North Central Health Care
1150 Lakeview Dr, Wausau, WI 54403 · 23 Priced Procedures
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
North Central Health Care prices shoppable and inpatient services (4.4× to 3.3× Medicare, divergence 0.75×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 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 (24.8% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.6× markup over Medicare rates
- Commercial insurance median sits at 1.00× Fair BaseRate (4.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
- Consolidated metro market (HHI 5,418) 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 North Central Health Care
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 23 published procedures.
Audit a Bill or Quote at North Central Health Care (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $142
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (24.8% of gross = $142).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
North Central Health Care's published 45 CFR § 180 self-pay cash rate is $571 (vs. $571 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $231 Fair BaseRate ($221 Medicare)
Your bill ($571) is $340 above the denoised Fair BaseRate ($231) and 2.6× the $221 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (24.8% 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.
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 North Central Health Care.
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.