Does Allina Health Faribault Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Allina Health Faribault Medical Center. In a medical emergency, call 911.

Where is Allina Health Faribault Medical Center?

200 State Avenue, Faribault, MN 55021, in Rice County, Minnesota.

What is the phone number of Allina Health Faribault Medical Center?

(507) 334-6451, as listed by Medicare (CMS).

What is the Medicare star rating of Allina Health Faribault Medical Center?

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

Allina Health Faribault Medical Center

Quick answers

Does Allina Health Faribault Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Allina Health Faribault Medical Center. In a medical emergency, call 911.
Where is Allina Health Faribault Medical Center?: 200 State Avenue, Faribault, MN 55021, in Rice County, Minnesota.
What is the phone number of Allina Health Faribault Medical Center?: (507) 334-6451, as listed by Medicare (CMS).
What is the Medicare star rating of Allina Health Faribault Medical Center?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][6][8][9][11]}

Conditions treated^[4][6]

Cancer
Severe chest pain
Breathing problems
Heavy bleeding
Stroke
Seizure
Broken bones
Head or brain injury
Poisoning
Major burns
Allergic reactions
Carbon monoxide exposure

Treatments^{[6][9][11][12]}

Chemotherapy
PET/CT
Palliative care
Cardiac rehabilitation
Pulmonary rehabilitation
Diagnostic imaging
Mammography
Laboratory services
Respiratory care
Nutrition services
Total hip replacement
Total knee replacement
Arthroscopic knee surgery
Arthroscopic shoulder surgery
Fracture care
Hand therapy
Physical therapy
Occupational therapy
Speech-language pathology
Vestibular rehabilitation
Neurologic rehabilitation
Cancer rehabilitation
Sports and orthopedic rehabilitation
Work conditioning
Functional capacity evaluations

Procedures^[6][9]

Inpatient and day surgery
Surgical care

Programs and centers^{[4][6][10][12]}

Allina Health Cancer Institute
Emergency department mental health assessment and referral
TeleStroke (virtual stroke care with United Hospital neurologists)
Lifeline medical alert system
Youth healthy weight loss program

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV
Stroke designation	Stroke ready hospital (designated by the state of Minnesota)

Visiting and practical information

Visiting	A family member may be able to spend the night with the patient; ask the nursing team^[7]
Parking	Visitor parking is near the east hospital entrance on State Avenue; east entrance open 6:30 a.m. to 8:30 p.m. daily^[7]

Doctors and clinicians (289)

289 doctors and other clinicians list Allina Health Faribault Medical Center 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

Doctors with a page on this site (289)

Abby K. Kershaw, PAPhysician Assistant
Adam C. Wolfe, MDCritical Care (Intensivists)
Adam P. RobinsonPhysician Assistant
Adei Shaqra, DOFamily Practice
Adina J. Connelly, MDEmergency Medicine
Akuffo Quarde, MDEndocrinology
Alexander R. Tokarski, DPMPodiatry
Alexander S. Benson, MDEmergency Medicine
Ali K. Shami, MDInternal Medicine
Allison Beilke, CNACertified Registered Nurse Anesthetist (CRNA)
Allyson Connor, MDNeurology
Amy J. Elliott, MDFamily Practice
Amy L. Selly, NPNurse Practitioner
Andrew B. StonePathology
Andrew J. Stiehm, MDPulmonary Disease
Andrew M. Pattock, MDCardiovascular Disease (Cardiology)
Andria E. Furlong, NPNurse Practitioner
Angela L. Timm, DOInternal Medicine
Anil K. Poulose, MDInterventional Cardiology
Anna N. Prenevost, PAPhysician Assistant
Aqeel Ahmad, MDNephrology
Austin C. Cudak, DOInternal Medicine
Barry M. Cabuay, MDAdvanced Heart Failure and Transplant Cardiology
Basir Tareen, MDUrology

And 265 more: the button below opens the full list.

Other emergency rooms nearby

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

Northfield Hospital13 mi · Northfield, MN · Acute Care Hospital
Owatonna Hospital16 mi · Owatonna, MN · Acute Care Hospital
Mayo Clinic Health System - Waseca19 mi · Waseca, MN · Critical Access Hospital
Mayo Clinic Health System - Cannon Falls21 mi · Cannon Falls, MN · Critical Access Hospital
Mayo Clinic Health System New Prague24 mi · New Prague, MN · Critical Access Hospital

Other hospitals nearby

M Health Fairview Ridges Hospital32 mi · Burnsville, MN · Acute Care 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

The Emeralds at Fairbault LLC0.3 mi · Faribault, MN · 1 of 5 stars
Benedictine Living Community Owatonna12 mi · Owatonna, MN · 1 of 5 stars
Three Links Care Center12 mi · Northfield, MN · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Minnesota Hospice LLC25 mi · Lakeville, MN · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Rice County PHNS1.1 mi · Faribault, MN
Steele County PHNS16 mi · Owatonna, MN
JB Kummer Enterprises LLC24 mi · Farmington, MN · 2 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Faribault Dialysis Unit1.1 mi · Faribault, MN · 4 of 5 stars
FMC - Cannon Valley8.6 mi · Dundas, MN · 3 of 5 stars
DaVita Northfield at Home13 mi · Northfield, MN · 1 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.

Crossroads Surgery Center1.1 mi · Faribault, MN
Olmsted Medical Center16 mi · Owatonna, MN
Allina Health Surgery Center- Lakeville, LLC25 mi · Lakeville, MN

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.

Clinics and urgent care

Allina Health System1.1 mi · Faribault, MN · Urgent care center
Presence Telehealth PLLC1.1 mi · Faribault, MN · Urgent care center
Northfield Hospital13 mi · Northfield, MN · Urgent care center

Pharmacies

Allina Health System1.1 mi · Faribault, MN · Community/retail pharmacy
Boyes Pharmacy1.1 mi · Faribault, MN · Community/retail pharmacy
Hy-Vee Inc1.1 mi · Faribault, MN · Community/retail pharmacy

Assisted living nearby

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

A Pleasant Senior Living LLC1.1 mi · Faribault, MN
Caring Connections LLC1.1 mi · Faribault, MN
Hallowstone at Faribault1.1 mi · Faribault, MN
Ivy Hill Senior Care Inc1.1 mi · Faribault, MN

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 Allina Health Faribault Medical Center 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	5 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	72%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	85%National average: 80%
Staff “always” explained medicines before giving them	69%National average: 62%
Were given information about recovery at home	91%National average: 86%
Room and bathroom “always” clean	65%National average: 74%
Area around the room “always” quiet at night	67%National average: 60%
Completed surveys	294Response rate: 25%

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)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0No different from 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	Too few cases to report
Deaths within 30 days: heart failure patients	12.8%
Deaths within 30 days: pneumonia patients	13.8%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	11.8%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.98No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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	Too few cases to report
Readmitted within 30 days: heart failure	21.4%
Readmitted within 30 days: pneumonia	17.3%
Readmitted within 30 days: COPD	19.6%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	128 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	50%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 Minnesota Best hospitals in Minnesota

