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Acute Care Hospital

Ascension St Vincent's Southside

Jacksonville, Florida · Duval County · Emergency services listed

Summary

Ascension St Vincent's Southside is an acute care hospital in Jacksonville, Florida. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 20 services, specialties and programs. Medicare lists 559 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(904) 296‑3700 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
559Doctors and clinicians
20Services listed

Quick answers

Does Ascension St Vincent's Southside have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Ascension St Vincent's Southside. In a medical emergency, call 911.
Where is Ascension St Vincent's Southside?
4201 Belfort Rd, Jacksonville, FL 32216, in Duval County, Florida.
What is the phone number of Ascension St Vincent's Southside?
(904) 296-3700, as listed by Medicare (CMS).
What is the Medicare star rating of Ascension St Vincent's Southside?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4]

Treatments[4]

  • Outpatient infusion

Procedures[4]

Programs and centers[4]

  • Maternal Care Telehealth Program
  • Cribs for Kids Gold Certified Safe Sleep Hospital

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingVisitors encouraged 6 a.m.-8:30 p.m.; two at a time; one adult may stay overnight; extra rules in NICU, PICU, ER, L&D, surgery[5]
Interpreters and languagesLanguage assistance offered (Spanish, Arabic, Polish, Haitian Creole, Vietnamese and others listed)[4]
Patient portalAscension One

Recognition[4]

  • Baby-Friendly Hospital designation
  • Joint Commission Level II Maternal Care Verified
  • Get With The Guidelines Stroke Bronze (AHA)
  • Leapfrog Group A Hospital Safety Grade (Spring 2025)

Doctors and clinicians (559)

559 doctors and other clinicians list Ascension St Vincent's Southside 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 (559)

And 535 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

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 St Vincent's Southside 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) 2 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines1 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night3 of 5 stars
Rated the hospital 9 or 10 out of 1068%National average: 72%
Would definitely recommend the hospital66%National average: 71%
Nurses “always” communicated well76%National average: 80%
Doctors “always” communicated well75%National average: 80%
Staff “always” explained medicines before giving them55%National average: 62%
Were given information about recovery at home84%National average: 86%
Room and bathroom “always” clean65%National average: 74%
Area around the room “always” quiet at night54%National average: 60%
Completed surveys414Response rate: 12%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.926No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.282No different from the national benchmark
Surgical site infections after colon surgery0.719No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.198Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients11.3%
Deaths within 30 days: heart failure patients11.6%
Deaths within 30 days: pneumonia patients16.7%
Deaths within 30 days: COPD patients8.6%
Deaths within 30 days: stroke patients12.2%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.94No different from the national rate
Complications after hip or knee replacement3.5%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.3%
Readmitted within 30 days: heart failure21.3%
Readmitted within 30 days: pneumonia17.2%
Readmitted within 30 days: COPD19.1%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement5.4%

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

Emergency room times and sepsis care

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

Average (median) time patients spent in the emergency room before leaving (OP-18b)126 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)77%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in JacksonvilleBest hospitals in Jacksonville

