▸ Hospital · WI · CCN 521308

Amery Hospital & Clinic

265 GRIFFIN STREET EAST, AMERY, WI, 54001-1292

25 bedsCritical Access Hospitals2

Compliance grade

97/100

Rates published

11,192

last crawl 2026-05-24

Procedures tracked

162

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All WI hospitals JSON

Source MRF: https://www.healthpartners.com/content/dam/brand-identity/pdfs/care/390908320_AmeryHospital_HospitalStandardCharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	5	$16,700	$8,707.38	$953.07	$994.91	$16,679
Psychiatric diagnostic evaluation	CPT	90791	7	$482	$251.31	$18.2	$144.63	$433.8
Psychiatric eval with medical services	CPT	90792	7	$492	$256.53	$18.56	$195.83	$442.8
Psychotherapy 30 minutes	CPT	90832	7	$194	$101.15	$56.38	$72.95	$174.6
Psychotherapy 45 minutes	CPT	90834	7	$260	$135.56	$74.37	$127.88	$375.88
Psychotherapy 60 minutes	CPT	90837	7	$361	$188.23	$110.07	$163.02	$324.9
Crisis psychotherapy 60 minutes	CPT	90839	7	$412	$214.82	$106.05	$180.73	$370.8
emergency
ED visit level 1	CPT	99281	6	$174	$90.72	$12.22	$64.55	$251.12
ED visit level 2	CPT	99282	6	$357	$186.14	$45.21	$132.45	$451.61
ED visit level 3	CPT	99283	6	$548	$285.73	$76.51	$203.31	$789.65
ED visit level 4	CPT	99284	6	$1,131	$589.7	$130.06	$419.6	$1,214.38
ED visit level 5	CPT	99285	6	$2,438	$1,271.17	$188.31	$646.2	$2,363.88
Critical care, first hour	CPT	99291	6	$2,977	$1,552.21	$232.11	$1,042.2	$2,886.5
imaging
CT head without contrast	CPT	70450	6	$1,679	$875.43	$327.88	$622.91	$1,627.96
CT head with contrast	CPT	70460	6	$2,225	$1,160.11	$446.6	$825.48	$2,157.36
CT head with and without contrast	CPT	70470	6	$2,772	$1,445.32	$446.6	$1,028.41	$2,687.73
CT neck with contrast	CPT	70491	6	$2,370	$1,235.72	$327.88	$879.27	$2,297.95
MRI brain without contrast	CPT	70551	6	$4,063	$2,118.45	$578.05	$1,507.37	$3,939.48
MRI brain with contrast	CPT	70552	6	$4,722	$2,462.05	$607.75	$1,751.86	$4,578.45
MRI brain with and without contrast	CPT	70553	6	$5,932	$3,092.94	$607.75	$2,200.77	$5,751.67
Chest X-ray single view	CPT	71045	6	$200	$104.28	$59.72	$74.9	$251.1
Chest X-ray 2 views	CPT	71046	6	$273	$142.34	$97.94	$118.25	$264.7
Chest X-ray 3 views	CPT	71047	6	$308	$160.59	$31.55	$115.35	$298.64
CT chest without contrast	CPT	71250	6	$1,970	$1,027.16	$327.88	$730.87	$1,910.11
CT chest with contrast	CPT	71260	6	$2,519	$1,313.41	$327.88	$934.55	$2,442.42
CT chest with and without contrast	CPT	71270	6	$3,065	$1,598.09	$327.88	$1,137.12	$2,971.82
MRI chest without contrast	CPT	71550	6	$3,945	$2,056.92	$578.05	$1,463.6	$3,825.07
MRI chest with and without contrast	CPT	71552	6	$5,610	$2,925.05	$607.75	$2,081.31	$5,439.46
Lumbosacral spine X-ray	CPT	72100	6	$360	$187.7	$107.5	$134.82	$349.06
CT cervical spine without contrast	CPT	72125	6	$2,118	$1,104.33	$327.88	$785.78	$2,053.61
CT thoracic spine without contrast	CPT	72128	6	$2,118	$1,104.33	$327.88	$785.78	$2,053.61
