Does Ascension Seton Northwest have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Ascension Seton Northwest. In a medical emergency, call 911.

Where is Ascension Seton Northwest?

11113 Research Boulevard, Austin, TX 78759, in Travis County, Texas.

What is the phone number of Ascension Seton Northwest?

(512) 324-6000, as listed by Medicare (CMS).

What is the Medicare star rating of Ascension Seton Northwest?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Ascension Seton Northwest for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for Ascension Seton Northwest under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.9387; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Ascension Seton Northwest — Phone, Address & ER

Quick answers

Does Ascension Seton Northwest have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Ascension Seton Northwest. In a medical emergency, call 911.
Where is Ascension Seton Northwest?: 11113 Research Boulevard, Austin, TX 78759, in Travis County, Texas.
What is the phone number of Ascension Seton Northwest?: (512) 324-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Ascension Seton Northwest?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Ascension Seton Northwest for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for Ascension Seton Northwest under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.9387; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4]

Treatments^[4]

Anemia management
Diabetes management
Smoking cessation
Weight loss management

Procedures^[4]

Minimally invasive procedures
Lab tests
Sleep studies
Cardiac testing and clearance

Programs and centers^[4]

Perioperative Surgical Home and Optimization Clinic
Dell Children's Emergency Care on site

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Interpreters and languages	Language assistance page with interpreter links for Spanish, Arabic, Polish, Haitian Creole, Vietnamese and more^[4]
Patient portal	Patient Portal

Recognition^[4]

Leapfrog Hospital Safety Grade A

Doctors and clinicians (298)

298 doctors and other clinicians list Ascension Seton Northwest 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 (298)

Aaron R. Kirkpatrick, MDInternal Medicine
Abed K. Abdelaziz, MDSports Medicine
Adam S. Lipp, MDAnesthesiology
Adelina C. Resendez, CNACertified Registered Nurse Anesthetist (CRNA)
Ahmad P. Ghafoori, MDRadiation Oncology
Alan D. Collebrusco, MDAnesthesiology
Alex Cruz, MDOrthopedic Surgery
Alexander R. Farr, MDInterventional Cardiology
Alexander Wright, MDAnesthesiology
Alexandria J. Miller, CNACertified Registered Nurse Anesthetist (CRNA)
Alexsandra A. Davidovic, CNACertified Registered Nurse Anesthetist (CRNA)
Allison A. Urrutia, MDObstetrics/Gynecology
Allison R. Losey, MDAnesthesiology
Allyson Lemay, MDAnesthesiology
Amanda L. Hollon, NPNurse Practitioner
Amber L. Nelson, PAPhysician Assistant
Amy E. McFarling, DDSOral Surgery
Amy M. Coffman, MDAnesthesiology
Amy M. Dekerlegand, MDGeneral Surgery
Andrew E. Grimes, MDAnesthesiology
Andrew T. Seider, CNACertified Registered Nurse Anesthetist (CRNA)
Andrew W. Jensen, MDAnesthesiology
Andria Hillman, CNACertified Registered Nurse Anesthetist (CRNA)
Anish Raman, MDOtolaryngology

And 274 more: the button below opens the full list.

Other emergency rooms nearby

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

North Austin Medical Center2.3 mi · Austin, TX · Acute Care Hospital
Northwest Hills Surgical Hospital3.8 mi · Austin, TX · Acute Care Hospital
Texas Childrens Hospital North Austin Campus5.6 mi · Austin, TX · Children's Hospital
Ascension Seton Medical Center Austin6.8 mi · Austin, TX · Acute Care Hospital
Round Rock Medical Center7.5 mi · Round Rock, TX · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Austin

Cross Creek Hospital6.2 mi · Austin, TX · Psychiatric Hospital
Encompass Health Rehabilitation Hospital of Round6.2 mi · Round Rock, TX · Inpatient Rehabilitation Hospital
Cornerstone Specialty Hospitals Round Rock6.4 mi · Austin, TX · Long-Term Acute Care Hospital

All hospitals in Austin · Hospitals in Travis County · Hospitals near me

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

Windsor Nursing and Rehabilitation Center of Duval0.9 mi · Austin, TX · 3 of 5 stars
Sage Park Austin2.4 mi · Austin, TX · 2 of 5 stars
Avir at Park Bend2.5 mi · Austin, TX · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Amedisys Hospice1.0 mi · Austin, TX
Carefor Hospice, LLC1.0 mi · Austin, TX
Embrace Hospice1.0 mi · Austin, TX

All hospice providers in the state →

Home health agencies

Capitol Home Health1.0 mi · Austin, TX · 4 of 5 stars
Halcyon Home LLC1.0 mi · Austin, TX · 3.5 of 5 stars
Mga Homecare1.0 mi · Austin, TX

All home health agencies in the state →

Dialysis facilities

DaVita Balcones Dialysis1.0 mi · Austin, TX · 4 of 5 stars
Nna - North2.6 mi · Austin, TX · 3 of 5 stars
SHC Metric2.6 mi · Austin, TX · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Northwest Surgery Center LLP1.0 mi · Austin, TX
Texas Orthopedics Surgery Center1.0 mi · Austin, TX
The Pain Relief Surgicenter1.0 mi · Austin, TX

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Lone Star Circle of Care at Northwest Austin0.1 mi · Austin, TX · Community health center
CommUnityCare at Balcones Terrace1.0 mi · Austin, TX · Community health center
The Charlie Center2.2 mi · Austin, TX · Community health center

Clinics and urgent care

Arboretum Austin Management, LLC1.0 mi · Austin, TX · Urgent care center
Auc Arboretum LLC1.0 mi · Austin, TX · Urgent care center
Carbon Health Medical Group of Florida PA1.0 mi · Austin, TX · Urgent care center

Pharmacies

Costco Wholesale Corporation1.0 mi · Austin, TX · Community/retail pharmacy
H-E-B, LP1.0 mi · Austin, TX · Community/retail pharmacy
Pharmacist on Demand LLC1.0 mi · Austin, TX · Community/retail pharmacy

Assisted living nearby

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

Asher Point Senior Living of Austin1.0 mi · Austin, TX
Clearwater at the Arboretum1.0 mi · Austin, TX
Sage Park Austin1.0 mi · Austin, TX
Silverleaf Eldercare at the Arboretum1.0 mi · Austin, TX

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Restfulness of Environment	3 of 5 stars
Care Coordination	2 of 5 stars
Symptoms After Stay	2 of 5 stars
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	71%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	76%National average: 80%
“Always” got help as soon as they wanted	55%National average: 64%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	79%National average: 73%
Completed surveys	547Response rate: 15%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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)	0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.654No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0Better than the national benchmark
Not reported to Medicare	Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 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 failure patients	8.5%
Deaths within 30 days: pneumonia patients	13.6%
Serious complications (patient safety indicator PSI-90)	0.94No different from the national rate
Complications after hip or knee replacement	3.9%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)
Too few cases to report	Deaths within 30 days: heart attack patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)	15.5%
Readmitted within 30 days: heart failure	21.2%
Readmitted within 30 days: pneumonia	18.7%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: COPD; Readmitted within 30 days: hip or knee replacement

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	169 minutesNational average: 162 minutes
Sepsis patients who got all the recommended early care (SEP-1)	50%National average: 66%
Not reported to Medicare	Patients who left the emergency room before being seen (OP-22)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Ascension Seton Northwest, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	-0.9387Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart failure	1.0223More readmissions than expected
Pneumonia	1.0116More readmissions than expected
COPD (chronic lung disease)	1.0164More readmissions than expected
Hip or knee replacement	1.0418More readmissions than expected
No result published	Heart attack; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio	1.08Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

No result for this hospital: Hospital Value-Based Purchasing Program. This is normal when a hospital is paid under another Medicare system (for example critical access, children’s or psychiatric hospitals), is not in the program that year, or has too few cases.

