Does Allen Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Allen Hospital. In a medical emergency, call 911.

Where is Allen Hospital?

1825 Logan Avenue, Waterloo, IA 50703, in Black Hawk County, Iowa.

What is the phone number of Allen Hospital?

(319) 235-3941, as listed by Medicare (CMS).

What is the Medicare star rating of Allen Hospital?

3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Allen Hospital — Waterloo, IA

Quick answers

Does Allen Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Allen Hospital. In a medical emergency, call 911.
Where is Allen Hospital?: 1825 Logan Avenue, Waterloo, IA 50703, in Black Hawk County, Iowa.
What is the phone number of Allen Hospital?: (319) 235-3941, as listed by Medicare (CMS).
What is the Medicare star rating of Allen Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5][6][8]

Treatments^[4][5][6]

Infusion services
Cardiac rehab
Inpatient rehab
Hyperbaric wound treatment
Anticoagulation clinic
PICC line placement
Blood product transfusion
Parenteral nutrition
IV fluid hydration
IV medication and antibiotic administration
Vascular access device maintenance

Procedures^[6]

Mammography
Walk-in mammogram
MRI
CT scan
Ultrasound
PET/CT
Nuclear medicine
Interventional radiology
Phlebotomy and lab testing

Programs and centers^[5][6][7]

Wound & Hyperbaric Center
Nutrition Center
Birthing center
Cardiac rehabilitation
Digestive health center
Anticoagulation clinic
Child protection center
Inpatient rehabilitation
Infusion services outpatient center

Emergency care (hospital website)^[4][6][8][9]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III
Stroke designation	Primary Stroke Center (Joint Commission)

Visiting and practical information

Visiting	Visitors daily 6:00 a.m. to 9:00 p.m.; up to two visitors at a time; building locks at 9 p.m^[10]
Parking	Free valet at Entrance 8 weekdays 8 a.m.-4 p.m.; self-parking and handicap spaces at public entrances^[7]

Recognition^[4][8]

Get With The Guidelines-Stroke GoldPlus (AHA), 2026
Chest Pain-MI Registry Platinum, 2026
Primary Stroke Center (Joint Commission)
Accredited Chest Pain Center with PCI (Society of Chest Pain Centers)

Doctors and clinicians (567)

567 doctors and other clinicians list Allen Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 543 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

MercyOne Waterloo Medical Center4.3 mi · Waterloo, IA · Acute Care Hospital
Sartori Memorial Hospital, Inc6.0 mi · Cedar Falls, IA · Acute Care Hospital
Waverly Health Center16 mi · Waverly, IA · Critical Access Hospital
Buchanan County Health Center22 mi · Independence, IA · Critical Access Hospital
MercyOne Oelwein Medical Center24 mi · Oelwein, IA · Critical Access Hospital

Other hospitals nearby

Mental Health Institute22 mi · Independence, IA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Northcrest Specialty Care1.2 mi · Waterloo, IA · 2 of 5 stars
Pillar of Cedar Valley3.4 mi · Waterloo, IA · 1 of 5 stars
Harmony Waterloo4.1 mi · Waterloo, IA · 1 of 5 stars

All nursing homes in the state →

Hospice providers

UnityPoint Hospice3.0 mi · Waterloo, IA · 3 of 5 stars
Cedar Valley Hospice7.5 mi · Waterloo, IA · 5 of 5 stars
Care Initiatives Hospice - Cedar Falls7.6 mi · Cedar Falls, IA · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Open Arms Home Health Care - Waterloo, LLC3.0 mi · Waterloo, IA
UnityPoint at Home3.0 mi · Waterloo, IA · 3 of 5 stars
MercyOne Waterloo Home Health Care4.6 mi · Waterloo, IA

All home health agencies in the state →

Dialysis facilities

DaVita Black Hawk Dialysis4.6 mi · Waterloo, IA · 4 of 5 stars
DaVita Cedar Valley Dialysis7.5 mi · Waterloo, IA · 4 of 5 stars
DaVita Cedar Valley Waverly Dialysis17 mi · Waverly, IA · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Digestive Health Center LLC7.5 mi · Waterloo, IA
The Surgery Center at United Medical Park7.5 mi · Waterloo, IA

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Peoples Community Health Clinic1.9 mi · Waterloo, IA · Community health center
Peoples Clinic - Traer24 mi · Traer, IA · Community health center
Peoples Clinic Butler County24 mi · Clarksville, IA · Community health center

Clinics and urgent care

UnityPoint Clinic - Family Medicine - Denver10 mi · Denver, IA · Rural health clinic
Janesville Clinic12 mi · Janesville, IA · Rural health clinic
BCHC Family Medicine - Jesup13 mi · Jesup, IA · Rural health clinic

Pharmacies

Hy-Vee Inc3.0 mi · Waterloo, IA · Community/retail pharmacy
Peoples Community Health Clinic, Inc.3.0 mi · Waterloo, IA · Pharmacy
Walgreen Co3.0 mi · Waterloo, IA · Pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Rose of Waterloo3.0 mi · Waterloo, IA
Lakeview Lodge4.6 mi · Waterloo, IA
Bickford Cottage Cedar Falls7.6 mi · Cedar Falls, IA
Bryhl Assisted Living7.6 mi · Cedar Falls, IA

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Allen Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	70%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	72%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	58%National average: 74%
Area around the room “always” quiet at night	54%National average: 60%
Completed surveys	491Response rate: 26%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	1.155No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.536No different from the national benchmark
Surgical site infections after colon surgery	1.763No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.226Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	12.5%
Deaths within 30 days: heart failure patients	15.8%
Deaths within 30 days: pneumonia patients	18.7%
Deaths within 30 days: COPD patients	10.8%
Deaths within 30 days: stroke patients	12.4%
Deaths within 30 days: coronary bypass surgery (CABG)	2.4%
Serious complications (patient safety indicator PSI-90)	1.1No different from the national rate
Complications after hip or knee replacement	4.6%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	15.1%
Readmitted within 30 days: heart failure	22.4%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	19.3%
Readmitted within 30 days: coronary bypass surgery	9.4%
Readmitted within 30 days: hip or knee replacement	5.6%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	163 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	62%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Waterloo Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Allen Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$237	$189.60	$74.50 – $168.46
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — HMO: $153.11 Aetna — Medicare Advantage: $74.50 Aetna — PPO: $150.11 Amerivantage — Medicare Advantage: $78.23 Cigna/Midlands — Commercial: $153.98 Health Partners Open Network — Commercial: $127.02 Humana — Medicare Advantage: $78.23 Molina — Medicare Advantage: $75.99 United Healthcare — HMO: $168.46 United Healthcare — Medicare Advantage: $78.23
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$362	$289.60	$121.61 – $288.21
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — HMO: $259.76 Aetna — Medicare Advantage: $121.61 Aetna — PPO: $254.67 Amerivantage — Medicare Advantage: $127.69 Cigna/Midlands — Commercial: $251.15 Health Partners Open Network — Commercial: $214.84 Humana — Medicare Advantage: $127.69 Molina — Medicare Advantage: $124.04 United Healthcare — HMO: $288.21 United Healthcare — Medicare Advantage: $127.69
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$459	$367.20	$165.20 – $376.67
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna — HMO: $337.68 Aetna — Medicare Advantage: $165.20 Aetna — PPO: $331.06 Amerivantage — Medicare Advantage: $173.46 Cigna/Midlands — Commercial: $341.28 Health Partners Open Network — Commercial: $279.38 Humana — Medicare Advantage: $173.46 Molina — Medicare Advantage: $168.50 United Healthcare — HMO: $376.67 United Healthcare — Medicare Advantage: $173.46
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$201	$160.80	$60.36 – $124.66
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna — HMO: $101.15 Aetna — Medicare Advantage: $60.36 Aetna — PPO: $99.17 Amerivantage — Medicare Advantage: $63.38 Cigna/Midlands — Commercial: $124.66 Health Partners Open Network — Commercial: $83.62 Humana — Medicare Advantage: $63.38 Molina — Medicare Advantage: $61.57 United Healthcare — HMO: $114.52 United Healthcare — Medicare Advantage: $63.38
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$240	$192	$88.83 – $184.05
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna — HMO: $155.85 Aetna — Medicare Advantage: $88.83 Aetna — PPO: $152.79 Amerivantage — Medicare Advantage: $93.27 Cigna/Midlands — Commercial: $184.05 Health Partners Open Network — Commercial: $129.20 Humana — Medicare Advantage: $93.27 Molina — Medicare Advantage: $90.61 United Healthcare — HMO: $176.73 United Healthcare — Medicare Advantage: $93.27
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$274	$219.20	$124.50 – $216.83
Office consultation with a specialist (moderate): rates for 9 insurance plans Aetna — HMO: $195.49 Aetna — PPO: $191.66 Cigna/Midlands — Commercial: $171.80 Health Partners Open Network — Commercial: $166.22 United Healthcare — HMO: $216.83 United Healthcare — PPO: $216.83 Wellmark Blue Cross and Blue Shield — HMO: $124.50 Wellmark Blue Cross and Blue Shield — PPO: $124.50 Wellmark UPH Self-Funded — Commercial: $124.50
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$411	$328.80	$188.80 – $348.60
Office consultation with a specialist (moderate to high): rates for 9 insurance plans Aetna — HMO: $308.98 Aetna — PPO: $302.92 Cigna/Midlands — Commercial: $261.58 Health Partners Open Network — Commercial: $262.53 United Healthcare — HMO: $348.60 United Healthcare — PPO: $348.60 Wellmark Blue Cross and Blue Shield — HMO: $188.80 Wellmark Blue Cross and Blue Shield — PPO: $188.80 Wellmark UPH Self-Funded — Commercial: $188.80
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PREVENTIVE VISIT,NEW,18-39	$294	$235.20	$136.77 – $222.47
Preventive checkup, new patient, age 18–39: rates for 9 insurance plans Aetna — HMO: $168.13 Aetna — PPO: $164.83 Cigna/Midlands — Commercial: $186.60 Health Partners Open Network — Commercial: $136.77 United Healthcare — HMO: $222.47 United Healthcare — PPO: $222.47 Wellmark Blue Cross and Blue Shield — HMO: $160.30 Wellmark Blue Cross and Blue Shield — PPO: $160.30 Wellmark UPH Self-Funded — Commercial: $160.30
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PREVENTIVE VISIT,NEW,40-64	$341	$272.80	$166.18 – $270.05
Preventive checkup, new patient, age 40–64: rates for 9 insurance plans Aetna — HMO: $203.69 Aetna — PPO: $199.70 Cigna/Midlands — Commercial: $226.37 Health Partners Open Network — Commercial: $166.18 United Healthcare — HMO: $270.05 United Healthcare — PPO: $270.05 Wellmark Blue Cross and Blue Shield — HMO: $194.10 Wellmark Blue Cross and Blue Shield — PPO: $194.10 Wellmark UPH Self-Funded — Commercial: $194.10
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 3 VISIT	$748.94	$599.16	$229.51 – $754.56
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — HMO: $614.83 Aetna — Medicare Advantage: $260.40 Aetna — PPO: $639.67 Amerigroup — Managed Medicaid: $229.51 Amerivantage — Medicare Advantage: $268.06 Cigna/Midlands — Commercial: $484.56 Health Partners Open Network — Commercial: $396.13 Humana — Medicare Advantage: $268.06 Iowa Total Care — Managed Medicaid: $229.51 Medica Exchange Inspire — Commercial: $352.75
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 3 INIT ASSESS	$55	$44	$25.91 – $754.56
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — HMO: $614.83 Aetna — Medicare Advantage: $260.40 Aetna — PPO: $639.67 Amerigroup — Managed Medicaid: $229.51 Amerivantage — Medicare Advantage: $268.06 Cigna/Midlands — Commercial: $35.59 Health Partners Open Network — Commercial: $396.13 Humana — Medicare Advantage: $268.06 Iowa Total Care — Managed Medicaid: $229.51 Medica Exchange Inspire — Commercial: $25.91
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$162	$129.60	$64.46 – $145.66
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — HMO: $123.04 Aetna — Medicare Advantage: $64.46 Aetna — PPO: $120.63 Amerivantage — Medicare Advantage: $67.68 Cigna/Midlands — Commercial: $136.71 Health Partners Open Network — Commercial: $105.08 Humana — Medicare Advantage: $67.68 Molina — Medicare Advantage: $65.75 United Healthcare — HMO: $145.66 United Healthcare — Medicare Advantage: $67.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 4 VISIT	$1,208.35	$966.68	$352.95 – $1,160.42
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — HMO: $945.53 Aetna — Medicare Advantage: $400.46 Aetna — PPO: $983.73 Amerigroup — Managed Medicaid: $352.95 Amerivantage — Medicare Advantage: $412.24 Cigna/Midlands — Commercial: $781.80 Health Partners Open Network — Commercial: $609.20 Humana — Medicare Advantage: $412.24 Iowa Total Care — Managed Medicaid: $352.95 Medica Exchange Inspire — Commercial: $569.13
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 4 INIT ASSESS	$55	$44	$25.91 – $1,160.42
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — HMO: $945.53 Aetna — Medicare Advantage: $400.46 Aetna — PPO: $983.73 Amerigroup — Managed Medicaid: $352.95 Amerivantage — Medicare Advantage: $412.24 Cigna/Midlands — Commercial: $35.59 Health Partners Open Network — Commercial: $609.20 Humana — Medicare Advantage: $412.24 Iowa Total Care — Managed Medicaid: $352.95 Medica Exchange Inspire — Commercial: $25.91
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$276	$220.80	$109.75 – $266.24
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — HMO: $235.13 Aetna — Medicare Advantage: $109.75 Aetna — PPO: $230.52 Amerivantage — Medicare Advantage: $115.24 Cigna/Midlands — Commercial: $232.68 Health Partners Open Network — Commercial: $199.47 Humana — Medicare Advantage: $115.24 Molina — Medicare Advantage: $111.95 United Healthcare — HMO: $266.24 United Healthcare — Medicare Advantage: $115.24
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 5 VISIT	$1,759	$1,407.20	$508.18 – $1,670.80
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — HMO: $1,361.39 Aetna — Medicare Advantage: $576.58 Aetna — PPO: $1,416.39 Amerigroup — Managed Medicaid: $508.18 Amerivantage — Medicare Advantage: $593.54 Cigna/Midlands — Commercial: $1,138.07 Health Partners Open Network — Commercial: $877.13 Humana — Medicare Advantage: $593.54 Iowa Total Care — Managed Medicaid: $508.18 Medica Exchange Inspire — Commercial: $828.49
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 5 INIT ASSESS	$55	$44	$25.91 – $1,670.80
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — HMO: $1,361.39 Aetna — Medicare Advantage: $576.58 Aetna — PPO: $1,416.39 Amerigroup — Managed Medicaid: $508.18 Amerivantage — Medicare Advantage: $593.54 Cigna/Midlands — Commercial: $35.59 Health Partners Open Network — Commercial: $877.13 Humana — Medicare Advantage: $593.54 Iowa Total Care — Managed Medicaid: $508.18 Medica Exchange Inspire — Commercial: $25.91
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$399	$319.20	$159.07 – $386.61
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — HMO: $348.62 Aetna — Medicare Advantage: $159.07 Aetna — PPO: $341.78 Amerivantage — Medicare Advantage: $167.02 Cigna/Midlands — Commercial: $337.22 Health Partners Open Network — Commercial: $296.09 Humana — Medicare Advantage: $167.02 Molina — Medicare Advantage: $162.25 United Healthcare — HMO: $386.61 United Healthcare — Medicare Advantage: $167.02

