Compare real prices at McLaren Northern Michigan in Petoskey, MI. Taven tracks 243 procedures at this hospital using data from their publicly filed transparency report. Last updated March 2026.
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243
Procedures Tracked
with pricing data
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4/5
Star Rating
CMS Care Compare
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3.4x
Markup Ratio
Avg = 3.0x
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Grade B
Data Quality
Good data coverage
✓
CMS v3.0 Compliant
This hospital's pricing data meets the latest CMS v3.0 requirements, including actual allowed amounts from insurer remittance data.
Attested by: STEVEN THOMPSONOrg NPI: 1881754554
🔒 De-identification Notice: All pricing data shown on this page is derived from publicly available hospital machine-readable files and insurer transparency data as mandated by federal law. No individual patient data, protected health information (PHI), or personally identifiable information is collected, stored, or displayed. Aggregate statistics (such as allowed amount medians and percentiles) are calculated from de-identified claim payment data reported by hospitals per CMS requirements.
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Procedure Prices at McLaren Northern Michigan
243 procedures with pricing data. Prices reflect negotiated rates across insurance payers compared to the Petoskey, MI metro average.
Last updated: March 26, 2026
| Procedure | Cash Price | Avg Negotiated | Petoskey Avg | vs. Avg | Payers |
|---|---|---|---|---|---|
| Debridement - Subcutaneous Tissue CPT 11042 Wound debridement — removal of dead, damaged, or infected tissue from a wound to promote healing. |
— | $127 | $127 | avg | 36 |
| Skin Biopsy (Tangential, Single Lesion) CPT 11102 Skin biopsy, tangential — removal of a thin layer of skin tissue for microscopic examination to diagnose skin conditions or suspicious lesions. |
— | $17 | $17 | +3% | 25 |
| Skin Biopsy (Punch, Single Lesion) CPT 11104 Skin punch biopsy — removal of a small, full-thickness circular sample of skin for laboratory analysis to diagnose skin conditions. |
— | $22 | $22 | +1% | 25 |
| Skin Graft Preparation CPT 15002 Skin Graft Preparation — CPT code 15002 covers skin graft preparation performed in a clinical or hospital setting. |
— | $186 | $186 | avg | 25 |
| Split-Thickness Skin Graft CPT 15100 Split-Thickness Skin Graft — CPT code 15100 covers split-thickness skin graft performed in a clinical or hospital setting. |
— | $1,401 | $1,401 | avg | 36 |
| Skin Substitute Graft (≤25 sq cm) CPT 15271 Skin Substitute Graft (≤25 sq cm) — CPT code 15271 covers skin substitute graft (≤25 sq cm) performed in a clinical or hospital setting. |
— | $1,251 | $1,251 | avg | 36 |
| Skin Substitute Graft (≤100 sq cm) CPT 15275 Skin Substitute Graft (≤100 sq cm) — CPT code 15275 covers skin substitute graft (≤100 sq cm) performed in a clinical or hospital setting. |
— | $71 | $71 | avg | 25 |
| Destruction of Premalignant Lesion (First) CPT 17000 Destruction of precancerous skin lesion — removal of a precancerous growth (actinic keratosis) using freezing, chemicals, or other methods. |
— | $32 | $32 | -1% | 25 |
| Wart Removal (Up to 14 Lesions) CPT 17110 Destruction of benign skin lesions, up to 14 — removal of warts, skin tags, or other non-cancerous growths. |
— | $67 | $67 | avg | 25 |
| Breast Excision CPT 19120 Surgical removal of a breast lump or abnormal tissue. This procedure removes a specific area of concern while preserving as much healthy breast tissue as possible. |
— | $1,333 | $1,333 | avg | 36 |
| Partial Mastectomy (Lumpectomy) CPT 19301 Surgical removal of a breast tumor along with a small margin of surrounding tissue. Also called a lumpectomy, this breast-conserving surgery removes the cancer while keeping most of the breast intact. |
— | $2,389 | $2,389 | avg | 36 |
| Simple Mastectomy CPT 19303 Complete surgical removal of one breast. This procedure removes all breast tissue to treat or prevent breast cancer. |
— | $5,033 | $5,033 | avg | 36 |
| Joint Injection (small joint) CPT 20600 Small joint injection — injection of medication into a small joint like a finger or toe to reduce pain and inflammation. |
— | $169 | $169 | avg | 36 |
| Joint Injection (medium joint) CPT 20605 Medium joint injection — injection of medication into a medium-sized joint like the elbow, wrist, or ankle to reduce pain and inflammation. |
— | $172 | $172 | avg | 36 |
| Joint Injection (Major Joint) CPT 20610 Large joint injection — injection of medication (such as cortisone) into a large joint like the knee, shoulder, or hip to reduce pain and inflammation. |
— | $181 | $181 | avg | 36 |
| Joint Injection with Ultrasound (Major Joint) CPT 20611 Ultrasound — joint injection with ultrasound (major joint). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $34 | $34 | +1% | 25 |
| Lumbar Spinal Fusion (Posterior) CPT 22612 Lumbar spinal fusion (lower back) — surgery to permanently join two vertebrae in the lower spine to treat conditions like degenerative disc disease or spondylolisthesis. |
— | $2,045 | $2,045 | avg | 25 |
| Lumbar Spinal Fusion (Posterior Interbody) CPT 22630 Posterior lumbar interbody fusion (PLIF) — spinal fusion through the back where a damaged disc is removed and replaced with a bone graft or cage to stabilize the spine. |
— | $1,849 | $1,849 | avg | 25 |
| Rotator Cuff Repair CPT 23412 Rotator Cuff Repair — CPT code 23412 covers rotator cuff repair performed in a clinical or hospital setting. |
— | $1,105 | $1,105 | avg | 25 |
| Shoulder Replacement (Arthroplasty) CPT 23472 Shoulder Replacement (Arthroplasty) — CPT code 23472 covers shoulder replacement (arthroplasty) performed in a clinical or hospital setting. |
— | $12,526 | $12,526 | avg | 36 |
| Trigger Finger Release CPT 26055 Trigger finger release — a procedure to free a finger tendon that has become stuck, causing the finger to catch or lock when bending. |
— | $863 | $863 | avg | 36 |
| Open Fracture Treatment - Metacarpal CPT 26615 Open Fracture Treatment - Metacarpal — CPT code 26615 covers open fracture treatment - metacarpal performed in a clinical or hospital setting. |
— | $1,620 | $1,620 | avg | 36 |
| Total Hip Replacement CPT 27130 Total hip replacement surgery where the damaged hip joint is replaced with an artificial implant to relieve pain and improve mobility. |
— | $7,937 | $7,937 | avg | 36 |
| Open Treatment Hip Fracture CPT 27236 Surgical repair of a broken hip using metal pins, screws, or plates to hold the bone fragments together while they heal. |
— | $1,447 | $1,447 | avg | 25 |
