▸ Hospital · WI · CCN 520089
Unitypoint Health - Meriter
202 SOUTH PARK STREET, MADISON, WI, 53715-1596
332 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
14
with negotiated rates
Rates published
71,204
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 12 | — | — | $11,219 | $15,210 | $35,013 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 14 | $733 | $586.4 | $67.39 | $226.85 | $696.35 |
| Psychiatric eval with medical services | CPT | 90792 | 14 | $786.98 | $629.59 | $61.64 | $234.5 | $747.63 |
| Psychotherapy 30 minutes | CPT | 90832 | 14 | $307 | $245.6 | $28.06 | $102.4 | $291.65 |
| Psychotherapy 45 minutes | CPT | 90834 | 14 | $425 | $340 | $38.64 | $135.51 | $403.75 |
| Psychotherapy 60 minutes | CPT | 90837 | 14 | $617 | $493.6 | $68.77 | $182.55 | $586.15 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 14 | $836.15 | $668.92 | $38.64 | $236.59 | $794.34 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 14 | $469.27 | $375.42 | $10.27 | $52.25 | $1,619 |
| ED visit level 2 | CPT | 99282 | 14 | $899.98 | $719.99 | $12.65 | $88.07 | $1,619 |
| ED visit level 3 | CPT | 99283 | 14 | $1,630.18 | $1,304.15 | $12.65 | $138.55 | $2,158 |
| ED visit level 4 | CPT | 99284 | 14 | $2,594.98 | $2,075.99 | $12.65 | $199.47 | $3,880 |
| ED visit level 5 | CPT | 99285 | 14 | $3,751.36 | $3,001.09 | $12.65 | $317.45 | $3,880 |
| Critical care, first hour | CPT | 99291 | 14 | $5,431.07 | $4,344.86 | $95.45 | $813.89 | $5,159.52 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 14 | $2,413.04 | $1,930.44 | $37.52 | $127.79 | $2,292.39 |
| CT head with contrast | CPT | 70460 | 14 | $3,728.52 | $2,982.82 | $49.78 | $182.39 | $3,542.09 |
| CT head with and without contrast | CPT | 70470 | 14 | $4,156.39 | $3,325.12 | $55.96 | $217.41 | $3,948.57 |
| CT neck with contrast | CPT | 70491 | 14 | $3,728.52 | $2,982.82 | $60.76 | $268.68 | $3,542.09 |
| MRI brain without contrast | CPT | 70551 | 14 | $2,655.68 | $2,124.55 | $65.03 | $325.09 | $2,522.9 |
| MRI brain with contrast | CPT | 70552 | 14 | $3,308.82 | $2,647.06 | $78.55 | $480.7 | $3,143.38 |
| MRI brain with and without contrast | CPT | 70553 | 14 | $3,962.09 | $3,169.68 | $100.85 | $547.95 | $3,763.99 |
| Chest X-ray single view | CPT | 71045 | 14 | $645.56 | $516.45 | $8.1 | $48.26 | $613.28 |
| Chest X-ray 2 views | CPT | 71046 | 14 | $659.9 | $527.92 | $9.7 | $62.46 | $626.91 |
| Chest X-ray 3 views | CPT | 71047 | 14 | $681.44 | $545.16 | $12.25 | $61.35 | $647.37 |
| CT chest without contrast | CPT | 71250 | 14 | $3,968.25 | $3,174.6 | $47.54 | $219.25 | $3,769.84 |
| CT chest with contrast | CPT | 71260 | 14 | $6,131.56 | $4,905.25 | $51.37 | $292.73 | $5,824.98 |
| CT chest with and without contrast | CPT | 71270 | 14 | $6,835.19 | $5,468.16 | $55.01 | $357.65 | $6,493.43 |
| MRI chest without contrast | CPT | 71550 | 14 | $2,582.7 | $2,066.16 | $64.38 | $594.02 | $2,453.57 |
| MRI chest with contrast | CPT | 71551 | 9 | — | — | $76.01 | $351.52 | $1,163.53 |
| MRI chest with and without contrast | CPT | 71552 | 14 | $4,426.13 | $3,540.91 | $99.57 | $968.16 | $4,204.82 |
| Lumbosacral spine X-ray | CPT | 72100 | 14 | $751.29 | $601.04 | $10.01 | $84.84 | $713.73 |
| CT cervical spine without contrast | CPT | 72125 | 14 | $3,982.82 | $3,186.26 | $43.92 | $230.97 | $3,783.68 |
| CT thoracic spine without contrast | CPT | 72128 | 14 | $3,880.15 | $3,104.12 | $43.92 | $230.97 | $3,686.14 |
