▸ Hospital · · CCN 529803

Childrens Hospital Of Wisconsin

Compliance grade
A
100/100
Procedures tracked
185
of 209 target codes
Payers
30
with negotiated rates
Rates published
42,085
last crawl 2026-05-24

Procedures & rates

ProcedureTypeCodePayersGrossCashNeg minNeg medianNeg max
behavioral
PsychosesMS-DRG8851$42,774$42,774$42,774
Psychiatric diagnostic evaluationCPT9079129$138.75$76.31$97.13$117.38$131.81
Psychiatric eval with medical servicesCPT9079229$138.75$76.31$97.13$117.38$131.81
Psychotherapy 30 minutesCPT9083229$69.25$38.09$48.48$58.59$65.79
Psychotherapy 45 minutesCPT9083429$104$57.2$72.8$87.98$98.8
Psychotherapy 60 minutesCPT9083729$138.75$76.31$97.13$117.38$131.81
Crisis psychotherapy 60 minutesCPT9083929$138.75$76.31$97.13$117.38$131.81
emergency
ED visit level 1CPT9928137$272.75$150.01$12.89$200.47$868
ED visit level 2CPT9928229$483.5$265.93$338.45$410.98$868
ED visit level 3CPT9928329$834$458.7$583.8$708.9$1,905
ED visit level 4CPT9928429$1,394.5$766.98$976.15$1,185.33$4,005
ED visit level 5CPT9928529$1,832.25$1,007.74$1,282.58$1,557.41$4,005
Critical care, first hourCPT9929129$2,805$1,542.75$1,963.5$2,384.25$5,870
imaging
CT head without contrastCPT7045029$2,197.25$1,208.49$1,538.08$1,858.87$2,087.39
CT head with contrastCPT7046029$2,449.25$1,347.09$1,714.48$2,072.07$2,326.79
CT head with and without contrastCPT7047029$3,323.75$1,828.06$2,326.63$2,811.89$3,157.56
CT neck with contrastCPT7049129$2,064.5$1,135.48$1,445.15$1,746.57$1,961.28
MRI brain without contrastCPT7055129$4,981.5$2,739.83$1,243.38$2,587.25$4,732.43
MRI brain with contrastCPT7055229$4,748.75$2,611.81$3,324.13$4,017.44$4,511.31
MRI brain with and without contrastCPT7055329$6,521.25$3,586.69$4,564.88$5,516.98$6,195.19
Chest X-ray single viewCPT7104529$236$129.8$165.2$199.66$224.2
Chest X-ray 2 viewsCPT7104629$433.75$238.56$303.63$366.95$412.06
Chest X-ray 3 viewsCPT7104729$500$275$350$423$475
CT chest without contrastCPT7125029$2,654.5$1,459.98$1,858.15$2,245.71$2,521.78
CT chest with contrastCPT7126029$2,694$1,481.7$1,885.8$2,279.12$2,559.3
CT chest with and without contrastCPT7127029$3,019.5$1,660.73$2,113.65$2,554.5$2,868.53
MRI chest without contrastCPT7155029$4,748.75$2,611.81$3,324.13$4,017.44$4,511.31
MRI chest with contrastCPT7155129$3,979.5$2,188.73$2,785.65$3,366.66$3,780.53
MRI chest with and without contrastCPT7155229$4,611.5$2,536.33$3,228.05$3,901.33$4,380.93
Lumbosacral spine X-rayCPT7210029$428$235.4$299.6$362.09$406.6
CT cervical spine without contrastCPT7212529$2,308.25$1,269.54$1,615.78$1,952.78$2,192.84
CT thoracic spine without contrastCPT7212829$2,770$1,523.5$1,939$2,343.42$2,631.5
CT lumbar spine without contrastCPT7213129$2,308.25$1,269.54$1,615.78$1,952.78$2,192.84
MRI cervical spine without contrastCPT7214129$5,061.75$2,783.96$3,543.23$4,282.24$4,808.66
MRI thoracic spine without contrastCPT7214629$4,925.5$2,709.03$3,447.85$4,166.97$4,679.23
MRI lumbar spine without contrastCPT7214829$5,061.75$2,783.96$3,543.23$4,282.24$4,808.66
MRI lumbar spine with and without contrastCPT7214929$5,061.75$2,783.96$3,543.23$4,282.24$4,808.66
MRI cervical spine with and without contrastCPT7215629$7,012$3,856.6$4,908.4$5,932.15$6,661.4
MRI lumbar spine with contrastCPT7215829$6,435.25$3,539.39$4,504.68$5,444.22$6,113.49
CT pelvis without contrastCPT7219229$2,539$1,396.45$1,777.3$2,147.99$2,412.05
CT pelvis with contrastCPT7219329$3,004.75$1,652.61$2,103.33$2,542.02$2,854.51
Shoulder X-rayCPT7303029$428$235.4$299.6$362.09$406.6
Humerus X-rayCPT7306029$369$202.95$258.3$312.17$350.55