| Total Knee Replacement - Unicompartmental CPT 27446 Partial knee replacement surgery that replaces only the damaged compartment of the knee joint with an artificial implant, preserving healthy bone and tissue. |
— | $9,611 | $9,611 | avg | 36 |
| Total Knee Replacement CPT 27447 Full knee replacement surgery where the damaged knee joint is replaced with artificial metal and plastic components to relieve pain and restore function. |
— | $8,104 | $8,104 | avg | 36 |
| Closed Treatment Tibial Fracture CPT 27750 Treatment of a broken shinbone (tibia) without surgery, using a cast or brace to hold the bone in place while it heals. |
— | $229 | $229 | avg | 25 |
| Hammertoe Correction CPT 28285 Surgical correction of a hammertoe — a toe that has become bent or curled. The procedure straightens the toe by removing bone or releasing tight tendons. |
— | $1,375 | $1,375 | avg | 36 |
| Bunionectomy with Metatarsal Osteotomy CPT 28296 Surgical correction of a bunion (hallux valgus) that includes cutting and realigning the metatarsal bone to straighten the big toe and relieve pain. |
— | $2,411 | $2,411 | avg | 36 |
| Shoulder Arthroscopy - Debridement CPT 29823 Minimally invasive shoulder surgery using a small camera (arthroscope) to clean out damaged tissue, bone spurs, or loose fragments from the shoulder joint. |
— | $924 | $924 | avg | 25 |
| Arthroscopic Rotator Cuff Repair CPT 29827 Arthroscopic repair of a torn rotator cuff — the group of tendons that stabilize the shoulder. The surgeon reattaches the torn tendon to the bone using small anchors. |
— | $954 | $954 | avg | 25 |
| Knee Arthroscopy Medial & Lateral CPT 29880 Arthroscopic knee surgery to treat torn meniscus cartilage on both the inner and outer sides of the knee. Uses a small camera and tools to trim or repair the damaged cartilage. |
— | $2,087 | $2,087 | avg | 36 |
| Knee Arthroscopy (Meniscus Surgery) CPT 29881 Arthroscopic knee surgery to treat a torn meniscus on one side of the knee. The surgeon trims or repairs the damaged cartilage through small incisions. |
— | $1,997 | $1,997 | avg | 36 |
| Septoplasty (Deviated Septum Repair) CPT 30520 Septoplasty (Deviated Septum Repair) — CPT code 30520 covers septoplasty (deviated septum repair) performed in a clinical or hospital setting. |
— | $733 | $733 | avg | 25 |
| Nasal Endoscopy (diagnostic) CPT 31231 Nasal Endoscopy (diagnostic) — CPT code 31231 covers nasal endoscopy (diagnostic) performed in a clinical or hospital setting. |
— | $139 | $139 | avg | 36 |
| Nasal Endoscopy - Surgical Debridement CPT 31237 Nasal Endoscopy - Surgical Debridement — CPT code 31237 covers nasal endoscopy - surgical debridement performed in a clinical or hospital setting. |
— | $131 | $131 | avg | 25 |
| Ethmoidectomy - Partial CPT 31254 Ethmoidectomy - Partial — CPT code 31254 covers ethmoidectomy - partial performed in a clinical or hospital setting. |
— | $170 | $170 | avg | 25 |
| Sinus Surgery - Ethmoidectomy CPT 31255 Sinus Surgery - Ethmoidectomy — CPT code 31255 covers sinus surgery - ethmoidectomy performed in a clinical or hospital setting. |
— | $253 | $253 | avg | 25 |
| Sinus Surgery - Frontal CPT 31276 Sinus Surgery - Frontal — CPT code 31276 covers sinus surgery - frontal performed in a clinical or hospital setting. |
— | $301 | $301 | avg | 25 |
| TAVR - Transcatheter Aortic Valve Replacement CPT 33361 Replacement of a diseased aortic heart valve without open-heart surgery. A new valve is delivered through a catheter (thin tube) inserted through the leg artery. |
— | $2,041 | $2,041 | avg | 29 |
| Mitral Valve Repair CPT 33430 Open-heart surgery to repair a damaged mitral valve — the valve between the upper and lower left chambers of the heart — restoring normal blood flow. |
— | $2,650 | $2,650 | avg | 25 |
| Coronary Artery Bypass (CABG) - Single CPT 33533 Coronary artery bypass surgery (CABG) using a single graft. A healthy blood vessel from another part of the body is used to reroute blood around a blocked heart artery. |
— | $1,736 | $1,736 | avg | 25 |
| Venipuncture (blood draw) CPT 36415 A routine blood draw where a needle is inserted into a vein (usually in the arm) to collect blood for laboratory testing. |
— | $9 | $9 | -6% | 35 |
| Central Venous Catheter CPT 36556 Insertion of a central venous catheter (a thin, flexible tube) into a large vein to deliver medications, fluids, or nutrition directly into the bloodstream. |
— | $2,583 | $2,583 | avg | 36 |
| Central Venous Access Device CPT 36571 Central Venous Access Device — CPT code 36571 covers central venous access device performed in a clinical or hospital setting. |
— | $2,090 | $2,090 | avg | 36 |
| Central Venous Access - Jugular CPT 36573 Insertion of a central venous catheter into the jugular vein (in the neck) for direct access to the central bloodstream for medications or monitoring. |
— | $835 | $835 | avg | 36 |
| Arterial Line Placement CPT 36620 Placement of a thin tube (catheter) into an artery, usually in the wrist, to continuously monitor blood pressure during surgery or critical care. |
— | $239 | $239 | avg | 29 |
| Tonsillectomy & Adenoidectomy (Under 12) CPT 42820 Surgical removal of the tonsils and adenoids. This procedure treats chronic infections, breathing problems, or sleep apnea caused by enlarged tonsils and adenoids. |
— | $2,505 | $2,505 | avg | 36 |
| Tonsillectomy (Age 12+) CPT 42826 Surgical removal of the tonsils for patients age 12 and older. This procedure treats chronic tonsillitis, recurrent infections, or breathing problems caused by enlarged tonsils. |
— | $2,087 | $2,087 | avg | 36 |
| Upper Endoscopy (EGD) Diagnostic CPT 43235 Upper endoscopy (EGD) — a flexible tube with a camera is passed through the mouth to visually examine the esophagus, stomach, and upper intestine. |
— | $553 | $553 | avg | 36 |
| Upper Endoscopy (EGD) with Biopsy CPT 43239 Upper endoscopy with biopsy — a flexible tube with a camera is passed through the mouth to examine the esophagus, stomach, and upper intestine, and tissue samples are taken for analysis. |
— | $612 | $612 | avg | 36 |
| Upper Endoscopy with Dilation CPT 43249 Upper endoscopy with dilation — a flexible scope is used to stretch a narrowed area of the esophagus or stomach to improve swallowing. |
— | $1,201 | $1,201 | avg | 36 |
| Upper GI Endoscopy with Polypectomy CPT 43251 Upper GI Endoscopy with Polypectomy — CPT code 43251 covers upper gi endoscopy with polypectomy performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | avg | 36 |
| Upper GI Endoscopy with Band Ligation CPT 43270 Upper GI Endoscopy with Band Ligation — CPT code 43270 covers upper gi endoscopy with band ligation performed in a clinical or hospital setting. |
— | $1,348 | $1,348 | avg | 36 |
| Laparoscopic Hiatal Hernia Repair CPT 43282 Laparoscopic Hiatal Hernia Repair — CPT code 43282 covers laparoscopic hiatal hernia repair performed in a clinical or hospital setting. |
