▸ Hospital · WI · CCN 521345

Westfields Hospital And Clinic

535 HOSPITAL ROAD, NEW RICHMOND, WI, 54017

25 bedsCritical Access Hospitals2

Compliance grade

97/100

Rates published

13,754

last crawl 2026-05-24

Procedures tracked

160

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_WestfieldsHospital_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	5	$17,327	$9,114	$3,666.64	$3,791.85	$17,784
Psychiatric diagnostic evaluation	CPT	90791	8	$425	$223.55	$73.48	$167.54	$425
Psychiatric eval with medical services	CPT	90792	8	$207	$108.88	$82.22	$171.75	$410.54
Psychotherapy 30 minutes	CPT	90832	8	$194	$102.04	$37.05	$82.83	$410.54
Psychotherapy 45 minutes	CPT	90834	8	$289	$152.01	$49.4	$117.25	$410.54
Psychotherapy 60 minutes	CPT	90837	8	$386	$203.04	$72.4	$163.73	$410.54
Crisis psychotherapy 60 minutes	CPT	90839	8	$412	$216.71	$106.05	$163.04	$412
emergency
ED visit level 1	CPT	99281	8	$304	$159.9	$12.22	$129.79	$304
ED visit level 2	CPT	99282	8	$486	$255.64	$45.21	$200.72	$486
ED visit level 3	CPT	99283	8	$763	$401.34	$76.51	$315.12	$763
ED visit level 4	CPT	99284	8	$1,235	$649.61	$130.06	$518.7	$1,235
ED visit level 5	CPT	99285	8	$2,249	$1,182.97	$188.31	$810.26	$2,249
Critical care, first hour	CPT	99291	8	$2,539	$1,335.51	$232.11	$1,024.74	$2,539
imaging
CT head without contrast	CPT	70450	8	$1,575	$828.45	$271.72	$661.5	$1,575
CT head with contrast	CPT	70460	8	$1,657	$871.58	$327.88	$695.94	$1,657
CT head with and without contrast	CPT	70470	8	$2,202	$1,158.25	$327.88	$924.84	$2,202
CT neck with contrast	CPT	70491	8	$2,201	$1,157.73	$327.88	$924.42	$2,201
MRI brain without contrast	CPT	70551	8	$3,451	$1,815.23	$578.05	$1,449.42	$3,451
MRI brain with contrast	CPT	70552	8	$3,415	$1,796.29	$607.75	$1,434.3	$3,415
MRI brain with and without contrast	CPT	70553	8	$3,720	$1,956.72	$607.75	$1,562.4	$3,720
Chest X-ray single view	CPT	71045	8	$306	$160.96	$121.54	$174.74	$306
Chest X-ray 2 views	CPT	71046	8	$349	$183.57	$118.25	$183.94	$349
Chest X-ray 3 views	CPT	71047	8	$199	$104.67	$79.04	$123.68	$224.97
CT chest without contrast	CPT	71250	8	$2,120	$1,115.12	$271.72	$890.4	$2,120
CT chest with contrast	CPT	71260	8	$1,497	$787.42	$327.88	$628.74	$1,497
CT chest with and without contrast	CPT	71270	8	$2,841	$1,494.37	$327.88	$1,193.22	$2,841
MRI chest without contrast	CPT	71550	8	$2,982	$1,568.53	$578.05	$1,252.44	$2,982
MRI chest with and without contrast	CPT	71552	8	$3,718	$1,955.67	$607.75	$1,561.56	$3,718
Lumbosacral spine X-ray	CPT	72100	8	$459	$241.43	$182.31	$230.18	$459
CT cervical spine without contrast	CPT	72125	8	$2,885	$1,517.51	$271.72	$1,211.7	$2,885
CT thoracic spine without contrast	CPT	72128	8	$2,120	$1,115.12	$263.91	$890.4	$2,120
