Does Mille Lacs Health System have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mille Lacs Health System. In a medical emergency, call 911.

Where is Mille Lacs Health System?

200 North Elm Street, Onamia, MN 56359, in Mille Lacs County, Minnesota.

What is the phone number of Mille Lacs Health System?

(320) 532-3154, as listed by Medicare (CMS).

What is the Medicare star rating of Mille Lacs Health System?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Mille Lacs Health System — Onamia, MN

Quick answers

Does Mille Lacs Health System have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mille Lacs Health System. In a medical emergency, call 911.
Where is Mille Lacs Health System?: 200 North Elm Street, Onamia, MN 56359, in Mille Lacs County, Minnesota.
What is the phone number of Mille Lacs Health System?: (320) 532-3154, as listed by Medicare (CMS).
What is the Medicare star rating of Mille Lacs Health System?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[6][8][9][10][11][12][14][15]}

Conditions treated^{[9][10][12][14][15]}

Cardiovascular disease
Heart attack
Congestive heart failure
Arrhythmias
Arthritis and chronic joint pain
Sports and activity-related injuries
Fractures
Carpal tunnel syndrome
Trigger finger
Depression
Anxiety
Addiction support
Diabetes
Menopause-related conditions
Sleep disorders
Bladder health and incontinence
Balance, vertigo, dizziness

Treatments^{[5][8][9][10][11][13][14]}

Infusion therapy
Heart bypass surgery
Stents
Pacemaker
Beta-blocker therapy
ACE inhibitor therapy
Cardiac rehabilitation
Joint injections
Physical therapy
Occupational therapy
Speech and language therapy
Lymphedema therapy
Wound care
Telehealth tele-radiology

Procedures^{[8][9][10][11][15]}

Arthroscopic procedures
Appendectomy
Hernia repair
Colonoscopy
Upper endoscopy
Mastectomy
Carpal tunnel release
Rotator cuff repair
ACL repair
Meniscal repair
Stress testing
Holter monitoring
CT scan
MRI
Ultrasound
X-ray
3-D mammography
DEXA scan
Echocardiography
Nuclear medicine
Fluoroscopy

Programs and centers^{[4][5][13][17]}

Inpatient care
Observation patient care
Transitional swing bed care
Emergency room
Urgent care
Cardiac rehabilitation
Medication therapy management

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

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	Typical visiting hours are 8:00 a.m. to 8:00 p.m.; check with staff before visiting a patient's room^[16]

Doctors and clinicians (47)

47 doctors and other clinicians list Mille Lacs Health System 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 23 more: the button below opens the full list.

Other emergency rooms nearby

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

Welia Health23 mi · Mora, MN · Critical Access Hospital
Cuyuna Regional Medical Center31 mi · Crosby, MN · Critical Access Hospital
Riverwood Healthcare Center31 mi · Aitkin, MN · Critical Access Hospital
Essentia Health St Joseph's Medical Center33 mi · Brainerd, MN · Acute Care Hospital
St Gabriels Hospital34 mi · Little Falls, MN · Critical Access Hospital

Other hospitals nearby

Community Behavioral Health Hospital - Baxter35 mi · Baxter, MN · Psychiatric Hospital

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

Cura of Onamia0.2 mi · Onamia, MN · 2 of 5 stars
St Clare Living Community of Mora22 mi · Mora, MN · 3 of 5 stars
Milaca Elim Meadows Health Care Center22 mi · Milaca, MN · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Mille Lacs Health System Hospice1.9 mi · Onamia, MN
Horizon Health Hospice20 mi · Pierz, MN

All hospice providers in the state →

Home health agencies

Mille Lacs Home Care1.9 mi · Onamia, MN · 3 of 5 stars
Kanabec County Community Health18 mi · Mora, MN
Horizon Health Homecare20 mi · Pierz, MN

All home health agencies in the state →

Dialysis facilities

FMC Mora Dialysis Center18 mi · Mora, MN · 4 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

NE IA Shing Clinic1.9 mi · Onamia, MN · Community health center

Clinics and urgent care

Mille Lacs Health System1.9 mi · Onamia, MN · Rural health clinic
Mille Lacs Health System9.6 mi · Hillman, MN · Rural health clinic
Riverwood Health Care Center14 mi · Garrison, MN · Rural health clinic

Pharmacies

Mille Lacs Band of Ojibwe Indians1.9 mi · Onamia, MN · Pharmacy
Mille Lacs Health System1.9 mi · Onamia, MN · Community/retail pharmacy
Onamia Pharmacy LLC1.9 mi · Onamia, MN · Community/retail pharmacy

Assisted living nearby

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

Lake Song Assisted Living1.9 mi · Onamia, MN

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 Mille Lacs Health System 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	74%National average: 72%
Would definitely recommend the hospital	73%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	86%National average: 80%
Staff “always” explained medicines before giving them	61%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	87%National average: 74%
Area around the room “always” quiet at night	78%National average: 60%
Completed surveys	42Response rate: 24%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 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)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

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	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	Too few cases to report
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

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)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.2%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 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)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	42 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

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 Minnesota Best hospitals in Minnesota