— | $7,288 | $7,288 | avg | 36 |
| Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) CPT 43775 Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) — CPT code 43775 covers gastric sleeve (laparoscopic sleeve gastrectomy) performed in a clinical or hospital setting. |
— | $703 | $703 | avg | 25 |
| Small Bowel Resection CPT 44120 Small bowel resection �� surgical removal of a portion of the small intestine to treat disease, obstruction, or injury. |
— | $1,280 | $1,280 | avg | 25 |
| Laparoscopic Small Bowel Enterostomy CPT 44180 Laparoscopic Small Bowel Enterostomy — CPT code 44180 covers laparoscopic small bowel enterostomy performed in a clinical or hospital setting. |
— | $766 | $766 | avg | 25 |
| Laparoscopic Appendectomy CPT 44970 Laparoscopic appendectomy — minimally invasive surgical removal of the appendix, typically performed for appendicitis. |
— | $3,465 | $3,465 | avg | 36 |
| Colonoscopy (diagnostic) CPT 45378 Diagnostic colonoscopy — a flexible tube with a camera is inserted through the rectum to examine the entire large intestine for polyps, cancer, or other abnormalities. |
— | $617 | $617 | avg | 36 |
| Colonoscopy with Biopsy CPT 45380 Colonoscopy with biopsy — examination of the large intestine with a camera, during which tissue samples are taken from suspicious areas for laboratory analysis. |
— | $763 | $763 | avg | 36 |
| Colonoscopy with Polyp Removal CPT 45385 Colonoscopy with polyp removal — examination of the large intestine during which precancerous growths (polyps) are found and removed to prevent colon cancer. |
— | $789 | $789 | avg | 36 |
| Gallbladder Removal (Laparoscopic) CPT 47562 Minimally invasive removal of the gallbladder (laparoscopic cholecystectomy). Small incisions and a camera are used to remove the gallbladder, typically for gallstones or inflammation. |
— | $3,244 | $3,244 | avg | 36 |
| Gallbladder Removal with Cholangiography CPT 47563 Laparoscopic gallbladder removal with X-ray imaging of the bile ducts (cholangiography) to check for gallstones in the ducts during surgery. |
— | $3,626 | $3,626 | avg | 36 |
| Cholecystectomy - Open CPT 47600 Open cholecystectomy — surgical removal of the gallbladder through a larger incision in the abdomen. |
— | $1,004 | $1,004 | avg | 25 |
| Inguinal Hernia Repair CPT 49505 Inguinal hernia repair — surgical repair of a hernia in the groin area where tissue pushes through a weak spot in the abdominal muscles. |
— | $2,058 | $2,058 | avg | 36 |
| Inguinal Hernia Repair (Incarcerated) CPT 49507 Inguinal Hernia Repair (Incarcerated) — CPT code 49507 covers inguinal hernia repair (incarcerated) performed in a clinical or hospital setting. |
— | $2,289 | $2,289 | avg | 36 |
| Ventral Hernia Repair CPT 49585 Ventral Hernia Repair — CPT code 49585 covers ventral hernia repair performed in a clinical or hospital setting. |
— | $2,813 | $2,813 | avg | 14 |
| Laparoscopic Inguinal Hernia Repair CPT 49650 Laparoscopic inguinal hernia repair — minimally invasive repair of a groin hernia using small incisions and a camera. |
— | $2,885 | $2,885 | avg | 36 |
| Lithotripsy (Kidney Stone Treatment) CPT 50590 Lithotripsy — shock waves are used to break kidney stones into small pieces that can pass naturally through the urinary tract. |
— | $3,670 | $3,670 | avg | 36 |
| Bladder Aspiration/Drainage CPT 51102 Bladder Aspiration/Drainage — CPT code 51102 covers bladder aspiration/drainage performed in a clinical or hospital setting. |
— | $1,818 | $1,818 | avg | 36 |
| Cystoscopy (Bladder Exam) CPT 52000 Cystoscopy — a thin scope with a camera is inserted through the urethra to examine the inside of the bladder and urinary tract. |
— | $603 | $603 | avg | 36 |
| TURP (Prostate Resection) CPT 52601 Transurethral resection of the prostate (TURP) — surgical removal of prostate tissue through the urethra to treat enlarged prostate and improve urinary flow. |
— | $3,635 | $3,635 | avg | 36 |
| Prostate Biopsy CPT 55700 Prostate Biopsy — CPT code 55700 covers prostate biopsy performed in a clinical or hospital setting. |
— | $589 | $589 | avg | 36 |
| Robotic Prostatectomy CPT 55866 Robotic Prostatectomy — CPT code 55866 covers robotic prostatectomy performed in a clinical or hospital setting. |
— | $8,104 | $8,104 | avg | 36 |
| Colposcopy with Biopsy (Cervical) CPT 57454 Colposcopy with Biopsy (Cervical) — CPT code 57454 covers colposcopy with biopsy (cervical) performed in a clinical or hospital setting. |
— | $121 | $121 | avg | 25 |
| Endometrial Biopsy CPT 58100 Endometrial Biopsy — CPT code 58100 covers endometrial biopsy performed in a clinical or hospital setting. |
— | $141 | $141 | avg | 25 |
| Total Hysterectomy - Abdominal CPT 58150 Total Hysterectomy - Abdominal — CPT code 58150 covers total hysterectomy - abdominal performed in a clinical or hospital setting. |
— | $1,240 | $1,240 | avg | 25 |
| IUD Insertion CPT 58300 IUD Insertion — CPT code 58300 covers iud insertion performed in a clinical or hospital setting. |
— | $87 | $87 | avg | 25 |
| IUD Removal CPT 58301 IUD Removal — CPT code 58301 covers iud removal performed in a clinical or hospital setting. |
— | $470 | $470 | avg | 36 |
| Laparoscopic Hysterectomy (250g or Less) CPT 58571 Total laparoscopic hysterectomy including removal of the cervix — minimally invasive complete removal of the uterus and cervix. |
— | $5,325 | $5,325 | avg | 36 |
| Laparoscopic Ovarian Cyst/Adnexal Removal CPT 58661 Laparoscopic removal of the uterus (hysterectomy) — minimally invasive surgery using small incisions and a camera to remove the uterus. |
— | $2,820 | $2,820 | avg | 36 |
| Fetal Non-Stress Test CPT 59025 Fetal non-stress test — monitoring the baby's heart rate in response to its own movements to assess fetal wellbeing. |
— | $101 | $101 | avg | 36 |
| Vaginal Delivery (routine, global) CPT 59400 Routine obstetric care including prenatal visits, vaginal delivery, and postpartum care — comprehensive maternity care package. |
— | $1,856 | $1,856 | avg | 25 |
| Vaginal Delivery Only CPT 59409 Vaginal Delivery Only — CPT code 59409 covers vaginal delivery only performed in a clinical or hospital setting. |
— | $1,116 | $1,116 | avg | 25 |
| C-Section Delivery (global) CPT 59510 Routine obstetric care including prenatal visits, cesarean delivery, and postpartum care — comprehensive maternity care package with C-section. |
— | $1,949 | $1,949 | avg | 25 |
| VBAC Delivery CPT 59610 VBAC Delivery — CPT code 59610 covers vbac delivery performed in a clinical or hospital setting. |
— | $1,867 | $1,867 | avg | 25 |
| Lumbar Epidural Injection CPT 62322 Lumbar or sacral epidural injection — injection of medication into the epidural space of the lower spine for pain relief. |
