How many shoppable procedure prices are published for Door County Medical Center?

Door County Medical Center in Sturgeon Bay, WI currently has 106 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Door County Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Door County Medical Center's median negotiated commercial rate is 1.7× the regionally adjusted fair BaseRate benchmark.

What is Door County Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Door County Medical Center an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 12/15/2025

Door County Medical Center

323 South 18Th Avenue, Sturgeon Bay, WI 54235 · 106 Priced Procedures · 85% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.68×vs. Fair Market Price

Typical commercial prices here are +68% above the fair benchmark (1.68×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 57% of the Time

File Completeness100

Price Logic63

Peer Alignment71

Clean Billing72

Real Cash Discount100

High-Markup · Check Safety

5-Star CMS clinical quality rating paired with 1.68× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +78% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Door County Medical Center prices routine shoppable procedures at 2.2× Medicare (median 1.39× Fair BaseRate) while upper-quartile commercial rates jump +78% to 2.47× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#59 of 99 in WI · 58th State Percentile#2,864 of 3,385 in U.S. · 84th 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 57% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 85% patient recommendation (82/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
Commercial insurance median sits at 1.39× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.47×) jump +78% above the median procedure ratio (Q50 1.39×)
Unnegotiated chargemaster list prices average 8.8× Medicare (18¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.2× Medicare

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

Back-Door Captive & ER0.45× Divergence

1.0× Medicare

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

Quantile Tail Spread+78% Upper Tail

Q25 0.97× · Q50 1.39× · 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

2.2× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.3× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.1× MedicareGood

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

1.3× MedicareGood

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

57% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 82/100Good

Procedure Prices at Door County Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 106 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$26,813	$26,813	$8,223	3.3×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$20,896	$22,564	$19,087	1.2×
Total hip replacement CPT Code: `27130`	$10,007	$10,007	$13,413	unverified
Total knee replacement CPT Code: `27447`	$13,730	$7,211	$13,523	0.5×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$9,268	$5,920	$6,109	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,778	$2,778	$3,372	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,572	$1,571	$511	3.1×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,667	$1,486	$1,021	1.5×
Cataract surgery with lens implant CPT Code: `66984`	$3,472	$1,497	$2,540	0.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,341	$1,341	$242	5.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,244	$1,311	$448	2.9×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,320	$1,212	$981	1.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,624	$1,131	$303	3.7×
MRI, lower back (no contrast) CPT Code: `72148`	$2,543	$1,097	$338	3.2×
Upper endoscopy with biopsy CPT Code: `43239`	$2,072	$1,056	$987	1.1×
Colonoscopy with biopsy CPT Code: `45380`	$2,234	$1,068	$1,256	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$2,331	$1,005	$343	2.9×
MRI, knee or other leg joint CPT Code: `73721`	$2,375	$1,029	$369	2.8×
Trauma team activation HCPCS Code: `G0390`	$2,273	$988	$1,453	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,875	$809	$583	1.4×
CT scan, pelvis CPT Code: `72192`	$1,577	$683	$163	4.2×
CT scan, chest (no contrast) CPT Code: `71250`	$1,532	$689	$167	4.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,514	$686	$258	2.7×
CT scan, sinuses CPT Code: `70486`	$1,283	$556	$166	3.3×
Injection procedure for pain management HCPCS Code: `G0260`	$1,318	$576	$855	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,230	$535	$168	3.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,175	$506	$169	3.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,118	$484	$272	1.8×
Blood transfusion CPT Code: `36430`	$1,016	$495	$498	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$1,031	$446	$160	2.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$471	$417	$181	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$863	$373	$134	2.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$332	$335	$185	1.8×
Ultrasound, pelvis CPT Code: `76856`	$706	$304	$130	2.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$642	$281	$126	2.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$681	$294	$132	2.2×
Group therapy session CPT Code: `90853`	$586	$253	$100	2.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$411	$266	$166	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$227	$272	$110	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$527	$224	$86	2.6×
Rabies immune globulin HCPCS Code: `90375`	$1,241	$238	$322	0.7×
X-ray, lower back CPT Code: `72110`	$416	$181	$112	1.6×
Physical therapy (functional capacity test) CPT Code: `97750`	$125	$125	$38	3.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	$235	$129	$123	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$202	$120	$201	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$330	$92	$25	3.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$183	$105	$64	1.6×
X-ray, chest (two views) CPT Code: `71046`	$295	$127	$93	1.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$290	$125	$93	1.3×
X-ray, hip CPT Code: `73502`	$287	$124	$93	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$196	$116	$87	1.3×
X-ray, shoulder CPT Code: `73030`	$276	$119	$92	1.3×
X-ray, chest (single view) CPT Code: `71045`	$260	$112	$92	1.2×
X-ray, foot CPT Code: `73630`	$260	$112	$92	1.2×
X-ray, hand CPT Code: `73130`	$263	$113	$93	1.2×
X-ray, ankle CPT Code: `73610`	$259	$112	$93	1.2×
X-ray, pelvis CPT Code: `72170`	$282	$127	$110	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$270	$117	$148	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$194	$86	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$626	$251	$347	0.7×
Blood test, vitamin D CPT Code: `82306`	$161	$161	$31	5.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$155	$155	$11	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$168	$168	$14	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$115	$115	$9	12.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$128	$128	$14	9.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$128	$128	$19	6.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$129	$129	$111	1.2×
Culture, blood CPT Code: `87040`	$147	$147	$11	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$102	$102	$8	12.8×
Hepatitis C antibody test CPT Code: `86803`	$125	$125	$15	8.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$121	$121	$18	6.7×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$128	$128	$20	6.4×
Blood test, lipase CPT Code: `83690`	$119	$119	$7	unverified
Blood test, amylase CPT Code: `82150`	$86	$86	$7	12.3×
Blood test, magnesium CPT Code: `83735`	$83	$83	$7	11.9×
Blood test, liver function panel CPT Code: `80076`	$98	$98	$9	10.9×
Culture, bacterial CPT Code: `87070`	$92	$92	$9	10.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$97	$97	$10	9.7×
Blood test, vitamin B12 CPT Code: `82607`	$113	$113	$16	7.1×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$55	$55	$4	13.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$50	$50	$4	12.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$75	$75	$6	12.5×
Blood test, sodium CPT Code: `84295`	$59	$59	$5	11.8×
Blood test, potassium CPT Code: `84132`	$58	$58	$5	11.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$38	$38	$5	7.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$90	$44	$14	3.1×
Physical therapy (gait training) CPT Code: `97116`	$125	$54	$33	1.6×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$128	$55	$35	1.6×
Occupational therapy (self-care training) CPT Code: `97535`	$134	$58	$38	1.5×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$77	$59	$40	1.5×
Physical therapy (manual therapy) CPT Code: `97140`	$115	$50	$34	1.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$126	$54	$38	1.4×
Hepatitis B vaccine HCPCS Code: `90744`	$46	$46	$37	1.2×
Orthotic fitting and training CPT Code: `97760`	$130	$56	$51	1.1×
Blood antibody screen CPT Code: `86850`	$174	$46	$46	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$62	$62	$3	unverified
Blood test, calcium CPT Code: `82310`	$65	$65	$5	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$71	$71	$5	unverified
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$79	$38	$56	0.7×
Hospital observation (per hour) HCPCS Code: `G0378`	$159	$56	$86	0.7×
Drug screening test HCPCS Code: `G0480`	$182	$74	$116	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	$65	$31	$49	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$65	$30	$48	0.6×
Colorectal cancer screening HCPCS Code: `G0010`	$65	$30	$49	0.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$31	$13	$35	0.4×
Blood test, hemoglobin CPT Code: `85018`	$25	$25	$3	unverified

