Does Ascension St Vincent's St Johns County have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Ascension St Vincent's St Johns County. In a medical emergency, call 911.

Where is Ascension St Vincent's St Johns County?

205 Trinity Way, St. Johns, FL 32259, in St. Johns County, Florida.

What is the phone number of Ascension St Vincent's St Johns County?

(904) 450-6020, as listed by Medicare (CMS).

What is the Medicare star rating of Ascension St Vincent's St Johns County?

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

Ascension St Vincent's St Johns County

Quick answers

Does Ascension St Vincent's St Johns County have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Ascension St Vincent's St Johns County. In a medical emergency, call 911.
Where is Ascension St Vincent's St Johns County?: 205 Trinity Way, St. Johns, FL 32259, in St. Johns County, Florida.
What is the phone number of Ascension St Vincent's St Johns County?: (904) 450-6020, as listed by Medicare (CMS).
What is the Medicare star rating of Ascension St Vincent's St Johns County?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Cancer care
Gynecologic oncology
Cardiology
Diabetes and endocrinology
Neurology
Neurosurgery
Spine care
Orthopedic and sports medicine
OB/GYN and women's health
Lung Institute
Imaging

Conditions treated^[4]

Procedures^[4][5]

Advanced surgical care
Mammograms

Programs and centers^[4][5]

Pediatric emergency care

Emergency care (hospital website)^[4][5][6]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center

Visiting and practical information

Patient portal	Ascension One

Recognition^[4][5]

Primary Stroke Center

Doctors and clinicians (302)

302 doctors and other clinicians list Ascension St Vincent's St Johns County as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 278 more: the button below opens the full list.

Other emergency rooms nearby

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

HCA Florida Orange Park Hospital11 mi · Orange Park, FL · Acute Care Hospital
NH Jacksonville12 mi · Jacksonville, FL · Military Hospital (Department of Defense)
Ascension St Vincent's Southside13 mi · Jacksonville, FL · Acute Care Hospital
HCA Florida Memorial Hospital15 mi · Jacksonville, FL · Acute Care Hospital
Mayo Clinic16 mi · Jacksonville, FL · Acute Care Hospital

Other hospitals nearby

Kindred Hospital-North Florida8.3 mi · Green Cove Springs, FL · Long-Term Acute Care Hospital
Encompass Health Rehabilitation Hospital of Jackso…9.7 mi · Jacksonville, FL · Inpatient Rehabilitation Hospital
Wekiva Springs13 mi · Jacksonville, FL · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Westminster Woods on Julington Creek3.9 mi · Jacksonville, FL · 5 of 5 stars
Bartram Crossing5.0 mi · Jacksonville, FL · 1 of 5 stars
River Garden Hebrew Home for the Aged6.4 mi · Jacksonville, FL · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Community Hospice of Northeast Florida Inc8.1 mi · Jacksonville, FL · 4 of 5 stars
Heartland Hospice (Jacksonville)9.7 mi · Jacksonville, FL · 2 of 5 stars
Hospice of Florida18 mi · Jacksonville, FL

All hospice providers in the state →

Home health agencies

Allstar Home Care LLC5.0 mi · Jacksonville, FL · 3 of 5 stars
Trilogy Home Healthcare5.0 mi · Jacksonville, FL · 4 of 5 stars
Joyal Health Care Services Inc8.1 mi · Jacksonville, FL

All home health agencies in the state →

Dialysis facilities

ARA South Jacksonville Dialysis Center5.0 mi · Jacksonville, FL · 4 of 5 stars
DaVita Jacksonville South Dialysis Center5.0 mi · Jacksonville, FL · 3 of 5 stars
DialySuites Bartram Park, LLC5.0 mi · Jacksonville, FL · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Durbin Crossing Endoscopy Center0.0 mi · St Johns, FL
Baptist South Surgery Center5.0 mi · Jacksonville, FL
East West Surgery Center7.6 mi · Fleming Island, FL

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

Palms Medical Group - Fleming Island7.4 mi · Fleming Island, FL · Community health center
Coastal Community Health-Jacksonville11 mi · Orange Park, FL · Community health center
Palms Medical Group11 mi · Orange Park, FL · Community health center