CT lumbar spine without contrast	CPT	72131	8	$2,120	$1,115.12	$271.72	$890.4	$2,120
MRI cervical spine without contrast	CPT	72141	8	$2,891	$1,520.67	$578.05	$1,214.22	$2,891
MRI thoracic spine without contrast	CPT	72146	8	$2,628	$1,382.33	$578.05	$1,103.76	$2,628
MRI lumbar spine without contrast	CPT	72148	8	$3,203	$1,684.78	$578.05	$1,345.26	$3,203
MRI lumbar spine with and without contrast	CPT	72149	8	$3,373	$1,774.2	$607.75	$1,416.66	$3,373
MRI cervical spine with and without contrast	CPT	72156	8	$3,906	$2,054.56	$607.75	$1,640.52	$3,906
MRI lumbar spine with contrast	CPT	72158	8	$3,382	$1,778.93	$607.75	$1,420.44	$3,382
CT pelvis without contrast	CPT	72192	8	$1,624	$854.22	$271.72	$682.08	$1,624
CT pelvis with contrast	CPT	72193	8	$2,202	$1,158.25	$327.88	$924.84	$2,202
Shoulder X-ray	CPT	73030	8	$543	$285.62	$215.68	$230.75	$543
Humerus X-ray	CPT	73060	8	$307	$161.48	$121.94	$174.95	$307
Hand X-ray 3 views	CPT	73130	8	$238	$125.19	$94.53	$147.92	$238
MRI upper extremity joint without contrast	CPT	73221	8	$2,986	$1,570.64	$578.05	$1,254.12	$2,986
MRI upper extremity joint with and without contrast	CPT	73223	8	$3,629	$1,908.85	$607.75	$1,524.18	$3,629
Knee X-ray 1-2 views	CPT	73560	8	$243	$127.82	$96.52	$151.03	$243
Ankle X-ray 3 views	CPT	73610	8	$492	$258.79	$195.42	$214.54	$492
MRI lower extremity joint without contrast	CPT	73721	8	$3,858	$2,029.31	$578.05	$1,620.36	$3,858
MRI lower extremity joint with and without contrast	CPT	73723	8	$3,884	$2,042.98	$607.75	$1,631.28	$3,884
CT abdomen without contrast	CPT	74150	8	$1,861	$978.89	$263.91	$781.62	$1,861
CT abdomen with contrast	CPT	74160	8	$2,839	$1,493.31	$327.88	$1,192.38	$2,839
CT abdomen with and without contrast	CPT	74170	8	$2,756	$1,449.66	$327.88	$1,157.52	$2,756
CT abdomen and pelvis without contrast	CPT	74176	8	$3,394	$1,785.24	$327.88	$1,425.48	$3,394
CT abdomen and pelvis with contrast	CPT	74177	8	$3,897	$2,049.82	$327.88	$1,636.74	$3,897
CT abdomen and pelvis with and without contrast	CPT	74178	8	$3,233	$1,700.56	$327.88	$1,357.86	$3,233
MRI abdomen without contrast	CPT	74181	8	$3,878	$2,039.83	$578.05	$1,628.76	$3,878
MRI abdomen with and without contrast	CPT	74183	8	$3,627	$1,907.8	$607.75	$1,523.34	$3,627
Abdominal ultrasound complete	CPT	76700	8	$694	$365.04	$263.91	$294.92	$694
Abdominal ultrasound limited	CPT	76705	8	$627	$329.8	$52.39	$233.23	$627
Retroperitoneal ultrasound complete	CPT	76770	8	$676	$355.58	$263.91	$287.27	$676
Obstetric ultrasound first trimester	CPT	76801	8	$753	$396.08	$81.4	$267.82	$753
Obstetric ultrasound after first trimester	CPT	76805	8	$740	$389.24	$101.46	$310.8	$740
Obstetric ultrasound with fetal anatomy	CPT	76811	8	$424	$223.02	$102.74	$172.25	$644.59
Transvaginal ultrasound	CPT	76830	8	$539	$283.51	$64.31	$217.54	$539