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL TOTAL CA	$85.70	$68.56	$8.46 – $55.45
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — HMO: $14.38 Aetna — Medicare Advantage: $8.63 Aetna — PPO: $14.38 Amerivantage — Medicare Advantage: $8.88 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $16.64 Humana — Medicare Advantage: $8.88 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $8.63
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$27	$21.60	$5.08 – $16.40
Basic metabolic panel (blood test): rates for 9 insurance plans Aetna — HMO: $16.40 Aetna — PPO: $16.08 Cigna/Midlands — Commercial: $11 Health Partners Open Network — Commercial: $13.16 United Healthcare — HMO: $5.08 United Healthcare — PPO: $5.08 Wellmark Blue Cross and Blue Shield — HMO: $8.46 Wellmark Blue Cross and Blue Shield — PPO: $8.46 Wellmark UPH Self-Funded — Commercial: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL TOTAL CA	$85.70	$68.56	$55.45
Basic metabolic panel (blood test): rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$85.70	$68.56	$10.56 – $55.45
Comprehensive metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — HMO: $17.95 Aetna — Medicare Advantage: $10.77 Aetna — PPO: $17.95 Amerivantage — Medicare Advantage: $11.09 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $20.76 Humana — Medicare Advantage: $11.09 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $10.77
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG METABOLIC PANEL,COMPREHENSIVE	$34	$27.20	$6.34 – $20.52
Comprehensive metabolic panel (blood test): rates for 9 insurance plans Aetna — HMO: $20.52 Aetna — PPO: $20.12 Cigna/Midlands — Commercial: $13.73 Health Partners Open Network — Commercial: $16.43 United Healthcare — HMO: $6.34 United Healthcare — PPO: $6.34 Wellmark Blue Cross and Blue Shield — HMO: $10.56 Wellmark Blue Cross and Blue Shield — PPO: $10.56 Wellmark UPH Self-Funded — Commercial: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$85.70	$68.56	$55.45
Comprehensive metabolic panel (blood test): rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$85.70	$68.56	$40.36 – $94.02
Obstetric blood test panel: 10 of 14 insurance plan rates Aetna — HMO: $81.28 Aetna — Medicare Advantage: $48.77 Aetna — PPO: $81.28 Amerivantage — Medicare Advantage: $50.20 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $94.02 Humana — Medicare Advantage: $50.20 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $48.77
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG OBSTETRIC PANEL	$120	$96	$28.69 – $76.56
Obstetric blood test panel: rates for 9 insurance plans Aetna — HMO: $76.56 Aetna — PPO: $75.06 Cigna/Midlands — Commercial: $62.15 Health Partners Open Network — Commercial: $74.37 United Healthcare — HMO: $28.69 United Healthcare — PPO: $28.69 Wellmark Blue Cross and Blue Shield — HMO: $47.81 Wellmark Blue Cross and Blue Shield — PPO: $47.81 Wellmark UPH Self-Funded — Commercial: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$85.70	$68.56	$55.45
Obstetric blood test panel: rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$85.70	$68.56	$13.39 – $55.45
Cholesterol panel (lipid panel): 10 of 14 insurance plan rates Aetna — HMO: $22.76 Aetna — Medicare Advantage: $13.66 Aetna — PPO: $22.76 Amerivantage — Medicare Advantage: $14.06 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $26.32 Humana — Medicare Advantage: $14.06 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $13.66
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG LIPID PANEL	$42	$33.60	$8.03 – $25.98
Cholesterol panel (lipid panel): rates for 9 insurance plans Aetna — HMO: $25.98 Aetna — PPO: $25.47 Cigna/Midlands — Commercial: $17.41 Health Partners Open Network — Commercial: $20.82 United Healthcare — HMO: $8.03 United Healthcare — PPO: $8.03 Wellmark Blue Cross and Blue Shield — HMO: $13.39 Wellmark Blue Cross and Blue Shield — PPO: $13.39 Wellmark UPH Self-Funded — Commercial: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$85.70	$68.56	$55.45
Cholesterol panel (lipid panel): rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$85.70	$68.56	$8.68 – $55.45
Kidney function panel: 10 of 14 insurance plan rates Aetna — HMO: $14.76 Aetna — Medicare Advantage: $8.85 Aetna — PPO: $14.76 Amerivantage — Medicare Advantage: $9.11 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $17.06 Humana — Medicare Advantage: $9.11 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $8.85
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG RENAL FUNCTION PANEL	$28	$22.40	$5.21 – $17.11
Kidney function panel: rates for 9 insurance plans Aetna — HMO: $17.11 Aetna — PPO: $16.77 Cigna/Midlands — Commercial: $11.28 Health Partners Open Network — Commercial: $13.51 United Healthcare — HMO: $5.21 United Healthcare — PPO: $5.21 Wellmark Blue Cross and Blue Shield — HMO: $8.68 Wellmark Blue Cross and Blue Shield — PPO: $8.68 Wellmark UPH Self-Funded — Commercial: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$85.70	$68.56	$55.45
Kidney function panel: rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$85.70	$68.56	$8.17 – $55.45
Liver function panel: 10 of 14 insurance plan rates Aetna — HMO: $13.89 Aetna — Medicare Advantage: $8.33 Aetna — PPO: $13.89 Amerivantage — Medicare Advantage: $8.58 Cigna/Midlands — Commercial: $55.45 Health Partners Open Network — Commercial: $16.06 Humana — Medicare Advantage: $8.58 Medica Exchange Inspire — Commercial: $40.36 Medica Exchange Insure — Commercial: $45.16 Molina — Medicare Advantage: $8.33
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG HEPATIC FUNCTION PANEL	$26	$20.80	$4.90 – $15.74
Liver function panel: rates for 9 insurance plans Aetna — HMO: $15.74 Aetna — PPO: $15.43 Cigna/Midlands — Commercial: $10.62 Health Partners Open Network — Commercial: $12.71 United Healthcare — HMO: $4.90 United Healthcare — PPO: $4.90 Wellmark Blue Cross and Blue Shield — HMO: $8.17 Wellmark Blue Cross and Blue Shield — PPO: $8.17 Wellmark UPH Self-Funded — Commercial: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$85.70	$68.56	$55.45
Liver function panel: rates for 1 insurance plan Cigna/Midlands — Commercial: $55.45
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AUTOM URINE DIP W MICRO	$32.14	$25.72	$3.17 – $20.79
Urine test (automated, with microscope): 10 of 14 insurance plan rates Aetna — HMO: $5.39 Aetna — Medicare Advantage: $3.23 Aetna — PPO: $5.39 Amerivantage — Medicare Advantage: $3.33 Cigna/Midlands — Commercial: $20.79 Health Partners Open Network — Commercial: $6.24 Humana — Medicare Advantage: $3.33 Medica Exchange Inspire — Commercial: $15.14 Medica Exchange Insure — Commercial: $16.94 Molina — Medicare Advantage: $3.23
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS, AUTO, W/SCOPE	$10	$8	$3.17 – $6.16
Urine test (automated, with microscope): rates for 9 insurance plans Aetna — HMO: $6.16 Aetna — PPO: $6.04 Cigna/Midlands — Commercial: $4.12 Health Partners Open Network — Commercial: $4.93 United Healthcare — HMO: $3.17 United Healthcare — PPO: $3.17 Wellmark Blue Cross and Blue Shield — HMO: $3.17 Wellmark Blue Cross and Blue Shield — PPO: $3.17 Wellmark UPH Self-Funded — Commercial: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC AUTOM URINE DIP W MICRO	$32.14	$25.72	$20.79
Urine test (automated, with microscope): rates for 1 insurance plan Cigna/Midlands — Commercial: $20.79
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC N-AUTOM URINALYS WO MICRO	$32.14	$25.72	$3.48 – $20.79
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — HMO: $5.92 Aetna — Medicare Advantage: $3.55 Aetna — PPO: $5.92 Amerivantage — Medicare Advantage: $3.65 Cigna/Midlands — Commercial: $20.79 Health Partners Open Network — Commercial: $6.84 Humana — Medicare Advantage: $3.65 Medica Exchange Inspire — Commercial: $15.14 Medica Exchange Insure — Commercial: $16.94 Molina — Medicare Advantage: $3.55
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS NONAUTO W/O SCOPE	$9	$7.20	$3.48 – $4.88
Urine test (manual, without microscope): rates for 9 insurance plans Aetna — HMO: $4.79 Aetna — PPO: $4.70 Cigna/Midlands — Commercial: $4.52 Health Partners Open Network — Commercial: $4.88 United Healthcare — HMO: $3.48 United Healthcare — PPO: $3.48 Wellmark Blue Cross and Blue Shield — HMO: $3.48 Wellmark Blue Cross and Blue Shield — PPO: $3.48 Wellmark UPH Self-Funded — Commercial: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC N-AUTOM URINALYS WO MICRO	$32.14	$25.72	$20.79
Urine test (manual, without microscope): rates for 1 insurance plan Cigna/Midlands — Commercial: $20.79
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AUTOM URINALYSIS WO MICRO	$32.14	$25.72	$2.25 – $20.79
Urine test (automated, without microscope): 10 of 14 insurance plan rates Aetna — HMO: $3.83 Aetna — Medicare Advantage: $2.30 Aetna — PPO: $3.83 Amerivantage — Medicare Advantage: $2.36 Cigna/Midlands — Commercial: $20.79 Health Partners Open Network — Commercial: $4.42 Humana — Medicare Advantage: $2.36 Medica Exchange Inspire — Commercial: $15.14 Medica Exchange Insure — Commercial: $16.94 Molina — Medicare Advantage: $2.30
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS, AUTO, W/O SCOPE	$8	$6.40	$2.25 – $4.11
Urine test (automated, without microscope): rates for 9 insurance plans Aetna — HMO: $4.11 Aetna — PPO: $4.03 Cigna/Midlands — Commercial: $2.93 Health Partners Open Network — Commercial: $3.49 United Healthcare — HMO: $2.25 United Healthcare — PPO: $2.25 Wellmark Blue Cross and Blue Shield — HMO: $2.25 Wellmark Blue Cross and Blue Shield — PPO: $2.25 Wellmark UPH Self-Funded — Commercial: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC AUTOM URINALYSIS WO MICRO	$32.14	$25.72	$20.79
Urine test (automated, without microscope): rates for 1 insurance plan Cigna/Midlands — Commercial: $20.79
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA; TOTAL	$80.35	$64.28	$18.39 – $51.99
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — HMO: $31.26 Aetna — Medicare Advantage: $18.76 Aetna — PPO: $31.26 Amerivantage — Medicare Advantage: $19.31 Cigna/Midlands — Commercial: $51.99 Health Partners Open Network — Commercial: $36.17 Humana — Medicare Advantage: $19.31 Medica Exchange Inspire — Commercial: $37.84 Medica Exchange Insure — Commercial: $42.34 Molina — Medicare Advantage: $18.76
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG PROSTATE SPECIFIC ANTIGEN,TOTAL	$58	$46.40	$11.03 – $35.54
PSA (prostate specific antigen) blood test: rates for 9 insurance plans Aetna — HMO: $35.54 Aetna — PPO: $34.84 Cigna/Midlands — Commercial: $23.91 Health Partners Open Network — Commercial: $28.62 United Healthcare — HMO: $11.03 United Healthcare — PPO: $11.03 Wellmark Blue Cross and Blue Shield — HMO: $18.39 Wellmark Blue Cross and Blue Shield — PPO: $18.39 Wellmark UPH Self-Funded — Commercial: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSA; TOTAL	$80.35	$64.28	$51.99
PSA (prostate specific antigen) blood test: rates for 1 insurance plan Cigna/Midlands — Commercial: $51.99
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE	$68.75	$55	$16.80 – $44.48
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — HMO: $28.56 Aetna — Medicare Advantage: $17.14 Aetna — PPO: $28.56 Amerivantage — Medicare Advantage: $17.64 Cigna/Midlands — Commercial: $44.48 Health Partners Open Network — Commercial: $33.03 Humana — Medicare Advantage: $17.64 Medica Exchange Inspire — Commercial: $32.38 Medica Exchange Insure — Commercial: $36.23 Molina — Medicare Advantage: $17.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG ASSAY THYROID STIM HORMONE	$53	$42.40	$10.08 – $32.80
Thyroid stimulating hormone (TSH) test: rates for 9 insurance plans Aetna — HMO: $32.80 Aetna — PPO: $32.16 Cigna/Midlands — Commercial: $21.84 Health Partners Open Network — Commercial: $26.14 United Healthcare — HMO: $10.08 United Healthcare — PPO: $10.08 Wellmark Blue Cross and Blue Shield — HMO: $16.80 Wellmark Blue Cross and Blue Shield — PPO: $16.80 Wellmark UPH Self-Funded — Commercial: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE	$68.75	$55	$44.48
Thyroid stimulating hormone (TSH) test: rates for 1 insurance plan Cigna/Midlands — Commercial: $44.48
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPL CBC W PLT W AUTOM DIFF	$41.96	$33.57	$7.77 – $27.15
Complete blood count (CBC) with differential: 10 of 14 insurance plan rates Aetna — HMO: $13.21 Aetna — Medicare Advantage: $7.93 Aetna — PPO: $13.21 Amerivantage — Medicare Advantage: $8.16 Cigna/Midlands — Commercial: $27.15 Health Partners Open Network — Commercial: $15.27 Humana — Medicare Advantage: $8.16 Medica Exchange Inspire — Commercial: $19.76 Medica Exchange Insure — Commercial: $22.11 Molina — Medicare Advantage: $7.93
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG COMPLETE CBC & AUTO DIFF WBC	$25	$20	$4.66 – $15.05
Complete blood count (CBC) with differential: rates for 9 insurance plans Aetna — HMO: $15.05 Aetna — PPO: $14.75 Cigna/Midlands — Commercial: $10.10 Health Partners Open Network — Commercial: $12.08 United Healthcare — HMO: $4.66 United Healthcare — PPO: $4.66 Wellmark Blue Cross and Blue Shield — HMO: $7.77 Wellmark Blue Cross and Blue Shield — PPO: $7.77 Wellmark UPH Self-Funded — Commercial: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPL CBC W PLT W AUTOM DIFF	$41.96	$33.57	$27.15
Complete blood count (CBC) with differential: rates for 1 insurance plan Cigna/Midlands — Commercial: $27.15
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPL AUTOM CBC W PLT	$41.96	$33.57	$6.47 – $27.15
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — HMO: $11 Aetna — Medicare Advantage: $6.60 Aetna — PPO: $11 Amerivantage — Medicare Advantage: $6.79 Cigna/Midlands — Commercial: $27.15 Health Partners Open Network — Commercial: $12.72 Humana — Medicare Advantage: $6.79 Medica Exchange Inspire — Commercial: $19.76 Medica Exchange Insure — Commercial: $22.11 Molina — Medicare Advantage: $6.60
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG COMPLETE CBC	$21	$16.80	$3.88 – $12.99
Complete blood count (CBC), automated: rates for 9 insurance plans Aetna — HMO: $12.99 Aetna — PPO: $12.74 Cigna/Midlands — Commercial: $8.41 Health Partners Open Network — Commercial: $10.06 United Healthcare — HMO: $3.88 United Healthcare — PPO: $3.88 Wellmark Blue Cross and Blue Shield — HMO: $6.47 Wellmark Blue Cross and Blue Shield — PPO: $6.47 Wellmark UPH Self-Funded — Commercial: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPL AUTOM CBC W PLT	$41.96	$33.57	$27.15
Complete blood count (CBC), automated: rates for 1 insurance plan Cigna/Midlands — Commercial: $27.15
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$41.06	$32.85	$4.29 – $26.57
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — HMO: $7.29 Aetna — Medicare Advantage: $4.38 Aetna — PPO: $7.29 Amerivantage — Medicare Advantage: $4.50 Cigna/Midlands — Commercial: $26.57 Health Partners Open Network — Commercial: $8.43 Humana — Medicare Advantage: $4.50 Medica Exchange Inspire — Commercial: $19.34 Medica Exchange Insure — Commercial: $21.64 Molina — Medicare Advantage: $4.38
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG PROTHROMBIN TIME	$13	$10.40	$4.29 – $6.84
Blood clotting time test (prothrombin time, PT): rates for 9 insurance plans Aetna — HMO: $6.84 Aetna — PPO: $6.71 Cigna/Midlands — Commercial: $5.58 Health Partners Open Network — Commercial: $6.13 United Healthcare — HMO: $4.29 United Healthcare — PPO: $4.29 Wellmark Blue Cross and Blue Shield — HMO: $4.29 Wellmark Blue Cross and Blue Shield — PPO: $4.29 Wellmark UPH Self-Funded — Commercial: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$41.06	$32.85	$26.57
Blood clotting time test (prothrombin time, PT): rates for 1 insurance plan Cigna/Midlands — Commercial: $26.57
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PTT; PLASMA OR WHOLE BLOOD	$41.06	$32.85	$6.01 – $26.57
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — HMO: $10.22 Aetna — Medicare Advantage: $6.13 Aetna — PPO: $10.22 Amerivantage — Medicare Advantage: $6.31 Cigna/Midlands — Commercial: $26.57 Health Partners Open Network — Commercial: $11.82 Humana — Medicare Advantage: $6.31 Medica Exchange Inspire — Commercial: $19.34 Medica Exchange Insure — Commercial: $21.64 Molina — Medicare Advantage: $6.13
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG THROMBOPLAS TIME PARTIAL	$19	$15.20	$3.61 – $10.26
Blood clotting test (partial thromboplastin time, PTT): rates for 9 insurance plans Aetna — HMO: $10.26 Aetna — PPO: $10.06 Cigna/Midlands — Commercial: $7.81 Health Partners Open Network — Commercial: $9.35 United Healthcare — HMO: $3.61 United Healthcare — PPO: $3.61 Wellmark Blue Cross and Blue Shield — HMO: $6.01 Wellmark Blue Cross and Blue Shield — PPO: $6.01 Wellmark UPH Self-Funded — Commercial: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PTT; PLASMA OR WHOLE BLOOD	$41.06	$32.85	$26.57
Blood clotting test (partial thromboplastin time, PTT): rates for 1 insurance plan Cigna/Midlands — Commercial: $26.57

