Does SSM Health St Mary's Hospital - Madison have an emergency room?

Yes. Medicare (CMS) data lists emergency services at SSM Health St Mary's Hospital - Madison. In a medical emergency, call 911.

Where is SSM Health St Mary's Hospital - Madison?

700 South Park St, Madison, WI 53715, in Dane County, Wisconsin.

What is the phone number of SSM Health St Mary's Hospital - Madison?

(608) 251-6100, as listed by Medicare (CMS).

What is the Medicare star rating of SSM Health St Mary's Hospital - Madison?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

SSM Health St Mary's Hospital - Madison

Quick answers

Does SSM Health St Mary's Hospital - Madison have an emergency room?: Yes. Medicare (CMS) data lists emergency services at SSM Health St Mary's Hospital - Madison. In a medical emergency, call 911.
Where is SSM Health St Mary's Hospital - Madison?: 700 South Park St, Madison, WI 53715, in Dane County, Wisconsin.
What is the phone number of SSM Health St Mary's Hospital - Madison?: (608) 251-6100, as listed by Medicare (CMS).
What is the Medicare star rating of SSM Health St Mary's Hospital - Madison?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Trauma care
Stroke care
Neonatal intensive care (Level III NICU)
Pediatrics
Senior health

Procedures^[4]

Thrombectomy

Emergency care (hospital website)^[4]

Trauma designation	Level II
Stroke designation	Thrombectomy-Capable Stroke Center

Visiting and practical information

Visiting	General visiting hours 6:30 a.m. to 9 p.m.; children under 16 must be with an adult^[4]

Recognition^[4]

ACS-verified Level II Trauma Center
Joint Commission Thrombectomy-Capable Stroke Center
Level III NICU
U.S. News Best Regional Hospital in Wisconsin

Doctors and clinicians (996)

996 doctors and other clinicians list SSM Health St Mary's Hospital - Madison 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 972 more: the button below opens the full list.

Other emergency rooms nearby

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

UnityPoint Health - Meriter0.4 mi · Madison, WI · Acute Care Hospital
Madison VA Medical Center1.7 mi · Madison, WI · Federal/VA Acute Care Hospital
University of WI Hospitals & Clinics Authority1.9 mi · Madison, WI · Acute Care Hospital
Stoughton Hospital14 mi · Stoughton, WI · Critical Access Hospital
Edgerton Hospital and Health Services24 mi · Edgerton, WI · Critical Access Hospital

Other hospitals nearby

Select Specialty Hospital Madison0.4 mi · Madison, WI · Long-Term Acute Care Hospital
Encompass Health Rehabilitation HSPTL of Fitchburg4.6 mi · Fitchburg, WI · Inpatient Rehabilitation Hospital
Mendota Mental Health Institute5.1 mi · Madison, WI · 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

Capitol Lakes Health Center1.1 mi · Madison, WI · 4 of 5 stars
Oak Park Place of Nakoma2.8 mi · Madison, WI · 3 of 5 stars
Middleton Village Nursing and Rehab5.0 mi · Middleton, WI · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Bristol Hospice Madison1.6 mi · Madison, WI · 1 of 5 stars
Interim Healthcare of WI Madison1.6 mi · Madison, WI
Agrace Hospicecare3.4 mi · Madison, WI · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Interim Healthcare of Wisconsin1.6 mi · Madison, WI
Aveanna Home Health1.8 mi · Madison, WI · 4 of 5 stars
Awooncare Home Health, LLC3.4 mi · Fitchburg, WI

All home health agencies in the state →

Dialysis facilities

Fresenius Kidney Care Fitchburg1.6 mi · Madison, WI · 2 of 5 stars
Fresenius Medical Care - Madison Capitol1.6 mi · Fitchburg, WI · 3 of 5 stars
Fresenius Kidney Care Middleton6.1 mi · Madison, WI

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

SSM Health Surgery Center0.7 mi · Madison, WI
Madison SurgiCenter, LLC3.4 mi · Madison, WI
Novamed Surgery Center of Madison6.1 mi · Madison, WI

All outpatient surgery centers 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