Pelvic ultrasound complete	CPT	76856	8	$297	$156.22	$84.26	$118.67	$297
Scrotal ultrasound	CPT	76870	8	$539	$283.51	$214.09	$247.3	$539
Diagnostic mammography unilateral	CPT	77065	8	$396	$208.3	$157.29	$246.12	$396
Screening mammography bilateral	CPT	77067	8	$646	$339.8	$165	$328.95	$646
EKG tracing only	CPT	93005	8	$230	$120.98	$79.75	$122.92	$230
EKG interpretation only	CPT	93010	8	$93	$48.92	$5.75	$9.63	$93
Transthoracic echocardiogram complete	CPT	93306	8	$1,334	$701.68	$529.86	$968.48	$1,400.99
Transthoracic echocardiogram	CPT	93307	8	$1,117	$587.54	$443.67	$538.98	$1,117
Stress echocardiogram	CPT	93350	8	$1,158	$609.11	$459.96	$719.7	$1,400.99
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	5	$18,661	$9,815.69	$3,666.64	$3,791.85	$19,896
COPD w MCC	MS-DRG	190	5	$10,962	$5,766.01	$3,666.64	$3,791.85	$14,103
COPD w CC	MS-DRG	191	5	$8,300	$4,365.8	$3,666.64	$3,791.85	$10,733
COPD w/o CC/MCC	MS-DRG	192	5	$3,895	$2,048.77	$3,666.64	$3,791.85	$8,173.94
Simple pneumonia & pleurisy w CC	MS-DRG	194	5	$8,994	$4,730.84	$3,666.64	$3,791.85	$10,261
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	5	$2,936	$1,544.34	$3,666.64	$3,791.85	$8,002.06
AMI discharged alive w MCC	MS-DRG	280	5	$21,408	$11,261	$3,666.64	$3,791.85	$20,423
AMI discharged alive w CC	MS-DRG	281	5	$2,351	$1,236.63	$3,666.64	$3,791.85	$11,702
Heart failure & shock w MCC	MS-DRG	291	5	$17,056	$8,971.46	$3,666.64	$3,791.85	$16,345
Heart failure & shock w CC	MS-DRG	292	5	$10,644	$5,598.74	$3,666.64	$3,791.85	$10,809
Cardiac arrhythmia w MCC	MS-DRG	308	5	$3,941	$2,072.97	$3,666.64	$3,791.85	$15,329
Cardiac arrhythmia w CC	MS-DRG	309	5	$4,334	$2,279.68	$3,666.64	$3,791.85	$9,366.93
GI hemorrhage w CC	MS-DRG	378	5	$5,348	$2,813.05	$3,666.64	$3,791.85	$12,486
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	5	$11,485	$6,041.11	$3,666.64	$3,791.85	$9,925.87
Kidney/UTI w MCC	MS-DRG	689	5	$13,162	$6,923.21	$3,666.64	$3,791.85	$14,773
Kidney/UTI w/o MCC	MS-DRG	690	5	$10,685	$5,620.31	$3,666.64	$3,791.85	$10,307
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	5	$14,949	$7,863.17	$3,666.64	$3,791.85	$24,732
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	5	$16,578	$8,720.03	$3,666.64	$3,791.85	$13,029
Initial hospital care, low complexity	CPT	99221	8	$369	$194.09	$30.29	$85.76	$369
Initial hospital care, moderate complexity	CPT	99222	8	$497	$261.42	$143.08	$290.15	$497
Initial hospital care, high complexity	CPT	99223	8	$735	$386.61	$190.98	$401.78	$735
Hospital discharge, <30 min	CPT	99238	8	$266	$139.92	$89.83	$165.04	$266
Hospital discharge, >30 min	CPT	99239	8	$391	$205.67	$127.19	$242.6	$391
lab
Basic metabolic panel (BMP)	CPT	80048	8	$208	$109.41	$25.56	$87.36	$208