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD OR BRAIN WO CONTRAST	$1,627.13	$1,301.71	$88.15 – $1,052.75
CT scan of the head or brain, without contrast: 10 of 16 insurance plan rates Aetna — HMO: $236.13 Aetna — Medicare Advantage: $100.01 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $88.15 Amerivantage — Medicare Advantage: $102.95 Cigna/Midlands — Commercial: $1,052.75 Health Partners Open Network — Commercial: $152.14 Humana — Medicare Advantage: $102.95 Iowa Total Care — Managed Medicaid: $88.15 Medica Exchange Inspire — Commercial: $766.38
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: PR CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL	$337	$269.60	$97.63 – $317.66
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Aetna — HMO: $276.17 Aetna — Medicare Advantage: $97.63 Aetna — PPO: $317.66 Amerivantage — Medicare Advantage: $102.51 Cigna/Midlands — Commercial: $208.17 Health Partners Open Network — Commercial: $226.12 Humana — Medicare Advantage: $102.51 Molina — Medicare Advantage: $99.58 United Healthcare — HMO: $140.89 United Healthcare — Medicare Advantage: $102.51
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD OR BRAIN WO CONTRAST	$1,627.13	$1,301.71	$1,052.75
CT scan of the head or brain, without contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $1,052.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W WO CONTRAST	$2,526.36	$2,021.09	$296.02 – $1,634.55
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — HMO: $793.01 Aetna — Medicare Advantage: $335.86 Aetna — PPO: $825.05 Amerigroup — Managed Medicaid: $296.02 Amerivantage — Medicare Advantage: $345.74 Cigna/Midlands — Commercial: $1,634.55 Health Partners Open Network — Commercial: $510.93 Humana — Medicare Advantage: $345.74 Iowa Total Care — Managed Medicaid: $296.02 Medica Exchange Inspire — Commercial: $1,189.92
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI BRAIN COMBO	$1,182	$945.60	$290.84 – $1,220.99
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates Aetna — HMO: $1,054.03 Aetna — Medicare Advantage: $290.84 Aetna — PPO: $1,220.99 Amerivantage — Medicare Advantage: $305.38 Cigna/Midlands — Commercial: $625.51 Health Partners Open Network — Commercial: $865.17 Humana — Medicare Advantage: $305.38 Molina — Medicare Advantage: $296.66 United Healthcare — HMO: $444.82 United Healthcare — Medicare Advantage: $305.38
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN W WO CONTRAST	$2,526.36	$2,021.09	$1,634.55
MRI of the brain, before and after contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $1,634.55
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC X-RAY EXAM CHEST 2 VIEWS	$181.37	$145.10	$72.98 – $239.94
Chest X-ray, 2 views: 10 of 16 insurance plan rates Aetna — HMO: $195.51 Aetna — Medicare Advantage: $82.81 Aetna — PPO: $203.40 Amerigroup — Managed Medicaid: $72.98 Amerivantage — Medicare Advantage: $85.24 Cigna/Midlands — Commercial: $117.35 Health Partners Open Network — Commercial: $125.96 Humana — Medicare Advantage: $85.24 Iowa Total Care — Managed Medicaid: $72.98 Medica Exchange Inspire — Commercial: $85.43
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$77	$61.60	$30.15 – $67.80
Chest X-ray, 2 views: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $30.15 Amerivantage — Medicare Advantage: $31.66 Cigna/Midlands — Commercial: $64.09 Health Partners Open Network — Commercial: $61.21 Humana — Medicare Advantage: $31.66 Molina — Medicare Advantage: $30.75 United Healthcare — HMO: $39.72 United Healthcare — Medicare Advantage: $31.66 United Healthcare — PPO: $39.72 Wellmark Blue Cross and Blue Shield — HMO: $57.70
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC X-RAY EXAM CHEST 2 VIEWS	$181.37	$145.10	$117.35
Chest X-ray, 2 views: rates for 1 insurance plan Cigna/Midlands — Commercial: $117.35
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LUMBOSACR SPINE MIN 4 VIEWS	$519.76	$415.81	$88.15 – $336.28
X-ray of the lower spine, at least 4 views: 10 of 16 insurance plan rates Aetna — HMO: $236.13 Aetna — Medicare Advantage: $100.01 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $88.15 Amerivantage — Medicare Advantage: $102.95 Cigna/Midlands — Commercial: $336.28 Health Partners Open Network — Commercial: $152.14 Humana — Medicare Advantage: $102.95 Iowa Total Care — Managed Medicaid: $88.15 Medica Exchange Inspire — Commercial: $244.81
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG X-RAY LUMBAR SPINE 4 VW	$169	$135.20	$46.51 – $144.76
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Aetna — HMO: $125.77 Aetna — Medicare Advantage: $46.51 Aetna — PPO: $144.76 Amerivantage — Medicare Advantage: $48.84 Cigna/Midlands — Commercial: $98.87 Health Partners Open Network — Commercial: $104.17 Humana — Medicare Advantage: $48.84 Molina — Medicare Advantage: $47.44 United Healthcare — HMO: $58.65 United Healthcare — Medicare Advantage: $48.84
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LUMBOSACR SPINE MIN 4 VIEWS	$519.76	$415.81	$336.28
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan Cigna/Midlands — Commercial: $336.28
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST	$1,479.85	$1,183.88	$200.36 – $957.46
MRI of the lower back (lumbar spine), without contrast: 10 of 16 insurance plan rates Aetna — HMO: $536.74 Aetna — Medicare Advantage: $227.32 Aetna — PPO: $558.42 Amerigroup — Managed Medicaid: $200.36 Amerivantage — Medicare Advantage: $234.01 Cigna/Midlands — Commercial: $957.46 Health Partners Open Network — Commercial: $345.82 Humana — Medicare Advantage: $234.01 Iowa Total Care — Managed Medicaid: $200.36 Medica Exchange Inspire — Commercial: $697.01
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI, LUMBAR SPINE	$650	$520	$174.72 – $710.34
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates Aetna — HMO: $613.81 Aetna — Medicare Advantage: $174.72 Aetna — PPO: $710.34 Amerivantage — Medicare Advantage: $183.46 Cigna/Midlands — Commercial: $376.13 Health Partners Open Network — Commercial: $506.36 Humana — Medicare Advantage: $183.46 Molina — Medicare Advantage: $178.21 United Healthcare — HMO: $265.30 United Healthcare — Medicare Advantage: $183.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST	$1,479.85	$1,183.88	$957.46
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $957.46
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$1,448.31	$1,158.65	$147.55 – $937.06
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates Aetna — HMO: $395.29 Aetna — Medicare Advantage: $167.42 Aetna — PPO: $411.26 Amerigroup — Managed Medicaid: $147.55 Amerivantage — Medicare Advantage: $172.34 Cigna/Midlands — Commercial: $937.06 Health Partners Open Network — Commercial: $254.68 Humana — Medicare Advantage: $172.34 Iowa Total Care — Managed Medicaid: $147.55 Medica Exchange Inspire — Commercial: $682.15
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: PR CT SCAN OF PELVIS CONTRAST	$671	$536.80	$206.01 – $625.91
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Aetna — HMO: $541.37 Aetna — Medicare Advantage: $206.01 Aetna — PPO: $625.91 Amerivantage — Medicare Advantage: $216.31 Cigna/Midlands — Commercial: $442.64 Health Partners Open Network — Commercial: $494.75 Humana — Medicare Advantage: $216.31 Molina — Medicare Advantage: $210.13 United Healthcare — HMO: $293.98 United Healthcare — Medicare Advantage: $216.31
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$1,448.31	$1,158.65	$937.06
CT scan of the pelvis, with contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $937.06
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOW EXTR ANY JOINT WO CONTRAST	$4,140.35	$3,312.28	$200.36 – $2,678.81
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — HMO: $536.74 Aetna — Medicare Advantage: $227.32 Aetna — PPO: $558.42 Amerigroup — Managed Medicaid: $200.36 Amerivantage — Medicare Advantage: $234.01 Cigna/Midlands — Commercial: $2,678.81 Health Partners Open Network — Commercial: $345.82 Humana — Medicare Advantage: $234.01 Iowa Total Care — Managed Medicaid: $200.36 Medica Exchange Inspire — Commercial: $1,950.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI LOWER EXTREM JT, W/O CONTRAST	$690	$552	$185.28 – $763.97
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Aetna — HMO: $658.93 Aetna — Medicare Advantage: $185.28 Aetna — PPO: $763.97 Amerivantage — Medicare Advantage: $194.54 Cigna/Midlands — Commercial: $397.64 Health Partners Open Network — Commercial: $540.86 Humana — Medicare Advantage: $194.54 Molina — Medicare Advantage: $188.99 United Healthcare — HMO: $278.59 United Healthcare — Medicare Advantage: $194.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOW EXTR ANY JOINT WO CONTRAST	$4,140.35	$3,312.28	$2,678.81
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $2,678.81
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,258.04	$2,606.44	$296.02 – $2,107.95
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — HMO: $793.01 Aetna — Medicare Advantage: $335.86 Aetna — PPO: $825.05 Amerigroup — Managed Medicaid: $296.02 Amerivantage — Medicare Advantage: $345.74 Cigna/Midlands — Commercial: $2,107.95 Health Partners Open Network — Commercial: $510.93 Humana — Medicare Advantage: $345.74 Iowa Total Care — Managed Medicaid: $296.02 Medica Exchange Inspire — Commercial: $1,534.54
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG CT SCAN,ABDOMENT AND PELVIS,W CONTRAST	$781	$624.80	$274.75 – $861.80
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — HMO: $746.42 Aetna — Medicare Advantage: $274.75 Aetna — PPO: $861.80 Amerivantage — Medicare Advantage: $288.49 Cigna/Midlands — Commercial: $593.82 Health Partners Open Network — Commercial: $650.23 Humana — Medicare Advantage: $288.49 Molina — Medicare Advantage: $280.25 United Healthcare — HMO: $398.03 United Healthcare — Medicare Advantage: $288.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,258.04	$2,606.44	$2,107.95
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan Cigna/Midlands — Commercial: $2,107.95
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$1,146.96	$917.57	$88.15 – $742.08
Ultrasound of the abdomen, complete: 10 of 16 insurance plan rates Aetna — HMO: $236.13 Aetna — Medicare Advantage: $100.01 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $88.15 Amerivantage — Medicare Advantage: $102.95 Cigna/Midlands — Commercial: $742.08 Health Partners Open Network — Commercial: $152.14 Humana — Medicare Advantage: $102.95 Iowa Total Care — Managed Medicaid: $88.15 Medica Exchange Inspire — Commercial: $540.22
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE	$304	$243.20	$103.58 – $320.34
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Aetna — HMO: $278.90 Aetna — Medicare Advantage: $103.58 Aetna — PPO: $320.34 Amerivantage — Medicare Advantage: $108.76 Cigna/Midlands — Commercial: $222.08 Health Partners Open Network — Commercial: $236 Humana — Medicare Advantage: $108.76 Molina — Medicare Advantage: $105.65 United Healthcare — HMO: $150.09 United Healthcare — Medicare Advantage: $108.76
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$1,146.96	$917.57	$742.08
Ultrasound of the abdomen, complete: rates for 1 insurance plan Cigna/Midlands — Commercial: $742.08
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB COMPLETE SNGL FETUS	$992.78	$794.23	$88.15 – $642.33
Pregnancy ultrasound (after the first trimester): 10 of 16 insurance plan rates Aetna — HMO: $236.13 Aetna — Medicare Advantage: $100.01 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $88.15 Amerivantage — Medicare Advantage: $102.95 Cigna/Midlands — Commercial: $642.33 Health Partners Open Network — Commercial: $152.14 Humana — Medicare Advantage: $102.95 Iowa Total Care — Managed Medicaid: $88.15 Medica Exchange Inspire — Commercial: $467.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: US, OB >/= 14 WKS, SNGL FETUS	$338	$270.40	$120.62 – $372.60
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Aetna — HMO: $324.01 Aetna — Medicare Advantage: $120.62 Aetna — PPO: $372.60 Amerivantage — Medicare Advantage: $126.65 Cigna/Midlands — Commercial: $259.56 Health Partners Open Network — Commercial: $269.77 Humana — Medicare Advantage: $126.65 Molina — Medicare Advantage: $123.03 United Healthcare — HMO: $171.33 United Healthcare — Medicare Advantage: $126.65
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB COMPLETE SNGL FETUS	$992.78	$794.23	$642.33
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan Cigna/Midlands — Commercial: $642.33
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US NON OB TRANSVAG	$807.08	$645.67	$88.15 – $522.18
Transvaginal ultrasound: 10 of 16 insurance plan rates Aetna — HMO: $236.13 Aetna — Medicare Advantage: $100.01 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $88.15 Amerivantage — Medicare Advantage: $102.95 Cigna/Midlands — Commercial: $522.18 Health Partners Open Network — Commercial: $152.14 Humana — Medicare Advantage: $102.95 Iowa Total Care — Managed Medicaid: $88.15 Medica Exchange Inspire — Commercial: $380.13
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ECHOGRAPHY,TRANSVAGINAL	$297	$237.60	$105.45 – $320.34
Transvaginal ultrasound: 10 of 15 insurance plan rates Aetna — HMO: $280.27 Aetna — Medicare Advantage: $105.45 Aetna — PPO: $320.34 Amerivantage — Medicare Advantage: $110.72 Cigna/Midlands — Commercial: $227.30 Health Partners Open Network — Commercial: $228.80 Humana — Medicare Advantage: $110.72 Molina — Medicare Advantage: $107.56 United Healthcare — HMO: $150.01 United Healthcare — Medicare Advantage: $110.72
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US NON OB TRANSVAG	$807.08	$645.67	$522.18
Transvaginal ultrasound: rates for 1 insurance plan Cigna/Midlands — Commercial: $522.18
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$283	$226.40	$112.73 – $273.30
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Aetna — HMO: $131.55 Aetna — Medicare Advantage: $112.73 Aetna — PPO: $131.55 Amerivantage — Medicare Advantage: $118.37 Cigna/Midlands — Commercial: $239.34 Health Partners Open Network — Commercial: $259.38 Humana — Medicare Advantage: $118.37 Molina — Medicare Advantage: $114.98 United Healthcare — HMO: $163.30 United Healthcare — Medicare Advantage: $118.37
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNIL	$264.38	$211.51	$78.92 – $171.05
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — HMO: $132.19 Aetna — Medicare Advantage: $78.92 Aetna — PPO: $132.19 Amerivantage — Medicare Advantage: $81.24 Cigna/Midlands — Commercial: $171.05 Health Partners Open Network — Commercial: $117.47 Humana — Medicare Advantage: $81.24 Medica Exchange Inspire — Commercial: $124.52 Medica Exchange Insure — Commercial: $139.33 Molina — Medicare Advantage: $78.92
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNIL	$264.38	$211.51	$171.05
Diagnostic mammogram, one breast: rates for 1 insurance plan Cigna/Midlands — Commercial: $171.05
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$357	$285.60	$142.21 – $344.40
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Aetna — HMO: $167.69 Aetna — Medicare Advantage: $142.21 Aetna — PPO: $167.69 Amerivantage — Medicare Advantage: $149.32 Cigna/Midlands — Commercial: $302.63 Health Partners Open Network — Commercial: $328.22 Humana — Medicare Advantage: $149.32 Molina — Medicare Advantage: $145.05 United Healthcare — HMO: $205.90 United Healthcare — Medicare Advantage: $149.32
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BILAT	$320.44	$256.36	$100.61 – $207.32
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — HMO: $160.22 Aetna — Medicare Advantage: $100.61 Aetna — PPO: $160.22 Amerivantage — Medicare Advantage: $103.57 Cigna/Midlands — Commercial: $207.32 Health Partners Open Network — Commercial: $149.75 Humana — Medicare Advantage: $103.57 Medica Exchange Inspire — Commercial: $150.93 Medica Exchange Insure — Commercial: $168.87 Molina — Medicare Advantage: $100.61
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BILAT	$320.44	$256.36	$207.32
Diagnostic mammogram, both breasts: rates for 1 insurance plan Cigna/Midlands — Commercial: $207.32
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$289	$231.20	$115.10 – $279.10
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — HMO: $138.82 Aetna — Medicare Advantage: $115.10 Aetna — PPO: $138.82 Amerivantage — Medicare Advantage: $120.86 Cigna/Midlands — Commercial: $244.06 Health Partners Open Network — Commercial: $264.13 Humana — Medicare Advantage: $120.86 Molina — Medicare Advantage: $117.40 United Healthcare — HMO: $166.50 United Healthcare — Medicare Advantage: $120.86
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCR MAMMO INCL CAD BILAT	$306.68	$245.35	$83.29 – $198.42
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — HMO: $153.34 Aetna — Medicare Advantage: $83.29 Aetna — PPO: $153.34 Amerivantage — Medicare Advantage: $85.74 Cigna/Midlands — Commercial: $198.42 Health Partners Open Network — Commercial: $123.75 Humana — Medicare Advantage: $85.74 Medica Exchange Inspire — Commercial: $144.45 Medica Exchange Insure — Commercial: $161.62 Molina — Medicare Advantage: $83.29
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCR MAMMO INCL CAD UNIL	$306.68	$245.35	$83.29 – $198.42
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — HMO: $153.34 Aetna — Medicare Advantage: $83.29 Aetna — PPO: $153.34 Amerivantage — Medicare Advantage: $85.74 Cigna/Midlands — Commercial: $198.42 Health Partners Open Network — Commercial: $123.75 Humana — Medicare Advantage: $85.74 Medica Exchange Inspire — Commercial: $144.45 Medica Exchange Insure — Commercial: $161.62 Molina — Medicare Advantage: $83.29