| CT lumbar spine without contrast | CPT | 72131 | 14 | $3,983.93 | $3,187.15 | $43.92 | $229.41 | $3,784.73 |
| MRI cervical spine without contrast | CPT | 72141 | 14 | $2,648.54 | $2,118.84 | $65.34 | $312.3 | $2,516.11 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | $2,532.03 | $2,025.63 | $65.34 | $312.3 | $2,405.43 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | $2,648.54 | $2,118.84 | $65.34 | $313.08 | $2,516.11 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | $3,926.41 | $3,141.13 | $78.77 | $484.61 | $3,730.09 |
| MRI cervical spine with and without contrast | CPT | 72156 | 14 | $3,926.41 | $3,141.13 | $101.16 | $554.2 | $3,730.09 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | $3,926.41 | $3,141.13 | $101.16 | $552.65 | $3,730.09 |
| CT pelvis without contrast | CPT | 72192 | 14 | $3,968.25 | $3,174.6 | $47.87 | $182.45 | $3,769.84 |
| CT pelvis with contrast | CPT | 72193 | 14 | $6,131.56 | $4,905.25 | $51.06 | $382.88 | $5,824.98 |
| Shoulder X-ray | CPT | 73030 | 14 | $751.29 | $601.04 | $8.41 | $61.9 | $713.73 |
| Humerus X-ray | CPT | 73060 | 14 | $751.29 | $601.04 | $7.14 | $59.73 | $713.73 |
| Hand X-ray 3 views | CPT | 73130 | 14 | $751.29 | $601.04 | $7.77 | $68.97 | $713.73 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | $2,580.37 | $2,064.3 | $59.79 | $352.44 | $2,451.35 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 14 | $4,127.65 | $3,302.12 | $94.98 | $755.99 | $3,921.27 |
| Knee X-ray 1-2 views | CPT | 73560 | 14 | $751.29 | $601.04 | $7.45 | $58 | $713.73 |
| Ankle X-ray 3 views | CPT | 73610 | 14 | $751.29 | $601.04 | $7.77 | $65 | $713.73 |
| MRI lower extremity joint without contrast | CPT | 73721 | 14 | $2,583.45 | $2,066.76 | $59.79 | $352.44 | $2,454.28 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 14 | $4,132.58 | $3,306.07 | $94.98 | $754.41 | $3,925.95 |
| CT abdomen without contrast | CPT | 74150 | 14 | $3,968.25 | $3,174.6 | $52.34 | $180.22 | $3,769.84 |
| CT abdomen with contrast | CPT | 74160 | 14 | $6,131.56 | $4,905.25 | $55.96 | $334.38 | $5,824.98 |
| CT abdomen with and without contrast | CPT | 74170 | 14 | $6,835.19 | $5,468.16 | $61.41 | $383.94 | $6,493.43 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 14 | $3,968.25 | $3,174.6 | $76.64 | $246.61 | $3,769.84 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 14 | $6,131.56 | $4,905.25 | $80.37 | $467.58 | $5,824.98 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 14 | $6,835.19 | $5,468.16 | $88.38 | $557.53 | $6,493.43 |
| MRI abdomen without contrast | CPT | 74181 | 14 | $3,853.65 | $3,082.92 | $64.07 | $896.29 | $3,660.97 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | $6,459.02 | $5,167.22 | $96.9 | $1,376.52 | $6,136.07 |
| Abdominal ultrasound complete | CPT | 76700 | 14 | $2,076.21 | $1,660.97 | $35.61 | $166.4 | $1,972.4 |
| Abdominal ultrasound limited | CPT | 76705 | 14 | $1,767.9 | $1,414.32 | $25.91 | $131.79 | $1,679.51 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 14 | $1,769.83 | $1,415.87 | $32.41 | $160.08 | $1,681.34 |
| Obstetric ultrasound first trimester | CPT | 76801 | 14 | $1,309.78 | $1,047.83 | $43.9 | $146.16 | $1,244.29 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 14 | $1,769.83 | $1,415.87 | $44.21 | $173.49 | $1,681.34 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 14 | $2,757.21 | $2,205.77 | $81.42 | $239.52 | $2,619.35 |