Clinics and urgent care

Avecina Medical PA0.0 mi · Jacksonville, FL · Urgent care center
Avecina Medical, PA0.0 mi · St Johns, FL · Urgent care center
Avecina Medical, PA0.0 mi · St Johns, FL · Urgent care center

Pharmacies

Careaid LLC0.0 mi · Saint Johns, FL · Community/retail pharmacy
Publix Super Markets Inc0.0 mi · Jacksonville, FL · Community/retail pharmacy
Publix Super Markets Inc0.0 mi · Jacksonville, FL · Community/retail pharmacy

Assisted living nearby

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

Golden House Senior Living #10.0 mi · St. Johns, FL
Silver Treasures at St. Johns0.0 mi · St. Johns, FL
The Blake at St. Johns0.0 mi · St. Johns, FL
Westminster Woods on Julington Creek0.0 mi · Jacksonville, FL

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	77%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	65%National average: 60%
Completed surveys	420Response rate: 24%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	8.6%
Deaths within 30 days: pneumonia patients	13.7%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
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 replacement	4%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	18%
Readmitted within 30 days: COPD	19.3%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	5.9%

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)	118 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)	89%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 Florida Best hospitals in Florida

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

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · 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 — 1658_HUMANA HMO SIFL 20250101: $270.75 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 — 1658_HUMANA HMO SIFL 20250101: $270.75 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $406.73 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $628.75
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$406.73 – $628.75
New patient office visit (about 45–59 minutes): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $406.73 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $406.73
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 — 1658_HUMANA HMO SIFL 20250101: $538.48 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 — 1658_HUMANA HMO SIFL 20250101: $538.48 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $219.60 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $219.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital 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 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $392.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$219.60 – $392.50
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $219.60 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $309.88 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $396.25
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE O/P EST MOD 30 MIN	Not listed in the file	Not listed in the file	$309.88 – $396.25
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $309.88 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $309.88
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	$270.78
Office consultation with a specialist (moderate): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $270.78 HUMANA PPO — 1660_HUMANA PPO SIFL 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	$270.78
Office consultation with a specialist (moderate): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
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	$385.50
Office consultation with a specialist (moderate to high): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $385.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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	$385.50
Office consultation with a specialist (moderate to high): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
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 — 1658_HUMANA HMO SIFL 20250101: $311.30 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 — 1658_HUMANA HMO SIFL 20250101: $359 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 EMERGENCY CARE	$3,565	$1,319.05	$174.98 – $4,456.25
Emergency room visit (moderate): 10 of 14 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $1,376 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $427 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $563 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $427 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $640 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $1,204 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $856 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $563 CIGNA HMO — 1696_CIGNA HMO 20250701: $3,266 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $1,686
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	$174.98 – $4,456.25
Emergency room visit (moderate): 10 of 14 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $1,376 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $427 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $563 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $427 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $640 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $1,204 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $856 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $563 CIGNA HMO — 1696_CIGNA HMO 20250701: $3,266 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $1,686
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: ED LEVEL 3 EMERGENCY CARE	$3,565	$1,319.05	$174.98 – $4,456.25
Emergency room visit (moderate): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $4,456.25
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED LEVEL 4 EMERGENCY CARE	$3,588	$1,327.56	$299.30 – $4,485
Emergency room visit (moderately high): 10 of 11 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $1,834 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $1,465 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $1,800 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $1,465 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $2,295 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $2,785 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $1,800 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $2,327 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $299.30 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $299.30
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	$299.30 – $4,485
Emergency room visit (moderately high): 10 of 11 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $1,834 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $1,465 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $1,800 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $1,465 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $2,295 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $2,785 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $1,800 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $2,327 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $299.30 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $299.30
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: ED LEVEL 4 EMERGENCY CARE	$3,588	$1,327.56	$299.30 – $4,485
Emergency room visit (moderately high): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $4,485
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED LEVEL 5 EMERGENCY CARE	$3,771.50	$1,395.46	$434.53 – $4,714.38
Emergency room visit (high): 10 of 11 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $2,292 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $1,465 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $1,800 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $1,465 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $2,295 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $2,785 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $1,800 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $2,801 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $434.53 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $434.53
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	$434.53 – $4,714.38
Emergency room visit (high): 10 of 11 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $2,292 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $1,465 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $1,800 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $1,465 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $2,295 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $2,785 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $1,800 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $2,801 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $434.53 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $434.53
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: ED LEVEL 5 EMERGENCY CARE	$3,771.50	$1,395.46	$434.53 – $4,714.38
Emergency room visit (high): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $4,714.38