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 Austin Best hospitals in Austin

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as Ascension Seton Northwest 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 →

Show the prices of 85 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW LOW 30 MIN	Not listed in the file	Not listed in the file	$75.13 – $321.54
New patient office visit (about 30–44 minutes): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $132.49 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $290.55 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $263.43 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $263.43 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $321.54 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $75.13 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $77.21
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$127.40 – $544.40
New patient office visit (about 45–59 minutes): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $224.32 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $491.93 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $446.01 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $446.01 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $544.40 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $127.40 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $130.52
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW HI 60 MIN	Not listed in the file	Not listed in the file	$166.28 – $710.44
New patient office visit (about 60–74 minutes): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $292.73 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $641.96 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $582.05 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $582.05 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $710.44 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $166.28 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $170.44
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$50.49 – $215.39
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $88.75 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $194.63 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $176.46 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $176.46 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $215.39 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $50.49 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $51.87
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE O/P EST MOD 30 MIN	Not listed in the file	Not listed in the file	$77.89 – $332.04
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $136.82 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $300.04 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $272.03 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $272.03 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $332.04 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $77.89 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $79.48
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$94.91 – $403.84
Office consultation with a specialist (moderate): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $166.40 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $364.91 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $330.85 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $330.85 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $403.84 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $94.91 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $96.73
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$152.54 – $649.10
Office consultation with a specialist (moderate to high): rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $267.46 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $586.54 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $531.79 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $531.79 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $649.10 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $152.54 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $155.46
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$97.03 – $412.80
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $170.09 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $373.01 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $338.20 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $338.20 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $412.80 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $97.03 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $99.28
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$118.07 – $502.52
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $207.06 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $454.09 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $411.71 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $411.71 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $502.52 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $118.07 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $120.73
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: VISIT ER III W/25	$2,031.75	$731.43	$11.12 – $2,031.75
Emergency room visit (moderate): 10 of 56 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $1,009 AETNA HMO — 4486_AETNA HMO 20250801: $1,301 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $902 AETNA POS 20140601 — 235_AETNA POS 20140601: $1,009 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,041 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $359.58 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $51.36
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: VISIT ER LVL III	$1,450	$522	$11.12 – $1,450
Emergency room visit (moderate): 10 of 42 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $1,009 AETNA HMO — 4486_AETNA HMO 20250801: $1,301 AETNA POS 20140601 — 235_AETNA POS 20140601: $1,009 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,041 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $359.58 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $51.36 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $51.36 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $1,295
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: VISIT ER III W/25	$2,031.75	$731.43	$11.12 – $2,031.75
Emergency room visit (moderate): 10 of 24 insurance plan rates BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $51.36 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $51.36 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $20.38 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $25.30 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $51.36 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $51.36 DELL STAR — 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901: $20.38 DELL STAR — 3708_CHIRP DELL STAR (NW) INPATIENT 20240901: $25.30 SUPERIOR AMBETTER — 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901: $77.47 SUPERIOR AMBETTER — 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901: $77.47
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: VISIT ER IV W/25	$3,006	$1,082.16	$172.84 – $3,006
Emergency room visit (moderately high): 10 of 59 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $1,325 AETNA HMO — 4486_AETNA HMO 20250801: $1,710 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,185 AETNA POS 20140601 — 235_AETNA POS 20140601: $1,325 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,368 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $566.38 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $434.37 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $434.37 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $172.84 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $172.84
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: VISIT ER LVL IV	$3,250	$1,170	$186.88 – $3,250
Emergency room visit (moderately high): 10 of 51 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $1,325 AETNA HMO — 4486_AETNA HMO 20250801: $1,710 AETNA POS 20140601 — 235_AETNA POS 20140601: $1,325 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,368 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $566.38 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $469.63 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $469.63 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $186.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $186.88 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $3,040
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: VISIT ER IV W/25	$3,006	$1,082.16	$172.84 – $3,006
Emergency room visit (moderately high): 10 of 24 insurance plan rates BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $434.37 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $172.84 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $434.37 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $172.84 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $434.37 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $172.84 DELL STAR — 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901: $434.37 DELL STAR — 3708_CHIRP DELL STAR (NW) INPATIENT 20240901: $172.84 SUPERIOR AMBETTER — 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901: $347.57 SUPERIOR AMBETTER — 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901: $347.57
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: VISIT ER V W/25	$5,575	$2,007	$200 – $5,575
Emergency room visit (high): 10 of 59 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $2,648 AETNA HMO — 4486_AETNA HMO 20250801: $3,416 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $2,368 AETNA POS 20140601 — 235_AETNA POS 20140601: $2,648 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $2,733 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $812.26 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $805.59 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $805.59 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $320.56 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $320.56
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: VISIT ER LVL V	$5,575	$2,007	$200 – $5,575
Emergency room visit (high): 10 of 50 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $2,648 AETNA HMO — 4486_AETNA HMO 20250801: $3,416 AETNA POS 20140601 — 235_AETNA POS 20140601: $2,648 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $2,733 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $812.26 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $805.59 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $805.59 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $320.56 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $320.56 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $5,200
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: VISIT ER V W/25	$5,575	$2,007	$200 – $5,575
Emergency room visit (high): 10 of 30 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $2,693 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $2,955 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $805.59 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $320.56 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $805.59 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $320.56 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $805.59 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $320.56 DELL STAR — 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901: $805.59 DELL STAR — 3708_CHIRP DELL STAR (NW) INPATIENT 20240901: $320.56

