Thedacare Regional Medical Center - Appleton Inc
ThedaCare Regional Medical Center - Appleton Inc charges 3.6x the Medicare reimbursement rate on average across 35 analyzed procedures at this Appleton, Wisconsin nonprofit facility.
Appleton, WI 54911 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
C
Average
Avg markup vs Medicare
3.6x
Charge / Medicare rate
Max markup
6.45x
Worst procedure
Procedures analyzed
35
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 |
|---|---|---|---|---|---|
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $69,064 | $34,532 | — | 6.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $25,765 | $12,883 | — | 5.5x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $27,164 | $13,582 | — | 5.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $20,633 | $10,317 | — | 5.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $23,989 | $11,994 | — | 5.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $18,744 | $9,372 | — | 4.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $23,774 | $11,887 | — | 4.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $17,422 | $8,711 | — | 4.3x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | 236 | $117,536 | $58,768 | — | 4.3x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $51,988 | $25,994 | — | 4.2x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $69,299 | $34,649 | — | 4.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $23,496 | $11,748 | — | 4x |
| RENAL FAILURE WITH CC | 683 | $19,163 | $9,581 | — | 3.8x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $42,828 | $21,414 | — | 3.8x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $73,629 | $36,815 | — | 3.7x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $57,260 | $28,630 | — | 3.7x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | 270 | $130,302 | $65,151 | — | 3.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $24,901 | $12,450 | — | 3.3x |
| CELLULITIS WITHOUT MCC | 603 | $16,648 | $8,324 | — | 3.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $41,422 | $20,711 | — | 3.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $13,543 | $6,772 | — | 3.2x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $30,383 | $15,191 | — | 3.1x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $76,397 | $38,199 | — | 3.1x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $22,531 | $11,266 | — | 3x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $15,475 | $7,738 | — | 3x |
| RENAL FAILURE WITH MCC | 682 | $26,238 | $13,119 | — | 2.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $33,455 | $16,727 | — | 2.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $29,682 | $14,841 | — | 2.9x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $16,006 | $8,003 | — | 2.8x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $27,703 | $13,852 | — | 2.7x |
| COAGULATION DISORDERS | 813 | $24,868 | $12,434 | — | 2.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $25,176 | $12,588 | — | 2.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $57,708 | $28,854 | — | 2x |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $49,249 | $24,624 | — | 2x |
| OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | 264 | $36,472 | $18,236 | — | 1.7x |
How THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC 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