▸ 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
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 1 | — | — | $42,774 | $42,774 | $42,774 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 29 | $138.75 | $76.31 | $97.13 | $117.38 | $131.81 |
| Psychiatric eval with medical services | CPT | 90792 | 29 | $138.75 | $76.31 | $97.13 | $117.38 | $131.81 |
| Psychotherapy 30 minutes | CPT | 90832 | 29 | $69.25 | $38.09 | $48.48 | $58.59 | $65.79 |
| Psychotherapy 45 minutes | CPT | 90834 | 29 | $104 | $57.2 | $72.8 | $87.98 | $98.8 |
| Psychotherapy 60 minutes | CPT | 90837 | 29 | $138.75 | $76.31 | $97.13 | $117.38 | $131.81 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 29 | $138.75 | $76.31 | $97.13 | $117.38 | $131.81 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 37 | $272.75 | $150.01 | $12.89 | $200.47 | $868 |
| ED visit level 2 | CPT | 99282 | 29 | $483.5 | $265.93 | $338.45 | $410.98 | $868 |
| ED visit level 3 | CPT | 99283 | 29 | $834 | $458.7 | $583.8 | $708.9 | $1,905 |
| ED visit level 4 | CPT | 99284 | 29 | $1,394.5 | $766.98 | $976.15 | $1,185.33 | $4,005 |
| ED visit level 5 | CPT | 99285 | 29 | $1,832.25 | $1,007.74 | $1,282.58 | $1,557.41 | $4,005 |
| Critical care, first hour | CPT | 99291 | 29 | $2,805 | $1,542.75 | $1,963.5 | $2,384.25 | $5,870 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 29 | $2,197.25 | $1,208.49 | $1,538.08 | $1,858.87 | $2,087.39 |
| CT head with contrast | CPT | 70460 | 29 | $2,449.25 | $1,347.09 | $1,714.48 | $2,072.07 | $2,326.79 |
| CT head with and without contrast | CPT | 70470 | 29 | $3,323.75 | $1,828.06 | $2,326.63 | $2,811.89 | $3,157.56 |
| CT neck with contrast | CPT | 70491 | 29 | $2,064.5 | $1,135.48 | $1,445.15 | $1,746.57 | $1,961.28 |
| MRI brain without contrast | CPT | 70551 | 29 | $4,981.5 | $2,739.83 | $1,243.38 | $2,587.25 | $4,732.43 |
| MRI brain with contrast | CPT | 70552 | 29 | $4,748.75 | $2,611.81 | $3,324.13 | $4,017.44 | $4,511.31 |
| MRI brain with and without contrast | CPT | 70553 | 29 | $6,521.25 | $3,586.69 | $4,564.88 | $5,516.98 | $6,195.19 |
| Chest X-ray single view | CPT | 71045 | 29 | $236 | $129.8 | $165.2 | $199.66 | $224.2 |
| Chest X-ray 2 views | CPT | 71046 | 29 | $433.75 | $238.56 | $303.63 | $366.95 | $412.06 |
| Chest X-ray 3 views | CPT | 71047 | 29 | $500 | $275 | $350 | $423 | $475 |
| CT chest without contrast | CPT | 71250 | 29 | $2,654.5 | $1,459.98 | $1,858.15 | $2,245.71 | $2,521.78 |
| CT chest with contrast | CPT | 71260 | 29 | $2,694 | $1,481.7 | $1,885.8 | $2,279.12 | $2,559.3 |
| CT chest with and without contrast | CPT | 71270 | 29 | $3,019.5 | $1,660.73 | $2,113.65 | $2,554.5 | $2,868.53 |
| MRI chest without contrast | CPT | 71550 | 29 | $4,748.75 | $2,611.81 | $3,324.13 | $4,017.44 | $4,511.31 |
| MRI chest with contrast | CPT | 71551 | 29 | $3,979.5 | $2,188.73 | $2,785.65 | $3,366.66 | $3,780.53 |
| MRI chest with and without contrast | CPT | 71552 | 29 | $4,611.5 | $2,536.33 | $3,228.05 | $3,901.33 | $4,380.93 |
| Lumbosacral spine X-ray | CPT | 72100 | 29 | $428 | $235.4 | $299.6 | $362.09 | $406.6 |
| CT cervical spine without contrast | CPT | 72125 | 29 | $2,308.25 | $1,269.54 | $1,615.78 | $1,952.78 | $2,192.84 |
| CT thoracic spine without contrast | CPT | 72128 | 29 | $2,770 | $1,523.5 | $1,939 | $2,343.42 | $2,631.5 |
| CT lumbar spine without contrast | CPT | 72131 | 29 | $2,308.25 | $1,269.54 | $1,615.78 | $1,952.78 | $2,192.84 |
| MRI cervical spine without contrast | CPT | 72141 | 29 | $5,061.75 | $2,783.96 | $3,543.23 | $4,282.24 | $4,808.66 |
| MRI thoracic spine without contrast | CPT | 72146 | 29 | $4,925.5 | $2,709.03 | $3,447.85 | $4,166.97 | $4,679.23 |