Lab tests

Service	Hospital charge	Cash price	Insurance 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 — 1664_AETNA SIFL 20250701: $7.45 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $21.15 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $21.15 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $71.50 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $38.65 CIGNA PPO — 1697_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 — 1476_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 — 1664_AETNA SIFL 20250701: $9.29 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $26.40 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $26.40 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $122.38 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $66.15 CIGNA PPO — 1697_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 — 1476_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	$46.85 – $107.57
Obstetric blood test panel: 10 of 31 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $86.06 AETNA — 1664_AETNA SIFL 20250701: $42.07 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $49.24 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $98.01 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $74.11 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $74.11 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $90.84 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $86.06 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $47.81 BLUE CROSS ALIGNMENT — 1585_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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $86.06 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $49.24 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $98.01 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $74.11 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $74.11 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $90.84 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $86.06 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $47.81 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $47.81 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $48.77
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 — 1696_CIGNA HMO 20250701: 37% (a percentage in the contract, not a dollar amount) CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: 20% (a percentage in the contract, not a dollar amount) CIGNA PPO — 1697_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	$424.25	$156.97	$11.78 – $424.25
Cholesterol panel (lipid panel): rates for 4 insurance plans AETNA — 1664_AETNA SIFL 20250701: $11.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $33.48 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $33.48 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PROFILE	$424.25	$156.97	$11.78 – $424.25
Cholesterol panel (lipid panel): rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $156.97 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $84.85 CIGNA PPO — 1697_CIGNA PPO 20250701: $156.97
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: LIPID PROFILE	$424.25	$156.97	$11.78 – $424.25
Cholesterol panel (lipid panel): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $424.25
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 — 1664_AETNA SIFL 20250701: $7.64 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $21.70 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $21.70 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $77.70 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $42 CIGNA PPO — 1697_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 — 1476_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 — 1664_AETNA SIFL 20250701: $7.19 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $20.43 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $20.43 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $50.13 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $27.10 CIGNA PPO — 1697_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 — 1476_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 — 1664_AETNA SIFL 20250701: $2.79 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $7.93 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $7.93 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $22.20 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $12 CIGNA PPO — 1697_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 — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $60
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 — 1664_AETNA SIFL 20250701: $3.06 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $8.70 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $8.70 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA SPEC GRAVIT NON-AUTO WO MICR	$13.25	$4.90	$2.65 – $13.25
Urine test (manual, without microscope): rates for 4 insurance plans AETNA — 1664_AETNA SIFL 20250701: $3.06 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $8.70 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $8.70 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient 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 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $4.90 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $2.65 CIGNA PPO — 1697_CIGNA PPO 20250701: $4.90
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 — 1664_AETNA SIFL 20250701: $1.98 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $5.63 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $5.63 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $1.98 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $5.63 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $5.63 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: UA MACROSCOPIC AUTO WO MICRO	$28.25	$10.45	$1.98 – $28.25
Urine test (automated, without microscope): rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $10.45 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $5.65 CIGNA PPO — 1697_CIGNA PPO 20250701: $10.45
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 — 1696_CIGNA HMO 20250701: $12.67 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $6.85 CIGNA PPO — 1697_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 — 1696_CIGNA HMO 20250701: $2.22 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $1.20 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $16.18 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $18.39
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 — 1664_AETNA SIFL 20250701: $14.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $42 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $42 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $14.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $42 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $42 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: ULTRASENSITIVE TSH3	$97.75	$36.17	$14.78 – $97.75
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $36.17 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $19.55 CIGNA PPO — 1697_CIGNA PPO 20250701: $36.17