General health panel	CPT	80050	7	$436	$229.34	$50.13	$185.74	$436
Electrolyte panel	CPT	80051	8	$161	$84.69	$7.01	$66.11	$161
Comprehensive metabolic panel	CPT	80053	8	$344	$180.94	$31.46	$144.48	$344
Lipid panel	CPT	80061	8	$179	$94.15	$31.38	$70.03	$179
Renal function panel	CPT	80069	8	$147	$77.32	$8.68	$60.36	$147
Hepatic function panel	CPT	80076	8	$195	$102.57	$24.58	$82.87	$195
Urinalysis non-automated	CPT	81002	7	$37	$19.46	$3.48	$15.77	$37
Urinalysis automated	CPT	81003	8	$37	$19.46	$6.88	$15.73	$37
Glucose quantitative	CPT	82947	8	$48	$25.25	$11.8	$20.16	$48
Hemoglobin A1c	CPT	83036	8	$83	$43.66	$29.49	$35.36	$83
Thyroid stimulating hormone (TSH)	CPT	84443	8	$165	$86.79	$49.5	$68.64	$165
Complete blood count with automated differential	CPT	85025	8	$94	$49.44	$23.59	$40.05	$94
Complete blood count without differential	CPT	85027	8	$123	$64.7	$5.5	$50.51	$123
Urine culture bacterial	CPT	87086	8	$75	$39.45	$6.86	$31.5	$75
Urine culture identification	CPT	87088	8	$87	$45.76	$24.58	$36.97	$87
Tissue exam by pathologist level IV	CPT	88305	8	$205	$107.83	$79.75	$110.17	$205
maternity
Fetal non-stress test	CPT	59025	8	$791	$416.07	$314.19	$418.9	$791
Routine obstetric care including vaginal delivery	CPT	59400	8	$8,225	$4,326.35	$2,532.57	$5,020.48	$8,225
Vaginal delivery only	CPT	59409	8	$3,585	$1,885.71	$817.17	$2,224.32	$8,124.16
Vaginal delivery with postpartum	CPT	59410	8	$3,999	$2,103.47	$1,110.35	$2,283.33	$3,999
Routine obstetric care with C-section	CPT	59510	8	$9,071	$4,771.35	$1,387.89	$2,994.72	$9,071
C-section delivery only	CPT	59514	8	$4,429	$2,329.65	$540	$986.76	$4,429
C-section with postpartum	CPT	59515	8	$5,745	$3,021.87	$696.73	$1,468.41	$5,745
office
Office visit, new patient, 15-29 min	CPT	99202	8	$416	$218.82	$51.89	$176.78	$416
Office visit, new patient, 30-44 minutes	CPT	99203	8	$465	$244.59	$89.8	$197.6	$465
Office visit, new patient, 45-59 min	CPT	99204	8	$907	$477.08	$97.65	$337.7	$907
Office visit, new patient, 60-74 min	CPT	99205	8	$977	$513.9	$132.49	$388.06	$977
Office visit, established patient, 5 min	CPT	99211	8	$386	$203.04	$9.71	$71.41	$386
Office visit, established patient, 10-19 min	CPT	99212	8	$372	$195.67	$38.98	$150.14	$372
Office visit, established patient, 20-29 minutes	CPT	99213	8	$415	$218.29	$72.99	$177.62	$415
Office visit, established patient, 30-39 minutes	CPT	99214	8	$427	$224.6	$107.36	$182.76	$427
Office visit, established patient, 40-54 min	CPT	99215	8	$654	$344	$105.78	$278.61	$654
preventive
Upper GI endoscopy diagnostic	CPT	43235	8	$1,267	$666.44	$133.19	$1,024.46	$2,395.6
Upper GI endoscopy with biopsy	CPT	43239	8	$2,660	$1,399.16	$149.94	$1,090.6	$2,660
Sigmoidoscopy diagnostic	CPT	45330	8	$1,558	$819.51	$62.44	$628.81	$2,329.55