| MRI lumbar spine without contrast | CPT | 72148 | 29 | $5,061.75 | $2,783.96 | $3,543.23 | $4,282.24 | $4,808.66 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 29 | $5,061.75 | $2,783.96 | $3,543.23 | $4,282.24 | $4,808.66 |
| MRI cervical spine with and without contrast | CPT | 72156 | 29 | $7,012 | $3,856.6 | $4,908.4 | $5,932.15 | $6,661.4 |
| MRI lumbar spine with contrast | CPT | 72158 | 29 | $6,435.25 | $3,539.39 | $4,504.68 | $5,444.22 | $6,113.49 |
| CT pelvis without contrast | CPT | 72192 | 29 | $2,539 | $1,396.45 | $1,777.3 | $2,147.99 | $2,412.05 |
| CT pelvis with contrast | CPT | 72193 | 29 | $3,004.75 | $1,652.61 | $2,103.33 | $2,542.02 | $2,854.51 |
| Shoulder X-ray | CPT | 73030 | 29 | $428 | $235.4 | $299.6 | $362.09 | $406.6 |
| Humerus X-ray | CPT | 73060 | 29 | $369 | $202.95 | $258.3 | $312.17 | $350.55 |
| Hand X-ray 3 views | CPT | 73130 | 29 | $428 | $235.4 | $299.6 | $362.09 | $406.6 |
| MRI upper extremity joint without contrast | CPT | 73221 | 29 | $4,576.25 | $2,516.94 | $947.8 | $2,244.84 | $4,347.44 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 29 | $6,225.5 | $3,424.03 | $4,357.85 | $5,266.77 | $5,914.23 |
| Knee X-ray 1-2 views | CPT | 73560 | 29 | $289.5 | $159.23 | $202.65 | $244.92 | $275.03 |
| Ankle X-ray 3 views | CPT | 73610 | 29 | $428 | $235.4 | $299.6 | $362.09 | $406.6 |
| MRI lower extremity joint without contrast | CPT | 73721 | 29 | $4,576.25 | $2,516.94 | $3,203.38 | $3,871.51 | $4,347.44 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 29 | $6,225.5 | $3,424.03 | $4,357.85 | $5,266.77 | $5,914.23 |
| CT abdomen without contrast | CPT | 74150 | 29 | $2,381.75 | $1,309.96 | $1,667.23 | $2,014.96 | $2,262.66 |
| CT abdomen with contrast | CPT | 74160 | 29 | $2,560.5 | $1,408.28 | $1,792.35 | $2,166.18 | $2,432.48 |
| CT abdomen with and without contrast | CPT | 74170 | 29 | $2,918.5 | $1,605.18 | $2,042.95 | $2,469.05 | $2,772.58 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 29 | $3,362.5 | $1,849.38 | $2,353.75 | $2,844.68 | $3,194.38 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 29 | $3,600 | $1,980 | $2,520 | $3,045.6 | $3,420 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 29 | $4,631.5 | $2,547.33 | $3,242.05 | $3,918.25 | $4,399.93 |
| MRI abdomen without contrast | CPT | 74181 | 29 | $4,576.25 | $2,516.94 | $3,203.38 | $3,871.51 | $4,347.44 |
| MRI abdomen with and without contrast | CPT | 74183 | 29 | $5,790 | $3,184.5 | $4,053 | $4,898.34 | $5,500.5 |
| Abdominal ultrasound complete | CPT | 76700 | 29 | $1,571.25 | $864.19 | $1,099.88 | $1,329.28 | $1,492.69 |
| Abdominal ultrasound limited | CPT | 76705 | 29 | $803 | $441.65 | $148.75 | $534.63 | $762.85 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 29 | $1,635.25 | $899.39 | $1,144.68 | $1,383.42 | $1,553.49 |
| Obstetric ultrasound first trimester | CPT | 76801 | 29 | $1,220.25 | $671.14 | $617.23 | $845.92 | $1,159.24 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 29 | $1,099.5 | $604.73 | $769.65 | $930.18 | $1,044.53 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 29 | $1,475 | $811.25 | $1,032.5 | $1,247.85 | $1,401.25 |
| Transvaginal ultrasound | CPT | 76830 | 29 | $900.25 | $495.14 | $630.18 | $761.61 | $855.24 |
| Pelvic ultrasound complete | CPT | 76856 | 29 | $895.25 | $492.39 | $626.68 | $757.38 | $850.49 |
| Scrotal ultrasound | CPT | 76870 | 29 | $774 | $425.7 | $541.8 | $654.8 | $735.3 |
| EKG tracing only | CPT | 93005 | 29 | $294.5 | $161.98 | $206.15 | $249.15 | $279.78 |
| Transthoracic echocardiogram complete | CPT | 93306 | 29 | $4,694 | $2,581.7 | $3,285.8 | $3,971.12 | $4,459.3 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 1 | — | — | $60,362 | $60,362 | $60,362 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 1 | — | — | $30,858 | $30,858 | $30,858 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 1 | — | — | $20,886 | $20,886 | $20,886 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 1 | — | — | $49,053 | $49,053 | $49,053 |