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 55 common services exactly as Mille Lacs Health System 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE VST NEW LVL 3	$111	$77.70	$111 – $782
New patient office visit (about 30–44 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $111 (WPS) MEDICARE — WPS-MEDICARE: $34.41 AETNA — AETNA: $94.35 BEECH STREET CORP — BEECH STREET CORP: $111 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $111 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $111 CHAMPVA — CHAMPVA: $111 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $111 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $111 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $111
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFIC VST NEW PT III	$314	$219.80	$111 – $782
New patient office visit (about 30–44 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $314 (WPS) MEDICARE — WPS-MEDICARE: $97.34 AETNA — AETNA: $266.90 BEECH STREET CORP — BEECH STREET CORP: $314 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $314 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $314 CHAMPVA — CHAMPVA: $314 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $314 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $314 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $314
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE VISIT NEW III	$357	$249.90	$111 – $782
New patient office visit (about 30–44 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $357 (WPS) MEDICARE — WPS-MEDICARE: $110.67 AETNA — AETNA: $303.45 BEECH STREET CORP — BEECH STREET CORP: $357 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $357 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $357 CHAMPVA — CHAMPVA: $357 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $357 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $357 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $357
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE VISIT NEW IV	$158	$110.60	$158 – $1,113
New patient office visit (about 45–59 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $158 (WPS) MEDICARE — WPS-MEDICARE: $48.98 AETNA — AETNA: $134.30 BEECH STREET CORP — BEECH STREET CORP: $158 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $158 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $158 CHAMPVA — CHAMPVA: $158 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $158 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $158 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $158
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFIC VST NEW PT IV	$448	$313.60	$158 – $1,113
New patient office visit (about 45–59 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $448 (WPS) MEDICARE — WPS-MEDICARE: $138.88 AETNA — AETNA: $380.80 BEECH STREET CORP — BEECH STREET CORP: $448 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $448 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $448 CHAMPVA — CHAMPVA: $448 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $448 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $448 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $448
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE O/P NEW MOD 45 MIN	$158	$110.60	$158 – $1,113
New patient office visit (about 45–59 minutes): 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $158 AETNA — AETNA: $158 BEECH STREET CORP — BEECH STREET CORP: $158 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $158 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $158 CHAMPVA — CHAMPVA: $158 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $158 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $158 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $158 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $158
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFIC VST NEW PT V	$603	$422.10	$243.40 – $1,217
New patient office visit (about 60–74 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $603 (WPS) MEDICARE — WPS-MEDICARE: $186.93 AETNA — AETNA: $512.55 BEECH STREET CORP — BEECH STREET CORP: $603 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $603 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $603 CHAMPVA — CHAMPVA: $603 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $603 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $603 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $603
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFICE VISIT NEW V	$614	$429.80	$243.40 – $1,217
New patient office visit (about 60–74 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $614 (WPS) MEDICARE — WPS-MEDICARE: $190.34 AETNA — AETNA: $521.90 BEECH STREET CORP — BEECH STREET CORP: $614 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $614 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $614 CHAMPVA — CHAMPVA: $614 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $614 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $614 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $614
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFFICE VST EST LVL 3	$83	$58.10	$83 – $557
Established patient office visit (about 20–29 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $83 (WPS) MEDICARE — WPS-MEDICARE: $25.73 AETNA — AETNA: $70.55 BEECH STREET CORP — BEECH STREET CORP: $83 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $83 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $83 CHAMPVA — CHAMPVA: $83 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $83 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $83 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $83
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFFIC VST EST PT III	$217	$151.90	$83 – $557
Established patient office visit (about 20–29 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $217 (WPS) MEDICARE — WPS-MEDICARE: $67.27 AETNA — AETNA: $184.45 BEECH STREET CORP — BEECH STREET CORP: $217 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $217 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $217 CHAMPVA — CHAMPVA: $217 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $217 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $217 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $217
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFFICE VISIT EST III	$257	$179.90	$83 – $557
Established patient office visit (about 20–29 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $257 (WPS) MEDICARE — WPS-MEDICARE: $79.67 AETNA — AETNA: $218.45 BEECH STREET CORP — BEECH STREET CORP: $257 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $257 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $257 CHAMPVA — CHAMPVA: $257 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $257 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $257 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $257
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFFICE VST EST IV	$117	$81.90	$117 – $833
Established patient office visit (about 30–39 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $117 (WPS) MEDICARE — WPS-MEDICARE: $36.27 AETNA — AETNA: $99.45 BEECH STREET CORP — BEECH STREET CORP: $117 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $117 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $117 CHAMPVA — CHAMPVA: $117 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $117 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $117 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $117
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFFIC VST EST PT IV	$326	$228.20	$117 – $833
Established patient office visit (about 30–39 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $326 (WPS) MEDICARE — WPS-MEDICARE: $101.06 AETNA — AETNA: $277.10 BEECH STREET CORP — BEECH STREET CORP: $326 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $326 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $326 CHAMPVA — CHAMPVA: $326 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $326 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $326 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $326
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFFICE VISIT EST IV	$390	$273	$117 – $833
Established patient office visit (about 30–39 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $390 (WPS) MEDICARE — WPS-MEDICARE: $120.90 AETNA — AETNA: $331.50 BEECH STREET CORP — BEECH STREET CORP: $390 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $390 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $390 CHAMPVA — CHAMPVA: $390 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $390 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $390 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $390
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFFICE CONSULT III	$425	$297.50	$85 – $425
Office consultation with a specialist (moderate): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $425 (WPS) MEDICARE — WPS-MEDICARE: $131.75 AETNA — AETNA: $361.25 BEECH STREET CORP — BEECH STREET CORP: $425 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $425 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $425 CHAMPVA — CHAMPVA: $425 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $425 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $425 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $425
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFFICE CONSULT IV	$605	$423.50	$121 – $605
Office consultation with a specialist (moderate to high): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $605 (WPS) MEDICARE — WPS-MEDICARE: $187.55 AETNA — AETNA: $514.25 BEECH STREET CORP — BEECH STREET CORP: $605 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $605 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $605 CHAMPVA — CHAMPVA: $605 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $605 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $605 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $605

