Does Atrium Health Cleveland have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Atrium Health Cleveland. In a medical emergency, call 911.

Where is Atrium Health Cleveland?

201 E Grover St, Shelby, NC 28150, in Cleveland County, North Carolina.

What is the phone number of Atrium Health Cleveland?

(704) 487-3000, as listed by Medicare (CMS).

What is the Medicare star rating of Atrium Health Cleveland?

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

Atrium Health Cleveland — Shelby, NC

Quick answers

Does Atrium Health Cleveland have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Atrium Health Cleveland. In a medical emergency, call 911.
Where is Atrium Health Cleveland?: 201 E Grover St, Shelby, NC 28150, in Cleveland County, North Carolina.
What is the phone number of Atrium Health Cleveland?: (704) 487-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Atrium Health Cleveland?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5][6]

Conditions treated^[5]

Diabetes

Treatments^[5][7]

Labor and delivery
C-section delivery
Postpartum care
Lactation consultation
Joint replacement (hip, knee, total shoulder)
Cardiac rehabilitation
Wound care treatment

Procedures^[5]

Joint replacement

Programs and centers^[5][7]

Chest pain center
Carolinas Stroke Network access
Levine Cancer Institute partnership
Sanger Heart & Vascular Institute
Joint Academy
Diabetes Center
Level III trauma center program
Maternity center
Community Care Management
Community Alternatives Program for Disabled Adults
Private Care Management
Access to Carolinas Stroke Network

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

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

Visiting and practical information

Visiting	Main entrance open 6 a.m. to 8 p.m.; ICU visits allowed any time, two visitors at once; quiet time 2-4 p.m^[4]
Parking	Free parking is listed on the maternity center page; no general hospital parking info found^[7]

Recognition^[4][5]

Level III trauma center (first in NC)

Doctors and clinicians (762)

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

Main specialties

Doctors with a page on this site (762)

Aaron H. Baer, MDDiagnostic Radiology
Abbigail A. Mattfeld, PAPhysician Assistant
Abby M. Fowler, NPNurse Practitioner
Abigail BellNurse Practitioner
Abigail M. Phelps, MDHematology/Oncology
Achint D. Patel, MDHospitalist
Achint Singh, MDDiagnostic Radiology
Adam J. Glenn, MDFamily Practice
Adam Kinzel, MDDiagnostic Radiology
Adam Raynes, CNACertified Registered Nurse Anesthetist (CRNA)
Adarsh Hiremath, MDHematology/Oncology
Adit Mahale, MDNephrology
Aditya M. Sharma, MDCardiovascular Disease (Cardiology)
Adnan Basheer, MDHospitalist
Adolphus S. Bonar, MDEndocrinology
Adrian D. HadionoNeurology
Alan V. Jubane, MDFamily Practice
Alana G. Nethercutt, PAPhysician Assistant
Aleigh R. KingPhysician Assistant
Alexander H. Hunter, DOAnesthesiology
Alexander M. Eskandari, MDEmergency Medicine
Alexandria D. Black, NPNurse Practitioner
Alexis W. Damish-Kemp, DOObstetrics/Gynecology
Ali Reza Golshayan, MDMedical Oncology

And 738 more: the button below opens the full list.

Other emergency rooms nearby

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

Cherokee Medical Center16 mi · Gaffney, SC · Acute Care Hospital
CaroMont Regional Medical Center23 mi · Gastonia, NC · Acute Care Hospital
Atrium Health Lincoln23 mi · Lincolnton, NC · Acute Care Hospital
Rutherford Regional Medical Center25 mi · Rutherfordton, NC · Acute Care Hospital
Blue Ridge Healthcare Hospitals, Inc30 mi · Morganton, NC · Acute Care Hospital

Other hospitals nearby

Broughton Hospital31 mi · Morganton, NC · 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

White Oak Manor-Shelby0.5 mi · Shelby, NC · 2 of 5 stars
Ignite Medical Resort Shelby1.1 mi · Shelby, NC · 4 of 5 stars
Carolina Care Health and Rehabilitation10 mi · Cherryville, NC · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Via Health Partners - Cleveland3.6 mi · Shelby, NC · 4 of 5 stars
Carolina Caring22 mi · Gastonia, NC · 3 of 5 stars
Bon Secours Hospice by Compassus-Gaffney23 mi · Gaffney, SC

All hospice providers in the state →

Home health agencies

Atrium Health at Home Cleveland3.6 mi · Shelby, NC · 3 of 5 stars
Centerwell Home Health3.6 mi · Shelby, NC · 4 of 5 stars
Centerwell Home Health16 mi · Gaffney, SC

All home health agencies in the state →

Dialysis facilities

DCI - Dialysis Clinic, Inc3.6 mi · Shelby, NC · 1 of 5 stars
DCI Shelby Inc3.6 mi · Shelby, NC · 2 of 5 stars
DCI South Shelby5.2 mi · Shelby, NC · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Atrium Health Surgery Center Shelby3.6 mi · Shelby, NC
The Eye Surgery Center of Shelby3.6 mi · Shelby, NC
CaroMont Speciality Surgery22 mi · Gastonia, NC

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

Kintegra at Turning Point Academy0.8 mi · Shelby, NC · Community health center
Senior TLC - Shelby1.4 mi · Shelby, NC · Community health center
Kintegra Pediatrics Behavioral Health Family Dentistry1.6 mi · Shelby, NC · Community health center

Clinics and urgent care

Mainstreet and Kidsstreet of North Carolina PLLC3.6 mi · Shelby, NC · Urgent care center
Mainstreet and Kidsstreet of North Carolina PLLC10 mi · Cherryville, NC · Urgent care center
Mainstreet Family Care - Cherryville10 mi · Cherryville, NC · Rural health clinic

Pharmacies

Community Family Pharmacy3.6 mi · Shelby, NC · Community/retail pharmacy
Eric Rich Inc3.6 mi · Shelby, NC · Community/retail pharmacy
Kerr Drug Inc a Delaware Company3.6 mi · Shelby, NC · Community/retail pharmacy

Assisted living nearby

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

Cleveland House3.6 mi · Shelby, NC
Navion of Shelby3.6 mi · Shelby, NC
Shelby Manor3.6 mi · Shelby, NC
TerraBella Shelby5.2 mi · Shelby, NC

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	70%National average: 72%
Would definitely recommend the hospital	66%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	61%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	69%National average: 74%
Area around the room “always” quiet at night	57%National average: 60%
Completed surveys	1,023Response rate: 15%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.27No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.16Better than the national benchmark
Surgical site infections after colon surgery	0No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.796No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.245Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12%
Deaths within 30 days: heart failure patients	11.9%
Deaths within 30 days: pneumonia patients	16%
Deaths within 30 days: COPD patients	8.2%
Deaths within 30 days: stroke patients	11.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.03No different from the national rate
Complications after hip or knee replacement	3.7%

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	22.9%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	20.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.2%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	160 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	45%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in North Carolina Best hospitals in North Carolina

Prices

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

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$68.70 – $338.32
New patient office visit (about 30–44 minutes): 10 of 27 insurance plan rates Aetna — Broad Network: $229.99 Aetna — Medicare Advantage: $70.07 Aetna — North Carolina Preferred Plus Commercial: $214.44 Aetna — Whole Health HMO: $202.75 Aetna First Health — Commercial: $338.32 Alliance — Managed Medicaid: $76.48 Amerihealth Caritas — Managed Medicaid: $75.73 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $167.39 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $127.22 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $128.63
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$111.70 – $117.63
New patient office visit (about 30–44 minutes): rates for 6 insurance plans Aetna — Medicare Advantage: $115.61 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $111.70 Cigna Healthspring — Medicare Advantage: $117.29 Devoted Health — Medicare Advantage: $116.17 Humana — Medicare Advantage: $113.94 United Healthcare — Medicare Advantage: $117.63
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$112.53 – $482.03
New patient office visit (about 45–59 minutes): 10 of 27 insurance plan rates Aetna — Broad Network: $343.78 Aetna — Medicare Advantage: $114.78 Aetna — North Carolina Preferred Plus Commercial: $320.54 Aetna — Whole Health HMO: $287.53 Aetna First Health — Commercial: $482.03 Alliance — Managed Medicaid: $129.37 Amerihealth Caritas — Managed Medicaid: $128.10 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $279.73 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $212.59 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $214.94
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$168.94 – $177.91
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Aetna — Medicare Advantage: $174.85 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $168.94 Cigna Healthspring — Medicare Advantage: $177.38 Devoted Health — Medicare Advantage: $175.69 Humana — Medicare Advantage: $172.32 United Healthcare — Medicare Advantage: $177.91
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$153.88 – $613.92
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates Aetna — Broad Network: $454.96 Aetna — Medicare Advantage: $156.96 Aetna — North Carolina Preferred Plus Commercial: $424.18 Aetna — Whole Health HMO: $364.95 Aetna First Health — Commercial: $613.92 Alliance — Managed Medicaid: $168.93 Amerihealth Caritas — Managed Medicaid: $167.28 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $364.02 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $276.66 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $279.72
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$225.24 – $237.20
New patient office visit (about 60–74 minutes): rates for 6 insurance plans Aetna — Medicare Advantage: $233.13 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $225.24 Cigna Healthspring — Medicare Advantage: $236.51 Devoted Health — Medicare Advantage: $234.25 Humana — Medicare Advantage: $229.75 United Healthcare — Medicare Advantage: $237.20
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20-29 MIN	Not listed in the file	Not listed in the file	$50.41 – $186.29
Established patient office visit (about 20–29 minutes): 10 of 27 insurance plan rates Aetna — Broad Network: $186.29 Aetna — Medicare Advantage: $56.74 Aetna — North Carolina Preferred Plus Commercial: $173.69 Aetna — Whole Health HMO: $110.19 Aetna First Health — Commercial: $185.44 Alliance — Managed Medicaid: $51.42 Amerihealth Caritas — Managed Medicaid: $50.91 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $108.29 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $82.30 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $83.21
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20-29 MIN	Not listed in the file	Not listed in the file	$90.84 – $95.66
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans Aetna — Medicare Advantage: $94.02 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $90.84 Cigna Healthspring — Medicare Advantage: $95.38 Devoted Health — Medicare Advantage: $94.47 Humana — Medicare Advantage: $92.66 United Healthcare — Medicare Advantage: $95.66
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P EST LOW 20-29 MIN	Not listed in the file	Not listed in the file	$110.19
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan Aetna — Whole Health HMO: $110.19
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30-39 MIN	Not listed in the file	Not listed in the file	$77.28 – $291.46
Established patient office visit (about 30–39 minutes): 10 of 27 insurance plan rates Aetna — Broad Network: $263.24 Aetna — Medicare Advantage: $83.40 Aetna — North Carolina Preferred Plus Commercial: $245.44 Aetna — Whole Health HMO: $173.04 Aetna First Health — Commercial: $291.46 Alliance — Managed Medicaid: $78.83 Amerihealth Caritas — Managed Medicaid: $78.05 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $169.12 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $128.53 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $129.95
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30-39 MIN	Not listed in the file	Not listed in the file	$129.44 – $136.32
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans Aetna — Medicare Advantage: $133.97 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $129.44 Cigna Healthspring — Medicare Advantage: $135.92 Devoted Health — Medicare Advantage: $134.62 Humana — Medicare Advantage: $132.03 United Healthcare — Medicare Advantage: $136.32
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee · modifier GT In the file: OFFICE O/P EST MOD 30-39 MIN	Not listed in the file	Not listed in the file	$173.04
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan Aetna — Whole Health HMO: $173.04
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$92.54 – $426.42
Office consultation with a specialist (moderate): 10 of 21 insurance plan rates Aetna — Broad Network: $246.38 Aetna — North Carolina Preferred Plus Commercial: $229.72 Aetna — Whole Health HMO: $256.39 Aetna First Health — Commercial: $426.42 Alliance — Managed Medicaid: $94.39 Amerihealth Caritas — Managed Medicaid: $93.47 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $237.27 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $180.33 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $182.32 Carolina Complete Health — Managed Medicaid: $93.47
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$107.97 – $113.70
Office consultation with a specialist (moderate): rates for 6 insurance plans Aetna — Medicare Advantage: $111.75 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $107.97 Cigna Healthspring — Medicare Advantage: $113.37 Devoted Health — Medicare Advantage: $112.29 Humana — Medicare Advantage: $110.13 United Healthcare — Medicare Advantage: $113.70
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$148.71 – $606.37
Office consultation with a specialist (moderate to high): 10 of 21 insurance plan rates Aetna — Broad Network: $368.28 Aetna — North Carolina Preferred Plus Commercial: $343.37 Aetna — Whole Health HMO: $362.38 Aetna First Health — Commercial: $606.37 Alliance — Managed Medicaid: $151.68 Amerihealth Caritas — Managed Medicaid: $150.20 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $373.25 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $283.67 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $286.81 Carolina Complete Health — Managed Medicaid: $150.20
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$154.56 – $162.76
Office consultation with a specialist (moderate to high): rates for 6 insurance plans Aetna — Medicare Advantage: $159.97 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $154.56 Cigna Healthspring — Medicare Advantage: $162.28 Devoted Health — Medicare Advantage: $160.74 Humana — Medicare Advantage: $157.65 United Healthcare — Medicare Advantage: $162.76
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$362.38
Office consultation with a specialist (moderate to high): rates for 1 insurance plan Aetna — Whole Health HMO: $362.38
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS	$271	$135.50	$37.13 – $257.45
Preventive checkup, new patient, age 18–39: 10 of 45 insurance plan rates Aetna — Broad Network: $153.93 Aetna — Connected North Carolina Individual HMO: $69.11 Aetna — Medicare Advantage: $133.21 Aetna — North Carolina Preferred Plus Commercial: $140.92 Aetna — Whole Health HMO: $102.98 Aetna First Health — Commercial: $208.67 Alliance — Behavioral Health: $37.86 Alliance — Managed Medicaid: $37.86 Ambetter — CoBranded Commercial: $84.88 Ambetter — Individual Commercial: $96.48
