Does Ascension NE Wisconsin - St. Elizabeth Campus publish its standard charges and chargemaster?

Yes. Ascension NE Wisconsin - St. Elizabeth Campus publishes a machine-readable file with 15,828 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 NE Wisconsin - St. Elizabeth Campus charge for procedures?

Ascension NE Wisconsin - St. Elizabeth Campus (Appleton, WI) 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 · WI · CCN 520009

Ascension NE Wisconsin - St. Elizabeth Campus

Appleton, WI, 54915

244 bedsAcute Care Hospitals1

Compliance grade

100/100

Rates published

15,828

last crawl 2026-05-24

Procedures tracked

198

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All WI 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/wi-csv/390816818-1407803638_ascension-ne-wisconsin-inc-fka-st-elizabeth-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	9	—	—	$1,690	$9,371.76	0.73×	$25,008
Psychiatric diagnostic evaluation	CPT	90791	9	$1,470	$837.9	$154.46	$162.18	0.92×	$476.78
Psychiatric eval with medical services	CPT	90792	9	$798	$454.86	$154.46	$183.95	1.1×	$528.09
Psychotherapy 30 minutes	CPT	90832	9	$551	$314.07	$74.83	$154.46	1.0×	$324.37
Psychotherapy 45 minutes	CPT	90834	9	$773	$440.61	$99.06	$162.18	1.0×	$324.37
Psychotherapy 60 minutes	CPT	90837	9	$890	$507.3	$146.18	$162.18	0.85×	$464.04
Crisis psychotherapy 60 minutes	CPT	90839	8	$1,296	$738.72	$141	$158.32	1.00×	$484.52
emergency
ED visit level 1	CPT	99281	14	$462	$263.34	$11.83	$86.77	0.62×	$444
ED visit level 2	CPT	99282	14	$809	$461.13	$43.4	$156.05	0.66×	$778
ED visit level 3	CPT	99283	14	$1,386	$790.02	$73.88	$272.85	0.67×	$1,537
ED visit level 4	CPT	99284	14	$2,197	$1,252.29	$125.71	$429.84	0.64×	$2,890
ED visit level 5	CPT	99285	14	$3,434	$1,957.38	$182.14	$604.15	0.58×	$3,383
Critical care, first hour	CPT	99291	13	$2,432	$1,386.24	$222.55	$810.05	0.76×	$4,444
imaging
CT head without contrast	CPT	70450	9	$1,225	$698.25	$42.89	$107.34	0.52×	$391.59
CT head with contrast	CPT	70460	9	$1,348	$768.36	$57.14	$179.7	0.77×	$513.63
CT head with and without contrast	CPT	70470	9	$1,470	$837.9	$64.27	$179.7	0.67×	$518.95
CT neck with contrast	CPT	70491	9	$668	$380.76	$69.8	$179.7	0.66×	$635.98
MRI brain without contrast	CPT	70551	9	$1,532	$873.24	$74.72	$244	0.60×	$1,021.72
MRI brain with contrast	CPT	70552	9	$1,694	$965.58	$89.95	$360.5	0.75×	$1,140.74
MRI brain with and without contrast	CPT	70553	9	$2,056	$1,171.92	$115.4	$360.5	0.61×	$1,336.86
Chest X-ray single view	CPT	71045	8	$99	$56.43	$8.97	$72.76	0.77×	$177.77
Chest X-ray 2 views	CPT	71046	8	$322	$183.54	$11.18	$81.34	0.83×	$177.77
Chest X-ray 3 views	CPT	71047	8	$355	$202.35	$14.11	$84.65	0.88×	$177.77
CT chest without contrast	CPT	71250	9	$659	$375.63	$54.56	$141.78	0.66×	$498.17
CT chest with contrast	CPT	71260	9	$834	$475.38	$58.97	$179.7	0.64×	$622.83
CT chest with and without contrast	CPT	71270	9	$1,001	$570.57	$63.04	$179.7	0.62×	$755.05