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: CASH BMP	$375	$262.50	$82.60 – $413
Basic metabolic panel (blood test): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $375 (WPS) MEDICARE — WPS-MEDICARE: $116.25 AETNA — AETNA: $318.75 BEECH STREET CORP — BEECH STREET CORP: $375 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $375 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $375 CHAMPVA — CHAMPVA: $375 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $375 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $375 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $375
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: NIS BASIC MET PANEL	$38	$26.60	$82.60 – $413
Basic metabolic panel (blood test): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: NIS CHEM 14 PANEL	$38	$26.60	$7.60 – $38
Comprehensive metabolic panel (blood test): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: CASH LIPID	$264	$184.80	$60.40 – $302
Cholesterol panel (lipid panel): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $264 (WPS) MEDICARE — WPS-MEDICARE: $81.84 AETNA — AETNA: $224.40 BEECH STREET CORP — BEECH STREET CORP: $264 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $264 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $264 CHAMPVA — CHAMPVA: $264 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $264 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $264 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $264
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: NIS LIPID PANEL	$38	$26.60	$60.40 – $302
Cholesterol panel (lipid panel): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: NIS RENAL PROFILE	$38	$26.60	$7.60 – $38
Kidney function panel: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Liver function panel CPT 80076 · Inpatient or outpatient In the file: NIS LIVER PROFILE	$38	$26.60	$13.60 – $68
Liver function panel: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Liver function panel CPT 80076 · Inpatient or outpatient In the file: CASH LIVER PANEL	$30	$21	$13.60 – $68
Liver function panel: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $30 (WPS) MEDICARE — WPS-MEDICARE: $9.30 AETNA — AETNA: $25.50 BEECH STREET CORP — BEECH STREET CORP: $30 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $30 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $30 CHAMPVA — CHAMPVA: $30 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $30 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $30 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $30
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: LAB URINALYSIS	$136	$95.20	$58.80 – $294
Urine test (automated, with microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $136 (WPS) MEDICARE — WPS-MEDICARE: $42.16 AETNA — AETNA: $115.60 BEECH STREET CORP — BEECH STREET CORP: $136 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $136 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $136 CHAMPVA — CHAMPVA: $136 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $136 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $136 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $136
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: ISLE URINALYSIS	$120	$84	$58.80 – $294
Urine test (automated, with microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $120 (WPS) MEDICARE — WPS-MEDICARE: $37.20 AETNA — AETNA: $102 BEECH STREET CORP — BEECH STREET CORP: $120 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $120 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $120 CHAMPVA — CHAMPVA: $120 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $120 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $120 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $120
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: NIS URINALYSIS	$38	$26.60	$58.80 – $294
Urine test (automated, with microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: NIS ICTOTEST	$38	$26.60	$19.40 – $97
Urine test (manual, without microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: UA DIP MANUAL	$59	$41.30	$19.40 – $97
Urine test (manual, without microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $59 (WPS) MEDICARE — WPS-MEDICARE: $18.29 AETNA — AETNA: $50.15 BEECH STREET CORP — BEECH STREET CORP: $59 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $59 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $59 CHAMPVA — CHAMPVA: $59 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $59 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $59 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $59
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: SPECIFIC GRAVITYFUMC	$53	$37.10	$18.20 – $91
Urine test (automated, without microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $53 (WPS) MEDICARE — WPS-MEDICARE: $16.43 AETNA — AETNA: $45.05 BEECH STREET CORP — BEECH STREET CORP: $53 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $53 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $53 CHAMPVA — CHAMPVA: $53 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $53 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $53 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $53
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: NIS UA W/O MICRO	$38	$26.60	$18.20 – $91
Urine test (automated, without microscope): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: CASH PSA	$192	$134.40	$92 – $460
PSA (prostate specific antigen) blood test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $192 (WPS) MEDICARE — WPS-MEDICARE: $59.52 AETNA — AETNA: $163.20 BEECH STREET CORP — BEECH STREET CORP: $192 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $192 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $192 CHAMPVA — CHAMPVA: $192 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $192 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $192 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $192
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA TOTAL	$192	$134.40	$92 – $460
PSA (prostate specific antigen) blood test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $192 (WPS) MEDICARE — WPS-MEDICARE: $59.52 AETNA — AETNA: $163.20 BEECH STREET CORP — BEECH STREET CORP: $192 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $192 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $192 CHAMPVA — CHAMPVA: $192 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $192 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $192 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $192
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: NIS PSA DIAGNOSTIC	$38	$26.60	$92 – $460
PSA (prostate specific antigen) blood test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: LAB PKU-TSH	$239	$167.30	$106.60 – $533
Thyroid stimulating hormone (TSH) test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $239 (WPS) MEDICARE — WPS-MEDICARE: $74.09 AETNA — AETNA: $203.15 BEECH STREET CORP — BEECH STREET CORP: $239 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $239 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $239 CHAMPVA — CHAMPVA: $239 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $239 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $239 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $239
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: CASH TSH	$256	$179.20	$106.60 – $533
Thyroid stimulating hormone (TSH) test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $256 (WPS) MEDICARE — WPS-MEDICARE: $79.36 AETNA — AETNA: $217.60 BEECH STREET CORP — BEECH STREET CORP: $256 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $256 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $256 CHAMPVA — CHAMPVA: $256 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $256 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $256 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $256
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: NIS TSH	$38	$26.60	$106.60 – $533
Thyroid stimulating hormone (TSH) test: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $38 (WPS) MEDICARE — WPS-MEDICARE: $11.78 AETNA — AETNA: $32.30 BEECH STREET CORP — BEECH STREET CORP: $38 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $38 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $38 CHAMPVA — CHAMPVA: $38 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $38 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $38 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $38
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CASH CBC	$264	$184.80	$58 – $290
Complete blood count (CBC) with differential: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $264 (WPS) MEDICARE — WPS-MEDICARE: $81.84 AETNA — AETNA: $224.40 BEECH STREET CORP — BEECH STREET CORP: $264 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $264 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $264 CHAMPVA — CHAMPVA: $264 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $264 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $264 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $264
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: NIS CBC AUTO DIFF	$26	$18.20	$58 – $290
Complete blood count (CBC) with differential: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $26 (WPS) MEDICARE — WPS-MEDICARE: $8.06 AETNA — AETNA: $22.10 BEECH STREET CORP — BEECH STREET CORP: $26 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $26 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $26 CHAMPVA — CHAMPVA: $26 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $26 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $26 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $26
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: LAB HEMOGRAM	$127	$88.90	$30.60 – $153
Complete blood count (CBC), automated: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $127 (WPS) MEDICARE — WPS-MEDICARE: $39.37 AETNA — AETNA: $107.95 BEECH STREET CORP — BEECH STREET CORP: $127 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $127 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $127 CHAMPVA — CHAMPVA: $127 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $127 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $127 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $127
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: NIS HEMOGRAM	$26	$18.20	$30.60 – $153
Complete blood count (CBC), automated: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $26 (WPS) MEDICARE — WPS-MEDICARE: $8.06 AETNA — AETNA: $22.10 BEECH STREET CORP — BEECH STREET CORP: $26 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $26 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $26 CHAMPVA — CHAMPVA: $26 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $26 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $26 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $26
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT/INR METER	$99	$69.30	$67.20 – $336
Blood clotting time test (prothrombin time, PT): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $99 (WPS) MEDICARE — WPS-MEDICARE: $30.69 AETNA — AETNA: $84.15 BEECH STREET CORP — BEECH STREET CORP: $99 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $99 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $99 CHAMPVA — CHAMPVA: $99 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $99 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $99 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $99
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: CASH PROTIME	$115	$80.50	$67.20 – $336
Blood clotting time test (prothrombin time, PT): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $115 (WPS) MEDICARE — WPS-MEDICARE: $35.65 AETNA — AETNA: $97.75 BEECH STREET CORP — BEECH STREET CORP: $115 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $115 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $115 CHAMPVA — CHAMPVA: $115 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $115 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $115 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $115
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: NIS PROTIME	$26	$18.20	$67.20 – $336
Blood clotting time test (prothrombin time, PT): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $26 (WPS) MEDICARE — WPS-MEDICARE: $8.06 AETNA — AETNA: $22.10 BEECH STREET CORP — BEECH STREET CORP: $26 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $26 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $26 CHAMPVA — CHAMPVA: $26 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $26 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $26 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $26
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT SEND OUT	$82	$57.40	$21.60 – $108
Blood clotting test (partial thromboplastin time, PTT): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $82 (WPS) MEDICARE — WPS-MEDICARE: $25.42 AETNA — AETNA: $69.70 BEECH STREET CORP — BEECH STREET CORP: $82 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $82 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $82 CHAMPVA — CHAMPVA: $82 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $82 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $82 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $82
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: NIS PTT	$26	$18.20	$21.60 – $108
Blood clotting test (partial thromboplastin time, PTT): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $26 (WPS) MEDICARE — WPS-MEDICARE: $8.06 AETNA — AETNA: $22.10 BEECH STREET CORP — BEECH STREET CORP: $26 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $26 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $26 CHAMPVA — CHAMPVA: $26 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $26 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $26 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $26

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 · Inpatient or outpatient In the file: CT HEAD W/O	$2,481	$1,736.70	$116.17 – $2,726
CT scan of the head or brain, without contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $2,481 (WPS) MEDICARE — WPS-MEDICARE: $769.11 AETNA — AETNA: $2,108.85 BEECH STREET CORP — BEECH STREET CORP: $2,481 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $2,481 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $2,481 CHAMPVA — CHAMPVA: $2,481 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $2,481 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $2,481 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $2,481
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O DYE	$245	$171.50	$116.17 – $2,726
CT scan of the head or brain, without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $245 (WPS) MEDICARE — WPS-MEDICARE: $116.17 AETNA — AETNA: $245 BEECH STREET CORP — BEECH STREET CORP: $245 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $245 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $245 CHAMPVA — CHAMPVA: $245 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $245 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $245 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $245
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier TC In the file: CT HEAD/BRAIN W/O DYE	$245	$171.50	$75.06 – $245
CT scan of the head or brain, without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $245 (WPS) MEDICARE — WPS-MEDICARE: $75.06 AETNA — AETNA: $245 BEECH STREET CORP — BEECH STREET CORP: $245 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $245 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $245 CHAMPVA — CHAMPVA: $245 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $245 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $245 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $245
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI HEAD W & W/O	$6,949	$4,864.30	$363.22 – $7,599
MRI of the brain, before and after contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $6,949 (WPS) MEDICARE — WPS-MEDICARE: $2,154.19 AETNA — AETNA: $5,906.65 BEECH STREET CORP — BEECH STREET CORP: $6,949 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $6,949 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $6,949 CHAMPVA — CHAMPVA: $6,949 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $6,949 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $6,949 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $6,949
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN STEM W/O & W/DYE	$650	$455	$363.22 – $7,599
MRI of the brain, before and after contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $650 (WPS) MEDICARE — WPS-MEDICARE: $363.22 AETNA — AETNA: $650 BEECH STREET CORP — BEECH STREET CORP: $650 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $650 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $650 CHAMPVA — CHAMPVA: $650 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $650 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $650 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $650
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier TC In the file: MRI BRAIN STEM W/O & W/DYE	$650	$455	$252.62 – $650
MRI of the brain, before and after contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $650 (WPS) MEDICARE — WPS-MEDICARE: $252.62 AETNA — AETNA: $650 BEECH STREET CORP — BEECH STREET CORP: $650 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $650 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $650 CHAMPVA — CHAMPVA: $650 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $650 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $650 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $650
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY CHEST 2V	$510	$357	$34.08 – $572
Chest X-ray, 2 views: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $510 (WPS) MEDICARE — WPS-MEDICARE: $158.10 AETNA — AETNA: $433.50 BEECH STREET CORP — BEECH STREET CORP: $510 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $510 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $510 CHAMPVA — CHAMPVA: $510 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $510 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $510 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $510
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHEST 2V	$62	$43.40	$34.08 – $572
Chest X-ray, 2 views: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $62 (WPS) MEDICARE — WPS-MEDICARE: $19.22 AETNA — AETNA: $52.70 BEECH STREET CORP — BEECH STREET CORP: $62 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $62 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $62 CHAMPVA — CHAMPVA: $62 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $62 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $62 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $62
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY EXAM CHEST 2 VIEWS	$62	$43.40	$34.08 – $572
Chest X-ray, 2 views: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $62 (WPS) MEDICARE — WPS-MEDICARE: $34.08 AETNA — AETNA: $62 BEECH STREET CORP — BEECH STREET CORP: $62 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $62 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $62 CHAMPVA — CHAMPVA: $62 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $62 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $62 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $62
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-RAY L SPINE 4 +	$619	$433.30	$51.73 – $1,478
X-ray of the lower spine, at least 4 views: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $619 (WPS) MEDICARE — WPS-MEDICARE: $191.89 AETNA — AETNA: $526.15 BEECH STREET CORP — BEECH STREET CORP: $619 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $619 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $619 CHAMPVA — CHAMPVA: $619 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $619 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $619 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $619
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-RAY L SPINE 4V	$804	$562.80	$51.73 – $1,478
X-ray of the lower spine, at least 4 views: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $804 (WPS) MEDICARE — WPS-MEDICARE: $249.24 AETNA — AETNA: $683.40 BEECH STREET CORP — BEECH STREET CORP: $804 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $804 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $804 CHAMPVA — CHAMPVA: $804 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $804 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $804 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $804
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: L SPINE MIN 4V	$55	$38.50	$51.73 – $1,478
X-ray of the lower spine, at least 4 views: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $55 (WPS) MEDICARE — WPS-MEDICARE: $17.05 AETNA — AETNA: $46.75 BEECH STREET CORP — BEECH STREET CORP: $55 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $55 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $55 CHAMPVA — CHAMPVA: $55 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $55 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $55 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $55
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI L SPINE W/O	$4,024	$2,816.80	$216.51 – $4,322
MRI of the lower back (lumbar spine), without contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $4,024 (WPS) MEDICARE — WPS-MEDICARE: $1,247.44 AETNA — AETNA: $3,420.40 BEECH STREET CORP — BEECH STREET CORP: $4,024 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $4,024 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $4,024 CHAMPVA — CHAMPVA: $4,024 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $4,024 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $4,024 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $4,024
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O DYE	$298	$208.60	$216.51 – $4,322
MRI of the lower back (lumbar spine), without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $298 (WPS) MEDICARE — WPS-MEDICARE: $216.51 AETNA — AETNA: $298 BEECH STREET CORP — BEECH STREET CORP: $298 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $298 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $298 CHAMPVA — CHAMPVA: $298 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $298 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $298 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $298
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier TC In the file: MRI LUMBAR SPINE W/O DYE	$298	$208.60	$145.04 – $298
MRI of the lower back (lumbar spine), without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $298 (WPS) MEDICARE — WPS-MEDICARE: $145.04 AETNA — AETNA: $298 BEECH STREET CORP — BEECH STREET CORP: $298 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $298 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $298 CHAMPVA — CHAMPVA: $298 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $298 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $298 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $298
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/CON	$2,891	$2,023.70	$255.06 – $3,221
CT scan of the pelvis, with contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $2,891 (WPS) MEDICARE — WPS-MEDICARE: $896.21 AETNA — AETNA: $2,457.35 BEECH STREET CORP — BEECH STREET CORP: $2,891 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $2,891 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $2,891 CHAMPVA — CHAMPVA: $2,891 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $2,891 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $2,891 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $2,891
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/DYE	$330	$231	$255.06 – $3,221
CT scan of the pelvis, with contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $330 (WPS) MEDICARE — WPS-MEDICARE: $255.06 AETNA — AETNA: $330 BEECH STREET CORP — BEECH STREET CORP: $330 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $330 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $330 CHAMPVA — CHAMPVA: $330 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $330 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $330 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $330
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier TC In the file: CT PELVIS W/DYE	$330	$231	$199.13 – $330
CT scan of the pelvis, with contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $330 (WPS) MEDICARE — WPS-MEDICARE: $199.13 AETNA — AETNA: $330 BEECH STREET CORP — BEECH STREET CORP: $330 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $330 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $330 CHAMPVA — CHAMPVA: $330 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $330 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $330 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $330
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOW EXT JT W/O	$4,649	$3,254.30	$228.71 – $4,920
MRI of a leg joint (such as the knee), without contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $4,649 (WPS) MEDICARE — WPS-MEDICARE: $1,441.19 AETNA — AETNA: $3,951.65 BEECH STREET CORP — BEECH STREET CORP: $4,649 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $4,649 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $4,649 CHAMPVA — CHAMPVA: $4,649 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $4,649 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $4,649 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $4,649
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI JNT OF LWR EXTRE W/O DYE	$271	$189.70	$228.71 – $4,920
MRI of a leg joint (such as the knee), without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $271 (WPS) MEDICARE — WPS-MEDICARE: $228.71 AETNA — AETNA: $271 BEECH STREET CORP — BEECH STREET CORP: $271 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $271 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $271 CHAMPVA — CHAMPVA: $271 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $271 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $271 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $271
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier TC In the file: MRI JNT OF LWR EXTRE W/O DYE	$271	$189.70	$163.19 – $271
MRI of a leg joint (such as the knee), without contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $271 (WPS) MEDICARE — WPS-MEDICARE: $163.19 AETNA — AETNA: $271 BEECH STREET CORP — BEECH STREET CORP: $271 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $271 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $271 CHAMPVA — CHAMPVA: $271 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $271 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $271 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $271