Wingra Family Medical Center0.4 mi · Madison, WI · Community health center
Joyce & Marshall Erdman Clinic1.3 mi · Madison, WI · Community health center
Madison Pediatric Dental & Orthodontics3.8 mi · Monona, WI · Community health center

Clinics and urgent care

Group Health Cooperative of South Central Wisconsin1.8 mi · Madison, WI · Urgent care center
American Current Care P.A .5.9 mi · Madison, WI · Urgent care center
American Current Care P.A.5.9 mi · Madison, WI · Urgent care center

Pharmacies

Dean Retail Services Inc0.7 mi · Madison, WI · Community/retail pharmacy
Dean Retail Services Inc0.7 mi · Madison, WI · Community/retail pharmacy
University of Wisconsin Hospitals & Clinics Authority0.7 mi · Madison, WI · Pharmacy

Assisted living nearby

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

Arc Maternal & Infant Program1.6 mi · Madison, WI
The Ridge at Madison1.6 mi · Fitchburg, WI
Arc House1.8 mi · Madison, WI
Capitol Lakes1.8 mi · Madison, WI

About the Medicare star rating

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

Medicare quality data

What SSM Health St Mary's Hospital - Madison 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	73%National average: 72%
Would definitely recommend the hospital	74%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	76%National average: 74%
Area around the room “always” quiet at night	59%National average: 60%
Completed surveys	1,221Response rate: 37%

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)	0.169Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.158Better than the national benchmark
Surgical site infections after colon surgery	1.185No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0No different from the national benchmark
MRSA bloodstream infections	0.652No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.251Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.3%
Deaths within 30 days: heart failure patients	14.5%
Deaths within 30 days: pneumonia patients	17%
Deaths within 30 days: COPD patients	10.4%
Deaths within 30 days: stroke patients	9.6%
Deaths within 30 days: coronary bypass surgery (CABG)	1.5%
Serious complications (patient safety indicator PSI-90)	0.9No different from the national rate
Complications after hip or knee replacement	4.4%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.3%
Readmitted within 30 days: heart failure	21.2%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	19.7%
Readmitted within 30 days: coronary bypass surgery	11.3%
Readmitted within 30 days: hip or knee replacement	6.2%

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)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	190 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	51%National average: 65%

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 Madison Best hospitals in Madison

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 78 common services exactly as SSM Health St Mary's Hospital - Madison 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)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pulm Rehab Visit Level 3	$159	$87.45	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op Est Pt Level 3	$168	$92.40	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Cardiac Rehab Visit Level 3	$159	$87.45	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pulm Rehab Visit Level 4	$239	$131.45	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op Est Pt Level 4	$211	$116.05	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Cardiac Rehab Visit Level 4	$239	$131.45	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$198.86 – $265.15
Emergency room visit (moderate): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $265.15 Molina — Medicare Managed Care Plan: $198.86
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iii	$1,932	$1,062.60	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Emergency Dept Visit Level 3	$1,932	$1,062.60	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$303.98 – $405.30
Emergency room visit (moderately high): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $405.30 Molina — Medicare Managed Care Plan: $303.98
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iv	$2,620	$1,441	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Emergency Dept Visit Level 4	$2,620	$1,441	Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$433.84 – $578.46
Emergency room visit (high): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $578.46 Molina — Medicare Managed Care Plan: $433.84
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level V	$4,171	$2,294.05	Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Emergency Dept Visit Level 5	$4,171	$2,294.05	Not listed in the file