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS	$299	$149.50	$40.96 – $284.05
Preventive checkup, new patient, age 18–39: 10 of 45 insurance plan rates Aetna — Broad Network: $169.83 Aetna — Connected North Carolina Individual HMO: $76.25 Aetna — Medicare Advantage: $133.21 Aetna — North Carolina Preferred Plus Commercial: $155.48 Aetna — Whole Health HMO: $113.62 Aetna First Health — Commercial: $230.23 Alliance — Behavioral Health: $41.77 Alliance — Managed Medicaid: $41.77 Ambetter — CoBranded Commercial: $93.65 Ambetter — Individual Commercial: $106.44
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS	$271	$135.50	$94.85 – $268.94
Preventive checkup, new patient, age 18–39: 10 of 38 insurance plan rates Aetna — Broad Network: $268.94 Aetna — Connected North Carolina Individual HMO: $178.86 Aetna — North Carolina Preferred Plus Commercial: $250.75 Aetna — Whole Health HMO: $249.17 Aetna First Health — Commercial: $230.35 Alliance — Managed Medicaid: $96.84 Ambetter — CoBranded Commercial: $136.56 Ambetter — Individual Commercial: $174.33 Amerihealth Caritas — Managed Medicaid: $95.89 Beechstreet — Commercial: $243.90
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW PREVT 40-64 YRS	$308	$154	$42.20 – $292.60
Preventive checkup, new patient, age 40–64: 10 of 45 insurance plan rates Aetna — Broad Network: $174.94 Aetna — Connected North Carolina Individual HMO: $78.54 Aetna — Medicare Advantage: $154.17 Aetna — North Carolina Preferred Plus Commercial: $160.16 Aetna — Whole Health HMO: $117.04 Aetna First Health — Commercial: $237.16 Alliance — Behavioral Health: $43.03 Alliance — Managed Medicaid: $43.03 Ambetter — CoBranded Commercial: $96.47 Ambetter — Individual Commercial: $109.65
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS	$366	$183	$50.14 – $347.70
Preventive checkup, new patient, age 40–64: 10 of 45 insurance plan rates Aetna — Broad Network: $207.89 Aetna — Connected North Carolina Individual HMO: $93.33 Aetna — Medicare Advantage: $154.17 Aetna — North Carolina Preferred Plus Commercial: $190.32 Aetna — Whole Health HMO: $139.08 Aetna First Health — Commercial: $281.82 Alliance — Behavioral Health: $51.13 Alliance — Managed Medicaid: $51.13 Ambetter — CoBranded Commercial: $114.63 Ambetter — Individual Commercial: $130.30
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: HC CLINIC VISIT NEW PREVT 40-64 YRS	$308	$154	$107.80 – $311.52
Preventive checkup, new patient, age 40–64: 10 of 38 insurance plan rates Aetna — Broad Network: $311.52 Aetna — Connected North Carolina Individual HMO: $203.28 Aetna — North Carolina Preferred Plus Commercial: $290.45 Aetna — Whole Health HMO: $293.37 Aetna First Health — Commercial: $261.80 Alliance — Managed Medicaid: $117.76 Ambetter — CoBranded Commercial: $165.74 Ambetter — Individual Commercial: $211.58 Amerihealth Caritas — Managed Medicaid: $116.60 Beechstreet — Commercial: $277.20
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 3 VISIT MODERATE SEVERITY	$3,403	$1,701.50	$263.18 – $3,232.85
Emergency room visit (moderate): 10 of 47 insurance plan rates Aetna — Broad Network: $1,932.90 Aetna — Connected North Carolina Individual HMO: $867.77 Aetna — Medicare Advantage: $272.39 Aetna — North Carolina Preferred Plus Commercial: $1,769.56 Aetna — Whole Health HMO: $1,293.14 Aetna First Health — Commercial: $2,620.31 Alliance — Behavioral Health: $475.40 Alliance — Managed Medicaid: $475.40 Ambetter — CoBranded Commercial: $1,065.82 Ambetter — Individual Commercial: $1,211.47
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: HC ER LEVEL 3 VISIT MODERATE SEVERITY	$3,403	$1,701.50	$20 – $3,062.70
Emergency room visit (moderate): 10 of 43 insurance plan rates Aetna — Broad Network: $149.96 Aetna — Connected North Carolina Individual HMO: $2,245.98 Aetna — Medicare Advantage: $67.77 Aetna — North Carolina Preferred Plus Commercial: $139.81 Aetna — Whole Health HMO: $131.51 Aetna First Health — Commercial: $2,892.55 Alliance — Managed Medicaid: $55.96 Ambetter — CoBranded Commercial: $89.72 Ambetter — Individual Commercial: $114.53 Amerihealth Caritas — Managed Medicaid: $55.41
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 3 VISIT MODERATE SEVERITY	$3,403	$1,701.50	$990.27 – $3,232.85
Emergency room visit (moderate): 10 of 24 insurance plan rates Aetna — Broad Network: $1,715.11 Aetna — Connected North Carolina Individual HMO: $990.27 Aetna — North Carolina Preferred Plus Commercial: $1,565.38 Aetna — Whole Health HMO: $1,242.10 Aetna First Health — Commercial: $2,620.31 Beechstreet — Commercial: $3,130.76 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,658.96 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,260.81 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,520.80 Cigna — Commercial NB: $1,446.28
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 4 VISIT HIGH/URGENT SEVERITY	$3,563	$1,781.50	$402.28 – $3,384.85
Emergency room visit (moderately high): 10 of 47 insurance plan rates Aetna — Broad Network: $2,023.78 Aetna — Connected North Carolina Individual HMO: $908.57 Aetna — Medicare Advantage: $416.36 Aetna — North Carolina Preferred Plus Commercial: $1,852.76 Aetna — Whole Health HMO: $1,353.94 Aetna First Health — Commercial: $2,743.51 Alliance — Behavioral Health: $497.75 Alliance — Managed Medicaid: $497.75 Ambetter — CoBranded Commercial: $1,115.93 Ambetter — Individual Commercial: $1,268.43
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: HC ER LEVEL 4 VISIT HIGH/URGENT SEVERITY	$3,563	$1,781.50	$20 – $3,206.70
Emergency room visit (moderately high): 10 of 43 insurance plan rates Aetna — Broad Network: $253.41 Aetna — Connected North Carolina Individual HMO: $2,351.58 Aetna — Medicare Advantage: $115.27 Aetna — North Carolina Preferred Plus Commercial: $236.27 Aetna — Whole Health HMO: $205.37 Aetna First Health — Commercial: $342.45 Alliance — Managed Medicaid: $106.19 Ambetter — CoBranded Commercial: $164.50 Ambetter — Individual Commercial: $210.01 Amerihealth Caritas — Managed Medicaid: $105.15
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 4 VISIT HIGH/URGENT SEVERITY	$3,563	$1,781.50	$1,036.83 – $3,384.85
Emergency room visit (moderately high): 10 of 24 insurance plan rates Aetna — Broad Network: $1,795.75 Aetna — Connected North Carolina Individual HMO: $1,036.83 Aetna — North Carolina Preferred Plus Commercial: $1,638.98 Aetna — Whole Health HMO: $1,300.50 Aetna First Health — Commercial: $2,743.51 Beechstreet — Commercial: $3,277.96 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,736.96 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,320.09 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,592.30 Cigna — Commercial NB: $1,514.28
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$3,768	$1,884	$516.22 – $3,579.60
Emergency room visit (high): 10 of 47 insurance plan rates Aetna — Broad Network: $2,140.22 Aetna — Connected North Carolina Individual HMO: $960.84 Aetna — Medicare Advantage: $594.25 Aetna — North Carolina Preferred Plus Commercial: $1,959.36 Aetna — Whole Health HMO: $1,431.84 Aetna First Health — Commercial: $2,901.36 Alliance — Behavioral Health: $526.39 Alliance — Managed Medicaid: $526.39 Ambetter — CoBranded Commercial: $1,180.14 Ambetter — Individual Commercial: $1,341.41
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: HC ER LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$3,768	$1,884	$20 – $3,391.20
Emergency room visit (high): 10 of 43 insurance plan rates Aetna — Broad Network: $368.01 Aetna — Connected North Carolina Individual HMO: $2,486.88 Aetna — Medicare Advantage: $167.38 Aetna — North Carolina Preferred Plus Commercial: $343.11 Aetna — Whole Health HMO: $321.49 Aetna First Health — Commercial: $535 Alliance — Managed Medicaid: $156.47 Ambetter — CoBranded Commercial: $238.98 Ambetter — Individual Commercial: $305.09 Amerihealth Caritas — Managed Medicaid: $154.93
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$3,768	$1,884	$1,096.49 – $3,579.60
Emergency room visit (high): 10 of 24 insurance plan rates Aetna — Broad Network: $1,899.07 Aetna — Connected North Carolina Individual HMO: $1,096.49 Aetna — North Carolina Preferred Plus Commercial: $1,733.28 Aetna — Whole Health HMO: $1,375.32 Aetna First Health — Commercial: $2,901.36 Beechstreet — Commercial: $3,466.56 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,836.90 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,396.04 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,683.92 Cigna — Commercial NB: $1,601.40