MRI chest without contrast	CPT	71550	9	$1,243	$708.51	$73.62	$244	0.57×	$1,116.1
MRI chest with contrast	CPT	71551	9	—	—	$87.37	$797.51	0.98×	$1,595.01
MRI chest with and without contrast	CPT	71552	9	$1,831	$1,043.67	$113.92	$360.5	0.60×	$1,577.7
Lumbosacral spine X-ray	CPT	72100	9	$174	$99.18	$11.54	$90.77	0.88×	$214.68
CT cervical spine without contrast	CPT	72125	9	$668	$380.76	$50.39	$122.37	0.61×	$509.45
CT thoracic spine without contrast	CPT	72128	9	$502	$286.14	$50.39	$122.37	0.61×	$498.9
CT lumbar spine without contrast	CPT	72131	9	$648	$369.36	$50.39	$122.36	0.60×	$497.32
MRI cervical spine without contrast	CPT	72141	9	$1,521	$866.97	$74.72	$244	0.61×	$904.76
MRI thoracic spine without contrast	CPT	72146	9	$1,418	$808.26	$74.72	$244	0.65×	$906.34
MRI lumbar spine without contrast	CPT	72148	9	$2,547	$1,451.79	$75.07	$244	0.65×	$892.44
MRI lumbar spine with and without contrast	CPT	72149	9	$2,647	$1,508.79	$90.07	$360.5	0.79×	$1,124.85
MRI cervical spine with and without contrast	CPT	72156	9	$1,878	$1,070.46	$115.76	$360.5	0.67×	$1,337.67
MRI lumbar spine with contrast	CPT	72158	9	$1,931	$1,100.67	$115.76	$360.5	0.66×	$1,308.41
CT pelvis without contrast	CPT	72192	9	$585	$333.45	$54.94	$132.98	0.67×	$412.69
CT pelvis with contrast	CPT	72193	9	$752	$428.64	$58.62	$179.7	0.64×	$649.54
Shoulder X-ray	CPT	73030	9	$182	$103.74	$9.69	$78.69	0.85×	$177.77
Humerus X-ray	CPT	73060	9	$124	$70.68	$8.23	$74.35	0.83×	$177.77
Hand X-ray 3 views	CPT	73130	9	$182	$103.74	$8.96	$82.88	0.89×	$177.77
MRI upper extremity joint without contrast	CPT	73221	9	$1,852	$1,055.64	$68.68	$244	0.59×	$658.68
MRI upper extremity joint with and without contrast	CPT	73223	9	$2,052	$1,169.64	$108.99	$360.5	0.59×	$1,281.31
Hip X-ray 2 views	CPT	73510	1	—	—	$25.86	$68.72	0.91×	$94.58
Knee X-ray 1-2 views	CPT	73560	9	$125	$71.25	$8.59	$79.46	0.85×	$177.77
Ankle X-ray 3 views	CPT	73610	9	$182	$103.74	$8.96	$82.88	0.90×	$177.77
MRI lower extremity joint without contrast	CPT	73721	9	$1,626	$926.82	$68.68	$244	0.52×	$658.68
MRI lower extremity joint with and without contrast	CPT	73723	9	$1,838	$1,047.66	$108.63	$360.5	0.57×	$1,280.51
CT abdomen without contrast	CPT	74150	9	$543	$309.51	$60.09	$143.12	0.76×	$421.07
CT abdomen with contrast	CPT	74160	9	$771	$439.47	$64.27	$179.7	0.63×	$661.03
CT abdomen with and without contrast	CPT	74170	9	$917	$522.69	$70.54	$179.7	0.54×	$761.12
CT abdomen and pelvis without contrast	CPT	74176	9	$1,251	$713.07	$87.75	$244	0.67×	$544.08
CT abdomen and pelvis with contrast	CPT	74177	9	$1,418	$808.26	$91.8	$360.5	0.66×	$818.18
CT abdomen and pelvis with and without contrast	CPT	74178	9	$1,501	$855.57	$101.15	$360.5	0.63×	$957.81
MRI abdomen without contrast	CPT	74181	9	$1,356	$772.92	$73.62	$244	0.63×	$893.85
MRI abdomen with and without contrast	CPT	74183	9	$2,547	$1,451.79	$110.85	$360.5	0.64×	$1,374.53
Abdominal ultrasound complete	CPT	76700	9	$752	$428.64	$40.68	$107.34	0.72×	$335.12