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$6.34 – $73.97
Basic metabolic panel (blood test): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $73.97 BCBS — Blue Access PPO: $73.97 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $68.78 Centivo — Broad(WI2) Other Commercial Plan: $10.58 Dean Health Plan — Medicare Managed Care Plan: $8.46 Molina — Medicare Managed Care Plan: $6.34 The Alliance — All Commercial Plans: $14.81
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Basic Metabolic Panel (Ca Total)	$317	$174.35	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$7.92 – $92.40
Comprehensive metabolic panel (blood test): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $92.40 BCBS — Blue Access PPO: $92.40 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $85.91 Centivo — Broad(WI2) Other Commercial Plan: $13.20 Dean Health Plan — Medicare Managed Care Plan: $10.56 Molina — Medicare Managed Care Plan: $7.92 The Alliance — All Commercial Plans: $18.48
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Comprehensive Metabolic Panel	$386	$212.30	Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$35.86 – $418.12
Obstetric blood test panel: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $418.12 BCBS — Blue Access PPO: $418.12 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $388.77 Centivo — Broad(WI2) Other Commercial Plan: $59.76 Dean Health Plan — Medicare Managed Care Plan: $47.81 Molina — Medicare Managed Care Plan: $35.86 The Alliance — All Commercial Plans: $83.67
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$10.04 – $117.12
Cholesterol panel (lipid panel): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $117.12 BCBS — Blue Access PPO: $117.12 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $108.90 Centivo — Broad(WI2) Other Commercial Plan: $16.74 Dean Health Plan — Medicare Managed Care Plan: $13.39 Molina — Medicare Managed Care Plan: $10.04 The Alliance — All Commercial Plans: $23.43
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Lipid Profile	$227	$124.85	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Lipid Profile I	$68	$37.40	Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$6.51 – $75.97
Kidney function panel: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $75.97 BCBS — Blue Access PPO: $75.97 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $70.63 Centivo — Broad(WI2) Other Commercial Plan: $10.85 Dean Health Plan — Medicare Managed Care Plan: $8.68 Molina — Medicare Managed Care Plan: $6.51 The Alliance — All Commercial Plans: $15.19
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Renal Function Panel	$363	$199.65	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$6.13 – $71.48
Liver function panel: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $71.48 BCBS — Blue Access PPO: $71.48 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $66.44 Centivo — Broad(WI2) Other Commercial Plan: $10.21 Dean Health Plan — Medicare Managed Care Plan: $8.17 Molina — Medicare Managed Care Plan: $6.13 The Alliance — All Commercial Plans: $14.30
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Hepatic Function Panel	$274	$150.70	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$2.38 – $27.74
Urine test (automated, with microscope): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $27.74 BCBS — Blue Access PPO: $27.74 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $25.79 Centivo — Broad(WI2) Other Commercial Plan: $3.96 Dean Health Plan — Medicare Managed Care Plan: $3.17 Molina — Medicare Managed Care Plan: $2.38 The Alliance — All Commercial Plans: $5.55
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Routine Auto W Microscopic	$113	$62.15	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Routine Auto	$116	$63.80	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$2.61 – $22.34
Urine test (manual, without microscope): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $22.34 BCBS — Blue Access PPO: $22.34 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $20.78 Centivo — Broad(WI2) Other Commercial Plan: $4.35 Dean Health Plan — Medicare Managed Care Plan: $3.48 Molina — Medicare Managed Care Plan: $2.61 The Alliance — All Commercial Plans: $6.09
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Reducing Substance Urine	$29	$15.95	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$1.69 – $19.64
Urine test (automated, without microscope): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $19.64 BCBS — Blue Access PPO: $19.64 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $18.27 Centivo — Broad(WI2) Other Commercial Plan: $2.81 Dean Health Plan — Medicare Managed Care Plan: $2.25 Molina — Medicare Managed Care Plan: $1.69 The Alliance — All Commercial Plans: $3.94
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ketones Qualitative Urine Auto	$39	$21.45	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Specific Gravity Urine Auto	$33	$18.15	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total	Not listed in the file	Not listed in the file	$13.79 – $160.91
PSA (prostate specific antigen) blood test: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $160.91 BCBS — Blue Access PPO: $160.91 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $149.60 Centivo — Broad(WI2) Other Commercial Plan: $22.99 Dean Health Plan — Medicare Managed Care Plan: $18.39 Molina — Medicare Managed Care Plan: $13.79 The Alliance — All Commercial Plans: $32.18
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Psa Total Refer	$18	$9.90	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Prostate Specific Antigen Diag	$318	$174.90	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$12.60 – $146.97
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $146.97 BCBS — Blue Access PPO: $146.97 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $136.68 Centivo — Broad(WI2) Other Commercial Plan: $21 Dean Health Plan — Medicare Managed Care Plan: $16.80 Molina — Medicare Managed Care Plan: $12.60 The Alliance — All Commercial Plans: $29.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Tsh	$193	$106.15	Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$5.83 – $68
Complete blood count (CBC) with differential: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $68 BCBS — Blue Access PPO: $68 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $63.24 Centivo — Broad(WI2) Other Commercial Plan: $9.71 Dean Health Plan — Medicare Managed Care Plan: $7.77 Molina — Medicare Managed Care Plan: $5.83 The Alliance — All Commercial Plans: $13.60
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W Auto Differential	$281	$154.55	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$4.85 – $56.56
Complete blood count (CBC), automated: rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $56.56 BCBS — Blue Access PPO: $56.56 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $52.61 Centivo — Broad(WI2) Other Commercial Plan: $8.09 Dean Health Plan — Medicare Managed Care Plan: $6.47 Molina — Medicare Managed Care Plan: $4.85 The Alliance — All Commercial Plans: $11.32
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W/O Auto Differential	$164	$90.20	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time	Not listed in the file	Not listed in the file	$3.22 – $34.39
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $34.39 BCBS — Blue Access PPO: $34.39 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $32 Centivo — Broad(WI2) Other Commercial Plan: $5.36 Dean Health Plan — Medicare Managed Care Plan: $4.29 Molina — Medicare Managed Care Plan: $3.22 The Alliance — All Commercial Plans: $7.51
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Pt-Inr	$14	$7.70	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Pt I	$23	$12.65	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial	Not listed in the file	Not listed in the file	$4.51 – $52.53
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans BCBS — Anthem Blue Traditional Traditional: $52.53 BCBS — Blue Access PPO: $52.53 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $48.84 Centivo — Broad(WI2) Other Commercial Plan: $7.51 Dean Health Plan — Medicare Managed Care Plan: $6.01 Molina — Medicare Managed Care Plan: $4.51 The Alliance — All Commercial Plans: $10.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ptt Inhibitor I	$46	$25.30	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ptt Inhibitor 1Hr	$30	$16.50	Not listed in the file

