lap cholecystectomy with cholangiography	CPT	47563	3	—	—	$799.73	$1,518.69	0.81×	$1,518.69
Hip & femur procedures except major joint w MCC	MS-DRG	480	13	—	—	$1,506	$5,674.5	0.20×	$18,736
Hip & femur procedures except major joint w CC	MS-DRG	481	13	—	—	$1,506	$5,674.5	0.28×	$18,736
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	13	—	—	$1,506	$5,674.5	0.36×	$18,736
Open umbilical hernia repair	CPT	49560	3	—	—	$801.88	$1,565.49	0.82×	$1,565.49
Umbilical hernia repair age 5+	CPT	49585	3	—	—	$469.62	$943.83	0.72×	$943.83
Lap inguinal hernia repair	CPT	49650	3	—	—	$457.03	$909.5	0.81×	$909.5
Lap incisional hernia repair	CPT	49652	3	—	—	$832.13	$1,485.15	0.55×	$1,485.15
Total abdominal hysterectomy	CPT	58150	3	—	—	$1,127.4	$2,162.21	2.2×	$2,162.21
Vaginal hysterectomy	CPT	58260	3	—	—	$912.1	$1,789.37	0.99×	$1,789.37
Lap-assisted vaginal hysterectomy	CPT	58550	3	—	—	$973.9	$1,910.27	1.3×	$1,910.27
Lap-assisted vaginal hysterectomy >250g	CPT	58552	3	—	—	$1,092.88	$2,123.99	0.95×	$2,123.99
Lap salpingo-oophorectomy	CPT	58661	3	—	—	$721.11	$1,393.11	0.69×	$1,393.11
OR procedure for obesity w MCC	MS-DRG	619	13	—	—	$1,506	$5,674.5	0.21×	$18,736
OR procedure for obesity w CC	MS-DRG	620	13	—	—	$1,506	$5,674.5	0.35×	$18,736
OR procedure for obesity w/o CC/MCC	MS-DRG	621	13	—	—	$1,506	$5,674.5	0.37×	$18,736
Complex cataract surgery	CPT	66982	3	—	—	$863.63	$1,733.98	0.78×	$1,733.98
Cataract surgery with lens implant	CPT	66984	3	—	—	$693.12	$1,393.89	0.64×	$1,393.89
Intravitreal injection	CPT	67028	3	—	—	$109.39	$217.63	0.64×	$217.63
Vitrectomy mechanical	CPT	67042	3	—	—	$1,253.81	$3,283.1	1.3×	$3,283.1
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	13	—	—	$1,506	$5,674.5	0.46×	$18,736
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	13	—	—	$1,506	$5,674.5	0.30×	$18,736
PCI single major coronary artery	CPT	92920	3	—	—	$605.5	$1,159.88	0.20×	$19,696
PCI with drug-eluting stent	CPT	92928	3	—	—	$673.91	$1,288.59	0.13×	$21,711
PCI bypass graft	CPT	92937	3	—	—	$673.5	$1,287.04	0.12×	$21,711
Left heart catheterization	CPT	93452	2	—	—	$591.02	$1,821.34	0.59×	$1,821.34
Coronary angiography with cath	CPT	93455	2	—	—	$703.11	$2,166.89	0.69×	$2,166.89
Coronary angiography with bypass cath	CPT	93458	2	—	—	$715.7	$2,234.76	0.72×	$2,234.76

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 16)

Payer	Codes covered	Median rate
Aetna	197	$728.47
Blue Cross Blue Shield	188	$953.19
First Health	177	$163.55
community care - st john network senior - govt	51	$2,284
UnitedHealthcare	43	$13,440
va community care network	40	$2,110
communitycare (select)	40	$2,734.8
communitycare (standard)	40	$2,734.8
connect health benefit	40	$4,568
medica	40	$8,300
smarthealth	40	$1,506
TRICARE	40	$1,982
kempton group administrators	40	$2,284
communitycare senior	11	$89.25
community care smarthealth	1	$600
community care (select) 7/1/13	1	$600

Related data on other Healthparse brands

Explore this hospital across cost reports, quality ratings, and non-profit filings.

HCRIS.io

Medicare cost reports, margins, utilization

Stetho.io

SNF, HHA, hospice, dialysis cost reports + ownership

990Health

IRS Form 990 financials, executive compensation

CareLens

CMS quality ratings, inspections, staffing