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 St Vincent's Southside lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL III $366.75 $135.70 $270.75 – $458.44
New patient office visit (about 30–44 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $270.75
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $270.75
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL III $366.75 $135.70 $270.75 – $458.44
New patient office visit (about 30–44 minutes): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $458.44
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 $270.75 – $458.44
New patient office visit (about 30–44 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $270.75
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $270.75
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL IV $503 $186.11 $406.73 – $628.75
New patient office visit (about 45–59 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $406.73
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $406.73
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL IV $503 $186.11 $406.73 – $628.75
New patient office visit (about 45–59 minutes): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $628.75
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: SPOC OFFICE VISIT NEW PT LEVEL IV $169.75 $62.81 $212.19
New patient office visit (about 45–59 minutes): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $212.19
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL V $847.75 $313.67 $538.48 – $1,059.69
New patient office visit (about 60–74 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $538.48
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $538.48
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL V $847.75 $313.67 $538.48 – $1,059.69
New patient office visit (about 60–74 minutes): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $1,059.69
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 $538.48 – $1,059.69
New patient office visit (about 60–74 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $538.48
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $538.48
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE VISIT EST PT LEVEL III $314 $116.18 $219.60 – $392.50
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $219.60
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $219.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: L&D OB TRIAGE LEVEL 3 $415.25 $153.64 $219.60 – $519.06
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $219.60
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $219.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OBOP OB TRIAGE LEVEL 3 $415.25 $153.64 $219.60 – $519.06
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $219.60
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $219.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE VISIT EST PT LEVEL IV $317 $117.29 $309.88 – $396.25
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $309.88
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $309.88
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OBOP OB TRIAGE LEVEL 4 $419.25 $155.12 $309.88 – $524.06
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $309.88
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $309.88
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: OFFICE VISIT EST PT LEVEL IV $317 $117.29 $309.88 – $396.25
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $396.25
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) In the file: OP OFFICE CONSULT LEVEL III $210 $77.70 $262.50
Office consultation with a specialist (moderate): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $262.50
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 $262.50 – $270.78
Office consultation with a specialist (moderate): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $270.78
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $270.78
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) In the file: OFF/OP CNSLTJ NEW/EST LOW 30 Not listed in the file Not listed in the file $262.50 – $270.78
Office consultation with a specialist (moderate): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $262.50
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) In the file: OP OFFICE CONSULT LEVEL IV $241 $89.17 $301.25
Office consultation with a specialist (moderate to high): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $301.25
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 $301.25 – $385.50
Office consultation with a specialist (moderate to high): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $385.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $385.50
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) In the file: OFF/OP CNSLTJ NEW/EST MOD 40 Not listed in the file Not listed in the file $301.25 – $385.50
Office consultation with a specialist (moderate to high): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $301.25
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 $311.30
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $311.30
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $311.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) In the file: PREV VISIT NEW AGE 18-39 Not listed in the file Not listed in the file $311.30
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
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 $359
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $359
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $359
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) In the file: PREV VISIT NEW AGE 40-64 Not listed in the file Not listed in the file $359
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED LEVEL 3 EMERG CARE SEP EVAL $3,565 $1,319.05 $427 – $4,456.25
Emergency room visit (moderate): 10 of 15 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $1,376
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $427
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $563
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $427
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $640
  • BLUE CROSS PHS — 1457_BLUE CROSS BLUE SHIELD PHS 20250701: $1,204
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $856
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $563
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $3,266
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $1,686
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED OB LEVEL 3 EMERG CARE SEP EVAL $3,565 $1,319.05 $427 – $4,456.25
Emergency room visit (moderate): 10 of 15 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $1,376
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $427
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $563
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $427
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $640
  • BLUE CROSS PHS — 1457_BLUE CROSS BLUE SHIELD PHS 20250701: $1,204
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $856
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $563
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $3,266
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $1,686
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED LEVEL 3 EMERGENCY CARE $3,565 $1,319.05 $427 – $4,456.25
Emergency room visit (moderate): 10 of 14 insurance plan rates
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $427
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $563
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $427
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $640
  • BLUE CROSS PHS — 1457_BLUE CROSS BLUE SHIELD PHS 20250701: $1,204
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $856
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $563
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $3,266
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $1,686
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $3,266
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED LEVEL 4 EMERG CARE SEP EVAL $3,588 $1,327.56 $934 – $4,485
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $1,834
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,327
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED OB LEVEL 4 EMERG CARE SEP EVAL $3,588 $1,327.56 $934 – $4,485
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $1,834
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,327
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED LEVEL 4 EMERGENCY CARE $3,588 $1,327.56 $934 – $4,485
Emergency room visit (moderately high): rates for 10 insurance plans
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,327
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
  • UHC — 1460_UNITED HEALTH CARE 20250701: $2,956
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED LEVEL 5 EMERG CARE SEP EVAL $3,771.50 $1,395.46 $934 – $4,714.38
Emergency room visit (high): 10 of 11 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $2,292
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,801
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED OB LEVEL 5 EMERG CARE SEP EVAL $3,771.50 $1,395.46 $934 – $4,714.38
Emergency room visit (high): 10 of 11 insurance plan rates
  • AETNA — 1447_AETNA SOUTH 20250701: $2,292
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,801
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED LEVEL 5 EMERGENCY CARE $3,771.50 $1,395.46 $934 – $4,714.38
Emergency room visit (high): rates for 10 insurance plans
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $1,465
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $1,800
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $1,465
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $2,295
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $2,785
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $1,800
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $2,801
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $934
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $934
  • UHC — 1460_UNITED HEALTH CARE 20250701: $3,270