— | $445 | $445 | avg | 36 |
| Lumbar Epidural - Fluoroscopic CPT 62323 Lumbar or sacral epidural injection with imaging guidance — a precisely targeted spinal injection using X-ray or fluoroscopy for accurate placement. |
— | $544 | $544 | avg | 36 |
| Lumbar Laminotomy CPT 63030 Lumbar laminotomy — surgical removal of a small portion of the vertebral bone (lamina) in the lower back to relieve pressure on spinal nerves, typically for a herniated disc. |
— | $6,440 | $6,440 | avg | 36 |
| Lumbar Laminectomy (Single Level) CPT 63047 Lumbar laminectomy — surgical removal of the bony arch (lamina) of a vertebra in the lower back to create more space for the spinal cord and nerves. |
— | $5,852 | $5,852 | avg | 36 |
| Transforaminal Epidural Injection CPT 64483 Lumbar epidural steroid injection — injection of anti-inflammatory medication into the space around spinal nerves in the lower back to relieve pain. |
— | $574 | $574 | avg | 36 |
| Facet Joint Injection - Lumbar CPT 64493 Lumbar facet joint injection — injection of medication into the small joints of the lower spine to diagnose and treat back pain. |
— | $632 | $632 | avg | 36 |
| Facet Joint Destruction - Lumbar CPT 64635 Facet Joint Destruction - Lumbar — CPT code 64635 covers facet joint destruction - lumbar performed in a clinical or hospital setting. |
— | $171 | $171 | avg | 25 |
| Carpal Tunnel Release CPT 64721 Carpal tunnel release — surgery to relieve pressure on the median nerve in the wrist, treating numbness, tingling, and weakness in the hand. |
— | $1,052 | $1,052 | avg | 36 |
| Glaucoma Laser Surgery CPT 65855 Glaucoma Laser Surgery — CPT code 65855 covers glaucoma laser surgery performed in a clinical or hospital setting. |
— | $630 | $630 | avg | 25 |
| Glaucoma Filter Surgery CPT 66170 Glaucoma Filter Surgery — CPT code 66170 covers glaucoma filter surgery performed in a clinical or hospital setting. |
— | $703 | $703 | avg | 25 |
| Complex Cataract Surgery CPT 66982 CT scan — complex cataract surgery. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $1,911 | $1,911 | avg | 36 |
| Cataract Surgery CPT 66984 Cataract surgery with lens implant — removal of the clouded natural lens of the eye and replacement with a clear artificial lens to restore vision. |
— | $1,768 | $1,768 | avg | 36 |
| Eyelid Repair - Blepharoplasty CPT 67904 Eyelid Repair - Blepharoplasty — CPT code 67904 covers eyelid repair - blepharoplasty performed in a clinical or hospital setting. |
— | $1,248 | $1,248 | avg | 25 |
| Eyelid Repair - Lower Lid CPT 67917 Eyelid Repair - Lower Lid — CPT code 67917 covers eyelid repair - lower lid performed in a clinical or hospital setting. |
— | $772 | $772 | avg | 25 |
| Ear Wax Removal CPT 69210 Ear Wax Removal — CPT code 69210 covers ear wax removal performed in a clinical or hospital setting. |
— | $123 | $123 | avg | 36 |
| Ear Tube Placement (Tympanostomy) CPT 69436 Ear Tube Placement (Tympanostomy) — CPT code 69436 covers ear tube placement (tympanostomy) performed in a clinical or hospital setting. |
— | $938 | $938 | avg | 36 |
| CT Head without Contrast CPT 70450 CT scan — ct head without contrast. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $267 | $267 | avg | 36 |
| CT Head with Contrast CPT 70460 CT scan — ct head with contrast. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $366 | $366 | avg | 36 |
| Brain MRI without Contrast CPT 70551 MRI of the brain without contrast — detailed magnetic resonance imaging of the brain to evaluate for abnormalities without using contrast dye. |
— | $459 | $459 | avg | 36 |
| MRI Brain with/without Contrast CPT 70553 MRI of the brain with and without contrast dye — detailed imaging of the brain using magnetic fields and radio waves to diagnose tumors, stroke, or other conditions. |
— | $740 | $740 | avg | 36 |
| Chest X-Ray (single view) CPT 71045 X-ray imaging — chest x-ray (single view). A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $51 | $51 | avg | 36 |
| Chest X-Ray (2 views) CPT 71046 Chest X-ray, two views — standard imaging of the lungs and chest from front and side to evaluate for pneumonia, heart problems, or other chest conditions. |
— | $63 | $63 | -1% | 36 |
| CT Chest without Contrast CPT 71250 CT scan of the chest without contrast — detailed cross-sectional imaging of the lungs, heart, and chest structures without contrast dye. |
— | $271 | $271 | avg | 36 |
| CT Chest with Contrast CPT 71260 CT scan of the chest with contrast — detailed cross-sectional imaging of the chest after injecting contrast dye to better visualize blood vessels and tissues. |
— | $371 | $371 | avg | 36 |
| Lumbar Spine X-Ray CPT 72100 X-ray imaging — lumbar spine x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $72 | $72 | -1% | 36 |
| MRI Cervical Spine without Contrast CPT 72141 MRI of the cervical spine (neck) without contrast — detailed imaging of the neck spine to evaluate for herniated discs, spinal cord problems, or nerve issues. |
— | $471 | $471 | avg | 36 |
| MRI Lumbar Spine without Contrast CPT 72148 MRI of the lumbar spine (lower back) without contrast — detailed imaging of the lower spine to evaluate for herniated discs, spinal stenosis, or nerve compression. |
— | $466 | $466 | avg | 36 |
| Shoulder X-Ray CPT 73030 X-ray imaging — shoulder x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $63 | $63 | avg | 36 |
| Hand X-Ray CPT 73130 X-ray imaging — hand x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $66 | $66 | avg | 36 |
| MRI Shoulder without Contrast CPT 73221 MRI of any joint of the upper extremity without contrast — detailed imaging of a shoulder, elbow, wrist, or hand joint. |
— | $464 | $464 | avg | 36 |
| Knee X-Ray CPT 73560 X-ray imaging — knee x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $60 | $60 | -1% | 36 |
| Ankle X-Ray CPT 73610 X-ray imaging — ankle x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $63 | $63 | -1% | 36 |
| MRI Knee without Contrast CPT 73721 MRI of any joint of the lower extremity without contrast — detailed imaging of a hip, knee, ankle, or foot joint using magnetic resonance. |
— | $463 | $463 | avg | 36 |
| CT Abdomen/Pelvis without Contrast CPT 74176 CT scan of the abdomen and pelvis without contrast followed by with contrast — complete imaging study of the abdomen and pelvis. |
— | $535 | $535 | avg | 36 |
| CT Abdomen/Pelvis with Contrast CPT 74177 CT scan of the abdomen and pelvis with contrast — comprehensive cross-sectional imaging of the abdominal and pelvic organs after contrast injection. |
— | $734 | $734 | avg | 36 |
| Breast Ultrasound CPT 76642 Ultrasound — breast ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $73 | $73 | avg | 36 |