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC MET PANEL CA TOTL	$659.75	$237.51	$7.04 – $296.89
Basic metabolic panel (blood test): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $24.45 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $24.45 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.11 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $7.11 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $7.11 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $7.11 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $8.77 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $8.77 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $19.67 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.11
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC MET PANEL CA TOTL	$659.75	$237.51	$7.04 – $296.89
Basic metabolic panel (blood test): 10 of 41 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $62.89 AETNA HMO — 4486_AETNA HMO 20250801: $46.11 AETNA POS 20140601 — 235_AETNA POS 20140601: $62.89 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $36.89 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $7.11 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $7.11 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $7.11 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $7.11 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $36.04 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $32.66
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: METABOLIC PANEL TOTAL CA	Not listed in the file	Not listed in the file	$8.29 – $15.23
Basic metabolic panel (blood test): 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $8.29 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $8.46 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $62.89 AETNA HMO — 4486_AETNA HMO 20250801: $46.11 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $22.37 AETNA POS 20140601 — 235_AETNA POS 20140601: $62.89 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $36.89 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $8.46 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $16.07 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $7.11
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREH METABOLIC PANEL	$264.25	$95.13	$8.87 – $118.91
Comprehensive metabolic panel (blood test): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $30.53 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $30.53 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $8.87 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $8.87 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $8.87 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $8.87 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $10.95 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $10.95 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $24.57 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $8.87
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREH METABOLIC PANEL	$264.25	$95.13	$8.87 – $118.91
Comprehensive metabolic panel (blood test): 10 of 41 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $78.53 AETNA HMO — 4486_AETNA HMO 20250801: $57.55 AETNA POS 20140601 — 235_AETNA POS 20140601: $78.53 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $46.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $8.87 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $8.87 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $8.87 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $8.87 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $44.99 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $40.76
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$10.35 – $19.01
Comprehensive metabolic panel (blood test): 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $10.35 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $10.56 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $78.53 AETNA HMO — 4486_AETNA HMO 20250801: $57.55 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $27.93 AETNA POS 20140601 — 235_AETNA POS 20140601: $78.53 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $46.04 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $10.56 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $20.06 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $8.87
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$46.85 – $86.06
Obstetric blood test panel: 10 of 36 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $46.85 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $47.81 AETNA HMO — 4486_AETNA HMO 20250801: $260.56 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $126.34 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $208.45 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $47.81 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $90.84 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $203.67 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $184.55 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $184.55
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$46.85 – $86.06
Obstetric blood test panel: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $46.85 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $47.81 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $47.81 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $47.81 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $49.24 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $47.81 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $47.81 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $47.81 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $47.81 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $47.81
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$78.89 – $405.84
Obstetric blood test panel: rates for 3 insurance plans AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $138.08 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $138.08 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $111.19
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$564.75	$203.31	$11.25 – $254.14
Cholesterol panel (lipid panel): 10 of 64 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $13.12 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $13.39 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $99.57 AETNA HMO — 4486_AETNA HMO 20250801: $72.98 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $35.38 AETNA POS 20140601 — 235_AETNA POS 20140601: $99.57 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $58.38 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $13.39 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $25.44 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $11.25
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL	$564.75	$203.31	$11.25 – $254.14
Cholesterol panel (lipid panel): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $38.67 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $38.67 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $11.25 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $11.25 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $11.25 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $11.25 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $13.89 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $13.89 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $31.14 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $11.25
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: LIPID PANEL	Not listed in the file	Not listed in the file	$13.12 – $24.10
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $13.12 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $13.39 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $13.39 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $13.39 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $13.79 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $13.39 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $13.39 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $13.39 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $13.39 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$409.25	$147.33	$7.29 – $184.16
Kidney function panel: 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $8.51 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $8.68 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $64.58 AETNA HMO — 4486_AETNA HMO 20250801: $47.31 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $22.94 AETNA POS 20140601 — 235_AETNA POS 20140601: $64.58 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $37.84 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $8.68 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $16.49 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $7.29
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL	$409.25	$147.33	$7.29 – $184.16
Kidney function panel: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $25.08 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $25.08 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.29 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $7.29 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $7.29 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $7.29 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $9 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $9 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $20.19 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.29
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$8.51 – $15.62
Kidney function panel: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $8.51 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $8.68 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $8.68 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $8.68 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $8.94 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $8.68 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $8.68 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $8.68 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $8.68 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$453.75	$163.35	$6.86 – $204.19
Liver function panel: 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $8.01 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $8.17 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $60.71 AETNA HMO — 4486_AETNA HMO 20250801: $44.53 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $21.60 AETNA POS 20140601 — 235_AETNA POS 20140601: $60.71 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $35.62 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $8.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $15.52 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $6.86
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL	$453.75	$163.35	$6.86 – $204.19
Liver function panel: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $23.60 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $23.60 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $6.86 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $6.86 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $6.86 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $6.86 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $8.48 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $8.48 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $19 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $6.86
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HEPATIC FUNCTION PANEL	Not listed in the file	Not listed in the file	$8.01 – $14.71
Liver function panel: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $8.01 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $8.17 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $8.17 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $8.17 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $8.42 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $8.17 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $8.17 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $8.17 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $8.17 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $8.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: UA W/MICRO	$250.75	$90.27	$2.66 – $112.84
Urine test (automated, with microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $9.16 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $9.16 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.66 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $2.66 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $2.66 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $2.66 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $3.29 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $3.29 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $7.37 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.66
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W/MICRO	$250.75	$90.27	$2.66 – $112.84
Urine test (automated, with microscope): 10 of 41 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $23.54 AETNA HMO — 4486_AETNA HMO 20250801: $17.28 AETNA POS 20140601 — 235_AETNA POS 20140601: $23.54 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $13.82 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $2.66 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $2.66 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $2.66 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $2.66 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $13.50 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $12.24
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$3.11 – $5.71
Urine test (automated, with microscope): 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $3.11 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $3.17 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $23.54 AETNA HMO — 4486_AETNA HMO 20250801: $17.28 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $8.38 AETNA POS 20140601 — 235_AETNA POS 20140601: $23.54 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $13.82 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $3.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6.02 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $2.66
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: CLINITEST	$41	$14.76	$2.92 – $19.02
Urine test (manual, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $7.38 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $7.38 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $2.92 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $2.92 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $2.92 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.92 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.92 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $7.28 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: KETONE GLUCOSE SCRN	$41	$14.76	$2.92 – $19.02
Urine test (manual, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $7.38 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $7.38 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $2.92 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $2.92 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $2.92 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.92 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.92 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $7.28 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: URINE DIP/NON-AUTO	$41	$14.76	$2.92 – $19.02
Urine test (manual, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $7.38 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $7.38 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $2.92 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $2.92 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $2.92 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.92 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.92 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $7.28 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $2.92
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: ACETONE UR	$140.25	$50.49	$1.89 – $63.11
Urine test (automated, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $6.48 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $6.48 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.89 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.89 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.89 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.33 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.33 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $5.22 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: SPEC GRAV UR	$140.25	$50.49	$1.89 – $63.11
Urine test (automated, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $6.48 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $6.48 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.89 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.89 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.89 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.33 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.33 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $5.22 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: UA-CHEM(EMP)	$140.25	$50.49	$1.89 – $63.11
Urine test (automated, without microscope): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $6.48 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $6.48 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.89 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.89 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.89 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $2.33 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $2.33 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $5.22 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.89
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA,TOTAL	$248.25	$89.37	$15.45 – $136.74
PSA (prostate specific antigen) blood test: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $53.15 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $53.15 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.45 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $15.45 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $15.45 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $15.45 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $19.08 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $19.08 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $42.79 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.45
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA,TOTAL	$248.25	$89.37	$15.45 – $136.74
PSA (prostate specific antigen) blood test: 10 of 41 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $136.74 AETNA HMO — 4486_AETNA HMO 20250801: $100.23 AETNA POS 20140601 — 235_AETNA POS 20140601: $136.74 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $80.18 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $15.45 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $15.45 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $15.45 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $15.45 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $78.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $70.99
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: ASSAY OF PSA TOTAL	Not listed in the file	Not listed in the file	$18.02 – $33.10
PSA (prostate specific antigen) blood test: 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $18.02 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $18.39 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $136.74 AETNA HMO — 4486_AETNA HMO 20250801: $100.23 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $48.63 AETNA POS 20140601 — 235_AETNA POS 20140601: $136.74 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $80.18 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $18.39 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $34.94 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $15.45
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH	$129.50	$46.62	$7.58 – $124.97
Thyroid stimulating hormone (TSH) test: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $48.54 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $48.54 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.58 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $7.58 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $7.58 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $7.58 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $17.43 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $17.43 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $39.09 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $7.58
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$129.50	$46.62	$7.58 – $124.97
Thyroid stimulating hormone (TSH) test: 10 of 41 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $124.97 AETNA HMO — 4486_AETNA HMO 20250801: $91.56 AETNA POS 20140601 — 235_AETNA POS 20140601: $124.97 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $73.25 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $14.11 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $14.11 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $14.11 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $14.11 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $71.57 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $64.85
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$16.46 – $30.24
Thyroid stimulating hormone (TSH) test: 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $16.46 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $16.80 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $124.97 AETNA HMO — 4486_AETNA HMO 20250801: $91.56 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $44.42 AETNA POS 20140601 — 235_AETNA POS 20140601: $124.97 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $73.25 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $16.80 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $31.92 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $14.11
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: EOSINOPHIL COUNT	$165.50	$59.58	$1.99 – $74.47
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $22.44 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $22.44 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.99 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.99 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.99 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $8.06 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $8.06 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $18.06 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC W/AUTO DIFF	$98	$35.28	$1.99 – $57.82
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $22.44 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $22.44 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.99 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.99 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.99 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $8.06 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $8.06 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $18.06 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC (EMP)	$98	$35.28	$1.99 – $57.82
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $22.44 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $22.44 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.99 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.99 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.99 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $8.06 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $8.06 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $18.06 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: FETAL HEMOGRAM	$113	$40.68	$1.99 – $50.85
Complete blood count (CBC), automated: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $18.68 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $18.68 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.99 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.99 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.99 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $6.70 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $6.70 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $15.04 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM	$173	$62.28	$1.99 – $77.85
Complete blood count (CBC), automated: 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $18.68 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $18.68 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $1.99 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $1.99 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $1.99 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $6.70 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $6.70 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $15.04 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $1.99
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: FETAL HEMOGRAM	$113	$40.68	$1.99 – $50.85
Complete blood count (CBC), automated: 10 of 42 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $48.12 AETNA HMO — 4486_AETNA HMO 20250801: $35.26 AETNA POS 20140601 — 235_AETNA POS 20140601: $48.12 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $28.21 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $12.29 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $5.43 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $5.43 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $5.43 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $5.43 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $27.56
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME	$219	$78.84	$3.60 – $98.55
Blood clotting time test (prothrombin time, PT): 10 of 63 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $4.20 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $4.29 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $29.27 AETNA HMO — 4486_AETNA HMO 20250801: $23.38 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $10.39 AETNA POS 20140601 — 235_AETNA POS 20140601: $29.27 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $18.70 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $4.29 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $8.15 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $3.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT	$197	$70.92	$3.60 – $88.65
Blood clotting time test (prothrombin time, PT): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $11.35 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $11.35 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.10 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $15.10 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $15.10 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $15.10 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $4.07 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $4.07 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $9.14 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.10
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT&PTT	$197	$70.92	$3.60 – $88.65
Blood clotting time test (prothrombin time, PT): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $11.35 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $11.35 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.10 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $15.10 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $15.10 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $15.10 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $4.07 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $4.07 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $9.14 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $15.10
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT-D HEPARIN REFLEX	$30.75	$11.07	$5.05 – $28.31
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $17.34 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $17.34 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $5.75 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $5.75 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $5.75 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $6.23 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $6.23 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $13.97 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: APTT MIXING STUDIES-85730	$120	$43.20	$5.05 – $54
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $17.34 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $17.34 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $5.75 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $5.75 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $5.75 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $6.23 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $6.23 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $13.97 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT, ACTIVATED	$120	$43.20	$5.05 – $54
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $17.34 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $17.34 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $5.75 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $5.75 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $5.75 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $6.23 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $6.23 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $13.97 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $5.75