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PROF 2000 $193.25 $71.50 $7.45 – $193.25
Basic metabolic panel (blood test): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $7.45
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $21.15
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $21.15
  • UHC — 1460_UNITED HEALTH CARE 20250701: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PROF 2000 $193.25 $71.50 $7.45 – $193.25
Basic metabolic panel (blood test): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $71.50
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $38.65
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $71.50
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: BASIC METABOLIC PROF 2000 $193.25 $71.50 $7.45 – $193.25
Basic metabolic panel (blood test): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $193.25
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL 2000 $330.75 $122.38 $9.29 – $330.75
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $9.29
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $26.40
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $26.40
  • UHC — 1460_UNITED HEALTH CARE 20250701: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMP METABOLIC PANEL 2000 $330.75 $122.38 $9.29 – $330.75
Comprehensive metabolic panel (blood test): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $122.38
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $66.15
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $122.38
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: COMP METABOLIC PANEL 2000 $330.75 $122.38 $9.29 – $330.75
Comprehensive metabolic panel (blood test): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $330.75
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 $45.90 – $107.57
Obstetric blood test panel: 10 of 34 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $86.06
  • AETNA — 1447_AETNA SOUTH 20250701: $42.07
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $49.24
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $98.01
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $74.11
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $74.11
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $90.84
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $86.06
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $47.81
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: OBSTETRIC PANEL Not listed in the file Not listed in the file $42.07 – $119.53
Obstetric blood test panel: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $86.06
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $49.24
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $98.01
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $74.11
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $74.11
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $90.84
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $86.06
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $47.81
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $47.81
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $64.54
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: OBSTETRIC PANEL Not listed in the file Not listed in the file $42.07 – $119.53
Obstetric blood test panel: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: 37% (a percentage in the contract, not a dollar amount)
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: 20% (a percentage in the contract, not a dollar amount)
  • CIGNA PPO — 1464_CIGNA PPO 20250701: 37% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PROFILE-TOTAL 80061 $424.25 $156.97 $11.78 – $424.25
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $11.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $33.48
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $33.48
  • UHC — 1460_UNITED HEALTH CARE 20250701: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PROFILE $424.25 $156.97 $11.78 – $424.25
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $11.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $33.48
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $33.48
  • UHC — 1460_UNITED HEALTH CARE 20250701: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PROFILE-TOTAL 80061 $424.25 $156.97 $11.78 – $424.25
Cholesterol panel (lipid panel): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $156.97
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $84.85
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $156.97
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL 2000 $210 $77.70 $7.64 – $210
Kidney function panel: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $7.64
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $21.70
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $21.70
  • UHC — 1460_UNITED HEALTH CARE 20250701: $8.68
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL 2000 $210 $77.70 $7.64 – $210
Kidney function panel: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $77.70
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $42
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $77.70
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: RENAL FUNCTION PANEL 2000 $210 $77.70 $7.64 – $210
Kidney function panel: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $210
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC PANEL 2000 $135.50 $50.14 $7.19 – $135.50
Liver function panel: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $7.19
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $20.43
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $20.43
  • UHC — 1460_UNITED HEALTH CARE 20250701: $8.17
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC PANEL 2000 $135.50 $50.14 $7.19 – $135.50
Liver function panel: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $50.13
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $27.10
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $50.13
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HEPATIC PANEL 2000 $135.50 $50.14 $7.19 – $135.50
Liver function panel: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $135.50
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS ROUT W/MICROSCOPIC $60 $22.20 $2.79 – $60
Urine test (automated, with microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $2.79
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $7.93
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $7.93
  • UHC — 1460_UNITED HEALTH CARE 20250701: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS ROUT W/MICROSCOPIC $60 $22.20 $2.79 – $60
Urine test (automated, with microscope): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $22.20
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $12
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $22.20
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: URINALYSIS ROUT W/MICROSCOPIC $60 $22.20 $2.79 – $60
Urine test (automated, with microscope): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA NONAUTO W/0 SCOPE 81002 $13.25 $4.90 $2.65 – $13.25
Urine test (manual, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.06
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $8.70
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $8.70
  • UHC — 1460_UNITED HEALTH CARE 20250701: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: ED OB URINALYSIS DIP STICK $13.25 $4.90 $2.65 – $13.25
Urine test (manual, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.06
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $8.70
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $8.70
  • UHC — 1460_UNITED HEALTH CARE 20250701: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA REDUCING SUB NON-AU WO MICR $13.25 $4.90 $2.65 – $13.25
Urine test (manual, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.06
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $8.70
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $8.70
  • UHC — 1460_UNITED HEALTH CARE 20250701: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: URINALYSIS AUTOMATED W/O MICRO $28.25 $10.45 $1.98 – $28.25
Urine test (automated, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1.98
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $5.63
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $5.63
  • UHC — 1460_UNITED HEALTH CARE 20250701: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA MACROSCOPIC AUTO WO MICRO $28.25 $10.45 $1.98 – $28.25
Urine test (automated, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1.98
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $5.63
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $5.63
  • UHC — 1460_UNITED HEALTH CARE 20250701: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA COMPONENT PH AUTO WO MICRO $28.25 $10.45 $1.98 – $28.25
Urine test (automated, without microscope): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1.98
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $5.63
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $5.63
  • UHC — 1460_UNITED HEALTH CARE 20250701: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PROSTATE SPECIFIC ANTIGEN $34.25 $12.67 $6.85 – $34.25
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $12.67
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $6.85
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $12.67
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: REF PSA TOTAL-A $6 $2.22 $1.20 – $6
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $2.22
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $1.20
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $2.22
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROSTATE SPECIFIC ANTIGEN $34.25 $12.67 $6.85 – $34.25
PSA (prostate specific antigen) blood test: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $16.18
  • UHC — 1460_UNITED HEALTH CARE 20250701: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HTSH II ULTRASENSITIVE $97.75 $36.17 $14.78 – $97.75
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $14.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $42
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $42
  • UHC — 1460_UNITED HEALTH CARE 20250701: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ULTRASENSITIVE TSH3 $97.75 $36.17 $14.78 – $97.75
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $14.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $42
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $42
  • UHC — 1460_UNITED HEALTH CARE 20250701: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH - ED FAST TSH $97.75 $36.17 $14.78 – $97.75
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $14.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $42
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $42
  • UHC — 1460_UNITED HEALTH CARE 20250701: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC W/DIFFERENTIAL 85025 $138.50 $51.25 $6.84 – $138.50
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $6.84
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $19.43
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $19.43
  • UHC — 1460_UNITED HEALTH CARE 20250701: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC W/DIFFERENTIAL $138.50 $51.25 $6.84 – $138.50
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $6.84
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $19.43
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $19.43
  • UHC — 1460_UNITED HEALTH CARE 20250701: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC W/DIFFERENTIAL 85025 $138.50 $51.25 $6.84 – $138.50
Complete blood count (CBC) with differential: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $51.24
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $27.70
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $51.24
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HEMOGRAM CBC 85027 $126 $46.62 $5.69 – $126
Complete blood count (CBC), automated: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5.69
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $16.18
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $16.18
  • UHC — 1460_UNITED HEALTH CARE 20250701: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC W/O DIFFERENTIAL $126 $46.62 $5.69 – $126
Complete blood count (CBC), automated: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5.69
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $16.18
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $16.18
  • UHC — 1460_UNITED HEALTH CARE 20250701: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM CBC 85027 $126 $46.62 $5.69 – $126
Complete blood count (CBC), automated: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $46.62
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $25.20
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $46.62
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME (PT) $58 $21.46 $3.78 – $58
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $10.73
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $10.73
  • UHC — 1460_UNITED HEALTH CARE 20250701: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME WITH INR $58 $21.46 $3.78 – $58
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $10.73
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $10.73
  • UHC — 1460_UNITED HEALTH CARE 20250701: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: REF FACTOR 2 INHIBIT PROTIME $45 $16.65 $3.78 – $45
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $3.78
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $10.73
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $10.73
  • UHC — 1460_UNITED HEALTH CARE 20250701: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PARTIAL THROMBOPLASTIN TIME PTT $131.25 $48.56 $5.29 – $131.25
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5.29
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $15.03
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $15.03
  • UHC — 1460_UNITED HEALTH CARE 20250701: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: REF THROMBOPLAST TM (PTT) (APC-P) $74 $27.38 $5.29 – $74
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5.29
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $15.03
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $15.03
  • UHC — 1460_UNITED HEALTH CARE 20250701: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: REF FAC IX PTT (S44096) $238 $88.06 $5.29 – $238
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5.29
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $15.03
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $15.03
  • UHC — 1460_UNITED HEALTH CARE 20250701: $6.01

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O CONTRAST $1,828.50 $676.55 $235.69 – $783
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $676.54
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $365.70
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $676.54
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONTRAST $1,828.50 $676.55 $235.69 – $783
CT scan of the head or brain, without contrast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • UHC — 1460_UNITED HEALTH CARE 20250701: $235.69
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 $102.47 – $240.16
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $218.82
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $165.45
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $165.45
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $192.13
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $106.74
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W/WO CONTRAST $1,681.75 $622.25 $336.35 – $1,111
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $622.25
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $336.35
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $622.25
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W/WO CONTRAST $1,681.75 $622.25 $336.35 – $1,111
MRI of the brain, before and after contrast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1,111
  • UHC — 1460_UNITED HEALTH CARE 20250701: $824.45
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN STEM W/O & W/DYE Not listed in the file Not listed in the file $344.14 – $806.58
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $645.26
  • AETNA — 1447_AETNA SOUTH 20250701: $1,111
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $369.23
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $734.88
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $555.64
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $555.64
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $681.11
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $645.26
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $358.48
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $358.48
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST 2 VIEWS $479.50 $177.42 $63.39 – $194.81
Chest X-ray, 2 views: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $177.41
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $95.90
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $177.41
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST 2 VIEW $383.50 $141.90 $76.70 – $141.90
Chest X-ray, 2 views: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $141.90
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $76.70
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $141.90
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST 2 VIEWS $479.50 $177.42 $63.39 – $194.81
Chest X-ray, 2 views: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $63.39
  • UHC — 1460_UNITED HEALTH CARE 20250701: $194.81
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR SPINE LUMBAR COMP 4+VIEWS $1,254 $463.98 $102.56 – $463.98
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $463.98
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $250.80
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $463.98
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR SPINE LUMBAR COMP W/OBLIQUES $1,003.25 $371.20 $200.65 – $371.20
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $371.20
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $200.65
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $371.20
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR SPINE LUMBAR COMP 4+VIEWS $1,254 $463.98 $102.56 – $463.98
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $102.56
  • UHC — 1460_UNITED HEALTH CARE 20250701: $235.69
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI SPINE LUMBAR W/O CONTRAST $3,071 $1,136.27 $525.31 – $1,136.27
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $1,136.27
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $614.20
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $1,136.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI SPINE LUMBAR W/O CONTRAST $3,071 $1,136.27 $525.31 – $1,136.27
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1,111
  • UHC — 1460_UNITED HEALTH CARE 20250701: $525.31
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 $232.92 – $545.92
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $436.73
  • AETNA — 1447_AETNA SOUTH 20250701: $1,111
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $249.91
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $497.39
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $376.08
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $376.08
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $461
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $436.73
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $242.63
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $242.63
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/CONTRAST $1,811.25 $670.16 $362.25 – $783
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $670.16
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $362.25
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $670.16
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST $1,811.25 $670.16 $362.25 – $783
CT scan of the pelvis, with contrast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • UHC — 1460_UNITED HEALTH CARE 20250701: $393.89
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/DYE Not listed in the file Not listed in the file $171.54 – $402.05
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $321.64
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $184.05
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $366.31
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $276.97
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $276.97
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $339.51
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $321.64
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $178.69
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $178.69
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOW EXT JOINT LT $1,595 $590.15 $319 – $1,111
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $590.15
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $319
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $590.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOW EXT JOINT RT $1,595 $590.15 $319 – $1,111
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $590.15
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $319
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $590.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOW EXT JOINT W/O LT $1,595 $590.15 $319 – $1,111
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $590.15
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $319
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $590.15
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PELV W/CONTRAST $1,873.25 $693.10 $374.65 – $824.45
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $693.10
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $374.65
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $693.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD/PELV W/CONTRAST $1,873.25 $693.10 $374.65 – $824.45
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • UHC — 1460_UNITED HEALTH CARE 20250701: $824.45
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 $344.14 – $806.58
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $645.26
  • AETNA — 1447_AETNA SOUTH 20250701: $783
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $369.23
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $734.88
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $555.64
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $555.64
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $681.11
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $645.26
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $358.48
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $358.48
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN COMPLETE $2,424.50 $897.07 $235.69 – $897.07
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $897.07
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $484.90
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $897.07
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $2,424.50 $897.07 $235.69 – $897.07
Ultrasound of the abdomen, complete: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $238.67
  • UHC — 1460_UNITED HEALTH CARE 20250701: $235.69
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 $102.47 – $240.16
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13
  • AETNA — 1447_AETNA SOUTH 20250701: $238.67
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $218.82
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $165.45
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $165.45
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $192.13
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $106.74
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB FETAL MATERNAL EVAL $667.75 $247.07 $133.55 – $262.37
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $247.07
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $133.55
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $247.07
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB FETAL MATERNAL EVAL $921.50 $340.96 $184.30 – $340.95
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $340.95
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $184.30
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $340.95
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: L&D US>/= 14WKS SNGL FETUS $921.50 $340.96 $184.30 – $340.95
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $340.95
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $184.30
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $340.95
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL $1,391 $514.67 $235.69 – $514.67
Transvaginal ultrasound: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $514.67
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $278.20
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $514.67
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL $1,391 $514.67 $235.69 – $514.67
Transvaginal ultrasound: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $257.21
  • UHC — 1460_UNITED HEALTH CARE 20250701: $235.69
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: TRANSVAGINAL US NON-OB Not listed in the file Not listed in the file $102.47 – $240.16
Transvaginal ultrasound: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13
  • AETNA — 1447_AETNA SOUTH 20250701: $257.21
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $218.82
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $165.45
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $165.45
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $192.13
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $106.74
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MA DX MAMMO UNILATERAL RT $815 $301.55 $163 – $301.55
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $301.55
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $163
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $301.55
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MA DX MAMMO UNILATERAL LT $815 $301.55 $163 – $301.55
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $301.55
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $163
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $301.55
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MA DX MAMMO UNILATERAL RT $815 $301.55 $163 – $301.55
Diagnostic mammogram, one breast: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $270.63
  • UHC — 1460_UNITED HEALTH CARE 20250701: $193.03
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MA DX MAMMO BILATERAL $821.50 $303.96 $164.30 – $344.86
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $303.95
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $164.30
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $303.95
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MA DX MAMMO BILATERAL $821.50 $303.96 $164.30 – $344.86
Diagnostic mammogram, both breasts: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $344.86
  • UHC — 1460_UNITED HEALTH CARE 20250701: $247.55
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DX MAMMO INCL CAD BI Not listed in the file Not listed in the file $98.11 – $229.95
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $183.96
  • AETNA — 1447_AETNA SOUTH 20250701: $344.86
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $105.27
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $209.51
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $158.41
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $158.41
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $194.18
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $183.96
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $102.20
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $102.20
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MA SCREEN MAMMO BILATERAL $776 $287.12 $155.20 – $287.12
Screening mammogram, both breasts: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $287.12
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $155.20
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $287.12
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MA SCREEN MAMMO RT $694.25 $256.87 $138.85 – $256.87
Screening mammogram, both breasts: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $256.87
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $138.85
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $256.87
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MA SCREEN MAMMO LT $694.25 $256.87 $138.85 – $256.87
Screening mammogram, both breasts: rates for 3 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $256.87
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $138.85
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $256.87

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance 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 $34.38 – $1,636
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $1,636
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $34.38
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $34.38
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) In the file: ELECTROCARDIOGRAM COMPLETE Not listed in the file Not listed in the file $34.38 – $1,636
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · modifier TC In the file: ELECTROCARDIOGRAM COMPLETE Not listed in the file Not listed in the file $34.38 – $1,636
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $34.38
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $34.38
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 $1,428.48 – $17,301
Left heart catheterization (diagnostic): rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $15,191
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $17,301
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $2,009.43
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $2,009.43
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: LEFT HRT CATH W/VENTRCLGRPHY Not listed in the file Not listed in the file $1,428.48 – $17,301
Left heart catheterization (diagnostic): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY Not listed in the file Not listed in the file $1,428.48 – $17,301
Left heart catheterization (diagnostic): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $1,428.48
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $1,428.48
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 $16,849.98 – $34,348
Heart rhythm study (electrophysiology evaluation): rates for 9 insurance plans
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $25,736
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $27,140
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $25,736
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $28,637
  • BLUE CROSS PHS — 1457_BLUE CROSS BLUE SHIELD PHS 20250701: $34,007
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $34,348
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $27,140
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $17,789.05
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $17,789.05
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: COMPREHENSIVE EP EVALUATION Not listed in the file Not listed in the file $16,849.98 – $34,348
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · modifier TC In the file: COMPREHENSIVE EP EVALUATION Not listed in the file Not listed in the file $16,849.98 – $34,348
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $16,849.98
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $16,849.98
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 $2,351.98 – $39,982
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans
  • BLUE CROSS BSL — 1454_BLUE CROSS BLUE SHIELD BSL 20250701: $25,736
  • BLUE CROSS HMO — 1455_BLUE CROSS BLUE SHIELD HMO 20250701: $27,140
  • BLUE CROSS MBN — 1461_BLUE CROSS BLUE SHIELD MBN 20250701: $25,736
  • BLUE CROSS NWB — 1456_BLUE CROSS BLUE SHIELD NWB 20250701: $28,637
  • BLUE CROSS PHS — 1457_BLUE CROSS BLUE SHIELD PHS 20250701: $34,007
  • BLUE CROSS PPO — 1458_BLUE CROSS BLUE SHIELD PPO 20250701: $34,348
  • BLUE CROSS SBN — 1462_BLUE CROSS BLUE SHIELD SBN 20250701: $27,140
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $2,351.98
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $2,351.98
  • UHC — 1460_UNITED HEALTH CARE 20250701: $39,982
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) In the file: COMPRE EP EVAL ABLTJ ATR FIB Not listed in the file Not listed in the file $2,351.98 – $39,982
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY SLEEP STUDY 6YRS + $13,948 $5,160.76 $1,172.88 – $17,435
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $4,031
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $1,452.18
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $1,452.18
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: TERMINATED POLYSOMNOGRAPY 6YRS + $13,948 $5,160.76 $1,172.88 – $17,435
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $4,031
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $1,452.18
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $1,452.18
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: POLYSOMNOGRAPHY SLEEP STUDY 6YRS + $13,948 $5,160.76 $1,172.88 – $17,435
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $17,435