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 52 common services exactly as Allina Health Faribault Medical Center 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 →

$ 6 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG UC-EST PT FAC VISIT LEVEL III	$199.40	$111.66	$40.12 – $408.76
Established patient office visit (about 20–29 minutes): 10 of 26 insurance plan rates Aetna — Aetna Elevate (BDOSV): $88.81 Aetna — Aetna Performance (BDOSV): $93.82 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $118.52 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.40 All Other Medicaid (V) — All Other Medicaid (V): $69 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.82 Blue Cross — Allina Health BluePrint (BDOSHV): $271.88 Blue Cross Blue Shield — BC AEHP (B D O S V): $361.75 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $408.76
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG E/M EST PT LEVEL III	$143.50	$80.36	$28.87 – $408.76
Established patient office visit (about 20–29 minutes): 10 of 26 insurance plan rates Aetna — Aetna Elevate (BDOSV): $63.91 Aetna — Aetna Performance (BDOSV): $67.52 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $85.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $143.50 All Other Medicaid (V) — All Other Medicaid (V): $69 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $120.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $110.70 Blue Cross — Allina Health BluePrint (BDOSHV): $271.88 Blue Cross Blue Shield — BC AEHP (B D O S V): $361.75 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $408.76
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG EST PT FAC VISIT LEVEL III	$143	$80.08	$28.77 – $408.76
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (BDOSV): $63.69 Aetna — Aetna Performance (BDOSV): $67.28 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $85 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $143 All Other Medicaid (V) — All Other Medicaid (V): $69 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $120.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $110.31 Blue Cross — Allina Health BluePrint (BDOSHV): $271.88 Blue Cross Blue Shield — BC AEHP (B D O S V): $361.75 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $408.76
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG UC-EST PT FAC VISIT LEVEL IV	$238.30	$133.45	$47.95 – $630.16
Established patient office visit (about 30–39 minutes): 10 of 26 insurance plan rates Aetna — Aetna Elevate (BDOSV): $106.14 Aetna — Aetna Performance (BDOSV): $112.12 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $141.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $238.30 All Other Medicaid (V) — All Other Medicaid (V): $98.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $200.17 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $183.82 Blue Cross — Allina Health BluePrint (BDOSHV): $419.15 Blue Cross Blue Shield — BC AEHP (B D O S V): $557.69 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $630.16
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG E/M EST PT LEVEL IV	$171.50	$96.04	$34.51 – $630.16
Established patient office visit (about 30–39 minutes): 10 of 26 insurance plan rates Aetna — Aetna Elevate (BDOSV): $76.39 Aetna — Aetna Performance (BDOSV): $80.69 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $101.94 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $171.50 All Other Medicaid (V) — All Other Medicaid (V): $98.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $144.06 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $132.30 Blue Cross — Allina Health BluePrint (BDOSHV): $419.15 Blue Cross Blue Shield — BC AEHP (B D O S V): $557.69 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $630.16
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG EST PT FAC VISIT LEVEL IV	$170.50	$95.48	$34.30 – $630.16
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (BDOSV): $75.94 Aetna — Aetna Performance (BDOSV): $80.22 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $101.35 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $170.50 All Other Medicaid (V) — All Other Medicaid (V): $98.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $143.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $131.52 Blue Cross — Allina Health BluePrint (BDOSHV): $419.15 Blue Cross Blue Shield — BC AEHP (B D O S V): $557.69 Blue Cross Blue Shield — BC AWARE/Blue Plus (B D O S V): $630.16
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 3 HCHG	$801.80	$449.01	$161.32 – $1,459
Emergency room visit (moderate): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $357.12 Aetna — Aetna Performance (BDOSV): $377.25 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $476.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $801.80 All Other Medicaid (V) — All Other Medicaid (V): $260.08 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $267.26 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $673.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $618.51 BCBS — BC Medicare (V): $293.36 Blue Cross — Allina Health BluePrint (BDOSHV): $833.27
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 3 HCHG	$801.80	$449.01	$356.24 – $801.80
Emergency room visit (moderate): rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $356.24 Aetna — Aetna Performance (BDOSV): $376.28 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $475.31 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $801.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $673.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $618.51 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $673.51
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 4 HCHG	$1,315.80	$736.85	$264.74 – $3,686
Emergency room visit (moderately high): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $586.06 Aetna — Aetna Performance (BDOSV): $619.08 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $782.11 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,315.80 All Other Medicaid (V) — All Other Medicaid (V): $397.55 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $408.53 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,105.27 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,015.01 BCBS — BC Medicare (V): $448.41 Blue Cross — Allina Health BluePrint (BDOSHV): $833.27
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 4 HCHG	$1,315.80	$736.85	$584.61 – $1,315.80
Emergency room visit (moderately high): rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $584.61 Aetna — Aetna Performance (BDOSV): $617.50 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $780.01 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,315.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,105.27 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,015.01 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,105.27
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 5 HCHG	$1,818.50	$1,018.36	$304.92 – $3,893
Emergency room visit (high): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $809.96 Aetna — Aetna Performance (BDOSV): $855.60 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,080.92 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,818.50 All Other Medicaid (V) — All Other Medicaid (V): $567.39 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $583.06 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,527.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,402.79 BCBS — BC Medicare (V): $639.99 Blue Cross — Allina Health BluePrint (BDOSHV): $833.27
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 5 HCHG	$1,818.50	$1,018.36	$807.96 – $1,818.50
Emergency room visit (high): rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $807.96 Aetna — Aetna Performance (BDOSV): $853.42 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,078.01 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,818.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,527.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,402.79 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,527.54

