SSM Health St Clare Hospital - Baraboo
707 14Th St, Baraboo, WI 53913 · 115 Priced Procedures · 70% Patient Recommendation
Typical commercial prices here are +61% above the fair benchmark (1.61×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.61× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
SSM Health St Clare Hospital - Baraboo prices routine shoppable procedures at 3.2× Medicare (median 1.26× Fair BaseRate) while upper-quartile commercial rates jump +92% to 2.42× 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 0.99× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 30% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 70% patient recommendation (76/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (16.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 4.0× markup over Medicare rates
- Commercial insurance median sits at 1.26× Fair BaseRate (3.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.42×) jump +92% above the median procedure ratio (Q50 1.26×)
- Consolidated metro market (HHI 3,551) 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 SSM Health St Clare Hospital - Baraboo
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 115 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $56,341 | 1.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $33,879 | 1.8× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $33,642 | 1.7× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $30,748 | 1.7× |
| Total hip replacement CPT Code: 27130 | $21,489 | 1.6× |
| Total knee replacement CPT Code: 27447 | $19,316 | 1.4× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $16,725 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $13,597 | 1.7× |
| C-section delivery (full package) CPT Code: 59510 | $13,059 | 4.4× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $8,248 | 2.4× |
| Bunion correction surgery CPT Code: 28296 | $8,248 | 2.4× |
| Inguinal hernia repair CPT Code: 49505 | $8,248 | 2.3× |
| Breast lump removal CPT Code: 19120 | $7,081 | 1.8× |
| Cataract surgery with lens implant CPT Code: 66984 | $5,680 | 2.2× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $3,367 | 3.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | $3,367 | 3.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $3,367 | 2.7× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,884 | 6.4× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,825 | unverified |
| Injection procedure for pain management HCPCS Code: G0260 | $2,783 | 3.3× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,810 | 4.9× |
| Blood transfusion CPT Code: 36430 | $1,775 | 3.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,681 | 4.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,592 | 4.7× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,372 | 5.3× |
Audit a Bill or Quote at SSM Health St Clare Hospital - Baraboo (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $22,149
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (16.4% of gross = $22,149).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask SSM Health St Clare Hospital - Baraboo'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 ($135,218) is $104,443 above the denoised Fair BaseRate ($30,775) and 5.8× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (16.4% 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)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at SSM Health St Clare Hospital - Baraboo. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-04-17·administrative_or_closure
Met Requirements
Recorded - 2023-08-16·administrative_or_closure
Closure Notice
Recorded - 2023-04-20·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (325 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 SSM Health St Clare Hospital - Baraboo.
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.