Indianhead Medical Center
Listed in its price file as “Indianhead Medical Center Shell Lake Inc.”.
Indianhead Medical Center in Shell Lake, WI publishes cash prices for 143 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Wisconsin median for 99 of 139 procedures and below it for 39. By typical cash price it ranks #87 of 93 Wisconsin hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
113 Fourth Ave West, P.O. Box 300, Shell Lake, WI, 54871-0300 Collected Sep 27, 2026 Source price file (715) 468-7833
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 521342 · CMS hospital register NPI 1568438125
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE MIN 3V LEFT/RIGHT | $372.00 | $465.00 | — | 120% above | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US DIGITAL PRESSURE API ABI | $420.00 | $525.00 | — | 16% above | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS BARIUM XRAY | $508.12 | $635.15 | — | 27% above | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN TOTAL | $711.36 | $889.20 | — | 49% below | 20% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREASTS LEFT/RIGHT COMPLETE | $560.00 | $700.00 | — | 26% above | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREASTS LEFT/RIGHT LIMITED | $500.00 | $625.00 | — | 50% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST | $3,196.00 | $3,995.00 | — | 68% above | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W CONTRAST | $4,360.00 | $5,450.00 | — | 139% above | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS COMBINED | $4,391.20 | $5,489.00 | — | 96% above | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT RENAL/BLADDER | $4,391.20 | $5,489.00 | — | 96% above | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN CT EXT COMBINED | $912.16 | $1,140.20 | — | 38% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST | $2,360.00 | $2,950.00 | — | 61% above | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST | $1,073.27 | $1,341.59 | — | 3% above | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST | $2,000.00 | $2,500.00 | — | 102% above | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $2,040.00 | $2,550.00 | — | 118% above | 20% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST | $2,880.00 | $3,600.00 | — | 148% above | 20% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST | $2,440.00 | $3,050.00 | — | 81% above | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE 1 LEVEL CT | $345.76 | $432.20 | — | 68% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE INTRATHECAL CT | $691.72 | $864.65 | — | 36% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR 3 LEVELS | $1,960.00 | $2,450.00 | — | 80% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE 1 LEVEL CT | $345.76 | $432.20 | — | 68% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE INTRATHECAL CT | $691.72 | $864.65 | — | 36% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE >3 LEVELS CT | $865.28 | $1,081.60 | — | 20% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL 3 LEVELS | $2,480.00 | $3,100.00 | — | 128% above | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST | $1,888.00 | $2,360.00 | — | 28% above | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BILATERAL | $680.00 | $850.00 | — | — | 20% |
| Chest X-ray, 2 views CPT 71046 RADEX CHEST 2V FRONT & LAT | $205.80 | $257.25 | — | 20% above | 20% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS | $336.00 | $420.00 | — | 96% above | 20% |
| Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW | $268.80 | $336.00 | — | 107% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL | $504.00 | $630.00 | — | 1% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY-DEXA SCAN | $500.80 | $626.00 | — | 85% above | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST | $1,840.00 | $2,300.00 | — | 68% above | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST | $1,888.00 | $2,360.00 | — | 41% above | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LOWER EXT ARTERY OR GRAFT BILATERAL | $800.00 | $1,000.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS COMPLETE BILATERAL | $624.00 | $780.00 | — | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM RESTING | $1,036.00 | $1,295.00 | — | 25% below | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY WITH PAP TITRATION | $3,200.00 | $4,000.00 | — | 5% below | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LEFT/RIGHT | $368.00 | $460.00 | — | 71% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US KIDNEY | $343.37 | $429.21 | — | 19% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER | $352.00 | $440.00 | — | 17% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER OR PANCREAS | $535.12 | $668.90 | — | 26% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED | $580.00 | $725.00 | — | 36% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD FOL UP 76705 | $752.00 | $940.00 | — | 77% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER JOINT LEFT/RIGHT W/O CONTRAST | $3,720.00 | $4,650.00 | — | 123% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER JOINT LEFT/RIGHT WITH W/O CONTRAST | $3,744.00 | $4,680.00 | — | 22% above | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $2,376.00 | $2,970.00 | — | 24% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST | $3,040.00 | $3,800.00 | — | 7% above | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $2,560.00 | $3,200.00 | — | 58% above | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST | $5,040.00 | $6,300.00 | — | 118% above | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O CONTRAST | $3,316.00 | $4,145.00 | — | 70% above | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W W/O CONTRAST | $3,900.00 | $4,875.00 | — | 42% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE W/O | $3,080.00 | $3,850.00 | — | 55% above | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W-W/O CONT | $3,780.00 | $4,725.00 | — | 84% above | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 CT MRI/C-SPINE | $1,586.40 | $1,983.00 | — | 10% below | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W/O CONT | $3,196.00 | $3,995.00 | — | 82% above | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W-W/O CONTRAST | $3,800.00 | $4,750.00 | — | 34% above | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST | $2,640.00 | $3,300.00 | — | 37% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPR JOINT W/O LEFT | $3,520.00 | $4,400.00 | — | 94% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPR JOINT W/O RIGHT | $3,520.00 | $4,400.00 | — | 94% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM THALLIUM HEART | $735.80 | $919.75 | — | 72% below | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 STRESS TEST-LEXI SCAN | $2,852.10 | $3,565.12 | — | 8% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LTD | $660.00 | $825.00 | — | 114% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC MISC GYN | $920.00 | $1,150.00 | — | 114% above | 20% |
| Screening mammogram, both breasts both sides CPT 77067 MA MAM SCREENING BILATERAL DIGITAL | $368.00 | $460.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS RIGHT | $332.00 | $415.00 | — | 93% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS LEFT/RIGHT | $332.00 | $415.00 | — | 93% above | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 BASELINE SLEEP STUDY | $4,080.00 | $5,100.00 | — | 21% above | 20% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHOCARDIOGRAM STRESS | $1,920.00 | $2,400.00 | — | 17% above | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $1,040.00 | $1,300.00 | — | 161% above | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US COMP ABDOMEN | $792.00 | $990.00 | — | 43% above | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICLE ULTRASOUND | $520.00 | $650.00 | — | 22% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US PAROTID ULTRASOUND | $330.16 | $412.70 | — | 23% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $784.00 | $980.00 | — | 83% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK SOFT TISSUE ULTRASOUND | $876.00 | $1,095.00 | — | 105% above | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR STOMACH XRAY | $400.94 | $501.17 | — | 5% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT VENOUS DUPLEX IMAGING RIGHT | $560.00 | $700.00 | — | 7% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT VENOUS DUPLEX IMAGING LEFT | $560.00 | $700.00 | — | 7% below | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST MIN 3 VIEWS LEFT/RIGHT | $368.00 | $460.00 | — | 87% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR PELVIS & HIP UNILATERAL 2-3 VIEW | $580.00 | $725.00 | — | 179% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR PELVIS & HIP UNILATERAL 2-3 VIEWS | $592.00 | $740.00 | — | 185% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $597.60 | $747.00 | — | 187% above | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LEFT/RIGHT | $332.00 | $415.00 | — | 120% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB-FINGER MIN 2V LEFT/RIGHT | $332.00 | $415.00 | — | 91% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LEFT/RIGHT | $332.00 | $415.00 | — | 84% above | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEWS LEFT/RIGHT | $360.00 | $450.00 | — | 71% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEWS LEFT/RIGHT | $360.00 | $450.00 | — | 86% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR PATELLA 2 VIEWS RIGHT | $164.64 | $205.80 | — | at median | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR PATELLA 2 VIEWS LEFT | $164.64 | $205.80 | — | at median | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS LEFT | $308.00 | $385.00 | — | 87% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS RIGHT | $332.00 | $415.00 | — | 102% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR 2 VIEW | $318.40 | $398.00 | — | 39% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR 3 VIEWS | $352.00 | $440.00 | — | 53% above | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBAR WITH OBL | $470.40 | $588.00 | — | 60% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS | $317.86 | $397.33 | — | 57% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL AP/LAT/OD 3VIEW | $440.00 | $550.00 | — | 104% above | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS | $309.12 | $386.40 | — | 69% above | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 4 FILMS | $479.14 | $598.92 | — | 163% above | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE Na PEPTIDE-BNP | $97.60 | $122.00 | — | 29% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL-CHEM 8 | $136.00 | $170.00 | — | 59% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 QUEST | $216.00 | $270.00 | — | 61% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PCR | $103.20 | $129.00 | — | 28% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $158.40 | $198.00 | — | 71% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF | $140.00 | $175.00 | — | 100% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 CBC-NO DIFF | $67.50 | $84.38 | — | 35% above | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $72.00 | $90.00 | — | 20% below | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $264.80 | $331.00 | — | 3% above | 20% |
| H. pylori antibody blood test CPT 86677 H-PYLORI ANTIBODY | $70.96 | $88.70 | — | 16% below | 20% |
| H. pylori stool antigen test CPT 87338 H-PYLORI STOOL, ANTIGEN | $140.00 | $175.00 | — | 12% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1C GLYCOSYLATED HGB | $87.36 | $109.20 | — | 74% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 | $17.65 | $22.06 | — | 78% below | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $75.04 | $93.80 | — | 27% below | 20% |
| Liver function blood test panel CPT 80076 PROFILE LIVER | $53.36 | $66.70 | — | 44% below | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $56.32 | $70.40 | — | 41% below | 20% |
| Lyme disease antibody test CPT 86618 LYME - ABS (EIA) | $144.00 | $180.00 | — | 83% above | 20% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $29.60 | $37.00 | — | 63% below | 20% |
| Obstetric blood test panel CPT 80055 PROFILE PRENATAL | $54.36 | $67.95 | — | 72% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC CHARGE | $93.04 | $116.30 | — | 3% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP THINPREP W REFLEX AGE 21-29 QUEST | $192.00 | $240.00 | — | 82% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP THINPREP W HPV AGE 30-65 QUEST | $276.00 | $345.00 | — | 162% above | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SL PAP SMEAR-THIN PREP SCREEN | $81.60 | $102.00 | — | 7% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR | $60.00 | $75.00 | — | 89% above | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP RAPID-GROUP A | $69.24 | $86.55 | — | 52% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER | $29.60 | $37.00 | — | 63% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS | $40.00 | $50.00 | — | 50% below | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT | $13.36 | $16.70 | — | 34% below | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN CHARGE | $40.00 | $50.00 | — | 99% above | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 SL OCCULT BLOOD SCREEN | $72.80 | $91.00 | — | 262% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH - SENSITIVE | $172.00 | $215.00 | — | 98% above | 20% |
| Uric acid blood test CPT 84550 URIC ACID | $25.28 | $31.60 | — | 46% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPY | $40.80 | $51.00 | — | 2% above | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URNLS DIP STICK/TAB REGNT AUTO W/O MICRS | $32.80 | $41.00 | — | 37% above | 20% |
| Urine pregnancy test, read by color change CPT 81025 HCG URINE | $128.00 | $160.00 | — | 115% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QUANT | $120.00 | $150.00 | — | 7% above | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Bunion correction with removal of part of the big toe joint CPT 28292 SURG BUNIONECTOMY | $7,284.00 | $9,105.00 | — | 107% above | 20% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $2,398.40 | $2,998.00 | — | 24% above | 20% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFR | $2,600.00 | $3,250.00 | — | 68% above | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG/LVG UNI | $120.00 | $150.00 | — | 110% above | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUM UNILAT | $132.00 | $165.00 | — | 57% above | 20% |
| Gallbladder removal, laparoscopic CPT 47562 NJX CHOLANGIO PRQ W/IMG GID RS&I | $2,271.20 | $2,839.00 | — | 44% below | 20% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $3,840.00 | $4,800.00 | — | 5% below | 20% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/>REDUCIBLE | $2,344.80 | $2,931.00 | — | 13% below | 20% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY | $3,159.20 | $3,949.00 | — | 14% below | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,960.00 | $2,450.00 | — | 24% above | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD TRANSORAL DIAGNOSTIC | $1,520.80 | $1,901.00 | — | 4% above | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG | $404.00 | $505.00 | — | 41% below | 20% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE W/ LEAST 12 LDS W/LR | $158.40 | $198.00 | — | 199% above | 20% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE W/ LEAST 12 LDS W/I&R | $172.80 | $216.00 | — | 226% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $116.00 | $145.00 | — | 17% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMER DEPT SELF LIMITED/MINOR | $184.00 | $230.00 | — | 67% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY VISIT LIMITED/MINOR | $240.00 | $300.00 | — | 117% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY VISIT LOW/MODERATE SEVERITY | $438.40 | $548.00 | — | 65% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMER DEPT LOW TO MOD SEVERITY | $438.40 | $548.00 | — | 65% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E.R. CLINIC - LEVEL 3 | $119.60 | $149.50 | — | 70% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY VISIT MODERATE SEVERITY | $704.00 | $880.00 | — | 75% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER DEPT MODERATE SEVERITY | $704.00 | $880.00 | — | 75% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMER DEPT HI SEVERITY URGENT | $1,008.00 | $1,260.00 | — | 69% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY VISIT HIGH/URGENT SEVERITY | $1,008.00 | $1,260.00 | — | 69% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E.R. CLINIC - LEVEL 5 | $167.44 | $209.30 | — | 83% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERG DEPT HIGH SEVERITY&THREAT | $1,360.00 | $1,700.00 | — | 34% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY VISIT HIGH SEVERITY&THREAT | $1,360.00 | $1,700.00 | — | 34% above | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 TREAD M EXER TST CARDIAC | $527.20 | $659.00 | — | 33% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE OUTPATIENT NEW 30 MINUTES | $344.00 | $430.00 | — | 74% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE OUTPATIENT NEW 45 MIN | $592.00 | $740.00 | — | 189% above | 20% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE OUTPATIENT NEW 60 MINUTES | $664.00 | $830.00 | — | 118% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $249.60 | $312.00 | — | 91% above | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MED NP 18-39YRS | $292.00 | $365.00 | — | 109% above | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT | $401.60 | $502.00 | — | 38% above | 20% |
| Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PTN 65&> | $335.20 | $419.00 | — | 6% above | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 SL HEALTH MAINT-LIMITED 18-39 | $33.60 | $42.00 | — | 78% below | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PDIC COMPRE PREV MED REE/M EST PT/18-39 | $348.00 | $435.00 | — | 124% above | 20% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PDIC PREVENTIVE MED EST PT/40-64 | $352.00 | $440.00 | — | 109% above | 20% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PDIC COMP PREV MED EST PT/65+ | $400.00 | $500.00 | — | 54% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OUTPATIENT VISIT 40 MINUTES | $496.00 | $620.00 | — | 76% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPATIENT VISIT 15 MINS | $272.00 | $340.00 | — | 72% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OUTPATIENT VISIT 25 MINUTES | $350.40 | $438.00 | — | 92% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUTPATIENT VISIT 10 MINUTES | $180.00 | $225.00 | — | 85% above | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT NEW/ESTAB 40 MIN | $332.00 | $415.00 | — | 66% above | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT NEW/ESTAB 60 MIN | $388.80 | $486.00 | — | 21% above | 20% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 TREADMILL EXERCISE TEST | $365.60 | $457.00 | — | 17% below | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 3 DOSE SCHEDULE IM USE | $288.00 | $360.00 | — | 8% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNUEMOCOCCAL VACCINE-POLYVALENT | $26.96 | $33.70 | — | 81% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX | $180.80 | $226.00 | — | 28% above | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (IMOVAX) 2.5U INJ | $2,000.00 | $2,500.00 | — | 269% above | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (IMOVAX) 2.5U INJ | $2,000.00 | $2,500.00 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SL ADMINISTRATION PNEUMONIA VACCINE | $16.00 | $20.00 | — | 57% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SL IMMUNIZATION ADM VACCINE | $16.66 | $20.83 | — | 55% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SL ADMINISTRATION INFLUENZA VACCINE | $20.00 | $25.00 | — | 47% below | 20% |