How many shoppable procedure prices are published for Aspirus Wausau Hospital?

Aspirus Wausau Hospital in Wausau, WI currently has 130 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Aspirus Wausau Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Aspirus Wausau Hospital's median negotiated commercial rate is 2.1× the regionally adjusted fair BaseRate benchmark.

What is Aspirus Wausau Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Aspirus Wausau Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 239 Beds · rural Updated: 2026-04-01

Aspirus Wausau Hospital

333 Pine Ridge Blvd, Wausau, WI 54401 · 130 Priced Procedures · 73% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

2.11×vs. Fair Market Price

Typical commercial prices here are +111% above the fair benchmark (2.11×) even after accounting for local nurse/doctor wages and patient complexity.

72/100 · Corroborated

72/100Self-Pay Cash Beats Insurance 36% of the Time

File Completeness45

Price Logic68

Peer Alignment75

Clean Billing83

Real Cash Discount100

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 2.11× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Aspirus Wausau Hospital prices routine shoppable procedures near 2.2× Medicare (p50 1.62×) while skewing captive emergency, lab, and upper-quartile codes to 3.1× Medicare (p75 3.40×, +110% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#79 of 99 in WI · 78th State Percentile#3,143 of 3,385 in U.S. · 92nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 36% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 73% patient recommendation (74/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (2.11× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (0.6×) & laboratory (0.6×) services average 1.41× higher multiples than routine shoppable care (2.2×)
Upper-quartile procedures (Q75 3.40×) jump +110% above the median procedure ratio (Q50 1.62×)
Consolidated metro market (HHI 5,418) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.2× Medicare