| Transvaginal ultrasound | CPT | 76830 | 14 | $1,769.83 | $1,415.87 | $30.69 | $163.34 | $1,681.34 |
| Pelvic ultrasound complete | CPT | 76856 | 14 | $1,769.83 | $1,415.87 | $30.38 | $157.01 | $1,681.34 |
| Scrotal ultrasound | CPT | 76870 | 14 | $1,769.83 | $1,415.87 | $28.14 | $150.75 | $1,681.34 |
| Diagnostic mammography unilateral | CPT | 77065 | 13 | $459 | $367.2 | $31.74 | $90.71 | $546 |
| Diagnostic mammography bilateral | CPT | 77066 | 13 | $578 | $462.4 | $38.64 | $113.73 | $549.1 |
| Screening mammography bilateral | CPT | 77067 | 13 | $466 | $372.8 | $29.67 | $92.09 | $546 |
| EKG complete | CPT | 93000 | 13 | $340 | $272 | $13.14 | $40.73 | $323 |
| EKG tracing only | CPT | 93005 | 14 | $305.47 | $244.38 | $5.68 | $70.26 | $290.2 |
| EKG interpretation only | CPT | 93010 | 13 | $143 | $114.4 | $7.46 | $26.51 | $135.85 |
| Transthoracic echocardiogram complete | CPT | 93306 | 14 | $3,989 | $3,191.2 | $63.75 | $529.61 | $3,789.55 |
| Transthoracic echocardiogram | CPT | 93307 | 14 | $2,517.86 | $2,014.29 | $40.3 | $235.39 | $2,391.97 |
| Stress echocardiogram | CPT | 93350 | 14 | $3,301.81 | $2,641.45 | $63.75 | $413.78 | $3,136.72 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 12 | — | — | $15,611 | $21,464 | $49,410 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 12 | — | — | $8,243.28 | $10,973 | $25,259 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 12 | — | — | $5,753.3 | $7,427.11 | $17,097 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 12 | — | — | $12,787 | $17,443 | $40,152 |
| COPD w MCC | MS-DRG | 190 | 12 | — | — | $9,047.27 | $12,118 | $27,894 |
| COPD w CC | MS-DRG | 191 | 12 | — | — | $7,047.56 | $9,270.12 | $21,339 |
| COPD w/o CC/MCC | MS-DRG | 192 | 12 | — | — | $5,441.87 | $6,983.61 | $16,076 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 12 | — | — | $6,751.28 | $8,848.21 | $20,368 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 12 | — | — | $5,256.21 | $6,719.25 | $15,467 |
| AMI discharged alive w MCC | MS-DRG | 280 | 12 | — | — | $12,975 | $17,712 | $40,771 |
| AMI discharged alive w CC | MS-DRG | 281 | 12 | — | — | $7,522.66 | $9,946.69 | $22,897 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 12 | — | — | $6,032.16 | $7,824.2 | $18,011 |
| Heart failure & shock w MCC | MS-DRG | 291 | 12 | — | — | $10,425 | $14,079 | $32,410 |
| Heart failure & shock w CC | MS-DRG | 292 | 12 | — | — | $7,063.47 | $9,292.78 | $21,391 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 12 | — | — | $4,695.48 | $5,920.75 | $13,629 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 12 | — | — | $9,675.43 | $13,012 | $29,953 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 12 | — | — | $6,139.75 | $7,977.42 | $18,363 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 12 | — | — | $4,777.32 | $6,037.29 | $13,897 |
| GI hemorrhage w CC | MS-DRG | 378 | 12 | — | — | $8,008.38 | $10,638 | $24,489 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 12 | — | — | $5,362.31 | $6,870.32 | $15,815 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 12 | — | — | $6,450.44 | $8,419.83 | $19,382 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 12 | — | — | $12,093 | $16,454 | $37,877 |