| Abdominal Ultrasound CPT 76700 Abdominal ultrasound — uses sound waves to create images of organs in the abdomen including the liver, gallbladder, kidneys, and pancreas. |
— | $180 | $180 | avg | 36 |
| OB Ultrasound (first trimester) CPT 76801 Ultrasound — ob ultrasound (first trimester). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $135 | $135 | avg | 36 |
| OB Ultrasound (complete) CPT 76805 Ultrasound — ob ultrasound (complete). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $91 | $91 | -1% | 36 |
| Transvaginal Ultrasound CPT 76830 Transvaginal ultrasound — an ultrasound probe is placed internally to obtain detailed images of the uterus, ovaries, and pelvic structures. |
— | $100 | $100 | avg | 36 |
| Pelvic Ultrasound CPT 76856 Pelvic ultrasound — uses sound waves to examine the uterus, ovaries, bladder, and other pelvic organs. |
— | $86 | $86 | avg | 36 |
| 3D Mammography (Tomosynthesis) CPT 77063 3D Mammography (Tomosynthesis) — CPT code 77063 covers 3d mammography (tomosynthesis) performed in a clinical or hospital setting. |
— | $36 | $36 | -1% | 29 |
| Diagnostic Mammogram (unilateral) CPT 77065 Screening mammogram of one breast — X-ray imaging of one breast to check for early signs of breast cancer. |
— | $95 | $95 | avg | 29 |
| Diagnostic Mammogram (bilateral) CPT 77066 Screening mammogram of both breasts — routine X-ray imaging of both breasts to detect early breast cancer in women without symptoms. |
— | $124 | $124 | avg | 29 |
| Screening Mammogram (bilateral) CPT 77067 Screening mammogram of both breasts including computer-aided detection — enhanced breast X-ray with software assistance for improved cancer detection. |
— | $107 | $107 | avg | 29 |
| Nuclear Stress Test (SPECT MPI) CPT 78452 Myocardial perfusion imaging (stress test with nuclear imaging) — evaluates blood flow to the heart muscle during rest and stress to detect blocked arteries. |
— | $546 | $546 | avg | 36 |
| BMP (Basic Metabolic Panel) CPT 80048 Basic metabolic panel — a blood test measuring 8 substances (glucose, calcium, sodium, potassium, CO2, chloride, BUN, creatinine) to assess kidney function, blood sugar, and electrolyte balance. |
— | $18 | $18 | avg | 29 |
| CMP (Comprehensive Metabolic Panel) CPT 80053 Comprehensive metabolic panel — a blood test measuring 14 substances to evaluate kidney and liver function, blood sugar, electrolytes, and protein levels. |
— | $22 | $22 | -2% | 28 |
| Lipid Panel CPT 80061 Lipid panel — a blood test measuring cholesterol levels including total cholesterol, HDL ("good"), LDL ("bad"), and triglycerides to assess heart disease risk. |
— | $26 | $26 | -1% | 29 |
| Hepatic Function Panel CPT 80076 Hepatic Function Panel — CPT code 80076 covers hepatic function panel performed in a clinical or hospital setting. |
— | $16 | $16 | +2% | 28 |
| Urinalysis with Microscopy CPT 81001 Urinalysis with microscopy — a urine test that examines the physical, chemical, and microscopic properties of urine to detect infections, kidney disease, or other conditions. |
— | $6 | $6 | +1% | 29 |
| Urinalysis (automated) CPT 81003 Urinalysis (automated) — CPT code 81003 covers urinalysis (automated) performed in a clinical or hospital setting. |
— | $5 | $5 | -7% | 29 |
| Vitamin D Level CPT 82306 Vitamin D blood test — measures the level of vitamin D in your blood to check for deficiency. |
— | $61 | $61 | avg | 28 |
| Urine Creatinine CPT 82570 Urine Creatinine — CPT code 82570 covers urine creatinine performed in a clinical or hospital setting. |
— | $8 | $8 | -1% | 28 |
| Ferritin Level CPT 82728 Ferritin Level — CPT code 82728 covers ferritin level performed in a clinical or hospital setting. |
— | $34 | $34 | +1% | 28 |
| Glucose (blood sugar) CPT 82947 Blood glucose test — measures the level of sugar in your blood, used to screen for and monitor diabetes. |
— | $8 | $8 | +3% | 27 |
| Hemoglobin A1C CPT 83036 Hemoglobin A1c test — a blood test that shows your average blood sugar level over the past 2-3 months, used to diagnose and monitor diabetes. |
— | $20 | $20 | avg | 28 |
| Potassium Level CPT 84132 Potassium Level — CPT code 84132 covers potassium level performed in a clinical or hospital setting. |
— | $8 | $8 | -6% | 27 |
| PSA (Prostate) CPT 84153 PSA (Prostate) — CPT code 84153 covers psa (prostate) performed in a clinical or hospital setting. |
— | $42 | $42 | avg | 28 |
| Sodium Level CPT 84295 Sodium Level — CPT code 84295 covers sodium level performed in a clinical or hospital setting. |
— | $8 | $8 | -6% | 27 |
| TSH (Thyroid) CPT 84443 Thyroid-stimulating hormone (TSH) test — a blood test to check how well your thyroid gland is working. |
— | $38 | $38 | avg | 28 |
| CBC (Complete Blood Count) CPT 85025 Complete blood count (CBC) with differential — a common blood test that measures red blood cells, white blood cells, platelets, and hemoglobin to evaluate overall health. |
— | $19 | $19 | -3% | 29 |
| PT/INR (Prothrombin Time) CPT 85610 PT/INR (Prothrombin Time) — CPT code 85610 covers pt/inr (prothrombin time) performed in a clinical or hospital setting. |
— | $10 | $10 | +2% | 28 |
| TB Skin Test CPT 86580 TB Skin Test — CPT code 86580 covers tb skin test performed in a clinical or hospital setting. |
— | $18 | $18 | -1% | 28 |
| Blood Type (ABO) CPT 86900 Blood Type (ABO) — CPT code 86900 covers blood type (abo) performed in a clinical or hospital setting. |
— | $8 | $8 | +1% | 28 |
| Chlamydia Test CPT 87491 Chlamydia test — a laboratory test to detect the sexually transmitted infection chlamydia using genetic material from a sample. |
— | $37 | $37 | avg | 29 |
| Gonorrhea Test CPT 87591 Gonorrhea test — a laboratory test to detect the sexually transmitted infection gonorrhea using genetic material from a sample. |
— | $37 | $37 | avg | 29 |
| COVID-19 Test (PCR) CPT 87635 COVID-19 Test (PCR) — CPT code 87635 covers covid-19 test (pcr) performed in a clinical or hospital setting. |
— | $58 | $58 | +1% | 28 |
| Flu Test (rapid) CPT 87804 Flu Test (rapid) — CPT code 87804 covers flu test (rapid) performed in a clinical or hospital setting. |
— | $16 | $16 | avg | 28 |
| Pap Smear (ThinPrep) CPT 88175 Pap Smear (ThinPrep) — CPT code 88175 covers pap smear (thinprep) performed in a clinical or hospital setting. |
— | $37 | $37 | +1% | 28 |
| Immunization Administration CPT 90471 Immunization Administration — CPT code 90471 covers immunization administration performed in a clinical or hospital setting. |
— | $44 | $44 | avg | 34 |
| Flu Vaccine (high dose) CPT 90662 Flu Vaccine (high dose) — CPT code 90662 covers flu vaccine (high dose) performed in a clinical or hospital setting. |
— | $251 | $251 | avg | 15 |
| Tdap Vaccine CPT 90715 Tdap Vaccine — CPT code 90715 covers tdap vaccine performed in a clinical or hospital setting. |
