Does The Monroe Clinic have an emergency room?

Yes. Medicare (CMS) data lists emergency services at The Monroe Clinic. In a medical emergency, call 911.

Where is The Monroe Clinic?

515 22nd Ave, Monroe, WI 53566, in Green County, Wisconsin.

What is the phone number of The Monroe Clinic?

(608) 324-2000, as listed by Medicare (CMS).

What is the Medicare star rating of The Monroe Clinic?

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

Does Medicare reduce its payments to The Monroe Clinic for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for The Monroe Clinic under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.7513; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

The Monroe Clinic — Phone, Address, ER & Ratings

Quick answers

Does The Monroe Clinic have an emergency room?: Yes. Medicare (CMS) data lists emergency services at The Monroe Clinic. In a medical emergency, call 911.
Where is The Monroe Clinic?: 515 22nd Ave, Monroe, WI 53566, in Green County, Wisconsin.
What is the phone number of The Monroe Clinic?: (608) 324-2000, as listed by Medicare (CMS).
What is the Medicare star rating of The Monroe Clinic?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to The Monroe Clinic for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for The Monroe Clinic under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.7513; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4][6][7]

Treatments^[6][7]

Physical therapy
Occupational therapy
Speech therapy
Sports medicine services
Emergency care
Air transport (helipad)

Procedures^[4]

Knee and hip replacement

Programs and centers^[4][5][7]

Family Birth Suites
e-ICU
Family Birth Suites (labor-delivery-recovery suites)
e-ICU (with UW Health)
Rehabilitation & Sports Medicine Center
Spiritual Care

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Visiting	General visiting hours 6 a.m. to 9 p.m. daily; after 7 p.m. visitors enter through the Emergency Department^[5]
Parking	Hospital is handicap accessible; handicap parking near entrances is marked. No other parking details found^[5]

Doctors and clinicians (308)

308 doctors and other clinicians list The Monroe Clinic 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 284 more: the button below opens the full list.

Other emergency rooms nearby

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

Mercyhealth FHN Hospital22 mi · Freeport, IL · Acute Care Hospital
Lafayette Hospital and Clinics25 mi · Darlington, WI · Critical Access Hospital
Stoughton Hospital30 mi · Stoughton, WI · Critical Access Hospital
Mercy Health System Corp31 mi · Janesville, WI · Acute Care Hospital
Beloit Health System32 mi · Beloit, WI · Acute Care Hospital

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

Other hospitals near Monroe

Encompass Health Rehabilitation Hospital of Fitchburg29 mi · Fitchburg, WI · Inpatient Rehabilitation Hospital

Hospitals in Green County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Monroe Health Services0.2 mi · Monroe, WI · 4 of 5 stars
Pleasant View Nursing Home0.8 mi · Monroe, WI · 1 of 5 stars
New Glarus Home15 mi · New Glarus, WI · 2 of 5 stars

All nursing homes in the state →

Hospice providers

SSM Health at Home Monroe0.9 mi · Monroe, WI · 5 of 5 stars
FHN Hospice20 mi · Freeport, IL · 4 of 5 stars

All hospice providers in the state →

Home health agencies

SSM Health at Home Monroe0.9 mi · Monroe, WI · 3 of 5 stars
Tri-State Home Healthcare, LLC20 mi · Freeport, IL · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

Monroe Clinic Dialysis0.9 mi · Monroe, WI · 3 of 5 stars
DaVita Driftwood Dialysis20 mi · Freeport, IL · 3 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.