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ELECTROCARDIOGRAM, COMPLETE	$47	$37.60	$12.88 – $42.87
Electrocardiogram (ECG/EKG) with reading: 10 of 15 insurance plan rates Aetna — HMO: $36.90 Aetna — Medicare Advantage: $12.88 Aetna — PPO: $42.87 Amerivantage — Medicare Advantage: $13.52 Cigna/Midlands — Commercial: $33.90 Health Partners Open Network — Commercial: $33.44 Humana — Medicare Advantage: $13.52 Molina — Medicare Advantage: $13.14 United Healthcare — HMO: $42.16 United Healthcare — Medicare Advantage: $13.52
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$9,904.84	$7,923.88	$2,666.01 – $8,765.25
Left heart catheterization (diagnostic): 10 of 16 insurance plan rates Aetna — HMO: $7,142.06 Aetna — Medicare Advantage: $3,024.84 Aetna — PPO: $7,430.63 Amerigroup — Managed Medicaid: $2,666.01 Amerivantage — Medicare Advantage: $3,113.81 Cigna/Midlands — Commercial: $6,408.43 Health Partners Open Network — Commercial: $4,601.58 Humana — Medicare Advantage: $3,113.81 Iowa Total Care — Managed Medicaid: $2,666.01 Medica Exchange Inspire — Commercial: $4,665.18
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$2,434	$1,947.20	$757.63 – $2,403.26
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Aetna — HMO: $1,978.17 Aetna — Medicare Advantage: $757.63 Aetna — PPO: $2,360.24 Amerivantage — Medicare Advantage: $795.51 Cigna/Midlands — Commercial: $2,059.75 Health Partners Open Network — Commercial: $1,717.50 Humana — Medicare Advantage: $795.51 Molina — Medicare Advantage: $772.78 United Healthcare — HMO: $2,403.26 United Healthcare — Medicare Advantage: $795.51
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$9,904.84	$7,923.88	$6,408.43
Left heart catheterization (diagnostic): rates for 1 insurance plan Cigna/Midlands — Commercial: $6,408.43
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMP EP EVAL WO A INDUCTION	$5,810.75	$4,648.60	$2,736.86 – $20,678.81
Heart rhythm study (electrophysiology evaluation): 10 of 16 insurance plan rates Aetna — HMO: $16,849.40 Aetna — Medicare Advantage: $7,136.15 Aetna — PPO: $17,530.19 Amerigroup — Managed Medicaid: $6,289.59 Amerivantage — Medicare Advantage: $7,346.04 Cigna/Midlands — Commercial: $3,759.56 Health Partners Open Network — Commercial: $10,855.95 Humana — Medicare Advantage: $7,346.04 Iowa Total Care — Managed Medicaid: $6,289.59 Medica Exchange Inspire — Commercial: $2,736.86
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$2,181	$1,744.80	$787.77 – $2,152.57
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Aetna — HMO: $1,596.76 Aetna — Medicare Advantage: $787.77 Aetna — PPO: $1,904.56 Amerivantage — Medicare Advantage: $827.16 Cigna/Midlands — Commercial: $871.21 Health Partners Open Network — Commercial: $1,360.27 Humana — Medicare Advantage: $827.16 Molina — Medicare Advantage: $803.53 United Healthcare — HMO: $2,152.57 United Healthcare — Medicare Advantage: $827.16
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMP EP EVAL WO A INDUCTION	$5,810.75	$4,648.60	$3,759.56
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan Cigna/Midlands — Commercial: $3,759.56
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEIN ISOL	$44,850.61	$35,880.49	$20,334.22 – $66,854.50
Heart rhythm study with ablation for atrial fibrillation: 10 of 16 insurance plan rates Aetna — HMO: $54,474.04 Aetna — Medicare Advantage: $23,071.16 Aetna — PPO: $56,675.01 Amerigroup — Managed Medicaid: $20,334.22 Amerivantage — Medicare Advantage: $23,749.72 Cigna/Midlands — Commercial: $29,018.34 Health Partners Open Network — Commercial: $35,097.24 Humana — Medicare Advantage: $23,749.72 Iowa Total Care — Managed Medicaid: $20,334.22 Medica Exchange Inspire — Commercial: $21,124.64
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$3,444	$2,755.20	$810.28 – $3,443.33
Heart rhythm study with ablation for atrial fibrillation: 10 of 15 insurance plan rates Aetna — HMO: $2,587.90 Aetna — Medicare Advantage: $810.28 Aetna — PPO: $3,088.01 Amerivantage — Medicare Advantage: $850.79 Cigna/Midlands — Commercial: $2,127.97 Health Partners Open Network — Commercial: $2,233.18 Humana — Medicare Advantage: $850.79 Molina — Medicare Advantage: $826.49 United Healthcare — HMO: $3,443.33 United Healthcare — Medicare Advantage: $850.79
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEIN ISOL	$44,850.61	$35,880.49	$29,018.34
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan Cigna/Midlands — Commercial: $29,018.34
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSS W 4/> PARAM W TECH 6+ YRS	$3,599.05	$2,879.24	$843.29 – $2,772.56
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates Aetna — HMO: $1,044.46 Aetna — Medicare Advantage: $956.79 Aetna — PPO: $1,244.74 Amerigroup — Managed Medicaid: $843.29 Amerivantage — Medicare Advantage: $984.94 Cigna/Midlands — Commercial: $2,328.59 Health Partners Open Network — Commercial: $1,455.54 Humana — Medicare Advantage: $984.94 Iowa Total Care — Managed Medicaid: $843.29 Medica Exchange Inspire — Commercial: $1,695.15
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$1,746	$1,396.80	$559 – $1,586.90
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates Aetna — HMO: $1,357.52 Aetna — Medicare Advantage: $559 Aetna — PPO: $1,586.90 Amerivantage — Medicare Advantage: $586.95 Cigna/Midlands — Commercial: $1,464.27 Health Partners Open Network — Commercial: $1,214.60 Humana — Medicare Advantage: $586.95 Molina — Medicare Advantage: $570.18 United Healthcare — HMO: $1,503.90 United Healthcare — Medicare Advantage: $586.95
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSS W 4/> PARAM W TECH 6+ YRS	$3,599.05	$2,879.24	$2,328.59
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan Cigna/Midlands — Commercial: $2,328.59