Hand X-ray 3 viewsCPT7313029$428$235.4$299.6$362.09$406.6
MRI upper extremity joint without contrastCPT7322129$4,576.25$2,516.94$947.8$2,244.84$4,347.44
MRI upper extremity joint with and without contrastCPT7322329$6,225.5$3,424.03$4,357.85$5,266.77$5,914.23
Knee X-ray 1-2 viewsCPT7356029$289.5$159.23$202.65$244.92$275.03
Ankle X-ray 3 viewsCPT7361029$428$235.4$299.6$362.09$406.6
MRI lower extremity joint without contrastCPT7372129$4,576.25$2,516.94$3,203.38$3,871.51$4,347.44
MRI lower extremity joint with and without contrastCPT7372329$6,225.5$3,424.03$4,357.85$5,266.77$5,914.23
CT abdomen without contrastCPT7415029$2,381.75$1,309.96$1,667.23$2,014.96$2,262.66
CT abdomen with contrastCPT7416029$2,560.5$1,408.28$1,792.35$2,166.18$2,432.48
CT abdomen with and without contrastCPT7417029$2,918.5$1,605.18$2,042.95$2,469.05$2,772.58
CT abdomen and pelvis without contrastCPT7417629$3,362.5$1,849.38$2,353.75$2,844.68$3,194.38
CT abdomen and pelvis with contrastCPT7417729$3,600$1,980$2,520$3,045.6$3,420
CT abdomen and pelvis with and without contrastCPT7417829$4,631.5$2,547.33$3,242.05$3,918.25$4,399.93
MRI abdomen without contrastCPT7418129$4,576.25$2,516.94$3,203.38$3,871.51$4,347.44
MRI abdomen with and without contrastCPT7418329$5,790$3,184.5$4,053$4,898.34$5,500.5
Abdominal ultrasound completeCPT7670029$1,571.25$864.19$1,099.88$1,329.28$1,492.69
Abdominal ultrasound limitedCPT7670529$803$441.65$148.75$534.63$762.85
Retroperitoneal ultrasound completeCPT7677029$1,635.25$899.39$1,144.68$1,383.42$1,553.49
Obstetric ultrasound first trimesterCPT7680129$1,220.25$671.14$617.23$845.92$1,159.24
Obstetric ultrasound after first trimesterCPT7680529$1,099.5$604.73$769.65$930.18$1,044.53
Obstetric ultrasound with fetal anatomyCPT7681129$1,475$811.25$1,032.5$1,247.85$1,401.25
Transvaginal ultrasoundCPT7683029$900.25$495.14$630.18$761.61$855.24
Pelvic ultrasound completeCPT7685629$895.25$492.39$626.68$757.38$850.49
Scrotal ultrasoundCPT7687029$774$425.7$541.8$654.8$735.3
EKG tracing onlyCPT9300529$294.5$161.98$206.15$249.15$279.78
Transthoracic echocardiogram completeCPT9330629$4,694$2,581.7$3,285.8$3,971.12$4,459.3
inpatient
Intracranial hemorrhage/CVA w MCCMS-DRG0641$60,362$60,362$60,362
Intracranial hemorrhage/CVA w CCMS-DRG0651$30,858$30,858$30,858
Intracranial hemorrhage/CVA w/o CC/MCCMS-DRG0661$20,886$20,886$20,886
Respiratory infections & inflammations w MCCMS-DRG1771$49,053$49,053$49,053
COPD w MCCMS-DRG1901$34,077$34,077$34,077
COPD w CCMS-DRG1911$26,069$26,069$26,069
COPD w/o CC/MCCMS-DRG1921$19,639$19,639$19,639
Simple pneumonia & pleurisy w CCMS-DRG1941$24,883$24,883$24,883
Simple pneumonia & pleurisy w/o CC/MCCMS-DRG1951$18,896$18,896$18,896
AMI discharged alive w MCCMS-DRG2801$49,808$49,808$49,808
AMI discharged alive w CCMS-DRG2811$27,972$27,972$27,972
AMI discharged alive w/o CC/MCCMS-DRG2821$22,003$22,003$22,003
Heart failure & shock w MCCMS-DRG2911$39,594$39,594$39,594
Heart failure & shock w CCMS-DRG2921$26,133$26,133$26,133
Heart failure & shock w/o CC/MCCMS-DRG2931$16,650$16,650$16,650
Cardiac arrhythmia w MCCMS-DRG3081$36,593$36,593$36,593
Cardiac arrhythmia w CCMS-DRG3091$22,434$22,434$22,434
Cardiac arrhythmia w/o CC/MCCMS-DRG3101$16,978$16,978$16,978
GI hemorrhage w CCMS-DRG3781$29,917$29,917$29,917
GI hemorrhage w/o CC/MCCMS-DRG3791$19,321$19,321$19,321
Esophagitis/gastroenteritis w/o MCCMS-DRG3921$23,678$23,678$23,678
Fractures of femur w/o MCCMS-DRG5331$46,273$46,273$46,273
Kidney/UTI w MCCMS-DRG6891$35,513$35,513$35,513