| COPD w MCC | MS-DRG | 190 | 1 | — | — | $34,077 | $34,077 | $34,077 |
| COPD w CC | MS-DRG | 191 | 1 | — | — | $26,069 | $26,069 | $26,069 |
| COPD w/o CC/MCC | MS-DRG | 192 | 1 | — | — | $19,639 | $19,639 | $19,639 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 1 | — | — | $24,883 | $24,883 | $24,883 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 1 | — | — | $18,896 | $18,896 | $18,896 |
| AMI discharged alive w MCC | MS-DRG | 280 | 1 | — | — | $49,808 | $49,808 | $49,808 |
| AMI discharged alive w CC | MS-DRG | 281 | 1 | — | — | $27,972 | $27,972 | $27,972 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 1 | — | — | $22,003 | $22,003 | $22,003 |
| Heart failure & shock w MCC | MS-DRG | 291 | 1 | — | — | $39,594 | $39,594 | $39,594 |
| Heart failure & shock w CC | MS-DRG | 292 | 1 | — | — | $26,133 | $26,133 | $26,133 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | — | — | $16,650 | $16,650 | $16,650 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 1 | — | — | $36,593 | $36,593 | $36,593 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 1 | — | — | $22,434 | $22,434 | $22,434 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 1 | — | — | $16,978 | $16,978 | $16,978 |
| GI hemorrhage w CC | MS-DRG | 378 | 1 | — | — | $29,917 | $29,917 | $29,917 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 1 | — | — | $19,321 | $19,321 | $19,321 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 1 | — | — | $23,678 | $23,678 | $23,678 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 1 | — | — | $46,273 | $46,273 | $46,273 |
| Kidney/UTI w MCC | MS-DRG | 689 | 1 | — | — | $35,513 | $35,513 | $35,513 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 1 | — | — | $24,355 | $24,355 | $24,355 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 1 | — | — | $59,540 | $59,540 | $59,540 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 1 | — | — | $31,286 | $31,286 | $31,286 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 34 | $212.5 | $116.88 | $8.46 | $170 | $201.88 |
| General health panel | CPT | 80050 | 7 | — | — | $40.66 | $56.07 | $64.3 |
| Electrolyte panel | CPT | 80051 | 34 | $199 | $109.45 | $7.01 | $159.2 | $189.05 |
| Comprehensive metabolic panel | CPT | 80053 | 34 | $294.5 | $161.98 | $10.56 | $235.6 | $279.78 |
| Lipid panel | CPT | 80061 | 34 | $217.25 | $119.49 | $13.39 | $173.8 | $206.39 |
| Renal function panel | CPT | 80069 | 7 | — | — | $8.68 | $9.46 | $10.85 |
| Hepatic function panel | CPT | 80076 | 34 | $209.25 | $115.09 | $8.17 | $34.88 | $198.79 |
| Urinalysis non-automated | CPT | 81002 | 37 | $65.5 | $36.03 | $3.48 | $39.3 | $62.23 |
| Urinalysis automated | CPT | 81003 | 34 | $68.75 | $37.81 | $2.25 | $55 | $65.31 |
| Glucose quantitative | CPT | 82947 | 34 | $88.75 | $48.81 | $3.93 | $71 | $84.31 |
| Hemoglobin A1c | CPT | 83036 | 34 | $184.25 | $101.34 | $9.71 | $147.4 | $175.04 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 34 | $226.25 | $124.44 | $16.8 | $43.2 | $214.94 |
| Complete blood count with automated differential | CPT | 85025 | 34 | $157.75 | $86.76 | $7.77 | $126.2 | $149.86 |
| Complete blood count without differential | CPT | 85027 | 34 | $134 | $73.7 | $6.47 | $99.65 | $127.3 |
| Urine culture bacterial | CPT | 87086 | 34 | $192 | $105.6 | $8.07 | $153.6 | $182.4 |
| Urine culture identification | CPT | 87088 | 34 | $83.75 | $46.06 | $8.09 | $67 | $79.56 |
| Tissue exam by pathologist level IV | CPT | 88305 | 34 | $1,863.25 | $1,024.79 | $50.14 | $330.19 | $1,770.09 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 29 | $272.75 | $150.01 | $190.93 | $231.3 | $3,990 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $8,006 | $8,450 | $8,894 |
