Does Marshfield Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Marshfield Medical Center. In a medical emergency, call 911.

Where is Marshfield Medical Center?

611 St Joseph Ave, Marshfield, WI 54449, in Wood County, Wisconsin.

What is the phone number of Marshfield Medical Center?

(715) 387-9963, as listed by Medicare (CMS).

What is the Medicare star rating of Marshfield Medical Center?

1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Marshfield Medical Center for hospital-acquired conditions?

Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Marshfield Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.7373; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Marshfield Medical Center — Phone, Address & ER

Quick answers

Does Marshfield Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Marshfield Medical Center. In a medical emergency, call 911.
Where is Marshfield Medical Center?: 611 St Joseph Ave, Marshfield, WI 54449, in Wood County, Wisconsin.
What is the phone number of Marshfield Medical Center?: (715) 387-9963, as listed by Medicare (CMS).
What is the Medicare star rating of Marshfield Medical Center?: 1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Marshfield Medical Center for hospital-acquired conditions?: Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Marshfield Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.7373; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4][5]

Cardiology
Pediatrics
Anesthesiology
Bariatric Surgery
Cardiac Electrophysiology
Cardiovascular & Thoracic Surgery
Colorectal Surgery
Critical Care
Emergency Medicine
Gastroenterology
General Surgery
Gynecologic Oncology
Hand Surgery
Hematology
Internal Medicine
Interventional Radiology
Maternal Fetal Medicine
Medical Oncology
Neurology
Neurosurgery
Obstetrics & Gynecology
Orthopedic Surgery
Orthopedic Trauma Surgery
Pediatric Neonatal-Perinatal Medicine
Physical Medicine & Rehabilitation
Pulmonology
Radiation Oncology
Surgical Oncology
Vascular Surgery

Treatments^[5][8]

Endovascular coiling for aneurysm
Metabolic and bariatric surgery
Roux-en-Y gastric bypass
Sleeve gastrectomy
LAPBAND revisions

Procedures^[4]

Metabolic and bariatric surgery

Programs and centers^[4][5]

Birth center
Neonatal ICU
Marshfield Children's Hospital
Intensive care unit
Urgent care
LifeLink transportation (helicopter, airplane)

Emergency care (hospital website)^[4][5][6][7]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II
Stroke designation	Certified advanced primary stroke center

Visiting and practical information

Visiting	Visiting hours listed Mon-Sun 10:30 AM-8:00 PM on location page^[5]

Recognition^[5][7]

Accredited by The Joint Commission
Certified advanced primary stroke center (Joint Commission)

Doctors and clinicians (899)

899 doctors and other clinicians list Marshfield Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 875 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Marshfield Medical Center - Neillsville23 mi · Neillsville, WI · Critical Access Hospital
Aspirus Riverview Hospital & Clinics Inc27 mi · Wisconsin Rapids, WI · Acute Care Hospital
Aspirus Stevens Point Hospital & Clinics, Inc.32 mi · Stevens Point, WI · Acute Care Hospital
Aspirus Wausau Hospital32 mi · Wausau, WI · Acute Care Hospital
Marshfield Medical Center - Weston33 mi · Weston, WI · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Marshfield

Norwood Health Center0.9 mi · Marshfield, WI · Psychiatric Hospital
North Central Health Care32 mi · Wausau, WI · Psychiatric Hospital

All hospitals in Marshfield · Hospitals in Wood County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Norwood Health Center-Central0.9 mi · Marshfield, WI · 5 of 5 stars
North Shore Healthcare at Marshfield1.5 mi · Marshfield, WI · 4 of 5 stars
Three Oaks Health Services1.9 mi · Marshfield, WI · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Compassus Central Wisconsin2.8 mi · Marshfield, WI · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Compassus Home Health2.8 mi · Marshfield, WI · 4.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Marshfield Dialysis2.8 mi · Marshfield, WI · 2 of 5 stars

All dialysis facilities in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Family Health Center - Marshfield Dental Center & Administration0.4 mi · Marshfield, WI · Community health center
Family Health Center - Marshfield Alcohol & Drug Recovery Center1.0 mi · Marshfield, WI · Community health center
Family Health Center - Marshfield Primary Care Center1.0 mi · Marshfield, WI · Community health center

Clinics and urgent care

Aspirus Clinic - Marshfield2.8 mi · Marshfield, WI · Rural health clinic
Astia Health Clinical Services, SC2.8 mi · Marshfield, WI · Urgent care center
Marshfield Clinic Stratford Center9.9 mi · Stratford, WI · Rural health clinic

Pharmacies

Family Health Center of Marshfield, Inc.2.8 mi · Marshfield, WI · Pharmacy
Family Health Center of Marshfield, Inc.2.8 mi · Marshfield, WI · Community/retail pharmacy
MCHS Hospitals Inc2.8 mi · Marshfield, WI · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

Alice & Louises III LLC2.8 mi · Marshfield, WI
Clarity Care Adams2.8 mi · Marshfield, WI
Clarity Care Fern2.8 mi · Marshfield, WI
Clarity Care Peach Avenue2.8 mi · Marshfield, WI

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Marshfield Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Restfulness of Environment	2 of 5 stars
Care Coordination	2 of 5 stars
Symptoms After Stay	3 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	61%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	73%National average: 80%
“Always” got help as soon as they wanted	57%National average: 64%
Staff “always” explained medicines before giving them	60%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	69%National average: 73%
Completed surveys	2,916Response rate: 32%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	0.715No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.353Better than the national benchmark
Surgical site infections after colon surgery	0.518No different from the national benchmark
MRSA bloodstream infections	0.222No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	1.708Worse than the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	12.5%
Deaths within 30 days: heart failure patients	11.5%
Deaths within 30 days: pneumonia patients	13.7%
Deaths within 30 days: COPD patients	7.2%
Deaths within 30 days: stroke patients	11%
Deaths within 30 days: coronary bypass surgery (CABG)	2.7%
Serious complications (patient safety indicator PSI-90)	1.96Worse than the national rate
Complications after hip or knee replacement	5.3%

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	16.2%
Readmitted within 30 days: heart attack	15.4%
Readmitted within 30 days: heart failure	23.2%
Readmitted within 30 days: pneumonia	19.3%
Readmitted within 30 days: COPD	21.6%
Readmitted within 30 days: coronary bypass surgery	10.4%
Readmitted within 30 days: hip or knee replacement	6.2%

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	168 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	78%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Marshfield Medical Center, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026	YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score	0.7373Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack	0.9989Fewer readmissions than expected
Heart failure	1.0475More readmissions than expected
Pneumonia	1.1737More readmissions than expected
COPD (chronic lung disease)	1.0492More readmissions than expected
Hip or knee replacement	0.8468Fewer readmissions than expected
Coronary bypass surgery (CABG)	1.0226More readmissions than expected

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score	21.42 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	10.00 out of 100
Person and community engagement (patient survey)	24.00 out of 100
Safety (infections and sepsis care)	31.67 out of 100
Efficiency and cost reduction (Medicare spending)	20.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio	0.99Below the national median hospital (1.00): Medicare spent less

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Wisconsin Best hospitals in Wisconsin