| Kidney/UTI w MCC | MS-DRG | 689 | 12 | — | — | $9,405.69 | $12,628 | $29,069 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 12 | — | — | $6,619.42 | $8,660.46 | $19,936 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 12 | — | — | $15,406 | $21,172 | $48,737 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 12 | — | — | $8,350.13 | $11,125 | $25,609 |
| Initial hospital care, low complexity | CPT | 99221 | 13 | $939.94 | $751.96 | $74.98 | $164.47 | $892.94 |
| Initial hospital care, moderate complexity | CPT | 99222 | 13 | $1,401.74 | $1,121.4 | $116.61 | $241.97 | $1,331.65 |
| Initial hospital care, high complexity | CPT | 99223 | 13 | $1,750.7 | $1,400.56 | $159.24 | $339.35 | $1,663.17 |
| Hospital discharge, <30 min | CPT | 99238 | 13 | $400.92 | $320.74 | $74.57 | $118.59 | $380.87 |
| Hospital discharge, >30 min | CPT | 99239 | 13 | $456 | $364.8 | $41.63 | $110.9 | $433.2 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 14 | $183.52 | $146.82 | $5.08 | $55.3 | $174.34 |
| General health panel | CPT | 80050 | 10 | $334 | $267.2 | $26.92 | $96.86 | $317.3 |
| Electrolyte panel | CPT | 80051 | 14 | $152.19 | $121.76 | $4.21 | $45.51 | $144.58 |
| Comprehensive metabolic panel | CPT | 80053 | 14 | $228.28 | $182.63 | $6.34 | $62.16 | $216.87 |
| Lipid panel | CPT | 80061 | 14 | $289.43 | $231.55 | $8.03 | $81.03 | $274.96 |
| Renal function panel | CPT | 80069 | 14 | $187.97 | $150.38 | $5.21 | $51.8 | $178.57 |
| Hepatic function panel | CPT | 80076 | 14 | $177.55 | $142.04 | $4.9 | $42.92 | $168.67 |
| Urinalysis non-automated | CPT | 81002 | 14 | $95 | $76 | $3.48 | $16.72 | $90.25 |
| Urinalysis automated | CPT | 81003 | 14 | $48 | $38.4 | $2.25 | $13.21 | $45.6 |
| Glucose quantitative | CPT | 82947 | 14 | $59.47 | $47.58 | $3.93 | $18.44 | $56.5 |
| Hemoglobin A1c | CPT | 83036 | 14 | $161.62 | $129.3 | $5.83 | $41.07 | $153.54 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 14 | $227.05 | $181.64 | $10.08 | $64.01 | $215.7 |
| Complete blood count with automated differential | CPT | 85025 | 14 | $149.13 | $119.31 | $4.66 | $43.29 | $141.67 |
| Complete blood count without differential | CPT | 85027 | 14 | $124.07 | $99.26 | $3.88 | $37.45 | $117.87 |
| Urine culture bacterial | CPT | 87086 | 14 | $135.43 | $108.35 | $4.84 | $31.15 | $128.66 |
| Urine culture identification | CPT | 87088 | 14 | $135.39 | $108.32 | $4.85 | $18.5 | $128.62 |
| Tissue exam by pathologist level IV | CPT | 88305 | 14 | $890.49 | $712.4 | $13.57 | $51.61 | $845.97 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | $690.89 | $552.72 | $14.26 | $83.63 | $1,756 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 13 | $6,952 | $5,561.6 | $1,598.96 | $3,299.55 | $10,922 |
| Vaginal delivery only | CPT | 59409 | 13 | $3,619 | $2,895.2 | $684.45 | $1,505.79 | $6,026 |
| Vaginal delivery with postpartum | CPT | 59410 | 13 | $4,586 | $3,668.8 | $928.17 | $1,659.61 | $10,922 |
| Routine obstetric care with C-section | CPT | 59510 | 13 | $9,569 | $7,655.2 | $2,200.87 | $3,666.23 | $10,922 |
| C-section delivery only | CPT | 59514 | 13 | $5,718 | $4,574.4 | $768.55 | $1,690.81 | $5,432.1 |
| C-section with postpartum | CPT | 59515 | 13 | $5,760 | $4,608 | $1,140.71 | $2,016 | $10,922 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 13 | $229 | $183.2 | $20.93 | $52.67 | $217.55 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | $321 | $256.8 | $29.44 | $78.57 | $304.95 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | $477 | $381.6 | $44.16 | $128.38 | $453.15 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | $622 | $497.6 | $57.5 | $174.37 | $590.9 |