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: HCHG BASIC METABOLIC PANEL	$199.30	$111.61	$7.88 – $199.30
Basic metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $88.77 Aetna — Aetna Performance (BDOSV): $93.77 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $118.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.30 All Other Medicaid (V) — All Other Medicaid (V): $8.45 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.41 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.74 BCBS — BC Medicare (V): $8.70 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BASIC METABOLIC PANEL QUEST	$30	$16.80	$6.04 – $62.26
Basic metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $13.36 Aetna — Aetna Performance (BDOSV): $14.11 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $17.83 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $30 All Other Medicaid (V) — All Other Medicaid (V): $8.45 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $25.20 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $23.14 BCBS — BC Medicare (V): $8.70 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BASIC METABOLIC RTR	$199.30	$111.61	$7.88 – $199.30
Basic metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $88.77 Aetna — Aetna Performance (BDOSV): $93.77 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $118.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.30 All Other Medicaid (V) — All Other Medicaid (V): $8.45 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.41 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.74 BCBS — BC Medicare (V): $8.70 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPREHENSIVE METABOLIC PANE	$362.80	$203.17	$9.83 – $362.80
Comprehensive metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $161.59 Aetna — Aetna Performance (BDOSV): $170.70 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $215.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $362.80 All Other Medicaid (V) — All Other Medicaid (V): $10.55 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $304.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $279.86 BCBS — BC Medicare (V): $10.87 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPREHENSIVE METABOLIC PANEL QUEST	$31.20	$17.47	$6.28 – $62.26
Comprehensive metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $13.90 Aetna — Aetna Performance (BDOSV): $14.68 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $18.55 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.20 All Other Medicaid (V) — All Other Medicaid (V): $10.55 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.07 BCBS — BC Medicare (V): $10.87 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMP METABOLIC RTR	$362.80	$203.17	$9.83 – $362.80
Comprehensive metabolic panel (blood test): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $161.59 Aetna — Aetna Performance (BDOSV): $170.70 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $215.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $362.80 All Other Medicaid (V) — All Other Medicaid (V): $10.55 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $304.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $279.86 BCBS — BC Medicare (V): $10.87 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OBSTETRIC PANEL	$501.50	$280.84	$16.16 – $501.50
Obstetric blood test panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $223.37 Aetna — Aetna Performance (BDOSV): $235.96 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $298.09 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $501.50 All Other Medicaid (V) — All Other Medicaid (V): $47.77 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $44.51 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $421.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $386.86 BCBS — BC Medicare (V): $49.19 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG OBSTETRIC PANEL	$501.50	$280.84	$222.82 – $501.50
Obstetric blood test panel: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $222.82 Aetna — Aetna Performance (BDOSV): $235.35 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $297.29 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $501.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $421.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $386.86 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $421.26
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL	$55.20	$30.91	$11.11 – $62.26
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $24.59 Aetna — Aetna Performance (BDOSV): $25.97 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $32.81 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $55.20 All Other Medicaid (V) — All Other Medicaid (V): $13.38 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $46.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $42.58 BCBS — BC Medicare (V): $13.78 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL LCC	$27.50	$15.40	$5.53 – $62.26
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $12.25 Aetna — Aetna Performance (BDOSV): $12.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $16.35 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $27.50 All Other Medicaid (V) — All Other Medicaid (V): $13.38 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $23.10 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $21.21 BCBS — BC Medicare (V): $13.78 Blue Cross — Allina Health BluePrint (BDOSHV): $41.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL QUEST	$34.20	$19.15	$6.88 – $62.26
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $15.23 Aetna — Aetna Performance (BDOSV): $16.09 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $20.33 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $34.20 All Other Medicaid (V) — All Other Medicaid (V): $13.38 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $28.73 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $26.38 BCBS — BC Medicare (V): $13.78 Blue Cross — Allina Health BluePrint (BDOSHV): $41.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL	$231.20	$129.47	$8.08 – $231.20
Kidney function panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $102.98 Aetna — Aetna Performance (BDOSV): $108.78 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $137.43 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $231.20 All Other Medicaid (V) — All Other Medicaid (V): $8.67 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $194.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $178.35 BCBS — BC Medicare (V): $8.94 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL QUEST	$43.20	$24.19	$8.08 – $62.26
Kidney function panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $19.24 Aetna — Aetna Performance (BDOSV): $20.33 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $25.68 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $43.20 All Other Medicaid (V) — All Other Medicaid (V): $8.67 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $36.29 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $33.32 BCBS — BC Medicare (V): $8.94 Blue Cross — Allina Health BluePrint (BDOSHV): $41.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL RTR	$196.10	$109.82	$8.08 – $196.10
Kidney function panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $87.34 Aetna — Aetna Performance (BDOSV): $92.27 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $116.56 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $196.10 All Other Medicaid (V) — All Other Medicaid (V): $8.67 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $164.72 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $151.27 BCBS — BC Medicare (V): $8.94 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL	$190.90	$106.90	$7.61 – $190.90
Liver function panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $85.03 Aetna — Aetna Performance (BDOSV): $89.82 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $113.47 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $190.90 All Other Medicaid (V) — All Other Medicaid (V): $8.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.61 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $160.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $147.26 BCBS — BC Medicare (V): $8.41 Blue Cross — Allina Health BluePrint (BDOSHV): $41.41
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL QUEST	$29.70	$16.63	$5.98 – $62.26
Liver function panel: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $13.23 Aetna — Aetna Performance (BDOSV): $13.97 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $17.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $29.70 All Other Medicaid (V) — All Other Medicaid (V): $8.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.61 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $24.95 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $22.91 BCBS — BC Medicare (V): $8.41 Blue Cross — Allina Health BluePrint (BDOSHV): $41.40
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL	$190.90	$106.90	$84.82 – $190.90
Liver function panel: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $84.82 Aetna — Aetna Performance (BDOSV): $89.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $113.17 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $190.90 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $160.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $147.26 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $160.36
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS COMPLETE	$130.20	$72.91	$2.95 – $130.20
Urine test (automated, with microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $57.99 Aetna — Aetna Performance (BDOSV): $61.26 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $77.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $130.20 All Other Medicaid (V) — All Other Medicaid (V): $3.17 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $109.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $100.44 BCBS — BC Medicare (V): $3.27 Blue Cross — Allina Health BluePrint (BDOSHV): $6.10
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS COMPLETE QUEST	$38.10	$21.34	$2.95 – $38.10
Urine test (automated, with microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $16.97 Aetna — Aetna Performance (BDOSV): $17.93 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $22.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $38.10 All Other Medicaid (V) — All Other Medicaid (V): $3.17 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $32 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $29.39 BCBS — BC Medicare (V): $3.27 Blue Cross — Allina Health BluePrint (BDOSHV): $6.10
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG UA COMPLETE RTR	$130.20	$72.91	$2.95 – $130.20
Urine test (automated, with microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $57.99 Aetna — Aetna Performance (BDOSV): $61.26 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $77.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $130.20 All Other Medicaid (V) — All Other Medicaid (V): $3.17 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $109.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $100.44 BCBS — BC Medicare (V): $3.27 Blue Cross — Allina Health BluePrint (BDOSHV): $6.10
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SPECIFIC GRAVITY URINE	$67.10	$37.58	$2.09 – $67.10