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

Back-Door Captive & ER1.41× Divergence

3.1× Medicare

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

Quantile Tail Spread+110% Upper Tail

Q25 0.97× · Q50 1.62× · Q75 3.40×

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

2.2× MedicareFair

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.6× MedicareGood

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

0.5× MedicareGood

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

36% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 74/100Fair

Procedure Prices at Aspirus Wausau Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 130 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`	—	$56,361	$30,775	1.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$218	$33,654	$19,432	1.7×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$17,805	$19,087	0.9×
Total hip replacement CPT Code: `27130`	$6,673	$12,720	$13,413	unverified
Bunion correction surgery CPT Code: `28296`	$3,747	$12,277	$3,446	3.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$10,937	$8,223	1.3×
Total knee replacement CPT Code: `27447`	$6,839	$6,839	$13,523	0.5×
Breast lump removal CPT Code: `19120`	$2,153	$6,261	$3,875	1.6×
Trauma team activation HCPCS Code: `G0390`	$2,072	$6,233	$1,453	unverified
Vaginal delivery (full package) CPT Code: `59400`	$4,891	$5,306	$2,680	2.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$4,053	$4,989	$6,109	0.8×
C-section delivery (full package) CPT Code: `59510`	$5,793	$4,914	$2,975	1.7×
Injection procedure for pain management HCPCS Code: `G0260`	$345	$4,155	$855	unverified
Inguinal hernia repair CPT Code: `49505`	$4,059	$3,582	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,852	$3,337	$3,372	unverified
Psychological testing by technician CPT Code: `96138`	$87	$1,473	$395	3.7×
Blood transfusion CPT Code: `36430`	$584	$1,473	$498	3.0×
Neurobehavioral status check CPT Code: `96116`	$357	$1,473	$231	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$4,597	$1,305	$511	2.6×
MRI, lower back (no contrast) CPT Code: `72148`	$2,948	$857	$338	2.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,409	$851	$1,021	0.8×
MRI, knee or other leg joint CPT Code: `73721`	$2,654	$757	$369	2.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,839	$709	$258	2.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,806	$682	$981	0.7×
Colonoscopy with biopsy CPT Code: `45380`	$2,157	$701	$1,256	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,512	$637	$303	2.1×
Cataract surgery with lens implant CPT Code: `66984`	$4,623	$647	$2,540	unverified
CT scan, head (with contrast) CPT Code: `70460`	$1,543	$594	$242	2.5×
MRI, brain (no contrast) CPT Code: `70551`	$2,963	$618	$343	1.8×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,208	$628	$448	1.4×
CT scan, pelvis CPT Code: `72192`	$1,277	$512	$163	3.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$473	$471	$134	3.5×
CT scan, chest (no contrast) CPT Code: `71250`	$1,435	$469	$167	2.8×
Upper endoscopy with biopsy CPT Code: `43239`	$1,582	$467	$987	0.5×
CT scan, sinuses CPT Code: `70486`	$1,392	$438	$166	2.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,856	$433	$168	2.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,305	$441	$583	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,566	$396	$169	2.3×
Rabies immune globulin HCPCS Code: `90375`	$877	$344	$322	1.1×
Behavioral health day treatment HCPCS Code: `H0010`	$309	$309	$343	0.9×
Ultrasound, pelvis CPT Code: `76856`	$322	$275	$130	2.1×
Care planning with family CPT Code: `90887`	$239	$239	$107	2.2×
X-ray, lower back CPT Code: `72110`	$179	$237	$112	2.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$353	$259	$132	2.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$544	$247	$148	1.7×
CT scan, head (no contrast) CPT Code: `70450`	$1,288	$244	$160	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$278	$236	$185	1.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$591	$240	$272	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$117	$167	$93	1.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$224	$188	$123	1.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$398	$186	$126	1.5×
Screening mammogram (both breasts) CPT Code: `77067`	$234	$153	$123	1.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$365	$175	$151	1.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$244	$176	$166	1.1×
Family therapy session CPT Code: `90847`	$306	$181	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$366	$187	$181	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$158	$125	$87	1.4×
New patient office visit (30-44 min) CPT Code: `99203`	$205	$143	$110	1.3×
X-ray, pelvis CPT Code: `72170`	$127	$117	$110	1.1×
Group therapy session CPT Code: `90853`	$58	$104	$100	1.0×
X-ray, chest (two views) CPT Code: `71046`	$157	$89	$93	1.0×
X-ray, hand CPT Code: `73130`	$146	$89	$93	1.0×
X-ray, hip CPT Code: `73502`	$138	$87	$93	0.9×
X-ray, ankle CPT Code: `73610`	$94	$87	$93	0.9×
X-ray, chest (single view) CPT Code: `71045`	$122	$86	$92	0.9×
X-ray, shoulder CPT Code: `73030`	$150	$86	$92	0.9×
Behavioral health assessment HCPCS Code: `H0001`	$111	$111	$157	0.7×
Psychological testing evaluation CPT Code: `96136`	$115	$132	$128	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	$104	$88	$35	2.5×
X-ray, foot CPT Code: `73630`	$91	$85	$92	0.9×
Mental health services (assessment) HCPCS Code: `H0031`	$116	$107	$140	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$67	$96	$201	0.5×
Colorectal cancer screening HCPCS Code: `G0010`	$48	$1,473	$49	30.1×
Typhoid vaccine HCPCS Code: `90675`	$588	$394	$347	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$27	$218	$49	4.4×
Pneumococcal vaccine HCPCS Code: `90732`	$182	$180	$140	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$164	$187	$203	0.9×
Drug screening test HCPCS Code: `G0480`	$235	$180	$116	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$274	$132	$111	1.2×
Speech therapy (language evaluation) CPT Code: `92507`	$254	$78	$86	0.9×
Culture, blood CPT Code: `87040`	$87	$46	$11	4.2×
Blood antibody screen CPT Code: `86850`	$94	$51	$46	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$141	$52	$56	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$131	$59	$64	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$66	$66	$86	0.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$118	$72	$19	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$114	$42	$11	3.8×
Blood test, vitamin D CPT Code: `82306`	$178	$62	$31	2.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$112	$67	$18	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$13	$3	4.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$65	$24	$6	4.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$80	$31	$8	3.9×
Blood test, basic metabolic panel CPT Code: `80048`	$92	$34	$9	3.8×
Blood test, liver function panel CPT Code: `80076`	$102	$33	$9	3.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$97	$40	$35	1.1×
Flu vaccine injection HCPCS Code: `G0008`	$27	$47	$48	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$94	$38	$39	1.0×
Orthotic fitting and training CPT Code: `97760`	$109	$47	$51	0.9×
Prosthetic fitting and training CPT Code: `97761`	$92	$41	$45	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$107	$54	$14	unverified
Blood test, calcium CPT Code: `82310`	$53	$14	$5	2.8×
Blood test, amylase CPT Code: `82150`	$62	$17	$7	2.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$49	$11	$5	2.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$90	$29	$14	2.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$75	$13	$14	0.9×
Physical therapy (gait training) CPT Code: `97116`	$98	$30	$33	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$139	$34	$38	0.9×
Speech therapy (group session) CPT Code: `92508`	$68	$24	$27	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$85	$35	$40	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$98	$33	$38	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$97	$33	$38	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$115	$55	$20	unverified
Extended office visit (prolonged) HCPCS Code: `G2212`	$96	$29	$33	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$97	$28	$34	0.8×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$126	$52	$27	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$154	$20	$25	0.8×
Hepatitis C antibody test CPT Code: `86803`	$116	$43	$15	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$16	$5	3.2×
Blood test, hemoglobin CPT Code: `85018`	$36	$9	$3	3.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$55	$29	$25	1.2×
Hepatitis B vaccine HCPCS Code: `90744`	$100	$41	$37	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$111	$28	$16	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$44	$16	$4	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$69	$38	$10	unverified
Blood test, sodium CPT Code: `84295`	$42	$10	$5	2.0×
Blood test, lipase CPT Code: `83690`	$68	$25	$7	unverified
Blood test, magnesium CPT Code: `83735`	$53	$27	$7	unverified
Blood test, potassium CPT Code: `84132`	$44	$19	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$47	$12	$4	unverified
Culture, bacterial CPT Code: `87070`	$77	$22	$9	unverified

