How many shoppable procedure prices are published for West Allis Memorial Hospital?

West Allis Memorial Hospital in West Allis, WI currently has 111 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do West Allis Memorial Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, West Allis Memorial Hospital's median negotiated commercial rate is 2.3× the regionally adjusted fair BaseRate benchmark.

What is West Allis Memorial Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns West Allis Memorial Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 202 Beds · urban Updated: 2025-11-21

West Allis Memorial Hospital

8901 W Lincoln Ave, West Allis, WI 53227 · 111 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

2.29×vs. Fair Market Price

Typical commercial prices here are +129% above the fair benchmark (2.29×) even after accounting for local nurse/doctor wages and patient complexity.

72/100 · Corroborated

72/100Self-Pay Cash Beats Insurance 52% of the Time

File Completeness66

Price Logic60

Peer Alignment72

Clean Billing72

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 2.29× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +34% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

West Allis Memorial Hospital prices routine shoppable procedures at 3.5× Medicare (median 2.49× Fair BaseRate) while upper-quartile commercial rates jump +34% to 3.33× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#87 of 99 in WI · 86th State Percentile#3,202 of 3,385 in U.S. · 94th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.85× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 52% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 69% patient recommendation (66/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (50.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 4.4× markup over Medicare rates
Commercial insurance median sits at 2.49× Fair BaseRate (3.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 3.33×) jump +34% above the median procedure ratio (Q50 2.49×)
Unnegotiated chargemaster list prices average 12.7× Medicare (19¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

3.5× Medicare

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

Back-Door Captive & ER0.69× Divergence

2.4× Medicare

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

Quantile Tail Spread+34% Upper Tail

Q25 1.85× · Q50 2.49× · Q75 3.33×

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

3.5× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

4.4× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.5× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