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$76.16 – $627.93
CT scan of the head or brain, without contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $627.93 BCBS — Blue Access PPO: $627.93 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $591.47 Dean Health Plan — Medicare Managed Care Plan: $101.55 Molina — Medicare Managed Care Plan: $76.16
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Head Non Contrast	$1,899	$1,044.45	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$254.15 – $2,258.25
MRI of the brain, before and after contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $2,258.25 BCBS — Blue Access PPO: $2,258.25 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $2,127.15 Dean Health Plan — Medicare Managed Care Plan: $338.87 Molina — Medicare Managed Care Plan: $254.15
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Brain With & Without Contrast	$5,985	$3,291.75	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$63.40 – $168.02
Chest X-ray, 2 views: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $168.02 BCBS — Blue Access PPO: $168.02 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $158.27 Dean Health Plan — Medicare Managed Care Plan: $84.53 Molina — Medicare Managed Care Plan: $63.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Xray Chest 2 Views	$484	$266.20	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$76.16 – $282.50
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $282.50 BCBS — Blue Access PPO: $282.50 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $266.08 Dean Health Plan — Medicare Managed Care Plan: $101.55 Molina — Medicare Managed Care Plan: $76.16
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lumbar Spine 4+ Vw	$952	$523.60	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$173.82 – $1,272.53
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $1,272.53 BCBS — Blue Access PPO: $1,272.53 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $1,198.66 Dean Health Plan — Medicare Managed Care Plan: $231.76 Molina — Medicare Managed Care Plan: $173.82
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Spine Lumbar Non Contrast	$4,558	$2,506.90	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: Hc Mri L-Spine Limited	$3,419	$1,880.45	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$127.78 – $1,442.20
CT scan of the pelvis, with contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $1,442.20 BCBS — Blue Access PPO: $1,442.20 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $1,358.47 Dean Health Plan — Medicare Managed Care Plan: $170.37 Molina — Medicare Managed Care Plan: $127.78
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Pelvis With Iv Contrast	$3,170	$1,743.50	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$173.82 – $1,447.10
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $1,447.10 BCBS — Blue Access PPO: $1,447.10 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $1,363.09 Dean Health Plan — Medicare Managed Care Plan: $231.76 Molina — Medicare Managed Care Plan: $173.82
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Lower Ext Any Joint Non Contrast	$3,962	$2,179.10	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast	Not listed in the file	Not listed in the file	$254.15 – $1,892.48
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $1,892.48 BCBS — Blue Access PPO: $1,892.48 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $1,782.63 Dean Health Plan — Medicare Managed Care Plan: $338.87 Molina — Medicare Managed Care Plan: $254.15
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Abdomen Pelvis W Contrast	$5,550	$3,052.50	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$76.16 – $714.29
Ultrasound of the abdomen, complete: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $714.29 BCBS — Blue Access PPO: $714.29 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $672.85 Dean Health Plan — Medicare Managed Care Plan: $101.55 Molina — Medicare Managed Care Plan: $76.16
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Abdomen Complete	$1,848	$1,016.40	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$76.16 – $794.50
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $794.50 BCBS — Blue Access PPO: $794.50 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $748.37 Dean Health Plan — Medicare Managed Care Plan: $101.55 Molina — Medicare Managed Care Plan: $76.16
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Ob 14+ Wks Single Gest	$2,010	$1,105.50	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Us Ob >=14 Wks Single Gest	$2,312	$1,271.60	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$76.16 – $757.48
Transvaginal ultrasound: rates for 5 insurance plans BCBS — Anthem Blue Traditional Traditional: $757.48 BCBS — Blue Access PPO: $757.48 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $713.50 Dean Health Plan — Medicare Managed Care Plan: $101.55 Molina — Medicare Managed Care Plan: $76.16
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Transvaginal Non Ob	$1,484	$816.20	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$769.16 – $816.55
Diagnostic mammogram, one breast: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $816.55 BCBS — Blue Access PPO: $816.55 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $769.16
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Unilateral Includes Cad/Ai	$334	$183.70	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$61.76 – $82.34
Diagnostic mammogram, one breast: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $82.34 Molina — Medicare Managed Care Plan: $61.76
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$984.38 – $1,045.02
Diagnostic mammogram, both breasts: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $1,045.02 BCBS — Blue Access PPO: $1,045.02 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $984.38
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Bilateral Includes Cad/Ai	$666	$366.30	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$79.11 – $105.48
Diagnostic mammogram, both breasts: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $105.48 Molina — Medicare Managed Care Plan: $79.11
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$812.81 – $862.87
Screening mammogram, both breasts: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $862.87 BCBS — Blue Access PPO: $862.87 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $812.81
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$65.36 – $87.14
Screening mammogram, both breasts: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $87.14 Molina — Medicare Managed Care Plan: $65.36