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 76 common services exactly as Marshfield Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 76 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 3 TECH	$212	$201.40	$106 – $443
New patient office visit (about 30–44 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $116.60 Anthem BCBS of WI — HMO/POS: $344 Anthem BCBS of WI — PPO: $402 Anthem BCBS of WI — Traditional: $443 Besse Forest Products — Direct Employer: $180.20 Cigna — PPO: $199.28 CORVEL — Third Party: $201.40 Coventry — Workers Comp: $203.52 Family Health Center (FHC) — Prepaid Health Svcs: $106 First Health — PPO Network: $201.40
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 3 TECH	$212	$201.40	$116.60 – $205.64
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $116.60 Besse Forest Products — Direct Employer: $180.20 Cigna — PPO: $199.28 CORVEL — Third Party: $201.40 Coventry — Workers Comp: $203.52 First Health — PPO Network: $201.40 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $195.04 Group Health Cooperative of Eau Claire — ETF - River Region: $173.84 Health Partners — PPO: $201.40 Health Smart — PPO Network: $203.52
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: VISIT NEW PAT LEVEL 3-TECH	$106	$100.70	$53 – $102.82
New patient office visit (about 30–44 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $58.30 Anthem BCBS of WI — HMO/POS: $80.56 Anthem BCBS of WI — PPO: $87.98 Anthem BCBS of WI — Traditional: $93.28 Besse Forest Products — Direct Employer: $90.10 CORVEL — Third Party: $100.70 Coventry — Workers Comp: $101.76 Family Health Center (FHC) — Prepaid Health Svcs: $53 First Health — PPO Network: $100.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $97.52
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 4 TECH	$312	$296.40	$156 – $443
New patient office visit (about 45–59 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $171.60 Anthem BCBS of WI — HMO/POS: $344 Anthem BCBS of WI — PPO: $402 Anthem BCBS of WI — Traditional: $443 Besse Forest Products — Direct Employer: $265.20 Cigna — PPO: $293.28 CORVEL — Third Party: $296.40 Coventry — Workers Comp: $299.52 Family Health Center (FHC) — Prepaid Health Svcs: $156 First Health — PPO Network: $296.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT NEW PAT LEVEL 4-TECH	$156	$148.20	$78 – $151.32
New patient office visit (about 45–59 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $85.80 Anthem BCBS of WI — HMO/POS: $118.56 Anthem BCBS of WI — PPO: $129.48 Anthem BCBS of WI — Traditional: $137.28 Besse Forest Products — Direct Employer: $132.60 CORVEL — Third Party: $148.20 Coventry — Workers Comp: $149.76 Family Health Center (FHC) — Prepaid Health Svcs: $78 First Health — PPO Network: $148.20 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $143.52
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 4 TECH	$312	$296.40	$171.60 – $302.64
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $171.60 Besse Forest Products — Direct Employer: $265.20 Cigna — PPO: $293.28 CORVEL — Third Party: $296.40 Coventry — Workers Comp: $299.52 First Health — PPO Network: $296.40 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $287.04 Group Health Cooperative of Eau Claire — ETF - River Region: $255.84 Health Partners — PPO: $296.40 Health Smart — PPO Network: $299.52
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 5 TECH	$409	$388.55	$204.50 – $443
New patient office visit (about 60–74 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $224.95 Anthem BCBS of WI — HMO/POS: $344 Anthem BCBS of WI — PPO: $402 Anthem BCBS of WI — Traditional: $443 Besse Forest Products — Direct Employer: $347.65 Cigna — PPO: $384.46 CORVEL — Third Party: $388.55 Coventry — Workers Comp: $392.64 Family Health Center (FHC) — Prepaid Health Svcs: $204.50 First Health — PPO Network: $388.55
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT NEW PAT LEVEL 5-TECH	$204	$193.80	$102 – $197.88
New patient office visit (about 60–74 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $112.20 Anthem BCBS of WI — HMO/POS: $155.04 Anthem BCBS of WI — PPO: $169.32 Anthem BCBS of WI — Traditional: $179.52 Besse Forest Products — Direct Employer: $173.40 CORVEL — Third Party: $193.80 Coventry — Workers Comp: $195.84 Family Health Center (FHC) — Prepaid Health Svcs: $102 First Health — PPO Network: $193.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $187.68
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UC VISIT NEW, LEVEL 5 TECH	$409	$388.55	$224.95 – $396.73
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $224.95 Besse Forest Products — Direct Employer: $347.65 Cigna — PPO: $384.46 CORVEL — Third Party: $388.55 Coventry — Workers Comp: $392.64 First Health — PPO Network: $388.55 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $376.28 Group Health Cooperative of Eau Claire — ETF - River Region: $335.38 Health Partners — PPO: $388.55 Health Smart — PPO Network: $392.64
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UC VISIT EST, LEVEL 3 TECH	$132	$125.40	$66 – $443
Established patient office visit (about 20–29 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $72.60 Anthem BCBS of WI — HMO/POS: $344 Anthem BCBS of WI — PPO: $402 Anthem BCBS of WI — Traditional: $443 Besse Forest Products — Direct Employer: $112.20 Cigna — PPO: $124.08 CORVEL — Third Party: $125.40 Coventry — Workers Comp: $126.72 Family Health Center (FHC) — Prepaid Health Svcs: $66 First Health — PPO Network: $125.40
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT EST PAT LEVEL 3-TECH	$66	$62.70	$33 – $64.02
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $36.30 Anthem BCBS of WI — HMO/POS: $50.16 Anthem BCBS of WI — PPO: $54.78 Anthem BCBS of WI — Traditional: $58.08 Besse Forest Products — Direct Employer: $56.10 CORVEL — Third Party: $62.70 Coventry — Workers Comp: $63.36 Family Health Center (FHC) — Prepaid Health Svcs: $33 First Health — PPO Network: $62.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $60.72
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SUBSEQUENT ANTEPARTUM CARE-TECH	$66	$62.70	$33 – $64.02
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $36.30 Anthem BCBS of WI — HMO/POS: $50.16 Anthem BCBS of WI — PPO: $54.78 Anthem BCBS of WI — Traditional: $58.08 Besse Forest Products — Direct Employer: $56.10 CORVEL — Third Party: $62.70 Coventry — Workers Comp: $63.36 Family Health Center (FHC) — Prepaid Health Svcs: $33 First Health — PPO Network: $62.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $60.72
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UC VISIT, LEVEL 4 EST TECH	$200	$190	$100 – $443
Established patient office visit (about 30–39 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $110 Anthem BCBS of WI — HMO/POS: $344 Anthem BCBS of WI — PPO: $402 Anthem BCBS of WI — Traditional: $443 Besse Forest Products — Direct Employer: $170 Cigna — PPO: $188 CORVEL — Third Party: $190 Coventry — Workers Comp: $192 Family Health Center (FHC) — Prepaid Health Svcs: $100 First Health — PPO Network: $190
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT EST PAT LEVEL 4-TECH	$100	$95	$50 – $97
Established patient office visit (about 30–39 minutes): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $55 Anthem BCBS of WI — HMO/POS: $76 Anthem BCBS of WI — PPO: $83 Anthem BCBS of WI — Traditional: $88 Besse Forest Products — Direct Employer: $85 CORVEL — Third Party: $95 Coventry — Workers Comp: $96 Family Health Center (FHC) — Prepaid Health Svcs: $50 First Health — PPO Network: $95 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $92
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UC VISIT, LEVEL 4 EST TECH	$200	$190	$110 – $194
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $110 Besse Forest Products — Direct Employer: $170 Cigna — PPO: $188 CORVEL — Third Party: $190 Coventry — Workers Comp: $192 First Health — PPO Network: $190 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $184 Group Health Cooperative of Eau Claire — ETF - River Region: $164 Health Partners — PPO: $190 Health Smart — PPO Network: $192
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT OP CONSULT LEVEL 3-TECH	$151	$143.45	$75.50 – $146.47
Office consultation with a specialist (moderate): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $83.05 Anthem BCBS of WI — HMO/POS: $114.76 Anthem BCBS of WI — PPO: $125.33 Anthem BCBS of WI — Traditional: $132.88 Besse Forest Products — Direct Employer: $128.35 CORVEL — Third Party: $143.45 Coventry — Workers Comp: $144.96 Family Health Center (FHC) — Prepaid Health Svcs: $75.50 First Health — PPO Network: $143.45 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $138.92
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 3 ESTAB - BASED ON COMPONENT-TECH	$151	$143.45	$75.50 – $146.47
Office consultation with a specialist (moderate): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $83.05 Anthem BCBS of WI — HMO/POS: $114.76 Anthem BCBS of WI — PPO: $125.33 Anthem BCBS of WI — Traditional: $132.88 Besse Forest Products — Direct Employer: $128.35 CORVEL — Third Party: $143.45 Coventry — Workers Comp: $144.96 Family Health Center (FHC) — Prepaid Health Svcs: $75.50 First Health — PPO Network: $143.45 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $138.92
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 3 NEW - BASED ON TIME 99243-TECH	$151	$143.45	$75.50 – $146.47
Office consultation with a specialist (moderate): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $83.05 Anthem BCBS of WI — HMO/POS: $114.76 Anthem BCBS of WI — PPO: $125.33 Anthem BCBS of WI — Traditional: $132.88 Besse Forest Products — Direct Employer: $128.35 CORVEL — Third Party: $143.45 Coventry — Workers Comp: $144.96 Family Health Center (FHC) — Prepaid Health Svcs: $75.50 First Health — PPO Network: $143.45 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $138.92
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT OP CONSULT LEVEL 4-TECH	$204	$193.80	$102 – $197.88
Office consultation with a specialist (moderate to high): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $112.20 Anthem BCBS of WI — HMO/POS: $155.04 Anthem BCBS of WI — PPO: $169.32 Anthem BCBS of WI — Traditional: $179.52 Besse Forest Products — Direct Employer: $173.40 CORVEL — Third Party: $193.80 Coventry — Workers Comp: $195.84 Family Health Center (FHC) — Prepaid Health Svcs: $102 First Health — PPO Network: $193.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $187.68
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 4 ESTAB - BASED ON COMPONENTS-TECH	$204	$193.80	$102 – $197.88
Office consultation with a specialist (moderate to high): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $112.20 Anthem BCBS of WI — HMO/POS: $155.04 Anthem BCBS of WI — PPO: $169.32 Anthem BCBS of WI — Traditional: $179.52 Besse Forest Products — Direct Employer: $173.40 CORVEL — Third Party: $193.80 Coventry — Workers Comp: $195.84 Family Health Center (FHC) — Prepaid Health Svcs: $102 First Health — PPO Network: $193.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $187.68
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 4 ESTAB - BASED ON TIME 99244-TECH	$204	$193.80	$102 – $197.88
Office consultation with a specialist (moderate to high): 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $112.20 Anthem BCBS of WI — HMO/POS: $155.04 Anthem BCBS of WI — PPO: $169.32 Anthem BCBS of WI — Traditional: $179.52 Besse Forest Products — Direct Employer: $173.40 CORVEL — Third Party: $193.80 Coventry — Workers Comp: $195.84 Family Health Center (FHC) — Prepaid Health Svcs: $102 First Health — PPO Network: $193.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $187.68
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT PREV MED INIT AGE 18-39-TECH	$147	$139.65	$73.50 – $142.59
Preventive checkup, new patient, age 18–39: 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $80.85 Anthem BCBS of WI — HMO/POS: $111.72 Anthem BCBS of WI — PPO: $122.01 Anthem BCBS of WI — Traditional: $129.36 Besse Forest Products — Direct Employer: $124.95 CORVEL — Third Party: $139.65 Coventry — Workers Comp: $141.12 Family Health Center (FHC) — Prepaid Health Svcs: $73.50 First Health — PPO Network: $139.65 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $135.24
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VISIT PREV MED INIT AGE 18-39-TECH	$147	$139.65	$80.85 – $142.59
Preventive checkup, new patient, age 18–39: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $80.85 Besse Forest Products — Direct Employer: $124.95 Cigna — PPO: $138.18 CORVEL — Third Party: $139.65 Coventry — Workers Comp: $141.12 First Health — PPO Network: $139.65 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $135.24 Group Health Cooperative of Eau Claire — ETF - River Region: $120.54 Health Partners — PPO: $139.65 Health Smart — PPO Network: $141.12
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VISIT PREV MED INIT AGE 40-64-TECH	$159	$151.05	$79.50 – $154.23
Preventive checkup, new patient, age 40–64: 10 of 32 insurance plan rates Amish/Mennonite — Amish Mennonite: $87.45 Anthem BCBS of WI — HMO/POS: $120.84 Anthem BCBS of WI — PPO: $131.97 Anthem BCBS of WI — Traditional: $139.92 Besse Forest Products — Direct Employer: $135.15 CORVEL — Third Party: $151.05 Coventry — Workers Comp: $152.64 Family Health Center (FHC) — Prepaid Health Svcs: $79.50 First Health — PPO Network: $151.05 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $146.28
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VISIT PREV MED INIT AGE 40-64-TECH	$159	$151.05	$87.45 – $154.23
Preventive checkup, new patient, age 40–64: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $87.45 Besse Forest Products — Direct Employer: $135.15 Cigna — PPO: $149.46 CORVEL — Third Party: $151.05 Coventry — Workers Comp: $152.64 First Health — PPO Network: $151.05 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $146.28 Group Health Cooperative of Eau Claire — ETF - River Region: $130.38 Health Partners — PPO: $151.05 Health Smart — PPO Network: $152.64
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 3-TECH	$833	$791.35	$262.92 – $1,303
Emergency room visit (moderate): 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $458.15 Anthem BCBS of WI — HMO/POS: $1,033 Anthem BCBS of WI — Medicare Advantage: $270.81 Anthem BCBS of WI — PPO: $1,263 Anthem BCBS of WI — Traditional: $1,303 Besse Forest Products — Direct Employer: $708.05 Cigna — PPO: $783.02 CORVEL — Third Party: $791.35 Coventry — Workers Comp: $799.68 Family Health Center (FHC) — Prepaid Health Svcs: $416.50
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 3-TECH	$833	$791.35	$458.15 – $808.01
Emergency room visit (moderate): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $458.15 Besse Forest Products — Direct Employer: $708.05 Cigna — PPO: $783.02 CORVEL — Third Party: $791.35 Coventry — Workers Comp: $799.68 First Health — PPO Network: $791.35 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $766.36 Group Health Cooperative of Eau Claire — ETF - River Region: $683.06 Health Partners — PPO: $791.35 Health Smart — PPO Network: $799.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 4-TECH	$1,755	$1,667.25	$404.33 – $3,790
Emergency room visit (moderately high): 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $965.25 Anthem BCBS of WI — HMO/POS: $2,871 Anthem BCBS of WI — Medicare Advantage: $416.46 Anthem BCBS of WI — PPO: $3,446 Anthem BCBS of WI — Traditional: $3,790 Besse Forest Products — Direct Employer: $1,491.75 Cigna — PPO: $1,649.70 CORVEL — Third Party: $1,667.25 Coventry — Workers Comp: $1,684.80 Family Health Center (FHC) — Prepaid Health Svcs: $877.50
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 4-TECH	$1,755	$1,667.25	$965.25 – $1,702.35
Emergency room visit (moderately high): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $965.25 Besse Forest Products — Direct Employer: $1,491.75 Cigna — PPO: $1,649.70 CORVEL — Third Party: $1,667.25 Coventry — Workers Comp: $1,684.80 First Health — PPO Network: $1,667.25 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,614.60 Group Health Cooperative of Eau Claire — ETF - River Region: $1,439.10 Health Partners — PPO: $1,667.25 Health Smart — PPO Network: $1,684.80
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 5-TECH	$2,687	$2,552.65	$582.16 – $3,790
Emergency room visit (high): 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,477.85 Anthem BCBS of WI — HMO/POS: $2,871 Anthem BCBS of WI — Medicare Advantage: $599.62 Anthem BCBS of WI — PPO: $3,446 Anthem BCBS of WI — Traditional: $3,790 Besse Forest Products — Direct Employer: $2,283.95 Cigna — PPO: $2,525.78 CORVEL — Third Party: $2,552.65 Coventry — Workers Comp: $2,579.52 Family Health Center (FHC) — Prepaid Health Svcs: $1,343.50
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 5-TECH	$2,687	$2,552.65	$1,477.85 – $2,606.39
Emergency room visit (high): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,477.85 Besse Forest Products — Direct Employer: $2,283.95 Cigna — PPO: $2,525.78 CORVEL — Third Party: $2,552.65 Coventry — Workers Comp: $2,579.52 First Health — PPO Network: $2,552.65 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $2,472.04 Group Health Cooperative of Eau Claire — ETF - River Region: $2,203.34 Health Partners — PPO: $2,552.65 Health Smart — PPO Network: $2,579.52

