SSM Health St Mary's Hospital - Madison
SSM Health St. Mary's Hospital - Madison charges 5.2x the Medicare reimbursement rate across 159 analyzed procedures, reflecting the pricing structure at this nonprofit facility in Madison, Wisconsin.
Madison, WI 53715 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Pricing grade
D
High
Avg markup vs Medicare
5.2x
Charge / Medicare rate
Max markup
11.59x
Worst procedure
Procedures analyzed
159
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $43,829 | $21,914 | — | 11.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $23,716 | $11,858 | — | 8.9x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $40,372 | $20,186 | — | 8.4x |
| SEIZURES WITHOUT MCC | 101 | $45,078 | $22,539 | — | 8.2x |
| SYNCOPE AND COLLAPSE | 312 | $42,235 | $21,117 | — | 7.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $31,277 | $15,638 | — | 7.7x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $74,194 | $37,097 | — | 7.5x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $34,207 | $17,104 | — | 7.5x |
| OTHER FACTORS INFLUENCING HEALTH STATUS | 951 | $24,821 | $12,410 | — | 7.4x |
| OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | 205 | $83,905 | $41,952 | — | 7.3x |
| RESPIRATORY NEOPLASMS WITH CC | 181 | $54,963 | $27,481 | — | 7.2x |
| SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | 556 | $31,011 | $15,506 | — | 7.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $44,776 | $22,388 | — | 7.1x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/M | 544 | $29,517 | $14,759 | — | 6.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $33,917 | $16,958 | — | 6.8x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $40,317 | $20,159 | — | 6.8x |
| DYSEQUILIBRIUM | 149 | $29,297 | $14,649 | — | 6.7x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $39,113 | $19,556 | — | 6.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $45,049 | $22,525 | — | 6.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $28,587 | $14,293 | — | 6.4x |
| CAROTID ARTERY STENT PROCEDURES WITH CC | 035 | $91,173 | $45,586 | — | 6.4x |
| BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | 554 | $32,187 | $16,093 | — | 6.4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $34,613 | $17,306 | — | 6.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $36,868 | $18,434 | — | 6.4x |
| POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | 863 | $43,062 | $21,531 | — | 6.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $29,151 | $14,575 | — | 6.3x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $42,901 | $21,451 | — | 6.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $30,129 | $15,064 | — | 6.3x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $32,749 | $16,374 | — | 6.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $35,430 | $17,715 | — | 6.1x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $66,393 | $33,196 | — | 6x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $71,046 | $35,523 | — | 6x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $72,155 | $36,078 | — | 6x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $43,765 | $21,882 | — | 5.9x |
| COMPLICATIONS OF TREATMENT WITH CC | 920 | $42,559 | $21,280 | — | 5.9x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $58,156 | $29,078 | — | 5.9x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | 371 | $67,245 | $33,622 | — | 5.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $28,866 | $14,433 | — | 5.9x |
| ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | 283 | $75,395 | $37,697 | — | 5.8x |
| LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | 841 | $61,892 | $30,946 | — | 5.8x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $17,727 | $8,864 | — | 5.7x |
| SEIZURES WITH MCC | 100 | $77,257 | $38,628 | — | 5.7x |
| EXTRACRANIAL PROCEDURES WITH CC | 038 | $57,440 | $28,720 | — | 5.7x |
| MEDICAL BACK PROBLEMS WITH MCC | 551 | $65,794 | $32,897 | — | 5.7x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $61,962 | $30,981 | — | 5.6x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $82,682 | $41,341 | — | 5.6x |
| RENAL FAILURE WITH CC | 683 | $32,030 | $16,015 | — | 5.6x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $38,299 | $19,149 | — | 5.6x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $27,395 | $13,698 | — | 5.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $34,764 | $17,382 | — | 5.6x |
Showing 50 of 159 procedures
How SSM HEALTH ST MARY'S HOSPITAL - MADISON compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use