Skip to main content
States Procedures Methodology Search
Metro Price Directory

Sparta Area Hospital Prices

Cash and insurance-negotiated prices at hospitals in and around Sparta, WI. Part of all Wisconsin hospital prices.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
0.97×vs. Fair Market Price
Position vs. 1.00× Fair Price3% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Wisconsin Market & Best ValueSummarizes statewide hospital price coverage across Wisconsin, the average commercial markup over federal Medicare rates, and the #1 best-value hospital in the state.1 Hospitals Mapped
Hospitals Priced1 in WITotal hospitals in Wisconsin with verified machine-readable price disclosures indexed in the Crystal.
Avg vs. Medicare1.4× MedicareAverage commercial insurance negotiated rate across Wisconsin hospitals compared to what federal Medicare pays for the same procedure.
Best Value in WI0.97× FairLowest confounder-adjusted hospital in Wisconsin: Tomah Memorial Hospital (Tomah) at 0.97× fair market price.

Most affordable Wisconsin hospital: Tomah Memorial Hospital (Tomah) at 0.97× the fair price (3% below benchmark).

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Tomah Memorial Hospital prices shoppable and inpatient services (1.0× to 1.1× Medicare, divergence 1.10×) in alignment with regional hospital peers (0.97× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#17 of 99 in WI · 16th State Percentile#1,142 of 3,385 in U.S. · 33rd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 3% below peer Fair BaseRate (0.97×)
  • Self-pay cash beats commercial insurance on 41% of shoppable procedures (99/100 Cash Honesty)
  • 5-Star CMS clinical rating with 88% patient recommendation (83/100 safety score)
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (40.4% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
  • Captive ER (0.5×) & laboratory (1.8×) services average 1.10× higher multiples than routine shoppable care (1.0×)
  • Upper-quartile procedures (Q75 1.23×) jump +26% above the median procedure ratio (Q50 0.98×)
  • Consolidated metro market (HHI 8,541) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
1.0× Medicare

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

Back-Door Captive & ER1.10× Divergence
1.1× Medicare

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

Quantile Tail Spread+26% Upper Tail
Q25 0.52× · Q50 0.98× · Q75 1.23×

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
1.0× MedicareGood
Outpatient Surgery & ORBack-Door Captive
1.2× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.8× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.5× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.8× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.6× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
41% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
5 CMS · 83/100Good

Hospitals in the Sparta area

Ranked by how their prices compare to the fair BaseRate — best value first. The × fair figure is geo-adjusted. Tap any hospital for its full price list.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings

Total Knee Arthroplasty (Replacement)DRG 470 vs CPT 27447
Inpatient: $35,075Outpatient: $7,181 Save $27,894 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Cesarean Section DeliveryDRG 788 vs CPT 59510
Inpatient: $16,670Outpatient: $3,934 Save $12,736 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Upper GI Endoscopy (EGD) with BiopsyDRG 392 vs CPT 43239
Inpatient: $8,091Outpatient: $2,292 Save $5,798 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Uncomplicated Vaginal DeliveryDRG 807 vs CPT 59400
Inpatient: $6,698Outpatient: $4,572 Save $2,126 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Prices are sourced from each hospital's federally-required public price file, most recently published October 2026. The BaseRate is a modeled fair-price estimate — not a bill or quote. How we build these numbers →