How many shoppable procedure prices are published for Aurora Psychiatric Hospital?

Aurora Psychiatric Hospital in Wauwatosa, WI currently has 66 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Aurora Psychiatric Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Aurora Psychiatric Hospital's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Psychiatric Hospital Voluntary non-profit - Private 89 Beds · urban Updated: 2025-11-21

Aurora Psychiatric Hospital

1220 Dewey Ave, Wauwatosa, WI 53213 · 66 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

1.80×vs. Fair Market Price

Typical commercial prices here are +80% above the fair benchmark (1.80×) even after accounting for local nurse/doctor wages and patient complexity.

67/100 · Caution

67/100Self-Pay Cash Beats Insurance 57% of the Time

File Completeness66

Price Logic54

Peer Alignment67

Clean Billing56

Real Cash Discount100

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Aurora Psychiatric Hospital maintains elevated commercial insurance contracts (1.80× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 57% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#64 of 99 in WI · 63rd State Percentile#2,962 of 3,385 in U.S. · 87th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.22× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 57% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (60.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.1× markup over Medicare rates
Commercial insurance median sits at 2.16× Fair BaseRate (2.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (1.80× 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.
Unnegotiated chargemaster list prices average 14.5× Medicare (22¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.5× Medicare

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

Back-Door Captive & ER0.96× Divergence

2.4× Medicare

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

Quantile Tail Spread+14% Upper Tail

Q25 1.22× · Q50 2.16× · Q75 2.47×

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

2.5× MedicareFair

Outpatient Surgery & ORBack-Door Captive

3.1× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.7× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

3.6× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

3.8× MedicareElevated

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

0.5× MedicareGood

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

57% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Aurora Psychiatric Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 66 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`	—	$61,936	$30,775	2.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$39,379	$19,087	2.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$36,311	$17,936	2.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$33,609	$19,432	1.7×
Total hip replacement CPT Code: `27130`	—	$17,955	$13,413	1.3×
Total knee replacement CPT Code: `27447`	—	$17,955	$13,523	1.3×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$15,661	$8,223	1.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$13,050	$6,109	2.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$10,544	$2,680	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$9,882	$3,372	unverified
Inguinal hernia repair CPT Code: `49505`	—	$9,882	$3,629	unverified
Bunion correction surgery CPT Code: `28296`	—	$9,834	$3,446	unverified
Breast lump removal CPT Code: `19120`	—	$8,450	$3,875	2.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$3,350	$2,540	1.3×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,976	$1,256	2.4×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,976	$987	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,976	$981	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	—	$2,581	$1,021	unverified
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,115	$855	2.5×
Blood transfusion CPT Code: `36430`	—	$1,789	$498	3.6×
Rabies immune globulin HCPCS Code: `90375`	—	$358	$322	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$228	$228	$181	1.3×
Psychiatric evaluation (first visit) CPT Code: `90791`	$253	$253	$185	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$225	$254	$64	unverified
Family therapy session CPT Code: `90847`	$225	$225	$173	1.3×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$185	$151	1.2×
Group therapy session CPT Code: `90853`	$150	$150	$100	1.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$168	$168	$166	1.0×
Behavioral health day program HCPCS Code: `H2012`	$133	$133	$100	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$88	$88	$40	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$415	$347	1.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$203	$203	1.0×
Blood test, liver function panel CPT Code: `80076`	$140	$140	$9	15.6×
Blood test, vitamin D CPT Code: `82306`	$150	$150	$31	4.8×
Pneumococcal vaccine HCPCS Code: `90732`	—	$168	$140	1.2×
Blood test, lipase CPT Code: `83690`	$105	$105	$7	15.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$109	$109	$14	7.8×
Hepatitis C antibody test CPT Code: `86803`	$98	$98	$15	6.5×
Blood test, ferritin (iron stores) CPT Code: `82728`	$90	$90	$14	6.4×
Blood test, vitamin B12 CPT Code: `82607`	$100	$100	$16	6.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$70	$70	$8	8.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$90	$90	$19	4.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$106	$111	1.0×
Blood test, calcium CPT Code: `82310`	$50	$50	$5	10.0×
Blood test, amylase CPT Code: `82150`	$68	$68	$7	9.7×
Blood test, magnesium CPT Code: `83735`	$65	$65	$7	9.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$38	$38	$5	7.6×
Blood test, potassium CPT Code: `84132`	$35	$35	$5	7.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$35	$35	$5	7.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$55	$55	$10	5.5×
Hepatitis B vaccine HCPCS Code: `90744`	—	$39	$37	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$51	$56	0.9×
Blood test, sodium CPT Code: `84295`	$23	$23	$5	4.6×
Culture, bacterial CPT Code: `87070`	$80	$22	$9	2.4×
Culture, blood CPT Code: `87040`	$80	$26	$11	2.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$105	$42	$18	2.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$50	$8	$3	2.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$28	$10	$4	2.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$28	$10	$4	2.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$50	$15	$6	2.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$158	$26	$11	2.4×
Blood test, basic metabolic panel CPT Code: `80048`	$118	$21	$9	2.3×
Blood test, hemoglobin CPT Code: `85018`	$18	$6	$3	2.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$15	$28	$25	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$33	$39	0.8×
Blood antibody screen CPT Code: `86850`	$83	$22	$46	0.5×

Showing top 25 high-impact procedures of 66 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 60.0%

Audit a Bill or Quote at Aurora Psychiatric Hospital (Zero PHI Required)

CMS CCN: 524000

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $61,936

1. Amount on Your Bill or Quote ($) Pre-filled with Aurora Psychiatric 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 501(r) AGB Cap: $89,188 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $89,188

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.0% of gross = $89,188).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Aurora Psychiatric 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 +$117,871 Above Fair BaseRate

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

Your bill ($148,646) is $117,871 above the denoised Fair BaseRate ($30,775) and 6.3× 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 (60.0% 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 ↑

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

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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Aurora Psychiatric Hospital.

Price Index: 0.94× regional baseline

Quality: 54/100 CMS composite

Median Household Income$62,118U.S. Census ACS

Local Uninsured Share7.1%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 67/100 · Caution CMS CCN 524000

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 524000) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-11-21

Validated Rate Rows1,309 (CMS v3.0.0)

File Integrity DigestVerified · CCN 524000

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