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL W TOTAL CA-TECH	$144	$136.80	$8.46 – $139.68
Basic metabolic panel (blood test): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $79.20 Anthem BCBS of WI — HMO/POS: $44.41 Anthem BCBS of WI — Medicaid HMO: $8.91 Anthem BCBS of WI — Medicare Advantage: $8.71 Anthem BCBS of WI — PPO: $50.76 Anthem BCBS of WI — Traditional: $52.88 Besse Forest Products — Direct Employer: $122.40 Cigna — PPO: $135.36 CORVEL — Third Party: $136.80 Coventry — Workers Comp: $138.24
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL W TOTAL CA-TECH	$144	$136.80	$79.20 – $139.68
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $79.20 Besse Forest Products — Direct Employer: $122.40 Cigna — PPO: $135.36 CORVEL — Third Party: $136.80 Coventry — Workers Comp: $138.24 First Health — PPO Network: $136.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $132.48 Group Health Cooperative of Eau Claire — ETF - River Region: $118.08 Health Partners — PPO: $136.80 Health Smart — PPO Network: $138.24
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPR METABOLIC PANEL-TECH	$201	$190.95	$10.56 – $194.97
Comprehensive metabolic panel (blood test): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $110.55 Anthem BCBS of WI — HMO/POS: $55.44 Anthem BCBS of WI — Medicaid HMO: $11.13 Anthem BCBS of WI — Medicare Advantage: $10.88 Anthem BCBS of WI — PPO: $63.36 Anthem BCBS of WI — Traditional: $66 Besse Forest Products — Direct Employer: $170.85 Cigna — PPO: $188.94 CORVEL — Third Party: $190.95 Coventry — Workers Comp: $192.96
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPR METABOLIC PANEL-TECH	$201	$190.95	$110.55 – $194.97
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $110.55 Besse Forest Products — Direct Employer: $170.85 Cigna — PPO: $188.94 CORVEL — Third Party: $190.95 Coventry — Workers Comp: $192.96 First Health — PPO Network: $190.95 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $184.92 Group Health Cooperative of Eau Claire — ETF - River Region: $164.82 Health Partners — PPO: $190.95 Health Smart — PPO Network: $192.96
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL-TECH	$225	$213.75	$13.39 – $218.25
Cholesterol panel (lipid panel): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $123.75 Anthem BCBS of WI — HMO/POS: $70.30 Anthem BCBS of WI — Medicaid HMO: $14.12 Anthem BCBS of WI — Medicare Advantage: $13.79 Anthem BCBS of WI — PPO: $80.34 Anthem BCBS of WI — Traditional: $83.69 Besse Forest Products — Direct Employer: $191.25 Cigna — PPO: $211.50 CORVEL — Third Party: $213.75 Coventry — Workers Comp: $216
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL-TECH	$225	$213.75	$123.75 – $218.25
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $123.75 Besse Forest Products — Direct Employer: $191.25 Cigna — PPO: $211.50 CORVEL — Third Party: $213.75 Coventry — Workers Comp: $216 First Health — PPO Network: $213.75 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $207 Group Health Cooperative of Eau Claire — ETF - River Region: $184.50 Health Partners — PPO: $213.75 Health Smart — PPO Network: $216
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL-TECH	$133	$126.35	$8.68 – $129.01
Kidney function panel: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $73.15 Anthem BCBS of WI — HMO/POS: $45.57 Anthem BCBS of WI — Medicaid HMO: $9.15 Anthem BCBS of WI — Medicare Advantage: $8.94 Anthem BCBS of WI — PPO: $52.08 Anthem BCBS of WI — Traditional: $54.25 Besse Forest Products — Direct Employer: $113.05 Cigna — PPO: $125.02 CORVEL — Third Party: $126.35 Coventry — Workers Comp: $127.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL-TECH	$133	$126.35	$73.15 – $129.01
Kidney function panel: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $73.15 Besse Forest Products — Direct Employer: $113.05 Cigna — PPO: $125.02 CORVEL — Third Party: $126.35 Coventry — Workers Comp: $127.68 First Health — PPO Network: $126.35 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $122.36 Group Health Cooperative of Eau Claire — ETF - River Region: $109.06 Health Partners — PPO: $126.35 Health Smart — PPO Network: $127.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL-TECH	$162	$153.90	$8.17 – $157.14
Liver function panel: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $89.10 Anthem BCBS of WI — HMO/POS: $42.89 Anthem BCBS of WI — Medicaid HMO: $8.61 Anthem BCBS of WI — Medicare Advantage: $8.42 Anthem BCBS of WI — PPO: $49.02 Anthem BCBS of WI — Traditional: $51.06 Besse Forest Products — Direct Employer: $137.70 Cigna — PPO: $152.28 CORVEL — Third Party: $153.90 Coventry — Workers Comp: $155.52
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL-TECH	$162	$153.90	$89.10 – $157.14
Liver function panel: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $89.10 Besse Forest Products — Direct Employer: $137.70 Cigna — PPO: $152.28 CORVEL — Third Party: $153.90 Coventry — Workers Comp: $155.52 First Health — PPO Network: $153.90 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $149.04 Group Health Cooperative of Eau Claire — ETF - River Region: $132.84 Health Partners — PPO: $153.90 Health Smart — PPO Network: $155.52
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W MICRO-TECH	$84	$79.80	$3.17 – $81.48
Urine test (automated, with microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $46.20 Anthem BCBS of WI — HMO/POS: $16.64 Anthem BCBS of WI — Medicaid HMO: $3.35 Anthem BCBS of WI — Medicare Advantage: $3.27 Anthem BCBS of WI — PPO: $19.02 Anthem BCBS of WI — Traditional: $19.81 Besse Forest Products — Direct Employer: $71.40 Cigna — PPO: $78.96 CORVEL — Third Party: $79.80 Coventry — Workers Comp: $80.64
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W MICRO-TECH	$84	$79.80	$46.20 – $81.48
Urine test (automated, with microscope): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $46.20 Besse Forest Products — Direct Employer: $71.40 Cigna — PPO: $78.96 CORVEL — Third Party: $79.80 Coventry — Workers Comp: $80.64 First Health — PPO Network: $79.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $77.28 Group Health Cooperative of Eau Claire — ETF - River Region: $68.88 Health Partners — PPO: $79.80 Health Smart — PPO Network: $80.64
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NON AUTO WO MICRO-TECH	$41	$38.95	$3.48 – $39.77
Urine test (manual, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $22.55 Anthem BCBS of WI — HMO/POS: $18.27 Anthem BCBS of WI — Medicaid HMO: $3.67 Anthem BCBS of WI — Medicare Advantage: $3.58 Anthem BCBS of WI — PPO: $20.88 Anthem BCBS of WI — Traditional: $21.75 Besse Forest Products — Direct Employer: $34.85 Cigna — PPO: $38.54 CORVEL — Third Party: $38.95 Coventry — Workers Comp: $39.36
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIP-POC	$31	$29.45	$3.48 – $30.07
Urine test (manual, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $17.05 Anthem BCBS of WI — HMO/POS: $18.27 Anthem BCBS of WI — Medicaid HMO: $3.67 Anthem BCBS of WI — Medicare Advantage: $3.58 Anthem BCBS of WI — PPO: $20.88 Anthem BCBS of WI — Traditional: $21.75 Besse Forest Products — Direct Employer: $26.35 Cigna — PPO: $29.14 CORVEL — Third Party: $29.45 Coventry — Workers Comp: $29.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ONCOLOGY PROTEIN URINE SCREEN	$31	$29.45	$3.48 – $30.07
Urine test (manual, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $17.05 Anthem BCBS of WI — HMO/POS: $18.27 Anthem BCBS of WI — Medicaid HMO: $3.67 Anthem BCBS of WI — Medicare Advantage: $3.58 Anthem BCBS of WI — PPO: $20.88 Anthem BCBS of WI — Traditional: $21.75 Besse Forest Products — Direct Employer: $26.35 Cigna — PPO: $29.14 CORVEL — Third Party: $29.45 Coventry — Workers Comp: $29.76
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO MICROSCOPY-TECH	$43	$40.85	$2.25 – $41.71
Urine test (automated, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $23.65 Anthem BCBS of WI — HMO/POS: $11.81 Anthem BCBS of WI — Medicaid HMO: $2.37 Anthem BCBS of WI — Medicare Advantage: $2.32 Anthem BCBS of WI — PPO: $13.50 Anthem BCBS of WI — Traditional: $14.06 Besse Forest Products — Direct Employer: $36.55 Cigna — PPO: $40.42 CORVEL — Third Party: $40.85 Coventry — Workers Comp: $41.28
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ALBUMIN LEVEL URINE-TECH	$41	$38.95	$2.25 – $39.77
Urine test (automated, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $22.55 Anthem BCBS of WI — HMO/POS: $11.81 Anthem BCBS of WI — Medicaid HMO: $2.37 Anthem BCBS of WI — Medicare Advantage: $2.32 Anthem BCBS of WI — PPO: $13.50 Anthem BCBS of WI — Traditional: $14.06 Besse Forest Products — Direct Employer: $34.85 Cigna — PPO: $38.54 CORVEL — Third Party: $38.95 Coventry — Workers Comp: $39.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA BY DIP OR TABLET FOR BILI-TECH	$41	$38.95	$2.25 – $39.77
Urine test (automated, without microscope): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $22.55 Anthem BCBS of WI — HMO/POS: $11.81 Anthem BCBS of WI — Medicaid HMO: $2.37 Anthem BCBS of WI — Medicare Advantage: $2.32 Anthem BCBS of WI — PPO: $13.50 Anthem BCBS of WI — Traditional: $14.06 Besse Forest Products — Direct Employer: $34.85 Cigna — PPO: $38.54 CORVEL — Third Party: $38.95 Coventry — Workers Comp: $39.36
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL-TECH	$189	$179.55	$18.39 – $183.33
PSA (prostate specific antigen) blood test: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $103.95 Anthem BCBS of WI — HMO/POS: $96.55 Anthem BCBS of WI — Medicaid HMO: $19.38 Anthem BCBS of WI — Medicare Advantage: $18.94 Anthem BCBS of WI — PPO: $110.34 Anthem BCBS of WI — Traditional: $114.94 Besse Forest Products — Direct Employer: $160.65 Cigna — PPO: $177.66 CORVEL — Third Party: $179.55 Coventry — Workers Comp: $181.44
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA TOTAL-TECH	$189	$179.55	$103.95 – $183.33
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $103.95 Besse Forest Products — Direct Employer: $160.65 Cigna — PPO: $177.66 CORVEL — Third Party: $179.55 Coventry — Workers Comp: $181.44 First Health — PPO Network: $179.55 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $173.88 Group Health Cooperative of Eau Claire — ETF - River Region: $154.98 Health Partners — PPO: $179.55 Health Smart — PPO Network: $181.44
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE-TECH	$171	$162.45	$16.80 – $165.87
Thyroid stimulating hormone (TSH) test: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $94.05 Anthem BCBS of WI — HMO/POS: $88.20 Anthem BCBS of WI — Medicaid HMO: $17.71 Anthem BCBS of WI — Medicare Advantage: $17.30 Anthem BCBS of WI — PPO: $100.80 Anthem BCBS of WI — Traditional: $105 Besse Forest Products — Direct Employer: $145.35 Cigna — PPO: $160.74 CORVEL — Third Party: $162.45 Coventry — Workers Comp: $164.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID DIAGNOSTIC CASCADE-TECH	$171	$162.45	$16.80 – $165.87
Thyroid stimulating hormone (TSH) test: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $94.05 Anthem BCBS of WI — HMO/POS: $88.20 Anthem BCBS of WI — Medicaid HMO: $17.71 Anthem BCBS of WI — Medicare Advantage: $17.30 Anthem BCBS of WI — PPO: $100.80 Anthem BCBS of WI — Traditional: $105 Besse Forest Products — Direct Employer: $145.35 Cigna — PPO: $160.74 CORVEL — Third Party: $162.45 Coventry — Workers Comp: $164.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE-TECH	$171	$162.45	$94.05 – $165.87
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $94.05 Besse Forest Products — Direct Employer: $145.35 Cigna — PPO: $160.74 CORVEL — Third Party: $162.45 Coventry — Workers Comp: $164.16 First Health — PPO Network: $162.45 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $157.32 Group Health Cooperative of Eau Claire — ETF - River Region: $140.22 Health Partners — PPO: $162.45 Health Smart — PPO Network: $164.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W AUTO DIFF-TECH	$143	$135.85	$7.77 – $138.71
Complete blood count (CBC) with differential: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $78.65 Anthem BCBS of WI — HMO/POS: $40.79 Anthem BCBS of WI — Medicaid HMO: $8.19 Anthem BCBS of WI — Medicare Advantage: $8 Anthem BCBS of WI — PPO: $46.62 Anthem BCBS of WI — Traditional: $48.56 Besse Forest Products — Direct Employer: $121.55 Cigna — PPO: $134.42 CORVEL — Third Party: $135.85 Coventry — Workers Comp: $137.28
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W AUTO DIFF-TECH	$143	$135.85	$78.65 – $138.71
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $78.65 Besse Forest Products — Direct Employer: $121.55 Cigna — PPO: $134.42 CORVEL — Third Party: $135.85 Coventry — Workers Comp: $137.28 First Health — PPO Network: $135.85 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $131.56 Group Health Cooperative of Eau Claire — ETF - River Region: $117.26 Health Partners — PPO: $135.85 Health Smart — PPO Network: $137.28
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF-TECH	$115	$109.25	$6.47 – $111.55
Complete blood count (CBC), automated: 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $63.25 Anthem BCBS of WI — HMO/POS: $33.97 Anthem BCBS of WI — Medicaid HMO: $6.82 Anthem BCBS of WI — Medicare Advantage: $6.66 Anthem BCBS of WI — PPO: $38.82 Anthem BCBS of WI — Traditional: $40.44 Besse Forest Products — Direct Employer: $97.75 Cigna — PPO: $108.10 CORVEL — Third Party: $109.25 Coventry — Workers Comp: $110.40
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF-TECH	$115	$109.25	$63.25 – $111.55
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $63.25 Besse Forest Products — Direct Employer: $97.75 Cigna — PPO: $108.10 CORVEL — Third Party: $109.25 Coventry — Workers Comp: $110.40 First Health — PPO Network: $109.25 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $105.80 Group Health Cooperative of Eau Claire — ETF - River Region: $94.30 Health Partners — PPO: $109.25 Health Smart — PPO Network: $110.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME-TECH	$56	$53.20	$4.29 – $54.32
Blood clotting time test (prothrombin time, PT): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $30.80 Anthem BCBS of WI — HMO/POS: $22.52 Anthem BCBS of WI — Medicaid HMO: $4.52 Anthem BCBS of WI — Medicare Advantage: $4.42 Anthem BCBS of WI — PPO: $25.74 Anthem BCBS of WI — Traditional: $26.81 Besse Forest Products — Direct Employer: $47.60 Cigna — PPO: $52.64 CORVEL — Third Party: $53.20 Coventry — Workers Comp: $53.76
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ANTIPHOSPHOLIPID SYNDROME-TECH	$56	$53.20	$4.29 – $54.32
Blood clotting time test (prothrombin time, PT): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $30.80 Anthem BCBS of WI — HMO/POS: $22.52 Anthem BCBS of WI — Medicaid HMO: $4.52 Anthem BCBS of WI — Medicare Advantage: $4.42 Anthem BCBS of WI — PPO: $25.74 Anthem BCBS of WI — Traditional: $26.81 Besse Forest Products — Direct Employer: $47.60 Cigna — PPO: $52.64 CORVEL — Third Party: $53.20 Coventry — Workers Comp: $53.76
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME-TECH	$56	$53.20	$30.80 – $54.32
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $30.80 Besse Forest Products — Direct Employer: $47.60 Cigna — PPO: $52.64 CORVEL — Third Party: $53.20 Coventry — Workers Comp: $53.76 First Health — PPO Network: $53.20 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $51.52 Group Health Cooperative of Eau Claire — ETF - River Region: $45.92 Health Partners — PPO: $53.20 Health Smart — PPO Network: $53.76
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL-TECH	$69	$65.55	$6.01 – $66.93
Blood clotting test (partial thromboplastin time, PTT): 10 of 48 insurance plan rates Amish/Mennonite — Amish Mennonite: $37.95 Anthem BCBS of WI — HMO/POS: $31.55 Anthem BCBS of WI — Medicaid HMO: $6.33 Anthem BCBS of WI — Medicare Advantage: $6.19 Anthem BCBS of WI — PPO: $36.06 Anthem BCBS of WI — Traditional: $37.56 Besse Forest Products — Direct Employer: $58.65 Cigna — PPO: $64.86 CORVEL — Third Party: $65.55 Coventry — Workers Comp: $66.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL-TECH	$69	$65.55	$37.95 – $66.93
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $37.95 Besse Forest Products — Direct Employer: $58.65 Cigna — PPO: $64.86 CORVEL — Third Party: $65.55 Coventry — Workers Comp: $66.24 First Health — PPO Network: $65.55 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $63.48 Group Health Cooperative of Eau Claire — ETF - River Region: $56.58 Health Partners — PPO: $65.55 Health Smart — PPO Network: $66.24