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 — 1664_AETNA SIFL 20250701: $6.84 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $19.43 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $19.43 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC W/DIFFERENTIAL	$138.50	$51.25	$6.84 – $138.50
Complete blood count (CBC) with differential: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $51.24 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $27.70 CIGNA PPO — 1697_CIGNA PPO 20250701: $51.24
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: CBC W/DIFFERENTIAL	$138.50	$51.25	$6.84 – $138.50
Complete blood count (CBC) with differential: rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $138.50
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 — 1664_AETNA SIFL 20250701: $5.69 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $16.18 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $16.18 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CBC W/O DIFFERENTIAL	$126	$46.62	$5.69 – $126
Complete blood count (CBC), automated: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $46.62 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $25.20 CIGNA PPO — 1697_CIGNA PPO 20250701: $46.62
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: CBC W/O DIFFERENTIAL	$126	$46.62	$5.69 – $126
Complete blood count (CBC), automated: rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: $126
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 — 1664_AETNA SIFL 20250701: $3.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $10.73 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $10.73 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $3.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $10.73 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $10.73 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: REF MAYO PROTHOMBIN TIME	$25	$9.25	$3.78 – $25
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans AETNA — 1664_AETNA SIFL 20250701: $3.78 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $10.73 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $10.73 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $5.29 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $15.03 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $15.03 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $5.29 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $15.03 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $15.03 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1664_AETNA SIFL 20250701: $5.29 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $15.03 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $15.03 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/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 — 1696_CIGNA HMO 20250701: $676.54 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $365.70 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $783 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$104.61 – $240.16
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13 AETNA — 1664_AETNA SIFL 20250701: $783 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $218.82 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $165.45 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $165.45 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $192.13 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74 BLUE CROSS ALIGNMENT — 1585_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 — 1696_CIGNA HMO 20250701: $622.25 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $336.35 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $1,111 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$351.31 – $806.58
MRI of the brain, before and after contrast: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $645.26 AETNA — 1664_AETNA SIFL 20250701: $1,111 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $369.23 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $734.88 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $555.64 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $555.64 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $681.11 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $645.26 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $358.48 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $358.48
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST 2 VIEW	$383.50	$141.90	$63.39 – $141.90
Chest X-ray, 2 views: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $141.90 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $76.70 CIGNA PPO — 1697_CIGNA PPO 20250701: $141.90
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST 2 VIEWS	$479.50	$177.42	$63.39 – $177.41
Chest X-ray, 2 views: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $177.41 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $95.90 CIGNA PPO — 1697_CIGNA PPO 20250701: $177.41
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST 2 VIEW	$383.50	$141.90	$63.39 – $141.90
Chest X-ray, 2 views: rates for 1 insurance plan AETNA — 1664_AETNA SIFL 20250701: $63.39
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	$102.56 – $371.20
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $371.20 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $200.65 CIGNA PPO — 1697_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 W/OBLIQUES	$1,003.25	$371.20	$102.56 – $371.20
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan AETNA — 1664_AETNA SIFL 20250701: $102.56
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$104.61 – $240.16
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13 AETNA — 1664_AETNA SIFL 20250701: $102.56 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $218.82 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $165.45 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $165.45 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $192.13 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $106.74
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	$413.95 – $1,136.27
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $1,136.27 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $614.20 CIGNA PPO — 1697_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	$413.95 – $1,136.27
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans AETNA — 1664_AETNA SIFL 20250701: $413.95 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$237.78 – $545.92
MRI of the lower back (lumbar spine), without contrast: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $436.73 AETNA — 1664_AETNA SIFL 20250701: $413.95 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $249.91 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $497.39 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $376.08 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $376.08 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $461 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $436.73 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $242.63 BLUE CROSS ALIGNMENT — 1585_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 — 1696_CIGNA HMO 20250701: $670.16 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $362.25 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $783 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$175.12 – $402.05