CT lumbar spine without contrast	CPT	72131	6	$2,118	$1,104.33	$327.88	$785.78	$2,053.61
MRI cervical spine without contrast	CPT	72141	6	$3,945	$2,056.92	$578.05	$1,463.6	$3,825.07
MRI thoracic spine without contrast	CPT	72146	6	$3,945	$2,056.92	$578.05	$1,463.6	$3,825.07
MRI lumbar spine without contrast	CPT	72148	6	$3,945	$2,056.92	$578.05	$1,463.6	$3,825.07
MRI lumbar spine with and without contrast	CPT	72149	6	$4,402	$2,295.2	$607.75	$1,633.14	$4,268.18
MRI cervical spine with and without contrast	CPT	72156	6	$3,945	$2,056.92	$607.75	$1,463.6	$3,825.07
MRI lumbar spine with contrast	CPT	72158	6	$5,464	$2,848.93	$607.75	$2,027.14	$5,297.89
CT pelvis without contrast	CPT	72192	6	$1,824	$951.03	$303.28	$676.7	$1,768.55
CT pelvis with contrast	CPT	72193	6	$2,370	$1,235.72	$327.88	$879.27	$2,297.95
Shoulder X-ray	CPT	73030	6	$257	$134	$76.74	$96.25	$251.1
Humerus X-ray	CPT	73060	6	$257	$134	$76.74	$96.25	$251.1
Hand X-ray 3 views	CPT	73130	6	$289	$150.68	$86.3	$108.23	$280.21
MRI upper extremity joint without contrast	CPT	73221	6	$3,112	$1,622.6	$578.05	$1,154.55	$3,017.4
MRI upper extremity joint with and without contrast	CPT	73223	6	$3,939	$2,053.79	$607.75	$1,461.37	$3,819.25
Knee X-ray 1-2 views	CPT	73560	6	$243	$126.7	$72.56	$91	$251.1
Ankle X-ray 3 views	CPT	73610	6	$299	$155.9	$89.28	$111.98	$289.91
MRI lower extremity joint without contrast	CPT	73721	6	$3,112	$1,622.6	$578.05	$1,154.55	$3,017.4
MRI lower extremity joint with and without contrast	CPT	73723	6	$4,628	$2,413.04	$607.75	$1,716.99	$4,487.31
CT abdomen without contrast	CPT	74150	6	$2,118	$1,104.33	$327.88	$785.78	$2,053.61
CT abdomen with contrast	CPT	74160	6	$2,576	$1,343.13	$327.88	$955.7	$2,497.69
CT abdomen with and without contrast	CPT	74170	6	$2,991	$1,559.51	$446.6	$1,109.66	$2,900.07
CT abdomen and pelvis without contrast	CPT	74176	6	$2,922	$1,523.53	$327.88	$1,084.06	$2,833.17
CT abdomen and pelvis with contrast	CPT	74177	6	$3,320	$1,731.05	$327.88	$1,231.72	$3,219.07
CT abdomen and pelvis with and without contrast	CPT	74178	6	$3,868	$2,016.78	$327.88	$1,435.03	$3,750.41
MRI abdomen without contrast	CPT	74181	6	$3,795	$1,978.71	$578.05	$1,407.95	$3,679.63
MRI abdomen with and without contrast	CPT	74183	6	$5,464	$2,848.93	$607.75	$2,027.14	$5,297.89
Abdominal ultrasound complete	CPT	76700	6	$887	$462.48	$264.86	$329.08	$860.04
Abdominal ultrasound limited	CPT	76705	6	$887	$462.48	$37.92	$264.86	$860.04
Retroperitoneal ultrasound complete	CPT	76770	6	$933	$486.47	$278.59	$346.14	$904.64
Obstetric ultrasound first trimester	CPT	76801	6	$866	$451.53	$258.59	$321.29	$839.67
Obstetric ultrasound after first trimester	CPT	76805	6	$990	$516.19	$295.61	$367.29	$959.9
Transvaginal ultrasound	CPT	76830	6	$832	$433.8	$248.44	$308.67	$806.71
Pelvic ultrasound complete	CPT	76856	6	$829	$432.24	$247.54	$307.56	$803.8