Clinics and urgent care

Lafayette Hospital and Clinics13 mi · Argyle, WI · Rural health clinic

Pharmacies

Monroe Hometown Pharmacy LLC0.9 mi · Monroe, WI · Community/retail pharmacy
Monroe Hometown Pharmacy West LLC0.9 mi · Monroe, WI · Community/retail pharmacy
The Monroe Clinic, Inc.0.9 mi · Monroe, WI · Clinic pharmacy

Assisted living nearby

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

1st Health LLC0.9 mi · Monroe, WI
1st Health LLC 20.9 mi · Monroe, WI
Dimensions Living Monroe I0.9 mi · Monroe, WI
Dimensions Living Monroe II0.9 mi · Monroe, 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 The Monroe Clinic 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	5 of 5 stars
Doctors communicated well	4 of 5 stars
Patients got help quickly from staff	4 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	4 of 5 stars
Care Coordination	4 of 5 stars
Symptoms After Stay	4 of 5 stars
Rated the hospital 9 or 10 out of 10	76%National average: 72%
Would definitely recommend the hospital	74%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	83%National average: 80%
“Always” got help as soon as they wanted	68%National average: 64%
Staff “always” explained medicines before giving them	69%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	73%National average: 73%
Completed surveys	643Response rate: 32%

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

Infections caught in the hospital

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

Clostridioides difficile (C. diff) intestinal infections	0.288No different from the national benchmark
Not reported to Medicare	Central line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.8%
Deaths within 30 days: heart failure patients	10.5%
Deaths within 30 days: pneumonia patients	13.9%
Deaths within 30 days: COPD patients	7.8%
Deaths within 30 days: stroke patients	11.8%
Serious complications (patient safety indicator PSI-90)	0.96No different from the national rate
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)
Too few cases to report	Complications after hip or knee replacement

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	15.7%
Readmitted within 30 days: heart attack	15.2%
Readmitted within 30 days: heart failure	21.4%
Readmitted within 30 days: pneumonia	17.3%
Readmitted within 30 days: COPD	20.7%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	144 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	76%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	-0.7513Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack	0.9812Fewer readmissions than expected
Heart failure	1.0121More readmissions than expected
Pneumonia	0.9457Fewer readmissions than expected
COPD (chronic lung disease)	0.9827Fewer readmissions than expected
No result published	Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	54.62 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	47.50 out of 100
Person and community engagement (patient survey)	61.00 out of 100
Safety (infections and sepsis care)	30.00 out of 100
Efficiency and cost reduction (Medicare spending)	80.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	0.90Below the national median hospital (1.00): Medicare spent less