CT scan of the pelvis, with contrast: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $321.64 AETNA — 1664_AETNA SIFL 20250701: $783 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $184.05 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $366.31 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $276.97 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $276.97 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $339.51 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $321.64 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $178.69 BLUE CROSS ALIGNMENT — 1585_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 – $590.15
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $590.15 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $319 CIGNA PPO — 1697_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 – $590.15
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $590.15 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $319 CIGNA PPO — 1697_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	$2,278.50	$843.05	$455.70 – $843.04
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $843.04 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $455.70 CIGNA PPO — 1697_CIGNA PPO 20250701: $843.04
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 — 1696_CIGNA HMO 20250701: $693.10 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $374.65 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $783 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$351.31 – $806.58
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $645.26 AETNA — 1664_AETNA SIFL 20250701: $783 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $369.23 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $734.88 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $555.64 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $555.64 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $681.11 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $645.26 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $358.48 BLUE CROSS ALIGNMENT — 1585_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 — 1696_CIGNA HMO 20250701: $897.07 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $484.90 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $238.67 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$104.61 – $240.16
Ultrasound of the abdomen, complete: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13 AETNA — 1664_AETNA SIFL 20250701: $238.67 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $218.82 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $165.45 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $165.45 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $192.13 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74 BLUE CROSS ALIGNMENT — 1585_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	$921.50	$340.96	$184.30 – $340.95
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $340.95 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $184.30 CIGNA PPO — 1697_CIGNA PPO 20250701: $340.95
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB FETAL MATERNAL EVAL	$768	$284.16	$153.60 – $284.16
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $284.16 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $153.60 CIGNA PPO — 1697_CIGNA PPO 20250701: $284.16
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB FETAL MATERNAL EVAL	$921.50	$340.96	$184.30 – $340.95
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans AETNA — 1664_AETNA SIFL 20250701: $262.37 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $235.69
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL	$1,919.75	$710.31	$235.69 – $710.31
Transvaginal ultrasound: rates for 3 insurance plans CIGNA HMO — 1696_CIGNA HMO 20250701: $710.31 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $383.95 CIGNA PPO — 1697_CIGNA PPO 20250701: $710.31
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL	$1,919.75	$710.31	$235.69 – $710.31
Transvaginal ultrasound: rates for 2 insurance plans AETNA — 1664_AETNA SIFL 20250701: $257.21 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$104.61 – $240.16
Transvaginal ultrasound: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $192.13 AETNA — 1664_AETNA SIFL 20250701: $257.21 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $109.94 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $218.82 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $165.45 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $165.45 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $202.81 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $192.13 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $106.74 BLUE CROSS ALIGNMENT — 1585_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 — 1696_CIGNA HMO 20250701: $301.55 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $163 CIGNA PPO — 1697_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 — 1696_CIGNA HMO 20250701: $301.55 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $163 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $270.63 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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 — 1696_CIGNA HMO 20250701: $303.95 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $164.30 CIGNA PPO — 1697_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 — 1664_AETNA SIFL 20250701: $344.86 UHC HMO — 1693_UNITED HEALTH CARE SIFL 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	$100.16 – $229.95
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $183.96 AETNA — 1664_AETNA SIFL 20250701: $344.86 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $105.27 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $209.51 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $158.41 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $158.41 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $194.18 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $183.96 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $102.20 BLUE CROSS ALIGNMENT — 1585_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 — 1696_CIGNA HMO 20250701: $287.12 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $155.20 CIGNA PPO — 1697_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 — 1696_CIGNA HMO 20250701: $256.87 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $138.85 CIGNA PPO — 1697_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 — 1696_CIGNA HMO 20250701: $256.87 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $138.85 CIGNA PPO — 1697_CIGNA PPO 20250701: $256.87

