ThedaCare · Berlin, WI
40
In-network payers
214
Disclosed rate categories
25
Beds
5
Care quality
Thedacare-Berlin is a 25-bed voluntary non-profit - private hospital in Berlin, WI, affiliated with ThedaCare. Below you'll find publicly disclosed negotiated rates and facility details, including 40 in-network payers and 214 disclosed rate categories.
CCN (Medicare provider number)
521355
NPI
1760413777
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 Thedacare-Berlin 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
$11,582 - $25,609
from 4 insurers · median $21,513
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
$7,983 - $10,346
from 4 insurers · median $9,167
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
$844 - $3,491
from 4 insurers · median $1,773
Typical for a hospital with this service line
CT imaging
CPT 70450
$278 - $1,546
from 4 insurers · median $851
Typical for a hospital with this service line
CT imaging
CPT 74176
$530 - $3,170
from 4 insurers · median $1,488
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$584 - $1,621
from 4 insurers · median $1,433
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$7,983 - $10,346
from 4 insurers · median $9,167
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 obstetrics / child birth services to CMS
Mammography
CPT 77067
$100 - $503
from 4 insurers · median $330
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,217 - $3,173
from 4 insurers · median $2,833
Typical for a hospital with this service line
CT imaging
CPT 71275
$467 - $2,553
from 4 insurers · median $1,399
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,257 - $3,173
from 4 insurers · median $2,462
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,101 - $2,963
from 4 insurers · median $1,946
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$1,680 - $14,130
from 4 insurers · median $11,282
Typical for a hospital with this service line
Gynecology
CPT 58571
$9,015 - $15,798
from 3 insurers · median $12,581
Typical for a hospital with this service line
MRI imaging
CPT 70553
$926 - $2,728
from 4 insurers · median $1,779
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$29,335 - $45,402
from 4 insurers · median $33,238
Hospital reports orthopedic surgery services to CMS
X-ray and bone density
CPT 71046
$92 - $240
from 4 insurers · median $201
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,179 - $3,444
from 4 insurers · median $2,563
Hospital reports nuclear medicine services to CMS
Medicine & Surgery
CPT 66984
$1,438 - $5,130
from 4 insurers · median $4,363
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$939 - $2,963
from 4 insurers · median $2,046
Typical for a hospital with this service line
MRI imaging
CPT 72148
$561 - $2,300
from 4 insurers · median $1,420
Typical for a hospital with this service line
MRI imaging
CPT 70551
$557 - $2,463
from 4 insurers · median $1,381
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 743
$18,869 - $18,887
from 2 insurers · median $18,878
Hospital reports inpatient surgical services to CMS
MRI imaging
CPT 73721
$567 - $2,969
from 4 insurers · median $1,326
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 | 290% | 15 | 5 |
| Insurer B* | 23 | 270% | 8 | 10 |
| Insurer C* | 24 | 260% | 2 | 18 |
| Insurer D* | 23 | 168% | 1 | 14 |
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 Thedacare-Berlin.
225 Memorial Drive, Berlin, WI 54923
(920) 361-1313
The nearest hospitals of similar type and size. Their rates are compared with Thedacare-Berlin for the same insurers and services above.
Ripon Medical Center
▲ Rates typically 56% higher than Thedacare-Berlin (21 services)
Waupun Memorial Hospital
▲ Rates typically 46% higher than Thedacare-Berlin (21 services)
Calumet Hospital
▼ Rates typically 30% lower than Thedacare-Berlin (18 services)
Gundersen Moundview Hospital
▲ Rates typically 97% higher than Thedacare-Berlin (21 services)
Prairie Ridge Health
▲ Rates typically 147% higher than Thedacare-Berlin (17 services)
Reedsburg Area Medical Center
▲ Rates typically 54% higher than Thedacare-Berlin (19 services)
Thedacare Medical Center - Wild Rose
Thedacare Medical Center-New London
Thedacare Medical Center - Shawano
Thedacare Medical Center - Waupaca
About Thedacare-Berlin's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Thedacare-Berlin range from $926 to $2,728 across 4 insurers. UnitedHealthcare's rate is $928. The median at nearby comparable hospitals is $2,993. 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 Thedacare-Berlin range from $844 to $3,491 across 4 insurers. Aetna's rate is $3,491. The median at nearby comparable hospitals is $2,629. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Thedacare-Berlin range from $1,217 to $3,173 across 4 insurers. Blue Cross Blue Shield's rate is $2,667. The median at nearby comparable hospitals is $4,156. 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 Thedacare-Berlin range from $11,582 to $25,609 across 4 insurers. UnitedHealthcare's rate is $11,582. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Thedacare-Berlin range from $100 to $503 across 4 insurers. Blue Cross Blue Shield's rate is $296. The median at nearby comparable hospitals is $272. 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 Thedacare-Berlin range from $29,335 to $45,402 across 4 insurers. Cigna's rate is $30,265. The median at nearby comparable hospitals is $21,078. What a patient pays depends on their plan's deductible, coinsurance and network status.
Thedacare-Berlin has 25 beds. Facility type: Critical Access Hospital.
Thedacare-Berlin is located at 225 Memorial Drive, Berlin, WI 54923. Its main phone number is (920) 361-1313.
Thedacare-Berlin's CMS Certification Number (CCN), also called its Medicare provider number, is 521355.
The National Provider Identifier (NPI) on file for Thedacare-Berlin is 1760413777.
Thedacare-Berlin is affiliated with ThedaCare.
Thedacare-Berlin lists 40 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.
214 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