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

ER wait times and Medicare ratings nearby

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

ER wait times in Wisconsin Best hospitals in Wisconsin

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as The Monroe Clinic lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 77 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
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	$265.15
Emergency room visit (moderate): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $265.15
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iii	$1,117	$614.35	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	$405.30
Emergency room visit (moderately high): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $405.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iv	$1,673	$920.15	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	$578.46
Emergency room visit (high): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $578.46
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level V	$3,157	$1,736.35	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	$8.46 – $23.27
Basic metabolic panel (blood test): rates for 7 insurance plans Aetna — All Commercial Plans: $23.27 Aetna — Medicare Managed Care Plan: $8.46 BCBS — Blue Access PPO: $14.35 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $10.07 BCBS — Blue Traditional Traditional: $14.35 Centivo — Median(WI2) Other Commercial Plan: $10.58 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)	$127	$69.85	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	$10.56 – $29.04
Comprehensive metabolic panel (blood test): rates for 7 insurance plans Aetna — All Commercial Plans: $29.04 Aetna — Medicare Managed Care Plan: $10.56 BCBS — Blue Access PPO: $17.90 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $12.57 BCBS — Blue Traditional Traditional: $17.90 Centivo — Median(WI2) Other Commercial Plan: $13.20 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	$364	$200.20	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	$47.81 – $131.48
Obstetric blood test panel: rates for 7 insurance plans Aetna — All Commercial Plans: $131.48 Aetna — Medicare Managed Care Plan: $47.81 BCBS — Blue Access PPO: $81.05 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $56.91 BCBS — Blue Traditional Traditional: $81.05 Centivo — Median(WI2) Other Commercial Plan: $59.76 The Alliance — All Commercial Plans: $83.67
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Obstetric Panel	$433	$238.15	Not listed in the file
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	$13.39 – $36.82
Cholesterol panel (lipid panel): rates for 7 insurance plans Aetna — All Commercial Plans: $36.82 Aetna — Medicare Managed Care Plan: $13.39 BCBS — Blue Access PPO: $22.70 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $15.94 BCBS — Blue Traditional Traditional: $22.70 Centivo — Median(WI2) Other Commercial Plan: $16.74 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	$173	$95.15	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Lipid Profile Ii	$66	$36.30	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	$8.68 – $23.87
Kidney function panel: rates for 7 insurance plans Aetna — All Commercial Plans: $23.87 Aetna — Medicare Managed Care Plan: $8.68 BCBS — Blue Access PPO: $14.72 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $10.33 BCBS — Blue Traditional Traditional: $14.72 Centivo — Median(WI2) Other Commercial Plan: $10.85 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	$153	$84.15	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	$8.17 – $22.47
Liver function panel: rates for 7 insurance plans Aetna — All Commercial Plans: $22.47 Aetna — Medicare Managed Care Plan: $8.17 BCBS — Blue Access PPO: $13.85 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $9.73 BCBS — Blue Traditional Traditional: $13.85 Centivo — Median(WI2) Other Commercial Plan: $10.21 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	$137	$75.35	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	$3.17 – $8.72
Urine test (automated, with microscope): rates for 7 insurance plans Aetna — All Commercial Plans: $8.72 Aetna — Medicare Managed Care Plan: $3.17 BCBS — Blue Access PPO: $5.38 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $3.78 BCBS — Blue Traditional Traditional: $5.38 Centivo — Median(WI2) Other Commercial Plan: $3.96 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	$48	$26.40	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$49	$26.95	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	$3.48 – $9.57
Urine test (manual, without microscope): rates for 7 insurance plans Aetna — All Commercial Plans: $9.57 Aetna — Medicare Managed Care Plan: $3.48 BCBS — Blue Access PPO: $5.90 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4.14 BCBS — Blue Traditional Traditional: $5.90 Centivo — Median(WI2) Other Commercial Plan: $4.35 The Alliance — All Commercial Plans: $6.09
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lab Urinalysis Poct (Ip) Beaker	$36	$19.80	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	$2.25 – $6.19
Urine test (automated, without microscope): rates for 7 insurance plans Aetna — All Commercial Plans: $6.19 Aetna — Medicare Managed Care Plan: $2.25 BCBS — Blue Access PPO: $3.82 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $2.67 BCBS — Blue Traditional Traditional: $3.82 Centivo — Median(WI2) Other Commercial Plan: $2.81 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	$45	$24.75	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Glucose Urine Qualitative Auto	$94	$51.70	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	$18.39 – $50.57
PSA (prostate specific antigen) blood test: rates for 7 insurance plans Aetna — All Commercial Plans: $50.57 Aetna — Medicare Managed Care Plan: $18.39 BCBS — Blue Access PPO: $31.18 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $21.89 BCBS — Blue Traditional Traditional: $31.18 Centivo — Median(WI2) Other Commercial Plan: $22.99 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	$21	$11.55	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	$185	$101.75	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	$16.80 – $46.20
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna — All Commercial Plans: $46.20 Aetna — Medicare Managed Care Plan: $16.80 BCBS — Blue Access PPO: $28.48 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $20 BCBS — Blue Traditional Traditional: $28.48 Centivo — Median(WI2) Other Commercial Plan: $21 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	$183	$100.65	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	$7.77 – $21.37
Complete blood count (CBC) with differential: rates for 7 insurance plans Aetna — All Commercial Plans: $21.37 Aetna — Medicare Managed Care Plan: $7.77 BCBS — Blue Access PPO: $13.17 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $9.25 BCBS — Blue Traditional Traditional: $13.17 Centivo — Median(WI2) Other Commercial Plan: $9.71 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	$95	$52.25	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	$6.47 – $17.79