Abdominal ultrasound limited	CPT	76705	9	$721	$410.97	$29.5	$107.34	0.73×	$257.75
Retroperitoneal ultrasound complete	CPT	76770	9	$721	$410.97	$37.36	$107.34	0.75×	$315.83
Obstetric ultrasound first trimester	CPT	76801	9	$258	$147.06	$50.25	$121.47	0.86×	$302.71
Obstetric ultrasound after first trimester	CPT	76805	9	$317	$180.69	$50.6	$121.47	0.80×	$353.52
Obstetric ultrasound with fetal anatomy	CPT	76811	9	—	—	$97.38	$232.38	0.99×	$488
Transvaginal ultrasound	CPT	76830	9	$289	$164.73	$35.01	$107.34	0.73×	$295.64
Pelvic ultrasound complete	CPT	76856	9	$444	$253.08	$34.66	$107.34	0.75×	$296.97
Scrotal ultrasound	CPT	76870	9	$408	$232.56	$32.08	$107.34	0.82×	$296.46
Diagnostic mammography unilateral	CPT	77065	8	$1,000	$570	$41.04	$92.24	0.62×	$321.38
Diagnostic mammography bilateral	CPT	77066	8	$1,249	$711.93	$50.39	$115.42	0.61×	$405.5
Screening mammography bilateral	CPT	77067	8	$551	$314.07	$38.46	$91.54	0.58×	$327.96
EKG complete	CPT	93000	4	—	—	$15.15	$15.15	0.62×	$55.09
EKG tracing only	CPT	93005	9	$253	$144.21	$6.55	$57.1	0.48×	$119.91
EKG interpretation only	CPT	93010	4	—	—	$8.6	$8.6	0.48×	$28.09
Transthoracic echocardiogram complete	CPT	93306	9	$3,024	$1,723.68	$73.25	$527.11	0.88×	$1,106.93
Transthoracic echocardiogram	CPT	93307	9	$2,798	$1,594.86	$46.09	$232.38	0.94×	$488
Stress echocardiogram	CPT	93350	9	$1,419	$808.83	$73.25	$527.11	1.0×	$1,106.93
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	6	—	—	$10,209	$14,293	0.93×	$31,323
COPD w MCC	MS-DRG	190	6	—	—	$7,236.57	$10,131	0.90×	$20,169
COPD w CC	MS-DRG	191	6	—	—	$5,507.29	$7,710.21	0.87×	$15,538
COPD w/o CC/MCC	MS-DRG	192	6	—	—	$4,194.17	$5,871.84	0.84×	$11,746
Simple pneumonia & pleurisy w CC	MS-DRG	194	6	—	—	$5,264.92	$7,370.89	0.87×	$15,048
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	6	—	—	$4,105.97	$5,748.36	0.86×	$11,450
AMI discharged alive w MCC	MS-DRG	280	6	—	—	$10,480	$14,671	0.94×	$29,036
AMI discharged alive w CC	MS-DRG	281	6	—	—	$6,004.45	$8,406.23	0.87×	$16,710
AMI discharged alive w/o CC/MCC	MS-DRG	282	6	—	—	$4,723.99	$6,613.59	0.85×	$13,143
Heart failure & shock w MCC	MS-DRG	291	6	—	—	$8,387.03	$11,742	0.92×	$23,498
Heart failure & shock w CC	MS-DRG	292	6	—	—	$5,546.49	$7,765.09	0.87×	$15,676
Heart failure & shock w/o CC/MCC	MS-DRG	293	6	—	—	$3,697.66	$5,176.72	0.83×	$10,277
Cardiac arrhythmia w MCC	MS-DRG	308	6	—	—	$7,865.7	$11,012	0.91×	$22,003
Cardiac arrhythmia w CC	MS-DRG	309	6	—	—	$4,806.31	$6,728.83	0.87×	$13,630
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	6	—	—	$3,698.31	$5,177.63	0.83×	$10,121
GI hemorrhage w CC	MS-DRG	378	6	—	—	$6,406.88	$8,969.63	0.90×	$18,006
GI hemorrhage w/o CC/MCC	MS-DRG	379	6	—	—	$4,118.38	$5,765.73	0.84×	$11,589
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	6	—	—	$5,093.1	$7,130.34	0.89×	$14,378
Fractures of femur w/o MCC	MS-DRG	533	6	—	—	$10,242	$14,338	0.94×	$29,858
Kidney/UTI w MCC	MS-DRG	689	6	—	—	$7,580.21	$10,612	0.91×	$21,494