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$2,361.75 – $16,624
Left heart catheterization (diagnostic): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044 Centivo — Broad(WI2) Other Commercial Plan: $16,624 Dean Health Plan — Medicare Managed Care Plan: $3,148.99 Molina — Medicare Managed Care Plan: $2,361.75
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lhc W Lt Vent W S+I	$10,169	$5,592.95	Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation	Not listed in the file	Not listed in the file	$5,682.05 – $18,955
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Centivo — Broad(WI2) Other Commercial Plan: $18,955 Dean Health Plan — Medicare Managed Care Plan: $7,576.07 Molina — Medicare Managed Care Plan: $5,682.05
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ep Eval W/O Induction Right A/V	$12,411	$6,826.05	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol	Not listed in the file	Not listed in the file	$14,021 – $40,147
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $14,713 BCBS — Blue Access PPO: $14,713 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $14,021 Centivo — Broad(WI2) Other Commercial Plan: $40,147 Dean Health Plan — Medicare Managed Care Plan: $25,388.55 Molina — Medicare Managed Care Plan: $19,041.41
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ep Eval Ablation Afib By Pulm Vein Iso	$41,145	$22,629.75	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$625.59 – $834.12
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $834.12 Molina — Medicare Managed Care Plan: $625.59
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Polysomn 4 Or More >=6Yrs	$7,974	$4,385.70	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: Hc Polysomn 4 Or More Less Than 3 Hrs	$1,377	$757.35	Not listed in the file