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: PT PELVIC FLOOR THER EXER 15 MIN $86.75 $32.10 $70.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $70.25
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $70.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: PT PELVIC FLR THER EXER 15M PTA $86.75 $32.10 $70.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $70.25
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $70.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: PT THERAPEUTIC EXER 15M PTA $86.75 $32.10 $70.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $70.25
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $70.25
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW CMPLX 1-2 ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (low complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT PELVIC FLR EVAL LOW 1-2 ELMNTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (low complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT LYMPH EVAL LOW 1-2 ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (low complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MOD CMPLX 3 ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT PELVIC FLR EVAL MOD 3 ELMNTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT LYMPH EVAL MOD 3 ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH CMPLX 4+ ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (high complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT PELVIC FLR EVAL HIGH 4+ ELMNTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (high complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT LYMPH EVAL HIGH 4+ ELEMENTS $272.75 $100.92 $239.50 – $266
Physical therapy evaluation (high complexity): rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $239.50
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $239.50
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 $154.83 – $362.88
Psychotherapy, 30 minutes: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $249.98
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $233.86
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 $196.20
Psychotherapy, 30 minutes: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $290.30
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $249.98
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $217.73
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PSYCH THERAPY 45MIN W-PT $607.65 $224.83 $258.78 – $759.56
Psychotherapy, 45 minutes: rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $258.78
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $258.78
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: PSYCH THERAPY 45MIN W-PT $607.65 $224.83 $258.78 – $759.56
Psychotherapy, 45 minutes: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $759.56
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 $154.83 – $362.88
Psychotherapy, 45 minutes: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $249.98
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $233.86
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYCH THERAPY 60MIN W-PT $607.65 $224.83 $383.60 – $759.56
Psychotherapy, 60 minutes: rates for 2 insurance plans
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $383.60
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $383.60
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: PSYCH THERAPY 60MIN W-PT $607.65 $224.83 $383.60 – $759.56
Psychotherapy, 60 minutes: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $759.56
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 $154.83 – $362.88
Psychotherapy, 60 minutes: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $249.98
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $233.86
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 $154.83 – $362.88
Family psychotherapy, without the patient: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $249.98
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $233.86
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 $247.15
Family psychotherapy, without the patient: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $290.30
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $249.98
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $217.73
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 $154.83 – $362.88
Family psychotherapy, with the patient: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $249.98
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $233.86
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 $257.58
Family psychotherapy, with the patient: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $290.30
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $330.62
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $249.98
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $249.98
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $290.30
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $217.73
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY Not listed in the file Not listed in the file $89.14 – $208.91
Group psychotherapy: 10 of 32 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $167.13
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $95.64
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $190.34
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $143.92
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $143.92
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $176.41
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $167.13
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $92.85
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $92.85
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $134.63
Group psychotherapy CPT 90853 · Inpatient (hospital stay) In the file: GROUP PSYCHOTHERAPY Not listed in the file Not listed in the file $70.15
Group psychotherapy: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $167.13
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $95.64
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $190.34
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $143.92
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $143.92
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $176.41
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $167.13
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $92.85
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $92.85
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $125.35