Complete blood count (CBC), automated: rates for 7 insurance plans Aetna — All Commercial Plans: $17.79 Aetna — Medicare Managed Care Plan: $6.47 BCBS — Blue Access PPO: $10.97 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $7.70 BCBS — Blue Traditional Traditional: $10.97 Centivo — Median(WI2) Other Commercial Plan: $8.09 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	$91	$50.05	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	$4.29 – $11.80
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans Aetna — All Commercial Plans: $11.80 Aetna — Medicare Managed Care Plan: $4.29 BCBS — Blue Access PPO: $7.27 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $5.11 BCBS — Blue Traditional Traditional: $7.27 Centivo — Median(WI2) Other Commercial Plan: $5.36 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	$17	$9.35	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	$49	$26.95	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	$6.01 – $16.53
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans Aetna — All Commercial Plans: $16.53 Aetna — Medicare Managed Care Plan: $6.01 BCBS — Blue Access PPO: $10.20 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $7.16 BCBS — Blue Traditional Traditional: $10.20 Centivo — Median(WI2) Other Commercial Plan: $7.51 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	$66	$36.30	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 I	$37	$20.35	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	$101.55 – $207.28
CT scan of the head or brain, without contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $101.55 BCBS — Blue Access PPO: $207.28 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $193.74 BCBS — Blue Traditional Traditional: $207.28
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	$2,245	$1,234.75	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	$338.87 – $744.38
MRI of the brain, before and after contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $338.87 BCBS — Blue Access PPO: $744.38 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $695.79 BCBS — Blue Traditional Traditional: $744.38
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	$4,956	$2,725.80	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	$51.83 – $84.53
Chest X-ray, 2 views: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $84.53 BCBS — Blue Access PPO: $54.90 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $51.83 BCBS — Blue Traditional Traditional: $54.90
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$141	$77.55	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Xray Chest 2 Views	$194	$106.70	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	$86.22 – $101.55
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $101.55 BCBS — Blue Access PPO: $93.28 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $86.22 BCBS — Blue Traditional Traditional: $93.28
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	$461	$253.55	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	$231.76 – $422.12
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $231.76 BCBS — Blue Access PPO: $422.12 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $390.72 BCBS — Blue Traditional Traditional: $422.12
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	$4,918	$2,704.90	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	$170.37 – $475.59
CT scan of the pelvis, with contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $170.37 BCBS — Blue Access PPO: $475.59 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $444 BCBS — Blue Traditional Traditional: $475.59
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Pelvis With Iv Contrast	$2,831	$1,557.05	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	$231.76 – $478.10
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $231.76 BCBS — Blue Access PPO: $478.10 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $443.07 BCBS — Blue Traditional Traditional: $478.10
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	$2,155	$1,185.25	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	$338.87 – $623.86
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $338.87 BCBS — Blue Access PPO: $623.86 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $582.94 BCBS — Blue Traditional Traditional: $623.86
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	$6,305	$3,467.75	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	$101.55 – $234.49
Ultrasound of the abdomen, complete: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $101.55 BCBS — Blue Access PPO: $234.49 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $220.39 BCBS — Blue Traditional Traditional: $234.49
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Abdomen Complete	$2,675	$1,471.25	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	$101.55 – $263.76
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $101.55 BCBS — Blue Access PPO: $263.76 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $245.12 BCBS — Blue Traditional Traditional: $263.76
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Ob 14+ Wks Single Gest	$1,097	$603.35	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	$101.55 – $250.64
Transvaginal ultrasound: rates for 4 insurance plans Aetna — Medicare Managed Care Plan: $101.55 BCBS — Blue Access PPO: $250.64 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $233.70 BCBS — Blue Traditional Traditional: $250.64
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Transvaginal Non Ob	$707	$388.85	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	$251.94 – $266.77
Diagnostic mammogram, one breast: rates for 3 insurance plans BCBS — Blue Access PPO: $266.77 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $251.94 BCBS — Blue Traditional Traditional: $266.77
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Unilateral Includes Cad/Ai	$622	$342.10	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	$82.34
Diagnostic mammogram, one breast: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $82.34
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	$322.43 – $341.42
Diagnostic mammogram, both breasts: rates for 3 insurance plans BCBS — Blue Access PPO: $341.42 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $322.43 BCBS — Blue Traditional Traditional: $341.42
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Bilateral Includes Cad/Ai	$1,245	$684.75	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	$105.48
Diagnostic mammogram, both breasts: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $105.48
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	$266.23 – $281.92
Screening mammogram, both breasts: rates for 3 insurance plans BCBS — Blue Access PPO: $281.92 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $266.23 BCBS — Blue Traditional Traditional: $281.92
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Screen Bilat Includes Cad/Ai	$705	$387.75	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Screen Unilat Includes Cad/Ai	$352	$193.60	Not listed in the file