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT HEAD OR BRAIN WO CNTRST-TECH	$1,020	$969	$510 – $1,838
CT scan of the head or brain, without contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $561 Anthem BCBS of WI — HMO/POS: $1,609 Anthem BCBS of WI — PPO: $1,757 Anthem BCBS of WI — Traditional: $1,838 Besse Forest Products — Direct Employer: $867 Cigna — PPO: $958.80 CORVEL — Third Party: $969 Coventry — Workers Comp: $979.20 Family Health Center (FHC) — Prepaid Health Svcs: $510 First Health — PPO Network: $969
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: CT HEAD OR BRAIN WO CNTRST-TECH	$1,020	$969	$561 – $989.40
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $561 Besse Forest Products — Direct Employer: $867 Cigna — PPO: $958.80 CORVEL — Third Party: $969 Coventry — Workers Comp: $979.20 First Health — PPO Network: $969 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $938.40 Group Health Cooperative of Eau Claire — ETF - River Region: $836.40 Health Partners — PPO: $969 Health Smart — PPO Network: $979.20
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI BRAIN WO/W CNTRST + SEQ-TECH	$3,686	$3,501.70	$1,497.60 – $3,575.42
MRI of the brain, before and after contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $2,027.30 Anthem BCBS of WI — HMO/POS: $1,497.60 Anthem BCBS of WI — PPO: $1,647.36 Anthem BCBS of WI — Traditional: $1,697.28 Besse Forest Products — Direct Employer: $3,133.10 Cigna — PPO: $3,464.84 CORVEL — Third Party: $3,501.70 Coventry — Workers Comp: $3,538.56 Family Health Center (FHC) — Prepaid Health Svcs: $1,843 First Health — PPO Network: $3,501.70
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MRI BRAIN WO/W CNTRST + SEQ-TECH	$3,686	$3,501.70	$2,027.30 – $3,575.42
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $2,027.30 Besse Forest Products — Direct Employer: $3,133.10 Cigna — PPO: $3,464.84 CORVEL — Third Party: $3,501.70 Coventry — Workers Comp: $3,538.56 First Health — PPO Network: $3,501.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $3,391.12 Group Health Cooperative of Eau Claire — ETF - River Region: $3,022.52 Health Partners — PPO: $3,501.70 Health Smart — PPO Network: $3,538.56
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: XR CHEST 2 VWS FRONTAL&LATL-TECH	$591	$561.45	$122.23 – $573.27
Chest X-ray, 2 views: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $325.05 Anthem BCBS of WI — HMO/POS: $161.03 Anthem BCBS of WI — PPO: $177.13 Anthem BCBS of WI — Traditional: $182.50 Besse Forest Products — Direct Employer: $502.35 Cigna — PPO: $555.54 CORVEL — Third Party: $561.45 Coventry — Workers Comp: $567.36 Family Health Center (FHC) — Prepaid Health Svcs: $295.50 First Health — PPO Network: $561.45
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: XR CHEST 2 VWS FRONTAL&LATL-TECH	$591	$561.45	$325.05 – $573.27
Chest X-ray, 2 views: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $325.05 Besse Forest Products — Direct Employer: $502.35 Cigna — PPO: $555.54 CORVEL — Third Party: $561.45 Coventry — Workers Comp: $567.36 First Health — PPO Network: $561.45 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $543.72 Group Health Cooperative of Eau Claire — ETF - River Region: $484.62 Health Partners — PPO: $561.45 Health Smart — PPO Network: $567.36
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: XR SPINE LUMBOSACRAL MIN 4VWS-TECH	$740	$703	$203.31 – $717.80
X-ray of the lower spine, at least 4 views: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $407 Anthem BCBS of WI — HMO/POS: $272.48 Anthem BCBS of WI — PPO: $299.72 Anthem BCBS of WI — Traditional: $308.81 Besse Forest Products — Direct Employer: $629 Cigna — PPO: $695.60 CORVEL — Third Party: $703 Coventry — Workers Comp: $710.40 Family Health Center (FHC) — Prepaid Health Svcs: $370 First Health — PPO Network: $703
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: XR SPINE LUMBOSACRAL MIN 4VWS-TECH	$740	$703	$407 – $717.80
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $407 Besse Forest Products — Direct Employer: $629 Cigna — PPO: $695.60 CORVEL — Third Party: $703 Coventry — Workers Comp: $710.40 First Health — PPO Network: $703 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $680.80 Group Health Cooperative of Eau Claire — ETF - River Region: $606.80 Health Partners — PPO: $703 Health Smart — PPO Network: $710.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SPINE LUMBAR WO CNTRST-TECH	$2,082	$1,977.90	$862.95 – $2,306.59
MRI of the lower back (lumbar spine), without contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,145.10 Anthem BCBS of WI — HMO/POS: $862.95 Anthem BCBS of WI — PPO: $949.25 Anthem BCBS of WI — Traditional: $978.01 Besse Forest Products — Direct Employer: $1,769.70 Cigna — PPO: $1,957.08 CORVEL — Third Party: $1,977.90 Coventry — Workers Comp: $1,998.72 Family Health Center (FHC) — Prepaid Health Svcs: $1,041 First Health — PPO Network: $1,977.90
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MRI SPINE LUMBAR WO CNTRST-TECH	$2,082	$1,977.90	$1,145.10 – $2,019.54
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,145.10 Besse Forest Products — Direct Employer: $1,769.70 Cigna — PPO: $1,957.08 CORVEL — Third Party: $1,977.90 Coventry — Workers Comp: $1,998.72 First Health — PPO Network: $1,977.90 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,915.44 Group Health Cooperative of Eau Claire — ETF - River Region: $1,707.24 Health Partners — PPO: $1,977.90 Health Smart — PPO Network: $1,998.72
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT-PELVIS W/CONTRAST SI JOINTS	$2,045	$1,942.75	$169.04 – $1,983.65
CT scan of the pelvis, with contrast: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,124.75 Anthem BCBS of WI — HMO/POS: $1,609 Anthem BCBS of WI — Medicare Advantage: $174.11 Anthem BCBS of WI — PPO: $1,757 Anthem BCBS of WI — Traditional: $1,838 Besse Forest Products — Direct Employer: $1,738.25 Cigna — PPO: $1,922.30 CORVEL — Third Party: $1,942.75 Coventry — Workers Comp: $1,963.20 Family Health Center (FHC) — Prepaid Health Svcs: $1,022.50
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT-PELVIS W/CONTRAST SI JOINTS	$2,045	$1,942.75	$1,124.75 – $1,983.65
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,124.75 Besse Forest Products — Direct Employer: $1,738.25 Cigna — PPO: $1,922.30 CORVEL — Third Party: $1,942.75 Coventry — Workers Comp: $1,963.20 First Health — PPO Network: $1,942.75 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,881.40 Group Health Cooperative of Eau Claire — ETF - River Region: $1,676.90 Health Partners — PPO: $1,942.75 Health Smart — PPO Network: $1,963.20
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT-PELVIS W/CONTRAST	$2,045	$1,942.75	$979.11 – $1,983.65
CT scan of the pelvis, with contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,124.75 Anthem BCBS of WI — HMO/POS: $1,609 Anthem BCBS of WI — PPO: $1,757 Anthem BCBS of WI — Traditional: $1,838 Besse Forest Products — Direct Employer: $1,738.25 Cigna — PPO: $1,922.30 CORVEL — Third Party: $1,942.75 Coventry — Workers Comp: $1,963.20 Family Health Center (FHC) — Prepaid Health Svcs: $1,022.50 First Health — PPO Network: $1,942.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI LWR EXT ANY JT WO CNTRST-TECH	$2,339	$2,222.05	$989.10 – $2,306.59
MRI of a leg joint (such as the knee), without contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,286.45 Anthem BCBS of WI — HMO/POS: $989.10 Anthem BCBS of WI — PPO: $1,088.01 Anthem BCBS of WI — Traditional: $1,120.98 Besse Forest Products — Direct Employer: $1,988.15 Cigna — PPO: $2,198.66 CORVEL — Third Party: $2,222.05 Coventry — Workers Comp: $2,245.44 Family Health Center (FHC) — Prepaid Health Svcs: $1,169.50 First Health — PPO Network: $2,222.05
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MRI LWR EXT ANY JT WO CNTRST-TECH	$2,339	$2,222.05	$1,286.45 – $2,268.83
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,286.45 Besse Forest Products — Direct Employer: $1,988.15 Cigna — PPO: $2,198.66 CORVEL — Third Party: $2,222.05 Coventry — Workers Comp: $2,245.44 First Health — PPO Network: $2,222.05 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $2,151.88 Group Health Cooperative of Eau Claire — ETF - River Region: $1,917.98 Health Partners — PPO: $2,222.05 Health Smart — PPO Network: $2,245.44
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT ABDOMEN/PELVIS W CNTRST-TECH	$2,666	$2,532.70	$1,188.43 – $2,586.02
CT scan of the abdomen and pelvis, with contrast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,466.30 Anthem BCBS of WI — HMO/POS: $1,609 Anthem BCBS of WI — PPO: $1,757 Anthem BCBS of WI — Traditional: $1,838 Besse Forest Products — Direct Employer: $2,266.10 Cigna — PPO: $2,506.04 CORVEL — Third Party: $2,532.70 Coventry — Workers Comp: $2,559.36 Family Health Center (FHC) — Prepaid Health Svcs: $1,333 First Health — PPO Network: $2,532.70
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: CT ABDOMEN/PELVIS W CNTRST-TECH	$2,666	$2,532.70	$1,466.30 – $2,586.02
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $1,466.30 Besse Forest Products — Direct Employer: $2,266.10 Cigna — PPO: $2,506.04 CORVEL — Third Party: $2,532.70 Coventry — Workers Comp: $2,559.36 First Health — PPO Network: $2,532.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $2,452.72 Group Health Cooperative of Eau Claire — ETF - River Region: $2,186.12 Health Partners — PPO: $2,532.70 Health Smart — PPO Network: $2,559.36
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US ABDOMINAL COMPLT-TECH	$498	$473.10	$249 – $611.79
Ultrasound of the abdomen, complete: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $273.90 Anthem BCBS of WI — HMO/POS: $423 Anthem BCBS of WI — PPO: $459 Anthem BCBS of WI — Traditional: $473 Besse Forest Products — Direct Employer: $423.30 Cigna — PPO: $468.12 CORVEL — Third Party: $473.10 Coventry — Workers Comp: $478.08 Family Health Center (FHC) — Prepaid Health Svcs: $249 First Health — PPO Network: $473.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: US ABDOMINAL COMPLT-TECH	$498	$473.10	$273.90 – $483.06
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $273.90 Besse Forest Products — Direct Employer: $423.30 Cigna — PPO: $468.12 CORVEL — Third Party: $473.10 Coventry — Workers Comp: $478.08 First Health — PPO Network: $473.10 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $458.16 Group Health Cooperative of Eau Claire — ETF - River Region: $408.36 Health Partners — PPO: $473.10 Health Smart — PPO Network: $478.08
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US OB TRANSABD >=14 WKS SNGL-TECH	$455	$432.25	$227.50 – $611.79
Pregnancy ultrasound (after the first trimester): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $250.25 Anthem BCBS of WI — HMO/POS: $423 Anthem BCBS of WI — PPO: $459 Anthem BCBS of WI — Traditional: $473 Besse Forest Products — Direct Employer: $386.75 Cigna — PPO: $427.70 CORVEL — Third Party: $432.25 Coventry — Workers Comp: $436.80 Family Health Center (FHC) — Prepaid Health Svcs: $227.50 First Health — PPO Network: $432.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: US OB TRANSABD >=14 WKS SNGL-TECH	$455	$432.25	$250.25 – $441.35
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $250.25 Besse Forest Products — Direct Employer: $386.75 Cigna — PPO: $427.70 CORVEL — Third Party: $432.25 Coventry — Workers Comp: $436.80 First Health — PPO Network: $432.25 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $418.60 Group Health Cooperative of Eau Claire — ETF - River Region: $373.10 Health Partners — PPO: $432.25 Health Smart — PPO Network: $436.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND TRANSVAGINAL	$1,238	$1,176.10	$416.28 – $1,200.86
Transvaginal ultrasound: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $680.90 Anthem BCBS of WI — HMO/POS: $423 Anthem BCBS of WI — PPO: $459 Anthem BCBS of WI — Traditional: $473 Besse Forest Products — Direct Employer: $1,052.30 Cigna — PPO: $1,163.72 CORVEL — Third Party: $1,176.10 Coventry — Workers Comp: $1,188.48 Family Health Center (FHC) — Prepaid Health Svcs: $619 First Health — PPO Network: $1,176.10
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US FOLLICLE STUDY IVT INFERTILITY-TECH	$1,238	$1,176.10	$416.28 – $1,200.86
Transvaginal ultrasound: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $680.90 Anthem BCBS of WI — HMO/POS: $423 Anthem BCBS of WI — PPO: $459 Anthem BCBS of WI — Traditional: $473 Besse Forest Products — Direct Employer: $1,052.30 Cigna — PPO: $1,163.72 CORVEL — Third Party: $1,176.10 Coventry — Workers Comp: $1,188.48 Family Health Center (FHC) — Prepaid Health Svcs: $619 First Health — PPO Network: $1,176.10
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US PELVIS TRANSVAGINAL-TECH	$1,238	$1,176.10	$416.28 – $1,200.86
Transvaginal ultrasound: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $680.90 Anthem BCBS of WI — HMO/POS: $423 Anthem BCBS of WI — PPO: $459 Anthem BCBS of WI — Traditional: $473 Besse Forest Products — Direct Employer: $1,052.30 Cigna — PPO: $1,163.72 CORVEL — Third Party: $1,176.10 Coventry — Workers Comp: $1,188.48 Family Health Center (FHC) — Prepaid Health Svcs: $619 First Health — PPO Network: $1,176.10
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: 77065 TC TECH DIAG MAMMOGR CAD UNIL-MOBILE	$624	$592.80	$260 – $605.28
Diagnostic mammogram, one breast: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $343.20 Anthem BCBS of WI — HMO/POS: $260 Anthem BCBS of WI — PPO: $287 Anthem BCBS of WI — Traditional: $317 Besse Forest Products — Direct Employer: $530.40 Cigna — PPO: $586.56 CORVEL — Third Party: $592.80 Coventry — Workers Comp: $599.04 Family Health Center (FHC) — Prepaid Health Svcs: $312 First Health — PPO Network: $592.80
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: 77065 TC TECH DIAG MAMMOGR CAD UNIL-MOBILE	$624	$592.80	$343.20 – $605.28
Diagnostic mammogram, one breast: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $343.20 Besse Forest Products — Direct Employer: $530.40 Cigna — PPO: $586.56 CORVEL — Third Party: $592.80 Coventry — Workers Comp: $599.04 First Health — PPO Network: $592.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $574.08 Group Health Cooperative of Eau Claire — ETF - River Region: $511.68 Health Partners — PPO: $592.80 Health Smart — PPO Network: $599.04
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: 77066 TC DIAG MAMMOGR CAD BIL-MOBILE	$797	$757.15	$260 – $773.09
Diagnostic mammogram, both breasts: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $438.35 Anthem BCBS of WI — HMO/POS: $260 Anthem BCBS of WI — PPO: $287 Anthem BCBS of WI — Traditional: $317 Besse Forest Products — Direct Employer: $677.45 Cigna — PPO: $749.18 CORVEL — Third Party: $757.15 Coventry — Workers Comp: $765.12 Family Health Center (FHC) — Prepaid Health Svcs: $398.50 First Health — PPO Network: $757.15
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: 77066 TC DIAG MAMMOGR CAD BIL-MOBILE	$797	$757.15	$438.35 – $773.09
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $438.35 Besse Forest Products — Direct Employer: $677.45 Cigna — PPO: $749.18 CORVEL — Third Party: $757.15 Coventry — Workers Comp: $765.12 First Health — PPO Network: $757.15 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $733.24 Group Health Cooperative of Eau Claire — ETF - River Region: $653.54 Health Partners — PPO: $757.15 Health Smart — PPO Network: $765.12
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SCREENING MAMMOGRAPHY, UNILATERAL-TECH	$649	$616.55	$260 – $629.53
Screening mammogram, both breasts: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $356.95 Anthem BCBS of WI — HMO/POS: $260 Anthem BCBS of WI — PPO: $287 Anthem BCBS of WI — Traditional: $317 Besse Forest Products — Direct Employer: $551.65 Cigna — PPO: $610.06 CORVEL — Third Party: $616.55 Coventry — Workers Comp: $623.04 Family Health Center (FHC) — Prepaid Health Svcs: $324.50 First Health — PPO Network: $616.55
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SCR MAMMO INCL CAD UNIL MOBILE-TECH	$649	$616.55	$260 – $629.53
Screening mammogram, both breasts: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $356.95 Anthem BCBS of WI — HMO/POS: $260 Anthem BCBS of WI — PPO: $287 Anthem BCBS of WI — Traditional: $317 Besse Forest Products — Direct Employer: $551.65 Cigna — PPO: $610.06 CORVEL — Third Party: $616.55 Coventry — Workers Comp: $623.04 Family Health Center (FHC) — Prepaid Health Svcs: $324.50 First Health — PPO Network: $616.55
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SCREEN MAMMOGR,UNIL,CAD	$902	$856.90	$260 – $874.94
Screening mammogram, both breasts: 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $496.10 Anthem BCBS of WI — HMO/POS: $260 Anthem BCBS of WI — PPO: $287 Anthem BCBS of WI — Traditional: $317 Besse Forest Products — Direct Employer: $766.70 Cigna — PPO: $847.88 CORVEL — Third Party: $856.90 Coventry — Workers Comp: $865.92 Family Health Center (FHC) — Prepaid Health Svcs: $451 First Health — PPO Network: $856.90