Urine test (automated, without microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $29.89 Aetna — Aetna Performance (BDOSV): $31.57 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $39.88 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $67.10 All Other Medicaid (V) — All Other Medicaid (V): $2.25 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $56.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $51.76 BCBS — BC Medicare (V): $2.31 Blue Cross — Allina Health BluePrint (BDOSHV): $4.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS	$69.30	$38.81	$2.09 – $69.30
Urine test (automated, without microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $30.87 Aetna — Aetna Performance (BDOSV): $32.61 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $41.19 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $69.30 All Other Medicaid (V) — All Other Medicaid (V): $2.25 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $58.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $53.46 BCBS — BC Medicare (V): $2.31 Blue Cross — Allina Health BluePrint (BDOSHV): $4.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTEIN QUAL URINE	$69.30	$38.81	$2.09 – $69.30
Urine test (automated, without microscope): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $30.87 Aetna — Aetna Performance (BDOSV): $32.61 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $41.19 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $69.30 All Other Medicaid (V) — All Other Medicaid (V): $2.25 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $58.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $53.46 BCBS — BC Medicare (V): $2.31 Blue Cross — Allina Health BluePrint (BDOSHV): $4.36
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA-DIAGNOSTIC	$51.80	$29.01	$10.42 – $68.69
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $23.07 Aetna — Aetna Performance (BDOSV): $24.37 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $30.79 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $51.80 All Other Medicaid (V) — All Other Medicaid (V): $18.37 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $43.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $39.96 BCBS — BC Medicare (V): $18.92 Blue Cross — Allina Health BluePrint (BDOSHV): $45.70
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA TOTAL DIAGNOSTIC LCC	$39.30	$22.01	$7.91 – $68.69
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $17.50 Aetna — Aetna Performance (BDOSV): $18.49 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $23.36 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $39.30 All Other Medicaid (V) — All Other Medicaid (V): $18.37 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $33.01 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $30.32 BCBS — BC Medicare (V): $18.92 Blue Cross — Allina Health BluePrint (BDOSHV): $45.70
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSATOTAL LCC	$31.70	$17.75	$6.38 – $68.69
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $14.12 Aetna — Aetna Performance (BDOSV): $14.91 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $18.84 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.70 All Other Medicaid (V) — All Other Medicaid (V): $18.37 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.63 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.45 BCBS — BC Medicare (V): $18.92 Blue Cross — Allina Health BluePrint (BDOSHV): $45.70
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSH	$44.70	$25.03	$8.99 – $67.81
Thyroid stimulating hormone (TSH) test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $19.91 Aetna — Aetna Performance (BDOSV): $21.03 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $26.57 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $44.70 All Other Medicaid (V) — All Other Medicaid (V): $16.78 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $37.55 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $34.48 BCBS — BC Medicare (V): $17.28 Blue Cross — Allina Health BluePrint (BDOSHV): $45.11
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSHBL30 OR 60	$56.60	$31.70	$11.39 – $67.81
Thyroid stimulating hormone (TSH) test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $25.21 Aetna — Aetna Performance (BDOSV): $26.63 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $33.64 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $56.60 All Other Medicaid (V) — All Other Medicaid (V): $16.78 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $47.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $43.66 BCBS — BC Medicare (V): $17.28 Blue Cross — Allina Health BluePrint (BDOSHV): $45.11
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CONGENITAL HYPOTHYROIDISM	$51.60	$28.90	$10.38 – $67.81
Thyroid stimulating hormone (TSH) test: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $22.98 Aetna — Aetna Performance (BDOSV): $24.28 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $30.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $51.60 All Other Medicaid (V) — All Other Medicaid (V): $16.78 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $43.34 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $39.80 BCBS — BC Medicare (V): $17.28 Blue Cross — Allina Health BluePrint (BDOSHV): $45.11
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC W/DIFF	$76.80	$43.01	$6.63 – $76.80
Complete blood count (CBC) with differential: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $34.21 Aetna — Aetna Performance (BDOSV): $36.13 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $45.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid (V) — All Other Medicaid (V): $7.76 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BCBS — BC Medicare (V): $7.99 Blue Cross — Allina Health BluePrint (BDOSHV): $13.61
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC (INCLUDES DIFFERENTIAL AND PLATELETS) QUE	$34.20	$19.15	$6.63 – $34.20
Complete blood count (CBC) with differential: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $15.23 Aetna — Aetna Performance (BDOSV): $16.09 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $20.33 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $34.20 All Other Medicaid (V) — All Other Medicaid (V): $7.76 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $28.73 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $26.38 BCBS — BC Medicare (V): $7.99 Blue Cross — Allina Health BluePrint (BDOSHV): $13.61
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC/DIFF RTR	$226.20	$126.67	$6.63 – $226.20
Complete blood count (CBC) with differential: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $100.75 Aetna — Aetna Performance (BDOSV): $106.43 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $134.45 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $226.20 All Other Medicaid (V) — All Other Medicaid (V): $7.76 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $190.01 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $174.49 BCBS — BC Medicare (V): $7.99 Blue Cross — Allina Health BluePrint (BDOSHV): $13.61
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC	$239.70	$134.23	$6.02 – $239.70
Complete blood count (CBC), automated: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $106.76 Aetna — Aetna Performance (BDOSV): $112.78 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $142.48 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $239.70 All Other Medicaid (V) — All Other Medicaid (V): $6.46 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $201.35 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $184.90 BCBS — BC Medicare (V): $6.66 Blue Cross — Allina Health BluePrint (BDOSHV): $12.45
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC QUEST	$31.80	$17.81	$6.02 – $31.80
Complete blood count (CBC), automated: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $14.16 Aetna — Aetna Performance (BDOSV): $14.96 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $18.90 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.80 All Other Medicaid (V) — All Other Medicaid (V): $6.46 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.71 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.53 BCBS — BC Medicare (V): $6.66 Blue Cross — Allina Health BluePrint (BDOSHV): $12.45
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC RTR	$199.90	$111.94	$6.02 – $199.90
Complete blood count (CBC), automated: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $89.04 Aetna — Aetna Performance (BDOSV): $94.05 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $118.82 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.90 All Other Medicaid (V) — All Other Medicaid (V): $6.46 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.92 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $154.20 BCBS — BC Medicare (V): $6.66 Blue Cross — Allina Health BluePrint (BDOSHV): $12.45
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTHOMBIN TIME	$76.80	$43.01	$3.99 – $76.80
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $34.21 Aetna — Aetna Performance (BDOSV): $36.13 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $45.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid (V) — All Other Medicaid (V): $4.29 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BCBS — BC Medicare (V): $4.41 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INR POCT	$144.40	$80.86	$3.99 – $144.40
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $64.32 Aetna — Aetna Performance (BDOSV): $67.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $85.83 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $144.40 All Other Medicaid (V) — All Other Medicaid (V): $4.29 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $121.30 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $111.39 BCBS — BC Medicare (V): $4.41 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTHROMBIN TIME QUEST	$37.20	$20.83	$3.99 – $52.29
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $16.57 Aetna — Aetna Performance (BDOSV): $17.50 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $22.11 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $37.20 All Other Medicaid (V) — All Other Medicaid (V): $4.29 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $31.25 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $28.70 BCBS — BC Medicare (V): $4.41 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SCT SCREEN AND CONFIRM EACH	$76.80	$43.01	$5.60 – $76.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $34.21 Aetna — Aetna Performance (BDOSV): $36.13 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $45.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid (V) — All Other Medicaid (V): $6 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BCBS — BC Medicare (V): $6.18 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ACTIVATED PTT	$76.80	$43.01	$5.60 – $76.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $34.21 Aetna — Aetna Performance (BDOSV): $36.13 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $45.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid (V) — All Other Medicaid (V): $6 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BCBS — BC Medicare (V): $6.18 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PARTIAL THROMBOPLASTIN TIME ACTIVATED QUEST	$49.20	$27.55	$5.60 – $52.29
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $21.91 Aetna — Aetna Performance (BDOSV): $23.15 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $29.24 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $49.20 All Other Medicaid (V) — All Other Medicaid (V): $6 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $41.33 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $37.95 BCBS — BC Medicare (V): $6.18 Blue Cross — Allina Health BluePrint (BDOSHV): $34.79