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	$3,148.99 – $15,012
Left heart catheterization (diagnostic): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $3,148.99 BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528 Centivo — Median(WI2) Other Commercial Plan: $15,012
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lhc W Lt Vent W S+I	$7,786	$4,282.30	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	$7,576.07 – $17,116
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans Aetna — Medicare Managed Care Plan: $7,576.07 Centivo — Median(WI2) Other Commercial Plan: $17,116
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	$25,388.55 – $40,677
Heart rhythm study with ablation for atrial fibrillation: rates for 2 insurance plans Aetna — Medicare Managed Care Plan: $25,388.55 Centivo — Median(WI2) Other Commercial Plan: $40,677
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	$834.12
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $834.12
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Polysomn 4 Or More Less Than 6 Hrs	$4,728	$2,600.40	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Polysomn 4 Or More >=6Yrs	$6,313	$3,472.15	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	$28.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $28.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ther Exercise Ea 15 Min Pt	$243	$133.65	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 Ea 15 Min Ot	$243	$133.65	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	$95.70
Physical therapy evaluation (low complexity): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $95.70
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Low Complexity 1 Rvu	$390	$214.50	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Low Complexity 2 Rvu	$390	$214.50	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	$95.70
Physical therapy evaluation (moderate complexity): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $95.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$433	$238.15	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Mod Complexity 2 Rvu	$468	$257.40	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	$95.70
Physical therapy evaluation (high complexity): rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $95.70
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$471	$259.05	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval High Complexity 3 Rvu	$515	$283.25	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	$172.41
Psychotherapy, 30 minutes: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $172.41
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$136	$74.80	Not listed in the file
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	$172.41
Psychotherapy, 45 minutes: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $172.41
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$181	$99.55	Not listed in the file
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	$172.41
Psychotherapy, 60 minutes: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $172.41
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$272	$149.60	Not listed in the file
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	$172.41
Family psychotherapy, without the patient: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $172.41
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	$172.41
Family psychotherapy, with the patient: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $172.41
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy	Not listed in the file	Not listed in the file	$98.68
Group psychotherapy: rates for 1 insurance plan Aetna — Medicare Managed Care Plan: $98.68

