Hospital Sisters Health System · Sturgeon Bay, WI
34
In-network payers
90
Disclosed rate categories
25
Beds
4
Care quality
Door County Medical Center is a 25-bed voluntary non-profit - church hospital in Sturgeon Bay, WI, affiliated with Hospital Sisters Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 90 disclosed rate categories.
CCN (Medicare provider number)
521358
NPI
1093743874
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Church
Beds
25
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Door County Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 788
$10,983 - $14,437
from 3 insurers · median $13,587
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 807
$6,031 - $9,147
from 3 insurers · median $6,366
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
CT imaging
CPT 74177
$3,098 - $3,590
from 4 insurers · median $3,350
Typical for a hospital with this service line
CT imaging
CPT 74176
$2,684 - $2,964
from 4 insurers · median $2,902
Typical for a hospital with this service line
CT imaging
CPT 70450
$1,033 - $1,160
from 4 insurers · median $1,087
Typical for a hospital with this service line
CT imaging
CPT 71275
$2,782 - $3,263
from 4 insurers · median $3,104
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$815 - $2,110
from 4 insurers · median $1,978
Typical for a hospital with this service line
MRI imaging
CPT 70553
$3,655 - $4,287
from 4 insurers · median $4,035
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$2,495 - $2,867
from 4 insurers · median $2,754
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$2,171 - $3,405
from 4 insurers · median $3,238
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$2,191 - $2,795
from 4 insurers · median $2,620
Typical for a hospital with this service line
MRI imaging
CPT 72148
$2,602 - $3,052
from 4 insurers · median $2,872
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$302 - $343
from 4 insurers · median $326
Typical for a hospital with this service line
MRI imaging
CPT 70551
$1,721 - $2,774
from 4 insurers · median $2,622
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$6,031 - $9,147
from 3 insurers · median $6,366
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Digestive procedures
CPT 45378
$2,939 - $3,136
from 4 insurers · median $3,001
Typical for a hospital with this service line
Mammography
CPT 77067
$193 - $255
from 4 insurers · median $218
Typical for a hospital with this service line
MRI imaging
CPT 73721
$2,430 - $2,692
from 4 insurers · median $2,679
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$2,599 - $2,924
from 4 insurers · median $2,869
Hospital reports nuclear medicine services to CMS
Medicine & Surgery
CPT 47562
$5,678 - $10,503
from 4 insurers · median $8,088
Typical for a hospital with this service line
Ultrasound
CPT 76705
$665 - $770
from 4 insurers · median $719
Typical for a hospital with this service line
Laboratory and pathology
CPT 80053
$159 - $175
from 3 insurers · median $169
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$831 - $975
from 4 insurers · median $917
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$2,709 - $4,166
from 4 insurers · median $3,664
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 685% | 14 | 5 |
| Insurer B* | 24 | 661% | 20 | 1 |
| Insurer C* | 24 | 622% | 14 | 6 |
| Insurer D* | 20 | 554% | 13 | 7 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Door County Medical Center.
323 South 18th Avenue, Sturgeon Bay, WI 54235
(920) 743-5566
The nearest hospitals of similar type and size. Their rates are compared with Door County Medical Center for the same insurers and services above.
Bellin Health Oconto Hospital
▼ Rates typically 64% lower than Door County Medical Center (21 services)
Paul Oliver Memorial Hospital
▼ Rates typically 20% lower than Door County Medical Center (17 services)
Thedacare Medical Center - Shawano
▼ Rates typically 49% lower than Door County Medical Center (21 services)
Osf St. Francis Hospital & Medical Group - Escanaba
▼ Rates typically 35% lower than Door County Medical Center (20 services)
Calumet Hospital
▼ Rates typically 29% lower than Door County Medical Center (18 services)
Thedacare Medical Center-New London
▼ Rates typically 49% lower than Door County Medical Center (21 services)
St Clare Memorial Hospital Inc
Memorial Medical Center Inc.
Marshfield Medical Center - Ladysmith
Hudson Hospital
About Door County Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Door County Medical Center range from $3,655 to $4,287 across 4 insurers. Blue Cross Blue Shield's rate is $4,021. The median at nearby comparable hospitals is $1,177. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Door County Medical Center range from $3,098 to $3,590 across 4 insurers. Aetna's rate is $3,590. The median at nearby comparable hospitals is $1,069. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Door County Medical Center range from $2,171 to $3,405 across 4 insurers. UnitedHealthcare's rate is $2,171. The median at nearby comparable hospitals is $2,960. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Cesarean delivery, hospital stay (MS-DRG 788), published negotiated rates at Door County Medical Center range from $10,983 to $14,437 across 3 insurers. Blue Cross Blue Shield's rate is $10,983. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Door County Medical Center range from $193 to $255 across 4 insurers. UnitedHealthcare's rate is $193. The median at nearby comparable hospitals is $384. What a patient pays depends on their plan's deductible, coinsurance and network status.
Door County Medical Center has 25 beds. Facility type: Critical Access Hospital.
Door County Medical Center is located at 323 South 18th Avenue, Sturgeon Bay, WI 54235. Its main phone number is (920) 743-5566.
Door County Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 521358.
The National Provider Identifier (NPI) on file for Door County Medical Center is 1093743874.
Door County Medical Center is affiliated with Hospital Sisters Health System.
Door County Medical Center lists 34 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
90 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers