Mercy Health (WI) · Lake Geneva, WI
33
In-network payers
247
Disclosed rate categories
25
Beds
5
Care quality
Mercyhealth Hospital And Medical Center–Walworth is a 25-bed voluntary non-profit - private hospital in Lake Geneva, WI, affiliated with Mercy Health (WI). Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 247 disclosed rate categories.
CCN (Medicare provider number)
521357
NPI
1699728550
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
25
Care Quality
5
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 Mercyhealth Hospital And Medical Center–Walworth 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.
CT imaging
CPT 74177
$1,124 - $6,152
from 4 insurers · median $5,817
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$5,695 - $10,543
from 4 insurers · median $7,905
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$4,935 - $10,543
from 4 insurers · median $7,676
Typical for a hospital with this service line
CT imaging
CPT 70450
$331 - $1,792
from 4 insurers · median $1,254
Typical for a hospital with this service line
CT imaging
CPT 74176
$511 - $4,514
from 2 insurers · median $2,512
Typical for a hospital with this service line
MRI imaging
CPT 70553
$1,079 - $5,854
from 4 insurers · median $5,752
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$3,206 - $13,728
from 3 insurers · median $4,612
Typical for a hospital with this service line
Mammography
CPT 77067
$439 - $954
from 4 insurers · median $691
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$995 - $2,171
from 4 insurers · median $1,846
Typical for a hospital with this service line
CT imaging
CPT 71275
$984 - $3,275
from 2 insurers · median $2,130
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$8,249 - $26,319
from 4 insurers · median $20,268
Typical for a hospital with this service line
Gynecology
CPT 58571
$24,902 - $33,561
from 3 insurers · median $25,496
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$3,976 - $8,074
from 4 insurers · median $5,701
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$109 - $449
from 4 insurers · median $410
Typical for a hospital with this service line
MRI imaging
CPT 74183
$1,211 - $5,854
from 3 insurers · median $5,779
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$34,470 - $85,100
from 4 insurers · median $48,675
Hospital reports orthopedic surgery services to CMS
Ultrasound
CPT 76705
$286 - $1,345
from 4 insurers · median $1,158
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93970
$1,346 - $4,514
from 3 insurers · median $3,778
Typical for a hospital with this service line
MRI imaging
CPT 72148
$620 - $4,514
from 2 insurers · median $2,567
Typical for a hospital with this service line
MRI imaging
CPT 70551
$642 - $4,514
from 2 insurers · median $2,578
Typical for a hospital with this service line
Gynecology
CPT 58661
$4,222 - $26,319
from 4 insurers · median $20,268
Typical for a hospital with this service line
Medicine & Surgery
CPT 42820
$4,722 - $18,139
from 4 insurers · median $14,755
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93880
$796 - $4,514
from 3 insurers · median $3,778
Typical for a hospital with this service line
Gynecology
CPT 58662
$15,859 - $26,319
from 4 insurers · median $20,268
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* | 23 | 940% | 17 | 2 |
| Insurer B* | 17 | 856% | 10 | 2 |
| Insurer C* | 19 | 411% | 12 | 3 |
| Insurer D* | 24 | 314% | 8 | 10 |
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 Mercyhealth Hospital And Medical Center–Walworth.
N2950 State Road 67, Lake Geneva, WI 53147
(262) 245-0535
The nearest hospitals of similar type and size. Their rates are compared with Mercyhealth Hospital And Medical Center–Walworth for the same insurers and services above.
Edgerton Hospital & Health Services
▼ Rates typically 88% lower than Mercyhealth Hospital And Medical Center–Walworth (7 services)
Stoughton Hospital Association
▼ Rates typically 29% lower than Mercyhealth Hospital And Medical Center–Walworth (20 services)
Rochelle Community Hospital
Rates about the same as Mercyhealth Hospital And Medical Center–Walworth (19 services)
Prairie Ridge Health
Rates about the same as Mercyhealth Hospital And Medical Center–Walworth (20 services)
Northwestern Medicine Valley West Hospital
▼ Rates typically 38% lower than Mercyhealth Hospital And Medical Center–Walworth (24 services)
Waupun Memorial Hospital
▼ Rates typically 34% lower than Mercyhealth Hospital And Medical Center–Walworth (24 services)
Mayo Clinic Health-Chippewa Valley Bloomer
Adventhealth Durand
St Clare Memorial Hospital Inc
Aspirus Tomahawk Hospital
About Mercyhealth Hospital And Medical Center–Walworth's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Mercyhealth Hospital And Medical Center–Walworth range from $1,079 to $5,854 across 4 insurers. UnitedHealthcare's rate is $5,779. The median at nearby comparable hospitals is $4,804. 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 Mercyhealth Hospital And Medical Center–Walworth range from $1,124 to $6,152 across 4 insurers. Blue Cross Blue Shield's rate is $1,124. The median at nearby comparable hospitals is $5,111. 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 Mercyhealth Hospital And Medical Center–Walworth range from $5,695 to $10,543 across 4 insurers. Aetna's rate is $6,153. The median at nearby comparable hospitals is $4,564. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Mercyhealth Hospital And Medical Center–Walworth range from $439 to $954 across 4 insurers. Aetna's rate is $954. The median at nearby comparable hospitals is $300. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Mercyhealth Hospital And Medical Center–Walworth range from $34,470 to $85,100 across 4 insurers. Cigna's rate is $34,470. The median at nearby comparable hospitals is $30,085. What a patient pays depends on their plan's deductible, coinsurance and network status.
Mercyhealth Hospital And Medical Center–Walworth has 25 beds. Facility type: Critical Access Hospital.
Mercyhealth Hospital And Medical Center–Walworth is located at N2950 State Road 67, Lake Geneva, WI 53147. Its main phone number is (262) 245-0535.
Mercyhealth Hospital And Medical Center–Walworth's CMS Certification Number (CCN), also called its Medicare provider number, is 521357.
The National Provider Identifier (NPI) on file for Mercyhealth Hospital And Medical Center–Walworth is 1699728550.
Mercyhealth Hospital And Medical Center–Walworth is affiliated with Mercy Health (WI).
Mercyhealth Hospital And Medical Center–Walworth lists 33 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.
247 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