Kidney/UTI w/o MCC	MS-DRG	690	6	—	—	$5,288.44	$7,403.82	0.89×	$14,768
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	6	—	—	$12,690	$17,766	0.95×	$36,286
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	6	—	—	$6,685.19	$9,359.27	0.90×	$18,849
Initial hospital care, low complexity	CPT	99221	4	$361	$205.77	$86.18	$86.18	0.93×	$221.19
Initial hospital care, moderate complexity	CPT	99222	4	$487	$277.59	$137.23	$137.23	0.81×	$300.69
Initial hospital care, high complexity	CPT	99223	4	$717	$408.69	$182.93	$182.93	0.81×	$443.71
Hospital discharge, <30 min	CPT	99238	4	$258	$147.06	$85.82	$85.82	1.0×	$160.17
Hospital discharge, >30 min	CPT	99239	4	$378	$215.46	$121.25	$121.25	1.00×	$235.51
lab
Basic metabolic panel (BMP)	CPT	80048	13	$117	$66.69	$8.46	$11.67	0.36×	$59.96
General health panel	CPT	80050	3	$161	$91.77	$55.18	$61.92	0.58×	$61.92
Electrolyte panel	CPT	80051	13	$63	$35.91	$7.01	$9.67	0.41×	$49.74
Comprehensive metabolic panel	CPT	80053	13	$138	$78.66	$10.56	$14.57	0.33×	$74.89
Lipid panel	CPT	80061	13	$89	$50.73	$13.39	$18.75	0.49×	$94.94
Renal function panel	CPT	80069	13	$114	$64.98	$8.68	$11.98	0.44×	$61.56
Hepatic function panel	CPT	80076	13	$114	$64.98	$8.17	$11.27	0.42×	$31.54
Urinalysis non-automated	CPT	81002	13	$7	$3.99	$3.48	$3.65	0.52×	$13.43
Urinalysis automated	CPT	81003	13	$24	$13.68	$2.25	$3.11	0.22×	$15.91
Glucose quantitative	CPT	82947	13	$17	$9.69	$3.93	$5.5	0.31×	$27.85
Hemoglobin A1c	CPT	83036	13	$60	$34.2	$9.71	$13.59	0.50×	$68.86
Thyroid stimulating hormone (TSH)	CPT	84443	13	$104	$59.28	$16.8	$23.52	0.50×	$119.17
Complete blood count with automated differential	CPT	85025	13	$49	$27.93	$7.77	$10.88	0.41×	$49.56
Complete blood count without differential	CPT	85027	13	$41	$23.37	$6.47	$8.93	0.41×	$24.97
Urine culture bacterial	CPT	87086	13	$76	$43.32	$8.07	$11.14	0.48×	$31.15
Urine culture identification	CPT	87088	13	$37	$21.09	$8.09	$11.16	0.50×	$31.23
Tissue exam by pathologist level IV	CPT	88305	10	$676	$385.32	$39.5	$53.12	0.52×	$165.29
maternity
Fetal non-stress test	CPT	59025	10	$454	$258.78	$28.86	$169.43	0.90×	$417.68
Routine obstetric care including vaginal delivery	CPT	59400	4	—	—	$2,425.82	$2,425.82	1.1×	$5,571.02
Vaginal delivery only	CPT	59409	4	—	—	$788.43	$788.43	0.36×	$2,110.56
Vaginal delivery with postpartum	CPT	59410	4	—	—	$1,069.8	$1,069.8	1.0×	$2,721.49
Routine obstetric care with C-section	CPT	59510	4	—	—	$2,670.36	$2,670.36	1.1×	$6,132.4
C-section delivery only	CPT	59514	4	—	—	$885.84	$885.84	0.93×	$2,369.03
C-section with postpartum	CPT	59515	4	—	—	$1,316.09	$1,316.09	1.0×	$3,290
office
Office visit, new patient, 15-29 min	CPT	99202	4	$244	$139.08	$49.93	$49.93	0.58×	$164.91
Office visit, new patient, 30-44 minutes	CPT	99203	4	$351	$200.07	$85.89	$85.89	0.70×	$233.8
Office visit, new patient, 45-59 min	CPT	99204	4	$537	$306.09	$140.21	$140.21	0.81×	$357.24
Office visit, new patient, 60-74 min	CPT	99205	4	$668	$380.76	$190.58	$190.58	0.86×	$451.68
