▸ Hospital · SD · CCN 431320
Monument Health Lead-deadwood Hospital
61 CHARLES STREET, DEADWOOD, SD, 57732
18 bedsCritical Access Hospitals2
Compliance grade
A
100/100
Procedures tracked
75
of 209 target codes
Payers
30
with negotiated rates
Rates published
38,070
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 3 | $529 | $529 | $143.03 | $200.62 | $200.62 |
| Psychotherapy 30 minutes | CPT | 90832 | 3 | $229 | $229 | $66.11 | $86.85 | $86.85 |
| Psychotherapy 45 minutes | CPT | 90834 | 3 | $302 | $302 | $87.52 | $114.53 | $114.53 |
| Psychotherapy 60 minutes | CPT | 90837 | 3 | $445 | $445 | $129.16 | $168.77 | $168.77 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 33 | $319 | $319 | $48.61 | $309.43 | $319 |
| ED visit level 2 | CPT | 99282 | 33 | $509 | $509 | $78.4 | $493.73 | $509 |
| ED visit level 3 | CPT | 99283 | 33 | $817 | $817 | $65.65 | $792.49 | $817 |
| ED visit level 4 | CPT | 99284 | 33 | $1,327 | $1,327 | $111.68 | $1,287.19 | $1,327 |
| ED visit level 5 | CPT | 99285 | 33 | $1,892 | $1,892 | $161.77 | $1,835.24 | $1,892 |
| Critical care, first hour | CPT | 99291 | 33 | $2,868 | $2,868 | $329.28 | $2,781.96 | $2,868 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 33 | $2,163 | $2,163 | $405.54 | $2,098.11 | $2,163 |
| CT head with contrast | CPT | 70460 | 33 | $2,601 | $2,601 | $474.69 | $2,522.97 | $2,601 |
| CT head with and without contrast | CPT | 70470 | 33 | $3,266 | $3,266 | $590.56 | $3,168.02 | $3,266 |
| CT neck with contrast | CPT | 70491 | 33 | $2,931 | $2,931 | $502.72 | $2,843.07 | $2,931 |
| MRI brain without contrast | CPT | 70551 | 33 | $3,740 | $3,740 | $1,027.87 | $3,627.8 | $3,740 |
| MRI brain with and without contrast | CPT | 70553 | 33 | $5,035 | $5,035 | $1,308.2 | $4,883.95 | $5,035 |
| Chest X-ray single view | CPT | 71045 | 33 | $407 | $407 | $44.85 | $394.79 | $407 |
| Chest X-ray 2 views | CPT | 71046 | 33 | $428 | $428 | $59.8 | $415.16 | $428 |
| CT chest without contrast | CPT | 71250 | 33 | $2,319 | $2,319 | $493.38 | $2,249.43 | $2,319 |
| CT chest with contrast | CPT | 71260 | 33 | $3,110 | $3,110 | $568.13 | $3,016.7 | $3,110 |
| Lumbosacral spine X-ray | CPT | 72100 | 33 | $452 | $452 | $61.67 | $438.44 | $452 |
| CT cervical spine without contrast | CPT | 72125 | 33 | $2,319 | $2,319 | $485.9 | $2,249.43 | $2,319 |
| CT thoracic spine without contrast | CPT | 72128 | 33 | $2,319 | $2,319 | $485.9 | $2,249.43 | $2,319 |
| CT lumbar spine without contrast | CPT | 72131 | 33 | $2,268 | $2,268 | $485.9 | $2,199.96 | $2,268 |
| MRI cervical spine without contrast | CPT | 72141 | 33 | $3,808 | $3,808 | $1,027.87 | $3,693.76 | $3,808 |
| MRI thoracic spine without contrast | CPT | 72146 | 33 | $3,808 | $3,808 | $1,027.87 | $3,693.76 | $3,808 |
| MRI lumbar spine without contrast | CPT | 72148 | 33 | $3,808 | $3,808 | $1,027.87 | $3,693.76 | $3,808 |
| MRI cervical spine with and without contrast | CPT | 72156 | 33 | $5,002 | $5,002 | $1,308.2 | $4,851.94 | $5,002 |
| MRI lumbar spine with contrast | CPT | 72158 | 33 | $5,138 | $5,138 | $1,308.2 | $4,983.86 | $5,138 |
| CT pelvis without contrast | CPT | 72192 | 33 | $2,099 | $2,099 | $476.56 | $2,036.03 | $2,099 |
| CT pelvis with contrast | CPT | 72193 | 33 | $2,573 | $2,573 | $532.63 | $2,495.81 | $2,573 |
| Shoulder X-ray | CPT | 73030 | 33 | $398 | $398 | $14.8 | $386.06 | $398 |
| Humerus X-ray | CPT | 73060 | 33 | $341 | $341 | $52.33 | $330.77 | $341 |
| Hand X-ray 3 views | CPT | 73130 | 33 | $349 | $349 | $52.33 | $338.53 | $349 |
| MRI upper extremity joint without contrast | CPT | 73221 | 33 | $4,183 | $4,183 | $1,027.87 | $4,057.51 | $4,183 |
| Knee X-ray 1-2 views | CPT | 73560 | 33 | $314 | $314 | $46.72 | $304.58 | $314 |
| Ankle X-ray 3 views | CPT | 73610 | 33 | $325 | $325 | $52.33 | $315.25 | $325 |
| MRI lower extremity joint without contrast | CPT | 73721 | 33 | $3,692 | $3,692 | $1,027.87 | $3,581.24 | $3,692 |
| CT abdomen with contrast | CPT | 74160 | 33 | $3,545 | $3,545 | $556.92 | $3,438.65 | $3,545 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 33 | $4,158 | $4,158 | $388.72 | $4,033.26 | $4,158 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 33 | $5,471 | $5,471 | $609.25 | $5,306.87 | $5,471 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 33 | $5,294 | $5,294 | $771.84 | $5,135.18 | $5,294 |
| MRI abdomen with and without contrast | CPT | 74183 | 33 | $5,073 | $5,073 | $1,308.2 | $4,920.81 | $5,073 |