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$21.19 – $28.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $28.25 Molina — Medicare Managed Care Plan: $21.19
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ther Exercise Ea 15 Min Peds Ot	$219	$120.45	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ther Exercise Neonatal Ea 15 Min Ot	$219	$120.45	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$71.78 – $95.70
Physical therapy evaluation (low complexity): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $95.70 Molina — Medicare Managed Care Plan: $71.78
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval Low Complexity	$458	$251.90	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval Neonatal Low Complexity 2 Rvu	$458	$251.90	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$71.78 – $95.70
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $95.70 Molina — Medicare Managed Care Plan: $71.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval Mod Complexity	$624	$343.20	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval Neonatal Mod Complexity 3 Rvu	$624	$343.20	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$71.78 – $95.70
Physical therapy evaluation (high complexity): rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $95.70 Molina — Medicare Managed Care Plan: $71.78
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval High Complexity	$933	$513.15	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee · modifier GP In the file: Hc Pt Eval Neonatal High Complexity 4 Rvu	$933	$513.15	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes	Not listed in the file	Not listed in the file	$129.31 – $172.41
Psychotherapy, 30 minutes: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $172.41 Molina — Medicare Managed Care Plan: $129.31
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes	Not listed in the file	Not listed in the file	$129.31 – $172.41
Psychotherapy, 45 minutes: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $172.41 Molina — Medicare Managed Care Plan: $129.31
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes	Not listed in the file	Not listed in the file	$129.31 – $172.41
Psychotherapy, 60 minutes: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $172.41 Molina — Medicare Managed Care Plan: $129.31
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min	Not listed in the file	Not listed in the file	$129.31 – $172.41
Family psychotherapy, without the patient: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $172.41 Molina — Medicare Managed Care Plan: $129.31
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min	Not listed in the file	Not listed in the file	$129.31 – $172.41
Family psychotherapy, with the patient: rates for 2 insurance plans Dean Health Plan — Medicare Managed Care Plan: $172.41 Molina — Medicare Managed Care Plan: $129.31