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: HCHG CT HEAD WO CONTRAST	$1,629.40	$912.46	$99.61 – $1,629.40
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $725.73 Aetna — Aetna Performance (BDOSV): $766.63 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $968.52 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $236.57
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT HEAD BRAIN WO	$1,629.40	$912.46	$99.61 – $1,629.40
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $725.73 Aetna — Aetna Performance (BDOSV): $766.63 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $968.52 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $236.57
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT HEAD WO CONTRAST	$1,629.40	$912.46	$723.94 – $1,629.40
CT scan of the head or brain, without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $723.94 Aetna — Aetna Performance (BDOSV): $764.68 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $965.91 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,368.70
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI HEAD BRAIN WWO	$4,125.10	$2,310.06	$332.39 – $4,125.10
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,837.32 Aetna — Aetna Performance (BDOSV): $1,940.86 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,451.96 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,125.10 All Other Medicaid (V) — All Other Medicaid (V): $332.39 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $341.56 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,465.08 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,182.10 BCBS — BC Medicare (V): $374.91 Blue Cross — Allina Health BluePrint (BDOSHV): $1,091.97
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI HEAD BRAIN WWO	$4,125.10	$2,310.06	$1,832.78 – $4,125.10
MRI of the brain, before and after contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $1,832.78 Aetna — Aetna Performance (BDOSV): $1,935.91 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,445.36 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,125.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,465.08 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,182.10 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $3,465.08
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LATERAL	$248.80	$139.33	$50.06 – $336
Chest X-ray, 2 views: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $110.82 Aetna — Aetna Performance (BDOSV): $117.06 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $147.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 All Other Medicaid (V) — All Other Medicaid (V): $82.91 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $85.21 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 BCBS — BC Medicare (V): $93.52 Blue Cross — Allina Health BluePrint (BDOSHV): $168.03
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LAT PORTABLE	$373.20	$208.99	$75.09 – $373.20
Chest X-ray, 2 views: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $166.22 Aetna — Aetna Performance (BDOSV): $175.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $221.83 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $373.20 All Other Medicaid (V) — All Other Medicaid (V): $82.91 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $85.21 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $313.49 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $287.89 BCBS — BC Medicare (V): $93.52 Blue Cross — Allina Health BluePrint (BDOSHV): $168.03
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LATERAL	$248.80	$139.33	$110.54 – $248.80
Chest X-ray, 2 views: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $110.54 Aetna — Aetna Performance (BDOSV): $116.76 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $147.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $208.99
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY LUMBOSACRAL MINIMUM OF 4 VIEWS	$248.80	$139.33	$50.06 – $336
X-ray of the lower spine, at least 4 views: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $110.82 Aetna — Aetna Performance (BDOSV): $117.06 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $147.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $178.48
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD XRAY LUMBOSACRAL MINIMUM OF 4 VIEWS	$248.80	$139.33	$110.54 – $248.80
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $110.54 Aetna — Aetna Performance (BDOSV): $116.76 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $147.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $208.99
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO	$2,475	$1,386	$227.33 – $2,475
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,102.37 Aetna — Aetna Performance (BDOSV): $1,164.49 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,471.14 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,475 All Other Medicaid (V) — All Other Medicaid (V): $227.33 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,079 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,909.22 BCBS — BC Medicare (V): $256.41 Blue Cross — Allina Health BluePrint (BDOSHV): $651
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO LIMITED	$2,215.10	$1,240.46	$227.33 – $2,330
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $986.61 Aetna — Aetna Performance (BDOSV): $1,042.20 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,316.66 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,215.10 All Other Medicaid (V) — All Other Medicaid (V): $227.33 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,860.68 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,708.73 BCBS — BC Medicare (V): $256.41 Blue Cross — Allina Health BluePrint (BDOSHV): $651
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO	$2,475	$1,386	$1,099.64 – $2,475
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $1,099.64 Aetna — Aetna Performance (BDOSV): $1,161.52 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,467.18 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,475 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,079 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,909.22 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,079
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT PELVIS W CONTRAST	$2,444.30	$1,368.81	$167.11 – $2,444.30
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,088.69 Aetna — Aetna Performance (BDOSV): $1,150.04 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,452.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 All Other Medicaid (V) — All Other Medicaid (V): $167.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $171.73 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 BCBS — BC Medicare (V): $188.50 Blue Cross — Allina Health BluePrint (BDOSHV): $478.21
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT PELVIS W	$2,444.30	$1,368.81	$167.11 – $2,444.30
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,088.69 Aetna — Aetna Performance (BDOSV): $1,150.04 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,452.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 All Other Medicaid (V) — All Other Medicaid (V): $167.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $171.73 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 BCBS — BC Medicare (V): $188.50 Blue Cross — Allina Health BluePrint (BDOSHV): $478.21
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT PELVIS W CONTRAST	$2,444.30	$1,368.81	$1,086 – $2,444.30
CT scan of the pelvis, with contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $1,086 Aetna — Aetna Performance (BDOSV): $1,147.11 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,448.98 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,053.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO	$3,712.50	$2,079	$227.33 – $3,712.50
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,653.55 Aetna — Aetna Performance (BDOSV): $1,746.73 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,206.71 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,712.50 All Other Medicaid (V) — All Other Medicaid (V): $227.33 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,118.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,863.82 BCBS — BC Medicare (V): $256.41 Blue Cross — Allina Health BluePrint (BDOSHV): $686.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO LIMITED	$2,784.70	$1,559.43	$227.33 – $2,784.70
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,240.31 Aetna — Aetna Performance (BDOSV): $1,310.20 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,655.23 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,784.70 All Other Medicaid (V) — All Other Medicaid (V): $227.33 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,339.15 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,148.12 BCBS — BC Medicare (V): $256.41 Blue Cross — Allina Health BluePrint (BDOSHV): $686.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO	$3,712.50	$2,079	$1,649.46 – $3,712.50
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $1,649.46 Aetna — Aetna Performance (BDOSV): $1,742.28 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,200.77 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,712.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,118.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,863.82 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $3,118.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT ABDOMEN PELVIS W	$3,258.90	$1,824.98	$317.80 – $3,258.90
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,451.51 Aetna — Aetna Performance (BDOSV): $1,533.31 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,937.09 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,258.90 All Other Medicaid (V) — All Other Medicaid (V): $332.39 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $341.56 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,737.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,513.92 BCBS — BC Medicare (V): $374.91 Blue Cross — Allina Health BluePrint (BDOSHV): $652.36
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD CT ABDOMEN PELVIS W	$3,258.90	$1,824.98	$1,447.93 – $3,258.90
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $1,447.93 Aetna — Aetna Performance (BDOSV): $1,529.40 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,931.88 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,258.90 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,737.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,513.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,737.48
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US ABDOMEN COMPLETE	$724.80	$405.89	$99.61 – $724.80
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $322.83 Aetna — Aetna Performance (BDOSV): $341.02 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $430.82 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $724.80 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $608.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $559.11 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US ABDOMEN COMPLETE	$726.60	$406.90	$99.61 – $726.60
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $323.63 Aetna — Aetna Performance (BDOSV): $341.87 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $431.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $726.60 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $610.34 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $560.50 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US ABDOMEN COMPLETE PORTABLE	$1,089.90	$610.34	$99.61 – $1,089.90
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $485.44 Aetna — Aetna Performance (BDOSV): $512.80 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $647.84 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,089.90 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $915.52 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $840.75 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US OB EQUAL OR GREATER THAN 14 WKS SINGLE GES	$817.40	$457.74	$99.61 – $817.40
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $364.07 Aetna — Aetna Performance (BDOSV): $384.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $485.86 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $817.40 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $686.62 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $630.54 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $372.73
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE	$817.40	$457.74	$99.61 – $817.40
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $364.07 Aetna — Aetna Performance (BDOSV): $384.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $485.86 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $817.40 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $686.62 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $630.54 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $372.73
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SNGL G	$1,178	$659.68	$99.61 – $1,178
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $524.68 Aetna — Aetna Performance (BDOSV): $554.25 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $700.20 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,178 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $989.52 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $908.71 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $372.73
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US PELVIS TRANSVAGINAL NON OB	$543.70	$304.47	$99.61 – $625
Transvaginal ultrasound: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $242.16 Aetna — Aetna Performance (BDOSV): $255.81 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $323.18 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $543.70 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $456.71 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $419.41 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US TRANSVAGINAL	$544.80	$305.09	$99.61 – $625
Transvaginal ultrasound: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $242.65 Aetna — Aetna Performance (BDOSV): $256.33 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $323.83 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $544.80 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $457.63 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $420.26 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US PELVIS COMPLETE TV ADD ON	$272.50	$152.60	$54.83 – $625
Transvaginal ultrasound: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $121.37 Aetna — Aetna Performance (BDOSV): $128.21 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $161.97 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $272.50 All Other Medicaid (V) — All Other Medicaid (V): $99.61 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $228.90 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $210.21 BCBS — BC Medicare (V): $112.35 Blue Cross — Allina Health BluePrint (BDOSHV): $328.15
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC WWO CAD	$611.70	$342.55	$69.69 – $611.70
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $272.45 Aetna — Aetna Performance (BDOSV): $287.80 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $363.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid (V) — All Other Medicaid (V): $101.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BCBS — BC Medicare (V): $91.37 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC 3D WWO CAD	$593	$332.08	$69.69 – $593
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $264.12 Aetna — Aetna Performance (BDOSV): $279.01 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $352.48 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $593 All Other Medicaid (V) — All Other Medicaid (V): $101.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $498.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $457.44 BCBS — BC Medicare (V): $91.37 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC ADDL VIEWS WWO CAD	$611.70	$342.55	$69.69 – $611.70
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $272.45 Aetna — Aetna Performance (BDOSV): $287.80 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $363.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid (V) — All Other Medicaid (V): $101.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BCBS — BC Medicare (V): $91.37 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC WWO CAD	$611.70	$342.55	$69.69 – $611.70
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $272.45 Aetna — Aetna Performance (BDOSV): $287.80 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $363.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid (V) — All Other Medicaid (V): $127.88 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BCBS — BC Medicare (V): $117.03 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC 3D WWO CAD	$593	$332.08	$69.69 – $593
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $264.12 Aetna — Aetna Performance (BDOSV): $279.01 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $352.48 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $593 All Other Medicaid (V) — All Other Medicaid (V): $127.88 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $498.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $457.44 BCBS — BC Medicare (V): $117.03 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC IMPLANT W ADDL VIE	$551.80	$309.01	$69.69 – $551.80
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $245.77 Aetna — Aetna Performance (BDOSV): $259.62 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $327.99 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $551.80 All Other Medicaid (V) — All Other Medicaid (V): $127.88 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $463.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $425.66 BCBS — BC Medicare (V): $117.03 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT SCREENING WWO CAD	$458.80	$256.93	$69.69 – $458.80
Screening mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $204.35 Aetna — Aetna Performance (BDOSV): $215.87 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $272.71 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $458.80 All Other Medicaid (V) — All Other Medicaid (V): $103.32 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $385.39 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $353.92 BCBS — BC Medicare (V): $96.30 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI SCREENING 3D WWO CAD	$437.80	$245.17	$69.69 – $437.80
Screening mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $195 Aetna — Aetna Performance (BDOSV): $205.98 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $260.23 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $437.80 All Other Medicaid (V) — All Other Medicaid (V): $103.32 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $367.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $337.72 BCBS — BC Medicare (V): $96.30 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT SCREENING 3D WWO CAD	$455.10	$254.86	$69.69 – $455.10
Screening mammogram, both breasts: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $202.70 Aetna — Aetna Performance (BDOSV): $214.12 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $270.51 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $455.10 All Other Medicaid (V) — All Other Medicaid (V): $103.32 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $382.28 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $351.06 BCBS — BC Medicare (V): $96.30 Blue Cross — Allina Health BluePrint (BDOSHV): $190.46