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING TRANSSEPTAL CATHETERIZATIONS, INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHET	Not listed in the file	Not listed in the file	$23,294.40 – $59,158
Heart rhythm study with ablation for atrial fibrillation: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $51,691 Anthem BCBS of WI — Medicare Advantage: $23,993.23 Anthem BCBS of WI — PPO: $57,433 Anthem BCBS of WI — Traditional: $59,158 Group Health Cooperative of Eau Claire — Medicare Advantage: $24,692.06 Security Health Plan (SHP) — Broad: $51,568.75 Security Health Plan (SHP) — EPO: $45,896.75 Security Health Plan (SHP) — Medicare Advantage: $23,294.40 Security Health Plan (SHP) — SimplyOne QHP: $43,059.64 Security Health Plan (SHP) — SimplyOne Region 1: $44,865.37
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: POLYSOM 6+YRS 4+ PA-TECH	$4,804	$4,563.80	$2,297.81 – $4,659.88
Sleep study (overnight, in a sleep lab): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $2,642.20 Anthem BCBS of WI — HMO/POS: $3,651.04 Anthem BCBS of WI — PPO: $3,987.32 Anthem BCBS of WI — Traditional: $4,227.52 Besse Forest Products — Direct Employer: $4,083.40 Cigna — PPO: $4,515.76 CORVEL — Third Party: $4,563.80 Coventry — Workers Comp: $4,611.84 Family Health Center (FHC) — Prepaid Health Svcs: $2,402 First Health — PPO Network: $4,563.80
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: POLYSOM 6+YRS 4+ PA-TECH	$4,804	$4,563.80	$2,642.20 – $4,659.88
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $2,642.20 Besse Forest Products — Direct Employer: $4,083.40 Cigna — PPO: $4,515.76 CORVEL — Third Party: $4,563.80 Coventry — Workers Comp: $4,611.84 First Health — PPO Network: $4,563.80 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $4,419.68 Group Health Cooperative of Eau Claire — ETF - River Region: $3,939.28 Health Partners — PPO: $4,563.80 Health Smart — PPO Network: $4,611.84