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$369	$184.50	$8.46 – $350.55
Basic metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Broad Network: $209.59 Aetna — Connected North Carolina Individual HMO: $94.10 Aetna — Medicare Advantage: $8.76 Aetna — North Carolina Preferred Plus Commercial: $191.88 Aetna — Whole Health HMO: $140.22 Aetna First Health — Commercial: $284.13 Alliance — Behavioral Health: $51.55 Alliance — Managed Medicaid: $51.55 Ambetter — CoBranded Commercial: $115.57 Ambetter — Individual Commercial: $131.36
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$369	$184.50	$9.88 – $332.10
Basic metabolic panel (blood test): 10 of 38 insurance plan rates Aetna — Broad Network: $276.75 Aetna — Connected North Carolina Individual HMO: $243.54 Aetna — North Carolina Preferred Plus Commercial: $263.84 Aetna — Whole Health HMO: $243.54 Aetna First Health — Commercial: $313.65 Alliance — Managed Medicaid: $10.08 Ambetter — CoBranded Commercial: $162.36 Ambetter — Individual Commercial: $202.95 Amerihealth Caritas — Managed Medicaid: $9.98 Beechstreet — Commercial: $332.10
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$369	$184.50	$107.38 – $350.55
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Broad Network: $185.98 Aetna — Connected North Carolina Individual HMO: $107.38 Aetna — North Carolina Preferred Plus Commercial: $169.74 Aetna — Whole Health HMO: $134.69 Aetna First Health — Commercial: $284.13 Beechstreet — Commercial: $339.48 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $179.89 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $136.71 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $164.91 Cigna — Commercial NB: $156.83
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$510	$255	$10.56 – $484.50
Comprehensive metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Broad Network: $289.68 Aetna — Connected North Carolina Individual HMO: $130.05 Aetna — Medicare Advantage: $10.93 Aetna — North Carolina Preferred Plus Commercial: $265.20 Aetna — Whole Health HMO: $193.80 Aetna First Health — Commercial: $392.70 Alliance — Behavioral Health: $71.25 Alliance — Managed Medicaid: $71.25 Ambetter — CoBranded Commercial: $159.73 Ambetter — Individual Commercial: $181.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$510	$255	$10.42 – $459
Comprehensive metabolic panel (blood test): 10 of 38 insurance plan rates Aetna — Broad Network: $19.64 Aetna — Connected North Carolina Individual HMO: $336.60 Aetna — North Carolina Preferred Plus Commercial: $18.28 Aetna — Whole Health HMO: $19.66 Aetna First Health — Commercial: $49.75 Alliance — Managed Medicaid: $10.63 Ambetter — CoBranded Commercial: $224.40 Ambetter — Individual Commercial: $280.50 Amerihealth Caritas — Managed Medicaid: $10.52 Beechstreet — Commercial: $459
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$510	$255	$148.41 – $484.50
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Broad Network: $257.04 Aetna — Connected North Carolina Individual HMO: $148.41 Aetna — North Carolina Preferred Plus Commercial: $234.60 Aetna — Whole Health HMO: $186.15 Aetna First Health — Commercial: $392.70 Beechstreet — Commercial: $469.20 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $248.63 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $188.96 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $227.92 Cigna — Commercial NB: $216.75
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$27.81 – $28.37
Obstetric blood test panel: rates for 9 insurance plans Alliance — Managed Medicaid: $28.37 Amerihealth Caritas — Managed Medicaid: $28.09 Carolina Complete Health — Managed Medicaid: $28.09 Healthy Blue — Managed Medicaid: $28.09 Partners — Managed Medicaid: $28.09 Trillium — Managed Medicaid: $27.81 United Healthcare — Managed Medicaid: $28.09 Vaya — Managed Medicaid: $28.09 Wellcare — Managed Medicaid: $28.09
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$47.81 – $50.35
Obstetric blood test panel: rates for 6 insurance plans Aetna — Medicare Advantage: $49.48 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $47.81 Cigna Healthspring — Medicare Advantage: $50.20 Devoted Health — Medicare Advantage: $49.72 Humana — Medicare Advantage: $48.77 United Healthcare — Medicare Advantage: $50.35
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$392	$196	$13.39 – $372.40
Cholesterol panel (lipid panel): 10 of 45 insurance plan rates Aetna — Broad Network: $222.66 Aetna — Connected North Carolina Individual HMO: $99.96 Aetna — Medicare Advantage: $13.86 Aetna — North Carolina Preferred Plus Commercial: $203.84 Aetna — Whole Health HMO: $148.96 Aetna First Health — Commercial: $301.84 Alliance — Behavioral Health: $54.76 Alliance — Managed Medicaid: $54.76 Ambetter — CoBranded Commercial: $122.77 Ambetter — Individual Commercial: $139.55
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$392	$196	$16.53 – $352.80
Cholesterol panel (lipid panel): 10 of 38 insurance plan rates Aetna — Broad Network: $24.91 Aetna — Connected North Carolina Individual HMO: $258.72 Aetna — North Carolina Preferred Plus Commercial: $23.19 Aetna — Whole Health HMO: $31.18 Aetna First Health — Commercial: $78.97 Alliance — Managed Medicaid: $16.86 Ambetter — CoBranded Commercial: $172.48 Ambetter — Individual Commercial: $215.60 Amerihealth Caritas — Managed Medicaid: $16.70 Beechstreet — Commercial: $352.80
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$392	$196	$114.07 – $372.40
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — Broad Network: $197.57 Aetna — Connected North Carolina Individual HMO: $114.07 Aetna — North Carolina Preferred Plus Commercial: $180.32 Aetna — Whole Health HMO: $143.08 Aetna First Health — Commercial: $301.84 Beechstreet — Commercial: $360.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $191.10 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $145.24 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $175.18 Cigna — Commercial NB: $166.60
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$237	$118.50	$8.68 – $225.15
Kidney function panel: 10 of 45 insurance plan rates Aetna — Broad Network: $134.62 Aetna — Connected North Carolina Individual HMO: $60.44 Aetna — Medicare Advantage: $8.98 Aetna — North Carolina Preferred Plus Commercial: $123.24 Aetna — Whole Health HMO: $90.06 Aetna First Health — Commercial: $182.49 Alliance — Behavioral Health: $33.11 Alliance — Managed Medicaid: $33.11 Ambetter — CoBranded Commercial: $74.23 Ambetter — Individual Commercial: $84.37
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$237	$118.50	$9.88 – $213.30
Kidney function panel: 10 of 38 insurance plan rates Aetna — Broad Network: $177.75 Aetna — Connected North Carolina Individual HMO: $156.42 Aetna — North Carolina Preferred Plus Commercial: $169.46 Aetna — Whole Health HMO: $156.42 Aetna First Health — Commercial: $201.45 Alliance — Managed Medicaid: $10.08 Ambetter — CoBranded Commercial: $104.28 Ambetter — Individual Commercial: $130.35 Amerihealth Caritas — Managed Medicaid: $9.98 Beechstreet — Commercial: $213.30
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$237	$118.50	$68.97 – $225.15
Kidney function panel: 10 of 24 insurance plan rates Aetna — Broad Network: $119.45 Aetna — Connected North Carolina Individual HMO: $68.97 Aetna — North Carolina Preferred Plus Commercial: $109.02 Aetna — Whole Health HMO: $86.51 Aetna First Health — Commercial: $182.49 Beechstreet — Commercial: $218.04 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $115.54 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $87.81 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $105.92 Cigna — Commercial NB: $100.73
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$414	$207	$8.17 – $393.30
Liver function panel: 10 of 45 insurance plan rates Aetna — Broad Network: $235.15 Aetna — Connected North Carolina Individual HMO: $105.57 Aetna — Medicare Advantage: $8.46 Aetna — North Carolina Preferred Plus Commercial: $215.28 Aetna — Whole Health HMO: $157.32 Aetna First Health — Commercial: $318.78 Alliance — Behavioral Health: $57.84 Alliance — Managed Medicaid: $57.84 Ambetter — CoBranded Commercial: $129.66 Ambetter — Individual Commercial: $147.38
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$414	$207	$9.88 – $372.60