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS	$5,507.30	$3,084.09	$818.17 – $5,507.30
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $2,452.95 Aetna — Aetna Performance (BDOSV): $2,591.18 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $3,273.54 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $5,507.30 All Other Medicaid (V) — All Other Medicaid (V): $818.17 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $840.76 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $4,626.13 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $4,248.33 BCBS — BC Medicare (V): $922.83 Blue Cross — Allina Health BluePrint (BDOSHV): $2,637.07
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS REDUCE	$4,130.30	$2,312.97	$818.17 – $4,130.30
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,839.64 Aetna — Aetna Performance (BDOSV): $1,943.31 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,455.05 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,130.30 All Other Medicaid (V) — All Other Medicaid (V): $818.17 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $840.76 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,469.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,186.11 BCBS — BC Medicare (V): $922.83 Blue Cross — Allina Health BluePrint (BDOSHV): $2,637.07
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS	$5,507.30	$3,084.09	$2,446.89 – $5,507.30
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $2,446.89 Aetna — Aetna Performance (BDOSV): $2,584.58 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $3,264.73 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $5,507.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $4,626.13 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $4,248.33 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $4,626.13

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT THERAPEUTIC EXERCISE 15MIN	$145.50	$81.48	$21.60 – $311
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $64.81 Aetna — Aetna Performance (BDOSV): $68.46 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $86.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid (V) — All Other Medicaid (V): $23.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BCBS — BC Medicare (V): $30.19 Blue Cross — Allina Health BluePrint (BDOSHV): $59.03
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OT THERAPEUTIC EXERCISE 15MIN	$145.50	$81.48	$21.60 – $311
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $64.81 Aetna — Aetna Performance (BDOSV): $68.46 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $86.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid (V) — All Other Medicaid (V): $23.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BCBS — BC Medicare (V): $30.19 Blue Cross — Allina Health BluePrint (BDOSHV): $59.03
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT THERAPEUTIC EXERCISE 59	$145.50	$81.48	$21.60 – $311
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $64.81 Aetna — Aetna Performance (BDOSV): $68.46 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $86.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid (V) — All Other Medicaid (V): $23.16 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BCBS — BC Medicare (V): $30.19 Blue Cross — Allina Health BluePrint (BDOSHV): $59.03
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY XE	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY XP	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY XE	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY XP	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY XE	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY XP	$429.20	$240.35	$59.59 – $429.20
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $191.17 Aetna — Aetna Performance (BDOSV): $201.94 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $255.12 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid (V) — All Other Medicaid (V): $78.81 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BCBS — BC Medicare (V): $102.61 Blue Cross — Allina Health BluePrint (BDOSHV): $162.85
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 30 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 30 minutes: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $91.44 Aetna — Aetna Performance (BDOSV): $96.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $122.03 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid (V) — All Other Medicaid (V): $169.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BCBS — BC Medicare (V): $190.75 Blue Cross — Allina Health BluePrint (BDOSHV): $70.45
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 30 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$91.21 – $205.30
Psychotherapy, 30 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $91.21 Aetna — Aetna Performance (BDOSV): $96.35 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $121.70 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 45 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $91.44 Aetna — Aetna Performance (BDOSV): $96.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $122.03 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid (V) — All Other Medicaid (V): $169.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BCBS — BC Medicare (V): $190.75 Blue Cross — Allina Health BluePrint (BDOSHV): $70.45
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 45 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$91.21 – $205.30
Psychotherapy, 45 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $91.21 Aetna — Aetna Performance (BDOSV): $96.35 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $121.70 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 60 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 60 minutes: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $91.44 Aetna — Aetna Performance (BDOSV): $96.59 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $122.03 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid (V) — All Other Medicaid (V): $169.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BCBS — BC Medicare (V): $190.75 Blue Cross — Allina Health BluePrint (BDOSHV): $70.45
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 60 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$91.21 – $205.30
Psychotherapy, 60 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $91.21 Aetna — Aetna Performance (BDOSV): $96.35 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $121.70 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN	$310.10	$173.66	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $416.93
Family psychotherapy, without the patient: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $138.12 Aetna — Aetna Performance (BDOSV): $145.90 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $184.32 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $310.10 All Other Medicaid (V) — All Other Medicaid (V): $169.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $260.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $239.21 BCBS — BC Medicare (V): $190.75 Blue Cross — Allina Health BluePrint (BDOSHV): $277.38
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN	$310.10	$173.66	$137.78 – $310.10
Family psychotherapy, without the patient: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $137.78 Aetna — Aetna Performance (BDOSV): $145.53 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $183.83 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $310.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $260.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $239.21 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $260.48
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY W PATIENT 50 MIN	$371	$207.76	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $433.03
Family psychotherapy, with the patient: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $165.24 Aetna — Aetna Performance (BDOSV): $174.56 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $220.52 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $371 All Other Medicaid (V) — All Other Medicaid (V): $169.11 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $311.64 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $286.19 BCBS — BC Medicare (V): $190.75 Blue Cross — Allina Health BluePrint (BDOSHV): $288.08
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY W PATIENT 50 MIN	$371	$207.76	$164.84 – $371
Family psychotherapy, with the patient: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $164.84 Aetna — Aetna Performance (BDOSV): $174.11 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $219.93 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $371 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $311.64 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $286.19 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $311.64
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG GROUP PSYCHOTHERAPY CK OR HBC ONLY	$178.30	$99.85	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $178.30
Group psychotherapy: 10 of 33 insurance plan rates Aetna — Aetna Elevate (BDOSV): $79.41 Aetna — Aetna Performance (BDOSV): $83.89 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $105.98 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $178.30 All Other Medicaid (V) — All Other Medicaid (V): $96.79 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $99.47 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $149.77 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $137.54 BCBS — BC Medicare (V): $109.17 Blue Cross — Allina Health BluePrint (BDOSHV): $68.14
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG GROUP PSYCHOTHERAPY CK OR HBC ONLY	$178.30	$99.85	$79.22 – $178.30
Group psychotherapy: rates for 7 insurance plans Aetna — Aetna Elevate (BDOSV): $79.22 Aetna — Aetna Performance (BDOSV): $83.68 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $105.70 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $178.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $149.77 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $137.54 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $149.77