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 · Inpatient or outpatient In the file: CT HEAD WO CONT	$3,742.25	$1,347.21	$75.99 – $1,684.01
CT scan of the head or brain, without contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $507.38 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $747.81 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $507.38 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $109.60 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $109.60 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $109.60 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $109.60 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $109.60 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $109.60 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $109.60
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD WO CONT	$3,742.25	$1,347.21	$75.99 – $1,684.01
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates AETNA HMO — 4486_AETNA HMO 20250801: $706.77 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,345 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $118.80 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $106.88 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $452.80 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $411.33 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $411.33
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$100.99 – $185.49
CT scan of the head or brain, without contrast: 10 of 58 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $100.99 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $103.05 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $747.81 AETNA HMO — 4486_AETNA HMO 20250801: $706.77 AETNA POS 20140601 — 235_AETNA POS 20140601: $747.81 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,345 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $103.05 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $118.80 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MR BRAIN WOW	$7,530.50	$2,710.98	$274.01 – $3,388.72
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $3,084.62 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $2,558.97 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $3,084.62 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $357.85 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $356.19 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $357.85 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $356.19 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $356.19 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MR BRAIN WOW LTD	$4,858.75	$1,749.15	$274.01 – $3,084.62
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $3,084.62 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $2,558.97 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $3,084.62 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $357.85 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $356.19 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $357.85 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $356.19 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $356.19 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN FOR IAC WOW	$7,530.50	$2,710.98	$274.01 – $3,388.72
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $3,084.62 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $2,558.97 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $3,084.62 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $357.85 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $356.19 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $357.85 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $356.19 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $356.19 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $357.85
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CXR DECUB	$836.75	$301.23	$20.12 – $376.54
Chest X-ray, 2 views: 10 of 38 insurance plan rates BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $26.40 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $28.74 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $26.40 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $26.40 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $193.59 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $26.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CXR DECUB RT	$836.75	$301.23	$20.12 – $376.54
Chest X-ray, 2 views: 10 of 38 insurance plan rates BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $26.40 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $28.74 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $26.40 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $26.40 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $193.59 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $26.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CXR DECUB LT	$836.75	$301.23	$20.12 – $376.54
Chest X-ray, 2 views: 10 of 38 insurance plan rates BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $26.40 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $28.74 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $26.40 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $26.40 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $193.59 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $28.74 DELL CHIP/CHIP PERINATE — 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $26.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR SP COMP LUMB MIN 4 VWS	$1,429.75	$514.71	$34.08 – $643.39
X-ray of the lower spine, at least 4 views: 10 of 48 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $201.33 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $309.78 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $201.33 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $46.11 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $46.11 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $46.11 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $46.11 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $46.11 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $46.11 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR SP COMP LUMB MIN 4 VWS	$1,429.75	$514.71	$34.08 – $643.39
X-ray of the lower spine, at least 4 views: 10 of 38 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $309.78 AETNA HMO — 4486_AETNA HMO 20250801: $367.56 AETNA POS 20140601 — 235_AETNA POS 20140601: $309.78 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $294.05 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $51.45 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $51.45 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $51.45 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $51.45 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $411.33 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $372.11
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$100.99 – $185.49
X-ray of the lower spine, at least 4 views: 10 of 59 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $100.99 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $103.05 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $309.78 AETNA HMO — 4486_AETNA HMO 20250801: $367.56 AETNA POS 20140601 — 235_AETNA POS 20140601: $309.78 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $294.05 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $103.05 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $112.08 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $51.45 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $51.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MR L SPN CANL WO	$3,178.75	$1,144.35	$156.11 – $1,969
MRI of the lower back (lumbar spine), without contrast: 10 of 45 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,741.75 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,548.81 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,741.75 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $212.84 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $212.84 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $211.18 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $212.84 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $211.18 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $211.18 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $212.84
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MR L SPN CANL WO	$3,178.75	$1,144.35	$156.11 – $1,969
MRI of the lower back (lumbar spine), without contrast: 10 of 35 insurance plan rates AETNA HMO — 4486_AETNA HMO 20250801: $1,365.21 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,969 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $247.02 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $199.14 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $199.14 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $199.14 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $199.14 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $941.48 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $855.26 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $855.26
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$229.56 – $421.65
MRI of the lower back (lumbar spine), without contrast: 10 of 60 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $229.56 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $234.25 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $1,548.81 AETNA HMO — 4486_AETNA HMO 20250801: $1,365.21 AETNA POS 20140601 — 235_AETNA POS 20140601: $1,548.81 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,969 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $234.25 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $247.02 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $199.14 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $199.14
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W CONT	$3,774	$1,358.64	$173.75 – $1,701.09
CT scan of the pelvis, with contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,164.05 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,627.20 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,164.05 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $213.51 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $213.51 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $213.18 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $213.51 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $213.18 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $213.18 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $213.51
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS LTD W	$3,774	$1,358.64	$173.75 – $1,701.09
CT scan of the pelvis, with contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,164.05 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,627.20 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,164.05 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $213.51 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $213.51 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $213.18 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $213.51 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $213.18 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $213.18 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $213.51
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W CONT	$3,774	$1,358.64	$173.75 – $1,701.09
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates AETNA HMO — 4486_AETNA HMO 20250801: $1,701.09 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,345 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $193.15 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $180.34 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $180.34 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $180.34 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $180.34 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $736.17 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $668.75 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $668.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MR LW EXT WO J R	$2,022.75	$728.19	$175.86 – $1,975.92
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,975.92 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,708.92 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,975.92 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $224.88 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $223.54 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $224.88 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $223.54 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $223.54 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MR LW EXT WO J L	$2,022.75	$728.19	$175.86 – $1,975.92
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,975.92 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,708.92 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,975.92 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $224.88 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $223.54 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $224.88 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $223.54 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $223.54 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MR LW EXT WO J R LTD	$2,022.75	$728.19	$175.86 – $1,975.92
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,975.92 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $1,708.92 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,975.92 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $224.88 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $223.54 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $224.88 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $223.54 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $223.54 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $224.88
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PEL W CONT	$9,575	$3,447	$228.53 – $4,308.75
CT scan of the abdomen and pelvis, with contrast: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $1,523.31 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $2,140.47 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $1,523.31 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $252.74 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $252.74 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $293.70 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $252.74 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $293.70 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $293.70 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $252.74
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD/PEL W CONT	$9,575	$3,447	$228.53 – $4,308.75
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates AETNA HMO — 4486_AETNA HMO 20250801: $2,374.56 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,345 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $404.76 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $318.09 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $318.09 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $318.09 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $318.09 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,542.67 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $1,401.39 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $1,401.39
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	Not listed in the file	$339.17 – $622.96
CT scan of the abdomen and pelvis, with contrast: 10 of 58 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $339.17 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $346.09 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $2,140.47 AETNA HMO — 4486_AETNA HMO 20250801: $2,374.56 AETNA POS 20140601 — 235_AETNA POS 20140601: $2,140.47 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $1,345 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $346.09 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $404.76 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $318.09 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $318.09
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN CMPLT	$811.75	$292.23	$85.91 – $806.49
Ultrasound of the abdomen, complete: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $508.56 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $508.56 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $114.46 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $116.28 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $114.46 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $116.28 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $116.28 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN CMPLT	$811.75	$292.23	$85.91 – $806.49
Ultrasound of the abdomen, complete: 10 of 37 insurance plan rates AETNA HMO — 4486_AETNA HMO 20250801: $806.49 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $645.19 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $112.08 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $106.88 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $411.33 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $372.11 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $372.11
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$100.99 – $185.49
Ultrasound of the abdomen, complete: 10 of 59 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $100.99 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $103.05 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $927.63 AETNA HMO — 4486_AETNA HMO 20250801: $806.49 AETNA POS 20140601 — 235_AETNA POS 20140601: $927.63 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $645.19 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $103.05 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $112.08 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US PREG 2/3 TRIMST	$1,586.75	$571.23	$91.54 – $896.31
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $567.82 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $891.63 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $567.82 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $114.46 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $148.03 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $114.46 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $148.03 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $148.03 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB US >/= 14 WKS SNGL FETUS	$1,586.75	$571.23	$91.54 – $896.31
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $567.82 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $891.63 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $567.82 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $114.46 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $148.03 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $114.46 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $148.03 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $148.03 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG 2/3 TRIMST	$1,586.75	$571.23	$91.54 – $896.31
Pregnancy ultrasound (after the first trimester): 10 of 39 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $891.63 AETNA HMO — 4486_AETNA HMO 20250801: $896.31 AETNA POS 20140601 — 235_AETNA POS 20140601: $891.63 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $717.05 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $91.54 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $106.88 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $335.95
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRSVAG NONPREG	$738	$265.68	$88.30 – $706.39
Transvaginal ultrasound: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $541.47 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $541.47 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $114.46 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $119.29 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $114.46 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $119.29 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $119.29 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: EDUS NON-OB TRANSVAG	$738	$265.68	$88.30 – $706.39
Transvaginal ultrasound: 10 of 47 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $541.47 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $541.47 BCBS CHIP/CHIP PERINATE — 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46 BCBS CHIP/CHIP PERINATE — 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901: $114.46 BCBS STAR — 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901: $119.29 BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $114.46 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $119.29 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $119.29 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $349.61 DELL CHIP/CHIP PERINATE — 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901: $114.46
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRSVAG NONPREG	$738	$265.68	$88.30 – $706.39
Transvaginal ultrasound: 10 of 35 insurance plan rates AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $706.39 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $88.30 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $106.88 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $106.88 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.06 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $293.16 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $293.16 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $357.62
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM DIAG DIR DIG CON LT	$408	$146.88	$94.06 – $380.94
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $94.06 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $345.20 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $312.28 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $312.28 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $380.94 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $130.83 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $98.04 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $308.92 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $96.12 HUMANA HMO — 2668_HUMANA HMO 20230701: $159.44
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM DIAG DIR DIG CON RT	$408	$146.88	$94.06 – $380.94
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $94.06 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $345.20 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $312.28 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $312.28 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $380.94 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $130.83 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $98.04 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $308.92 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $96.12 HUMANA HMO — 2668_HUMANA HMO 20230701: $159.44
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM DIAG DIR DIG UNI LT	$408	$146.88	$94.06 – $380.94
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $94.06 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $345.20 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $312.28 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $312.28 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $380.94 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $130.83 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $98.04 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $308.92 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $96.12 HUMANA HMO — 2668_HUMANA HMO 20230701: $159.44
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAM DIAG DIR DIGITAL - BILAT	$526.25	$189.45	$120.37 – $487.50
Diagnostic mammogram, both breasts: rates for 10 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $120.37 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $441.76 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $399.63 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $399.63 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $487.50 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $164.95 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $125.24 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $395.41 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $122.76 HUMANA HMO — 2668_HUMANA HMO 20230701: $203.94
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAM DIAG DIR DIG BIL CON	$526.25	$189.45	$120.37 – $487.50
Diagnostic mammogram, both breasts: rates for 10 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $120.37 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $441.76 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $399.63 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $399.63 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $487.50 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $164.95 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $125.24 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $395.41 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $122.76 HUMANA HMO — 2668_HUMANA HMO 20230701: $203.94
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DIAG MAM DIR DIGITAL - BILAT	$526.25	$189.45	$120.37 – $487.50
Diagnostic mammogram, both breasts: rates for 10 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $120.37 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $441.76 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $399.63 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $399.63 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $487.50 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $164.95 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $125.24 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $395.41 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $122.76 HUMANA HMO — 2668_HUMANA HMO 20230701: $203.94
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAM SCRN DIR DIGITAL - BILAT	$482.50	$173.70	$44.79 – $402.85
Screening mammogram, both breasts: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $99.47 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $365.05 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $330.24 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $330.24 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $402.85 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $133.14 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $103.55 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $326.69 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $101.52 HUMANA HMO — 2668_HUMANA HMO 20230701: $168.58
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MOBILE MAM SCREEN DIGITAL	$535.50	$192.78	$44.79 – $402.85
Screening mammogram, both breasts: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $99.47 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $365.05 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $330.24 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $330.24 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $402.85 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $133.14 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $103.55 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $326.69 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $101.52 HUMANA HMO — 2668_HUMANA HMO 20230701: $168.58
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: SCRN MAM DIR DIGITAL - BILAT	$482.50	$173.70	$44.79 – $402.85
Screening mammogram, both breasts: 10 of 11 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $99.47 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $365.05 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $330.24 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $330.24 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $402.85 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $133.14 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $103.55 CIGNA HMO — 4476_CIGNA HMO (WIL,DEL) 20250701: $326.69 COMMUNITY HEALTH SERVICES — 2281_COMMUNITY HEALTH SERVICES Q32 20220901: $101.52 HUMANA HMO — 2668_HUMANA HMO 20230701: $168.58