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Doctor (professional) fee In the file: PR THERAPEUTIC EXERCISES	$69	$55.20	$27.40 – $45.80
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Aetna — HMO: $45.80 Aetna — Medicare Advantage: $27.40 Aetna — PPO: $45.80 Amerivantage — Medicare Advantage: $28.77 Cigna/Midlands — Commercial: $45.28 Health Partners Open Network — Commercial: $40.67 Humana — Medicare Advantage: $28.77 Molina — Medicare Advantage: $27.95 United Healthcare — HMO: $29.64 United Healthcare — Medicare Advantage: $28.77
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THERAP EXERCISE ROM EA 15M	$110.54	$88.44	$27.95 – $71.52
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates Aetna — HMO: $55.27 Aetna — Medicare Advantage: $27.95 Aetna — PPO: $55.27 Amerivantage — Medicare Advantage: $28.77 Cigna/Midlands — Commercial: $71.52 Health Partners Open Network — Commercial: $39 Humana — Medicare Advantage: $28.77 Medica Exchange Inspire — Commercial: $52.06 Medica Exchange Insure — Commercial: $58.25 Molina — Medicare Advantage: $27.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THERAP EXERCISE ROM EA 15M	$110.54	$88.44	$71.52
Physical therapy: therapeutic exercise (each 15 minutes): rates for 1 insurance plan Cigna/Midlands — Commercial: $71.52
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$234	$187.20	$82.70 – $155.77
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Aetna — HMO: $155.77 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $155.77 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $154.74 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89 Molina — Medicare Advantage: $95.09 United Healthcare — HMO: $82.70 United Healthcare — Medicare Advantage: $97.89
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX	$291.88	$233.51	$95.09 – $188.85
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates Aetna — HMO: $145.94 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $145.94 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $188.85 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89 Medica Exchange Inspire — Commercial: $137.48 Medica Exchange Insure — Commercial: $153.82 Molina — Medicare Advantage: $95.09
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX	$291.88	$233.51	$188.85
Physical therapy evaluation (low complexity): rates for 1 insurance plan Cigna/Midlands — Commercial: $188.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$234	$187.20	$82.70 – $155.77
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Aetna — HMO: $155.77 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $155.77 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $154.74 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89 Molina — Medicare Advantage: $95.09 United Healthcare — HMO: $82.70 United Healthcare — Medicare Advantage: $97.89
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX	$321.67	$257.34	$95.09 – $208.12
Physical therapy evaluation (moderate complexity): 10 of 14 insurance plan rates Aetna — HMO: $160.84 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $160.84 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $208.12 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89 Medica Exchange Inspire — Commercial: $151.51 Medica Exchange Insure — Commercial: $169.52 Molina — Medicare Advantage: $95.09
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX	$321.67	$257.34	$208.12
Physical therapy evaluation (moderate complexity): rates for 1 insurance plan Cigna/Midlands — Commercial: $208.12
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$234	$187.20	$82.70 – $155.77
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Aetna — HMO: $155.77 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $155.77 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $154.74 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89 Molina — Medicare Advantage: $95.09 United Healthcare — HMO: $82.70 United Healthcare — Medicare Advantage: $97.89
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX	$351.45	$281.16	$95.09 – $227.39
Physical therapy evaluation (high complexity): 10 of 14 insurance plan rates Aetna — HMO: $175.73 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $175.73 Amerivantage — Medicare Advantage: $97.89 Cigna/Midlands — Commercial: $227.39 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89 Medica Exchange Inspire — Commercial: $165.53 Medica Exchange Insure — Commercial: $185.21 Molina — Medicare Advantage: $95.09
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX	$351.45	$281.16	$227.39
Physical therapy evaluation (high complexity): rates for 1 insurance plan Cigna/Midlands — Commercial: $227.39
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 30 MIN (16-37 MIN)	$245.42	$196.34	$115.59 – $437.86
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates Aetna — HMO: $356.78 Aetna — Medicare Advantage: $151.10 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $133.18 Amerivantage — Medicare Advantage: $155.54 Cigna/Midlands — Commercial: $158.79 Health Partners Open Network — Commercial: $229.87 Humana — Medicare Advantage: $155.54 Iowa Total Care — Managed Medicaid: $133.18 Medica Exchange Inspire — Commercial: $115.59
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$210	$168	$67.55 – $170.59
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Aetna — HMO: $105.25 Aetna — Medicare Advantage: $67.55 Aetna — PPO: $107.22 Amerivantage — Medicare Advantage: $70.93 Cigna/Midlands — Commercial: $170.59 Health Partners Open Network — Commercial: $93.19 Humana — Medicare Advantage: $70.93 Molina — Medicare Advantage: $68.90 United Healthcare — HMO: $163.90 United Healthcare — Medicare Advantage: $70.93
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX W PT 30 MIN (16-37 MIN)	$245.42	$196.34	$158.79
Psychotherapy, 30 minutes: rates for 1 insurance plan Cigna/Midlands — Commercial: $158.79
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN (38-52 MIN)	$326.42	$261.14	$133.18 – $437.86
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates Aetna — HMO: $356.78 Aetna — Medicare Advantage: $151.10 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $133.18 Amerivantage — Medicare Advantage: $155.54 Cigna/Midlands — Commercial: $211.19 Health Partners Open Network — Commercial: $229.87 Humana — Medicare Advantage: $155.54 Iowa Total Care — Managed Medicaid: $133.18 Medica Exchange Inspire — Commercial: $153.74
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$262	$209.60	$89.14 – $225.73
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates Aetna — HMO: $139.43 Aetna — Medicare Advantage: $89.14 Aetna — PPO: $142.07 Amerivantage — Medicare Advantage: $93.60 Cigna/Midlands — Commercial: $225.73 Health Partners Open Network — Commercial: $128.07 Humana — Medicare Advantage: $93.60 Molina — Medicare Advantage: $90.92 United Healthcare — HMO: $218.53 United Healthcare — Medicare Advantage: $93.60
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN (38-52 MIN)	$326.42	$261.14	$211.19
Psychotherapy, 45 minutes: rates for 1 insurance plan Cigna/Midlands — Commercial: $211.19
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN (>53 MIN)	$326.42	$261.14	$133.18 – $437.86
Psychotherapy, 60 minutes: 10 of 16 insurance plan rates Aetna — HMO: $356.78 Aetna — Medicare Advantage: $151.10 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $133.18 Amerivantage — Medicare Advantage: $155.54 Cigna/Midlands — Commercial: $211.19 Health Partners Open Network — Commercial: $229.87 Humana — Medicare Advantage: $155.54 Iowa Total Care — Managed Medicaid: $133.18 Medica Exchange Inspire — Commercial: $153.74
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$392	$313.60	$131.89 – $333.11
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates Aetna — HMO: $210.53 Aetna — Medicare Advantage: $131.89 Aetna — PPO: $214.44 Amerivantage — Medicare Advantage: $138.48 Cigna/Midlands — Commercial: $333.11 Health Partners Open Network — Commercial: $193.26 Humana — Medicare Advantage: $138.48 Molina — Medicare Advantage: $134.53 United Healthcare — HMO: $327.38 United Healthcare — Medicare Advantage: $138.48
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN (>53 MIN)	$326.42	$261.14	$211.19
Psychotherapy, 60 minutes: rates for 1 insurance plan Cigna/Midlands — Commercial: $211.19
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$288	$230.40	$96.29 – $264.08
Family psychotherapy, without the patient: 10 of 15 insurance plan rates Aetna — HMO: $169.50 Aetna — Medicare Advantage: $96.29 Aetna — PPO: $172.89 Amerivantage — Medicare Advantage: $101.10 Cigna/Midlands — Commercial: $242.84 Health Partners Open Network — Commercial: $147.33 Humana — Medicare Advantage: $101.10 Molina — Medicare Advantage: $98.22 United Healthcare — HMO: $264.08 United Healthcare — Medicare Advantage: $101.10
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$133.18 – $437.86
Family psychotherapy, without the patient: 10 of 13 insurance plan rates Aetna — HMO: $356.78 Aetna — Medicare Advantage: $151.10 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $133.18 Amerivantage — Medicare Advantage: $155.54 Health Partners Open Network — Commercial: $229.87 Humana — Medicare Advantage: $155.54 Iowa Total Care — Managed Medicaid: $133.18 Molina — Medicare Advantage: $151.10 United Healthcare — HMO: $437.86
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY THERAPY W PT 50 MIN	$216.82	$173.46	$102.12 – $437.86
Family psychotherapy, with the patient: 10 of 16 insurance plan rates Aetna — HMO: $356.78 Aetna — Medicare Advantage: $151.10 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $133.18 Amerivantage — Medicare Advantage: $155.54 Cigna/Midlands — Commercial: $140.28 Health Partners Open Network — Commercial: $229.87 Humana — Medicare Advantage: $155.54 Iowa Total Care — Managed Medicaid: $133.18 Medica Exchange Inspire — Commercial: $102.12
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$299	$239.20	$100.44 – $274.48
Family psychotherapy, with the patient: 10 of 15 insurance plan rates Aetna — HMO: $176.35 Aetna — Medicare Advantage: $100.44 Aetna — PPO: $179.60 Amerivantage — Medicare Advantage: $105.46 Cigna/Midlands — Commercial: $253.76 Health Partners Open Network — Commercial: $159.54 Humana — Medicare Advantage: $105.46 Molina — Medicare Advantage: $102.45 United Healthcare — HMO: $274.48 United Healthcare — Medicare Advantage: $105.46
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY THERAPY W PT 50 MIN	$216.82	$173.46	$140.28
Family psychotherapy, with the patient: rates for 1 insurance plan Cigna/Midlands — Commercial: $140.28
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INTENSIVE OUTPATIENT GROUP 60 MIN	$237.06	$189.65	$76.67 – $252.09
Group psychotherapy: 10 of 16 insurance plan rates Aetna — HMO: $205.41 Aetna — Medicare Advantage: $86.99 Aetna — PPO: $213.70 Amerigroup — Managed Medicaid: $76.67 Amerivantage — Medicare Advantage: $89.55 Cigna/Midlands — Commercial: $153.38 Health Partners Open Network — Commercial: $132.34 Humana — Medicare Advantage: $89.55 Iowa Total Care — Managed Medicaid: $76.67 Medica Exchange Inspire — Commercial: $111.66
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP THERAPY NOT MULTI-FAMILY	$237.06	$189.65	$76.67 – $252.09
Group psychotherapy: 10 of 16 insurance plan rates Aetna — HMO: $205.41 Aetna — Medicare Advantage: $86.99 Aetna — PPO: $213.70 Amerigroup — Managed Medicaid: $76.67 Amerivantage — Medicare Advantage: $89.55 Cigna/Midlands — Commercial: $153.38 Health Partners Open Network — Commercial: $132.34 Humana — Medicare Advantage: $89.55 Iowa Total Care — Managed Medicaid: $76.67 Medica Exchange Inspire — Commercial: $111.66
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CONTINUED CARE PER DIEM	$583.50	$466.80	$76.67 – $377.52
Group psychotherapy: 10 of 16 insurance plan rates Aetna — HMO: $205.41 Aetna — Medicare Advantage: $86.99 Aetna — PPO: $213.70 Amerigroup — Managed Medicaid: $76.67 Amerivantage — Medicare Advantage: $89.55 Cigna/Midlands — Commercial: $377.52 Health Partners Open Network — Commercial: $132.34 Humana — Medicare Advantage: $89.55 Iowa Total Care — Managed Medicaid: $76.67 Medica Exchange Inspire — Commercial: $274.83

