How many shoppable procedure prices are published for Aspirus Medford Hospital & Clinics, Inc?

Aspirus Medford Hospital & Clinics, Inc in Medford, WI currently has 131 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Aspirus Medford Hospital & Clinics, Inc's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Aspirus Medford Hospital & Clinics, Inc's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-04-01

Aspirus Medford Hospital & Clinics, Inc

135 S Gibson St, Medford, WI 54451 · 131 Priced Procedures · 78% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.18×vs. Fair Market Price

Typical commercial prices here are +18% above the fair benchmark (1.18×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 11% of the Time

File Completeness60

Price Logic89

Peer Alignment65

Clean Billing81

Real Cash Discount100

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.18× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Aspirus Medford Hospital & Clinics, Inc prices routine shoppable procedures near 1.0× Medicare (p50 1.19×) while skewing captive emergency, lab, and upper-quartile codes to 1.7× Medicare (p75 1.48×, +24% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#37 of 99 in WI · 36th State Percentile#1,961 of 3,385 in U.S. · 57th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.61× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 11% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 78% patient recommendation (73/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (19.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (1.4×) & laboratory (1.3×) services average 1.70× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.48×) jump +24% above the median procedure ratio (Q50 1.19×)
Unnegotiated chargemaster list prices average 9.2× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.70× Divergence

1.7× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+24% Upper Tail

Q25 0.61× · Q50 1.19× · Q75 1.48×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.3× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.2× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

11% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 73/100Fair

Procedure Prices at Aspirus Medford Hospital & Clinics, Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 131 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$67,192	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$40,404	$19,087	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$40,121	$19,432	2.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$36,670	$17,936	2.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$16,216	$8,223	2.0×
Total knee replacement CPT Code: `27447`	$8,548	$8,548	$13,523	unverified
Total hip replacement CPT Code: `27130`	$8,341	$8,341	$13,413	0.6×
C-section delivery (full package) CPT Code: `59510`	$5,793	$5,793	$2,975	1.9×
Vaginal delivery (full package) CPT Code: `59400`	$4,891	$4,891	$2,680	1.8×
Breast lump removal CPT Code: `19120`	$2,691	$2,691	$3,875	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$2,654	$2,654	$369	7.2×
Trauma team activation HCPCS Code: `G0390`	$2,072	$2,072	$1,453	1.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,767	$1,767	$583	3.0×
CT scan, head (with contrast) CPT Code: `70460`	$1,543	$1,543	$242	6.4×
Bunion correction surgery CPT Code: `28296`	$3,747	$1,443	$3,446	0.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,652	$1,155	$6,109	0.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,864	$981	$981	1.0×
Colonoscopy with biopsy CPT Code: `45380`	$2,125	$925	$1,256	0.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$3,564	$893	$3,372	0.3×
Injection procedure for pain management HCPCS Code: `G0260`	$778	$778	$855	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,597	$645	$511	1.3×
Cataract surgery with lens implant CPT Code: `66984`	$4,623	$616	$2,540	0.2×
Blood transfusion CPT Code: `36430`	$584	$584	$498	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,208	$456	$448	1.0×
Inguinal hernia repair CPT Code: `49505`	$5,556	$464	$3,629	0.1×
MRI, lower back (no contrast) CPT Code: `72148`	$2,948	$418	$338	1.2×
Neurobehavioral status check CPT Code: `96116`	$357	$357	$231	1.5×
Rabies immune globulin HCPCS Code: `90375`	$877	$344	$322	1.1×
Behavioral health day treatment HCPCS Code: `H0010`	$309	$309	$343	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	$1,581	$317	$987	0.3×
Speech therapy (language evaluation) CPT Code: `92507`	$254	$254	$86	3.0×
CT scan, chest (no contrast) CPT Code: `71250`	$1,435	$254	$167	1.5×
CT scan, sinuses CPT Code: `70486`	$1,392	$252	$166	1.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,409	$270	$1,021	0.3×
Care planning with family CPT Code: `90887`	$239	$239	$107	2.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$590	$225	$134	1.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$544	$246	$148	1.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,566	$226	$169	1.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,512	$241	$303	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$241	$224	$123	unverified
Ultrasound, pelvis CPT Code: `76856`	$420	$191	$130	1.5×
CT scan, head (no contrast) CPT Code: `70450`	$1,288	$203	$160	1.3×
X-ray, chest (single view) CPT Code: `71045`	$162	$162	$92	1.8×
Screening mammogram (both breasts) CPT Code: `77067`	$343	$173	$123	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$403	$165	$126	1.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$353	$161	$132	1.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$265	$180	$151	1.2×
Family therapy session CPT Code: `90847`	$248	$205	$173	1.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$278	$182	$185	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$139	$139	$38	3.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$166	$150	$87	1.7×
New patient office visit (30-44 min) CPT Code: `99203`	$231	$163	$110	1.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,856	$155	$168	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$259	$154	$181	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$173	$141	$166	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$591	$145	$272	0.5×
Physical therapy (gait training) CPT Code: `97116`	$98	$98	$33	3.0×
Physical therapy (manual therapy) CPT Code: `97140`	$97	$97	$34	2.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$144	$98	$35	2.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$97	$97	$35	2.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$98	$98	$38	2.6×
Occupational therapy (self-care training) CPT Code: `97535`	$97	$97	$38	2.6×
Orthotic fitting and training CPT Code: `97760`	$109	$109	$51	2.1×
Psychological testing evaluation CPT Code: `96136`	$115	$115	$128	0.9×
Behavioral health assessment HCPCS Code: `H0001`	$111	$111	$157	0.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$85	$85	$40	2.1×
Prosthetic fitting and training CPT Code: `97761`	$92	$92	$45	2.0×
Mental health services (assessment) HCPCS Code: `H0031`	$116	$116	$140	0.8×
Psychological testing by technician CPT Code: `96138`	$87	$87	$395	0.2×
Typhoid vaccine HCPCS Code: `90675`	$588	$419	$347	1.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$164	$182	$203	0.9×
Hepatitis C antibody test CPT Code: `86803`	$116	$116	$15	7.7×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$126	$126	$27	4.7×
Pneumococcal vaccine HCPCS Code: `90732`	$182	$120	$140	0.9×
Culture, blood CPT Code: `87040`	$87	$87	$11	7.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$69	$69	$10	6.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$90	$90	$14	6.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$75	$75	$14	5.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$274	$94	$111	0.8×
Drug screening test HCPCS Code: `G0480`	$228	$88	$116	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$46	$5	9.2×
Speech therapy (group session) CPT Code: `92508`	$68	$68	$27	2.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$40	$3	13.3×
Hepatitis B vaccine HCPCS Code: `90744`	$100	$65	$37	1.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$118	$39	$19	2.1×
Blood test, vitamin D CPT Code: `82306`	$176	$62	$31	2.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$115	$38	$20	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$82	$59	$56	1.1×
Colorectal cancer screening HCPCS Code: `G0010`	$48	$48	$49	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$66	$66	$86	0.8×
X-ray, chest (two views) CPT Code: `71046`	$215	$60	$93	0.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$195	$57	$93	0.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,839	$66	$258	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$2,963	$75	$343	0.2×
Culture, bacterial CPT Code: `87070`	$77	$22	$9	2.4×
Blood test, vitamin B12 CPT Code: `82607`	$111	$24	$16	1.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$94	$34	$39	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$27	$40	$49	0.8×
Group therapy session CPT Code: `90853`	$58	$58	$100	0.6×
X-ray, ankle CPT Code: `73610`	$163	$47	$93	0.5×
X-ray, foot CPT Code: `73630`	$158	$45	$92	0.5×
X-ray, hand CPT Code: `73130`	$193	$44	$93	0.5×
X-ray, pelvis CPT Code: `72170`	$203	$44	$110	0.4×
Blood test, hemoglobin CPT Code: `85018`	$36	$7	$3	2.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$112	$28	$18	1.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$107	$18	$14	1.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$114	$14	$11	1.3×
Extended office visit (prolonged) HCPCS Code: `G2212`	$78	$26	$33	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$27	$30	$48	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$131	$35	$64	0.5×
X-ray, shoulder CPT Code: `73030`	$235	$34	$92	0.4×
CT scan, pelvis CPT Code: `72192`	$1,277	$56	$163	0.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$44	$6	$4	1.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$47	$6	$4	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$65	$9	$6	1.5×
Blood test, lipase CPT Code: `83690`	$68	$10	$7	1.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$80	$11	$8	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$92	$12	$9	1.3×
Blood test, magnesium CPT Code: `83735`	$53	$9	$7	1.3×
Blood test, liver function panel CPT Code: `80076`	$102	$11	$9	1.2×
Blood test, calcium CPT Code: `82310`	$53	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$49	$6	$5	1.2×
Blood test, potassium CPT Code: `84132`	$44	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$42	$6	$5	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$55	$30	$25	1.2×
Blood test, amylase CPT Code: `82150`	$62	$6	$7	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$154	$13	$25	0.5×
X-ray, hip CPT Code: `73502`	$243	$30	$93	0.3×
X-ray, lower back CPT Code: `72110`	$285	$35	$112	0.3×
Blood antibody screen CPT Code: `86850`	$94	$11	$46	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$77	$25	$201	0.1×