5.6× MedicareWatchout

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

2.1× MedicareGood

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

52% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 66/100Fair

Procedure Prices at West Allis Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 111 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`	—	$62,073	$30,775	2.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$39,467	$19,087	2.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$36,391	$17,936	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$33,781	$19,432	1.7×
Total hip replacement CPT Code: `27130`	—	$19,631	$13,413	1.5×
Total knee replacement CPT Code: `27447`	—	$19,631	$13,523	1.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$15,695	$8,223	1.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$13,851	$6,109	2.3×
Vaginal delivery (full package) CPT Code: `59400`	—	$10,865	$2,680	4.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$9,953	$3,372	3.0×
Inguinal hernia repair CPT Code: `49505`	—	$9,953	$3,629	2.7×
Bunion correction surgery CPT Code: `28296`	—	$9,882	$3,446	2.9×
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×
Trauma team activation HCPCS Code: `G0390`	$3,185	$3,185	$1,453	unverified
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,976	$987	3.0×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,976	$1,256	2.4×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,976	$981	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	—	$2,581	$1,021	2.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,928	$2,256	$583	unverified
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,115	$855	2.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,265	$1,142	$511	2.2×
MRI, brain (no contrast) CPT Code: `70551`	$2,110	$1,142	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$2,110	$1,142	$338	unverified
MRI, knee or other leg joint CPT Code: `73721`	$3,165	$1,142	$369	unverified
CT scan, head (no contrast) CPT Code: `70450`	$1,470	$828	$160	5.2×
CT scan, sinuses CPT Code: `70486`	$1,470	$828	$166	5.0×
CT scan, chest (no contrast) CPT Code: `71250`	$1,470	$828	$167	5.0×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,470	$828	$168	4.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,470	$828	$169	4.9×
CT scan, head (with contrast) CPT Code: `70460`	$1,570	$828	$242	3.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,305	$828	$258	3.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,940	$828	$303	2.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,140	$828	$448	1.8×
CT scan, pelvis CPT Code: `72192`	$1,470	$828	$163	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,015	$760	$272	unverified
Blood transfusion CPT Code: `36430`	$725	$725	$498	1.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$675	$407	$126	3.2×
Ultrasound, pelvis CPT Code: `76856`	$850	$407	$130	3.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$580	$407	$132	3.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$885	$407	$134	3.0×
Rabies immune globulin HCPCS Code: `90375`	$913	$358	$322	1.1×
X-ray, chest (single view) CPT Code: `71045`	$200	$312	$92	3.4×
X-ray, foot CPT Code: `73630`	$589	$312	$92	3.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$273	$312	$93	3.4×
X-ray, hand CPT Code: `73130`	$488	$312	$93	3.4×
X-ray, hip CPT Code: `73502`	$345	$312	$93	3.4×
X-ray, ankle CPT Code: `73610`	$473	$312	$93	3.4×
X-ray, lower back CPT Code: `72110`	$408	$312	$112	2.8×
X-ray, chest (two views) CPT Code: `71046`	$240	$312	$93	unverified
X-ray, pelvis CPT Code: `72170`	$270	$312	$110	unverified
X-ray, shoulder CPT Code: `73030`	$465	$312	$92	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$203	$282	$123	2.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$379	$282	$148	1.9×
Speech therapy (language evaluation) CPT Code: `92507`	$255	$255	$86	3.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$140	$268	$64	unverified
Family therapy session CPT Code: `90847`	$225	$225	$173	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$225	$185	$151	1.2×
Group therapy session CPT Code: `90853`	$123	$123	$100	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$88	$88	$35	2.5×
Occupational therapy (self-care training) CPT Code: `97535`	$88	$88	$38	2.3×
Physical therapy (functional capacity test) CPT Code: `97750`	$88	$88	$38	2.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$88	$88	$40	2.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$195	$82	$87	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$195	$82	$110	0.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$253	$82	$123	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$90	$90	$201	0.4×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$88	$88	$38	unverified
Physical therapy (gait training) CPT Code: `97116`	$88	$88	$33	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$88	$88	$34	unverified
Orthotic fitting and training CPT Code: `97760`	$93	$93	$51	unverified
Prosthetic fitting and training CPT Code: `97761`	$88	$88	$45	unverified
Typhoid vaccine HCPCS Code: `90675`	$1,131	$415	$347	1.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$606	$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×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$297	$106	$111	1.0×
Blood test, calcium CPT Code: `82310`	$50	$50	$5	10.0×
Blood test, amylase CPT Code: `82150`	$69	$69	$7	9.9×
Blood test, magnesium CPT Code: `83735`	$65	$65	$7	9.3×
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×
Speech therapy (group session) CPT Code: `92508`	$75	$75	$27	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	$63	$63	$35	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$70	$70	$86	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$34	$34	$5	6.8×
Blood test, potassium CPT Code: `84132`	$31	$31	$5	6.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$31	$31	$5	6.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$55	$55	$10	5.5×
Blood test, sodium CPT Code: `84295`	$20	$20	$5	4.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$78	$42	$18	2.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$139	$51	$56	0.9×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$50	$8	$3	2.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$25	$10	$4	2.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$25	$10	$4	2.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$50	$15	$6	2.5×
Culture, bacterial CPT Code: `87070`	$80	$22	$9	2.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$158	$26	$11	2.4×
Culture, blood CPT Code: `87040`	$80	$26	$11	2.4×
Blood test, basic metabolic panel CPT Code: `80048`	$66	$21	$9	2.3×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$28	$25	1.1×
Hepatitis B vaccine HCPCS Code: `90744`	$89	$39	$37	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$33	$39	0.8×
Blood antibody screen CPT Code: `86850`	$91	$23	$46	0.5×
Blood test, hemoglobin CPT Code: `85018`	$16	$6	$3	unverified

Showing top 25 high-impact procedures of 111 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 50.0%

Audit a Bill or Quote at West Allis Memorial Hospital (Zero PHI Required)

CMS CCN: 520139

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $62,073

1. Amount on Your Bill or Quote ($) Pre-filled with West Allis Memorial 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: $74,488 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $74,488

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (50.0% of gross = $74,488).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask West Allis Memorial 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 +$118,200 Above Fair BaseRate

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

Your bill ($148,975) is $118,200 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 (50.0% 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 ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait182 min

Left ER Before Seen3%

30-Day Mortality vs U.S.better

Unplanned Readmissionsame

Hip/Knee Complication Rate3.8%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (906 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

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for West Allis Memorial Hospital.

Price Index: 1.21× regional baseline

Quality: 68/100 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 72/100 · Corroborated CMS CCN 520139

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 520139) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-11-21

Validated Rate Rows2,880 (CMS v3.0.0)

File Integrity DigestVerified · CCN 520139

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