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PEL W/CON	$5,723	$4,006.10	$340.21 – $6,248
CT scan of the abdomen and pelvis, with contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $5,723 (WPS) MEDICARE — WPS-MEDICARE: $1,774.13 AETNA — AETNA: $4,864.55 BEECH STREET CORP — BEECH STREET CORP: $5,723 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $5,723 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $5,723 CHAMPVA — CHAMPVA: $5,723 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $5,723 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $5,723 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $5,723
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PELVIS W/CON	$525	$367.50	$340.21 – $6,248
CT scan of the abdomen and pelvis, with contrast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $525 (WPS) MEDICARE — WPS-MEDICARE: $162.75 AETNA — AETNA: $446.25 BEECH STREET CORP — BEECH STREET CORP: $525 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $525 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $525 CHAMPVA — CHAMPVA: $525 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $525 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $525 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $525
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS W/CONTRAST	$525	$367.50	$340.21 – $6,248
CT scan of the abdomen and pelvis, with contrast: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $525 (WPS) MEDICARE — WPS-MEDICARE: $340.21 AETNA — AETNA: $525 BEECH STREET CORP — BEECH STREET CORP: $525 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $525 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $525 CHAMPVA — CHAMPVA: $525 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $525 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $525 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $525
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN COMPL	$1,046	$732.20	$124.67 – $1,279
Ultrasound of the abdomen, complete: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,046 (WPS) MEDICARE — WPS-MEDICARE: $324.26 AETNA — AETNA: $889.10 BEECH STREET CORP — BEECH STREET CORP: $1,046 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,046 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,046 CHAMPVA — CHAMPVA: $1,046 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,046 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,046 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,046
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US EXAM ABDOM COMPLETE	$233	$163.10	$124.67 – $1,279
Ultrasound of the abdomen, complete: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $233 (WPS) MEDICARE — WPS-MEDICARE: $124.67 AETNA — AETNA: $233 BEECH STREET CORP — BEECH STREET CORP: $233 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $233 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $233 CHAMPVA — CHAMPVA: $233 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $233 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $233 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $233
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier TC In the file: US EXAM ABDOM COMPLETE	$233	$163.10	$85.66 – $233
Ultrasound of the abdomen, complete: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $233 (WPS) MEDICARE — WPS-MEDICARE: $85.66 AETNA — AETNA: $233 BEECH STREET CORP — BEECH STREET CORP: $233 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $233 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $233 CHAMPVA — CHAMPVA: $233 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $233 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $233 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $233
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB >14 WEEKS	$1,046	$732.20	$143.32 – $1,331
Pregnancy ultrasound (after the first trimester): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,046 (WPS) MEDICARE — WPS-MEDICARE: $324.26 AETNA — AETNA: $889.10 BEECH STREET CORP — BEECH STREET CORP: $1,046 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,046 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,046 CHAMPVA — CHAMPVA: $1,046 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,046 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,046 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,046
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB>14 WEEKS	$285	$199.50	$143.32 – $1,331
Pregnancy ultrasound (after the first trimester): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $285 (WPS) MEDICARE — WPS-MEDICARE: $88.35 AETNA — AETNA: $242.25 BEECH STREET CORP — BEECH STREET CORP: $285 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $285 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $285 CHAMPVA — CHAMPVA: $285 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $285 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $285 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $285
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB US >/= 14 WKS SNGL FETUS	$285	$199.50	$143.32 – $1,331
Pregnancy ultrasound (after the first trimester): 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $285 (WPS) MEDICARE — WPS-MEDICARE: $143.32 AETNA — AETNA: $285 BEECH STREET CORP — BEECH STREET CORP: $285 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $285 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $285 CHAMPVA — CHAMPVA: $285 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $285 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $285 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $285
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US PELVIS ENDOVAG	$1,239	$867.30	$127.20 – $1,457
Transvaginal ultrasound: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,239 (WPS) MEDICARE — WPS-MEDICARE: $384.09 AETNA — AETNA: $1,053.15 BEECH STREET CORP — BEECH STREET CORP: $1,239 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,239 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,239 CHAMPVA — CHAMPVA: $1,239 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,239 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,239 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,239
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: TRANSVAGINAL US NON-OB	$218	$152.60	$127.20 – $1,457
Transvaginal ultrasound: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $218 (WPS) MEDICARE — WPS-MEDICARE: $127.20 AETNA — AETNA: $218 BEECH STREET CORP — BEECH STREET CORP: $218 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $218 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $218 CHAMPVA — CHAMPVA: $218 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $218 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $218 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $218
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier TC In the file: TRANSVAGINAL US NON-OB	$218	$152.60	$93.79 – $218
Transvaginal ultrasound: 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $218 (WPS) MEDICARE — WPS-MEDICARE: $93.79 AETNA — AETNA: $218 BEECH STREET CORP — BEECH STREET CORP: $218 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $218 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $218 CHAMPVA — CHAMPVA: $218 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $218 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $218 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $218
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: X-RAY MAM DIAG UNI	$698	$488.60	$91.62 – $2,775
Diagnostic mammogram, one breast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $698 (WPS) MEDICARE — WPS-MEDICARE: $216.38 AETNA — AETNA: $593.30 BEECH STREET CORP — BEECH STREET CORP: $698 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $698 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $698 CHAMPVA — CHAMPVA: $698 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $698 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $698 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $698
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: X-RAY MAM UNI X VS	$464	$324.80	$91.62 – $2,775
Diagnostic mammogram, one breast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $464 (WPS) MEDICARE — WPS-MEDICARE: $143.84 AETNA — AETNA: $394.40 BEECH STREET CORP — BEECH STREET CORP: $464 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $464 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $464 CHAMPVA — CHAMPVA: $464 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $464 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $464 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $464
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: EKLUND MAMMO UNILATE	$806	$564.20	$91.62 – $2,775
Diagnostic mammogram, one breast: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $806 (WPS) MEDICARE — WPS-MEDICARE: $249.86 AETNA — AETNA: $685.10 BEECH STREET CORP — BEECH STREET CORP: $806 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $806 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $806 CHAMPVA — CHAMPVA: $806 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $806 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $806 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $806
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: X-RAY MAM DIAG BIL	$826	$578.20	$116.86 – $2,716
Diagnostic mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $826 (WPS) MEDICARE — WPS-MEDICARE: $256.06 AETNA — AETNA: $702.10 BEECH STREET CORP — BEECH STREET CORP: $826 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $826 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $826 CHAMPVA — CHAMPVA: $826 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $826 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $826 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $826
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: EKLUNF MAMMO DIAGNOS	$1,010	$707	$116.86 – $2,716
Diagnostic mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,010 (WPS) MEDICARE — WPS-MEDICARE: $313.10 AETNA — AETNA: $858.50 BEECH STREET CORP — BEECH STREET CORP: $1,010 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,010 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,010 CHAMPVA — CHAMPVA: $1,010 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,010 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,010 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,010
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMO SAGE DIAG BILA	$595	$416.50	$116.86 – $2,716
Diagnostic mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $595 (WPS) MEDICARE — WPS-MEDICARE: $184.45 AETNA — AETNA: $505.75 BEECH STREET CORP — BEECH STREET CORP: $595 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $595 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $595 CHAMPVA — CHAMPVA: $595 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $595 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $595 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $595
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: X-RAY MAM SCRE BIL	$826	$578.20	$96.53 – $3,178
Screening mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $826 (WPS) MEDICARE — WPS-MEDICARE: $256.06 AETNA — AETNA: $702.10 BEECH STREET CORP — BEECH STREET CORP: $826 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $826 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $826 CHAMPVA — CHAMPVA: $826 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $826 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $826 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $826
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: X-RAY MAM MBCCCP	$595	$416.50	$96.53 – $3,178
Screening mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $595 (WPS) MEDICARE — WPS-MEDICARE: $184.45 AETNA — AETNA: $505.75 BEECH STREET CORP — BEECH STREET CORP: $595 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $595 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $595 CHAMPVA — CHAMPVA: $595 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $595 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $595 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $595
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAM SCREEN EKLUN	$747	$522.90	$96.53 – $3,178
Screening mammogram, both breasts: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $747 (WPS) MEDICARE — WPS-MEDICARE: $231.57 AETNA — AETNA: $634.95 BEECH STREET CORP — BEECH STREET CORP: $747 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $747 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $747 CHAMPVA — CHAMPVA: $747 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $747 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $747 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $747