— | $243 | $243 | avg | 15 |
| Psychiatric Diagnostic Evaluation CPT 90791 Psychiatric Diagnostic Evaluation — CPT code 90791 covers psychiatric diagnostic evaluation performed in a clinical or hospital setting. |
— | $129 | $129 | avg | 36 |
| Psychiatric Eval with Medical Services CPT 90792 Psychiatric Eval with Medical Services — CPT code 90792 covers psychiatric eval with medical services performed in a clinical or hospital setting. |
— | $134 | $134 | avg | 36 |
| Psychotherapy (16-37 min) CPT 90832 Psychotherapy (16-37 min) — CPT code 90832 covers psychotherapy (16-37 min) performed in a clinical or hospital setting. |
— | $100 | $100 | avg | 36 |
| Psychotherapy (38-52 min) CPT 90834 Psychotherapy (38-52 min) — CPT code 90834 covers psychotherapy (38-52 min) performed in a clinical or hospital setting. |
— | $102 | $102 | avg | 36 |
| Psychotherapy (53+ min) CPT 90837 Psychotherapy (53+ min) — CPT code 90837 covers psychotherapy (53+ min) performed in a clinical or hospital setting. |
— | $97 | $97 | avg | 36 |
| Family Psychotherapy (with patient) CPT 90847 Family Psychotherapy (with patient) — CPT code 90847 covers family psychotherapy (with patient) performed in a clinical or hospital setting. |
— | $95 | $95 | avg | 36 |
| Group Psychotherapy CPT 90853 Group Psychotherapy — CPT code 90853 covers group psychotherapy performed in a clinical or hospital setting. |
— | $50 | $50 | avg | 36 |
| Coronary Stent Placement CPT 92928 Coronary Stent Placement — CPT code 92928 covers coronary stent placement performed in a clinical or hospital setting. |
— | $450 | $450 | avg | 25 |
| EKG (12-lead) CPT 93000 EKG (12-lead) — CPT code 93000 covers ekg (12-lead) performed in a clinical or hospital setting. |
— | $8 | $8 | +1% | 25 |
| EKG Interpretation CPT 93010 EKG Interpretation — CPT code 93010 covers ekg interpretation performed in a clinical or hospital setting. |
— | $8 | $8 | -4% | 25 |
| Echocardiogram Complete CPT 93306 Echocardiogram Complete — CPT code 93306 covers echocardiogram complete performed in a clinical or hospital setting. |
— | $351 | $351 | avg | 36 |
| Stress Echocardiogram CPT 93350 Stress Echocardiogram — CPT code 93350 covers stress echocardiogram performed in a clinical or hospital setting. |
— | $53 | $53 | -1% | 25 |
| Stress Echocardiogram CPT 93351 Stress Echocardiogram — CPT code 93351 covers stress echocardiogram performed in a clinical or hospital setting. |
— | $499 | $499 | avg | 36 |
| Left Heart Catheterization CPT 93458 Left Heart Catheterization — CPT code 93458 covers left heart catheterization performed in a clinical or hospital setting. |
— | $2,694 | $2,694 | avg | 36 |
| Carotid Ultrasound CPT 93880 Ultrasound — carotid ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $107 | $107 | avg | 36 |
| Venous Duplex Scan (legs) CPT 93971 Venous Duplex Scan (legs) — CPT code 93971 covers venous duplex scan (legs) performed in a clinical or hospital setting. |
— | $87 | $87 | +1% | 36 |
| Psychological Testing Evaluation CPT 96130 Psychological Testing Evaluation — CPT code 96130 covers psychological testing evaluation performed in a clinical or hospital setting. |
— | $150 | $150 | avg | 36 |
| Psychological Testing - Additional Hour CPT 96131 Psychological Testing - Additional Hour — CPT code 96131 covers psychological testing - additional hour performed in a clinical or hospital setting. |
— | $78 | $78 | -1% | 29 |
| Therapeutic Injection (IM/SubQ) CPT 96372 Therapeutic injection — injection of medication into a muscle or under the skin for treatment purposes. |
— | $57 | $57 | avg | 37 |
| IV Push (single drug) CPT 96374 IV push medication — rapid injection of medication directly into a vein or existing IV line. |
— | $166 | $166 | avg | 34 |
| Chemotherapy Infusion (first hour) CPT 96413 Chemotherapy IV infusion, first hour — administration of cancer-fighting medication through an IV line for the initial hour. |
— | $306 | $306 | avg | 34 |
| PT - Ultrasound Therapy CPT 97035 Ultrasound — pt - ultrasound therapy. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $41 | $41 | avg | 15 |
| PT - Therapeutic Exercise CPT 97110 Therapeutic exercises — a physical therapy session focused on exercises to improve strength, flexibility, endurance, or range of motion. |
— | $97 | $97 | avg | 15 |
| PT - Gait Training CPT 97116 PT - Gait Training — CPT code 97116 covers pt - gait training performed in a clinical or hospital setting. |
— | $67 | $67 | avg | 15 |
| PT - Manual Therapy CPT 97140 Manual therapy — hands-on treatment by a physical therapist including joint mobilization, soft tissue massage, and manual stretching. |
— | $57 | $57 | -1% | 15 |
| PT Evaluation - Low Complexity CPT 97161 Physical therapy evaluation, low complexity — initial assessment by a physical therapist for a straightforward condition. |
— | $103 | $103 | avg | 15 |
| PT Evaluation - Moderate Complexity CPT 97162 Physical therapy evaluation, moderate complexity — initial assessment by a physical therapist for a condition requiring moderate clinical decision-making. |
— | $148 | $148 | avg | 15 |
| PT Evaluation - High Complexity CPT 97163 Physical therapy evaluation, high complexity — comprehensive initial assessment by a physical therapist for a complex condition. |
— | $217 | $217 | avg | 15 |
| PT - Therapeutic Activities CPT 97530 Therapeutic activities — functional movement training to improve your ability to perform daily activities. |
— | $66 | $66 | avg | 15 |
| New Patient Visit - Low Complexity CPT 99202 New Patient Visit - Low Complexity — CPT code 99202 covers new patient visit - low complexity performed in a clinical or hospital setting. |
— | $26 | $26 | +1% | 25 |
| New Patient Visit - Moderate Complexity CPT 99203 Office visit for a new patient with a low complexity medical problem. Typically 30-44 minutes for initial evaluation, history, and treatment planning. |
— | $39 | $39 | +1% | 25 |
| New Patient Visit - High Complexity CPT 99204 Office visit for a new patient with a moderate to high complexity medical problem. Typically 45-59 minutes for comprehensive evaluation. |
— | $64 | $64 | avg | 25 |
| New Patient Visit - Comprehensive CPT 99205 Office visit for a new patient with a high complexity medical problem. Typically 60-74 minutes for comprehensive evaluation and management. |
— | $80 | $80 | +1% | 25 |
| Office Visit - Minimal (Level 1) CPT 99211 Office Visit - Minimal (Level 1) — CPT code 99211 covers office visit - minimal (level 1) performed in a clinical or hospital setting. |
— | $9 | $9 | -1% | 25 |
| Office Visit - Straightforward (Level 2) CPT 99212 Office Visit - Straightforward (Level 2) — CPT code 99212 covers office visit - straightforward (level 2) performed in a clinical or hospital setting. |