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ EPIDUR INTERLAM SUBA LUMB SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $3,760
Spinal injection, lower back (epidural), with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $680.62 Aetna — Aetna Performance (BDOSV): $718.97 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $908.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid (V) — All Other Medicaid (V): $672.53 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BCBS — BC Medicare (V): $758.56 Blue Cross — Allina Health BluePrint (BDOSHV): $1,159.77
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $3,760
Spinal injection, lower back (epidural), with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $680.62 Aetna — Aetna Performance (BDOSV): $718.97 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $908.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid (V) — All Other Medicaid (V): $672.53 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BCBS — BC Medicare (V): $758.56 Blue Cross — Allina Health BluePrint (BDOSHV): $1,159.77
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IR INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $3,760
Spinal injection, lower back (epidural), with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $680.62 Aetna — Aetna Performance (BDOSV): $718.97 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $908.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid (V) — All Other Medicaid (V): $672.53 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BCBS — BC Medicare (V): $758.56 Blue Cross — Allina Health BluePrint (BDOSHV): $1,159.77
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ TRANSFORAMINAL EPIDURAL LMBR/SAC 1 LVL W	$2,463.40	$1,379.50	$281.06 – $3,760
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,097.20 Aetna — Aetna Performance (BDOSV): $1,159.03 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,464.24 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,463.40 All Other Medicaid (V) — All Other Medicaid (V): $842.69 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,069.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,900.27 BCBS — BC Medicare (V): $950.49 Blue Cross — Allina Health BluePrint (BDOSHV): $602.29
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT TRANSFORAMINAL LUMB OR SACRAL SNGL W CT GU	$2,321.90	$1,300.26	$281.06 – $3,760
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,034.17 Aetna — Aetna Performance (BDOSV): $1,092.45 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,380.14 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,321.90 All Other Medicaid (V) — All Other Medicaid (V): $842.69 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,950.40 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,791.11 BCBS — BC Medicare (V): $950.49 Blue Cross — Allina Health BluePrint (BDOSHV): $602.29
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IR INJ TRANS EPIDURAL LUMBAR W FLUORO	$2,309.40	$1,293.26	$281.06 – $3,760
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,028.61 Aetna — Aetna Performance (BDOSV): $1,086.57 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,372.71 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,309.40 All Other Medicaid (V) — All Other Medicaid (V): $842.69 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,939.90 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,781.47 BCBS — BC Medicare (V): $950.49 Blue Cross — Allina Health BluePrint (BDOSHV): $602.29
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT	$2,541.60	$1,423.30	$199 – $2,694.31
Laser treatment of clouding after cataract surgery: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,132.03 Aetna — Aetna Performance (BDOSV): $1,195.82 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,510.73 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,541.60 All Other Medicaid (V) — All Other Medicaid (V): $524.01 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,134.94 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,960.59 BCBS — BC Medicare (V): $591.06 Blue Cross — Allina Health BluePrint (BDOSHV): $1,792.20
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT U	$3,341.70	$1,871.35	$524.01 – $3,760
Laser treatment of clouding after cataract surgery: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,488.39 Aetna — Aetna Performance (BDOSV): $1,572.27 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $1,986.31 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,341.70 All Other Medicaid (V) — All Other Medicaid (V): $524.01 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,807.03 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,577.79 BCBS — BC Medicare (V): $591.06 Blue Cross — Allina Health BluePrint (BDOSHV): $1,792.20
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT B	$3,876.40	$2,170.78	$524.01 – $3,876.40
Laser treatment of clouding after cataract surgery: 10 of 32 insurance plan rates Aetna — Aetna Elevate (BDOSV): $1,726.55 Aetna — Aetna Performance (BDOSV): $1,823.85 Aetna Direct/Indirect Regional Network — Aetna Direct/Indirect Regional (BDOSV): $2,304.13 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,876.40 All Other Medicaid (V) — All Other Medicaid (V): $524.01 Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,256.18 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,990.25 BCBS — BC Medicare (V): $591.06 Blue Cross — Allina Health BluePrint (BDOSHV): $1,792.20