| Vaginal delivery only | CPT | 59409 | 2 | — | — | $6,842 | $7,870 | $10,500 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $8,006 | $8,450 | $8,894 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $8,006 | $8,450 | $8,894 |
| C-section delivery only | CPT | 59514 | 2 | — | — | $6,842 | $7,870 | $8,085 |
| C-section with postpartum | CPT | 59515 | 2 | — | — | $8,006 | $8,085 | $8,894 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 32 | $400 | $220 | $48.35 | $320 | $380 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 32 | $490 | $269.5 | $74.38 | $392 | $465.5 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 32 | $734 | $403.7 | $110.94 | $587.2 | $697.3 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 32 | $970 | $533.5 | $146.41 | $776 | $921.5 |
| Office visit, established patient, 5 min | CPT | 99211 | 37 | $222 | $122.1 | $15.61 | $72.25 | $210.9 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 37 | $343.25 | $188.79 | $37.79 | $240.28 | $326.09 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 37 | $439 | $241.45 | $58.8 | $102.55 | $417.05 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 37 | $560 | $308 | $85.58 | $392 | $532 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 37 | $751 | $413.05 | $98 | $499.03 | $713.45 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 2 | — | — | $5,749 | $6,159 | $8,190 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 2 | — | — | $5,749 | $6,159 | $8,190 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 2 | — | — | $5,749 | $6,159 | $7,350 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 2 | — | — | $5,749 | $6,159 | $7,350 |
| Colonoscopy diagnostic | CPT | 45378 | 2 | — | — | $5,749 | $6,159 | $8,190 |
| Colonoscopy with biopsy | CPT | 45380 | 2 | — | — | $6,842 | $7,870 | $8,190 |
| Colonoscopy with polyp removal | CPT | 45385 | 2 | — | — | $6,842 | $7,870 | $8,190 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 2 | — | — | $13,774 | $13,958 | $25,306 |
| Hip hemiarthroplasty | CPT | 27125 | 2 | — | — | $8,006 | $8,894 | $18,060 |
| Total hip replacement | CPT | 27130 | 2 | — | — | $13,774 | $13,958 | $25,306 |
| Total knee replacement | CPT | 27447 | 2 | — | — | $14,056 | $15,055 | $25,306 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | — | — | $13,774 | $13,958 | $25,306 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | — | — | $13,774 | $13,958 | $25,306 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 2 | — | — | $3,990 | $5,749 | $6,159 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 2 | — | — | $13,774 | $13,958 | $18,060 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 2 | — | — | $8,006 | $8,894 | $11,655 |
| ACL reconstruction | CPT | 29888 | 2 | — | — | $13,774 | $13,958 | $18,060 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 1 | — | — | $139,341 | $139,341 | $139,341 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 1 | — | — | $71,726 | $71,726 | $71,726 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 1 | — | — | $50,100 | $50,100 | $50,100 |
| CABG single arterial graft | CPT | 33533 | 2 | — | — | $8,085 | $14,056 | $15,055 |
| CABG 2 arterial grafts | CPT | 33534 | 2 | — | — | $8,085 | $14,056 | $15,055 |
| CABG 3 arterial grafts | CPT | 33535 | 2 | — | — | $8,085 | $14,056 | $15,055 |
| CABG 4+ arterial grafts | CPT | 33536 | 2 | — | — | $8,085 | $14,056 | $15,055 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 1 | — | — | $50,324 | $50,324 | $50,324 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 1 | — | — | $39,983 | $39,983 | $39,983 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 1 | — | — | $107,103 | $107,103 | $107,103 |