Kidney/UTI w/o MCCMS-DRG6901$24,355$24,355$24,355
Septicemia or severe sepsis w MV 96+ hrsMS-DRG8711$59,540$59,540$59,540
Septicemia or severe sepsis w/o MV 96+ hrsMS-DRG8721$31,286$31,286$31,286
lab
Basic metabolic panel (BMP)CPT8004834$212.5$116.88$8.46$170$201.88
General health panelCPT800507$40.66$56.07$64.3
Electrolyte panelCPT8005134$199$109.45$7.01$159.2$189.05
Comprehensive metabolic panelCPT8005334$294.5$161.98$10.56$235.6$279.78
Lipid panelCPT8006134$217.25$119.49$13.39$173.8$206.39
Renal function panelCPT800697$8.68$9.46$10.85
Hepatic function panelCPT8007634$209.25$115.09$8.17$34.88$198.79
Urinalysis non-automatedCPT8100237$65.5$36.03$3.48$39.3$62.23
Urinalysis automatedCPT8100334$68.75$37.81$2.25$55$65.31
Glucose quantitativeCPT8294734$88.75$48.81$3.93$71$84.31
Hemoglobin A1cCPT8303634$184.25$101.34$9.71$147.4$175.04
Thyroid stimulating hormone (TSH)CPT8444334$226.25$124.44$16.8$43.2$214.94
Complete blood count with automated differentialCPT8502534$157.75$86.76$7.77$126.2$149.86
Complete blood count without differentialCPT8502734$134$73.7$6.47$99.65$127.3
Urine culture bacterialCPT8708634$192$105.6$8.07$153.6$182.4
Urine culture identificationCPT8708834$83.75$46.06$8.09$67$79.56
Tissue exam by pathologist level IVCPT8830534$1,863.25$1,024.79$50.14$330.19$1,770.09
maternity
Fetal non-stress testCPT5902529$272.75$150.01$190.93$231.3$3,990
Routine obstetric care including vaginal deliveryCPT594001$8,006$8,450$8,894
Vaginal delivery onlyCPT594092$6,842$7,870$10,500
Vaginal delivery with postpartumCPT594101$8,006$8,450$8,894
Routine obstetric care with C-sectionCPT595101$8,006$8,450$8,894
C-section delivery onlyCPT595142$6,842$7,870$8,085
C-section with postpartumCPT595152$8,006$8,085$8,894
office
Office visit, new patient, 15-29 minCPT9920232$400$220$48.35$320$380
Office visit, new patient, 30-44 minutesCPT9920332$490$269.5$74.38$392$465.5
Office visit, new patient, 45-59 minCPT9920432$734$403.7$110.94$587.2$697.3
Office visit, new patient, 60-74 minCPT9920532$970$533.5$146.41$776$921.5
Office visit, established patient, 5 minCPT9921137$222$122.1$15.61$72.25$210.9
Office visit, established patient, 10-19 minCPT9921237$343.25$188.79$37.79$240.28$326.09
Office visit, established patient, 20-29 minutesCPT9921337$439$241.45$58.8$102.55$417.05
Office visit, established patient, 30-39 minutesCPT9921437$560$308$85.58$392$532
Office visit, established patient, 40-54 minCPT9921537$751$413.05$98$499.03$713.45
preventive
Upper GI endoscopy diagnosticCPT432352$5,749$6,159$8,190
Upper GI endoscopy with biopsyCPT432392$5,749$6,159$8,190
Sigmoidoscopy diagnosticCPT453302$5,749$6,159$7,350
Sigmoidoscopy with biopsyCPT453312$5,749$6,159$7,350
Colonoscopy diagnosticCPT453782$5,749$6,159$8,190
Colonoscopy with biopsyCPT453802$6,842$7,870$8,190
Colonoscopy with polyp removalCPT453852$6,842$7,870$8,190
surgery
Total shoulder arthroplastyCPT234722$13,774$13,958$25,306
Hip hemiarthroplastyCPT271252$8,006$8,894$18,060
Total hip replacementCPT271302$13,774$13,958$25,306
Total knee replacementCPT274472$14,056$15,055$25,306
Knee revision arthroplasty single componentCPT274862$13,774$13,958$25,306
Knee revision arthroplasty all componentsCPT274872$13,774$13,958$25,306
Shoulder arthroscopy with decompressionCPT298262$3,990$5,749$6,159
Shoulder arthroscopy with rotator cuff repairCPT298272$13,774$13,958$18,060
Knee arthroscopy with meniscectomyCPT298812$8,006$8,894$11,655
ACL reconstructionCPT298882$13,774$13,958$18,060
Major small/large bowel procedures w MCCMS-DRG3291$139,341$139,341$139,341