Showing top 25 high-impact procedures of 130 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Aspirus Wausau Hospital (Zero PHI Required)

CMS CCN: 520030

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $56,361

1. Amount on Your Bill or Quote ($) Pre-filled with Aspirus Wausau Hospital’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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Aspirus Wausau Hospital'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 +$104,491 Above Fair BaseRate

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

Your bill ($135,266) is $104,491 above the denoised Fair BaseRate ($30,775) and 5.8× 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) For-Profit / Non-501(c)(3)

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

EIN: 391138241

Filing Period: 197107

Public IRS & CMS ownership records classify Aspirus Wausau Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Composite74/100

Would Recommend73%

Rated 9 or 10 (HCAHPS)71%

Median ER Wait156 min

Left ER Before Seen4%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.9%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Aspirus Wausau Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-02-02·administrative_or_closure
Met Requirements
Recorded
2022-02-08·administrative_or_closure
Closure Notice
Recorded
2021-10-27·cap_corrective_action
CAP Request
Recorded
2021-05-18·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,115 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 Wausau Hospital.

Price Index: 1.00× regional baseline

Quality: 73/100 CMS composite

Median Household Income$76,185U.S. Census ACS

Local Uninsured Share6.0%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 72/100 · Corroborated CMS CCN 520030 EIN 391138241

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 520030) ↗ Verify IRS Form 990 (EIN 391138241) ↗ CMS HCRIS Cost Reports ↗

Published MRF File391138241_1558363986_aspirus-wausau-hospital_standardcharges.json

Publication / Vintage2026-04-01 · 201.93 MB

Validated Rate Rows2,906 (CMS v3.0.0)

File Integrity DigestVerified · CCN 520030

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.

Submit MRF Update Correction Policy

Aspirus Wausau Hospital

Loss-Leader / Captive Ancillary Cross-Subsidizer

Where They're Good (Patient & Payer Edge)

Where You Can Get Burned (Markup Traps)

REA Pricing Decompiler · 5-Layer Cost-to-Charge Reverse Engineering

Insurer Bargaining Power & Cash-Vulnerability Matrix

Procedure Prices at Aspirus Wausau Hospital

Audit a Bill or Quote at Aspirus Wausau Hospital (Zero PHI Required)

Above Standard 400% FPL Financial-Assistance Ceiling

Compare Prompt-Pay Cash Rate Against Remaining Deductible

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

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

Clinical Quality, Patient Experience & Infection Benchmarks

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

CMS Price Transparency Administrative Enforcement Log

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

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