Liver function panel: 10 of 38 insurance plan rates Aetna — Broad Network: $310.50 Aetna — Connected North Carolina Individual HMO: $273.24 Aetna — North Carolina Preferred Plus Commercial: $296.01 Aetna — Whole Health HMO: $273.24 Aetna First Health — Commercial: $351.90 Alliance — Managed Medicaid: $10.08 Ambetter — CoBranded Commercial: $182.16 Ambetter — Individual Commercial: $227.70 Amerihealth Caritas — Managed Medicaid: $9.98 Beechstreet — Commercial: $372.60
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$414	$207	$120.47 – $393.30
Liver function panel: 10 of 24 insurance plan rates Aetna — Broad Network: $208.66 Aetna — Connected North Carolina Individual HMO: $120.47 Aetna — North Carolina Preferred Plus Commercial: $190.44 Aetna — Whole Health HMO: $151.11 Aetna First Health — Commercial: $318.78 Beechstreet — Commercial: $380.88 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $201.83 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $153.39 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $185.02 Cigna — Commercial NB: $175.95
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$85	$42.50	$3.17 – $80.75
Urine test (automated, with microscope): 10 of 45 insurance plan rates Aetna — Broad Network: $48.28 Aetna — Connected North Carolina Individual HMO: $21.68 Aetna — Medicare Advantage: $3.28 Aetna — North Carolina Preferred Plus Commercial: $44.20 Aetna — Whole Health HMO: $32.30 Aetna First Health — Commercial: $65.45 Alliance — Behavioral Health: $11.87 Alliance — Managed Medicaid: $11.87 Ambetter — CoBranded Commercial: $26.62 Ambetter — Individual Commercial: $30.26
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$85	$42.50	$3.91 – $76.50
Urine test (automated, with microscope): 10 of 38 insurance plan rates Aetna — Broad Network: $5.90 Aetna — Connected North Carolina Individual HMO: $56.10 Aetna — North Carolina Preferred Plus Commercial: $5.49 Aetna — Whole Health HMO: $7.38 Aetna First Health — Commercial: $18.63 Alliance — Managed Medicaid: $3.99 Ambetter — CoBranded Commercial: $37.40 Ambetter — Individual Commercial: $46.75 Amerihealth Caritas — Managed Medicaid: $3.95 Beechstreet — Commercial: $76.50
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$85	$42.50	$24.74 – $80.75
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — Broad Network: $42.84 Aetna — Connected North Carolina Individual HMO: $24.74 Aetna — North Carolina Preferred Plus Commercial: $39.10 Aetna — Whole Health HMO: $31.03 Aetna First Health — Commercial: $65.45 Beechstreet — Commercial: $78.20 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $41.44 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $31.49 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $37.99 Cigna — Commercial NB: $36.13
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS NONAUTO W/O MICRO	$78	$39	$3.48 – $74.10
Urine test (manual, without microscope): 10 of 45 insurance plan rates Aetna — Broad Network: $44.30 Aetna — Connected North Carolina Individual HMO: $19.89 Aetna — Medicare Advantage: $3.60 Aetna — North Carolina Preferred Plus Commercial: $40.56 Aetna — Whole Health HMO: $29.64 Aetna First Health — Commercial: $60.06 Alliance — Behavioral Health: $10.90 Alliance — Managed Medicaid: $10.90 Ambetter — CoBranded Commercial: $24.43 Ambetter — Individual Commercial: $27.77
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: HC URINALYSIS NONAUTO W/O MICRO	$78	$39	$3.15 – $70.20
Urine test (manual, without microscope): 10 of 38 insurance plan rates Aetna — Broad Network: $6.47 Aetna — Connected North Carolina Individual HMO: $51.48 Aetna — North Carolina Preferred Plus Commercial: $6.02 Aetna — Whole Health HMO: $5.95 Aetna First Health — Commercial: $15.11 Alliance — Managed Medicaid: $3.21 Ambetter — CoBranded Commercial: $34.32 Ambetter — Individual Commercial: $42.90 Amerihealth Caritas — Managed Medicaid: $3.18 Beechstreet — Commercial: $70.20
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS NONAUTO W/O MICRO	$78	$39	$22.70 – $74.10
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — Broad Network: $39.31 Aetna — Connected North Carolina Individual HMO: $22.70 Aetna — North Carolina Preferred Plus Commercial: $35.88 Aetna — Whole Health HMO: $28.47 Aetna First Health — Commercial: $60.06 Beechstreet — Commercial: $71.76 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $38.03 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $28.90 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $34.86 Cigna — Commercial NB: $33.15
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$110	$55	$2.25 – $104.50
Urine test (automated, without microscope): 10 of 45 insurance plan rates Aetna — Broad Network: $62.48 Aetna — Connected North Carolina Individual HMO: $28.05 Aetna — Medicare Advantage: $2.33 Aetna — North Carolina Preferred Plus Commercial: $57.20 Aetna — Whole Health HMO: $41.80 Aetna First Health — Commercial: $84.70 Alliance — Behavioral Health: $15.37 Alliance — Managed Medicaid: $15.37 Ambetter — CoBranded Commercial: $34.45 Ambetter — Individual Commercial: $39.16
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$110	$55	$2.34 – $99
Urine test (automated, without microscope): 10 of 38 insurance plan rates Aetna — Broad Network: $4.19 Aetna — Connected North Carolina Individual HMO: $72.60 Aetna — North Carolina Preferred Plus Commercial: $3.89 Aetna — Whole Health HMO: $5.24 Aetna First Health — Commercial: $13.22 Alliance — Managed Medicaid: $2.83 Ambetter — CoBranded Commercial: $48.40 Ambetter — Individual Commercial: $60.50 Amerihealth Caritas — Managed Medicaid: $2.80 Beechstreet — Commercial: $99
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$110	$55	$32.01 – $104.50
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — Broad Network: $55.44 Aetna — Connected North Carolina Individual HMO: $32.01 Aetna — North Carolina Preferred Plus Commercial: $50.60 Aetna — Whole Health HMO: $40.15 Aetna First Health — Commercial: $84.70 Beechstreet — Commercial: $101.20 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $53.63 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $40.76 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $49.16 Cigna — Commercial NB: $46.75
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$217	$108.50	$18.39 – $206.15
PSA (prostate specific antigen) blood test: 10 of 45 insurance plan rates Aetna — Broad Network: $123.26 Aetna — Connected North Carolina Individual HMO: $55.34 Aetna — Medicare Advantage: $19.03 Aetna — North Carolina Preferred Plus Commercial: $112.84 Aetna — Whole Health HMO: $82.46 Aetna First Health — Commercial: $167.09 Alliance — Behavioral Health: $30.31 Alliance — Managed Medicaid: $30.31 Ambetter — CoBranded Commercial: $67.96 Ambetter — Individual Commercial: $77.25
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$217	$108.50	$22.69 – $195.30
PSA (prostate specific antigen) blood test: 10 of 38 insurance plan rates Aetna — Broad Network: $162.75 Aetna — Connected North Carolina Individual HMO: $143.22 Aetna — North Carolina Preferred Plus Commercial: $155.16 Aetna — Whole Health HMO: $143.22 Aetna First Health — Commercial: $184.45 Alliance — Managed Medicaid: $23.14 Ambetter — CoBranded Commercial: $95.48 Ambetter — Individual Commercial: $119.35 Amerihealth Caritas — Managed Medicaid: $22.92 Beechstreet — Commercial: $195.30
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$217	$108.50	$63.15 – $206.15
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — Broad Network: $109.37 Aetna — Connected North Carolina Individual HMO: $63.15 Aetna — North Carolina Preferred Plus Commercial: $99.82 Aetna — Whole Health HMO: $79.21 Aetna First Health — Commercial: $167.09 Beechstreet — Commercial: $199.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $105.79 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $80.40 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $96.98 Cigna — Commercial NB: $92.23
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$390	$195	$16.80 – $370.50
Thyroid stimulating hormone (TSH) test: 10 of 45 insurance plan rates Aetna — Broad Network: $221.52 Aetna — Connected North Carolina Individual HMO: $99.45 Aetna — Medicare Advantage: $17.39 Aetna — North Carolina Preferred Plus Commercial: $202.80 Aetna — Whole Health HMO: $148.20 Aetna First Health — Commercial: $300.30 Alliance — Behavioral Health: $54.48 Alliance — Managed Medicaid: $29.61 Ambetter — CoBranded Commercial: $122.15 Ambetter — Individual Commercial: $138.84