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REMOVAL OF BREAST LESION	$1,534	$1,227.20	$371.96 – $1,264.49
Removal of breast growth (open surgery): 10 of 15 insurance plan rates Aetna — HMO: $932.35 Aetna — Medicare Advantage: $371.96 Aetna — PPO: $1,113.77 Amerivantage — Medicare Advantage: $390.56 Cigna/Midlands — Commercial: $989.48 Health Partners Open Network — Commercial: $753.98 Humana — Medicare Advantage: $390.56 Molina — Medicare Advantage: $379.40 United Healthcare — HMO: $1,264.49 United Healthcare — Medicare Advantage: $390.56
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$3,174 – $10,435.42
Removal of breast growth (open surgery): 10 of 13 insurance plan rates Aetna — HMO: $8,502.93 Aetna — Medicare Advantage: $3,601.21 Aetna — PPO: $8,846.48 Amerigroup — Managed Medicaid: $3,174 Amerivantage — Medicare Advantage: $3,707.13 Health Partners Open Network — Commercial: $5,478.38 Humana — Medicare Advantage: $3,707.13 Iowa Total Care — Managed Medicaid: $3,174 Molina — Medicare Advantage: $3,601.21 United Healthcare — HMO: $10,435.42
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REMOVAL OF BREAST LESION (BILAT)	$3,068	$2,454.40	$371.96 – $1,264.49
Removal of breast growth (open surgery): 10 of 15 insurance plan rates Aetna — HMO: $932.35 Aetna — Medicare Advantage: $371.96 Aetna — PPO: $1,113.77 Amerivantage — Medicare Advantage: $390.56 Cigna/Midlands — Commercial: $989.48 Health Partners Open Network — Commercial: $753.98 Humana — Medicare Advantage: $390.56 Molina — Medicare Advantage: $379.40 United Healthcare — HMO: $1,264.49 United Healthcare — Medicare Advantage: $390.56
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: PR TOTAL HIP ARTHROPLASTY	$4,172	$3,337.60	$1,146 – $4,171.24
Total hip replacement: 10 of 15 insurance plan rates Aetna — HMO: $3,086.90 Aetna — Medicare Advantage: $1,146 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,203.30 Cigna/Midlands — Commercial: $3,048.88 Health Partners Open Network — Commercial: $2,586.94 Humana — Medicare Advantage: $1,203.30 Molina — Medicare Advantage: $1,168.92 United Healthcare — HMO: $4,171.24 United Healthcare — Medicare Advantage: $1,203.30
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$10,664.99 – $35,064.17
Total hip replacement: 10 of 13 insurance plan rates Aetna — HMO: $28,570.81 Aetna — Medicare Advantage: $12,100.47 Aetna — PPO: $29,725.18 Amerigroup — Managed Medicaid: $10,664.99 Amerivantage — Medicare Advantage: $12,456.37 Health Partners Open Network — Commercial: $18,407.97 Humana — Medicare Advantage: $12,456.37 Iowa Total Care — Managed Medicaid: $10,664.99 Molina — Medicare Advantage: $12,100.47 United Healthcare — HMO: $35,064.17
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR TOTAL HIP ARTHROPLASTY (BILAT)	$8,344	$6,675.20	$1,146 – $4,171.24
Total hip replacement: 10 of 15 insurance plan rates Aetna — HMO: $3,086.90 Aetna — Medicare Advantage: $1,146 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,203.30 Cigna/Midlands — Commercial: $3,048.88 Health Partners Open Network — Commercial: $2,586.94 Humana — Medicare Advantage: $1,203.30 Molina — Medicare Advantage: $1,168.92 United Healthcare — HMO: $4,171.24 United Healthcare — Medicare Advantage: $1,203.30
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: PR TOTAL KNEE ARTHROPLASTY	$4,168	$3,334.40	$1,144.67 – $4,167.04
Total knee replacement: 10 of 15 insurance plan rates Aetna — HMO: $3,086.90 Aetna — Medicare Advantage: $1,144.67 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,201.90 Cigna/Midlands — Commercial: $3,044.93 Health Partners Open Network — Commercial: $2,631.60 Humana — Medicare Advantage: $1,201.90 Molina — Medicare Advantage: $1,167.56 United Healthcare — HMO: $4,167.04 United Healthcare — Medicare Advantage: $1,201.90
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$10,664.99 – $35,064.17
Total knee replacement: 10 of 13 insurance plan rates Aetna — HMO: $28,570.81 Aetna — Medicare Advantage: $12,100.47 Aetna — PPO: $29,725.18 Amerigroup — Managed Medicaid: $10,664.99 Amerivantage — Medicare Advantage: $12,456.37 Health Partners Open Network — Commercial: $18,407.97 Humana — Medicare Advantage: $12,456.37 Iowa Total Care — Managed Medicaid: $10,664.99 Molina — Medicare Advantage: $12,100.47 United Healthcare — HMO: $35,064.17
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR TOTAL KNEE ARTHROPLASTY (BILAT)	$8,336	$6,668.80	$1,144.67 – $4,167.04
Total knee replacement: 10 of 15 insurance plan rates Aetna — HMO: $3,086.90 Aetna — Medicare Advantage: $1,144.67 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,201.90 Cigna/Midlands — Commercial: $3,044.93 Health Partners Open Network — Commercial: $2,631.60 Humana — Medicare Advantage: $1,201.90 Molina — Medicare Advantage: $1,167.56 United Healthcare — HMO: $4,167.04 United Healthcare — Medicare Advantage: $1,201.90
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: PR SHOULDER SCOPE BONE SHAVING	$663	$530.40	$151.83 – $538.56
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — HMO: $401.94 Aetna — Medicare Advantage: $151.83 Aetna — PPO: $479.84 Amerivantage — Medicare Advantage: $159.42 Cigna/Midlands — Commercial: $403.73 Health Partners Open Network — Commercial: $329.08 Humana — Medicare Advantage: $159.42 Molina — Medicare Advantage: $154.87 United Healthcare — HMO: $538.56 United Healthcare — Medicare Advantage: $159.42
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR SHOULDER SCOPE BONE SHAVING (BILAT)	$1,326	$1,060.80	$151.83 – $538.56
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — HMO: $401.94 Aetna — Medicare Advantage: $151.83 Aetna — PPO: $479.84 Amerivantage — Medicare Advantage: $159.42 Cigna/Midlands — Commercial: $403.73 Health Partners Open Network — Commercial: $329.08 Humana — Medicare Advantage: $159.42 Molina — Medicare Advantage: $154.87 United Healthcare — HMO: $538.56 United Healthcare — Medicare Advantage: $159.42
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,662	$1,329.60	$490.70 – $1,661.93
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — HMO: $1,229 Aetna — Medicare Advantage: $490.70 Aetna — PPO: $1,466.27 Amerivantage — Medicare Advantage: $515.24 Cigna/Midlands — Commercial: $1,304.86 Health Partners Open Network — Commercial: $1,054.76 Humana — Medicare Advantage: $515.24 Molina — Medicare Advantage: $500.51 United Healthcare — HMO: $1,661.93 United Healthcare — Medicare Advantage: $515.24
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$2,689.38 – $8,842.09
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 13 insurance plan rates Aetna — HMO: $7,204.67 Aetna — Medicare Advantage: $3,051.36 Aetna — PPO: $7,495.76 Amerigroup — Managed Medicaid: $2,689.38 Amerivantage — Medicare Advantage: $3,141.11 Health Partners Open Network — Commercial: $4,641.92 Humana — Medicare Advantage: $3,141.11 Iowa Total Care — Managed Medicaid: $2,689.38 Molina — Medicare Advantage: $3,051.36 United Healthcare — HMO: $8,842.09
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG (BILAT)	$3,324	$2,659.20	$490.70 – $1,661.93
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — HMO: $1,229 Aetna — Medicare Advantage: $490.70 Aetna — PPO: $1,466.27 Amerivantage — Medicare Advantage: $515.24 Cigna/Midlands — Commercial: $1,304.86 Health Partners Open Network — Commercial: $1,054.76 Humana — Medicare Advantage: $515.24 Molina — Medicare Advantage: $500.51 United Healthcare — HMO: $1,661.93 United Healthcare — Medicare Advantage: $515.24
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS/ADENOIDS,<12 Y/O	$894	$715.20	$265.42 – $893.91
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — HMO: $661.65 Aetna — Medicare Advantage: $265.42 Aetna — PPO: $789.42 Amerivantage — Medicare Advantage: $278.69 Cigna/Midlands — Commercial: $708.85 Health Partners Open Network — Commercial: $547.27 Humana — Medicare Advantage: $278.69 Molina — Medicare Advantage: $270.73 United Healthcare — HMO: $893.91 United Healthcare — Medicare Advantage: $278.69
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$4,903.34 – $16,121.13
Removal of tonsils and adenoids (under age 12): 10 of 13 insurance plan rates Aetna — HMO: $13,135.74 Aetna — Medicare Advantage: $5,563.32 Aetna — PPO: $13,666.47 Amerigroup — Managed Medicaid: $4,903.34 Amerivantage — Medicare Advantage: $5,726.95 Health Partners Open Network — Commercial: $8,463.26 Humana — Medicare Advantage: $5,726.95 Iowa Total Care — Managed Medicaid: $4,903.34 Molina — Medicare Advantage: $5,563.32 United Healthcare — HMO: $16,121.13
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC UGI DIAGNOSTIC	$2,189.57	$1,751.66	$777.12 – $2,555
Upper GI endoscopy (diagnostic): 10 of 16 insurance plan rates Aetna — HMO: $2,081.85 Aetna — Medicare Advantage: $881.72 Aetna — PPO: $2,165.97 Amerigroup — Managed Medicaid: $777.12 Amerivantage — Medicare Advantage: $907.65 Cigna/Midlands — Commercial: $1,416.65 Health Partners Open Network — Commercial: $1,341.32 Humana — Medicare Advantage: $907.65 Iowa Total Care — Managed Medicaid: $777.12 Medica Exchange Inspire — Commercial: $1,031.29
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$859	$687.20	$109.69 – $385.30
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — HMO: $300.77 Aetna — Medicare Advantage: $109.69 Aetna — PPO: $359.20 Amerivantage — Medicare Advantage: $115.17 Cigna/Midlands — Commercial: $293.06 Health Partners Open Network — Commercial: $253.88 Humana — Medicare Advantage: $115.17 Molina — Medicare Advantage: $111.88 United Healthcare — HMO: $385.30 United Healthcare — Medicare Advantage: $115.17
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC UGI DIAGNOSTIC	$2,189.57	$1,751.66	$1,416.65
Upper GI endoscopy (diagnostic): rates for 1 insurance plan Cigna/Midlands — Commercial: $1,416.65
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$1,143	$914.40	$123.53 – $435.40
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — HMO: $337.68 Aetna — Medicare Advantage: $123.53 Aetna — PPO: $403.43 Amerivantage — Medicare Advantage: $129.71 Cigna/Midlands — Commercial: $330.99 Health Partners Open Network — Commercial: $289.14 Humana — Medicare Advantage: $129.71 Molina — Medicare Advantage: $126 United Healthcare — HMO: $435.40 United Healthcare — Medicare Advantage: $129.71
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$777.12 – $2,555
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates Aetna — HMO: $2,081.85 Aetna — Medicare Advantage: $881.72 Aetna — PPO: $2,165.97 Amerigroup — Managed Medicaid: $777.12 Amerivantage — Medicare Advantage: $907.65 Health Partners Open Network — Commercial: $1,341.32 Humana — Medicare Advantage: $907.65 Iowa Total Care — Managed Medicaid: $777.12 Molina — Medicare Advantage: $881.72 United Healthcare — HMO: $2,555
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$1,017	$813.60	$164.67 – $582.44
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — HMO: $488.04 Aetna — Medicare Advantage: $164.67 Aetna — PPO: $581.68 Amerivantage — Medicare Advantage: $172.90 Cigna/Midlands — Commercial: $439.77 Health Partners Open Network — Commercial: $404.53 Humana — Medicare Advantage: $172.90 Molina — Medicare Advantage: $167.96 United Healthcare — HMO: $582.44 United Healthcare — Medicare Advantage: $172.90
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$755.69 – $2,484.55
Colonoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — HMO: $2,024.45 Aetna — Medicare Advantage: $857.41 Aetna — PPO: $2,106.25 Amerigroup — Managed Medicaid: $755.69 Amerivantage — Medicare Advantage: $882.63 Health Partners Open Network — Commercial: $1,304.34 Humana — Medicare Advantage: $882.63 Iowa Total Care — Managed Medicaid: $755.69 Molina — Medicare Advantage: $857.41 United Healthcare — HMO: $2,484.55
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$82.56 – $220.27
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — Medicare Advantage: $82.56 Amerivantage — Medicare Advantage: $86.69 Cigna/Midlands — Commercial: $220.27 Health Partners Open Network — Commercial: $167.21 Humana — Medicare Advantage: $86.69 Molina — Medicare Advantage: $84.21 United Healthcare — Medicare Advantage: $86.69 Wellmark Blue Cross and Blue Shield — Medicare Advantage: $84.21
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$1,309	$1,047.20	$179.10 – $695.60
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — HMO: $583.75 Aetna — Medicare Advantage: $179.10 Aetna — PPO: $695.60 Amerivantage — Medicare Advantage: $188.06 Cigna/Midlands — Commercial: $478.46 Health Partners Open Network — Commercial: $484.27 Humana — Medicare Advantage: $188.06 Molina — Medicare Advantage: $182.68 United Healthcare — HMO: $632.60 United Healthcare — Medicare Advantage: $188.06
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$977.31 – $3,213.19
Colonoscopy with biopsy: 10 of 13 insurance plan rates Aetna — HMO: $2,618.15 Aetna — Medicare Advantage: $1,108.85 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $977.31 Amerivantage — Medicare Advantage: $1,141.47 Health Partners Open Network — Commercial: $1,686.86 Humana — Medicare Advantage: $1,141.47 Iowa Total Care — Managed Medicaid: $977.31 Molina — Medicare Advantage: $1,108.85 United Healthcare — HMO: $3,213.19
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,371	$1,096.80	$226.39 – $825.61
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Aetna — HMO: $691.73 Aetna — Medicare Advantage: $226.39 Aetna — PPO: $825.61 Amerivantage — Medicare Advantage: $237.71 Cigna/Midlands — Commercial: $605.71 Health Partners Open Network — Commercial: $574.03 Humana — Medicare Advantage: $237.71 Molina — Medicare Advantage: $230.92 United Healthcare — HMO: $803.60 United Healthcare — Medicare Advantage: $237.71
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$977.31 – $3,213.19
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates Aetna — HMO: $2,618.15 Aetna — Medicare Advantage: $1,108.85 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $977.31 Amerivantage — Medicare Advantage: $1,141.47 Health Partners Open Network — Commercial: $1,686.86 Humana — Medicare Advantage: $1,141.47 Iowa Total Care — Managed Medicaid: $977.31 Molina — Medicare Advantage: $1,108.85 United Healthcare — HMO: $3,213.19
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$815	$652	$229.83 – $814.61
Ultrasound of the lower bowel by endoscope: 10 of 15 insurance plan rates Aetna — HMO: $664.40 Aetna — Medicare Advantage: $229.83 Aetna — PPO: $792.09 Amerivantage — Medicare Advantage: $241.32 Cigna/Midlands — Commercial: $614.96 Health Partners Open Network — Commercial: $552.59 Humana — Medicare Advantage: $241.32 Molina — Medicare Advantage: $234.43 United Healthcare — HMO: $814.61 United Healthcare — Medicare Advantage: $241.32
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$977.31 – $3,213.19
Ultrasound of the lower bowel by endoscope: 10 of 13 insurance plan rates Aetna — HMO: $2,618.15 Aetna — Medicare Advantage: $1,108.85 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $977.31 Amerivantage — Medicare Advantage: $1,141.47 Health Partners Open Network — Commercial: $1,686.86 Humana — Medicare Advantage: $1,141.47 Iowa Total Care — Managed Medicaid: $977.31 Molina — Medicare Advantage: $1,108.85 United Healthcare — HMO: $3,213.19
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLON CA SCRN NOT HI RSK IND	$1,017	$813.60	$164.82 – $582.93
Screening colonoscopy (not high risk): 10 of 15 insurance plan rates Aetna — HMO: $455.26 Aetna — Medicare Advantage: $164.82 Aetna — PPO: $530.75 Amerivantage — Medicare Advantage: $173.06 Cigna/Midlands — Commercial: $431.86 Health Partners Open Network — Commercial: $383.51 Humana — Medicare Advantage: $173.06 Molina — Medicare Advantage: $168.12 United Healthcare — HMO: $582.93 United Healthcare — Medicare Advantage: $173.06
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$755.69 – $2,484.55
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — HMO: $2,024.45 Aetna — Medicare Advantage: $857.41 Aetna — PPO: $2,106.25 Amerigroup — Managed Medicaid: $755.69 Amerivantage — Medicare Advantage: $882.63 Health Partners Open Network — Commercial: $1,304.34 Humana — Medicare Advantage: $882.63 Iowa Total Care — Managed Medicaid: $755.69 Molina — Medicare Advantage: $857.41 United Healthcare — HMO: $2,484.55
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$82.56 – $216.50
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — Medicare Advantage: $82.56 Amerivantage — Medicare Advantage: $86.69 Cigna/Midlands — Commercial: $216.50 Health Partners Open Network — Commercial: $112.46 Humana — Medicare Advantage: $86.69 Molina — Medicare Advantage: $84.21 United Healthcare — Medicare Advantage: $86.69 Wellmark Blue Cross and Blue Shield — Medicare Advantage: $84.21
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: PR LAP,CHOLECYSTECTOMY	$2,018	$1,614.40	$583.24 – $2,017.34
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Aetna — HMO: $1,496.95 Aetna — Medicare Advantage: $583.24 Aetna — PPO: $1,786.59 Amerivantage — Medicare Advantage: $612.40 Cigna/Midlands — Commercial: $1,552.71 Health Partners Open Network — Commercial: $1,252.26 Humana — Medicare Advantage: $612.40 Molina — Medicare Advantage: $594.90 United Healthcare — HMO: $2,017.34 United Healthcare — Medicare Advantage: $612.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$4,835.96 – $15,899.59
Gallbladder removal by laparoscope: 10 of 13 insurance plan rates Aetna — HMO: $12,955.22 Aetna — Medicare Advantage: $5,486.87 Aetna — PPO: $13,478.66 Amerigroup — Managed Medicaid: $4,835.96 Amerivantage — Medicare Advantage: $5,648.24 Health Partners Open Network — Commercial: $8,346.96 Humana — Medicare Advantage: $5,648.24 Iowa Total Care — Managed Medicaid: $4,835.96 Molina — Medicare Advantage: $5,486.87 United Healthcare — HMO: $15,899.59
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REPAIR ING HERNIA,5+Y/O,REDUCIBL	$1,597	$1,277.60	$463.79 – $1,596.17
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Aetna — HMO: $1,182.52 Aetna — Medicare Advantage: $463.79 Aetna — PPO: $1,411.33 Amerivantage — Medicare Advantage: $486.98 Cigna/Midlands — Commercial: $1,233.87 Health Partners Open Network — Commercial: $962.18 Humana — Medicare Advantage: $486.98 Molina — Medicare Advantage: $473.07 United Healthcare — HMO: $1,596.17 United Healthcare — Medicare Advantage: $486.98
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$2,925.15 – $9,617.26
Groin (inguinal) hernia repair, age 5 or older: 10 of 13 insurance plan rates Aetna — HMO: $7,836.29 Aetna — Medicare Advantage: $3,318.87 Aetna — PPO: $8,152.90 Amerigroup — Managed Medicaid: $2,925.15 Amerivantage — Medicare Advantage: $3,416.48 Health Partners Open Network — Commercial: $5,048.86 Humana — Medicare Advantage: $3,416.48 Iowa Total Care — Managed Medicaid: $2,925.15 Molina — Medicare Advantage: $3,318.87 United Healthcare — HMO: $9,617.26
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REPAIR ING HERNIA,5+Y/O,REDUCIBL (BILAT)	$3,194	$2,555.20	$463.79 – $1,596.17
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Aetna — HMO: $1,182.52 Aetna — Medicare Advantage: $463.79 Aetna — PPO: $1,411.33 Amerivantage — Medicare Advantage: $486.98 Cigna/Midlands — Commercial: $1,233.87 Health Partners Open Network — Commercial: $962.18 Humana — Medicare Advantage: $486.98 Molina — Medicare Advantage: $473.07 United Healthcare — HMO: $1,596.17 United Healthcare — Medicare Advantage: $486.98
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BX PROSTATE NDLE PUNCH	$3,459.67	$2,767.74	$1,629.50 – $5,582.51
Prostate biopsy: 10 of 16 insurance plan rates Aetna — HMO: $4,548.71 Aetna — Medicare Advantage: $1,926.50 Aetna — PPO: $4,732.50 Amerigroup — Managed Medicaid: $1,697.96 Amerivantage — Medicare Advantage: $1,983.16 Cigna/Midlands — Commercial: $2,238.41 Health Partners Open Network — Commercial: $2,930.70 Humana — Medicare Advantage: $1,983.16 Iowa Total Care — Managed Medicaid: $1,697.96 Medica Exchange Inspire — Commercial: $1,629.50
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: PR BIOPSY OF PROSTATE,NEEDLE/PUNCH	$767	$613.60	$116.75 – $413.13
Prostate biopsy: 10 of 15 insurance plan rates Aetna — HMO: $315.80 Aetna — Medicare Advantage: $116.75 Aetna — PPO: $376.62 Amerivantage — Medicare Advantage: $122.59 Cigna/Midlands — Commercial: $312.41 Health Partners Open Network — Commercial: $261.61 Humana — Medicare Advantage: $122.59 Molina — Medicare Advantage: $119.09 United Healthcare — HMO: $413.13 United Healthcare — Medicare Advantage: $122.59
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BX PROSTATE NDLE PUNCH	$3,459.67	$2,767.74	$2,238.41
Prostate biopsy: rates for 1 insurance plan Cigna/Midlands — Commercial: $2,238.41
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: PR LAP,PROSTATECTOMY,RADICAL,W/NERVE SPARE	$4,560	$3,648	$1,078.87 – $4,678.90
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates Aetna — HMO: $3,922.19 Aetna — Medicare Advantage: $1,078.87 Aetna — PPO: $4,678.90 Amerivantage — Medicare Advantage: $1,132.81 Cigna/Midlands — Commercial: $2,875.94 Health Partners Open Network — Commercial: $3,287.65 Humana — Medicare Advantage: $1,132.81 Molina — Medicare Advantage: $1,100.45 United Healthcare — HMO: $4,559.83 United Healthcare — Medicare Advantage: $1,132.81
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$8,629.61 – $28,372.27
Prostate removal by laparoscope (radical prostatectomy): 10 of 13 insurance plan rates Aetna — HMO: $23,118.14 Aetna — Medicare Advantage: $9,791.13 Aetna — PPO: $24,052.21 Amerigroup — Managed Medicaid: $8,629.61 Amerivantage — Medicare Advantage: $10,079.10 Health Partners Open Network — Commercial: $14,894.86 Humana — Medicare Advantage: $10,079.10 Iowa Total Care — Managed Medicaid: $8,629.61 Molina — Medicare Advantage: $9,791.13 United Healthcare — HMO: $28,372.27
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: PR HYSTEROSCOPY,W/ENDO BX	$784	$627.20	$206.22 – $727.43
Hysteroscopy with biopsy of the uterus lining: 10 of 15 insurance plan rates Aetna — HMO: $598.79 Aetna — Medicare Advantage: $206.22 Aetna — PPO: $714.35 Amerivantage — Medicare Advantage: $216.53 Cigna/Midlands — Commercial: $551.60 Health Partners Open Network — Commercial: $498.47 Humana — Medicare Advantage: $216.53 Molina — Medicare Advantage: $210.34 United Healthcare — HMO: $727.43 United Healthcare — Medicare Advantage: $216.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$2,635.43 – $8,664.72
Hysteroscopy with biopsy of the uterus lining: 10 of 13 insurance plan rates Aetna — HMO: $7,060.15 Aetna — Medicare Advantage: $2,990.16 Aetna — PPO: $7,345.40 Amerigroup — Managed Medicaid: $2,635.43 Amerivantage — Medicare Advantage: $3,078.10 Health Partners Open Network — Commercial: $4,548.80 Humana — Medicare Advantage: $3,078.10 Iowa Total Care — Managed Medicaid: $2,635.43 Molina — Medicare Advantage: $2,990.16 United Healthcare — HMO: $8,664.72
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ INTERLAM L/S W IMG	$2,101.54	$1,681.24	$574.01 – $1,887.24
Spinal injection, lower back (epidural), with imaging guidance: 10 of 16 insurance plan rates Aetna — HMO: $1,537.75 Aetna — Medicare Advantage: $651.27 Aetna — PPO: $1,599.88 Amerigroup — Managed Medicaid: $574.01 Amerivantage — Medicare Advantage: $670.43 Cigna/Midlands — Commercial: $1,359.70 Health Partners Open Network — Commercial: $990.76 Humana — Medicare Advantage: $670.43 Iowa Total Care — Managed Medicaid: $574.01 Medica Exchange Inspire — Commercial: $989.83
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$787	$629.60	$90.27 – $314.20
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $90.27 Amerivantage — Medicare Advantage: $94.78 Cigna/Midlands — Commercial: $240.96 Health Partners Open Network — Commercial: $179.07 Humana — Medicare Advantage: $94.78 Molina — Medicare Advantage: $92.08 United Healthcare — HMO: $314.20 United Healthcare — Medicare Advantage: $94.78 United Healthcare — PPO: $314.20 Wellmark Blue Cross and Blue Shield — HMO: $190.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJ INTERLAM L/S W IMG	$2,101.54	$1,681.24	$1,359.70
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan Cigna/Midlands — Commercial: $1,359.70
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ(S) FORAMEN EPID L/S SGL LEV BILAT	$3,873.94	$3,099.16	$737.94 – $2,506.44
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates Aetna — HMO: $1,976.89 Aetna — Medicare Advantage: $837.26 Aetna — PPO: $2,056.77 Amerigroup — Managed Medicaid: $737.94 Amerivantage — Medicare Advantage: $861.89 Cigna/Midlands — Commercial: $2,506.44 Health Partners Open Network — Commercial: $1,273.70 Humana — Medicare Advantage: $861.89 Iowa Total Care — Managed Medicaid: $737.94 Medica Exchange Inspire — Commercial: $1,824.63
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV (REGENEXX)	$264.12	$211.30	$124.40 – $2,426.18
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates Aetna — HMO: $1,976.89 Aetna — Medicare Advantage: $837.26 Aetna — PPO: $2,056.77 Amerigroup — Managed Medicaid: $737.94 Amerivantage — Medicare Advantage: $861.89 Cigna/Midlands — Commercial: $170.89 Health Partners Open Network — Commercial: $1,273.70 Humana — Medicare Advantage: $861.89 Iowa Total Care — Managed Medicaid: $737.94 Medica Exchange Inspire — Commercial: $124.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$1,936.97	$1,549.58	$737.94 – $2,426.18
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates Aetna — HMO: $1,976.89 Aetna — Medicare Advantage: $837.26 Aetna — PPO: $2,056.77 Amerigroup — Managed Medicaid: $737.94 Amerivantage — Medicare Advantage: $861.89 Cigna/Midlands — Commercial: $1,253.22 Health Partners Open Network — Commercial: $1,273.70 Humana — Medicare Advantage: $861.89 Iowa Total Care — Managed Medicaid: $737.94 Medica Exchange Inspire — Commercial: $912.31
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG	$1,337	$1,069.60	$397.78 – $1,317.94
Carpal tunnel release: 10 of 15 insurance plan rates Aetna — HMO: $965.18 Aetna — Medicare Advantage: $397.78 Aetna — PPO: $1,151.29 Amerivantage — Medicare Advantage: $417.67 Cigna/Midlands — Commercial: $1,056.77 Health Partners Open Network — Commercial: $792.94 Humana — Medicare Advantage: $417.67 Molina — Medicare Advantage: $405.74 United Healthcare — HMO: $1,317.94 United Healthcare — Medicare Advantage: $417.67
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,618.61 – $5,321.63
Carpal tunnel release: 10 of 13 insurance plan rates Aetna — HMO: $4,336.14 Aetna — Medicare Advantage: $1,836.46 Aetna — PPO: $4,511.34 Amerigroup — Managed Medicaid: $1,618.61 Amerivantage — Medicare Advantage: $1,890.48 Health Partners Open Network — Commercial: $2,793.74 Humana — Medicare Advantage: $1,890.48 Iowa Total Care — Managed Medicaid: $1,618.61 Molina — Medicare Advantage: $1,836.46 United Healthcare — HMO: $5,321.63
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG (BILAT)	$2,674	$2,139.20	$397.78 – $1,317.94
Carpal tunnel release: 10 of 15 insurance plan rates Aetna — HMO: $965.18 Aetna — Medicare Advantage: $397.78 Aetna — PPO: $1,151.29 Amerivantage — Medicare Advantage: $417.67 Cigna/Midlands — Commercial: $1,056.77 Health Partners Open Network — Commercial: $792.94 Humana — Medicare Advantage: $417.67 Molina — Medicare Advantage: $405.74 United Healthcare — HMO: $1,317.94 United Healthcare — Medicare Advantage: $417.67
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: PR DISCISSION,2ND CATARACT,LASER	$1,025	$820	$278.82 – $961.39
Laser treatment of clouding after cataract surgery: 10 of 15 insurance plan rates Aetna — HMO: $693.11 Aetna — Medicare Advantage: $278.82 Aetna — PPO: $826.95 Amerivantage — Medicare Advantage: $292.76 Cigna/Midlands — Commercial: $751.91 Health Partners Open Network — Commercial: $565.32 Humana — Medicare Advantage: $292.76 Molina — Medicare Advantage: $284.40 United Healthcare — HMO: $961.39 United Healthcare — Medicare Advantage: $292.76
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$454.72 – $1,495.03
Laser treatment of clouding after cataract surgery: 10 of 13 insurance plan rates Aetna — HMO: $1,218.18 Aetna — Medicare Advantage: $515.93 Aetna — PPO: $1,267.39 Amerigroup — Managed Medicaid: $454.72 Amerivantage — Medicare Advantage: $531.10 Health Partners Open Network — Commercial: $784.86 Humana — Medicare Advantage: $531.10 Iowa Total Care — Managed Medicaid: $454.72 Molina — Medicare Advantage: $515.93 United Healthcare — HMO: $1,495.03
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR DISCISSION,2ND CATARACT,LASER (BILAT)	$2,050	$1,640	$278.82 – $961.39
Laser treatment of clouding after cataract surgery: 10 of 15 insurance plan rates Aetna — HMO: $693.11 Aetna — Medicare Advantage: $278.82 Aetna — PPO: $826.95 Amerivantage — Medicare Advantage: $292.76 Cigna/Midlands — Commercial: $751.91 Health Partners Open Network — Commercial: $565.32 Humana — Medicare Advantage: $292.76 Molina — Medicare Advantage: $284.40 United Healthcare — HMO: $961.39 United Healthcare — Medicare Advantage: $292.76
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$1,697	$1,357.60	$488.93 – $1,702.14
Cataract removal with lens implant: 10 of 15 insurance plan rates Aetna — HMO: $1,425.87 Aetna — Medicare Advantage: $488.93 Aetna — PPO: $1,702.14 Amerivantage — Medicare Advantage: $513.38 Cigna/Midlands — Commercial: $1,312.39 Health Partners Open Network — Commercial: $1,221.90 Humana — Medicare Advantage: $513.38 Molina — Medicare Advantage: $498.71 United Healthcare — HMO: $1,696.53 United Healthcare — Medicare Advantage: $513.38
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$1,890.44 – $6,215.36
Cataract removal with lens implant: 10 of 13 insurance plan rates Aetna — HMO: $5,064.36 Aetna — Medicare Advantage: $2,144.89 Aetna — PPO: $5,268.99 Amerigroup — Managed Medicaid: $1,890.44 Amerivantage — Medicare Advantage: $2,207.97 Health Partners Open Network — Commercial: $3,262.93 Humana — Medicare Advantage: $2,207.97 Iowa Total Care — Managed Medicaid: $1,890.44 Molina — Medicare Advantage: $2,144.89 United Healthcare — HMO: $6,215.36
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP (BILAT)	$3,394	$2,715.20	$488.93 – $1,702.14
Cataract removal with lens implant: 10 of 15 insurance plan rates Aetna — HMO: $1,425.87 Aetna — Medicare Advantage: $488.93 Aetna — PPO: $1,702.14 Amerivantage — Medicare Advantage: $513.38 Cigna/Midlands — Commercial: $1,312.39 Health Partners Open Network — Commercial: $1,221.90 Humana — Medicare Advantage: $513.38 Molina — Medicare Advantage: $498.71 United Healthcare — HMO: $1,696.53 United Healthcare — Medicare Advantage: $513.38