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$16.50 – $81.48
Electrocardiogram (ECG/EKG) with reading: 10 of 19 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $32.87 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $73.70 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $66.78 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $66.78 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $81.48 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $16.50 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $17.32 TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $17.28 AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: 46% (a percentage in the contract, not a dollar amount) AETNA ACO PPO/HMO - CHI — 4483_AETNA ACO PPO/HMO (CHI,DCN) 20250801: 70% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: HRT-LHC (INC LV-NO CORS)	$13,725	$4,941	$610.21 – $13,357
Left heart catheterization (diagnostic): 10 of 26 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $12,169 AETNA ACO PPO — 3438_AETNA ACO PPO 20240701: $6,450.75 AETNA ACO PPO/HMO - CHI — 4483_AETNA ACO PPO/HMO (CHI,DCN) 20250801: $9,607.50 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $10,288 AETNA HMO - CHI — 4481_AETNA HMO (CHI,DCN) 20250801: $11,666.25 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $9,289 AETNA MULTI-TIER WHOLE HEALTH SHA — 4484_AETNA MULTI-TIER WHOLE HEALTH SHA (CHI,DCN) 20250801: $10,568.25 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $13,357 AETNA POS 20140601 — 235_AETNA POS 20140601: $10,288 AETNA PPO — 4460_AETNA PPO (EBD,SHL) 20250701: $11,254.50
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$610.21 – $14,841
Left heart catheterization (diagnostic): 10 of 30 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $12,169 AETNA ACO PPO — 3438_AETNA ACO PPO 20240701: $6,450.75 AETNA ACO PPO/HMO - CHI — 4483_AETNA ACO PPO/HMO (CHI,DCN) 20250801: $9,607.50 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $10,288 AETNA HMO — 4486_AETNA HMO 20250801: $14,841 AETNA HMO - CHI — 4481_AETNA HMO (CHI,DCN) 20250801: $11,666.25 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $9,289 AETNA MULTI-TIER WHOLE HEALTH SHA — 4484_AETNA MULTI-TIER WHOLE HEALTH SHA (CHI,DCN) 20250801: $10,568.25 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $13,357 AETNA POS 20140601 — 235_AETNA POS 20140601: $10,288
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$610.21 – $14,841
Left heart catheterization (diagnostic): rates for 1 insurance plan HUMANA EXCHANGE — 415_HUMANA EXCHANGE (CHI,DCN) 20160101: $3,531
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP EPS COMP W/O ATTEMPT IND	$29,197.50	$10,511.10	$4,538.98 – $24,425.70
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $14,456 AETNA HMO — 4486_AETNA HMO 20250801: $19,473 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $12,432 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $17,526 AETNA POS 20140601 — 235_AETNA POS 20140601: $14,456 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $14,559 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $10,064.56 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $22,071.41 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $20,011.41 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $20,011.41
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$4,538.98 – $24,425.70
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $15,968 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $14,456 AETNA HMO — 4486_AETNA HMO 20250801: $19,473 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $12,432 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $17,526 AETNA POS 20140601 — 235_AETNA POS 20140601: $14,456 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $14,559 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $10,064.56 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $22,071.41 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $20,011.41
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: HEART EPS-ABLATE AFIB	$73,971.50	$26,629.74	$1,126.05 – $30,569
Heart rhythm study with ablation for atrial fibrillation: 10 of 18 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $16,328 AETNA HMO — 4486_AETNA HMO 20250801: $22,433 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $20,190 AETNA POS 20140601 — 235_AETNA POS 20140601: $16,328 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $16,770 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $14,713.39 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $21,048.33 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $19,617.86 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $19,617.86 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $23,909.27
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$1,126.05 – $30,569
Heart rhythm study with ablation for atrial fibrillation: 10 of 24 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $18,394 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $16,328 AETNA HMO — 4486_AETNA HMO 20250801: $22,433 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $14,041 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $20,190 AETNA POS 20140601 — 235_AETNA POS 20140601: $16,328 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $16,770 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $14,713.39 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $21,048.33 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $19,617.86
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$524.25 – $2,078.90
Sleep study (overnight, in a sleep lab): 10 of 43 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $966.23 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $985.95 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $985.95 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $856.61 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,878.53 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $1,703.20 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $1,703.20 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,078.90 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $602.98 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $524.25
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$966.23 – $1,774.71
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $966.23 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $985.95 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $985.95 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $985.95 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $1,015.53 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $985.95 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $985.95 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $985.95 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $985.95 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $985.95

