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County Price & Affordability Audit 2 of 2 Hospitals Priced Pop. 46,169 $68,213 Median Income

Monroe County, WI Hospital Rates

Compare hospital price transparency compliance, fair price benchmarks, and local household charity-care eligibility across all 2 mapped hospitals in Monroe County.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
0.97×vs. Fair Market Price
Position vs. 1.00× Fair Price3% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Monroe County Affordability & CoverageSummarizes local hospital price disclosure compliance in Monroe County, U.S. Census median household income, local uninsured rate, and federal 200%–400% FPL charity-care income thresholds.2 of 2 Hospitals Priced
Hospitals Priced2 of 2Number of CMS-certified hospitals located inside Monroe County that have published machine-readable price files out of all 2 local facilities.
Median Income$68.2k / yrU.S. Census ACS median annual household income in Monroe County ($68,213/yr), used to measure medical bill burden and charity-care eligibility.
Uninsured Rate8.9%Percentage of Monroe County residents without health insurance who rely on self-pay cash discounts and 501(r) nonprofit hospital financial assistance.

Local charity-care income cutoffs (200%–400% FPL): up to $31,920 (single) and $128,600 (family of 4) qualify for free or discounted hospital care.

County Hospital Pricing & Affordability Audit2 of 2 Local Hospitals Priced

Monroe County, WI Hospital Price & Affordability Summary

Monroe County, Wisconsin (pop. 46,169) has 2 CMS-certified hospitals (2 publishing verified machine-readable price files) with a local price index of 0.97× the U.S. fair price benchmark and a $68,213 median household income.

County Price Index: 0.97× Fair MarketMedian Income: $68,213/yr
Advantage

Best Value & Patient Protections in Monroe County

  • 2 of 2 hospitals in Monroe County publish verified 45 CFR § 180 price files (Mayo Clinic Hlth Systm Franciscan Hlthcare Sparta, Tomah Memorial Hospital).
  • High-rated local clinical care: Tomah Memorial Hospital (5/5 CMS Stars).
  • Under federal 26 U.S.C. § 501(r), nonprofit hospitals must provide discounted Financial Assistance Policy (FAP) rates for Monroe County families earning up to $128,600/yr (400% FPL).
Watchout

Where Monroe County Patients Get Burned (Billing Watchouts)

  • Hospital outpatient facility fees in Monroe County can add 1.8×–3.0× over freestanding imaging and surgery centers for the exact same CPT code.
  • With a 8.9% local uninsured rate and $68,213 median household income, an unnegotiated $5,000 hospital bill equals 3.8 weeks of typical Monroe County family take-home pay.
  • Emergency department and inpatient ancillary charges vary significantly across Wisconsin counties — inspect each hospital's profile below before paying a full chargemaster bill.
County MRF Price Coverage100% Published
2 of 2 Hospitals

Includes Mayo Clinic Hlth Systm Franciscan Hlthcare Sparta & Tomah Memorial Hospital.

Free Care Income Cutoff (200% FPL)Nonprofit 501(r) Rule
$31,920 – $64,300

Single ($31,920) to Family of 4 ($64,300) threshold for 100% free charity care.

Discounted Care Cutoff (400% FPL)AGB Billing Cap
Up to $128,600/yr

4-person household income cap qualifying for statutory AGB billing limits in Monroe County.

Wisconsin County Price & Affordability Heatmap 53 of 72 Counties with MRF Hospital Data

Wisconsin County-Level Hospital Price & Affordability Heatmap

Hospital price index, Medicare markup, and household affordability burden across 72 counties in Wisconsin

<0.94× Affordable 0.94–1.06× Near Avg 1.06–1.20× Elevated >1.20× High-Markup
Milwaukee County11hosps
1.39× Fair
Income $62k
Brown County5hosps
1.31× Fair
Income $77k
Dane County4hosps
1.42× Fair
Income $88k
Rock County3hosps
1.34× Fair
Income $74k
Dodge County3hosps
1.34× Fair
Income $74k
Waukesha County3hosps
1.36× Fair
Income $104k
Wood County3hosps
1.43× Fair
Income $66k
Outagamie County3hosps
1.54× Fair
Income $83k
Winnebago County3hosps
1.76× Fair
Income $73k
Marathon County3hosps
1.90× Fair
Income $76k
Grant County3hosps
1.99× Fair
Income $64k
Oneida County3hosps
2.04× Fair
Income $70k
Monroe County2hosps
0.97× Fair
Income $68k
Sauk County2hosps
1.25× Fair
Income $78k
Fond du Lac County2hosps
1.33× Fair
Income $73k
Oconto County2hosps
1.33× Fair
Income $76k
Eau Claire County2hosps
1.47× Fair
Income $72k
Columbia County2hosps
1.56× Fair
Income $83k
Washington County2hosps
1.62× Fair
Income $96k
Manitowoc County2hosps
1.77× Fair
Income $69k
Vernon County2hosps
1.77× Fair
Income $70k
Sheboygan County2hosps
1.84× Fair
Income $72k
Lincoln County2hosps
2.07× Fair
Income $68k
Racine County2hosps
2.91× Fair
Income $75k
Showing top 24 counties with hospital price filings of 72 total in Wisconsin

All Hospitals in Monroe County (2)

Select any published hospital below to inspect its procedure price list, insurer discounts, and official MRF verification links.

MRF Compliance: 2 of 2 Published

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