| Abdominal ultrasound complete | CPT | 76700 | 33 | $1,344 | $1,344 | $192.49 | $1,303.68 | $1,344 |
| Abdominal ultrasound limited | CPT | 76705 | 33 | $1,025 | $1,025 | $143.9 | $994.25 | $1,025 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 33 | $1,025 | $1,025 | $186.89 | $994.25 | $1,025 |
| Transvaginal ultrasound | CPT | 76830 | 33 | $675 | $675 | $186.89 | $654.75 | $675 |
| Scrotal ultrasound | CPT | 76870 | 33 | $1,147 | $1,147 | $149.51 | $1,112.59 | $1,147 |
| Screening mammography bilateral | CPT | 77067 | 33 | $564 | $564 | $208.68 | $547.08 | $564 |
| EKG complete | CPT | 93000 | 3 | $51 | $51 | $13.68 | $18.58 | $19.34 |
| EKG tracing only | CPT | 93005 | 33 | $281 | $281 | $25.75 | $272.57 | $281 |
| EKG interpretation only | CPT | 93010 | 3 | $25 | $25 | $7.66 | $9.48 | $9.48 |
| Transthoracic echocardiogram complete | CPT | 93306 | 33 | $2,796 | $2,796 | $470.02 | $2,712.12 | $2,796 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 33 | $172 | $172 | $13.54 | $166.84 | $172 |
| Comprehensive metabolic panel | CPT | 80053 | 33 | $192 | $192 | $16.78 | $186.24 | $192 |
| Lipid panel | CPT | 80061 | 33 | $129 | $129 | $21.66 | $125.13 | $129 |
| Renal function panel | CPT | 80069 | 33 | $167 | $167 | $14.08 | $161.99 | $167 |
| Hepatic function panel | CPT | 80076 | 33 | $167 | $167 | $12.99 | $161.99 | $167 |
| Urinalysis automated | CPT | 81003 | 33 | $47 | $47 | $3.79 | $45.59 | $47 |
| Glucose quantitative | CPT | 82947 | 33 | $71 | $71 | $6.5 | $68.87 | $71 |
| Hemoglobin A1c | CPT | 83036 | 33 | $88 | $88 | $15.17 | $40.18 | $88 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 33 | $192 | $192 | $9.99 | $79.24 | $192 |
| Complete blood count with automated differential | CPT | 85025 | 33 | $129 | $129 | $12.45 | $125.13 | $129 |
| Complete blood count without differential | CPT | 85027 | 33 | $102 | $102 | $10.29 | $98.94 | $102 |
| Urine culture identification | CPT | 87088 | 33 | $77 | $77 | $12.99 | $74.69 | $77 |
| Tissue exam by pathologist level IV | CPT | 88305 | 33 | $323 | $323 | $83.62 | $221.48 | $323 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 3 | $216 | $216 | $44.55 | $81.92 | $81.92 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 3 | $330 | $330 | $76.66 | $125.15 | $125.15 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 3 | $492 | $492 | $125.14 | $186.59 | $186.59 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 3 | $651 | $651 | $170.14 | $246.89 | $246.89 |
| Office visit, established patient, 5 min | CPT | 99211 | 3 | $70 | $70 | $8.31 | $26.55 | $26.55 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 3 | $168 | $168 | $33.17 | $63.71 | $63.71 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 3 | $269 | $269 | $62.16 | $102.02 | $102.02 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 3 | $381 | $381 | $91.8 | $144.49 | $144.49 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 3 | $535 | $535 | $136.02 | $202.9 | $202.9 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| Medicare | 75 | $175.01 |
| UnitedHealthcare | 75 | $788.47 |
| Blue Cross Blue Shield | 75 | $388.73 |
| Cigna | 60 | $1,014.75 |
| coresource 38225 [3081146] | 60 | $922.5 |
| employee benefit management 12x44 [3081079] | 60 | $922.5 |
| fedmed inc [3081283] | 60 | $994.25 |
| govt employees health assn [3081090] | 60 | $1,004.5 |
| Health Net | 60 | $379.25 |
| health partners sx009 [3081102] | 60 | $1,124.06 |
| healthpartners [3081368] | 60 | $1,064.28 |
| Humana | 60 | $1,025 |
| key benefit administrators [3081332] | 60 | $1,014.75 |
| medica (commercial) 94265 [3081118] | 60 | $1,004.5 |
| Meritain Health | 60 | $1,014.75 |
| midlands choice 47080 [3081136] | 60 | $1,014.75 |
| national telephone cooperative assn 52103 [3081149] | 60 | $1,004.5 |
| pacificsource health plans [3081333] | 60 | $922.5 |
| preferred one 41147 [3081160] | 60 | $1,014.75 |
| risk admin svs [3081167] | 60 | $405.54 |
| rocky mountain admin llc 83028 [3081168] | 60 | $922.5 |
| sanford health plan 91184 [3081174] | 60 | $994.25 |
| surest [3081369] | 60 | $1,004.5 |
| tlc advantage llc [3081189] | 60 | $963.5 |
| TRICARE | 60 | $448.2 |
| triwest healthcare alliance [3081322] | 60 | $379.25 |
| va black hills health care system 12115 [3081206] | 60 | $379.25 |
| va black hills health care system 12115 [3081207] | 60 | $379.25 |
| va ccn optum [3081339] | 60 | $379.25 |
| Aetna | 60 | $973.75 |