SSM Health · Monroe, WI
34
In-network payers
233
Disclosed rate categories
95
Beds
4
Care quality
Monroe Clinic Hospital is a 95-bed voluntary non-profit - private hospital in Monroe, WI, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 233 disclosed rate categories.
CCN (Medicare provider number)
520028
NPI
1740291491
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
95
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 Monroe Clinic Hospital 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
$14,764 - $57,113
from 4 insurers · median $21,520
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
$6,489 - $20,020
from 4 insurers · median $9,447
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
$606 - $4,485
from 4 insurers · median $3,004
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$11,383 - $27,982
from 4 insurers · median $19,146
53 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 66984
$4,982 - $11,110
from 4 insurers · median $7,517
327 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Digestive procedures
CPT 49650
$13,840 - $27,982
from 4 insurers · median $23,013
53 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Cardiology and vascular testing
CPT 93306
$1,741 - $3,365
from 4 insurers · median $2,532
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$331 - $3,500
from 4 insurers · median $2,615
Common here, based on CMS Medicare volume
Digestive procedures
CPT 47563
$13,840 - $27,982
from 4 insurers · median $22,077
53 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 43239
$3,600 - $8,651
from 4 insurers · median $5,479
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$284 - $493
from 4 insurers · median $417
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$3,524 - $7,620
from 4 insurers · median $4,524
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$474 - $2,852
from 4 insurers · median $1,906
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$10,057 - $38,903
from 4 insurers · median $17,208
Typical for a hospital with this service line
CT imaging
CPT 71275
$610 - $2,852
from 4 insurers · median $1,789
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78815
$2,445 - $7,471
from 4 insurers · median $6,058
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$54 - $1,502
from 4 insurers · median $391
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$767 - $4,045
from 4 insurers · median $2,186
Common here, based on CMS Medicare volume
Gynecology
CPT 58558
$4,982 - $22,900
from 4 insurers · median $15,538
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,196 - $7,022
from 4 insurers · median $3,415
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$435 - $3,498
from 4 insurers · median $2,615
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$16,971 - $27,982
from 4 insurers · median $23,013
Typical for a hospital with this service line
Gynecology
CPT 58661
$7,711 - $27,982
from 4 insurers · median $17,269
Typical for a hospital with this service line
Medicine & Surgery
CPT 49505
$8,858 - $22,914
from 3 insurers · median $13,623
13 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
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 | 603% | 8 | 1 |
| Insurer B* | 24 | 439% | 14 | 4 |
| Insurer C* | 24 | 380% | 16 | 6 |
| Insurer D* | 24 | 220% | 12 | 10 |
How we chose these services: 5 appear in this hospital's own Medicare claims, 13 are common here based on CMS Medicare volume, and 6 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 Monroe Clinic Hospital.
515 22nd Avenue, Monroe, WI 53566
(608) 324-1000
The nearest hospitals of similar type and size. Their rates are compared with Monroe Clinic Hospital for the same insurers and services above.
Fhn Memorial Hospital
▼ Rates typically 34% lower than Monroe Clinic Hospital (22 services)
Beloit Memorial Hospital
▼ Rates typically 7% lower than Monroe Clinic Hospital (22 services)
Fort Atkinson Memorial Hospital
▼ Rates typically 47% lower than Monroe Clinic Hospital (22 services)
Katherine Shaw Bethea
▼ Rates typically 41% lower than Monroe Clinic Hospital (12 services)
Unitypoint Health Finley Hospital
▼ Rates typically 55% lower than Monroe Clinic Hospital (22 services)
Cgh Medical Center
▼ Rates typically 83% lower than Monroe Clinic Hospital (18 services)
Ssm Health St. Mary S Hospital - Janesville
Ssm Health St. Clare Hospital - Baraboo
Ssm Health St. Mary S Hospital - Madison
St. Agnes Hospital
About Monroe Clinic Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Monroe Clinic Hospital range from $767 to $4,045 across 4 insurers. Cigna's rate is $4,045. The median at nearby comparable hospitals is $3,303. 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 Monroe Clinic Hospital range from $606 to $4,485 across 4 insurers. Aetna's rate is $4,485. The median at nearby comparable hospitals is $3,299. 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 Monroe Clinic Hospital range from $3,524 to $7,620 across 4 insurers. Blue Cross Blue Shield's rate is $4,982. The median at nearby comparable hospitals is $2,779. 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 Monroe Clinic Hospital range from $14,764 to $57,113 across 4 insurers. Aetna's rate is $57,113. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Monroe Clinic Hospital range from $284 to $493 across 4 insurers. Aetna's rate is $493. The median at nearby comparable hospitals is $291. What a patient pays depends on their plan's deductible, coinsurance and network status.
Monroe Clinic Hospital has 95 beds. Facility type: Short Term Acute Care Hospital.
Monroe Clinic Hospital is located at 515 22nd Avenue, Monroe, WI 53566. Its main phone number is (608) 324-1000.
Monroe Clinic Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 520028.
The National Provider Identifier (NPI) on file for Monroe Clinic Hospital is 1740291491.
Monroe Clinic Hospital is affiliated with SSM Health.
Monroe Clinic Hospital lists 34 in-network payers, including Aetna, Aspirus Health Plan, Avera Health Plans, BCBS, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
233 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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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.
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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