Showing top 25 high-impact procedures of 131 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 19.1%

Audit a Bill or Quote at Aspirus Medford Hospital & Clinics, Inc (Zero PHI Required)

CMS CCN: 521324

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $67,192

1. Amount on Your Bill or Quote ($) Pre-filled with Aspirus Medford Hospital & Clinics, Inc’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $30,720 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $30,720

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (19.1% of gross = $30,720).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Aspirus Medford Hospital & Clinics, Inc's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$130,486 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($161,261) is $130,486 above the denoised Fair BaseRate ($30,775) and 6.9× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 390964813

Filing Period: 196402

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (19.1% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite73/100

Would Recommend78%

Rated 9 or 10 (HCAHPS)82%

Median ER Wait149 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (130 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Aspirus Medford Hospital & Clinics, Inc.

Price Index: 0.59× regional baseline

Quality: 71/100 CMS composite

Median Household Income$63,142U.S. Census ACS

Local Uninsured Share7.3%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 521324 EIN 390964813

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (390964813_1619079597_aspirus-medford-hospital_standardcharges.json) Verify on CMS Medicare.gov (CCN 521324) ↗ Verify IRS Form 990 (EIN 390964813) ↗ CMS HCRIS Cost Reports ↗

Published MRF File390964813_1619079597_aspirus-medford-hospital_standardcharges.json

Publication / Vintage2026-04-01 · 159.09 MB

Validated Rate Rows1,203 (CMS v3.0.0)

File Integrity DigestVerified · CCN 521324

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

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