| Open appendectomy | CPT | 44950 | 2 | — | — | $8,006 | $8,894 | $11,655 |
| Laparoscopic appendectomy | CPT | 44970 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| Major joint replacement w MCC | MS-DRG | 469 | 1 | — | — | $99,189 | $99,189 | $99,189 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 1 | — | — | $57,216 | $57,216 | $57,216 |
| Laparoscopic cholecystectomy | CPT | 47562 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 1 | — | — | $89,245 | $89,245 | $89,245 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 1 | — | — | $62,963 | $62,963 | $62,963 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 1 | — | — | $48,139 | $48,139 | $48,139 |
| Lap inguinal hernia repair | CPT | 49650 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| Total abdominal hysterectomy | CPT | 58150 | 2 | — | — | $11,290 | $11,655 | $11,838 |
| Vaginal hysterectomy | CPT | 58260 | 2 | — | — | $10,196 | $10,948 | $11,655 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 2 | — | — | $14,056 | $15,055 | $18,060 |
| Lap salpingo-oophorectomy | CPT | 58661 | 2 | — | — | $11,290 | $11,838 | $18,060 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 1 | — | — | $82,736 | $82,736 | $82,736 |
| OR procedure for obesity w CC | MS-DRG | 620 | 1 | — | — | $48,461 | $48,461 | $48,461 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 1 | — | — | $44,358 | $44,358 | $44,358 |
| Complex cataract surgery | CPT | 66982 | 2 | — | — | $6,842 | $7,870 | $10,500 |
| Cataract surgery with lens implant | CPT | 66984 | 2 | — | — | $6,842 | $7,870 | $10,500 |
| Intravitreal injection | CPT | 67028 | 2 | — | — | $3,990 | $5,749 | $6,159 |
| Vitrectomy mechanical | CPT | 67042 | 2 | — | — | $10,196 | $10,948 | $13,913 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 1 | — | — | $36,375 | $36,375 | $36,375 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 1 | — | — | $59,294 | $59,294 | $59,294 |
| PCI single major coronary artery | CPT | 92920 | 29 | $2,115.75 | $1,163.66 | $1,481.03 | $1,794.16 | $18,060 |
| PCI with drug-eluting stent | CPT | 92928 | 29 | $4,674 | $2,570.7 | $3,271.8 | $3,963.55 | $18,060 |
| PCI bypass graft | CPT | 92937 | 1 | — | — | $18,060 | $18,060 | $18,060 |
| Left heart catheterization | CPT | 93452 | 29 | $10,329 | $5,680.95 | $7,230.3 | $8,758.99 | $13,913 |
| Coronary angiography with cath | CPT | 93455 | 1 | — | — | $13,913 | $13,913 | $13,913 |
| Coronary angiography with bypass cath | CPT | 93458 | 29 | $10,329 | $5,680.95 | $7,230.3 | $8,758.99 | $13,913 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 182 | $1,057.26 |
| Anthem BCBS | 140 | $850.49 |
| aspirus health plan | 97 | $455.91 |
| centivo | 97 | $474.15 |
| advocate aurora healthcare | 97 | $468.07 |
| Aetna | 97 | $441 |
| froedtert health | 97 | $472 |
| group health cooperative of south central wisconsin | 97 | $547.09 |
| health partners | 97 | $502.15 |
| health payment systems | 97 | $514.26 |
| mayo clinic health solutions | 97 | $528.85 |
| medical college of wisconsin | 97 | $425.52 |
| Multiplan | 97 | $474.1 |
| network health plan | 97 | $416.01 |
| oan llc | 97 | $486.3 |
| security health plan | 97 | $504.54 |
| sheboygan employer's health network | 97 | $516.7 |
| trilogy health solutions | 97 | $572.81 |
| wps health plan | 97 | $584.35 |
| Cigna | 97 | $547.09 |
| common ground healthcare cooperative | 97 | $540.72 |
| dean health plan | 97 | $486.3 |
| employer health care alliance cooperative | 97 | $386.03 |
| First Health | 97 | $577.48 |
| praire states | 93 | $657.9 |
| quartz health insurance | 93 | $657.9 |
| group health cooperative of eau claire | 93 | $619.2 |
| prevea health network | 93 | $696.6 |
| bellin thedacare | 93 | $696.6 |
| chorus community health plan | 27 | $12.22 |