Scrotal ultrasound	CPT	76870	6	$825	$430.15	$246.35	$306.08	$799.92
Diagnostic mammography bilateral	CPT	77066	6	$464	$241.93	$119.94	$173.77	$652.22
Screening mammography bilateral	CPT	77067	6	$468	$244.02	$165	$175.27	$527.21
EKG complete	CPT	93000	6	$83	$43.28	$10.51	$31.08	$80.48
EKG tracing only	CPT	93005	6	$49	$25.55	$17.58	$43.76	$169.39
EKG interpretation only	CPT	93010	7	$32	$16.68	$5.75	$10.89	$28.8
Transthoracic echocardiogram complete	CPT	93306	6	$1,708	$890.55	$612.75	$849.75	$1,656.08
Stress echocardiogram	CPT	93350	6	$1,413	$736.74	$138.22	$529.17	$1,563.69
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	5	$17,868	$9,316.38	$3,737.78	$3,883.64	$18,660
COPD w MCC	MS-DRG	190	5	$14,051	$7,326.19	$3,737.78	$3,883.64	$13,227
COPD w CC	MS-DRG	191	5	$4,358	$2,272.26	$3,737.78	$3,883.64	$10,066
COPD w/o CC/MCC	MS-DRG	192	5	$16,148	$8,419.57	$3,737.78	$3,883.64	$7,666.12
Simple pneumonia & pleurisy w CC	MS-DRG	194	5	$11,407	$5,947.61	$3,737.78	$3,883.64	$9,623.25
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	4	$8,850	$4,614.39	$201.25	$3,828.94	$3,901.87
AMI discharged alive w MCC	MS-DRG	280	5	$10,932	$5,699.94	$3,737.78	$3,883.64	$19,155
Heart failure & shock w MCC	MS-DRG	291	5	$17,479	$9,113.55	$3,737.78	$3,883.64	$15,330
Heart failure & shock w CC	MS-DRG	292	5	$18,738	$9,769.99	$3,737.78	$3,883.64	$10,138
Heart failure & shock w/o CC/MCC	MS-DRG	293	5	$5,954	$3,104.42	$3,737.78	$3,883.64	$6,758.61
Cardiac arrhythmia w MCC	MS-DRG	308	5	$13,446	$7,010.74	$3,737.78	$3,883.64	$14,377
Cardiac arrhythmia w CC	MS-DRG	309	5	$8,064	$4,204.57	$3,737.78	$3,883.64	$8,784.99
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	5	$6,609	$3,445.93	$3,737.78	$3,883.64	$6,759.8
GI hemorrhage w CC	MS-DRG	378	5	$10,422	$5,434.03	$3,737.78	$3,883.64	$11,711
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	5	$15,920	$8,300.69	$3,737.78	$3,883.64	$9,309.2
Kidney/UTI w MCC	MS-DRG	689	5	$25,565	$13,330	$3,737.78	$3,883.64	$13,855
Kidney/UTI w/o MCC	MS-DRG	690	5	$12,904	$6,728.15	$3,737.78	$3,883.64	$9,666.24
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	5	$21,326	$11,119	$3,737.78	$3,883.64	$23,195
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	5	$14,323	$7,468.01	$3,737.78	$3,883.64	$12,219
Initial hospital care, low complexity	CPT	99221	8	$328	$171.02	$59.76	$81.22	$295.2
Initial hospital care, moderate complexity	CPT	99222	8	$444	$231.5	$89.05	$129.27	$399.6
Initial hospital care, high complexity	CPT	99223	8	$654	$341	$101.95	$172.55	$588.6
Hospital discharge, <30 min	CPT	99238	8	$232	$120.96	$50.63	$81.16	$208.8
Hospital discharge, >30 min	CPT	99239	8	$343	$178.84	$84.42	$114.91	$308.7
lab
Basic metabolic panel (BMP)	CPT	80048	6	$183	$95.42	$10.76	$46.54	$177.44
General health panel	CPT	80050	6	$358	$186.66	$106.9	$134.07	$347.12
Electrolyte panel	CPT	80051	6	$115	$59.96	$28.53	$42.67	$111.5
