PayerPrice
Data Platform
Who We Serve
Use Cases
More
Check Local Rates
Critical Access HospitalVoluntary Non-Profit - Private

Edgerton Hospital & Health Services

Edgerton, WI

11101 North Sherman Road, Edgerton, WI 53534(608) 884-3441

31

In-network payers

84

Disclosed rate categories

16

Beds

About this hospital

Edgerton Hospital & Health Services is a 16-bed voluntary non-profit - private hospital in Edgerton, WI. Below you'll find publicly disclosed negotiated rates and facility details, including 31 in-network payers and 84 disclosed rate categories.

CCN (Medicare provider number)

521319

NPI

1154350049

Type

Critical Access Hospital

Ownership

Voluntary Non-Profit - Private

Beds

16

Insurance Accepted

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.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCenteneDean Health Plan

Negotiated Rates

The data below comes from CMS-mandated price transparency data. Learn more.

Book a call about hospital compliance MRFs
PayerCategoryCode Type & GroupContract Typevs. State Average

Aetna

Outpatient

CPT Anesthesia

Range: 00100 - 01999

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Anesthesia

Range: 00100 - 01999

Negotiated

Very Low

Aetna

Outpatient

CPT Category III Codes

Range: 0042T - 0810T

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Negotiated

Very Low

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Negotiated

Very Low

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Pathology and Laboratory Procedures

Range: 80047 - 89398

Negotiated

Very Low

Aetna

Outpatient

CPT Pathology and Laboratory Procedures

Range: 80047 - 89398

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Radiology Procedures

Range: 70010 - 79999

Negotiated

Very Low

Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

Showing 1 - 10 of 84

View all hospital rates
...

Location

11101 North Sherman Road, Edgerton, WI 53534

(608) 884-3441

Get directions

Frequently asked questions

About Edgerton Hospital & Health Services's rates and hospital price transparency.

How many beds does Edgerton Hospital & Health Services have?

Edgerton Hospital & Health Services has 16 beds. Facility type: Critical Access Hospital.

Where is Edgerton Hospital & Health Services and what is its phone number?

Edgerton Hospital & Health Services is located at 11101 North Sherman Road, Edgerton, WI 53534. Its main phone number is (608) 884-3441.

What is Edgerton Hospital & Health Services's CCN (Medicare provider number)?

Edgerton Hospital & Health Services's CMS Certification Number (CCN), also called its Medicare provider number, is 521319.

What is Edgerton Hospital & Health Services's NPI number?

The National Provider Identifier (NPI) on file for Edgerton Hospital & Health Services is 1154350049.

Which insurance plans are in network at Edgerton Hospital & Health Services?

Edgerton Hospital & Health Services lists 31 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.

What price transparency data is available for Edgerton Hospital & Health Services?

84 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.

What is a hospital price transparency MRF?

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.

What is a chargemaster review?

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.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "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
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
Talk to us about your MRF
Chargemaster analysis

Get your chargemaster right for billing and payer contracts

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

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
Talk to us about your chargemaster