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$390	$195	$20.10 – $351
Thyroid stimulating hormone (TSH) test: 10 of 38 insurance plan rates Aetna — Broad Network: $292.50 Aetna — Connected North Carolina Individual HMO: $257.40 Aetna — North Carolina Preferred Plus Commercial: $278.85 Aetna — Whole Health HMO: $257.40 Aetna First Health — Commercial: $331.50 Alliance — Managed Medicaid: $20.50 Ambetter — CoBranded Commercial: $171.60 Ambetter — Individual Commercial: $214.50 Amerihealth Caritas — Managed Medicaid: $20.30 Beechstreet — Commercial: $351
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$390	$195	$113.49 – $370.50
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — Broad Network: $196.56 Aetna — Connected North Carolina Individual HMO: $113.49 Aetna — North Carolina Preferred Plus Commercial: $179.40 Aetna — Whole Health HMO: $142.35 Aetna First Health — Commercial: $300.30 Beechstreet — Commercial: $358.80 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $190.13 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $144.50 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $174.29 Cigna — Commercial NB: $165.75
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$283	$141.50	$7.77 – $268.85
Complete blood count (CBC) with differential: 10 of 45 insurance plan rates Aetna — Broad Network: $160.74 Aetna — Connected North Carolina Individual HMO: $72.17 Aetna — Medicare Advantage: $8.04 Aetna — North Carolina Preferred Plus Commercial: $147.16 Aetna — Whole Health HMO: $107.54 Aetna First Health — Commercial: $217.91 Alliance — Behavioral Health: $39.54 Alliance — Managed Medicaid: $39.54 Ambetter — CoBranded Commercial: $88.64 Ambetter — Individual Commercial: $100.75
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$283	$141.50	$9.01 – $254.70
Complete blood count (CBC) with differential: 10 of 38 insurance plan rates Aetna — Broad Network: $14.45 Aetna — Connected North Carolina Individual HMO: $186.78 Aetna — North Carolina Preferred Plus Commercial: $13.45 Aetna — Whole Health HMO: $18.09 Aetna First Health — Commercial: $45.83 Alliance — Managed Medicaid: $9.77 Ambetter — CoBranded Commercial: $124.52 Ambetter — Individual Commercial: $155.65 Amerihealth Caritas — Managed Medicaid: $9.68 Beechstreet — Commercial: $254.70
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$283	$141.50	$82.35 – $268.85
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — Broad Network: $142.63 Aetna — Connected North Carolina Individual HMO: $82.35 Aetna — North Carolina Preferred Plus Commercial: $130.18 Aetna — Whole Health HMO: $103.30 Aetna First Health — Commercial: $217.91 Beechstreet — Commercial: $260.36 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $137.96 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $104.85 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $126.47 Cigna — Commercial NB: $120.28
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$139	$69.50	$6.47 – $132.05
Complete blood count (CBC), automated: 10 of 45 insurance plan rates Aetna — Broad Network: $78.95 Aetna — Connected North Carolina Individual HMO: $35.45 Aetna — Medicare Advantage: $6.70 Aetna — North Carolina Preferred Plus Commercial: $72.28 Aetna — Whole Health HMO: $52.82 Aetna First Health — Commercial: $107.03 Alliance — Behavioral Health: $19.42 Alliance — Managed Medicaid: $19.42 Ambetter — CoBranded Commercial: $43.53 Ambetter — Individual Commercial: $49.48
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: HC COMPLETE CBC	$139	$69.50	$7.50 – $125.10
Complete blood count (CBC), automated: 10 of 38 insurance plan rates Aetna — Broad Network: $12.03 Aetna — Connected North Carolina Individual HMO: $91.74 Aetna — North Carolina Preferred Plus Commercial: $11.21 Aetna — Whole Health HMO: $15.07 Aetna First Health — Commercial: $38.19 Alliance — Managed Medicaid: $8.14 Ambetter — CoBranded Commercial: $61.16 Ambetter — Individual Commercial: $76.45 Amerihealth Caritas — Managed Medicaid: $8.06 Beechstreet — Commercial: $125.10
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$139	$69.50	$40.45 – $132.05
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — Broad Network: $70.06 Aetna — Connected North Carolina Individual HMO: $40.45 Aetna — North Carolina Preferred Plus Commercial: $63.94 Aetna — Whole Health HMO: $50.74 Aetna First Health — Commercial: $107.03 Beechstreet — Commercial: $127.88 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $67.76 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $51.50 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $62.12 Cigna — Commercial NB: $59.08
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$142	$71	$4.29 – $134.90
Blood clotting time test (prothrombin time, PT): 10 of 45 insurance plan rates Aetna — Broad Network: $80.66 Aetna — Connected North Carolina Individual HMO: $36.21 Aetna — Medicare Advantage: $4.44 Aetna — North Carolina Preferred Plus Commercial: $73.84 Aetna — Whole Health HMO: $53.96 Aetna First Health — Commercial: $109.34 Alliance — Behavioral Health: $19.84 Alliance — Managed Medicaid: $19.84 Ambetter — CoBranded Commercial: $44.47 Ambetter — Individual Commercial: $50.55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: HC PROTHROMBIN TIME	$142	$71	$4.85 – $127.80
Blood clotting time test (prothrombin time, PT): 10 of 38 insurance plan rates Aetna — Broad Network: $7.98 Aetna — Connected North Carolina Individual HMO: $93.72 Aetna — North Carolina Preferred Plus Commercial: $7.43 Aetna — Whole Health HMO: $9.14 Aetna First Health — Commercial: $23.16 Alliance — Managed Medicaid: $4.95 Ambetter — CoBranded Commercial: $62.48 Ambetter — Individual Commercial: $78.10 Amerihealth Caritas — Managed Medicaid: $4.90 Beechstreet — Commercial: $127.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$142	$71	$41.32 – $134.90
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — Broad Network: $71.57 Aetna — Connected North Carolina Individual HMO: $41.32 Aetna — North Carolina Preferred Plus Commercial: $65.32 Aetna — Whole Health HMO: $51.83 Aetna First Health — Commercial: $109.34 Beechstreet — Commercial: $130.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $69.23 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $52.61 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $63.46 Cigna — Commercial NB: $60.35
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$146	$73	$6.01 – $138.70
Blood clotting test (partial thromboplastin time, PTT): 10 of 45 insurance plan rates Aetna — Broad Network: $82.93 Aetna — Connected North Carolina Individual HMO: $37.23 Aetna — Medicare Advantage: $6.22 Aetna — North Carolina Preferred Plus Commercial: $75.92 Aetna — Whole Health HMO: $55.48 Aetna First Health — Commercial: $112.42 Alliance — Behavioral Health: $20.40 Alliance — Managed Medicaid: $20.40 Ambetter — CoBranded Commercial: $45.73 Ambetter — Individual Commercial: $51.98
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: HC THROMBOPLAS TIME PARTIAL	$146	$73	$7.40 – $131.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 38 insurance plan rates Aetna — Broad Network: $109.50 Aetna — Connected North Carolina Individual HMO: $96.36 Aetna — North Carolina Preferred Plus Commercial: $104.39 Aetna — Whole Health HMO: $96.36 Aetna First Health — Commercial: $124.10 Alliance — Managed Medicaid: $7.55 Ambetter — CoBranded Commercial: $64.24 Ambetter — Individual Commercial: $80.30 Amerihealth Caritas — Managed Medicaid: $7.47 Beechstreet — Commercial: $131.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$146	$73	$42.49 – $138.70
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — Broad Network: $73.58 Aetna — Connected North Carolina Individual HMO: $42.49 Aetna — North Carolina Preferred Plus Commercial: $67.16 Aetna — Whole Health HMO: $53.29 Aetna First Health — Commercial: $112.42 Beechstreet — Commercial: $134.32 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $71.18 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $54.09 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $65.25 Cigna — Commercial NB: $62.05

