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Hospital Profile Acute Care Hospital Voluntary non-profit - Private 63 Beds · rural Updated: 2025-11-21

Aurora Medical Ctr Manitowoc County

5000 Memorial Drive, Two Rivers, WI 54241 · 107 Priced Procedures · 74% Patient Recommendation

CMS Overall Rating 5 / 5 Stars
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.High Markup · Shop Alternatives
2.62×vs. Fair Market Price
Position vs. 1.00× Fair Price+162% Above 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 +162% above the fair benchmark (2.62×) even 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).73/100 · Corroborated
73/100Self-Pay Cash Beats Insurance 53% of the Time
File Completeness66Provenance (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 Logic62Coherence (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 Alignment72Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing73Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash 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 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.High-Markup · Check Safety
CMS Star Rating5/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score80/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait113 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

5-Star CMS clinical quality rating paired with 2.62× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +29% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Aurora Medical Ctr Manitowoc County prices routine shoppable procedures at 3.5× Medicare (median 2.51× Fair BaseRate) while upper-quartile commercial rates jump +29% to 3.25× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#94 of 99 in WI · 93rd State Percentile#3,284 of 3,385 in U.S. · 96th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 1.76× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 53% of shoppable procedures (99/100 Cash Honesty)
  • 5-Star CMS clinical rating with 74% patient recommendation (80/100 safety score)
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (49.7% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 4.4× markup over Medicare rates
  • Commercial insurance median sits at 2.51× Fair BaseRate (3.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 3.25×) jump +29% above the median procedure ratio (Q50 2.51×)
  • Consolidated metro market (HHI 5,003) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
3.5× Medicare

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

Back-Door Captive & ER0.69× Divergence
2.4× Medicare

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

Quantile Tail Spread+29% Upper Tail
Q25 1.76× · Q50 2.51× · Q75 3.25×

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
3.5× MedicareElevated
Outpatient Surgery & ORBack-Door Captive
4.4× MedicareWatchout
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
4.6× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
1.7× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
5.0× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.6× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
53% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
5 CMS · 80/100Good

Procedure Prices at Aurora Medical Ctr Manitowoc County

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 107 published procedures.

Sort:
Procedure & Billing Code This Hospital vs. Fair
Spinal fusion, single level (inpatient stay)
MS-DRG Code: 451
$57,091 1.9×
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
$36,299 1.9×
Heart stent placement (inpatient stay)
MS-DRG Code: 322
$33,470 1.9×
Hip or knee replacement (inpatient stay)
MS-DRG Code: 470
$31,488 1.6×
Total knee replacement
CPT Code: 27447
$18,875 1.4×
Total hip replacement
CPT Code: 27130
$18,759 1.4×
Digestive disorders treatment (inpatient stay)
MS-DRG Code: 392
$14,436 1.8×
Gallbladder removal (laparoscopic)
CPT Code: 47562
$13,752 2.3×
Vaginal delivery (full package)
CPT Code: 59400
$10,544 3.9×
Knee arthroscopy with meniscus repair
CPT Code: 29881
$9,953 3.0×
Inguinal hernia repair
CPT Code: 49505
$9,953 unverified
Bunion correction surgery
CPT Code: 28296
$9,882 2.9×
Breast lump removal
CPT Code: 19120
$8,450 2.2×
Cataract surgery with lens implant
CPT Code: 66984
$3,350 1.3×
Trauma team activation
HCPCS Code: G0390
$3,185 2.2×
Colonoscopy (diagnostic)
CPT Code: 45378
$2,976 3.0×
Colonoscopy with biopsy
CPT Code: 45380
$2,976 2.4×
Upper endoscopy with biopsy
CPT Code: 43239
$2,976 unverified
Sleep study (overnight, in lab)
CPT Code: 95810
$2,570 2.5×
Echocardiogram (heart ultrasound)
CPT Code: 93306
$2,217 unverified
Injection procedure for pain management
HCPCS Code: G0260
$2,115 2.5×
MRI, brain (no contrast)
CPT Code: 70551
$1,114 3.2×
MRI, brain (with and without contrast)
CPT Code: 70553
$1,114 2.2×
MRI, lower back (no contrast)
CPT Code: 72148
$1,114 unverified
MRI, knee or other leg joint
CPT Code: 73721
$1,114 unverified
Showing top 25 high-impact procedures of 107 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 49.7%

Audit a Bill or Quote at Aurora Medical Ctr Manitowoc County (Zero PHI Required)

CMS CCN: 520034
CPT 451
Fair BaseRate™ $30,775
Medicare Rate $23,504
Self-Pay Cash Request Quote
Insurer Median $57,091
Pre-filled with Aurora Medical Ctr Manitowoc County’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $68,084 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $68,084

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (49.7% of gross = $68,084).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Aurora Medical Ctr Manitowoc County'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 +$106,243 Above Fair BaseRate

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

Your bill ($137,018) is $106,243 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) 501(c)(3) Nonprofit Hospital

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

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 (49.7% 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 Overall5/5 Stars (5/5)
Safety Composite80/100
Would Recommend74%
Rated 9 or 10 (HCAHPS)80%
Median ER Wait113 min
Left ER Before Seen1%
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 (482 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

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Aurora Medical Ctr Manitowoc County.

Price Index: 1.13× regional baseline
Quality: 81/100 CMS composite
Median Household Income$68,611U.S. Census ACS
Local Uninsured Share4.4%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 73/100 · Corroborated CMS CCN 520034

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

Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2025-11-21
Validated Rate Rows2,727 (CMS v3.0.0)
File Integrity DigestVerified · CCN 520034

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.