Sigmoidoscopy with biopsy	CPT	45331	8	$2,057	$1,081.98	$51.83	$817.04	$2,329.55
Colonoscopy diagnostic	CPT	45378	8	$3,106	$1,633.76	$199.17	$1,354.53	$3,106
Colonoscopy with biopsy	CPT	45380	8	$3,885	$2,043.51	$216.54	$1,628.52	$3,885
Colonoscopy with polyp removal	CPT	45385	8	$3,419	$1,798.39	$273.67	$1,463.33	$3,419
surgery
Total shoulder arthroplasty	CPT	23472	8	$6,618	$3,481.07	$1,568.36	$4,106.14	$46,989
Hip hemiarthroplasty	CPT	27125	8	$5,163	$2,715.74	$809.54	$2,768.87	$32,877
Total hip replacement	CPT	27130	8	$6,170	$3,245.42	$1,392.47	$3,828.18	$32,877
Total knee replacement	CPT	27447	8	$6,167	$3,243.84	$1,390.8	$3,826.32	$32,877
Knee revision arthroplasty single component	CPT	27486	8	$6,398	$3,365.35	$1,525.88	$3,969.64	$32,877
Knee revision arthroplasty all components	CPT	27487	8	$8,006	$4,211.16	$1,892.9	$4,967.33	$46,989
Shoulder arthroscopy with decompression	CPT	29826	7	$800	$420.8	$182.11	$268.37	$800
Shoulder arthroscopy with rotator cuff repair	CPT	29827	8	$4,791	$2,520.07	$766.97	$2,582.22	$18,253
Knee arthroscopy with meniscectomy	CPT	29881	8	$2,457	$1,292.38	$605.19	$1,524.45	$8,290.46
ACL reconstruction	CPT	29888	8	$4,473	$2,352.8	$1,067.72	$2,775.28	$18,253
Major small/large bowel procedures w MCC	MS-DRG	329	5	$26,857	$14,127	$3,666.64	$3,791.85	$58,523
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	5	$61,136	$32,158	$3,666.64	$3,791.85	$21,427
Open appendectomy	CPT	44950	8	$2,700	$1,420.2	$677.82	$1,675.22	$15,943
Laparoscopic appendectomy	CPT	44970	8	$2,536	$1,333.94	$641.94	$1,573.46	$14,908
Major joint replacement w MCC	MS-DRG	469	5	$45,386	$23,873	$3,666.64	$3,791.85	$38,619
Major joint replacement w/o MCC	MS-DRG	470	5	$44,146	$23,221	$3,666.64	$3,791.85	$24,559
Laparoscopic cholecystectomy	CPT	47562	8	$3,009	$1,582.73	$701.57	$1,866.94	$14,908
Lap cholecystectomy with cholangiography	CPT	47563	8	$2,903	$1,526.98	$761.54	$1,801.17	$14,908
Hip & femur procedures except major joint w CC	MS-DRG	481	5	$42,735	$22,479	$3,666.64	$3,791.85	$26,667
Lap inguinal hernia repair	CPT	49650	8	$1,960	$1,030.96	$466.64	$1,216.08	$14,908
Total abdominal hysterectomy	CPT	58150	7	$4,591	$2,414.87	$722.65	$1,169.5	$4,591
Lap-assisted vaginal hysterectomy >250g	CPT	58552	8	$4,427	$2,328.6	$1,062.12	$2,746.74	$26,602
Lap salpingo-oophorectomy	CPT	58661	8	$2,927	$1,539.6	$704.34	$1,816.06	$14,908
Cataract surgery with lens implant	CPT	66984	7	$2,867	$1,508.04	$398.63	$644.76	$2,867

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	160	$273.21
Medicaid	160	$410.54
Medicare	160	$293.18
UnitedHealthcare	160	$433.5
healthpartners [900713]	155	$594.8
medica [900156]	136	$511.42
First Health	136	$514.55
ma wisconsin replacement [950271]	136	$627.5

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