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FULL ROUT OBSTE CARE,VAGINAL DELIV	$5,690	$4,552	$2,106.28 – $5,372.16
Vaginal delivery, with care before and after: 10 of 15 insurance plan rates Aetna — HMO: $3,894.85 Aetna — Medicare Advantage: $2,106.28 Aetna — PPO: $4,144.15 Amerivantage — Medicare Advantage: $2,211.59 Cigna/Midlands — Commercial: $5,338.68 Health Partners Open Network — Commercial: $3,299.55 Humana — Medicare Advantage: $2,211.59 Molina — Medicare Advantage: $2,148.41 United Healthcare — HMO: $5,372.16 United Healthcare — Medicare Advantage: $2,211.59
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FULL ROUT OBSTE CARE,CESAREAN DELIV	$5,924	$4,739.20	$2,322.97 – $5,923.56
Cesarean delivery (C-section), with care before and after: 10 of 15 insurance plan rates Aetna — HMO: $4,303.60 Aetna — Medicare Advantage: $2,322.97 Aetna — PPO: $4,577.08 Amerivantage — Medicare Advantage: $2,439.12 Cigna/Midlands — Commercial: $5,892.65 Health Partners Open Network — Commercial: $3,666.23 Humana — Medicare Advantage: $2,439.12 Molina — Medicare Advantage: $2,369.43 United Healthcare — HMO: $5,923.56 United Healthcare — Medicare Advantage: $2,439.12
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ROUT OB CARE,VAG DELIV,PREV C-SEC	$5,615	$4,492	$2,188.50 – $5,614.60
Vaginal delivery after a previous C-section, with care before and after: 10 of 15 insurance plan rates Aetna — HMO: $4,080.74 Aetna — Medicare Advantage: $2,188.50 Aetna — PPO: $4,341.19 Amerivantage — Medicare Advantage: $2,297.93 Cigna/Midlands — Commercial: $5,551.23 Health Partners Open Network — Commercial: $3,460.25 Humana — Medicare Advantage: $2,297.93 Molina — Medicare Advantage: $2,232.27 United Healthcare — HMO: $5,614.60 United Healthcare — Medicare Advantage: $2,297.93