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$34.38 – $1,636
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans AETNA — 1664_AETNA SIFL 20250701: $1,636 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $34.38 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 — 1658_HUMANA HMO SIFL 20250101: $34.38 HUMANA PPO — 1660_HUMANA PPO SIFL 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 – $15,191
Left heart catheterization (diagnostic): rates for 3 insurance plans AETNA — 1664_AETNA SIFL 20250701: $15,191 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $2,009.43 HUMANA PPO — 1660_HUMANA PPO SIFL 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 – $15,191
Left heart catheterization (diagnostic): rates for 1 insurance plan OCCUNET — 1476_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 – $15,191
Left heart catheterization (diagnostic): rates for 2 insurance plans HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $1,428.48 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $25,736 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $27,140 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $25,736 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $28,637 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $34,007 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $34,348 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $27,140 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $17,789.05 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1476_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 — 1658_HUMANA HMO SIFL 20250101: $16,849.98 HUMANA PPO — 1660_HUMANA PPO SIFL 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 – $35,203
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $25,736 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $27,140 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $25,736 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $28,637 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $34,007 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $34,348 BLUE CROSS SBN — 1689_BLUE CROSS BLUE SHIELD SBN SIFL 20250701: $27,140 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $2,351.98 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $2,351.98 UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: $35,203
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 – $35,203
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan OCCUNET — 1476_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: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$1,172.88 – $4,031
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans AETNA — 1664_AETNA SIFL 20250701: $4,031 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $1,452.18 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $1,452.18
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$1,172.88 – $4,031
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 125% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$1,172.88 – $4,031
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan UHC HMO — 1693_UNITED HEALTH CARE SIFL 20250701: 43% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: 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 — 1658_HUMANA HMO SIFL 20250101: $70.25 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $70.25 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $70.25 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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 — 1658_HUMANA HMO SIFL 20250101: $239.50 HUMANA PPO — 1660_HUMANA PPO SIFL 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	$158.05 – $362.88
Psychotherapy, 30 minutes: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $330.62 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $249.98 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $164.51
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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $290.30 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $330.62 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $249.98 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $164.51
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	$158.05 – $362.88
Psychotherapy, 45 minutes: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $330.62 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $249.98 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $164.51
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$258.78
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $290.30 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $330.62 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $249.98 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $164.51
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	$158.05 – $362.88
Psychotherapy, 60 minutes: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $330.62 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $249.98 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $164.51
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$383.60
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $290.30 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $330.62 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $249.98 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $164.51
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	$158.05 – $362.88
Family psychotherapy, without the patient: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $330.62 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $249.98 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $164.51
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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $290.30 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $330.62 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $249.98 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $164.51
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	$158.05 – $362.88
Family psychotherapy, with the patient: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $290.30 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $166.12 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $330.62 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $249.98 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $306.43 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $161.28 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $161.28 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $164.51
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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $290.30 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $166.12 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $330.62 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $249.98 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $249.98 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $306.43 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $290.30 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $161.28 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $161.28 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $164.51
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$90.99 – $208.91
Group psychotherapy: 10 of 29 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $167.13 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $95.64 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $190.34 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $143.92 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $143.92 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $176.41 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $167.13 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $92.85 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $92.85 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $94.71
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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $167.13 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $95.64 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $190.34 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $143.92 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $143.92 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $176.41 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $167.13 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $92.85 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $92.85 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $94.71