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: REMOVAL OF BREAST LESION Not listed in the file Not listed in the file Not listed in the file
Removal of breast growth (open surgery): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Removal of breast growth (open surgery): rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
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 $26,877 – $32,093
Total hip replacement: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $26,877
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $32,093
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $32,093
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient (hospital stay) In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $26,877 – $32,093
Total hip replacement: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 $26,877 – $32,093
Total knee replacement: rates for 4 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $26,877
  • HUMANA HMO — 1443_HUMANA HMO 20250101: $32,093
  • HUMANA PPO — 1444_HUMANA PPO 20250101: $32,093
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Inpatient (hospital stay) In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $26,877 – $32,093
Total knee replacement: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 $13,544 – $27,040
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $27,040
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $13,544
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $27,040
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file Not listed in the file $13,544 – $27,040
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 $13,544 – $27,040
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans
  • CIGNA HMO — 1463_CIGNA HMO 20250701: $27,040
  • CIGNA NEW BUSINESS — 1465_CIGNA NEW BUSINESS 20250701: $13,544
  • CIGNA PPO — 1464_CIGNA PPO 20250701: $27,040
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) In the file: KNEE ARTHROSCOPY/SURGERY Not listed in the file Not listed in the file $13,544 – $27,040
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file Not listed in the file
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
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 $903.46 – $2,117.47
Upper GI endoscopy (diagnostic): 10 of 31 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,693.98
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $969.33
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,929.25
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $1,458.71
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $1,458.71
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,788.09
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $1,693.98
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $941.10
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $941.10
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 $5,618 – $11,236
Upper GI endoscopy (diagnostic): 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $1,693.98
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $969.33
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,929.25
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $1,458.71
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $1,458.71
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,788.09
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $1,693.98
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $941.10
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $941.10
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $1,270.49
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 50 In the file: EGD DIAGNOSTIC BRUSH WASH Not listed in the file Not listed in the file $5,618 – $11,236
Upper GI endoscopy (diagnostic): rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
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 $903.46 – $2,117.47
Upper GI endoscopy with biopsy: 10 of 31 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,693.98
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $969.33
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,929.25
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $1,458.71
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $1,458.71
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,788.09
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $1,693.98
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $941.10
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $941.10
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 $5,618 – $11,236
Upper GI endoscopy with biopsy: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $1,693.98
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $969.33
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,929.25
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $1,458.71
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $1,458.71
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,788.09
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $1,693.98
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $941.10
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $941.10
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $1,270.49
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 50 In the file: EGD BIOPSY SINGLE/MULTIPLE Not listed in the file Not listed in the file $5,618 – $11,236
Upper GI endoscopy with biopsy: rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $878.55 – $2,059.11
Colonoscopy (diagnostic): 10 of 31 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,647.29
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $942.61
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,876.08
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $1,418.50
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $1,418.50
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,738.80
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $1,647.29
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $915.16
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $915.16
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy (diagnostic): 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $1,647.29
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $942.61
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,876.08
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $1,418.50
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $1,418.50
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,738.80
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $1,647.29
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $915.16
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $915.16
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $1,235.47
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 50 In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy (diagnostic): rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
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 $5,618 – $11,236
Colonoscopy with biopsy: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy with biopsy: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 50 In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy with biopsy: rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
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 $5,618 – $11,236
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) In the file: COLONOSCOPY W/LESION REMOVAL Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 50 In the file: COLONOSCOPY W/LESION REMOVAL Not listed in the file Not listed in the file $5,618 – $11,236
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
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 $5,618 – $11,236
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans
  • AETNA — 1447_AETNA SOUTH 20250701: $5,618
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $5,618 – $11,236
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · modifier 50 In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $5,618 – $11,236
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan
  • AETNA — 1447_AETNA SOUTH 20250701: $11,236
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file Not listed in the file
Gallbladder removal by laparoscope: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Gallbladder removal by laparoscope: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: PRP I/HERN INIT REDUC >5 YR Not listed in the file Not listed in the file Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Inpatient (hospital stay) In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file Not listed in the file
Prostate biopsy: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file Not listed in the file
Prostate biopsy: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file Not listed in the file Not listed in the file
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) In the file: HYSTEROSCOPY BIOPSY ENDOMETRIUM $6,887 $2,548.19 $9,297.45 – $12,740.95
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $9,297.45
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY ENDOMETRIUM $6,887 $2,548.19 $9,297.45 – $12,740.95
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: $12,740.95
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) In the file: HYSTEROSCPY BX ENDOEMETRIUM $6,887 $2,548.19 $9,297.45 – $12,740.95
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $9,297.45
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: NJX INTERLAMINAR LMBR/SAC Not listed in the file Not listed in the file $667.33 – $1,564.07
Spinal injection, lower back (epidural), with imaging guidance: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $1,251.25
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $715.99
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,425.04
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $1,077.47