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$67,150.62 – $128,376.18
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 15 insurance plan rates Aetna — HMO: $97,929.71 Aetna — Medicare Advantage: $67,150.62 Aetna — PPO: $97,929.71 Amerigroup — Managed Medicaid: $68,808 Amerivantage — Medicare Advantage: $69,125.64 Health Partners Open Network — Commercial: $107,706.28 Humana — Medicare Advantage: $69,125.64 Iowa Total Care — Managed Medicaid: $68,808 Medica Exchange Inspire — Commercial: $115,209.40 Medica Exchange Insure — Commercial: $128,376.18
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$13,442.77 – $26,331.88
Hip or knee replacement (major joint of the leg), without major complications: 10 of 15 insurance plan rates Aetna — HMO: $19,132.17 Aetna — Medicare Advantage: $13,773.60 Aetna — PPO: $19,132.17 Amerigroup — Managed Medicaid: $13,442.77 Amerivantage — Medicare Advantage: $14,178.71 Health Partners Open Network — Commercial: $21,042.18 Humana — Medicare Advantage: $14,178.71 Iowa Total Care — Managed Medicaid: $13,442.77 Medica Exchange Inspire — Commercial: $23,631.18 Medica Exchange Insure — Commercial: $26,331.88
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$16,878.50 – $32,664.31
Neck (cervical) spinal fusion, without complications: 10 of 15 insurance plan rates Aetna — HMO: $24,022.01 Aetna — Medicare Advantage: $17,085.95 Aetna — PPO: $24,022.01 Amerigroup — Managed Medicaid: $16,878.50 Amerivantage — Medicare Advantage: $17,588.48 Health Partners Open Network — Commercial: $26,420.18 Humana — Medicare Advantage: $17,588.48 Iowa Total Care — Managed Medicaid: $16,878.50 Medica Exchange Inspire — Commercial: $29,314.13 Medica Exchange Insure — Commercial: $32,664.31
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$8,546.19 – $17,306.93
Uterus and ovary surgery (not for cancer), without complications: 10 of 15 insurance plan rates Aetna — HMO: $12,163.21 Aetna — Medicare Advantage: $9,052.86 Aetna — PPO: $12,163.21 Amerigroup — Managed Medicaid: $8,546.19 Amerivantage — Medicare Advantage: $9,319.12 Health Partners Open Network — Commercial: $13,377.49 Humana — Medicare Advantage: $9,319.12 Iowa Total Care — Managed Medicaid: $8,546.19 Medica Exchange Inspire — Commercial: $15,531.86 Medica Exchange Insure — Commercial: $17,306.93

Source: Allen Hospital’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 28, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	1825 Logan Avenue, Waterloo, IA 50703
County	Black Hawk County
State	Iowa
Phone	(319) 235‑3941
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	160110
Name in Medicare records	ALLEN HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	UnityPoint Health - Allen Hospital
Official website	unitypoint.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

UnityPoint Health - Allen Hospital — unitypoint.org
UnityPoint Health - Allen Hospital locations — unitypoint.org
UnityPoint Health - Allen Hospital — unitypoint.org
Directions, Parking and Maps - UnityPoint Health - Allen Hospital — unitypoint.org
UnityPoint Health - Allen Hospital Emergency Department — unitypoint.org
Trauma Services — unitypoint.org
Patients and Visitors - UnityPoint Health - Allen Hospital — unitypoint.org

Allen Hospital

Summary

Profile from official sources

At a glance