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) In the file: EXERCISE PER 15	$159	$57.24	$30.31 – $144.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $144.05 AETNA HMO — 4486_AETNA HMO 20250801: $137.33 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $66.13 AETNA POS 20140601 — 235_AETNA POS 20140601: $144.05 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $110.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $53.61 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $117.56 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $106.59 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $106.59 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $130.10
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: BTE TRNG PER 15	$159	$57.24	$30.31 – $144.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $144.05 AETNA HMO — 4486_AETNA HMO 20250801: $137.33 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $66.13 AETNA POS 20140601 — 235_AETNA POS 20140601: $144.05 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $110.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $53.61 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $117.56 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $106.59 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $106.59 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $130.10
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: ISOKIN TRNG PER 15	$159	$57.24	$30.31 – $144.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $144.05 AETNA HMO — 4486_AETNA HMO 20250801: $137.33 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $66.13 AETNA POS 20140601 — 235_AETNA POS 20140601: $144.05 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $110.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $53.61 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $117.56 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $106.59 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $106.59 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $130.10
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVALUATION LOW 1 15M	$286.25	$103.05	$83.55 – $180.42
Physical therapy evaluation (low complexity): rates for 4 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVALUATION LOW 2 30M	$286.25	$103.05	$83.55 – $180.42
Physical therapy evaluation (low complexity): rates for 4 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVALUATION LOW 3 45M	$286.25	$103.05	$83.55 – $180.42
Physical therapy evaluation (low complexity): rates for 4 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVALUATION MOD 3 45M	$334	$120.24	$83.55 – $324.34
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVALUATION MOD 4 60M	$334	$120.24	$83.55 – $324.34
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVALUATION MOD 5 75M	$334	$120.24	$83.55 – $324.34
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVALUATION HIGH 4 60M	$381.50	$137.34	$83.55 – $370.64
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $370.64 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $358.93 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVALUATION HIGH 5 75M	$381.50	$137.34	$83.55 – $370.64
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $370.64 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $358.93 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVALUATION HIGH 6 90M	$381.50	$137.34	$83.55 – $370.64
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $165.10 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $370.64 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $147.90 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $324.34 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $294.07 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $294.07 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $358.93 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $86.08
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 30 minutes: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $152.60 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $155.71 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $155.71 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $160.38 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $155.71 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $155.71 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $155.71 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $155.71
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 30 minutes: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $152.60 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $155.71 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $62.59 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $63.43 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $160.38 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $155.71 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $155.71 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $155.71
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 45 minutes: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $152.60 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $155.71 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $155.71 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $160.38 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $155.71 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $155.71 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $155.71 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $155.71
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 45 minutes: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $152.60 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $155.71 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $83.55 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $84.54 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $160.38 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $155.71 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $155.71 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $155.71
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 60 minutes: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $152.60 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $155.71 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $155.71 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $160.38 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $155.71 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $155.71 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $155.71 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $155.71
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$152.60 – $280.28
Psychotherapy, 60 minutes: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $152.60 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $155.71 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $125.47 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $127.13 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $160.38 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $155.71 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $155.71 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $155.71
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$152.60 – $280.28
Family psychotherapy, without the patient: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $152.60 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $155.71 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $155.71 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $160.38 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $155.71 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $155.71 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $155.71 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $155.71
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$152.60 – $280.28
Family psychotherapy, without the patient: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $152.60 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $155.71 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $101.24 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $102.42 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $160.38 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $155.71 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $155.71 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $155.71
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$152.60 – $280.28
Family psychotherapy, with the patient: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $152.60 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $155.71 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $155.71 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $160.38 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $155.71 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $155.71 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $155.71 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $155.71
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$152.60 – $280.28
Family psychotherapy, with the patient: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $152.60 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $155.71 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $155.71 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $105.19 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $106.76 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $160.38 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $155.71 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $155.71 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $155.71 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $155.71
Group psychotherapy CPT 90853 · Inpatient (hospital stay) In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$87.85 – $161.35
Group psychotherapy: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $87.85 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $89.64 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $89.64 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $89.64 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $92.33 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $89.64 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $89.64 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $89.64 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $89.64 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $89.64
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$87.85 – $161.35
Group psychotherapy: 10 of 23 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $87.85 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $89.64 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $89.64 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $24.88 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $25.09 CONNECTED SENIOR CARE — 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 202: $92.33 COVID HRSA — 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811: $89.64 DEVOTED HEALTH MCR REPLACEMENT — 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811: $89.64 HUMANA MCR REPLACEMENT — 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV: $89.64 MEDICARE REPLACEMENT — 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811: $89.64

