Aurora Memorial Hospital Burlington
252 McHenry St, Burlington, WI 53105 · 108 Priced Procedures · 64% Patient Recommendation
Typical commercial prices here are +161% above the fair benchmark (2.61×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 2.61× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Aurora Memorial Hospital Burlington prices routine shoppable procedures at 3.5× Medicare (median 2.49× Fair BaseRate) while upper-quartile commercial rates jump +31% to 3.25× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.79× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 53% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 64% patient recommendation (70/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (53.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 4.4× markup over Medicare rates
- Commercial insurance median sits at 2.49× 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 +31% above the median procedure ratio (Q50 2.49×)
- Consolidated metro market (HHI 6,648) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Aurora Memorial Hospital Burlington
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 108 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $58,116 | 1.9× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $36,950 | 1.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $34,071 | 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 | $14,695 | 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 | 2.7× |
| 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× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,976 | 3.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,976 | 2.4× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,581 | 2.5× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,217 | 3.8× |
| Injection procedure for pain management HCPCS Code: G0260 | $2,115 | 2.5× |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,114 | 3.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,114 | 3.2× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,114 | 3.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,114 | 2.2× |
Audit a Bill or Quote at Aurora Memorial Hospital Burlington (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $74,328
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (53.3% of gross = $74,328).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Aurora Memorial Hospital Burlington's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($139,478) is $108,703 above the denoised Fair BaseRate ($30,775) and 5.9× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (53.3% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (561 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Aurora Memorial Hospital Burlington.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.