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	$49,804.23 – $224,260.90
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 21 insurance plan rates Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $70,769.20 BCBS — BC Medicare (V): $108,070.67 Health Partners — HPI Cigna (BDOV): $165,758.76 HealthPartners — HPI (BDOV): $152,072.25 Medica — Medica Essentials (B D O S V): $134,756.31 Medica Health System — Medica Choice (B D O S V): $141,831.04 Medica Health System — Medica Elect (B D O S V): $129,066.24 Medica Health System — Medica PMAP (B D O S V): $49,804.23 Medica Medicare — Medica Medicare (V): $90,711.38 Medica MHPS — Medica MHPS (BDOSV): $134,756.31
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$26,835.98 – $66,086.17
Spinal fusion (not neck), without major complications: 10 of 15 insurance plan rates Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $26,835.98 BCBS — BC Medicare (V): $29,457.28 Health Partners — HPI Cigna (BDOV): $66,086.17 HealthPartners — HPI (BDOV): $61,278.83 Medica Medicare — Medica Medicare (V): $29,912.74 Medicare — Medicare (V): $28,360.62 Medicare Other — All Other Medicare (V): $28,054.56 SCHA MSHO (V) — SCHA MSHO (V): $30,860.01 Aetna — Aetna Elevate (BDOSV): 44.43% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (BDOSV): 46.93% (a percentage in the contract, not a dollar amount)
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	$9,820.03 – $44,218.10
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $14,434.06 BCBS — BC Medicare (V): $15,938.98 Health Partners — HPI Cigna (BDOV): $32,683.08 HealthPartners — HPI (BDOV): $29,984.48 Medica — Medica Essentials (B D O S V): $26,570.25 Medica Health System — Medica Choice (B D O S V): $27,965.19 Medica Health System — Medica Elect (B D O S V): $25,448.32 Medica Health System — Medica PMAP (B D O S V): $9,820.03 Medica Medicare — Medica Medicare (V): $16,268.28 Medica MHPS — Medica MHPS (BDOSV): $26,570.25
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	$12,428.66 – $55,964.36
Neck (cervical) spinal fusion, without complications: 10 of 21 insurance plan rates Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $18,109.46 BCBS — BC Medicare (V): $19,945.21 Health Partners — HPI Cigna (BDOV): $41,365.14 HealthPartners — HPI (BDOV): $37,949.67 Medica — Medica Essentials (B D O S V): $33,628.47 Medica Health System — Medica Choice (B D O S V): $35,393.97 Medica Health System — Medica Elect (B D O S V): $32,208.51 Medica Health System — Medica PMAP (B D O S V): $12,428.66 Medica Medicare — Medica Medicare (V): $20,311.90 Medica MHPS — Medica MHPS (BDOSV): $33,628.47
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	$6,316.40 – $28,441.81
Uterus and ovary surgery (not for cancer), without complications: 10 of 21 insurance plan rates Allina Aetna Medicare (V) — Allina Aetna Medicare (V): $9,497.69 BCBS — BC Medicare (V): $10,558.21 Health Partners — HPI Cigna (BDOV): $21,022.29 HealthPartners — HPI (BDOV): $19,286.51 Medica — Medica Essentials (B D O S V): $17,090.42 Medica Health System — Medica Choice (B D O S V): $17,987.67 Medica Health System — Medica Elect (B D O S V): $16,368.78 Medica Health System — Medica PMAP (B D O S V): $6,316.40 Medica Medicare — Medica Medicare (V): $10,837.32 Medica MHPS — Medica MHPS (BDOSV): $17,090.42

Source: Allina Health Faribault Medical Center’s standard charges file (allinahealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 16, 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	200 State Avenue, Faribault, MN 55021
County	Rice County
State	Minnesota
Phone	(507) 334‑6451
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	240071
Name in Medicare records	ALLINA HEALTH FARIBAULT MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	allinahealth.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.

Emergency Department - Allina Health Faribault Medical Center — allinahealth.org
Allina Health Faribault Medical Center| Faribault, MN | Allina Health — allinahealth.org
Visiting Allina Health Faribault Medical Center | Patient & Visitor Info — allinahealth.org
Services | Allina Health Faribault Medical Center | Faribault, MN — allinahealth.org
Orthopedic Care at Faribault Medical Center — allinahealth.org
Lifeline with AutoAlert System | Allina Health Faribault Medical Center — allinahealth.org
Rehabilitation Services at Faribault Medical Center — allinahealth.org
Nutrition Services at Faribault Medical Center — allinahealth.org