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: STD OVERNGHT SLEEP S	$5,107	$3,574.90	$1,294.80 – $6,474
Sleep study (overnight, in a sleep lab): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $5,107 (WPS) MEDICARE — WPS-MEDICARE: $1,583.17 AETNA — AETNA: $4,340.95 BEECH STREET CORP — BEECH STREET CORP: $5,107 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $5,107 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $5,107 CHAMPVA — CHAMPVA: $5,107 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $5,107 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $5,107 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $5,107
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOMNOGRAPHY 4	$1,367	$956.90	$1,294.80 – $6,474
Sleep study (overnight, in a sleep lab): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,367 (WPS) MEDICARE — WPS-MEDICARE: $423.77 AETNA — AETNA: $1,161.95 BEECH STREET CORP — BEECH STREET CORP: $1,367 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,367 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,367 CHAMPVA — CHAMPVA: $1,367 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,367 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,367 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,367

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: 97110 THERAPEUTIC EXERCISE	$157	$109.90	$93.20 – $466
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $157 (WPS) MEDICARE — WPS-MEDICARE: $48.67 AETNA — AETNA: $133.45 BEECH STREET CORP — BEECH STREET CORP: $157 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $157 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $157 CHAMPVA — CHAMPVA: $157 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $157 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $157 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $157
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: CARDIAC REHAB,PHASE1	$129	$90.30	$93.20 – $466
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $129 (WPS) MEDICARE — WPS-MEDICARE: $39.99 AETNA — AETNA: $109.65 BEECH STREET CORP — BEECH STREET CORP: $129 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $129 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $129 CHAMPVA — CHAMPVA: $129 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $129 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $129 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $129
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: 97110 OT THER EX 15	$158	$110.60	$93.20 – $466
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $158 (WPS) MEDICARE — WPS-MEDICARE: $48.98 AETNA — AETNA: $134.30 BEECH STREET CORP — BEECH STREET CORP: $158 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $158 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $158 CHAMPVA — CHAMPVA: $158 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $158 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $158 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $158
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: 97161 EVAL LOW COMP	$323	$226.10	$64.60 – $323
Physical therapy evaluation (low complexity): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $323 (WPS) MEDICARE — WPS-MEDICARE: $100.13 AETNA — AETNA: $274.55 BEECH STREET CORP — BEECH STREET CORP: $323 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $323 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $323 CHAMPVA — CHAMPVA: $323 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $323 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $323 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $323
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: 97162 EVAL MOD COMP	$323	$226.10	$64.60 – $323
Physical therapy evaluation (moderate complexity): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $323 (WPS) MEDICARE — WPS-MEDICARE: $100.13 AETNA — AETNA: $274.55 BEECH STREET CORP — BEECH STREET CORP: $323 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $323 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $323 CHAMPVA — CHAMPVA: $323 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $323 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $323 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $323
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: 97163 EVAL HIGH COMP	$323	$226.10	$64.60 – $323
Physical therapy evaluation (high complexity): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $323 (WPS) MEDICARE — WPS-MEDICARE: $100.13 AETNA — AETNA: $274.55 BEECH STREET CORP — BEECH STREET CORP: $323 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $323 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $323 CHAMPVA — CHAMPVA: $323 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $323 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $323 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $323
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: INDIV PSYTH 30 MIN	$177	$123.90	$35.40 – $177
Psychotherapy, 30 minutes: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $177 (WPS) MEDICARE — WPS-MEDICARE: $54.87 AETNA — AETNA: $150.45 BEECH STREET CORP — BEECH STREET CORP: $177 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $177 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $177 CHAMPVA — CHAMPVA: $177 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $177 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $177 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $177
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PSYTX W PT 30 MINUTES	$177	$123.90	$35.40 – $177
Psychotherapy, 30 minutes: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $177 AETNA — AETNA: $177 BEECH STREET CORP — BEECH STREET CORP: $177 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $177 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $177 CHAMPVA — CHAMPVA: $177 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $177 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $177 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $177 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $177
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · modifier AT In the file: PSYTX W PT 30 MINUTES	$177	$123.90	$177
Psychotherapy, 30 minutes: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $177 AETNA — AETNA: $177 BEECH STREET CORP — BEECH STREET CORP: $177 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $177 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $177 CHAMPVA — CHAMPVA: $177 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $177 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $177 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $177 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $177
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: INDIV PSYTH 45 MIN	$278	$194.60	$55.60 – $278
Psychotherapy, 45 minutes: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $278 (WPS) MEDICARE — WPS-MEDICARE: $86.18 AETNA — AETNA: $236.30 BEECH STREET CORP — BEECH STREET CORP: $278 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $278 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $278 CHAMPVA — CHAMPVA: $278 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $278 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $278 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $278
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PSYTX W PT 45 MINUTES	$278	$194.60	$55.60 – $278
Psychotherapy, 45 minutes: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $278 AETNA — AETNA: $278 BEECH STREET CORP — BEECH STREET CORP: $278 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $278 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $278 CHAMPVA — CHAMPVA: $278 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $278 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $278 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $278 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $278
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · modifier AT In the file: PSYTX W PT 45 MINUTES	$278	$194.60	$278
Psychotherapy, 45 minutes: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $278 AETNA — AETNA: $278 BEECH STREET CORP — BEECH STREET CORP: $278 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $278 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $278 CHAMPVA — CHAMPVA: $278 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $278 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $278 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $278 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $278
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: INDIVIDUAL PSYCHOTHERAPY 60 MIN	$453	$317.10	$90.60 – $453
Psychotherapy, 60 minutes: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $453 (WPS) MEDICARE — WPS-MEDICARE: $140.43 AETNA — AETNA: $385.05 BEECH STREET CORP — BEECH STREET CORP: $453 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $453 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $453 CHAMPVA — CHAMPVA: $453 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $453 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $453 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $453
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: FAMILY PSYTH W/O PT	$198	$138.60	$39.60 – $198
Family psychotherapy, without the patient: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $198 (WPS) MEDICARE — WPS-MEDICARE: $61.38 AETNA — AETNA: $168.30 BEECH STREET CORP — BEECH STREET CORP: $198 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $198 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $198 CHAMPVA — CHAMPVA: $198 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $198 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $198 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $198
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: FAMILY PSYTX W/O PT 50 MIN	$198	$138.60	$39.60 – $198
Family psychotherapy, without the patient: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $198 AETNA — AETNA: $198 BEECH STREET CORP — BEECH STREET CORP: $198 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $198 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $198 CHAMPVA — CHAMPVA: $198 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $198 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $198 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $198 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $198
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · modifier AT In the file: FAMILY PSYTX W/O PT 50 MIN	$198	$138.60	$198
Family psychotherapy, without the patient: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $198 AETNA — AETNA: $198 BEECH STREET CORP — BEECH STREET CORP: $198 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $198 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $198 CHAMPVA — CHAMPVA: $198 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $198 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $198 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $198 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $198
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: FAMILY PSYTH W/PT	$167	$116.90	$33.40 – $167
Family psychotherapy, with the patient: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $167 (WPS) MEDICARE — WPS-MEDICARE: $51.77 AETNA — AETNA: $141.95 BEECH STREET CORP — BEECH STREET CORP: $167 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $167 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $167 CHAMPVA — CHAMPVA: $167 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $167 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $167 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $167
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: FAMILY PSYTX W/PT 50 MIN	$167	$116.90	$33.40 – $167
Family psychotherapy, with the patient: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $167 AETNA — AETNA: $167 BEECH STREET CORP — BEECH STREET CORP: $167 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $167 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $167 CHAMPVA — CHAMPVA: $167 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $167 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $167 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $167 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $167
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · modifier AT In the file: FAMILY PSYTX W/PT 50 MIN	$167	$116.90	$167
Family psychotherapy, with the patient: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $167 AETNA — AETNA: $167 BEECH STREET CORP — BEECH STREET CORP: $167 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $167 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $167 CHAMPVA — CHAMPVA: $167 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $167 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $167 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $167 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $167
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: GROUP PSYCHOTHERAPY	$91	$63.70	$58.20 – $291
Group psychotherapy: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $91 (WPS) MEDICARE — WPS-MEDICARE: $28.21 AETNA — AETNA: $77.35 BEECH STREET CORP — BEECH STREET CORP: $91 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $91 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $91 CHAMPVA — CHAMPVA: $91 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $91 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $91 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $91

