PayerPrice
Data Platform
Who We Serve
Use Cases
More

Data Search

ProceduresSpecialtiesHospitalsPayers

Company

About UsContact

Resources

BlogResource Hub
Check Local Rates
Short Term Acute Care HospitalPhysician

Pinnacle Hospital

Crown Point, IN

9301 Connecticut Drive, Crown Point, IN 46307(219) 756-2100

Not rated by CMS

CMS star rating

18

Beds

482

Inpatient discharges a year

$39.7M

Net patient revenue a year

34

In-network payers

About this hospital

Pinnacle Hospital is an 18-bed physician hospital in Crown Point, IN. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 231 disclosed rate categories.

CCN
150166
NPI
1801969670
Teaching
No Medicare-funded residents
County
Lake County
Metro area
Chicago-Naperville-Elgin, IL-IN MSA
Medicare contractor
Jurisdiction 8, WPS Government Health Administrators (08001)
In Medicare since
2007
Last CMS survey
2019

Prices for common services

The 24 services Pinnacle 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, or start a free trial.

Medicine & Surgery · Inpatient

Major lower-extremity joint replacement without MCC

MS-DRG 470

$11,714 - $25,074

from 4 insurers · median $14,680

Aetna$13,907
Insurer A*$11,714
Insurer B*$15,452
Insurer C*$25,074
Medicare $10,413Nearby hospitals $26,08044% below nearby hospitals

72 Medicare discharges for this DRG in CMS hospital data

Medicine & Surgery · Inpatient

Spinal fusion except cervical without MCC

MS-DRG 460

$22,973 - $28,922

from 3 insurers · median $26,374

Aetna$26,374
Insurer A*$22,973
Insurer B*$28,922
Medicare $46,694Nearby hospitals $28,2707% below nearby hospitals

18 Medicare discharges for this DRG in CMS hospital data

Medicine & Surgery · Inpatient

Cervical spinal fusion without CC or MCC

MS-DRG 473

$14,892 - $31,248

from 4 insurers · median $16,680

Aetna$17,741
Insurer A*$14,892
Insurer B*$15,619
Insurer C*$31,248
Medicare $50,721Nearby hospitals $30,55445% below nearby hospitals

13 Medicare discharges for this DRG in CMS hospital data

Cardiology and vascular testing

Complete echocardiogram with Doppler and color flow

CPT 93306

$705 - $4,652

from 2 insurers · median $2,679

Aetna$4,652
Insurer A*$705
Medicare $545Nearby hospitals $1,074150% above nearby hospitals

Common here, based on CMS Medicare volume

How the insurers pay at Pinnacle Hospital

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.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*18
309%
02
Insurer B*23
179%
815
Insurer C*22
140%
019
Insurer D*22
76%
312

How we chose these services: 8 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 1 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 Pinnacle Hospital, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
AmbetterAmeri HealthAspirus Health PlanAvera Health PlansBanner HealthCareSource (incl Common Ground Health Coop)

More about this hospital

  • Quality

    Not rated by CMS

    • No Medicare readmissions penalty
    See quality ratings

  • Doctors and services

    Accredited by ACHC

    • No Medicare-funded residents
    • 23 services
    • 61 affiliated clinicians
    See doctors and services

  • Finances

    $39.7M net patient revenue

    • Operating margin on patient care -10.5%
    • $971,732 unreimbursed and uncompensated care
    • -$4.4M net income
    See finances

  • Ownership and leadership

    Owned by Pinnacle Healthcare LLC

    • Physician ownership
    • Haroon R Ansari, chief executive
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Pinnacle Hospital in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
20-2459247Pinnacle Healthcare LLC53Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 48 more1801969670 Pinnacle Healthcare LLC1922546530 Pinnacle Healthcare LLC1184916447 Pinnacle Healthcare LLC

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

9301 Connecticut Drive, Crown Point, IN 46307

(219) 756-2100

Get directions

Frequently asked questions

About Pinnacle Hospital's rates and hospital price transparency.

How much does an MRI cost at Pinnacle Hospital?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Pinnacle Hospital range from $270 to $1,853 across 4 insurers. Cigna's rate is $905. The median at nearby comparable hospitals is $856. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Pinnacle Hospital?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Pinnacle Hospital range from $311 to $1,077 across 4 insurers. Blue Cross Blue Shield's rate is $1,077. The median at nearby comparable hospitals is $856. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Pinnacle Hospital?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Pinnacle Hospital range from $565 to $2,435 across 4 insurers. UnitedHealthcare's rate is $629. The median at nearby comparable hospitals is $2,677. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Pinnacle Hospital?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Pinnacle Hospital range from $116 to $159 across 2 insurers. Blue Cross Blue Shield's rate is $159. The median at nearby comparable hospitals is $214. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does hip or knee replacement cost at Pinnacle Hospital?

For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Pinnacle Hospital range from $11,714 to $25,074 across 4 insurers. Aetna's rate is $13,907. The median at nearby comparable hospitals is $26,080. What a patient pays depends on their plan's deductible, coinsurance and network status.

Is Pinnacle Hospital a teaching hospital?

CMS reports no Medicare-funded interns or residents at Pinnacle Hospital for fiscal year 2027.

Does Medicare penalize Pinnacle Hospital for readmissions?

No. Pinnacle Hospital has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.

What are the most common Medicare inpatient stays at Pinnacle Hospital?

In 2024, the most common were combined anterior and posterior spinal fusion without cc/mcc (44 discharges), major hip and knee joint replacement or reattachment of lower extremity without mcc (42 discharges), cervical spinal fusion without cc/mcc (23 discharges).

What is Pinnacle Hospital's case mix index?

Pinnacle Hospital's Medicare case mix index is 3.09 for fiscal year 2027, higher than 97% of hospitals paid under the inpatient prospective payment system.

How many patients does Pinnacle Hospital admit?

Pinnacle Hospital reported 482 inpatient discharges and 1,118 inpatient days from Jan 1, 2025 to Dec 31, 2025.

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