— | $13 | $13 | +1% | 25 |
| Office Visit - Low Complexity (Level 3) CPT 99213 Office visit for an established patient with a low to moderate complexity medical problem. Typically 20-29 minutes with your doctor for evaluation and management. |
— | $26 | $26 | -2% | 25 |
| Office Visit - Moderate Complexity (Level 4) CPT 99214 Office visit for an established patient with a moderate to high complexity medical problem. Typically 30-39 minutes with your doctor for evaluation and management. |
— | $38 | $38 | +1% | 25 |
| Office Visit - High Complexity (Level 5) CPT 99215 Office visit for an established patient with a high complexity medical problem. Typically 40-54 minutes with your doctor for detailed evaluation and management. |
— | $53 | $53 | +1% | 25 |
| ER Visit - Minor Problem CPT 99281 Emergency department visit for a minor, self-limited problem requiring minimal evaluation. |
— | $64 | $64 | avg | 37 |
| ER Visit - Low Complexity CPT 99282 Emergency department visit for a low to moderate severity problem requiring a brief evaluation. |
— | $97 | $97 | avg | 37 |
| ER Visit - Moderate Complexity CPT 99283 Emergency department visit for a moderate severity problem requiring an expanded evaluation. |
— | $169 | $169 | avg | 37 |
| ER Visit - High Complexity CPT 99284 Emergency department visit for a high severity problem requiring urgent evaluation, but not an immediate threat to life. |
— | $274 | $274 | avg | 37 |
| ER Visit - Immediate Threat to Life CPT 99285 Emergency department visit for a severe, potentially life-threatening problem requiring immediate and comprehensive evaluation. |
— | $358 | $358 | avg | 37 |
| Critical Care - First Hour CPT 99291 Critical care, first 30-74 minutes — intensive medical care for a critically ill or injured patient whose condition requires constant attention from the physician. |
— | $611 | $611 | avg | 36 |
| Critical Care - Additional 30 Min CPT 99292 Critical care, each additional 30 minutes — continued intensive care beyond the first 74 minutes for a critically ill patient. |
— | $314 | $314 | avg | 29 |
| Preventive Visit - New Patient (18-39) CPT 99385 Preventive Visit - New Patient (18-39) — CPT code 99385 covers preventive visit - new patient (18-39) performed in a clinical or hospital setting. |
— | $103 | $103 | avg | 25 |
| Preventive Visit - New Patient (40-64) CPT 99386 Preventive Visit - New Patient (40-64) — CPT code 99386 covers preventive visit - new patient (40-64) performed in a clinical or hospital setting. |
— | $111 | $111 | avg | 25 |
| Preventive Visit - New Patient (65+) CPT 99387 Preventive Visit - New Patient (65+) — CPT code 99387 covers preventive visit - new patient (65+) performed in a clinical or hospital setting. |
— | $119 | $119 | avg | 25 |
| Preventive Visit - Established (18-39) CPT 99395 Preventive Visit - Established (18-39) — CPT code 99395 covers preventive visit - established (18-39) performed in a clinical or hospital setting. |
— | $102 | $102 | avg | 25 |
| Preventive Visit - Established (40-64) CPT 99396 Preventive Visit - Established (40-64) — CPT code 99396 covers preventive visit - established (40-64) performed in a clinical or hospital setting. |
— | $103 | $103 | avg | 25 |
| Preventive Visit - Established (65+) CPT 99397 Preventive Visit - Established (65+) — CPT code 99397 covers preventive visit - established (65+) performed in a clinical or hospital setting. |
— | $111 | $111 | avg | 25 |
| Telehealth Visit - 5-10 min CPT 99441 Telehealth Visit - 5-10 min — CPT code 99441 covers telehealth visit - 5-10 min performed in a clinical or hospital setting. |
— | $27 | $27 | -1% | 25 |
| Telehealth Visit - 11-20 min CPT 99442 Telehealth Visit - 11-20 min — CPT code 99442 covers telehealth visit - 11-20 min performed in a clinical or hospital setting. |
— | $45 | $45 | avg | 25 |
| Telehealth Visit - 21-30 min CPT 99443 Telehealth Visit - 21-30 min — CPT code 99443 covers telehealth visit - 21-30 min performed in a clinical or hospital setting. |
— | $65 | $65 | +1% | 25 |
| Ceftriaxone Injection 250mg CPT J0696 HCPCS Level II code J0696 — Ceftriaxone Injection 250mg. Healthcare Common Procedure Coding System code for ceftriaxone injection 250mg. |
— | $14 | $14 | -2% | 15 |
| Triamcinolone Injection CPT J3301 HCPCS Level II code J3301 — Triamcinolone Injection. Healthcare Common Procedure Coding System code for triamcinolone injection. |
— | $24 | $24 | avg | 15 |
| Dexamethasone Injection CPT J1100 HCPCS Level II code J1100 — Dexamethasone Injection. Healthcare Common Procedure Coding System code for dexamethasone injection. |
— | $6 | $6 | -2% | 14 |
| Septicemia/Severe Sepsis w/o MV >96hrs w MCC MS-DRG 871 Medicare Severity Diagnosis Related Group DRG-871 — Septicemia/Severe Sepsis w/o MV >96hrs w MCC. Inpatient hospital payment classification for cases involving septicemia/severe sepsis w/o mv >96hrs w mcc. |
— | $15,929 | $15,929 | avg | 1 |
| Heart Failure and Shock w MCC MS-DRG 291 Medicare Severity Diagnosis Related Group DRG-291 — Heart Failure and Shock w MCC. Inpatient hospital payment classification for cases involving heart failure and shock w mcc. |
— | $10,205 | $10,205 | avg | 1 |
| Respiratory Infections/Inflammations w MCC MS-DRG 177 Medicare Severity Diagnosis Related Group DRG-177 — Respiratory Infections/Inflammations w MCC. Inpatient hospital payment classification for cases involving respiratory infections/inflammations w mcc. |
— | $15,294 | $15,294 | avg | 1 |
| Simple Pneumonia and Pleurisy w MCC MS-DRG 193 Medicare Severity Diagnosis Related Group DRG-193 — Simple Pneumonia and Pleurisy w MCC. Inpatient hospital payment classification for cases involving simple pneumonia and pleurisy w mcc. |
— | $10,401 | $10,401 | avg | 1 |
| Septicemia/Severe Sepsis w/o MV >96hrs w/o MCC MS-DRG 872 Medicare Severity Diagnosis Related Group DRG-872 — Septicemia/Severe Sepsis w/o MV >96hrs w/o MCC. Inpatient hospital payment classification for cases involving septicemia/severe sepsis w/o mv >96hrs w/o mcc. |
— | $8,267 | $8,267 | avg | 1 |
| Pulmonary Edema and Respiratory Failure MS-DRG 189 Medicare Severity Diagnosis Related Group DRG-189 — Pulmonary Edema and Respiratory Failure. Inpatient hospital payment classification for cases involving pulmonary edema and respiratory failure. |
— | $9,681 | $9,681 | avg | 1 |
| Esophagitis/Gastroenteritis/Misc Digestive w/o MCC MS-DRG 392 Medicare Severity Diagnosis Related Group DRG-392 — Esophagitis/Gastroenteritis/Misc Digestive w/o MCC. Inpatient hospital payment classification for cases involving esophagitis/gastroenteritis/misc digestive w/o mcc. |
— | $6,398 | $6,398 | avg | 1 |
| Kidney/Urinary Tract Infections w/o MCC MS-DRG 690 CT scan — kidney/urinary tract infections w/o mcc. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $6,397 | $6,397 | avg | 1 |
| Acute Myocardial Infarction, Discharged Alive w MCC MS-DRG 280 Medicare Severity Diagnosis Related Group DRG-280 — Acute Myocardial Infarction, Discharged Alive w MCC. Inpatient hospital payment classification for cases involving acute myocardial infarction, discharged alive w mcc. |
— | $13,135 | $13,135 | avg | 1 |
| GI Hemorrhage w CC MS-DRG 378 Medicare Severity Diagnosis Related Group DRG-378 — GI Hemorrhage w CC. Inpatient hospital payment classification for cases involving gi hemorrhage w cc. |
— | $7,878 | $7,878 | avg | 1 |
| Infectious/Parasitic Diseases w OR Procedures w MCC MS-DRG 853 Medicare Severity Diagnosis Related Group DRG-853 — Infectious/Parasitic Diseases w OR Procedures w MCC. Inpatient hospital payment classification for cases involving infectious/parasitic diseases w or procedures w mcc. |
— | $38,712 | $38,712 | avg | 1 |
| Renal Failure w CC MS-DRG 683 Medicare Severity Diagnosis Related Group DRG-683 — Renal Failure w CC. Inpatient hospital payment classification for cases involving renal failure w cc. |
— | $7,186 | $7,186 | avg | 1 |
| Kidney/Urinary Tract Infections w MCC MS-DRG 689 CT scan — kidney/urinary tract infections w mcc. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $9,303 | $9,303 | avg | 1 |
| Major Hip/Knee Joint Replacement MS-DRG 470 Medicare Severity Diagnosis Related Group DRG-470 — Major Hip/Knee Joint Replacement. Inpatient hospital payment classification for cases involving major hip/knee joint replacement. |
— | $15,259 | $15,259 | avg | 1 |
| Intracranial Hemorrhage/Cerebral Infarction w CC MS-DRG 065 Medicare Severity Diagnosis Related Group DRG-065 — Intracranial Hemorrhage/Cerebral Infarction w CC. Inpatient hospital payment classification for cases involving intracranial hemorrhage/cerebral infarction w cc. |
— | $8,117 | $8,117 | avg | 1 |
| Other Kidney/Urinary Tract Diagnoses w MCC MS-DRG 698 CT scan — other kidney/urinary tract diagnoses w mcc. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $12,688 | $12,688 | avg | 1 |
| Misc Disorders of Nutrition/Metabolism/Fluids w MCC MS-DRG 640 Medicare Severity Diagnosis Related Group DRG-640 — Misc Disorders of Nutrition/Metabolism/Fluids w MCC. Inpatient hospital payment classification for cases involving misc disorders of nutrition/metabolism/fluids w mcc. |
— | $10,458 | $10,458 | avg | 1 |
| Intracranial Hemorrhage/Cerebral Infarction w MCC MS-DRG 064 Medicare Severity Diagnosis Related Group DRG-064 — Intracranial Hemorrhage/Cerebral Infarction w MCC. Inpatient hospital payment classification for cases involving intracranial hemorrhage/cerebral infarction w mcc. |
— | $16,040 | $16,040 | avg | 1 |
| Hip/Femur Procedures Except Major Joint w CC MS-DRG 481 Medicare Severity Diagnosis Related Group DRG-481 — Hip/Femur Procedures Except Major Joint w CC. Inpatient hospital payment classification for cases involving hip/femur procedures except major joint w cc. |
— | $16,763 | $16,763 | avg | 1 |
| Cardiac Arrhythmia/Conduction Disorders w CC MS-DRG 309 Medicare Severity Diagnosis Related Group DRG-309 — Cardiac Arrhythmia/Conduction Disorders w CC. Inpatient hospital payment classification for cases involving cardiac arrhythmia/conduction disorders w cc. |
— | $5,941 | $5,941 | avg | 1 |
| Misc Disorders of Nutrition/Metabolism/Fluids w/o MCC MS-DRG 641 Medicare Severity Diagnosis Related Group DRG-641 — Misc Disorders of Nutrition/Metabolism/Fluids w/o MCC. Inpatient hospital payment classification for cases involving misc disorders of nutrition/metabolism/fluids w/o mcc. |
— | $6,200 | $6,200 | avg | 1 |
| Cellulitis w/o MCC MS-DRG 603 Medicare Severity Diagnosis Related Group DRG-603 — Cellulitis w/o MCC. Inpatient hospital payment classification for cases involving cellulitis w/o mcc. |
— | $7,061 | $7,061 | avg | 1 |
| COPD w MCC MS-DRG 190 Medicare Severity Diagnosis Related Group DRG-190 — COPD w MCC. Inpatient hospital payment classification for cases involving copd w mcc. |
— | $8,650 | $8,650 | avg | 1 |
| Percutaneous Cardiovascular Proc w Drug-Eluting Stent w/o MCC MS-DRG 247 Medicare Severity Diagnosis Related Group DRG-247 — Percutaneous Cardiovascular Proc w Drug-Eluting Stent w/o MCC. Inpatient hospital payment classification for cases involving percutaneous cardiovascular proc w drug-eluting stent w/o mcc. |
— | $16,516 | $16,516 | avg | 1 |
| Major Small/Large Bowel Procedures w CC MS-DRG 330 Medicare Severity Diagnosis Related Group DRG-330 — Major Small/Large Bowel Procedures w CC. Inpatient hospital payment classification for cases involving major small/large bowel procedures w cc. |
— | $19,493 | $19,493 | avg | 1 |
| Syncope and Collapse MS-DRG 312 Medicare Severity Diagnosis Related Group DRG-312 — Syncope and Collapse. Inpatient hospital payment classification for cases involving syncope and collapse. |
— | $6,818 | $6,818 | avg | 1 |
Prices are typical ranges based on McLaren Northern Michigan's published transparency data. Your actual cost depends on your specific plan, deductible status, and clinical details.
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Insurance Plans with Negotiated Rates
Taven has payer-specific negotiated rate data from 7 insurers at McLaren Northern Michigan. The "Avg Negotiated" rate in the table above represents the average across all payers. Individual payer rates may be higher or lower.
Aetna (CVS Health)
BCBS (Various Licensees)
Humana
Medicaid
Medicare (CMS)
Other
UnitedHealthcare (UHC)
Negotiated rates vary by insurance plan. The prices shown are aggregated from this hospital's publicly filed machine-readable file. Your actual rate depends on your specific insurance plan and network tier. Use our price comparison tool to see payer-specific breakdowns.
Financial Assistance at McLaren Northern Michigan
As a nonprofit hospital, McLaren Northern Michigan is required under IRS Section 501(r) to offer a financial assistance program (also called "charity care").
Patients at or below 300% of the Federal Poverty Level generally qualify for reduced or free care. You can apply as soon as care is received — through the hospital's financial counseling office, online portal, or billing department.
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Under the No Surprises Act and hospital price transparency rules, you have the right to receive a Good Faith Estimate before scheduled care, protection from surprise out-of-network bills in emergencies, and access to the hospital's published pricing data.
▸ Technical Details
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare Provider #
230105
Emergency Services
Yes
Metro Area
Petoskey, MI
Procedures Tracked
243
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