Tomah, WI
37
In-network payers
116
Disclosed rate categories
25
Beds
5
Care quality
Tomah Health is a 25-bed voluntary non-profit - private hospital in Tomah, WI. Below you'll find publicly disclosed negotiated rates and facility details, including 37 in-network payers and 116 disclosed rate categories.
CCN (Medicare provider number)
521320
NPI
1184765240
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 Tomah Health 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
$9,545 - $28,588
from 4 insurers · median $25,996
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
$6,363 - $10,814
from 4 insurers · median $9,833
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
$520 - $4,764
from 4 insurers · median $2,625
Typical for a hospital with this service line
CT imaging
CPT 70450
$520 - $1,891
from 4 insurers · median $1,322
Typical for a hospital with this service line
CT imaging
CPT 74176
$520 - $4,115
from 4 insurers · median $2,433
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$71,095 - $78,873
from 4 insurers · median $72,995
Hospital reports orthopedic surgery services to CMS
CT imaging
CPT 71275
$642 - $3,026
from 4 insurers · median $1,921
Typical for a hospital with this service line
MRI imaging
CPT 70553
$640 - $5,303
from 4 insurers · median $3,406
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$6,363 - $10,814
from 4 insurers · median $9,833
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
Cardiology and vascular testing
CPT 93306
$526 - $1,157
from 4 insurers · median $885
Typical for a hospital with this service line
MRI imaging
CPT 70551
$385 - $3,495
from 4 insurers · median $2,363
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$89 - $294
from 4 insurers · median $241
Typical for a hospital with this service line
MRI imaging
CPT 73721
$404 - $4,008
from 4 insurers · median $2,654
Typical for a hospital with this service line
MRI imaging
CPT 72197
$640 - $5,044
from 4 insurers · median $3,668
Typical for a hospital with this service line
Gynecology
CPT 58571
$3,029 - $12,603
from 2 insurers · median $7,816
Typical for a hospital with this service line
Digestive procedures
CPT 49650
$1,668 - $12,556
from 2 insurers · median $7,112
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,412 - $3,663
from 4 insurers · median $1,524
Hospital reports nuclear medicine services to CMS
Cardiology and vascular testing
CPT 93971
$175 - $980
from 4 insurers · median $684
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$751 - $1,722
from 4 insurers · median $880
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$679 - $855
from 4 insurers · median $802
Typical for a hospital with this service line
Ultrasound
CPT 76770
$265 - $1,074
from 4 insurers · median $848
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$586 - $2,956
from 3 insurers · median $615
Typical for a hospital with this service line
Ultrasound
CPT 76536
$175 - $917
from 4 insurers · median $619
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$1,167 - $2,846
from 4 insurers · median $1,950
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* | 21 | 1005% | 14 | 3 |
| Insurer B* | 24 | 867% | 9 | 9 |
| Insurer C* | 24 | 261% | 0 | 14 |
| Insurer D* | 22 | 164% | 1 | 18 |
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 Tomah Health.
321 Butts Avenue, Tomah, WI 54660
(608) 372-2181
The nearest hospitals of similar type and size. Their rates are compared with Tomah Health for the same insurers and services above.
Mayo Clinic Health System - Franciscan Healthcare
▲ Rates typically 6% higher than Tomah Health (20 services)
Gundersen St Josephs Hospital
▲ Rates typically 102% higher than Tomah Health (19 services)
Black River Memorial Hospital
▲ Rates typically 58% higher than Tomah Health (16 services)
Gundersen Moundview Hospital
▲ Rates typically 54% higher than Tomah Health (19 services)
Vernon Memorial Hospital
Rates about the same as Tomah Health (17 services)
Marshfield Medical Center - Neillsville
▲ Rates typically 91% higher than Tomah Health (20 services)
Mayo Clinic Health System - Oakridge
Thedacare Medical Center-New London
Aspirus Tomahawk Hospital
Waupun Memorial Hospital
About Tomah Health's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Tomah Health range from $640 to $5,303 across 4 insurers. Blue Cross Blue Shield's rate is $640. The median at nearby comparable hospitals is $3,739. 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 Tomah Health range from $520 to $4,764 across 4 insurers. Aetna's rate is $4,522. The median at nearby comparable hospitals is $3,097. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Tomah Health range from $751 to $1,722 across 4 insurers. Cigna's rate is $1,722. The median at nearby comparable hospitals is $3,376. 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 Tomah Health range from $9,545 to $28,588 across 4 insurers. UnitedHealthcare's rate is $28,588. 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 Tomah Health range from $71,095 to $78,873 across 4 insurers. Aetna's rate is $71,095. The median at nearby comparable hospitals is $21,078. What a patient pays depends on their plan's deductible, coinsurance and network status.
Tomah Health has 25 beds. Facility type: Critical Access Hospital.
Tomah Health is located at 321 Butts Avenue, Tomah, WI 54660. Its main phone number is (608) 372-2181.
Tomah Health's CMS Certification Number (CCN), also called its Medicare provider number, is 521320.
The National Provider Identifier (NPI) on file for Tomah Health is 1184765240.
Tomah Health lists 37 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.
116 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