Office visit, established patient, 5 min	CPT	99211	4	$228	$129.96	$9.33	$9.33	0.14×	$50.56
Office visit, established patient, 10-19 min	CPT	99212	4	$986	$562.02	$37.18	$37.18	0.46×	$98.51
Office visit, established patient, 20-29 minutes	CPT	99213	4	$369	$210.33	$69.68	$69.68	0.61×	$163.26
Office visit, established patient, 30-39 minutes	CPT	99214	4	$393	$224.01	$102.92	$102.92	0.67×	$237.46
Office visit, established patient, 40-54 min	CPT	99215	4	$469	$267.33	$152.42	$152.42	0.81×	$319.23
preventive
Upper GI endoscopy diagnostic	CPT	43235	9	$2,787	$1,588.59	$126.8	$901.33	0.98×	$1,892.79
Upper GI endoscopy with biopsy	CPT	43239	9	—	—	$143.11	$901.33	0.93×	$1,892.79
Sigmoidoscopy diagnostic	CPT	45330	9	—	—	$58.84	$876.48	1.0×	$1,840.61
Sigmoidoscopy with biopsy	CPT	45331	9	—	—	$75.04	$876.48	0.98×	$1,840.61
Colonoscopy diagnostic	CPT	45378	9	—	—	$189.87	$876.48	1.00×	$1,840.61
Colonoscopy with biopsy	CPT	45380	4	—	—	$206.66	$206.66	0.17×	$1,547.7
Colonoscopy with polyp removal	CPT	45385	4	—	—	$261.49	$261.49	0.22×	$1,614.68
surgery
Total shoulder arthroplasty	CPT	23472	4	—	—	$1,482.79	$1,482.79	0.36×	$5,185.46
Hip hemiarthroplasty	CPT	27125	7	—	—	$1,164.81	$3,237.89	2.6×	$40,016
Total hip replacement	CPT	27130	7	—	—	$1,315.64	$3,962.39	0.91×	$40,016
Total knee replacement	CPT	27447	7	—	—	$1,313.97	$4,064.77	0.98×	$40,016
Knee revision arthroplasty single component	CPT	27486	7	—	—	$1,439.88	$4,020.97	2.4×	$40,016
Knee revision arthroplasty all components	CPT	27487	7	—	—	$1,790.3	$5,020.59	2.5×	$40,016
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$173.24	$173.24	0.53×	$620.93
Shoulder arthroscopy with rotator cuff repair	CPT	29827	4	—	—	$1,104.34	$1,104.34	0.34×	$3,824.63
Knee arthroscopy with meniscectomy	CPT	29881	4	—	—	$567.3	$567.3	0.28×	$1,936.69
ACL reconstruction	CPT	29888	4	—	—	$1,007.95	$1,007.95	0.30×	$3,505.13
Major small/large bowel procedures w MCC	MS-DRG	329	6	—	—	$30,029	$42,040	0.98×	$82,666
Major small/large bowel procedures w CC	MS-DRG	330	6	—	—	$15,661	$21,925	0.94×	$43,414
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	6	—	—	$10,994	$15,392	0.94×	$30,601
CABG single arterial graft	CPT	33533	4	—	—	$1,830.61	$1,830.61	0.98×	$6,542.78
CABG 2 arterial grafts	CPT	33534	4	—	—	$2,148.65	$2,148.65	1.0×	$7,686
CABG 3 arterial grafts	CPT	33535	4	—	—	$2,387.66	$2,387.66	1.1×	$8,568.11
CABG 4+ arterial grafts	CPT	33536	4	—	—	$2,572.45	$2,572.45	1.1×	$9,233.29
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	6	—	—	$11,051	$15,472	0.94×	$29,918
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	6	—	—	$8,922.73	$12,492	0.92×	$24,034
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	6	—	—	$22,258	$31,162	0.96×	$58,581
Open appendectomy	CPT	44950	4	—	—	$645.4	$645.4	0.57×	$2,268.3
Laparoscopic appendectomy	CPT	44970	4	—	—	$609.18	$609.18	0.39×	$2,123.14
Major joint replacement w MCC	MS-DRG	469	6	—	—	$19,816	$27,742	0.94×	$60,942
Major joint replacement w/o MCC	MS-DRG	470	6	—	—	$12,601	$17,642	0.93×	$34,439