Comprehensive metabolic panel	CPT	80053	6	$358	$186.66	$17.94	$61.37	$347.12
Lipid panel	CPT	80061	6	$154	$80.3	$12.56	$46.75	$149.32
Renal function panel	CPT	80069	6	$281	$146.51	$36.69	$102.28	$272.46
Hepatic function panel	CPT	80076	6	$188	$98.02	$10.45	$33.97	$182.28
Urinalysis non-automated	CPT	81002	6	$7	$3.65	$2.09	$2.62	$14.95
Urinalysis automated	CPT	81003	6	$38	$19.81	$9.51	$13.86	$36.84
Glucose quantitative	CPT	82947	6	$57	$29.72	$5.97	$17.84	$55.27
Hemoglobin A1c	CPT	83036	6	$35	$18.25	$12.56	$31.26	$40.76
Thyroid stimulating hormone (TSH)	CPT	84443	6	$163	$84.99	$12.56	$53.99	$158.04
Complete blood count with automated differential	CPT	85025	6	$96	$50.05	$19.73	$35.79	$93.08
Complete blood count without differential	CPT	85027	6	$79	$41.19	$10.45	$28.55	$76.6
Urine culture bacterial	CPT	87086	6	$41	$21.38	$12.24	$15.35	$39.75
Urine culture identification	CPT	87088	6	$29	$15.12	$8.66	$10.86	$33.97
Tissue exam by pathologist level IV	CPT	88305	6	$575	$299.8	$79.75	$211.32	$557.52
maternity
Fetal non-stress test	CPT	59025	6	$646	$336.82	$192.9	$241.93	$626.36
Routine obstetric care including vaginal delivery	CPT	59400	6	$5,783	$3,015.26	$1,387.89	$2,643.75	$9,037.38
Vaginal delivery only	CPT	59409	6	$2,322	$1,210.69	$540	$853.04	$9,067.65
Vaginal delivery with postpartum	CPT	59410	6	$2,947	$1,536.57	$696.73	$1,159.09	$3,958.18
Routine obstetric care with C-section	CPT	59510	6	$8,915	$4,648.28	$1,387.89	$2,904.32	$9,935.55
C-section delivery only	CPT	59514	6	$2,632	$1,372.32	$540	$956.97	$3,266.56
C-section with postpartum	CPT	59515	6	$3,565	$1,858.79	$696.73	$1,424.08	$4,867.22
office
Office visit, new patient, 15-29 min	CPT	99202	8	$167	$87.07	$17.84	$51.61	$375.88
Office visit, new patient, 30-44 minutes	CPT	99203	8	$240	$125.14	$25.48	$84.6	$375.88
Office visit, new patient, 45-59 min	CPT	99204	7	$365	$190.31	$28.09	$215.88	$375.88
Office visit, new patient, 60-74 min	CPT	99205	7	$458	$238.8	$24.19	$146.41	$877.78
Office visit, established patient, 5 min	CPT	99211	6	$139	$72.47	$9.26	$42.66	$379.42
Office visit, established patient, 10-19 min	CPT	99212	8	$95	$49.53	$14.2	$37.79	$110.88
Office visit, established patient, 20-29 minutes	CPT	99213	8	$273	$142.34	$16.02	$106.2	$379.42
Office visit, established patient, 30-39 minutes	CPT	99214	8	$241	$125.66	$20.75	$101.15	$375.88
Office visit, established patient, 40-54 min	CPT	99215	8	$324	$168.93	$26.94	$147.52	$375.88
preventive
Upper GI endoscopy diagnostic	CPT	43235	6	$3,741	$1,950.56	$133.19	$1,238.64	$3,627.27
Upper GI endoscopy with biopsy	CPT	43239	6	$2,660	$1,386.92	$149.94	$961.26	$2,673.81
Sigmoidoscopy diagnostic	CPT	45330	6	$1,989	$1,037.06	$62.44	$593.92	$2,600.09
Sigmoidoscopy with biopsy	CPT	45331	6	$3,741	$1,950.56	$51.83	$1,008.95	$3,627.27
Colonoscopy diagnostic	CPT	45378	6	$3,741	$1,950.56	$199.17	$1,351.9	$3,627.27