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN W/O CONTRAST	$2,644	$1,322	$100.79 – $2,511.80
CT scan of the head or brain, without contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $674.22 Aetna — Medicare Advantage: $104.32 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $1,004.72 Aetna First Health — Commercial: $2,035.88 Alliance — Behavioral Health: $369.37 Alliance — Managed Medicaid: $369.37 Ambetter — CoBranded Commercial: $828.10 Ambetter — Individual Commercial: $941.26
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: HC CT HEAD/BRAIN W/O CONTRAST	$2,644	$1,322	$100.68 – $2,379.60
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $1,983 Aetna — Connected North Carolina Individual HMO: $1,745.04 Aetna — Medicare Advantage: $102.69 Aetna — North Carolina Preferred Plus Commercial: $1,890.46 Aetna — Whole Health HMO: $1,745.04 Aetna First Health — Commercial: $2,247.40 Alliance — Managed Medicaid: $172.30 Ambetter — CoBranded Commercial: $154.12 Ambetter — Individual Commercial: $1,454.20 Amerihealth Caritas — Managed Medicaid: $170.61
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN W/O CONTRAST	$2,644	$1,322	$769.40 – $2,511.80
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $1,332.58 Aetna — Connected North Carolina Individual HMO: $769.40 Aetna — North Carolina Preferred Plus Commercial: $1,216.24 Aetna — Whole Health HMO: $965.06 Aetna First Health — Commercial: $2,035.88 Beechstreet — Commercial: $2,432.48 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,288.95 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $979.60 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,181.60 Cigna — Commercial NB: $1,123.70
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O CONTRAST	$5,539	$2,769.50	$336.35 – $5,262.05
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $1,412.45 Aetna — Medicare Advantage: $348.12 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $2,104.82 Aetna First Health — Commercial: $4,265.03 Alliance — Behavioral Health: $773.80 Alliance — Managed Medicaid: $773.80 Ambetter — CoBranded Commercial: $1,734.81 Ambetter — Individual Commercial: $1,971.88
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: HC MRI BRAIN W & W/O CONTRAST	$5,539	$2,769.50	$299.16 – $4,985.10
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $4,154.25 Aetna — Connected North Carolina Individual HMO: $3,655.74 Aetna — Medicare Advantage: $305.14 Aetna — North Carolina Preferred Plus Commercial: $3,960.39 Aetna — Whole Health HMO: $3,655.74 Aetna First Health — Commercial: $4,708.15 Alliance — Managed Medicaid: $667.38 Ambetter — CoBranded Commercial: $486.13 Ambetter — Individual Commercial: $620.59 Amerihealth Caritas — Managed Medicaid: $660.83
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O CONTRAST	$5,539	$2,769.50	$1,611.85 – $5,262.05
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $2,791.66 Aetna — Connected North Carolina Individual HMO: $1,611.85 Aetna — North Carolina Preferred Plus Commercial: $2,547.94 Aetna — Whole Health HMO: $2,021.74 Aetna First Health — Commercial: $4,265.03 Beechstreet — Commercial: $5,095.88 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $2,700.26 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,052.20 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,475.38 Cigna — Commercial NB: $2,354.08
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$484	$242	$66.31 – $459.80
Chest X-ray, 2 views: 10 of 45 insurance plan rates Aetna — Broad Network: $274.91 Aetna — Connected North Carolina Individual HMO: $123.42 Aetna — Medicare Advantage: $86.84 Aetna — North Carolina Preferred Plus Commercial: $251.68 Aetna — Whole Health HMO: $183.92 Aetna First Health — Commercial: $372.68 Alliance — Behavioral Health: $67.61 Alliance — Managed Medicaid: $67.61 Ambetter — CoBranded Commercial: $151.59 Ambetter — Individual Commercial: $172.30
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: HC DX EXAM CHEST 2 VIEWS	$484	$242	$24.94 – $435.60
Chest X-ray, 2 views: 10 of 42 insurance plan rates Aetna — Broad Network: $70.39 Aetna — Connected North Carolina Individual HMO: $319.44 Aetna — Medicare Advantage: $31.74 Aetna — North Carolina Preferred Plus Commercial: $65.71 Aetna — Whole Health HMO: $70.29 Aetna First Health — Commercial: $411.40 Alliance — Managed Medicaid: $25.44 Ambetter — CoBranded Commercial: $43.53 Ambetter — Individual Commercial: $55.57 Amerihealth Caritas — Managed Medicaid: $25.19
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$484	$242	$140.84 – $459.80
Chest X-ray, 2 views: 10 of 24 insurance plan rates Aetna — Broad Network: $243.94 Aetna — Connected North Carolina Individual HMO: $140.84 Aetna — North Carolina Preferred Plus Commercial: $222.64 Aetna — Whole Health HMO: $176.66 Aetna First Health — Commercial: $372.68 Beechstreet — Commercial: $445.28 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $235.95 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $179.32 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $216.30 Cigna — Commercial NB: $205.70
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX SPINE LUMBAR MIN 4 VIEWS	$897	$448.50	$100.79 – $852.15
X-ray of the lower spine, at least 4 views: 10 of 45 insurance plan rates Aetna — Broad Network: $509.50 Aetna — Connected North Carolina Individual HMO: $228.74 Aetna — Medicare Advantage: $104.32 Aetna — North Carolina Preferred Plus Commercial: $466.44 Aetna — Whole Health HMO: $340.86 Aetna First Health — Commercial: $690.69 Alliance — Behavioral Health: $125.31 Alliance — Managed Medicaid: $125.31 Ambetter — CoBranded Commercial: $280.94 Ambetter — Individual Commercial: $319.33
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: HC DX SPINE LUMBAR MIN 4 VIEWS	$897	$448.50	$41.50 – $807.30
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates Aetna — Broad Network: $107.37 Aetna — Connected North Carolina Individual HMO: $592.02 Aetna — Medicare Advantage: $51.13 Aetna — North Carolina Preferred Plus Commercial: $100.24 Aetna — Whole Health HMO: $113.40 Aetna First Health — Commercial: $192.32 Alliance — Managed Medicaid: $42.33 Ambetter — CoBranded Commercial: $64.20 Ambetter — Individual Commercial: $81.96 Amerihealth Caritas — Managed Medicaid: $41.92
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX SPINE LUMBAR MIN 4 VIEWS	$897	$448.50	$261.03 – $852.15