Laparoscopic cholecystectomy	CPT	47562	4	—	—	$665.89	$665.89	0.38×	$2,324.78
Lap cholecystectomy with cholangiography	CPT	47563	4	—	—	$723.39	$723.39	0.39×	$2,529.64
Hip & femur procedures except major joint w MCC	MS-DRG	480	6	—	—	$19,026	$26,636	0.95×	$53,971
Hip & femur procedures except major joint w CC	MS-DRG	481	6	—	—	$13,683	$19,157	0.94×	$37,975
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	6	—	—	$10,655	$14,917	0.93×	$29,071
Open umbilical hernia repair	CPT	49560	3	—	—	$1,571.27	$3,304.47	1.7×	$3,304.47
Umbilical hernia repair age 5+	CPT	49585	3	—	—	$955.14	$1,999.87	1.5×	$1,999.87
Lap inguinal hernia repair	CPT	49650	4	—	—	$440.73	$440.73	0.39×	$1,521.19
Lap incisional hernia repair	CPT	49652	3	—	—	$1,517.22	$3,330.25	1.2×	$3,330.25
Total abdominal hysterectomy	CPT	58150	4	—	—	$1,052.32	$1,052.32	1.1×	$3,643.65
Vaginal hysterectomy	CPT	58260	4	—	—	$870.4	$870.4	0.48×	$3,019.09
Lap-assisted vaginal hysterectomy	CPT	58550	4	—	—	$913.99	$913.99	0.62×	$3,189.75
Lap-assisted vaginal hysterectomy >250g	CPT	58552	4	—	—	$1,015.01	$1,015.01	0.46×	$3,553.09
Lap salpingo-oophorectomy	CPT	58661	4	—	—	$674.48	$674.48	0.33×	$2,347.88
OR procedure for obesity w MCC	MS-DRG	619	6	—	—	$18,863	$26,409	0.97×	$50,888
OR procedure for obesity w CC	MS-DRG	620	6	—	—	$10,455	$14,637	0.90×	$29,690
OR procedure for obesity w/o CC/MCC	MS-DRG	621	6	—	—	$9,854.33	$13,796	0.91×	$27,770
Complex cataract surgery	CPT	66982	4	—	—	$786.85	$786.85	0.35×	$2,729.06
Cataract surgery with lens implant	CPT	66984	4	—	—	$574.8	$574.8	0.26×	$1,990.05
Intravitreal injection	CPT	67028	9	—	—	$96.43	$318.87	0.93×	$669.63
Vitrectomy mechanical	CPT	67042	4	—	—	$1,202.61	$1,202.61	0.48×	$4,187.14
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	6	—	—	$8,105.46	$11,348	0.92×	$21,267
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	8	—	—	$1,790.68	$14,056	0.73×	$34,452
PCI single major coronary artery	CPT	92920	5	$21,084	$12,018	$514.98	$790.9	0.14×	$21,365
PCI with drug-eluting stent	CPT	92928	5	$40,726	$23,214	$573.01	$878.69	0.09×	$22,700
PCI bypass graft	CPT	92937	5	$40,726	$23,214	$572.76	$877.86	0.08×	$22,700
Left heart catheterization	CPT	93452	4	$7,820	$4,457.4	$233.2	$760.53	0.25×	$2,963.14
Coronary angiography with cath	CPT	93455	4	$19,207	$10,948	$274.26	$893.68	0.29×	$3,371.79
Coronary angiography with bypass cath	CPT	93458	4	$19,207	$10,948	$290.49	$946.97	0.30×	$3,472.54

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 18)

Payer	Codes covered	Median rate
Anthem BCBS	193	$99.06
centivo nw1	157	$268.07
centivo nw3	157	$268.07
cchp	150	$313.66
smarthealth	136	$239.6
WellCare	136	$179.7
Medicare	136	$171.14
Molina	136	$359.39
VA Health	136	$171.14
sehn	22	$17.66
network health plan	22	$20.67
alliance	21	$12.42
Cigna	21	$33.5
aca	13	$5,500
UnitedHealthcare	9	$3,173
trilogy	5	$29,489
arise	1	$1,690
wps	1	$1,690

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