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$2,852.39 – $9,825
Removal of breast growth (open surgery): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044 Centivo — Broad(WI2) Other Commercial Plan: $8,124 Dean Health Plan — Medicare Managed Care Plan: $3,803.19 Molina — Medicare Managed Care Plan: $2,852.39
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$9,352.97 – $27,690
Total hip replacement: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $20,837 BCBS — Blue Access PPO: $20,837 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $19,855 Centivo — Broad(WI2) Other Commercial Plan: $27,690 Dean Health Plan — Medicare Managed Care Plan: $12,470.63 Molina — Medicare Managed Care Plan: $9,352.97
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$9,352.97 – $27,690
Total knee replacement: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $21,804 BCBS — Blue Access PPO: $21,804 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $20,778 Centivo — Broad(WI2) Other Commercial Plan: $27,690 Dean Health Plan — Medicare Managed Care Plan: $12,470.63 Molina — Medicare Managed Care Plan: $9,352.97
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,036
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan Centivo — Broad(WI2) Other Commercial Plan: $2,036
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,383.65 – $9,825
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044 Centivo — Broad(WI2) Other Commercial Plan: $9,052 Dean Health Plan — Medicare Managed Care Plan: $3,178.20 Molina — Medicare Managed Care Plan: $2,383.65
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$4,312.59 – $15,110
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $15,110 BCBS — Blue Access PPO: $15,110 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $13,962 Centivo — Broad(WI2) Other Commercial Plan: $8,124 Dean Health Plan — Medicare Managed Care Plan: $5,750.12 Molina — Medicare Managed Care Plan: $4,312.59
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$660.74 – $5,563
Upper GI endoscopy (diagnostic): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $880.98 Molina — Medicare Managed Care Plan: $660.74
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$660.74 – $5,563
Upper GI endoscopy with biopsy: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $880.98 Molina — Medicare Managed Care Plan: $660.74
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Egd Flex Transoral W Bx Sngl Or Mult	$5,195	$2,857.25	Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$677.47 – $5,563
Colonoscopy (diagnostic): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $903.30 Molina — Medicare Managed Care Plan: $677.47
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$871.75 – $7,498
Colonoscopy with biopsy: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $1,162.34 Molina — Medicare Managed Care Plan: $871.75
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$871.75 – $7,498
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $1,162.34 Molina — Medicare Managed Care Plan: $871.75
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$871.75 – $7,498
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $3,863 Dean Health Plan — Medicare Managed Care Plan: $1,162.34 Molina — Medicare Managed Care Plan: $871.75
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$677.47 – $5,563
Screening colonoscopy (not high risk): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $3,313.38 BCBS — Blue Access PPO: $3,313.38 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $3,121 Centivo — Broad(WI2) Other Commercial Plan: $3,193 Dean Health Plan — Medicare Managed Care Plan: $903.30 Molina — Medicare Managed Care Plan: $677.47
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$4,404.16 – $22,413
Gallbladder removal by laparoscope: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $22,413 BCBS — Blue Access PPO: $22,413 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $21,366 Centivo — Broad(WI2) Other Commercial Plan: $18,955 Dean Health Plan — Medicare Managed Care Plan: $5,872.22 Molina — Medicare Managed Care Plan: $4,404.16
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$2,608.32 – $9,825
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044 Centivo — Broad(WI2) Other Commercial Plan: $9,052 Dean Health Plan — Medicare Managed Care Plan: $3,477.76 Molina — Medicare Managed Care Plan: $2,608.32
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$3,863 – $7,498
Prostate biopsy: rates for 4 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $3,863
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Biopsy Prostate	$4,332	$2,382.60	Not listed in the file
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy	Not listed in the file	Not listed in the file	$7,743.83 – $27,690
Prostate removal by laparoscope (radical prostatectomy): rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $21,804 BCBS — Blue Access PPO: $21,804 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $20,778 Centivo — Broad(WI2) Other Commercial Plan: $27,690 Dean Health Plan — Medicare Managed Care Plan: $10,325.10 Molina — Medicare Managed Care Plan: $7,743.83
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$2,358.24 – $8,124
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $8,124 Dean Health Plan — Medicare Managed Care Plan: $3,144.33 Molina — Medicare Managed Care Plan: $2,358.24
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$514.23 – $5,563
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,193 Dean Health Plan — Medicare Managed Care Plan: $685.65 Molina — Medicare Managed Care Plan: $514.23
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Epidural Lumbar Sacral W Img	$3,312	$1,821.60	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s	Not listed in the file	Not listed in the file	$644.34 – $5,563
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,193 Dean Health Plan — Medicare Managed Care Plan: $859.12 Molina — Medicare Managed Care Plan: $644.34
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Transforam Nerve L/S Sngl	$5,607	$3,083.85	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee · modifier 50 In the file: Hc Inj Trans Nerve L/S Sngl Bilat	$11,214	$6,167.70	Not listed in the file
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$1,422.56 – $8,124
Carpal tunnel release: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $8,124 Dean Health Plan — Medicare Managed Care Plan: $1,896.75 Molina — Medicare Managed Care Plan: $1,422.56
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$400.67 – $5,563
Laser treatment of clouding after cataract surgery: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $5,563 BCBS — Blue Access PPO: $5,563 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,198 Centivo — Broad(WI2) Other Commercial Plan: $3,193 Dean Health Plan — Medicare Managed Care Plan: $534.23 Molina — Medicare Managed Care Plan: $400.67
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$1,681.25 – $8,124
Cataract removal with lens implant: rates for 6 insurance plans BCBS — Anthem Blue Traditional Traditional: $7,498 BCBS — Blue Access PPO: $7,498 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $4,982 Centivo — Broad(WI2) Other Commercial Plan: $8,124 Dean Health Plan — Medicare Managed Care Plan: $2,241.66 Molina — Medicare Managed Care Plan: $1,681.25

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$6,044 – $9,825
Vaginal delivery, with care before and after: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$6,044 – $9,825
Cesarean delivery (C-section), with care before and after: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$6,044 – $9,825
Vaginal delivery after a previous C-section, with care before and after: rates for 3 insurance plans BCBS — Anthem Blue Traditional Traditional: $9,825 BCBS — Blue Access PPO: $9,825 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $6,044