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: OT THER EXERCISE EA 15MIN-TECH	$149	$141.55	$74.50 – $176.84
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Anthem BCBS of WI — HMO/POS: $113.24 Anthem BCBS of WI — PPO: $123.67 Anthem BCBS of WI — Traditional: $131.12 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 Family Health Center (FHC) — Prepaid Health Svcs: $74.50 First Health — PPO Network: $141.55
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT THER EXERCISE EA 15MIN-TECH	$149	$141.55	$74.50 – $176.84
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Anthem BCBS of WI — HMO/POS: $113.24 Anthem BCBS of WI — PPO: $123.67 Anthem BCBS of WI — Traditional: $131.12 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 Family Health Center (FHC) — Prepaid Health Svcs: $74.50 First Health — PPO Network: $141.55
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GO In the file: OT THER EXERCISE EA 15MIN-TECH	$149	$141.55	$81.95 – $144.53
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 First Health — PPO Network: $141.55 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $137.08 Group Health Cooperative of Eau Claire — ETF - River Region: $122.18 Health Partners — PPO: $141.55 Health Smart — PPO Network: $143.04
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN-TECH	$339	$322.05	$119.72 – $328.83
Physical therapy evaluation (moderate complexity): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $186.45 Anthem BCBS of WI — HMO/POS: $257.64 Anthem BCBS of WI — PPO: $281.37 Anthem BCBS of WI — Traditional: $298.32 Besse Forest Products — Direct Employer: $288.15 Cigna — PPO: $318.66 CORVEL — Third Party: $322.05 Coventry — Workers Comp: $325.44 Family Health Center (FHC) — Prepaid Health Svcs: $169.50 First Health — PPO Network: $322.05
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN-TECH	$339	$322.05	$186.45 – $328.83
Physical therapy evaluation (moderate complexity): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $186.45 Besse Forest Products — Direct Employer: $288.15 Cigna — PPO: $318.66 CORVEL — Third Party: $322.05 Coventry — Workers Comp: $325.44 First Health — PPO Network: $322.05 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $311.88 Group Health Cooperative of Eau Claire — ETF - River Region: $277.98 Health Partners — PPO: $322.05 Health Smart — PPO Network: $325.44
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN-TECH	$530	$503.50	$119.72 – $514.10
Physical therapy evaluation (high complexity): 10 of 40 insurance plan rates Amish/Mennonite — Amish Mennonite: $291.50 Anthem BCBS of WI — HMO/POS: $402.80 Anthem BCBS of WI — PPO: $439.90 Anthem BCBS of WI — Traditional: $466.40 Besse Forest Products — Direct Employer: $450.50 Cigna — PPO: $498.20 CORVEL — Third Party: $503.50 Coventry — Workers Comp: $508.80 Family Health Center (FHC) — Prepaid Health Svcs: $265 First Health — PPO Network: $503.50
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN-TECH	$530	$503.50	$291.50 – $514.10
Physical therapy evaluation (high complexity): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $291.50 Besse Forest Products — Direct Employer: $450.50 Cigna — PPO: $498.20 CORVEL — Third Party: $503.50 Coventry — Workers Comp: $508.80 First Health — PPO Network: $503.50 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $487.60 Group Health Cooperative of Eau Claire — ETF - River Region: $434.60 Health Partners — PPO: $503.50 Health Smart — PPO Network: $508.80
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,QTT-MSW-90832-TECH	$112	$106.40	$56 – $161.71
Psychotherapy, 30 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $61.60 Anthem BCBS of WI — HMO/POS: $85.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $92.96 Anthem BCBS of WI — Traditional: $98.56 Besse Forest Products — Direct Employer: $95.20 Cigna — PPO: $105.28 CORVEL — Third Party: $106.40 Coventry — Workers Comp: $107.52 Family Health Center (FHC) — Prepaid Health Svcs: $56
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,30 MIN-PHD 90832-TECH	$112	$106.40	$56 – $161.71
Psychotherapy, 30 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $61.60 Anthem BCBS of WI — HMO/POS: $85.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $92.96 Anthem BCBS of WI — Traditional: $98.56 Besse Forest Products — Direct Employer: $95.20 Cigna — PPO: $105.28 CORVEL — Third Party: $106.40 Coventry — Workers Comp: $107.52 Family Health Center (FHC) — Prepaid Health Svcs: $56
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY-30 MIN-MSW/MS 90832-TECH	$112	$106.40	$56 – $161.71
Psychotherapy, 30 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $61.60 Anthem BCBS of WI — HMO/POS: $85.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $92.96 Anthem BCBS of WI — Traditional: $98.56 Besse Forest Products — Direct Employer: $95.20 Cigna — PPO: $105.28 CORVEL — Third Party: $106.40 Coventry — Workers Comp: $107.52 Family Health Center (FHC) — Prepaid Health Svcs: $56
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,QTT-MSW-90834-TECH	$149	$141.55	$74.50 – $161.71
Psychotherapy, 45 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Anthem BCBS of WI — HMO/POS: $113.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $123.67 Anthem BCBS of WI — Traditional: $131.12 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 Family Health Center (FHC) — Prepaid Health Svcs: $74.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INDIVIDUAL; THERAPY,LMFT-MS 90834-TECH	$149	$141.55	$74.50 – $161.71
Psychotherapy, 45 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Anthem BCBS of WI — HMO/POS: $113.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $123.67 Anthem BCBS of WI — Traditional: $131.12 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 Family Health Center (FHC) — Prepaid Health Svcs: $74.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,45 MIN-MSW/MS 90834-TECH	$149	$141.55	$74.50 – $161.71
Psychotherapy, 45 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $81.95 Anthem BCBS of WI — HMO/POS: $113.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $123.67 Anthem BCBS of WI — Traditional: $131.12 Besse Forest Products — Direct Employer: $126.65 Cigna — PPO: $140.06 CORVEL — Third Party: $141.55 Coventry — Workers Comp: $143.04 Family Health Center (FHC) — Prepaid Health Svcs: $74.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INDIVIDUAL THERAPY,LMFT-MS 90837-TECH	$224	$212.80	$112 – $217.28
Psychotherapy, 60 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $123.20 Anthem BCBS of WI — HMO/POS: $170.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $185.92 Anthem BCBS of WI — Traditional: $197.12 Besse Forest Products — Direct Employer: $190.40 Cigna — PPO: $210.56 CORVEL — Third Party: $212.80 Coventry — Workers Comp: $215.04 Family Health Center (FHC) — Prepaid Health Svcs: $112
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,60 MIN-PHD 90837-TECH	$224	$212.80	$112 – $217.28
Psychotherapy, 60 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $123.20 Anthem BCBS of WI — HMO/POS: $170.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $185.92 Anthem BCBS of WI — Traditional: $197.12 Besse Forest Products — Direct Employer: $190.40 Cigna — PPO: $210.56 CORVEL — Third Party: $212.80 Coventry — Workers Comp: $215.04 Family Health Center (FHC) — Prepaid Health Svcs: $112
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY,60 MIN-MSW/MS 90837-TECH	$224	$212.80	$112 – $217.28
Psychotherapy, 60 minutes: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $123.20 Anthem BCBS of WI — HMO/POS: $170.24 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $185.92 Anthem BCBS of WI — Traditional: $197.12 Besse Forest Products — Direct Employer: $190.40 Cigna — PPO: $210.56 CORVEL — Third Party: $212.80 Coventry — Workers Comp: $215.04 Family Health Center (FHC) — Prepaid Health Svcs: $112
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THER W/O PT,50 MIN-PHD 90846-TECH	$180	$171	$90 – $174.60
Family psychotherapy, without the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $99 Anthem BCBS of WI — HMO/POS: $136.80 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $149.40 Anthem BCBS of WI — Traditional: $158.40 Besse Forest Products — Direct Employer: $153 Cigna — PPO: $169.20 CORVEL — Third Party: $171 Coventry — Workers Comp: $172.80 Family Health Center (FHC) — Prepaid Health Svcs: $90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THER W/O PT,50 MIN-MD 90846-TECH	$180	$171	$90 – $174.60
Family psychotherapy, without the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $99 Anthem BCBS of WI — HMO/POS: $136.80 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $149.40 Anthem BCBS of WI — Traditional: $158.40 Besse Forest Products — Direct Employer: $153 Cigna — PPO: $169.20 CORVEL — Third Party: $171 Coventry — Workers Comp: $172.80 Family Health Center (FHC) — Prepaid Health Svcs: $90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THER,W/O PT,50MN-MSW/MS 90846-TECH	$180	$171	$90 – $174.60
Family psychotherapy, without the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $99 Anthem BCBS of WI — HMO/POS: $136.80 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $149.40 Anthem BCBS of WI — Traditional: $158.40 Besse Forest Products — Direct Employer: $153 Cigna — PPO: $169.20 CORVEL — Third Party: $171 Coventry — Workers Comp: $172.80 Family Health Center (FHC) — Prepaid Health Svcs: $90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY,LMFT-MS 90847-TECH	$187	$177.65	$93.50 – $181.39
Family psychotherapy, with the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $102.85 Anthem BCBS of WI — HMO/POS: $142.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $155.21 Anthem BCBS of WI — Traditional: $164.56 Besse Forest Products — Direct Employer: $158.95 Cigna — PPO: $175.78 CORVEL — Third Party: $177.65 Coventry — Workers Comp: $179.52 Family Health Center (FHC) — Prepaid Health Svcs: $93.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY,50 MIN-PHD 90847-TECH	$187	$177.65	$93.50 – $181.39
Family psychotherapy, with the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $102.85 Anthem BCBS of WI — HMO/POS: $142.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $155.21 Anthem BCBS of WI — Traditional: $164.56 Besse Forest Products — Direct Employer: $158.95 Cigna — PPO: $175.78 CORVEL — Third Party: $177.65 Coventry — Workers Comp: $179.52 Family Health Center (FHC) — Prepaid Health Svcs: $93.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY,50 MIN-MSW/MS 90847-TECH	$187	$177.65	$93.50 – $181.39
Family psychotherapy, with the patient: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $102.85 Anthem BCBS of WI — HMO/POS: $142.12 Anthem BCBS of WI — Medicare Advantage: $157.14 Anthem BCBS of WI — PPO: $155.21 Anthem BCBS of WI — Traditional: $164.56 Besse Forest Products — Direct Employer: $158.95 Cigna — PPO: $175.78 CORVEL — Third Party: $177.65 Coventry — Workers Comp: $179.52 Family Health Center (FHC) — Prepaid Health Svcs: $93.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP THERAPY-MSW/MS 90853-TECH	$53	$50.35	$26.50 – $93.10
Group psychotherapy: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $29.15 Anthem BCBS of WI — HMO/POS: $40.28 Anthem BCBS of WI — Medicare Advantage: $90.46 Anthem BCBS of WI — PPO: $43.99 Anthem BCBS of WI — Traditional: $46.64 Besse Forest Products — Direct Employer: $45.05 Cigna — PPO: $49.82 CORVEL — Third Party: $50.35 Coventry — Workers Comp: $50.88 Family Health Center (FHC) — Prepaid Health Svcs: $26.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP THERAPY-APNP 90853-TECH	$53	$50.35	$26.50 – $93.10
Group psychotherapy: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $29.15 Anthem BCBS of WI — HMO/POS: $40.28 Anthem BCBS of WI — Medicare Advantage: $90.46 Anthem BCBS of WI — PPO: $43.99 Anthem BCBS of WI — Traditional: $46.64 Besse Forest Products — Direct Employer: $45.05 Cigna — PPO: $49.82 CORVEL — Third Party: $50.35 Coventry — Workers Comp: $50.88 Family Health Center (FHC) — Prepaid Health Svcs: $26.50
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: GROUP THERAPY-MSW/MS 90853-TECH	$53	$50.35	$29.15 – $51.41
Group psychotherapy: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $29.15 Besse Forest Products — Direct Employer: $45.05 Cigna — PPO: $49.82 CORVEL — Third Party: $50.35 Coventry — Workers Comp: $50.88 First Health — PPO Network: $50.35 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $48.76 Group Health Cooperative of Eau Claire — ETF - River Region: $43.46 Health Partners — PPO: $50.35 Health Smart — PPO Network: $50.88

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXN BRST LESN OPEN >=1 LESN-TECH	$914	$868.30	$457 – $3,854.21
Removal of breast growth (open surgery): 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $502.70 Anthem BCBS of WI — HMO/POS: $694.64 Anthem BCBS of WI — Medicare Advantage: $3,745.13 Anthem BCBS of WI — PPO: $758.62 Anthem BCBS of WI — Traditional: $804.32 Besse Forest Products — Direct Employer: $776.90 CORVEL — Third Party: $868.30 Coventry — Workers Comp: $877.44 Family Health Center (FHC) — Prepaid Health Svcs: $457 First Health — PPO Network: $868.30
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXN BRST LESN OPEN >=1 LESN-TECH	$914	$868.30	$502.70 – $886.58
Removal of breast growth (open surgery): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $502.70 Besse Forest Products — Direct Employer: $776.90 Cigna — PPO: $859.16 CORVEL — Third Party: $868.30 Coventry — Workers Comp: $877.44 First Health — PPO Network: $868.30 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $840.88 Group Health Cooperative of Eau Claire — ETF - River Region: $749.48 Health Partners — PPO: $868.30 Health Smart — PPO Network: $877.44
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19	Not listed in the file	Not listed in the file	$3,636.05 – $7,776.51
Removal of breast growth (open surgery): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $6,654 Anthem BCBS of WI — Medicare Advantage: $3,745.13 Anthem BCBS of WI — PPO: $7,393 Anthem BCBS of WI — Traditional: $7,621 Group Health Cooperative of Eau Claire — Medicare Advantage: $3,854.21 Security Health Plan (SHP) — Broad: $7,776.51 Security Health Plan (SHP) — EPO: $6,920.87 Security Health Plan (SHP) — Medicare Advantage: $3,636.05 Security Health Plan (SHP) — SimplyOne QHP: $6,493.60 Security Health Plan (SHP) — SimplyOne Region 1: $6,766
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT	Not listed in the file	Not listed in the file	$7,973.12 – $16,401
Total hip replacement: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $14,333 Anthem BCBS of WI — Medicare Advantage: $12,584.09 Anthem BCBS of WI — PPO: $15,923 Anthem BCBS of WI — Traditional: $16,401 Group Health Cooperative of Eau Claire — Medicare Advantage: $12,950.61 Security Health Plan (SHP) — Broad: $11,725.16 Security Health Plan (SHP) — EPO: $10,435.67 Security Health Plan (SHP) — Medicare Advantage: $12,217.56 Security Health Plan (SHP) — SimplyOne QHP: $9,790.92 Security Health Plan (SHP) — SimplyOne Region 1: $10,200.63
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)	Not listed in the file	Not listed in the file	$7,973.12 – $16,988
Total knee replacement: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $14,844 Anthem BCBS of WI — Medicare Advantage: $12,584.09 Anthem BCBS of WI — PPO: $16,493 Anthem BCBS of WI — Traditional: $16,988 Group Health Cooperative of Eau Claire — Medicare Advantage: $12,950.61 Security Health Plan (SHP) — Broad: $11,725.16 Security Health Plan (SHP) — EPO: $10,435.67 Security Health Plan (SHP) — Medicare Advantage: $12,217.56 Security Health Plan (SHP) — SimplyOne QHP: $9,790.92 Security Health Plan (SHP) — SimplyOne Region 1: $10,200.63
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULA	Not listed in the file	Not listed in the file	$3,080.89 – $7,776.51
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $6,654 Anthem BCBS of WI — Medicare Advantage: $3,173.32 Anthem BCBS of WI — PPO: $7,393 Anthem BCBS of WI — Traditional: $7,621 Group Health Cooperative of Eau Claire — Medicare Advantage: $3,265.74 Security Health Plan (SHP) — Broad: $7,776.51 Security Health Plan (SHP) — EPO: $6,920.87 Security Health Plan (SHP) — Medicare Advantage: $3,080.89 Security Health Plan (SHP) — SimplyOne QHP: $6,493.60 Security Health Plan (SHP) — SimplyOne Region 1: $6,766
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12	Not listed in the file	Not listed in the file	$5,617.16 – $11,725.16
Removal of tonsils and adenoids (under age 12): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $9,623 Anthem BCBS of WI — Medicare Advantage: $5,785.67 Anthem BCBS of WI — PPO: $10,694 Anthem BCBS of WI — Traditional: $11,015 Group Health Cooperative of Eau Claire — Medicare Advantage: $5,954.19 Security Health Plan (SHP) — Broad: $11,725.16 Security Health Plan (SHP) — EPO: $10,435.67 Security Health Plan (SHP) — Medicare Advantage: $5,617.16 Security Health Plan (SHP) — SimplyOne QHP: $9,790.92 Security Health Plan (SHP) — SimplyOne Region 1: $10,200.63
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEP	Not listed in the file	Not listed in the file	$890.25 – $3,163
Upper GI endoscopy (diagnostic): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $916.96 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Group Health Cooperative of Eau Claire — Medicare Advantage: $943.66 Security Health Plan (SHP) — Broad: $2,306.59 Security Health Plan (SHP) — EPO: $2,052.86 Security Health Plan (SHP) — Medicare Advantage: $890.25 Security Health Plan (SHP) — SimplyOne QHP: $1,926.55 Security Health Plan (SHP) — SimplyOne Region 1: $2,006.73
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE	Not listed in the file	Not listed in the file	$890.25 – $3,163
Upper GI endoscopy with biopsy: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $916.96 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Group Health Cooperative of Eau Claire — Medicare Advantage: $943.66 Security Health Plan (SHP) — Broad: $2,306.59 Security Health Plan (SHP) — EPO: $2,052.86 Security Health Plan (SHP) — Medicare Advantage: $890.25 Security Health Plan (SHP) — SimplyOne QHP: $1,926.55 Security Health Plan (SHP) — SimplyOne Region 1: $2,006.73
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAGNOSTIC-TECH	$1,546	$1,468.70	$773 – $3,163
Colonoscopy (diagnostic): 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $850.30 Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $891.68 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Besse Forest Products — Direct Employer: $1,314.10 Cigna — PPO: $1,453.24 CORVEL — Third Party: $1,468.70 Coventry — Workers Comp: $1,484.16 Family Health Center (FHC) — Prepaid Health Svcs: $773
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAGNOSTIC-TECH	$1,546	$1,468.70	$850.30 – $1,499.62
Colonoscopy (diagnostic): 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $850.30 Besse Forest Products — Direct Employer: $1,314.10 Cigna — PPO: $1,453.24 CORVEL — Third Party: $1,468.70 Coventry — Workers Comp: $1,484.16 First Health — PPO Network: $1,468.70 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,422.32 Group Health Cooperative of Eau Claire — ETF - River Region: $1,267.72 Health Partners — PPO: $1,468.70 Health Smart — PPO Network: $1,484.16
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)	Not listed in the file	Not listed in the file	$865.71 – $3,163
Colonoscopy (diagnostic): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $891.68 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Group Health Cooperative of Eau Claire — Medicare Advantage: $917.65 Security Health Plan (SHP) — Broad: $2,306.59 Security Health Plan (SHP) — EPO: $2,052.86 Security Health Plan (SHP) — Medicare Advantage: $865.71 Security Health Plan (SHP) — SimplyOne QHP: $1,926.55 Security Health Plan (SHP) — SimplyOne Region 1: $2,006.73
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSC FLEX W/BIOPSY-TECH	$1,314	$1,248.30	$657 – $4,686
Colonoscopy with biopsy: 10 of 44 insurance plan rates Amish/Mennonite — Amish Mennonite: $722.70 Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $1,153.17 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Besse Forest Products — Direct Employer: $1,116.90 Cigna — PPO: $1,235.16 CORVEL — Third Party: $1,248.30 Coventry — Workers Comp: $1,261.44 Family Health Center (FHC) — Prepaid Health Svcs: $657
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSC FLEX W/BIOPSY-TECH	$1,314	$1,248.30	$722.70 – $1,274.58
Colonoscopy with biopsy: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $722.70 Besse Forest Products — Direct Employer: $1,116.90 Cigna — PPO: $1,235.16 CORVEL — Third Party: $1,248.30 Coventry — Workers Comp: $1,261.44 First Health — PPO Network: $1,248.30 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,208.88 Group Health Cooperative of Eau Claire — ETF - River Region: $1,077.48 Health Partners — PPO: $1,248.30 Health Smart — PPO Network: $1,261.44
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE	Not listed in the file	Not listed in the file	$1,119.58 – $4,686
Colonoscopy with biopsy: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $1,153.17 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $1,186.75 Security Health Plan (SHP) — Broad: $2,745.94 Security Health Plan (SHP) — EPO: $2,443.89 Security Health Plan (SHP) — Medicare Advantage: $1,119.58 Security Health Plan (SHP) — SimplyOne QHP: $2,293.41 Security Health Plan (SHP) — SimplyOne Region 1: $2,388.96
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE	Not listed in the file	Not listed in the file	$1,119.58 – $4,686
Colonoscopy with removal of polyps (snare): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $1,153.17 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $1,186.75 Security Health Plan (SHP) — Broad: $2,745.94 Security Health Plan (SHP) — EPO: $2,443.89 Security Health Plan (SHP) — Medicare Advantage: $1,119.58 Security Health Plan (SHP) — SimplyOne QHP: $2,293.41 Security Health Plan (SHP) — SimplyOne Region 1: $2,388.96
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	Not listed in the file	Not listed in the file	$865.71 – $3,163
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $891.68 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Group Health Cooperative of Eau Claire — Medicare Advantage: $917.65 Security Health Plan (SHP) — Broad: $2,306.59 Security Health Plan (SHP) — EPO: $2,052.86 Security Health Plan (SHP) — Medicare Advantage: $865.71 Security Health Plan (SHP) — SimplyOne QHP: $1,926.55 Security Health Plan (SHP) — SimplyOne Region 1: $2,006.73
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$5,539.96 – $12,887
Gallbladder removal by laparoscope: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $11,260 Anthem BCBS of WI — Medicare Advantage: $5,706.16 Anthem BCBS of WI — PPO: $12,512 Anthem BCBS of WI — Traditional: $12,887 Group Health Cooperative of Eau Claire — Medicare Advantage: $5,872.36 Security Health Plan (SHP) — Broad: $11,725.16 Security Health Plan (SHP) — EPO: $10,435.67 Security Health Plan (SHP) — Medicare Advantage: $5,539.96 Security Health Plan (SHP) — SimplyOne QHP: $9,790.92 Security Health Plan (SHP) — SimplyOne Region 1: $10,200.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE	Not listed in the file	Not listed in the file	$3,350.98 – $7,776.51
Groin (inguinal) hernia repair, age 5 or older: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $6,654 Anthem BCBS of WI — Medicare Advantage: $3,451.51 Anthem BCBS of WI — PPO: $7,393 Anthem BCBS of WI — Traditional: $7,621 Group Health Cooperative of Eau Claire — Medicare Advantage: $3,552.04 Security Health Plan (SHP) — Broad: $7,776.51 Security Health Plan (SHP) — EPO: $6,920.87 Security Health Plan (SHP) — Medicare Advantage: $3,350.98 Security Health Plan (SHP) — SimplyOne QHP: $6,493.60 Security Health Plan (SHP) — SimplyOne Region 1: $6,766
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY PROSTRATE NEEDLE/PUNCH-TECH	$421	$399.95	$210.50 – $2,061.85
Prostate biopsy: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $231.55 Anthem BCBS of WI — HMO/POS: $319.96 Anthem BCBS of WI — Medicare Advantage: $2,003.49 Anthem BCBS of WI — PPO: $349.43 Anthem BCBS of WI — Traditional: $370.48 Besse Forest Products — Direct Employer: $357.85 CORVEL — Third Party: $399.95 Coventry — Workers Comp: $404.16 Family Health Center (FHC) — Prepaid Health Svcs: $210.50 First Health — PPO Network: $399.95
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY PROSTRATE NEEDLE/PUNCH-TECH	$421	$399.95	$231.55 – $408.37
Prostate biopsy: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $231.55 Besse Forest Products — Direct Employer: $357.85 Cigna — PPO: $395.74 CORVEL — Third Party: $399.95 Coventry — Workers Comp: $404.16 First Health — PPO Network: $399.95 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $387.32 Group Health Cooperative of Eau Claire — ETF - River Region: $345.22 Health Partners — PPO: $399.95 Health Smart — PPO Network: $404.16
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH	Not listed in the file	Not listed in the file	$1,945.14 – $5,711.56
Prostate biopsy: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $2,003.49 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $2,061.85 Security Health Plan (SHP) — Broad: $5,711.56 Security Health Plan (SHP) — EPO: $5,083.29 Security Health Plan (SHP) — Medicare Advantage: $1,945.14 Security Health Plan (SHP) — SimplyOne QHP: $4,769.15 Security Health Plan (SHP) — SimplyOne Region 1: $4,969.05
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED	Not listed in the file	Not listed in the file	$9,885.87 – $16,988
Prostate removal by laparoscope (radical prostatectomy): 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $14,844 Anthem BCBS of WI — Medicare Advantage: $10,182.45 Anthem BCBS of WI — PPO: $16,493 Anthem BCBS of WI — Traditional: $16,988 Group Health Cooperative of Eau Claire — Medicare Advantage: $10,479.02 Security Health Plan (SHP) — Broad: $16,475.64 Security Health Plan (SHP) — EPO: $14,663.32 Security Health Plan (SHP) — Medicare Advantage: $9,885.87 Security Health Plan (SHP) — SimplyOne QHP: $13,757.16 Security Health Plan (SHP) — SimplyOne Region 1: $14,333.81
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C	Not listed in the file	Not listed in the file	$3,019.09 – $7,776.51
Hysteroscopy with biopsy of the uterus lining: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $3,109.66 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $3,200.24 Security Health Plan (SHP) — Broad: $7,776.51 Security Health Plan (SHP) — EPO: $6,920.87 Security Health Plan (SHP) — Medicare Advantage: $3,019.09 Security Health Plan (SHP) — SimplyOne QHP: $6,493.60 Security Health Plan (SHP) — SimplyOne Region 1: $6,766
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ EPID/SUBARCH LUM/SAC W/GUIDE-TECH	$1,118	$1,062.10	$614.90 – $3,163
Spinal injection, lower back (epidural), with imaging guidance: 10 of 43 insurance plan rates Amish/Mennonite — Amish Mennonite: $614.90 Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $677.31 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Besse Forest Products — Direct Employer: $950.30 Cigna — PPO: $1,050.92 CORVEL — Third Party: $1,062.10 Coventry — Workers Comp: $1,073.28 First Health — PPO Network: $1,062.10
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ DIAG/THER SUB L/S W/IMAG-TECH	$289	$274.55	$144.50 – $697.03
Spinal injection, lower back (epidural), with imaging guidance: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $158.95 Anthem BCBS of WI — HMO/POS: $219.64 Anthem BCBS of WI — Medicare Advantage: $677.31 Anthem BCBS of WI — PPO: $239.87 Anthem BCBS of WI — Traditional: $254.32 Besse Forest Products — Direct Employer: $245.65 CORVEL — Third Party: $274.55 Coventry — Workers Comp: $277.44 Family Health Center (FHC) — Prepaid Health Svcs: $144.50 First Health — PPO Network: $274.55
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ EPID/SUBARCH LUM/SAC W/GUIDE-TECH	$1,118	$1,062.10	$614.90 – $1,084.46
Spinal injection, lower back (epidural), with imaging guidance: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $614.90 Besse Forest Products — Direct Employer: $950.30 Cigna — PPO: $1,050.92 CORVEL — Third Party: $1,062.10 Coventry — Workers Comp: $1,073.28 First Health — PPO Network: $1,062.10 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,028.56 Group Health Cooperative of Eau Claire — ETF - River Region: $916.76 Health Partners — PPO: $1,062.10 Health Smart — PPO Network: $1,073.28
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ ANES AGNT W/GUIDE-TECH	$1,118	$1,062.10	$614.90 – $3,163
Nerve root injection, lower back, with imaging guidance: 10 of 43 insurance plan rates Amish/Mennonite — Amish Mennonite: $614.90 Anthem BCBS of WI — HMO/POS: $2,763 Anthem BCBS of WI — Medicare Advantage: $870.73 Anthem BCBS of WI — PPO: $3,072 Anthem BCBS of WI — Traditional: $3,163 Besse Forest Products — Direct Employer: $950.30 Cigna — PPO: $1,050.92 CORVEL — Third Party: $1,062.10 Coventry — Workers Comp: $1,073.28 First Health — PPO Network: $1,062.10
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ ANES AGNT LMB/SAC-RAD ONLY-TECH	$329	$312.55	$164.50 – $896.09
Nerve root injection, lower back, with imaging guidance: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $180.95 Anthem BCBS of WI — HMO/POS: $250.04 Anthem BCBS of WI — Medicare Advantage: $870.73 Anthem BCBS of WI — PPO: $273.07 Anthem BCBS of WI — Traditional: $289.52 Besse Forest Products — Direct Employer: $279.65 CORVEL — Third Party: $312.55 Coventry — Workers Comp: $315.84 Family Health Center (FHC) — Prepaid Health Svcs: $164.50 First Health — PPO Network: $312.55
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ ANES AGNT W/GUIDE-TECH	$1,118	$1,062.10	$614.90 – $1,084.46
Nerve root injection, lower back, with imaging guidance: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $614.90 Besse Forest Products — Direct Employer: $950.30 Cigna — PPO: $1,050.92 CORVEL — Third Party: $1,062.10 Coventry — Workers Comp: $1,073.28 First Health — PPO Network: $1,062.10 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,028.56 Group Health Cooperative of Eau Claire — ETF - River Region: $916.76 Health Partners — PPO: $1,062.10 Health Smart — PPO Network: $1,073.28
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY MEDIAN CARPAL TUNNEL-TECH	$1,276	$1,212.20	$638 – $1,965.48
Carpal tunnel release: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $701.80 Anthem BCBS of WI — HMO/POS: $969.76 Anthem BCBS of WI — Medicare Advantage: $1,909.86 Anthem BCBS of WI — PPO: $1,059.08 Anthem BCBS of WI — Traditional: $1,122.88 Besse Forest Products — Direct Employer: $1,084.60 CORVEL — Third Party: $1,212.20 Coventry — Workers Comp: $1,224.96 Family Health Center (FHC) — Prepaid Health Svcs: $638 First Health — PPO Network: $1,212.20
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY MEDIAN CARPAL TUNNEL-TECH	$1,276	$1,212.20	$701.80 – $1,237.72
Carpal tunnel release: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $701.80 Besse Forest Products — Direct Employer: $1,084.60 Cigna — PPO: $1,199.44 CORVEL — Third Party: $1,212.20 Coventry — Workers Comp: $1,224.96 First Health — PPO Network: $1,212.20 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $1,173.92 Group Health Cooperative of Eau Claire — ETF - River Region: $1,046.32 Health Partners — PPO: $1,212.20 Health Smart — PPO Network: $1,224.96
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL	Not listed in the file	Not listed in the file	$1,854.23 – $5,711.56
Carpal tunnel release: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $1,909.86 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $1,965.48 Security Health Plan (SHP) — Broad: $5,711.56 Security Health Plan (SHP) — EPO: $5,083.29 Security Health Plan (SHP) — Medicare Advantage: $1,854.23 Security Health Plan (SHP) — SimplyOne QHP: $4,769.15 Security Health Plan (SHP) — SimplyOne Region 1: $4,969.05
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DISC SECNDRY MEMB CATARACT LSR-TECH	$949	$901.55	$474.50 – $920.53
Laser treatment of clouding after cataract surgery: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $521.95 Anthem BCBS of WI — HMO/POS: $721.24 Anthem BCBS of WI — Medicare Advantage: $536.55 Anthem BCBS of WI — PPO: $787.67 Anthem BCBS of WI — Traditional: $835.12 Besse Forest Products — Direct Employer: $806.65 CORVEL — Third Party: $901.55 Coventry — Workers Comp: $911.04 Family Health Center (FHC) — Prepaid Health Svcs: $474.50 First Health — PPO Network: $901.55
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: YAG LASER CAPS-EXT SHARE CARE-TECH	$949	$901.55	$474.50 – $920.53
Laser treatment of clouding after cataract surgery: 10 of 36 insurance plan rates Amish/Mennonite — Amish Mennonite: $521.95 Anthem BCBS of WI — HMO/POS: $721.24 Anthem BCBS of WI — Medicare Advantage: $536.55 Anthem BCBS of WI — PPO: $787.67 Anthem BCBS of WI — Traditional: $835.12 Besse Forest Products — Direct Employer: $806.65 CORVEL — Third Party: $901.55 Coventry — Workers Comp: $911.04 Family Health Center (FHC) — Prepaid Health Svcs: $474.50 First Health — PPO Network: $901.55
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DISC SECNDRY MEMB CATARACT LSR-TECH	$949	$901.55	$521.95 – $920.53
Laser treatment of clouding after cataract surgery: 10 of 24 insurance plan rates Amish/Mennonite — Amish Mennonite: $521.95 Besse Forest Products — Direct Employer: $806.65 Cigna — PPO: $892.06 CORVEL — Third Party: $901.55 Coventry — Workers Comp: $911.04 First Health — PPO Network: $901.55 Group Health Cooperative of Eau Claire — ETF - Greater WI/HMO: $873.08 Group Health Cooperative of Eau Claire — ETF - River Region: $778.18 Health Partners — PPO: $901.55 Health Smart — PPO Network: $911.04
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGA	Not listed in the file	Not listed in the file	$2,165.64 – $5,711.56
Cataract removal with lens implant: 10 of 14 insurance plan rates Anthem BCBS of WI — HMO/POS: $4,095 Anthem BCBS of WI — Medicare Advantage: $2,230.61 Anthem BCBS of WI — PPO: $4,549 Anthem BCBS of WI — Traditional: $4,686 Group Health Cooperative of Eau Claire — Medicare Advantage: $2,295.58 Security Health Plan (SHP) — Broad: $5,711.56 Security Health Plan (SHP) — EPO: $5,083.29 Security Health Plan (SHP) — Medicare Advantage: $2,165.64 Security Health Plan (SHP) — SimplyOne QHP: $4,769.15 Security Health Plan (SHP) — SimplyOne Region 1: $4,969.05

