SSM Health · Waupun, WI
36
In-network payers
260
Disclosed rate categories
25
Beds
5
Care quality
Waupun Memorial Hospital is a 25-bed voluntary non-profit - private hospital in Waupun, WI, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 36 in-network payers and 260 disclosed rate categories.
CCN (Medicare provider number)
521327
NPI
1548248644
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 Waupun Memorial 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.
Childbirth · Inpatient
MS-DRG 807
$8,021 - $10,977
from 3 insurers · median $8,717
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
$12,567 - $22,428
from 3 insurers · median $13,316
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
$778 - $4,071
from 4 insurers · median $2,352
Typical for a hospital with this service line
CT imaging
CPT 74176
$396 - $2,583
from 4 insurers · median $2,080
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$1,757 - $2,620
from 4 insurers · median $2,127
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$3,748 - $6,605
from 4 insurers · median $4,604
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$3,748 - $6,605
from 4 insurers · median $4,719
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$3,174 - $7,037
from 4 insurers · median $3,604
Typical for a hospital with this service line
CT imaging
CPT 71275
$737 - $1,813
from 3 insurers · median $1,729
Typical for a hospital with this service line
CT imaging
CPT 71260
$590 - $2,583
from 3 insurers · median $1,813
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$8,021 - $10,977
from 3 insurers · median $8,717
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 78452
$1,455 - $5,244
from 3 insurers · median $4,831
Hospital reports nuclear medicine services to CMS
MRI imaging
CPT 70553
$928 - $4,071
from 4 insurers · median $2,531
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$3,174 - $4,616
from 3 insurers · median $4,266
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$68 - $444
from 4 insurers · median $329
Typical for a hospital with this service line
MRI imaging
CPT 72148
$523 - $2,975
from 4 insurers · median $2,555
Typical for a hospital with this service line
MRI imaging
CPT 70551
$552 - $2,784
from 4 insurers · median $2,555
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$6,183 - $27,802
from 4 insurers · median $10,009
Typical for a hospital with this service line
Mammography
CPT 77067
$126 - $344
from 4 insurers · median $227
Typical for a hospital with this service line
MRI imaging
CPT 73721
$595 - $3,028
from 4 insurers · median $2,555
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$3,671 - $5,927
from 3 insurers · median $4,951
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93970
$2,149 - $2,641
from 4 insurers · median $2,555
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$12,337 - $30,085
from 3 insurers · median $29,055
Hospital reports orthopedic surgery services to CMS
Gynecology
CPT 58558
$4,314 - $12,398
from 3 insurers · median $9,323
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* | 20 | 650% | 15 | 2 |
| Insurer B* | 18 | 578% | 11 | 5 |
| Insurer C* | 24 | 431% | 20 | 0 |
| Insurer D* | 24 | 235% | 3 | 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 Waupun Memorial Hospital.
620 West Brown Street, Waupun, WI 53963
(920) 324-6512
The nearest hospitals of similar type and size. Their rates are compared with Waupun Memorial Hospital for the same insurers and services above.
Thedacare-Berlin
▼ Rates typically 29% lower than Waupun Memorial Hospital (21 services)
Calumet Hospital
▼ Rates typically 39% lower than Waupun Memorial Hospital (16 services)
Thedacare Medical Center - Wild Rose
▼ Rates typically 34% lower than Waupun Memorial Hospital (21 services)
Thedacare Medical Center-New London
▼ Rates typically 27% lower than Waupun Memorial Hospital (21 services)
Thedacare Medical Center - Waupaca
▼ Rates typically 27% lower than Waupun Memorial Hospital (21 services)
Edgerton Hospital & Health Services
▼ Rates typically 82% lower than Waupun Memorial Hospital (9 services)
Ripon Medical Center
Prairie Ridge Health
Stoughton Hospital Association
St. Mary S-Superior Clinic
About Waupun Memorial Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Waupun Memorial Hospital range from $928 to $4,071 across 4 insurers. Cigna's rate is $4,071. The median at nearby comparable hospitals is $1,779. 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 Waupun Memorial Hospital range from $778 to $4,071 across 4 insurers. Aetna's rate is $2,710. The median at nearby comparable hospitals is $1,773. 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 Waupun Memorial Hospital range from $3,748 to $6,605 across 4 insurers. Blue Cross Blue Shield's rate is $3,748. The median at nearby comparable hospitals is $3,119. 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 Waupun Memorial Hospital range from $8,021 to $10,977 across 3 insurers. UnitedHealthcare's rate is $8,717. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Waupun Memorial Hospital range from $126 to $344 across 4 insurers. Aetna's rate is $344. The median at nearby comparable hospitals is $400. 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 Waupun Memorial Hospital range from $12,337 to $30,085 across 3 insurers. Blue Cross Blue Shield's rate is $30,085. The median at nearby comparable hospitals is $29,335. What a patient pays depends on their plan's deductible, coinsurance and network status.
Waupun Memorial Hospital has 25 beds. Facility type: Critical Access Hospital.
Waupun Memorial Hospital is located at 620 West Brown Street, Waupun, WI 53963. Its main phone number is (920) 324-6512.
Waupun Memorial Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 521327.
The National Provider Identifier (NPI) on file for Waupun Memorial Hospital is 1548248644.
Waupun Memorial Hospital is affiliated with SSM Health.
Waupun Memorial Hospital lists 36 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.
260 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