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc	Not listed in the file	Not listed in the file	$55,146.54 – $303,022.23
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 18 insurance plan rates BCBS — Anthem Blue Traditional Traditional: $247,211.36 BCBS — Blue Access PPO: $247,211.36 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $198,483.23 Centivo — Broad(WI2) Other Commercial Plan: $193,102.69 Dean Health Plan — Medicare Managed Care Plan: $73,528.72 ICare — Medicare Managed Care Plan: $73,528.72 Molina — Medicare Managed Care Plan: $55,146.54 The Alliance — All Commercial Plans: $303,022.23 WPS — Southern Other Commercial Plan: $190,917.21 FABOH — All Commercial Plans: 75% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc	Not listed in the file	Not listed in the file	$74,215.13 – $118,969.54
Spinal fusion (not neck), without major complications: 10 of 12 insurance plan rates BCBS — Blue Access PPO: $92,435.13 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $74,215.13 The Alliance — All Commercial Plans: $118,969.54 FABOH — All Commercial Plans: 75% (a percentage in the contract, not a dollar amount) GHC-Eau Claire — Other Commercial Plan: 85% (a percentage in the contract, not a dollar amount) Multiplan — Aetna All Commercial Plans: 96% (a percentage in the contract, not a dollar amount) Multiplan — Complementary All Commercial Plans: 96% (a percentage in the contract, not a dollar amount) Multiplan — Health EOS All Commercial Plans: 87% (a percentage in the contract, not a dollar amount) Multiplan — PHCS All Commercial Plans: 87% (a percentage in the contract, not a dollar amount) Multiplan — UHC All Commercial Plans: 99% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc	Not listed in the file	Not listed in the file	$11,032.70 – $59,747.68
Hip or knee replacement (major joint of the leg), without major complications: 10 of 18 insurance plan rates BCBS — Anthem Blue Traditional Traditional: $48,743.30 BCBS — Blue Access PPO: $48,743.30 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $39,135.45 Centivo — Broad(WI2) Other Commercial Plan: $38,074.56 Dean Health Plan — Medicare Managed Care Plan: $14,710.26 ICare — Medicare Managed Care Plan: $14,710.26 Molina — Medicare Managed Care Plan: $11,032.70 The Alliance — All Commercial Plans: $59,747.68 WPS — Southern Other Commercial Plan: $37,643.64 FABOH — All Commercial Plans: 75% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc	Not listed in the file	Not listed in the file	$13,910.74 – $75,619.27
Neck (cervical) spinal fusion, without complications: 10 of 18 insurance plan rates BCBS — Anthem Blue Traditional Traditional: $61,691.65 BCBS — Blue Access PPO: $61,691.65 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $49,531.54 Centivo — Broad(WI2) Other Commercial Plan: $48,188.82 Dean Health Plan — Medicare Managed Care Plan: $18,547.66 ICare — Medicare Managed Care Plan: $18,547.66 Molina — Medicare Managed Care Plan: $13,910.74 The Alliance — All Commercial Plans: $75,619.27 WPS — Southern Other Commercial Plan: $47,643.43 FABOH — All Commercial Plans: 75% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc	Not listed in the file	Not listed in the file	$7,167.21 – $38,430.68
Uterus and ovary surgery (not for cancer), without complications: 10 of 18 insurance plan rates BCBS — Anthem Blue Traditional Traditional: $31,352.49 BCBS — Blue Access PPO: $31,352.49 BCBS — Blue Preferred/Blue Preferred Plus HMO/POS: $25,172.56 Centivo — Broad(WI2) Other Commercial Plan: $24,490.18 Dean Health Plan — Medicare Managed Care Plan: $9,556.28 ICare — Medicare Managed Care Plan: $9,556.28 Molina — Medicare Managed Care Plan: $7,167.21 The Alliance — All Commercial Plans: $38,430.68 WPS — Southern Other Commercial Plan: $24,213 FABOH — All Commercial Plans: 75% (a percentage in the contract, not a dollar amount)

Source: SSM Health St Mary's Hospital - Madison’s standard charges file (hospitalpricedisclosure.com, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	700 South Park St, Madison, WI 53715
County	Dane County
State	Wisconsin
Phone	(608) 251‑6100
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	520083
Name in Medicare records	SSM HEALTH ST MARY'S HOSPITAL - MADISON
Profile level	Medicare data + hospital website
Official website	ssmhealth.com
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 2026-11-02.

SSM Health St. Mary's Hospital - Madison | SSM Health — ssmhealth.com