Major small/large bowel procedures w CCMS-DRG3301$71,726$71,726$71,726
Major small/large bowel procedures w/o CC/MCCMS-DRG3311$50,100$50,100$50,100
CABG single arterial graftCPT335332$8,085$14,056$15,055
CABG 2 arterial graftsCPT335342$8,085$14,056$15,055
CABG 3 arterial graftsCPT335352$8,085$14,056$15,055
CABG 4+ arterial graftsCPT335362$8,085$14,056$15,055
Laparoscopic cholecystectomy w/o CDE w MCCMS-DRG4181$50,324$50,324$50,324
Laparoscopic cholecystectomy w/o CDE w CCMS-DRG4191$39,983$39,983$39,983
Laparoscopic cholecystectomy w/o CDE w/o CC/MCCMS-DRG4201$107,103$107,103$107,103
Open appendectomyCPT449502$8,006$8,894$11,655
Laparoscopic appendectomyCPT449702$11,290$11,838$18,060
Major joint replacement w MCCMS-DRG4691$99,189$99,189$99,189
Major joint replacement w/o MCCMS-DRG4701$57,216$57,216$57,216
Laparoscopic cholecystectomyCPT475622$11,290$11,838$18,060
Lap cholecystectomy with cholangiographyCPT475632$11,290$11,838$18,060
Hip & femur procedures except major joint w MCCMS-DRG4801$89,245$89,245$89,245
Hip & femur procedures except major joint w CCMS-DRG4811$62,963$62,963$62,963
Hip & femur procedures except major joint w/o CC/MCCMS-DRG4821$48,139$48,139$48,139
Lap inguinal hernia repairCPT496502$11,290$11,838$18,060
Total abdominal hysterectomyCPT581502$11,290$11,655$11,838
Vaginal hysterectomyCPT582602$10,196$10,948$11,655
Lap-assisted vaginal hysterectomyCPT585502$11,290$11,838$18,060
Lap-assisted vaginal hysterectomy >250gCPT585522$14,056$15,055$18,060
Lap salpingo-oophorectomyCPT586612$11,290$11,838$18,060
OR procedure for obesity w MCCMS-DRG6191$82,736$82,736$82,736
OR procedure for obesity w CCMS-DRG6201$48,461$48,461$48,461
OR procedure for obesity w/o CC/MCCMS-DRG6211$44,358$44,358$44,358
Complex cataract surgeryCPT669822$6,842$7,870$10,500
Cataract surgery with lens implantCPT669842$6,842$7,870$10,500
Intravitreal injectionCPT670282$3,990$5,749$6,159
Vitrectomy mechanicalCPT670422$10,196$10,948$13,913
Uterine & adnexa procedures w CC/MCCMS-DRG7431$36,375$36,375$36,375
Uterine & adnexa procedures w/o CC/MCCMS-DRG7441$59,294$59,294$59,294
PCI single major coronary arteryCPT9292029$2,115.75$1,163.66$1,481.03$1,794.16$18,060
PCI with drug-eluting stentCPT9292829$4,674$2,570.7$3,271.8$3,963.55$18,060
PCI bypass graftCPT929371$18,060$18,060$18,060
Left heart catheterizationCPT9345229$10,329$5,680.95$7,230.3$8,758.99$13,913
Coronary angiography with cathCPT934551$13,913$13,913$13,913
Coronary angiography with bypass cathCPT9345829$10,329$5,680.95$7,230.3$8,758.99$13,913

Payer mix (top 30)

PayerCodes coveredMedian rate
UnitedHealthcare182$1,057.26
Anthem BCBS140$850.49
aspirus health plan97$455.91
centivo97$474.15
advocate aurora healthcare97$468.07
Aetna97$441
froedtert health97$472
group health cooperative of south central wisconsin97$547.09
health partners97$502.15
health payment systems97$514.26
mayo clinic health solutions97$528.85
medical college of wisconsin97$425.52
Multiplan97$474.1
network health plan97$416.01
oan llc97$486.3
security health plan97$504.54
sheboygan employer's health network97$516.7
trilogy health solutions97$572.81
wps health plan97$584.35
Cigna97$547.09
common ground healthcare cooperative97$540.72
dean health plan97$486.3
employer health care alliance cooperative97$386.03
First Health97$577.48
praire states93$657.9
quartz health insurance93$657.9
group health cooperative of eau claire93$619.2
prevea health network93$696.6
bellin thedacare93$696.6
chorus community health plan27$12.22