Spooner Health System
1280 Chandler Dr, Spooner, WI 54801 · 81 Priced Procedures · 85% Patient Recommendation
Typical commercial prices here are +29% above the fair benchmark (1.29×) even after accounting for local nurse/doctor wages and patient complexity.
5-Star CMS clinical quality rating paired with 1.29× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Spooner Health System prices routine shoppable procedures near 0.7× Medicare (p50 1.91×) while skewing captive emergency, lab, and upper-quartile codes to 4.4× Medicare (p75 0.79×, +-59% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.79× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 21% of shoppable procedures (44/100 Cash Honesty)
- 5-Star CMS clinical rating with 85% patient recommendation (73/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (67.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.29× 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.
- Captive ER (0.8×) & laboratory (0.7×) services average 6.29× higher multiples than routine shoppable care (0.7×)
- Even at low-cost facilities (1.29× 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 14.2× Medicare (24¢ true HCRIS cost per $1 gross)
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 Spooner Health System
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 81 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $24,873 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,538 | 10.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,781 | 10.7× |
| Trauma team activation HCPCS Code: G0390 | $4,449 | 3.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $4,059 | 13.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $4,073 | 11.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $3,871 | 11.5× |
| MRI, knee or other leg joint CPT Code: 73721 | $3,260 | 8.8× |
| Upper endoscopy with biopsy CPT Code: 43239 | $3,161 | 3.2× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,970 | 11.5× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,893 | 2.3× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,491 | 2.5× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,459 | 14.6× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,269 | 13.4× |
| CT scan, pelvis CPT Code: 72192 | $2,138 | 13.1× |
| CT scan, head (no contrast) CPT Code: 70450 | $2,053 | 12.8× |
| CT scan, sinuses CPT Code: 70486 | $2,053 | 12.4× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $1,710 | 12.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,654 | 2.8× |
| Ultrasound, pelvis CPT Code: 76856 | $1,282 | 9.9× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $1,049 | 7.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $997 | 3.7× |
| Blood transfusion CPT Code: 36430 | $953 | 1.9× |
| X-ray, lower back CPT Code: 72110 | $802 | 7.2× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $750 | 6.0× |
Audit a Bill or Quote at Spooner Health System (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $32,204
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (67.9% of gross = $32,204).
Self-Pay Cash Rate ($42,710) Beats Your Bill
Spooner Health System's published 45 CFR § 180 self-pay cash rate is $42,710 (vs. $24,873 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $8,223 Fair BaseRate ($5,676 Medicare)
Your bill ($47,456) is $39,233 above the denoised Fair BaseRate ($8,223) and 8.4× the $5,676 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (67.9% 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
Source: CMS Hospital Care Compare (91 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 Spooner Health System.
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.