Procedures and surgery

Service	Hospital charge	Cash price	Insurance 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 — 1476_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 — 1578_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 — 1664_AETNA SIFL 20250701: $26,877 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $32,093 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $32,093 OCCUNET — 1578_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 — 1476_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 — 1664_AETNA SIFL 20250701: $26,877 HUMANA HMO — 1658_HUMANA HMO SIFL 20250101: $32,093 HUMANA PPO — 1660_HUMANA PPO SIFL 20250101: $32,093 OCCUNET — 1578_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 — 1476_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 — 1696_CIGNA HMO 20250701: $27,040 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $13,544 CIGNA PPO — 1697_CIGNA PPO 20250701: $27,040 OCCUNET — 1578_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 — 1476_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 — 1696_CIGNA HMO 20250701: $27,040 CIGNA HMO NEW BUSINESS — 1700_CIGNA HMO NEW BUSINESS 20250701: $13,544 CIGNA PPO — 1697_CIGNA PPO 20250701: $27,040 OCCUNET — 1578_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 — 1476_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 — 1476_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 — 1578_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	$922.28 – $2,117.47
Upper GI endoscopy (diagnostic): 10 of 28 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,693.98 AETNA — 1664_AETNA SIFL 20250701: $5,618 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $969.33 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,929.25 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $1,458.71 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $1,458.71 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,788.09 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $1,693.98 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $941.10 BLUE CROSS ALIGNMENT — 1585_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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $1,693.98 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $969.33 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,929.25 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $1,458.71 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $1,458.71 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,788.09 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $1,693.98 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $941.10 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $941.10 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $959.92
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 — 1664_AETNA SIFL 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	$922.28 – $2,117.47
Upper GI endoscopy with biopsy: 10 of 28 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,693.98 AETNA — 1664_AETNA SIFL 20250701: $5,618 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $969.33 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,929.25 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $1,458.71 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $1,458.71 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,788.09 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $1,693.98 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $941.10 BLUE CROSS ALIGNMENT — 1585_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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $1,693.98 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $969.33 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,929.25 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $1,458.71 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $1,458.71 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,788.09 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $1,693.98 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $941.10 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $941.10 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $959.92
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 — 1664_AETNA SIFL 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	$896.86 – $2,059.11
Colonoscopy (diagnostic): 10 of 28 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,647.29 AETNA — 1664_AETNA SIFL 20250701: $5,618 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $942.61 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,876.08 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $1,418.50 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $1,418.50 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,738.80 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $1,647.29 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $915.16 BLUE CROSS ALIGNMENT — 1585_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 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $1,647.29 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $942.61 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,876.08 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $1,418.50 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $1,418.50 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,738.80 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $1,647.29 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $915.16 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $915.16 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $933.46
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 — 1664_AETNA SIFL 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 — 1664_AETNA SIFL 20250701: $5,618 OCCUNET — 1578_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 — 1476_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 — 1664_AETNA SIFL 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 — 1664_AETNA SIFL 20250701: $5,618 OCCUNET — 1578_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 — 1476_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 — 1664_AETNA SIFL 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 — 1664_AETNA SIFL 20250701: $5,618 OCCUNET — 1578_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 — 1476_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 — 1664_AETNA SIFL 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 — 1476_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 — 1578_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 — 1476_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 — 1578_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 — 1476_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 — 1578_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 — 1476_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 — 1578_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	Not listed in the file	Not listed in the file	Not listed in the file
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan OCCUNET — 1476_MEDICARE ADVANTAGE OCCUNET INPATIENT 20241001: 135% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	Not listed in the file
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan OCCUNET — 1578_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
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	$681.24 – $1,564.07
Spinal injection, lower back (epidural), with imaging guidance: 10 of 27 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,251.25 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $715.99 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,425.04 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $1,077.47 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $1,077.47 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,320.77 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $1,251.25 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $695.14 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $695.14 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $709.04
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	$681.24 – $1,564.07
Spinal injection, lower back (epidural), with imaging guidance: 10 of 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $1,251.25 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $715.99 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,425.04 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $1,077.47 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $1,077.47 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,320.77 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $1,251.25 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $695.14 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $695.14 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $709.04