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$409.12 – $3,544.57
Removal of breast growth (open surgery): 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $2,181.28 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $963.66 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $963.66 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $963.66 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $963.66 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $3,120.44 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,908.37 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,908.37 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $3,544.57 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $963.66
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$409.12 – $3,544.57
Removal of breast growth (open surgery): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$969.15 – $14,153
Total hip replacement: 10 of 12 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $8,568.51 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $12,257.73 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $11,424.68 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $11,424.68 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $13,923.83 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $1,347.10 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $1,384.22 HUMANA EXCHANGE — 387_HUMANA EXCHANGE 20160101: $6,640 HUMANA HMO — 2668_HUMANA HMO 20230701: $9,036 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$969.15 – $14,153
Total hip replacement: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$969.15 – $14,153
Total knee replacement: 10 of 12 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $8,568.51 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $12,257.73 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $11,424.68 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $11,424.68 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $13,923.83 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $1,346.42 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $1,382.85 HUMANA EXCHANGE — 387_HUMANA EXCHANGE 20160101: $6,640 HUMANA HMO — 2668_HUMANA HMO 20230701: $9,036 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$969.15 – $14,153
Total knee replacement: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$175.13 – $1,549
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $175.13 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $179.10 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15 TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $1,549
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$175.13 – $1,549
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$535.09 – $3,202.82
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,970.96 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $1,088.27 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $1,088.27 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $1,088.27 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $1,088.27 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,819.57 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,627.95 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,627.95 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $3,202.82 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $1,088.27
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$535.09 – $3,202.82
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$286.93 – $5,675.12
Removal of tonsils and adenoids (under age 12): 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $3,492.38 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $1,954.22 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $1,954.22 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $1,954.22 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $1,954.22 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $4,996.05 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $4,656.51 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $4,656.51 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $5,675.12 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $1,954.22
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$286.93 – $5,675.12
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$890.42 – $1,635.46
Upper GI endoscopy (diagnostic): 10 of 61 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $890.42 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $908.59 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $908.59 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $565.86 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $334.95 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $809.50 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $754.48
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$890.42 – $1,635.46
Upper GI endoscopy (diagnostic): 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $890.42 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $908.59 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $908.59 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $908.59 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $935.85 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $908.59 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $908.59 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $908.59 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $908.59 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $908.59
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$124.26 – $1,000
Upper GI endoscopy (diagnostic): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$890.42 – $1,635.46
Upper GI endoscopy with biopsy: 10 of 61 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $890.42 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $908.59 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $908.59 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $565.86 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $334.95 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $334.95 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $809.50 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $754.48
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$890.42 – $1,635.46
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $890.42 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $908.59 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $908.59 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $908.59 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $935.85 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $908.59 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $908.59 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $908.59 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $908.59 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $908.59
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$140.61 – $1,000
Upper GI endoscopy with biopsy: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$865.87 – $1,590.37
Colonoscopy (diagnostic): 10 of 61 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $865.87 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $883.54 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $883.54 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $549.99 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $328.50 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $328.50 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $328.50 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $328.50 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $786.80 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $733.32
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$865.87 – $1,590.37
Colonoscopy (diagnostic): 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $865.87 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $883.54 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $883.54 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $883.54 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $910.05 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $883.54 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $883.54 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $883.54 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $883.54 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $883.54
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$187.81 – $1,000
Colonoscopy (diagnostic): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$203.98 – $1,174.94
Colonoscopy with biopsy: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $723.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $429.26 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,034.35 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $964.05 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $964.05 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $1,174.94 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $429.26
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$203.98 – $1,174.94
Colonoscopy with biopsy: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$258.93 – $1,174.94
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $723.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $429.26 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,034.35 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $964.05 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $964.05 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $1,174.94 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $429.26
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$258.93 – $1,174.94
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$262.58 – $1,174.94
Ultrasound of the lower bowel by endoscope: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $723.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $429.26 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $429.26 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,034.35 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $964.05 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $964.05 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $1,174.94 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $429.26
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$262.58 – $1,174.94
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$655.46 – $19,004
Gallbladder removal by laparoscope: 10 of 57 insurance plan rates AETNA ACO HMO — 4489_AETNA ACO HMO 20250801: $5,421 AETNA CHOICE — 236_AETNA ELECT CHOICE 20140601: $4,582 AETNA HMO — 4486_AETNA HMO 20250801: $6,612 AETNA HMO EXCHANGE — 1377_AETNA HMO EXCHANGE 20200101: $4,138 AETNA MULTI-TIER WHOLE HEALTH SHA — 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801: $5,950 AETNA POS 20140601 — 235_AETNA POS 20140601: $7,708 AETNA SHA AISD — 4335_AETNA SHA AISD 20250101: $4,943 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $3,480.27 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $1,888.85 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $1,888.85
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$655.46 – $19,004
Gallbladder removal by laparoscope: rates for 2 insurance plans HUMANA EXCHANGE — 415_HUMANA EXCHANGE (CHI,DCN) 20160101: $5,556 OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$517.65 – $3,637.93
Groin (inguinal) hernia repair, age 5 or older: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $2,238.72 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $1,151.54 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $1,151.54 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $1,151.54 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $1,151.54 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $3,202.62 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,984.97 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,984.97 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $3,637.93 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $1,151.54
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$517.65 – $3,637.93
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$131.65 – $2,072.71
Prostate biopsy: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,275.52 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $652.80 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $652.80 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $652.80 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $652.80 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,824.70 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $1,700.69 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $1,700.69 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,072.71 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $652.80
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$131.65 – $2,072.71
Prostate biopsy: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$969.15 – $9,843.34
Prostate removal by laparoscope (radical prostatectomy): rates for 8 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6,057.44 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $8,665.50 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $8,076.59 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $8,076.59 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $9,843.34 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $1,457.09 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $1,489.79 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$969.15 – $9,843.34
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$230.83 – $2,922.78
Hysteroscopy with biopsy of the uterus lining: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,798.63 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $1,063.52 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $1,063.52 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $1,063.52 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $1,063.52 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,573.04 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,398.18 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,398.18 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,922.78 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $1,063.52
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$230.83 – $2,922.78
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: PAIN EPIDRL INJ L/S W IMG	$3,069.25	$1,104.93	$99.21 – $969.15
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $450.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $262.86 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $643.80 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $600.05 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $600.05 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $731.31 BCBS STAR KIDS — 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $262.86
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: PAIN EPIDRL INJ L/S W IMG	$3,069.25	$1,104.93	$99.21 – $969.15
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates BCBS STAR — 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901: $193.54 BCBS STAR — 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201: $193.54 DELL CHIP/CHIP PERINATE — 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901: $193.54 DELL CHIP/CHIP PERINATE — 4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $193.54 DELL STAR — 3708_CHIRP DELL STAR (NW) INPATIENT 20240901: $203.73 DELL STAR — 4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201: $203.73 UHC STAR — 3741_CHIRP UHC STAR (NW) INPATIENT 20240901: $203.73 UHC STAR — 4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201: $203.73 UHC STAR KIDS — 4315_UHC STAR KIDS (NW) OUTPATIENT 20241201: $203.73 UHC STAR KIDS — 4326_UHC STAR KIDS (NW) INPATIENT 20240901: $203.73
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$99.21 – $1,675.78
Spinal injection, lower back (epidural), with imaging guidance: 10 of 51 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $657.70 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $671.12 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $671.12 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $450.04 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $262.86 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $262.86 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $643.80 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $600.05
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$845.52 – $1,553
Nerve root injection, lower back, with imaging guidance: 10 of 61 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $845.52 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $862.78 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $862.78 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $584.68 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $340.77 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $340.77 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $340.77 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $340.77 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $836.41 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $779.57
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$845.52 – $1,553
Nerve root injection, lower back, with imaging guidance: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $845.52 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $862.78 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $862.78 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $862.78 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $888.66 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $862.78 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $862.78 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $862.78 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $862.78 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $862.78
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$111.31 – $1,000
Nerve root injection, lower back, with imaging guidance: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$422.46 – $2,011.64
Carpal tunnel release: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,237.93 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $659.94 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $659.94 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $659.94 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $659.94 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $1,770.93 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $1,650.58 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $1,650.58 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,011.64 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $659.94
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$422.46 – $2,011.64
Carpal tunnel release: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$521.02 – $956.97
Laser treatment of clouding after cataract surgery: 10 of 61 insurance plan rates AARP MC WELLMED — 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,H: $521.02 ADDR CANCER TOGETHER — 4747_ADDR CANCER TOGETHER OUTPATIENT 20250811: $531.65 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 202508: $531.65 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $364.99 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $208.33 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $208.33 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $208.33 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $208.33 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $522.14 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $486.65
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$521.02 – $956.97
Laser treatment of clouding after cataract surgery: 10 of 24 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $521.02 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $531.65 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $531.65 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $531.65 CONNECTED SENIOR CARE — 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 2025: $547.60 COVID HRSA — 4693_COVID HRSA UNIN Q80 INPATIENT 20251001: $531.65 CSHCN CIDC — 4694_CSHCN CIDC IP (ADULT) 20251001: $531.65 DEVOTED HEALTH MCR REPLACEMENT — 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001: $531.65 HUMANA MCR REPLACEMENT — 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 202: $531.65 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $531.65
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$208.33 – $1,000
Laser treatment of clouding after cataract surgery: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$629.86 – $2,365.58
Cataract removal with lens implant: 10 of 41 insurance plan rates BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,455.74 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201: $849.94 BCBS CHIP/CHIP PERINATE — 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201: $849.94 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201: $849.94 BCBS CHIP/CHIP PERINATE — 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201: $849.94 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,082.52 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $1,940.99 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $1,940.99 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,365.58 BCBS STAR — 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201: $849.94
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$629.86 – $2,365.58
Cataract removal with lens implant: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$969.15 – $2,548.07
Vaginal delivery, with care before and after: rates for 8 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,568.04 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,243.18 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,090.73 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,090.73 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,548.07 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $2,075.42 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $2,102.92 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$969.15 – $2,548.07
Vaginal delivery, with care before and after: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$969.15 – $2,825.11
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,738.53 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,487.06 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,318.04 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,318.04 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,825.11 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $2,297.98 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $2,327.15 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$969.15 – $2,825.11
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$969.15 – $2,673.73
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $1,645.37 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $2,353.80 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $2,193.83 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $2,193.83 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $2,673.73 CHAMPVA — 1135_CHAMPVA REST_TX 20180301: $2,175.99 CHAMPVA — 1136_CHAMPVA AUSTIN 20180301: $2,208 HUMANA HMO CUST — 206_HUMANA HMO CUSTOM 20140201: $969.15
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$969.15 – $2,673.73
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan OSCAR HEALTH EXCHANGE — 4511_OSCAR HEALTH PLAN 20251001: $1,000

