ThedaCare · Waupaca, WI
39
In-network payers
258
Disclosed rate categories
25
Beds
3
Care quality
Thedacare Medical Center - Waupaca is a 25-bed voluntary non-profit - private hospital in Waupaca, WI, affiliated with ThedaCare. Below you'll find publicly disclosed negotiated rates and facility details, including 39 in-network payers and 258 disclosed rate categories.
CCN (Medicare provider number)
521334
NPI
1013995521
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
25
Care Quality
3
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 Medical Center - Waupaca 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 807
$6,520 - $8,908
from 4 insurers · median $8,483
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
Childbirth · Inpatient
MS-DRG 788
$11,149 - $11,582
from 2 insurers · median $11,365
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
CT imaging
CPT 74177
$844 - $3,491
from 4 insurers · median $1,069
Typical for a hospital with this service line
Mammography
CPT 77067
$100 - $553
from 4 insurers · median $433
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$584 - $1,779
from 4 insurers · median $1,433
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,101 - $3,522
from 4 insurers · median $2,650
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,257 - $4,457
from 4 insurers · median $3,119
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,217 - $4,554
from 4 insurers · median $3,087
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$6,520 - $8,908
from 4 insurers · median $8,483
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
Nuclear imaging
CPT 78815
$3,804 - $6,396
from 4 insurers · median $4,556
Hospital reports pet scan services to CMS
CT imaging
CPT 70450
$278 - $1,546
from 4 insurers · median $351
Typical for a hospital with this service line
Gynecology
CPT 58571
$9,015 - $15,798
from 3 insurers · median $12,406
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$1,680 - $13,550
from 4 insurers · median $9,519
Typical for a hospital with this service line
CT imaging
CPT 71275
$467 - $2,553
from 4 insurers · median $961
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$939 - $3,380
from 4 insurers · median $2,678
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$29,335 - $34,849
from 3 insurers · median $30,265
Hospital reports orthopedic surgery services to CMS
CT imaging
CPT 74176
$530 - $3,170
from 4 insurers · median $626
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$1,438 - $5,130
from 4 insurers · median $4,664
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,179 - $3,444
from 4 insurers · median $2,282
Hospital reports nuclear medicine services to CMS
X-ray and bone density
CPT 71046
$92 - $240
from 4 insurers · median $169
Typical for a hospital with this service line
MRI imaging
CPT 70553
$926 - $2,630
from 4 insurers · median $1,168
Typical for a hospital with this service line
Gynecology
CPT 58661
$1,664 - $25,846
from 4 insurers · median $9,731
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 743
$18,869 - $19,212
from 3 insurers · median $18,887
Hospital reports inpatient surgical services to CMS
Medicine & Surgery
CPT 42820
$4,822 - $8,100
from 3 insurers · median $7,696
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* | 24 | 319% | 14 | 6 |
| Insurer B* | 24 | 260% | 2 | 15 |
| Insurer C* | 21 | 253% | 8 | 7 |
| Insurer D* | 21 | 105% | 0 | 12 |
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 Medical Center - Waupaca.
800 Riverside Drive, Waupaca, WI 54981
(715) 258-1000
The nearest hospitals of similar type and size. Their rates are compared with Thedacare Medical Center - Waupaca for the same insurers and services above.
Ripon Medical Center
▲ Rates typically 35% higher than Thedacare Medical Center - Waupaca (21 services)
Gundersen Moundview Hospital
▲ Rates typically 37% higher than Thedacare Medical Center - Waupaca (21 services)
Calumet Hospital
▼ Rates typically 37% lower than Thedacare Medical Center - Waupaca (19 services)
Waupun Memorial Hospital
▲ Rates typically 36% higher than Thedacare Medical Center - Waupaca (21 services)
Aspirus Langlade Hospital
▲ Rates typically 46% higher than Thedacare Medical Center - Waupaca (15 services)
St Clare Memorial Hospital Inc
Rates about the same as Thedacare Medical Center - Waupaca (20 services)
Thedacare-Berlin
Thedacare Medical Center - Wild Rose
Thedacare Medical Center - Shawano
Thedacare Medical Center-New London
About Thedacare Medical Center - Waupaca's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Thedacare Medical Center - Waupaca range from $926 to $2,630 across 4 insurers. Blue Cross Blue Shield's rate is $1,408. The median at nearby comparable hospitals is $2,707. 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 Medical Center - Waupaca range from $844 to $3,491 across 4 insurers. Aetna's rate is $3,491. The median at nearby comparable hospitals is $2,491. 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 Thedacare Medical Center - Waupaca range from $1,257 to $4,457 across 4 insurers. Cigna's rate is $1,257. The median at nearby comparable hospitals is $3,933. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Thedacare Medical Center - Waupaca range from $6,520 to $8,908 across 4 insurers. UnitedHealthcare's rate is $8,487. 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 Medical Center - Waupaca range from $100 to $553 across 4 insurers. Cigna's rate is $364. The median at nearby comparable hospitals is $242. 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 Medical Center - Waupaca range from $29,335 to $34,849 across 3 insurers. Blue Cross Blue Shield's rate is $34,849. The median at nearby comparable hospitals is $22,006. What a patient pays depends on their plan's deductible, coinsurance and network status.
Thedacare Medical Center - Waupaca has 25 beds. Facility type: Critical Access Hospital.
Thedacare Medical Center - Waupaca is located at 800 Riverside Drive, Waupaca, WI 54981. Its main phone number is (715) 258-1000.
Thedacare Medical Center - Waupaca's CMS Certification Number (CCN), also called its Medicare provider number, is 521334.
The National Provider Identifier (NPI) on file for Thedacare Medical Center - Waupaca is 1013995521.
Thedacare Medical Center - Waupaca is affiliated with ThedaCare.
Thedacare Medical Center - Waupaca lists 39 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.
258 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