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY	$1,696	$1,187.20	$200.14 – $1,696
Colonoscopy (diagnostic): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,696 (WPS) MEDICARE — WPS-MEDICARE: $525.76 AETNA — AETNA: $1,441.60 BEECH STREET CORP — BEECH STREET CORP: $1,696 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,696 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,696 CHAMPVA — CHAMPVA: $1,696 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,696 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,696 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,696
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: DIAGNOSTIC COLONOSCOPY	$1,696	$1,187.20	$200.14 – $1,696
Colonoscopy (diagnostic): 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,696 (WPS) MEDICARE — WPS-MEDICARE: $200.14 AETNA — AETNA: $1,696 BEECH STREET CORP — BEECH STREET CORP: $1,696 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,696 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,696 CHAMPVA — CHAMPVA: $1,696 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,696 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,696 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,696
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · modifier AT In the file: DIAGNOSTIC COLONOSCOPY	$1,696	$1,187.20	$1,696
Colonoscopy (diagnostic): 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,696 AETNA — AETNA: $1,696 BEECH STREET CORP — BEECH STREET CORP: $1,696 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,696 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,696 CHAMPVA — CHAMPVA: $1,696 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,696 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,696 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,696 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $1,696
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: COLONSCOPY NOT HGH R	$1,406	$984.20	$205.64 – $1,406
Screening colonoscopy (not high risk): 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,406 (WPS) MEDICARE — WPS-MEDICARE: $435.86 AETNA — AETNA: $1,195.10 BEECH STREET CORP — BEECH STREET CORP: $1,406 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,406 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,406 CHAMPVA — CHAMPVA: $1,406 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,406 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,406 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,406
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: COLON CA SCRN NOT HI RSK IND	$1,406	$984.20	$205.64 – $1,406
Screening colonoscopy (not high risk): 10 of 80 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,406 (WPS) MEDICARE — WPS-MEDICARE: $205.64 AETNA — AETNA: $1,406 BEECH STREET CORP — BEECH STREET CORP: $1,406 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,406 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,406 CHAMPVA — CHAMPVA: $1,406 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,406 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,406 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,406
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · modifier AT In the file: COLON CA SCRN NOT HI RSK IND	$1,406	$984.20	$1,406
Screening colonoscopy (not high risk): 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $1,406 AETNA — AETNA: $1,406 BEECH STREET CORP — BEECH STREET CORP: $1,406 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $1,406 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $1,406 CHAMPVA — CHAMPVA: $1,406 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $1,406 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $1,406 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $1,406 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $1,406
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: INJ DRAIN ASP SPINE	$755	$528.50	$151 – $755
Spinal injection, lower back (epidural), with imaging guidance: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $755 (WPS) MEDICARE — WPS-MEDICARE: $234.05 AETNA — AETNA: $641.75 BEECH STREET CORP — BEECH STREET CORP: $755 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $755 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $755 CHAMPVA — CHAMPVA: $755 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $755 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $755 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $755
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: NJX INTERLAMINAR LMBR/SAC	$755	$528.50	$151 – $755
Spinal injection, lower back (epidural), with imaging guidance: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $755 AETNA — AETNA: $755 BEECH STREET CORP — BEECH STREET CORP: $755 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $755 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $755 CHAMPVA — CHAMPVA: $755 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $755 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $755 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $755 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $755
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier AT In the file: NJX INTERLAMINAR LMBR/SAC	$755	$528.50	$755
Spinal injection, lower back (epidural), with imaging guidance: 10 of 67 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $755 AETNA — AETNA: $755 BEECH STREET CORP — BEECH STREET CORP: $755 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $755 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $755 CHAMPVA — CHAMPVA: $755 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $755 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $755 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $755 CHOICEPLUS (TRW) — CHOICEPLUS (TRW): $755
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: INJ FORAMEN EPID L/S	$613	$429.10	$122.60 – $613
Nerve root injection, lower back, with imaging guidance: 10 of 90 insurance plan rates (WPS) MEDICARE — WISCONSIN PHYS SERVICE: $613 (WPS) MEDICARE — WPS-MEDICARE: $190.03 AETNA — AETNA: $521.05 BEECH STREET CORP — BEECH STREET CORP: $613 BENEFIT PLAN ADMIN. — BENEFIT PLAN ADMIN.: $613 BOILERMAKERS NATL HEALTH — BOILERMAKERS NATL HEALTH: $613 CHAMPVA — CHAMPVA: $613 CHIROPRACTIC COMMERCIAL — CHIRO CARE C/O LANDMARK: $613 CHIROPRACTIC COMMERCIAL — CHIROPRACTIC COMMERCIAL: $613 CHIROPRACTIC COMMERCIAL — HEALTH SERVICE MANAGEMENT: $613

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 or outpatient In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD	Not listed in the file	Not listed in the file	$1,145.10
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 13 insurance plan rates (WPS) MEDICARE — WPS-MEDICARE: $1,145.10 HUMANA INC — HUMANA INC: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLU: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLUTION: $1,145.10 MEDICARE — MEDICARE: $1,145.10 MEDICARE RAILROAD — MEDICARE RAILROAD: $1,145.10 MEDICARE REPLACEMENTS — ADVANTRA FREEDOM: $1,145.10 MEDICARE REPLACEMENTS — MEDICARE REPLACEMENTS: $1,145.10 SOUTH COUNTRY HEALTH PMAP — SOUTH COUNTRY HEALTH: $1,145.10 UCARE MEDICARE PLANS — UCARE MEDICARE PLANS: $1,145.10
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient or outpatient In the file: SPINAL FUSION EXCEPT CERVICAL W/O MCC	Not listed in the file	Not listed in the file	$1,145.10
Spinal fusion (not neck), without major complications: 10 of 13 insurance plan rates (WPS) MEDICARE — WPS-MEDICARE: $1,145.10 HUMANA INC — HUMANA INC: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLU: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLUTION: $1,145.10 MEDICARE — MEDICARE: $1,145.10 MEDICARE RAILROAD — MEDICARE RAILROAD: $1,145.10 MEDICARE REPLACEMENTS — ADVANTRA FREEDOM: $1,145.10 MEDICARE REPLACEMENTS — MEDICARE REPLACEMENTS: $1,145.10 SOUTH COUNTRY HEALTH PMAP — SOUTH COUNTRY HEALTH: $1,145.10 UCARE MEDICARE PLANS — UCARE MEDICARE PLANS: $1,145.10
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient or outpatient In the file: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER E	Not listed in the file	Not listed in the file	$1,145.10
Hip or knee replacement (major joint of the leg), without major complications: 10 of 13 insurance plan rates (WPS) MEDICARE — WPS-MEDICARE: $1,145.10 HUMANA INC — HUMANA INC: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLU: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLUTION: $1,145.10 MEDICARE — MEDICARE: $1,145.10 MEDICARE RAILROAD — MEDICARE RAILROAD: $1,145.10 MEDICARE REPLACEMENTS — ADVANTRA FREEDOM: $1,145.10 MEDICARE REPLACEMENTS — MEDICARE REPLACEMENTS: $1,145.10 SOUTH COUNTRY HEALTH PMAP — SOUTH COUNTRY HEALTH: $1,145.10 UCARE MEDICARE PLANS — UCARE MEDICARE PLANS: $1,145.10
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient or outpatient In the file: CERVICAL SPINAL FUSION W/O CC/MCC	Not listed in the file	Not listed in the file	$1,145.10
Neck (cervical) spinal fusion, without complications: 10 of 13 insurance plan rates (WPS) MEDICARE — WPS-MEDICARE: $1,145.10 HUMANA INC — HUMANA INC: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLU: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLUTION: $1,145.10 MEDICARE — MEDICARE: $1,145.10 MEDICARE RAILROAD — MEDICARE RAILROAD: $1,145.10 MEDICARE REPLACEMENTS — ADVANTRA FREEDOM: $1,145.10 MEDICARE REPLACEMENTS — MEDICARE REPLACEMENTS: $1,145.10 SOUTH COUNTRY HEALTH PMAP — SOUTH COUNTRY HEALTH: $1,145.10 UCARE MEDICARE PLANS — UCARE MEDICARE PLANS: $1,145.10
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient or outpatient In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MC	Not listed in the file	Not listed in the file	$1,145.10
Uterus and ovary surgery (not for cancer), without complications: 10 of 13 insurance plan rates (WPS) MEDICARE — WPS-MEDICARE: $1,145.10 HUMANA INC — HUMANA INC: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLU: $1,145.10 MEDICA ADVANTAGE — MEDICA ADV SOLUTION: $1,145.10 MEDICARE — MEDICARE: $1,145.10 MEDICARE RAILROAD — MEDICARE RAILROAD: $1,145.10 MEDICARE REPLACEMENTS — ADVANTRA FREEDOM: $1,145.10 MEDICARE REPLACEMENTS — MEDICARE REPLACEMENTS: $1,145.10 SOUTH COUNTRY HEALTH PMAP — SOUTH COUNTRY HEALTH: $1,145.10 UCARE MEDICARE PLANS — UCARE MEDICARE PLANS: $1,145.10

Source: Mille Lacs Health System’s standard charges file (mlhealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on August 13, 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	Critical Access Hospital
Address	200 North Elm Street, Onamia, MN 56359
County	Mille Lacs County
State	Minnesota
Phone	(320) 532‑3154
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	Not rated by CMS
CMS Certification Number	241356
Name in Medicare records	MILLE LACS HEALTH SYSTEM
Profile level	Medicare data + hospital website
Official website	mlhealth.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
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.

Our Facilities — mlhealth.org
Hospital — mlhealth.org
Mille Lacs Health System - Central Minnesota — mlhealth.org
Emergency Services & Urgent Care - Mille Lacs Health System — mlhealth.org
Diagnostic Imaging - Mille Lacs Health System — mlhealth.org
Cardiology - Mille Lacs Health System — mlhealth.org
Orthopedics - Mille Lacs Health System — mlhealth.org
Surgery - Mille Lacs Health System — mlhealth.org
Behavioral Health - Mille Lacs Health System — mlhealth.org
Cardiac Rehabilitation - Mille Lacs Health System — mlhealth.org
Rehabilitation Services - Mille Lacs Health System — mlhealth.org
Women's Health - Mille Lacs Health System — mlhealth.org
Visitor Information - Mille Lacs Health System — mlhealth.org
Pharmacy - Mille Lacs Health System — mlhealth.org

Mille Lacs Health System

Summary

Profile from official sources

At a glance