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	$3,803.19 – $13,528
Removal of breast growth (open surgery): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $3,803.19 BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528 Centivo — Median(WI2) Other Commercial Plan: $8,701
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	$12,470.63 – $25,004
Total hip replacement: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $12,470.63 BCBS — Blue Access PPO: $21,647 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $14,758 BCBS — Blue Traditional Traditional: $21,647 Centivo — Median(WI2) Other Commercial Plan: $25,004
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	$12,470.63 – $25,004
Total knee replacement: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $12,470.63 BCBS — Blue Access PPO: $17,882 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $16,164 BCBS — Blue Traditional Traditional: $17,882 Centivo — Median(WI2) Other Commercial Plan: $25,004
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	$2,181 – $13,180
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans BCBS — Blue Access PPO: $13,180 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $9,837 BCBS — Blue Traditional Traditional: $13,180 Centivo — Median(WI2) Other Commercial Plan: $2,181
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	$3,178.20 – $13,528
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $3,178.20 BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528 Centivo — Median(WI2) Other Commercial Plan: $10,137
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	$5,750.12 – $17,649
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $5,750.12 BCBS — Blue Access PPO: $17,649 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,960 BCBS — Blue Traditional Traditional: $17,649 Centivo — Median(WI2) Other Commercial Plan: $8,701
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	$880.98 – $5,652
Upper GI endoscopy (diagnostic): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $880.98 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$880.98 – $5,652
Upper GI endoscopy with biopsy: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $880.98 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$903.30 – $5,652
Colonoscopy (diagnostic): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $903.30 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$1,162.34 – $12,547
Colonoscopy with biopsy: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $1,162.34 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$1,162.34 – $12,547
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $1,162.34 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$1,162.34 – $12,547
Ultrasound of the lower bowel by endoscope: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $1,162.34 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $4,137
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	$897.22 – $5,652
Screening colonoscopy (not high risk): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $903.30 BCBS — Blue Access PPO: $897.22 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $3,420
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	$5,872.22 – $17,743
Gallbladder removal by laparoscope: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $5,872.22 BCBS — Blue Access PPO: $17,743 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $13,176 BCBS — Blue Traditional Traditional: $17,743 Centivo — Median(WI2) Other Commercial Plan: $17,116
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	$3,477.76 – $13,528
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $3,477.76 BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528 Centivo — Median(WI2) Other Commercial Plan: $10,137
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	$4,137 – $12,547
Prostate biopsy: rates for 4 insurance plans BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $4,137
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Biopsy Prostate	$1,249	$686.95	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	$10,325.10 – $25,004
Prostate removal by laparoscope (radical prostatectomy): rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $10,325.10 BCBS — Blue Access PPO: $17,882 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $16,164 BCBS — Blue Traditional Traditional: $17,882 Centivo — Median(WI2) Other Commercial Plan: $25,004
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	$3,144.33 – $12,547
Hysteroscopy with biopsy of the uterus lining: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $3,144.33 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $8,701
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	$685.65 – $5,652
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $685.65 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $3,420
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	$1,682	$925.10	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	$859.12 – $5,652
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $859.12 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $3,420
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	$2,643	$1,453.65	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Trans Nerve L/S Sngl Bilat	$5,284	$2,906.20	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	$1,896.75 – $12,547
Carpal tunnel release: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $1,896.75 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $8,701
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	$534.23 – $5,652
Laser treatment of clouding after cataract surgery: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $534.23 BCBS — Blue Access PPO: $5,652 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,217 BCBS — Blue Traditional Traditional: $5,652 Centivo — Median(WI2) Other Commercial Plan: $3,420
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	$2,241.66 – $12,547
Cataract removal with lens implant: rates for 5 insurance plans Aetna — Medicare Managed Care Plan: $2,241.66 BCBS — Blue Access PPO: $12,547 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $4,743 BCBS — Blue Traditional Traditional: $12,547 Centivo — Median(WI2) Other Commercial Plan: $8,701
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$5,669	$3,117.95	Not listed in the file