Colonoscopy with biopsy	CPT	45380	6	$3,741	$1,950.56	$216.54	$1,394.46	$3,627.27
Colonoscopy with polyp removal	CPT	45385	6	$3,741	$1,950.56	$273.67	$1,394.46	$3,627.27
surgery
Total shoulder arthroplasty	CPT	23472	7	$6,119	$3,190.45	$1,027.64	$1,810.88	$5,507.1
Total hip replacement	CPT	27130	7	$5,693	$2,968.33	$912.45	$1,606.07	$5,123.7
Total knee replacement	CPT	27447	7	$5,690	$2,966.77	$911.2	$1,604.5	$5,121
Knee revision arthroplasty single component	CPT	27486	7	$5,911	$3,082	$999.84	$1,759.4	$5,319.9
Knee revision arthroplasty all components	CPT	27487	7	$7,536	$3,929.27	$1,240.23	$2,184.85	$6,782.4
Shoulder arthroscopy with decompression	CPT	29826	7	$733	$382.19	$119.19	$211.14	$659.7
Shoulder arthroscopy with rotator cuff repair	CPT	29827	7	$4,486	$2,339	$766.97	$1,350.27	$4,037.4
Knee arthroscopy with meniscectomy	CPT	29881	7	$2,296	$1,197.13	$396.63	$695.58	$2,066.4
ACL reconstruction	CPT	29888	7	$4,235	$2,208.13	$699.61	$1,232.27	$3,811.5
Major small/large bowel procedures w CC	MS-DRG	330	5	$71,299	$37,175	$3,737.78	$3,883.64	$28,625
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	5	$106,841	$55,707	$3,737.78	$3,883.64	$20,096
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	5	$35,690	$18,609	$3,737.78	$3,883.64	$16,309
Open appendectomy	CPT	44950	6	$2,030	$1,058.44	$443.95	$707.57	$17,795
Laparoscopic appendectomy	CPT	44970	7	$1,892	$986.49	$420.42	$741.47	$1,702.8
Major joint replacement w/o MCC	MS-DRG	470	5	$6,058	$3,158.64	$3,737.78	$3,883.64	$25,463
Laparoscopic cholecystectomy	CPT	47562	7	$2,359	$1,229.98	$459.48	$809.65	$2,123.1
Lap cholecystectomy with cholangiography	CPT	47563	7	$2,877	$1,500.07	$498.79	$880.42	$2,589.3
Hip & femur procedures except major joint w MCC	MS-DRG	480	5	$118,032	$61,542	$3,737.78	$3,883.64	$34,776
Hip & femur procedures except major joint w CC	MS-DRG	481	5	$57,788	$30,131	$3,737.78	$3,883.64	$25,010
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	5	$43,355	$22,605	$3,737.78	$3,883.64	$19,476
Lap inguinal hernia repair	CPT	49650	7	$1,350	$703.89	$305.73	$537.75	$1,215
Total abdominal hysterectomy	CPT	58150	6	$3,276	$1,708.11	$722.65	$1,151.58	$3,918.78
Lap-assisted vaginal hysterectomy >250g	CPT	58552	6	$3,340	$1,741.48	$695.61	$1,108.75	$29,692
Lap salpingo-oophorectomy	CPT	58661	6	$2,120	$1,105.37	$633.03	$735.26	$16,639
Complex cataract surgery	CPT	66982	7	$3,477	$1,812.91	$545.12	$961.23	$3,129.3
Cataract surgery with lens implant	CPT	66984	7	$1,680	$875.95	$398.63	$702.62	$1,512

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 8)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	162	$264.26
Medicare	162	$342.06
UnitedHealthcare	162	$521.44
healthpartners [900713]	161	$507.68
medica [900156]	135	$732.38
First Health	135	$438.3
Medicaid	61	$1,946.52
ma wisconsin replacement [950271]	12	$83.21

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