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	$875.79 – $2,010.73
Nerve root injection, lower back, with imaging guidance: 10 of 27 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $1,608.59 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $920.47 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,832 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $1,385.17 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $1,385.17 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,697.95 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $1,608.59 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $893.66 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $893.66 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $911.53
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	$875.79 – $2,010.73
Nerve root injection, lower back, with imaging guidance: 10 of 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $1,608.59 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $920.47 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,832 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $1,385.17 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $1,385.17 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,697.95 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $1,608.59 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $893.66 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $893.66 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $911.53
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 — 1476_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 — 1578_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)
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	$539.66 – $1,239.01
Laser treatment of clouding after cataract surgery: 10 of 27 insurance plan rates 90 DEGREE BENEFITS — 1577_90 DEGREE BENEFITS OUTPATIENT 20250101: $991.21 AETNA MCR REPLACEMENT — 1584_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250101: $567.19 AETNA NEW BUSINESS — 1072_AETNA NEW BUSINESS DISCOUNT OUTPATIENT SIFL 20220829: $1,128.87 AETNA QUALIFIED HEALTH PLANS — 1574_AETNA QUALIFIED HEALTH PLANS (QHP) OUTPATIENT SIFL 2025: $853.54 AETNA WHOLE HEALTH — 1576_AETNA WHOLE HEALTH OUTPATIENT SIFL 20250101: $853.54 AMBETTER COMMERCIAL-EXCHANGE — 1580_SUNSHINE AMBETTER EXCHANGE COMMERCIAL OUTPATIENT 202501: $1,046.27 AVMED EXCHANGE — 1720_AVMED EXCHANGE OUTPATIENT 20250201: $991.21 BC ADVANTAGE MCR REPLACEMENT — 1586_MEDICARE ADVANTAGE BLUE CROSS OUTPATIENT 20250101: $550.67 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $550.67 CAREPLUS MCR REPLACEMENT — 1589_MEDICARE ADVANTAGE CAREPLUS OUTPATIENT SIFL 20250101: $561.68
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	$539.66 – $1,239.01
Laser treatment of clouding after cataract surgery: 10 of 26 insurance plan rates 90 DEGREE BENEFITS — 1782_90 DEGREE BENEFITS INPATIENT 20251001: $991.21 AETNA MCR REPLACEMENT — 1795_MEDICARE ADVANTAGE AETNA INPATIENT 20251001: $567.19 AETNA NEW BUSINESS — 1784_AETNA NEW BUSINESS DISCOUNT INPATIENT SIFL 20251001: $1,128.87 AETNA QUALIFIED HEALTH PLANS — 1790_AETNA QUALIFIED HEALTH PLANS (QHP) INPATIENT SIFL 20251: $853.54 AETNA WHOLE HEALTH — 1792_AETNA WHOLE HEALTH INPATIENT SIFL 20251001: $853.54 AMBETTER COMMERCIAL-EXCHANGE — 1785_SUNSHINE AMBETTER EXCHANGE COMMERCIAL INPATIENT 2025100: $1,046.27 AVMED EXCHANGE — 1793_AVMED EXCHANGE INPATIENT 20251001: $991.21 BC ADVANTAGE MCR REPLACEMENT — 1786_MEDICARE ADVANTAGE BLUE CROSS INPATIENT 20251001: $550.67 BLUE CROSS ALIGNMENT — 1779_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20251: $550.67 CAREPLUS MCR REPLACEMENT — 1796_MEDICARE ADVANTAGE CAREPLUS INPATIENT SIFL 20251001: $561.68
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 — 1476_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 — 1578_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance 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 — 1476_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 — 1578_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 — 1476_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 — 1578_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 — 1476_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 — 1578_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20250101: 185% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$7,840 – $64,448
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 45 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $20,049 AVMED EMPOWER — 1681_AVMED SELECT/EMPOWER SIFL 20250701: $14,888 BLUE CROSS ALIGNMENT — 1475_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20241: $7,840 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $7,840 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $9,559 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $11,819 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $9,559 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $14,891 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $24,633 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $20,964
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	$7,840 – $54,850
Hip or knee replacement (major joint of the leg), without major complications: 10 of 44 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $54,850 AVMED EMPOWER — 1681_AVMED SELECT/EMPOWER SIFL 20250701: $14,888 BLUE CROSS ALIGNMENT — 1475_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20241: $7,840 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $7,840 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $22,887 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $30,979 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $22,887 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $36,736 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $34,166 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $44,621
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	$7,840 – $51,194
Neck (cervical) spinal fusion, without complications: 10 of 44 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $51,194 AVMED EMPOWER — 1681_AVMED SELECT/EMPOWER SIFL 20250701: $14,888 BLUE CROSS ALIGNMENT — 1475_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20241: $7,840 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $7,840 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $9,559 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $11,819 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $9,559 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $14,891 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $24,633 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $20,964
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	$4,562 – $24,633
Uterus and ovary surgery (not for cancer), without complications: 10 of 44 insurance plan rates AETNA — 1664_AETNA SIFL 20250701: $20,049 AVMED EMPOWER — 1681_AVMED SELECT/EMPOWER SIFL 20250701: $14,888 BLUE CROSS ALIGNMENT — 1475_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE INPATIENT 20241: $4,562 BLUE CROSS ALIGNMENT — 1585_MEDICARE ADVANTAGE ALIGNMENT HEALTHCARE OUTPATIENT 2025: $4,562 BLUE CROSS BSL — 1684_BLUE CROSS BLUE SHIELD BSL SIFL 20250701: $9,559 BLUE CROSS HMO — 1688_BLUE CROSS BLUE SHIELD HMO SIFL 20250701: $11,819 BLUE CROSS MBN — 1687_BLUE CROSS BLUE SHIELD MBN SIFL 20250701: $9,559 BLUE CROSS NWB — 1683_BLUE CROSS BLUE SHIELD NWB SIFL 20250701: $14,891 BLUE CROSS PHS — 1690_BLUE CROSS BLUE SHIELD PHS SIFL 20250701: $24,633 BLUE CROSS PPO — 1691_BLUE CROSS BLUE SHIELD PPO SIFL 20250701: $20,964

Source: Ascension St Vincent's St Johns County’s standard charges file (healthcare.ascension.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	205 Trinity Way, St. Johns, FL 32259
County	St. Johns County
State	Florida
Phone	(904) 450‑6020
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
CMS Certification Number	100361
Name in Medicare records	ASCENSION ST VINCENT'S ST JOHNS COUNTY
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(904) 691‑1000^[6]
Official website	healthcare.ascension.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Ascension St. Vincent's St. Johns County — healthcare.ascension.org
Emergency care - Ascension St. Vincent's St. Johns County — healthcare.ascension.org
Hospitals near Saint Johns, FL — healthcare.ascension.org