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	$8,433 – $13,528
Vaginal delivery, with care before and after: rates for 3 insurance plans BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528
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	$8,433 – $13,528
Cesarean delivery (C-section), with care before and after: rates for 3 insurance plans BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528
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	$8,433 – $13,528
Vaginal delivery after a previous C-section, with care before and after: rates for 3 insurance plans BCBS — Blue Access PPO: $13,528 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $8,433 BCBS — Blue Traditional Traditional: $13,528

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	$69,577.41 – $194,599.46
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 23 insurance plan rates Aetna — Medicare Managed Care Plan: $69,577.41 BCBS — Anthem Medicare Managed Care Plan: $69,577.41 BCBS — Blue Access PPO: $141,840.82 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $111,993.49 BCBS — Blue Traditional Traditional: $141,840.82 Centivo — Median(WI2) Other Commercial Plan: $172,725.12 Dean Heath Plan — Medicare Managed Care Plan: $69,577.41 Humana — Medicare Managed Care Plan: $69,577.41 ICARE — Medicare Managed Care Plan: $69,577.41 Molina — Medicare Managed Care Plan: $69,577.41
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	Not listed in the file
Spinal fusion (not neck), without major complications: rates for 8 insurance plans Cigna — All Commercial Plans: 84.2% (a percentage in the contract, not a dollar amount) Employers Coalition on Health — All Commercial Plans: 81.2% (a percentage in the contract, not a dollar amount) First Health/Coventry — Other Commercial Plan: 70.6% (a percentage in the contract, not a dollar amount) Multiplan — Complementary Network All Commercial Plans: 95% (a percentage in the contract, not a dollar amount) Multiplan — HealthEOS Primary Network All Commercial Plans: 90% (a percentage in the contract, not a dollar amount) Multiplan — PHCS Primary Network All Commercial Plans: 90% (a percentage in the contract, not a dollar amount) TriWest — Government: 75% (a percentage in the contract, not a dollar amount) WPS — All Commercial Plans: 67.9% (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	$13,718.76 – $38,369.68
Hip or knee replacement (major joint of the leg), without major complications: 10 of 23 insurance plan rates Aetna — Medicare Managed Care Plan: $13,718.76 BCBS — Anthem Medicare Managed Care Plan: $13,718.76 BCBS — Blue Access PPO: $27,967.12 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $22,082.05 BCBS — Blue Traditional Traditional: $27,967.12 Centivo — Median(WI2) Other Commercial Plan: $34,056.66 Dean Heath Plan — Medicare Managed Care Plan: $13,718.76 Humana — Medicare Managed Care Plan: $13,718.76 ICARE — Medicare Managed Care Plan: $13,718.76 Molina — Medicare Managed Care Plan: $13,718.76
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	$17,363.06 – $48,562.34
Neck (cervical) spinal fusion, without complications: 10 of 23 insurance plan rates Aetna — Medicare Managed Care Plan: $17,363.06 BCBS — Anthem Medicare Managed Care Plan: $17,363.06 BCBS — Blue Access PPO: $35,396.41 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $27,948 BCBS — Blue Traditional Traditional: $35,396.41 Centivo — Median(WI2) Other Commercial Plan: $43,103.59 Dean Heath Plan — Medicare Managed Care Plan: $17,363.06 Humana — Medicare Managed Care Plan: $17,363.06 ICARE — Medicare Managed Care Plan: $17,363.06 Molina — Medicare Managed Care Plan: $17,363.06
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	$8,824.13 – $24,680
Uterus and ovary surgery (not for cancer), without complications: 10 of 23 insurance plan rates Aetna — Medicare Managed Care Plan: $8,824.13 BCBS — Anthem Medicare Managed Care Plan: $8,824.13 BCBS — Blue Access PPO: $17,988.91 BCBS — Blue Preferred / Blue Preferred Plus HMO/POS: $14,203.53 BCBS — Blue Traditional Traditional: $17,988.91 Centivo — Median(WI2) Other Commercial Plan: $21,905.80 Dean Heath Plan — Medicare Managed Care Plan: $8,824.13 Humana — Medicare Managed Care Plan: $8,824.13 ICARE — Medicare Managed Care Plan: $8,824.13 Molina — Medicare Managed Care Plan: $8,824.13

Source: The Monroe Clinic’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 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	515 22nd Ave, Monroe, WI 53566
County	Green County
State	Wisconsin
Phone	(608) 324‑2000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	520028
Name in Medicare records	THE MONROE CLINIC
Profile level	Medicare data + hospital website
Name on the hospital’s website	SSM Health Monroe Hospital
Official website	ssmhealth.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

SSM Health Monroe Hospital — ssmhealth.com
Visitor Information SSM Health Monroe Hospital — ssmhealth.com
Emergency Room at SSM Health Monroe Hospital — ssmhealth.com
Rehabilitation & Sports Medicine Center at SSM Health Monroe Hospital — ssmhealth.com

The Monroe Clinic

Summary

Profile from official sources

At a glance