| Office visit, established patient, 5 min | CPT | 99211 | 13 | $197.5 | $158 | $8.1 | $24.99 | $187.63 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 13 | $503.38 | $402.71 | $15.41 | $61.12 | $478.21 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 13 | $641.46 | $513.17 | $21.16 | $83.65 | $609.39 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 13 | $867.17 | $693.74 | $30.36 | $115.85 | $823.81 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 13 | $1,039.42 | $831.54 | $42.32 | $161.74 | $987.45 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 14 | $4,426.82 | $3,541.46 | $110.43 | $905.61 | $5,169 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 14 | $4,426.82 | $3,541.46 | $124.37 | $905.61 | $5,169 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | $561 | $448.8 | $51.47 | $170.88 | $3,937 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 13 | $880 | $704 | $65.52 | $218.84 | $3,937 |
| Colonoscopy diagnostic | CPT | 45378 | 13 | $2,019 | $1,615.2 | $82.94 | $424.2 | $5,169 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | $2,412 | $1,929.6 | $179.93 | $600.97 | $5,169 |
| Colonoscopy with polyp removal | CPT | 45385 | 14 | $4,346.62 | $3,477.3 | $227.49 | $1,138.9 | $5,169 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 13 | $31,625 | $25,300 | $1,296.9 | $8,014.53 | $30,044 |
| Hip hemiarthroplasty | CPT | 27125 | 13 | $10,035 | $8,028 | $1,019.89 | $3,010.5 | $10,922 |
| Total hip replacement | CPT | 27130 | 13 | $12,017 | $9,613.6 | $1,151.57 | $3,846.24 | $26,222 |
| Total knee replacement | CPT | 27447 | 13 | $25,392 | $20,314 | $1,150.22 | $6,517.28 | $28,405 |
| Knee revision arthroplasty single component | CPT | 27486 | 13 | $23,164 | $18,531 | $1,261.01 | $4,632.9 | $26,222 |
| Knee revision arthroplasty all components | CPT | 27487 | 13 | $30,438 | $24,350 | $1,566.58 | $6,087.6 | $28,916 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 13 | $1,645 | $1,316 | $151.65 | $383.95 | $1,756 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 13 | $14,691 | $11,753 | $965.46 | $3,770.69 | $26,222 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 13 | $10,854 | $8,683.2 | $496.73 | $2,785.86 | $10,922 |
| ACL reconstruction | CPT | 29888 | 13 | $18,775 | $15,020 | $880.9 | $4,818.8 | $26,222 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 12 | — | — | $35,333 | $49,549 | $114,058 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 12 | — | — | $18,449 | $25,506 | $58,712 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 12 | — | — | $13,048 | $17,815 | $41,009 |
| CABG single arterial graft | CPT | 33533 | 13 | $21,760 | $17,408 | $1,596.7 | $5,317.01 | $28,405 |
| CABG 2 arterial grafts | CPT | 33534 | 13 | $24,346 | $19,477 | $1,874.9 | $6,243.42 | $28,405 |
| CABG 3 arterial grafts | CPT | 33535 | 13 | $26,374 | $21,099 | $2,083.29 | $6,937.36 | $28,405 |
| CABG 4+ arterial grafts | CPT | 33536 | 13 | $27,895 | $22,316 | $2,242.81 | $7,468.56 | $28,405 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 12 | — | — | $13,104 | $17,895 | $41,193 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 12 | — | — | $10,522 | $14,218 | $32,728 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 12 | — | — | $27,283 | $38,085 | $87,669 |