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$85,440.40 – $255,416.36
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 19 insurance plan rates Anthem BCBS of WI — HMO/POS: $218,462.30 Anthem BCBS of WI — Medicare Advantage: $88,003.61 Anthem BCBS of WI — PPO: $241,016.92 Anthem BCBS of WI — Traditional: $255,416.36 Group Health Cooperative of Eau Claire — Medicare Advantage: $90,566.82 Medica of WI — PPO: $219,591.48 Security Health Plan (SHP) — Broad: $197,848.61 Security Health Plan (SHP) — EPO: $161,655.15 Security Health Plan (SHP) — Medicare Advantage: $85,440.40 Security Health Plan (SHP) — SimplyOne QHP: $194,545.72
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$16,692.17 – $49,899.76
Hip or knee replacement (major joint of the leg), without major complications: 10 of 19 insurance plan rates Anthem BCBS of WI — HMO/POS: $42,680.18 Anthem BCBS of WI — Medicare Advantage: $17,192.94 Anthem BCBS of WI — PPO: $47,086.59 Anthem BCBS of WI — Traditional: $49,899.76 Group Health Cooperative of Eau Claire — Medicare Advantage: $17,693.70 Medica of WI — PPO: $42,900.78 Security Health Plan (SHP) — Broad: $27,835.73 Security Health Plan (SHP) — EPO: $22,743.61 Security Health Plan (SHP) — Medicare Advantage: $16,692.17 Security Health Plan (SHP) — SimplyOne QHP: $27,371.04
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$20,958.40 – $62,653.24
Neck (cervical) spinal fusion, without complications: 10 of 19 insurance plan rates Anthem BCBS of WI — HMO/POS: $53,588.47 Anthem BCBS of WI — Medicare Advantage: $21,587.15 Anthem BCBS of WI — PPO: $59,121.08 Anthem BCBS of WI — Traditional: $62,653.24 Group Health Cooperative of Eau Claire — Medicare Advantage: $22,215.90 Medica of WI — PPO: $53,865.45 Security Health Plan (SHP) — Broad: $48,531.96 Security Health Plan (SHP) — EPO: $39,653.76 Security Health Plan (SHP) — Medicare Advantage: $20,958.40 Security Health Plan (SHP) — SimplyOne QHP: $47,721.77
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$10,611.99 – $31,723.60
Uterus and ovary surgery (not for cancer), without complications: 10 of 19 insurance plan rates Anthem BCBS of WI — HMO/POS: $27,133.77 Anthem BCBS of WI — Medicare Advantage: $10,930.35 Anthem BCBS of WI — PPO: $29,935.14 Anthem BCBS of WI — Traditional: $31,723.60 Group Health Cooperative of Eau Claire — Medicare Advantage: $11,248.71 Medica of WI — PPO: $27,274.02 Security Health Plan (SHP) — Broad: $24,573.48 Security Health Plan (SHP) — EPO: $20,078.13 Security Health Plan (SHP) — Medicare Advantage: $10,611.99 Security Health Plan (SHP) — SimplyOne QHP: $24,163.25

Source: Marshfield Medical Center’s standard charges file (marshfieldclinic.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on February 20, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	611 St Joseph Ave, Marshfield, WI 54449
County	Wood County
State	Wisconsin
Phone	(715) 387‑9963
Emergency services	Yes
Ownership	Voluntary non-profit - Church
Medicare overall rating	1 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	520037
Name in Medicare records	MARSHFIELD MEDICAL CENTER
Profile level	Medicare data + hospital website
Name on the hospital’s website	Marshfield Medical Center - Marshfield
Official website	marshfieldclinic.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Marshfield Medical Center - Marshfield — marshfieldclinic.org
Marshfield - Marshfield Medical Center in Marshfield — marshfieldclinic.org
24/7 Emergency Care & Level II Trauma | Marshfield Clinic — marshfieldclinic.org
Neuroscience Care | Marshfield Clinic — marshfieldclinic.org
Bariatric Surgery & Weight Loss Care | Marshfield Clinic — marshfieldclinic.org

Marshfield Medical Center

Summary

Profile from official sources

At a glance