SSM Health · Madison, WI
33
In-network payers
161
Disclosed rate categories
440
Beds
5
Care quality
Ssm Health St. Mary S Hospital - Madison is a 440-bed voluntary non-profit - private hospital in Madison, WI, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 161 disclosed rate categories.
CCN (Medicare provider number)
520083
NPI
1184621211
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
440
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 Ssm Health St. Mary S Hospital - Madison 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
$21,661 - $76,177
from 2 insurers · median $48,919
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 neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 807
$11,298 - $14,908
from 2 insurers · median $13,103
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 neonatal nursery services to CMS
CT imaging
CPT 74177
$1,221 - $5,033
from 3 insurers · median $1,949
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 470
$7,098 - $43,785
from 2 insurers · median $25,441
100 Medicare discharges for this DRG in CMS hospital data
Medicine & Surgery
CPT 47562
$16,166 - $25,037
from 3 insurers · median $21,130
124 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 216
$98,766 - $237,420
from 2 insurers · median $168,093
11 Medicare discharges for this DRG in CMS hospital data
Cardiology and vascular testing
CPT 93306
$1,715 - $3,333
from 3 insurers · median $3,241
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$14,365 - $23,086
from 3 insurers · median $21,755
67 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 70450
$647 - $2,019
from 2 insurers · median $1,333
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$7,110 - $25,037
from 3 insurers · median $21,130
124 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 460
$72,978
negotiated rate
55 Medicare discharges for this DRG in CMS hospital data
Digestive procedures
CPT 45385
$4,135 - $6,906
from 3 insurers · median $6,836
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$249 - $889
from 2 insurers · median $569
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$993 - $4,843
from 3 insurers · median $2,624
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$11,298 - $14,908
from 2 insurers · median $13,103
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 neonatal nursery services to CMS
Digestive procedures
CPT 47563
$5,838 - $25,037
from 3 insurers · median $21,615
124 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 45380
$2,943 - $6,836
from 3 insurers · median $5,995
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$1,443 - $2,510
from 2 insurers · median $1,977
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$1,221 - $4,750
from 3 insurers · median $2,326
Common here, based on CMS Medicare volume
Urology
CPT 50590
$11,730 - $23,284
from 2 insurers · median $17,507
157 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Nuclear imaging
CPT 78452
$2,747 - $4,716
from 3 insurers · median $3,467
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$5,475 - $7,775
from 2 insurers · median $6,625
Typical for a hospital with this service line
Gynecology
CPT 58661
$3,314 - $25,037
from 3 insurers · median $20,407
Typical for a hospital with this service line
MRI imaging
CPT 72148
$1,311 - $3,408
from 3 insurers · median $2,624
Common here, based on CMS Medicare volume
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 | 514% | 20 | 1 |
| Insurer B* | 19 | 405% | 9 | 7 |
| Insurer C* | 17 | 338% | 9 | 6 |
How we chose these services: 8 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 5 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 Ssm Health St. Mary S Hospital - Madison.
700 South Park Street, Madison, WI 53715
(608) 251-6100
The nearest hospitals of similar type and size. Their rates are compared with Ssm Health St. Mary S Hospital - Madison for the same insurers and services above.
Meriter Hospital
▼ Rates typically 38% lower than Ssm Health St. Mary S Hospital - Madison (21 services)
Uw Health University Hospital
▼ Rates typically 18% lower than Ssm Health St. Mary S Hospital - Madison (18 services)
Mercyhealth Hospital And Trauma Center–janesville
Rates about the same as Ssm Health St. Mary S Hospital - Madison (21 services)
Rockford Memorial Hospital
▼ Rates typically 6% lower than Ssm Health St. Mary S Hospital - Madison (17 services)
Uw Health Swedishamerican Hospital
▼ Rates typically 62% lower than Ssm Health St. Mary S Hospital - Madison (14 services)
Osf Saint Anthony Medical Center - Rockford
▲ Rates typically 14% higher than Ssm Health St. Mary S Hospital - Madison (21 services)
Ssm Health St. Clare Hospital - Baraboo
Ssm Health St. Mary S Hospital - Janesville
About Ssm Health St. Mary S Hospital - Madison's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Ssm Health St. Mary S Hospital - Madison range from $1,221 to $4,750 across 3 insurers. UnitedHealthcare's rate is $1,221. The median at nearby comparable hospitals is $1,636. 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 Ssm Health St. Mary S Hospital - Madison range from $1,221 to $5,033 across 3 insurers. Aetna's rate is $5,033. The median at nearby comparable hospitals is $2,532. 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 Ssm Health St. Mary S Hospital - Madison range from $4,135 to $6,906 across 3 insurers. UnitedHealthcare's rate is $6,836. The median at nearby comparable hospitals is $4,581. 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 Ssm Health St. Mary S Hospital - Madison range from $21,661 to $76,177 across 2 insurers. Blue Cross Blue Shield's rate is $21,661. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Ssm Health St. Mary S Hospital - Madison range from $249 to $889 across 2 insurers. Blue Cross Blue Shield's rate is $889. The median at nearby comparable hospitals is $352. 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 Ssm Health St. Mary S Hospital - Madison range from $7,098 to $43,785 across 2 insurers. Blue Cross Blue Shield's rate is $43,785. The median at nearby comparable hospitals is $31,167. What a patient pays depends on their plan's deductible, coinsurance and network status.
Ssm Health St. Mary S Hospital - Madison has 440 beds. Facility type: Short Term Acute Care Hospital.
Ssm Health St. Mary S Hospital - Madison is located at 700 South Park Street, Madison, WI 53715. Its main phone number is (608) 251-6100.
Ssm Health St. Mary S Hospital - Madison's CMS Certification Number (CCN), also called its Medicare provider number, is 520083.
The National Provider Identifier (NPI) on file for Ssm Health St. Mary S Hospital - Madison is 1184621211.
Ssm Health St. Mary S Hospital - Madison is affiliated with SSM Health.
Ssm Health St. Mary S Hospital - Madison lists 33 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.
161 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