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) 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	$60,821.99 – $111,713.87
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 47 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $60,821.99 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $62,063.26 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $62,063.26 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $62,063.26 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6,318 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $7,532 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $6,862 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $6,862 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $8,368 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $6,863
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient or outpatient 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	$4,937 – $112,179
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 3 insurance plans HUMANA EXCHANGE — 415_HUMANA EXCHANGE (CHI,DCN) 20160101: $57,489 SUPERIOR CHIP/CHIP PERINATE — 3619_SUPERIOR CHIP INPATIENT 20240901: $37,800 TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $56,632.91
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) 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	$11,992.43 – $22,026.91
Hip or knee replacement (major joint of the leg), without major complications: 10 of 46 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $11,992.43 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $12,237.17 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $12,237.17 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $12,237.17 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6,318 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $7,532 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $6,862 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $6,862 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $8,368 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $6,863
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient or outpatient 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	$4,701 – $13,993
Hip or knee replacement (major joint of the leg), without major complications: rates for 3 insurance plans HUMANA EXCHANGE — 415_HUMANA EXCHANGE (CHI,DCN) 20160101: $4,701 MEDICARE OON — 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001: $6,150 TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $12,180.64
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$15,178.14 – $27,878.22
Neck (cervical) spinal fusion, without complications: 10 of 47 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $15,178.14 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $15,487.90 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $15,487.90 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $15,487.90 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6,318 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $7,532 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $6,862 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $6,862 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $8,368 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $6,863
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient or outpatient In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,701 – $15,398.85
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans HUMANA EXCHANGE — 415_HUMANA EXCHANGE (CHI,DCN) 20160101: $4,701 TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $13,086.73
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$7,713.73 – $14,168.07
Uterus and ovary surgery (not for cancer), without complications: 10 of 36 insurance plan rates AARP MC WELLMED — 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HA: $7,713.73 ADDR CANCER TOGETHER — 4681_ADDR CANCER TOGETHER INPATIENT 20251001: $7,871.15 AETNA MCR REPLACEMENT — 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $7,871.15 ASCENSION COMPLETE MEDICARE REPLACEMENT — 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 2025100: $7,871.15 BCBS BAV EXCHANGE — 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101: $6,318 BCBS HMO ESSENTIALS — 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101: $7,532 BCBS HPN — 4440_BLUE CROSS BLUE SHIELD HPN 20250501: $6,862 BCBS HPN — 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 2025: $6,862 BCBS PPO — 4094_BLUE CROSS BLUE SHIELD PPO 20250101: $8,368 CIGNA HMO — 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701: $6,863
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient or outpatient In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,937 – $9,379
Uterus and ovary surgery (not for cancer), without complications: rates for 1 insurance plan TRICARE — 1229_TRICARE CAH OUTPATIENT 20170101: $6,838.86

Source: Ascension Seton Northwest’s standard charges file (healthcare.ascension.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 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	11113 Research Boulevard, Austin, TX 78759
County	Travis County
State	Texas
Phone	(512) 324‑6000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	450867
Name in Medicare records	ASCENSION SETON NORTHWEST
Profile level	Medicare data + hospital website
Name on the hospital’s website	Ascension Seton Northwest Hospital
Official website	healthcare.ascension.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
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.

Ascension Seton Northwest Hospital — healthcare.ascension.org

Ascension Seton Northwest

Summary

Profile from official sources

At a glance