| Open appendectomy | CPT | 44950 | 13 | $3,802 | $3,041.6 | $563.86 | $1,883.29 | $10,922 |
| Laparoscopic appendectomy | CPT | 44970 | 13 | $6,992 | $5,593.6 | $532.55 | $2,097.6 | $17,482 |
| Major joint replacement w MCC | MS-DRG | 469 | 12 | — | — | $25,306 | $35,271 | $81,191 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 12 | — | — | $14,825 | $20,345 | $46,834 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | $24,570 | $19,656 | $582.48 | $5,651.03 | $23,341 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 13 | $7,415 | $5,932 | $632.58 | $2,224.5 | $17,482 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 12 | — | — | $22,823 | $31,735 | $73,052 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 12 | — | — | $16,260 | $22,389 | $51,538 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 12 | — | — | $12,559 | $17,118 | $39,405 |
| Lap inguinal hernia repair | CPT | 49650 | 14 | $24,570 | $19,656 | $385.88 | $5,635.53 | $23,341 |
| Total abdominal hysterectomy | CPT | 58150 | 10 | — | — | $915.69 | $2,640.35 | $17,482 |
| Vaginal hysterectomy | CPT | 58260 | 13 | $3,674 | $2,939.2 | $754.24 | $2,519.16 | $14,203 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | — | — | $793.8 | $2,651.29 | $17,482 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | — | — | $882.18 | $2,946.48 | $28,405 |
| Lap salpingo-oophorectomy | CPT | 58661 | 13 | $6,304 | $5,043.2 | $585.39 | $1,955.2 | $17,482 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 12 | — | — | $21,198 | $29,420 | $67,724 |
| OR procedure for obesity w CC | MS-DRG | 620 | 12 | — | — | $12,639 | $17,232 | $39,668 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 12 | — | — | $11,615 | $15,774 | $36,310 |
| Complex cataract surgery | CPT | 66982 | 10 | — | — | $682.07 | $2,203 | $6,026 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $498.4 | $1,664.66 | $6,026 |
| Intravitreal injection | CPT | 67028 | 10 | — | — | $84.39 | $281.86 | $3,937 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | — | $1,042.68 | $3,482.55 | $14,203 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 12 | — | — | $9,620.89 | $12,935 | $29,775 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 12 | — | — | $15,344 | $21,085 | $48,535 |
| PCI single major coronary artery | CPT | 92920 | 14 | $19,367 | $15,493 | $448.25 | $5,507.21 | $37,154 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | $24,422 | $19,538 | $498.38 | $8,108.2 | $37,154 |
| PCI bypass graft | CPT | 92937 | 14 | $24,422 | $19,538 | $498.06 | $8,108.2 | $37,154 |
| Left heart catheterization | CPT | 93452 | 14 | $18,197 | $14,558 | $202.74 | $1,780.1 | $21,851 |
| Coronary angiography with cath | CPT | 93455 | 14 | $17,519 | $14,015 | $238.78 | $1,985.83 | $21,851 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | $19,107 | $15,286 | $252.33 | $2,030.31 | $21,851 |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 197 | $246.82 |
| aspirus | 197 | $196.35 |
| health partners open network | 197 | $333.98 |
| medical associates health plan | 197 | $416.78 |
| prevea 360 | 197 | $297.26 |
| Anthem BCBS | 197 | $377.03 |
| Humana | 196 | $155.19 |
| meridiancare | 196 | $155.19 |
| Blue Cross Blue Shield | 196 | $434.41 |
| illinicare | 196 | $155.19 |
| Cigna | 189 | $225.39 |
| security health plan | 146 | $232.9 |
| mercy care | 146 | $249.43 |
| quartz | 140 | $1,238.09 |