Showing top 25 high-impact procedures of 106 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.7%

Audit a Bill or Quote at Door County Medical Center (Zero PHI Required)

CMS CCN: 521358

CPT 392

Select Procedure to Audit:

Fair BaseRate™ $8,223

Medicare Rate $5,676

Self-Pay Cash $26,813

Insurer Median $26,813

1. Amount on Your Bill or Quote ($) Pre-filled with Door County Medical Center’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: $13,121 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $13,121

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.7% of gross = $13,121).

Step 2 · Cash vs. Insurance Arbitrage Save $8,938 Paying Cash

Self-Pay Cash Rate ($26,813) Beats Your Bill

Door County Medical Center's published 45 CFR § 180 self-pay cash rate is $26,813 (vs. $26,813 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$27,528 Above Fair BaseRate

Negotiate Toward $8,223 Fair BaseRate ($5,676 Medicare)

Your bill ($35,751) is $27,528 above the denoised Fair BaseRate ($8,223) and 6.3× the $5,676 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: 390806324

Filing Period: 194410

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 (36.7% 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 Composite82/100

Would Recommend85%

Rated 9 or 10 (HCAHPS)89%

Median ER Wait140 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 (190 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 Door County Medical Center.

Price Index: 1.48× regional baseline

Quality: 84/100 CMS composite

Median Household Income$71,785U.S. Census ACS

Local Uninsured Share3.8%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 80/100 · Corroborated CMS CCN 521358 EIN 390806324

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 521358) ↗ Verify IRS Form 990 (EIN 390806324) ↗ CMS HCRIS Cost Reports ↗

Published MRF File390806324_Door-County-Memorial-Hospital_standardcharges.csv

Publication / Vintage12/15/2025 · 49.77 MB

Validated Rate Rows1,484 (CMS v3.0.0)

File Integrity Digestac9a05291cb9398b293a…

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