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $1,077.47
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,320.77
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $1,251.25
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $695.14
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $695.14
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $938.44
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 $667.33 – $1,564.07
Spinal injection, lower back (epidural), with imaging guidance: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,251.25
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $715.99
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,425.04
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $1,077.47
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $1,077.47
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,320.77
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $1,251.25
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $695.14
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $695.14
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $1,007.95
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 $857.91 – $2,010.73
Nerve root injection, lower back, with imaging guidance: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $1,608.59
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $920.47
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,832
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $1,385.17
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $1,385.17
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,697.95
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $1,608.59
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $893.66
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $893.66
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $1,206.44
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 $857.91 – $2,010.73
Nerve root injection, lower back, with imaging guidance: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,608.59
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $920.47
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,832
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $1,385.17
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $1,385.17
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,697.95
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $1,608.59
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $893.66
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $893.66
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $1,295.81
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file Not listed in the file
Carpal tunnel release: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Carpal tunnel release: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
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 $528.64 – $1,239.01
Laser treatment of clouding after cataract surgery: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $991.21
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $567.19
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $1,128.87
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $853.54
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $853.54
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,046.27
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $991.21
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $550.67
  • BLUE CROSS ALIGNMENT — 1529_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $550.67
  • BRIGHT HEALTH — 1531_MEDICARE ADVANTAGE BRIGHT HEALTH INPATIENT 20251001: $743.40
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 $528.64 – $1,239.01
Laser treatment of clouding after cataract surgery: 10 of 30 insurance plan rates
  • 90 DEGREE BENEFITS — 1387_90 DEGREE BENEFITS OUTPATIENT 20250101: $991.21
  • AETNA MCR REPLACEMENT — 1397_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $567.19
  • AETNA NEW BUSINESS — 904_AETNA NEW BUSINESS DISCOUNT OUTPATIENT 20211015: $1,128.87
  • AETNA QUALIFIED HEALTH PLANS — 1385_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT 20250101: $853.54
  • AETNA WHOLE HEALTH — 1386_AETNA WHOLE HEALTH OUTPATIENT 20250101: $853.54
  • AMBETTER COMMERCIAL-EXCHANGE — 1394_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,046.27
  • AVMED EXCHANGE — 1482_AVMED EXCHANGE OUTPATIENT 20250201: $991.21
  • BC ADVANTAGE MCR REPLACEMENT — 1399_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $550.67
  • BLUE CROSS ALIGNMENT — 1398_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $550.67
  • BRIGHT HEALTH — 1400_MEDICARE ADVANTAGE BRIGHT HEALTH OUTPATIENT 20250101: $798.47
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file Not listed in the file
Cataract removal with lens implant: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Cataract removal with lens implant: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: OBSTETRICAL CARE Not listed in the file Not listed in the file Not listed in the file
Vaginal delivery, with care before and after: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Vaginal delivery, with care before and after: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: CESAREAN DELIVERY Not listed in the file Not listed in the file Not listed in the file
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) In the file: VBAC DELIVERY Not listed in the file Not listed in the file Not listed in the file
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan
  • OCCUNET — 1342_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
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 Not listed in the file
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan
  • OCCUNET — 1392_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance 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 $55,849.21 – $130,896.59
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 50 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $104,717.27
  • AETNA — 1447_AETNA SOUTH 20250701: $20,049
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $59,921.55
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $119,261.33
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $90,173.20
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $90,173.20
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $110,534.89
  • AVMED EMPOWER — 1453_AVMED SELECT/EMPOWER 20250701: $14,888
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $104,717.27
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $58,176.26
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 $11,011.93 – $25,809.21
Hip or knee replacement (major joint of the leg), without major complications: 10 of 49 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $20,647.37
  • AETNA — 1447_AETNA SOUTH 20250701: $54,850
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $11,814.88
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $23,515.06
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $17,779.68
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $17,779.68
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $21,794.44
  • AVMED EMPOWER — 1453_AVMED SELECT/EMPOWER 20250701: $14,888
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $20,647.37
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $11,470.76
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 $13,937.18 – $32,665.27
Neck (cervical) spinal fusion, without complications: 10 of 49 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $26,132.22
  • AETNA — 1447_AETNA SOUTH 20250701: $51,194
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $14,953.44
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $29,761.69
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $22,502.74
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $22,502.74
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $27,584.01
  • AVMED EMPOWER — 1453_AVMED SELECT/EMPOWER 20250701: $14,888
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $26,132.22
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $14,517.90
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 $7,083.05 – $16,600.90
Uterus and ovary surgery (not for cancer), without complications: 10 of 49 insurance plan rates
  • 90 DEGREE BENEFITS — 1518_90 DEGREE BENEFITS INPATIENT 20251001: $13,280.72
  • AETNA — 1447_AETNA SOUTH 20250701: $20,049
  • AETNA MCR REPLACEMENT — 1528_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $7,599.53
  • AETNA NEW BUSINESS — 1519_AETNA NEW BUSINESS DISCOUNT INPATIENT 20251001: $15,125.27
  • AETNA QUALIFIED HEALTH PLANS — 1520_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT 20251001: $11,436.18
  • AETNA WHOLE HEALTH — 1521_AETNA WHOLE HEALTH INPATIENT 20251001: $11,436.18
  • AMBETTER COMMERCIAL-EXCHANGE — 1550_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $14,018.54
  • AVMED EMPOWER — 1453_AVMED SELECT/EMPOWER 20250701: $14,888
  • AVMED EXCHANGE — 1522_AVMED EXCHANGE INPATIENT 20251001: $13,280.72
  • BC ADVANTAGE MCR REPLACEMENT — 1530_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $7,378.18

Source: Ascension St Vincent's Southside’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 typeAcute Care Hospital
Address4201 Belfort Rd, Jacksonville, FL 32216
CountyDuval County
StateFlorida
Phone(904) 296‑3700
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating4 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number100307
Name in Medicare recordsASCENSION ST VINCENT'S SOUTHSIDE
Profile levelMedicare data + hospital website
Name on the hospital’s websiteAscension St. Vincent's Southside Hospital
Official websitehealthcare.ascension.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Ascension St. Vincent's Southside Hospital — healthcare.ascension.org
  2. Visitor information - Ascension St. Vincent's Southside — healthcare.ascension.org