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — Broad Network: $452.09 Aetna — Connected North Carolina Individual HMO: $261.03 Aetna — North Carolina Preferred Plus Commercial: $412.62 Aetna — Whole Health HMO: $327.41 Aetna First Health — Commercial: $690.69 Beechstreet — Commercial: $825.24 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $437.29 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $332.34 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $400.87 Cigna — Commercial NB: $381.23
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$4,194	$2,097	$230.04 – $3,984.30
MRI of the lower back (lumbar spine), without contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $1,069.47 Aetna — Medicare Advantage: $238.09 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $1,593.72 Aetna First Health — Commercial: $3,229.38 Alliance — Behavioral Health: $585.90 Alliance — Managed Medicaid: $585.90 Ambetter — CoBranded Commercial: $1,313.56 Ambetter — Individual Commercial: $1,493.06
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$4,194	$2,097	$181.12 – $3,774.60
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $3,145.50 Aetna — Connected North Carolina Individual HMO: $2,768.04 Aetna — Medicare Advantage: $184.74 Aetna — North Carolina Preferred Plus Commercial: $2,998.71 Aetna — Whole Health HMO: $2,768.04 Aetna First Health — Commercial: $3,564.90 Alliance — Managed Medicaid: $415.38 Ambetter — CoBranded Commercial: $289.99 Ambetter — Individual Commercial: $370.20 Amerihealth Caritas — Managed Medicaid: $411.31
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$4,194	$2,097	$1,220.45 – $3,984.30
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $2,113.78 Aetna — Connected North Carolina Individual HMO: $1,220.45 Aetna — North Carolina Preferred Plus Commercial: $1,929.24 Aetna — Whole Health HMO: $1,530.81 Aetna First Health — Commercial: $3,229.38 Beechstreet — Commercial: $3,858.48 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $2,044.58 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,553.88 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,874.30 Cigna — Commercial NB: $1,782.45
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST	$3,352	$1,676	$169.10 – $3,184.40
CT scan of the pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $854.76 Aetna — Medicare Advantage: $175.02 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $1,273.76 Aetna First Health — Commercial: $2,581.04 Alliance — Behavioral Health: $468.27 Alliance — Managed Medicaid: $468.27 Ambetter — CoBranded Commercial: $1,049.85 Ambetter — Individual Commercial: $1,193.31
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: HC CT SCAN OF PELVIS CONTRAST	$3,352	$1,676	$212.31 – $3,016.80
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $2,514 Aetna — Connected North Carolina Individual HMO: $2,212.32 Aetna — Medicare Advantage: $216.56 Aetna — North Carolina Preferred Plus Commercial: $2,396.68 Aetna — Whole Health HMO: $2,212.32 Aetna First Health — Commercial: $2,849.20 Alliance — Managed Medicaid: $255.83 Ambetter — CoBranded Commercial: $1,474.88 Ambetter — Individual Commercial: $1,843.60 Amerihealth Caritas — Managed Medicaid: $253.32
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST	$3,352	$1,676	$975.43 – $3,184.40
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $1,689.41 Aetna — Connected North Carolina Individual HMO: $975.43 Aetna — North Carolina Preferred Plus Commercial: $1,541.92 Aetna — Whole Health HMO: $1,223.48 Aetna First Health — Commercial: $2,581.04 Beechstreet — Commercial: $3,083.84 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,634.10 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,241.92 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,498.01 Cigna — Commercial NB: $1,424.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREM JT W/O CONTRAST	$4,005	$2,002.50	$230.04 – $3,804.75
MRI of a leg joint (such as the knee), without contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $1,021.28 Aetna — Medicare Advantage: $238.09 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $1,521.90 Aetna First Health — Commercial: $3,083.85 Alliance — Behavioral Health: $559.50 Alliance — Managed Medicaid: $559.50 Ambetter — CoBranded Commercial: $1,254.37 Ambetter — Individual Commercial: $1,425.78
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: HC MRI LOWER EXTREM JT W/O CONTRAST	$4,005	$2,002.50	$192.79 – $3,604.50
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $3,003.75 Aetna — Connected North Carolina Individual HMO: $2,643.30 Aetna — Medicare Advantage: $196.65 Aetna — North Carolina Preferred Plus Commercial: $2,863.58 Aetna — Whole Health HMO: $2,643.30 Aetna First Health — Commercial: $3,404.25 Alliance — Managed Medicaid: $427.40 Ambetter — CoBranded Commercial: $304.55 Ambetter — Individual Commercial: $388.79 Amerihealth Caritas — Managed Medicaid: $423.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREM JT W/O CONTRAST	$4,005	$2,002.50	$1,165.46 – $3,804.75
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $2,018.52 Aetna — Connected North Carolina Individual HMO: $1,165.46 Aetna — North Carolina Preferred Plus Commercial: $1,842.30 Aetna — Whole Health HMO: $1,461.83 Aetna First Health — Commercial: $3,083.85 Beechstreet — Commercial: $3,684.60 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,952.44 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,483.85 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,789.83 Cigna — Commercial NB: $1,702.13
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN ABDOMEN AND PELVIS W CONTRAST	$6,702	$3,351	$336.35 – $6,366.90
CT scan of the abdomen and pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Broad Network: $1,020 Aetna — Connected North Carolina Individual HMO: $1,709.01 Aetna — Medicare Advantage: $348.12 Aetna — North Carolina Preferred Plus Commercial: $933 Aetna — Whole Health HMO: $2,546.76 Aetna First Health — Commercial: $5,160.54 Alliance — Behavioral Health: $936.27 Alliance — Managed Medicaid: $936.27 Ambetter — CoBranded Commercial: $2,099.07 Ambetter — Individual Commercial: $2,385.91
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: HC CT SCAN ABDOMEN AND PELVIS W CONTRAST	$6,702	$3,351	$239.28 – $6,031.80
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates Aetna — Broad Network: $5,026.50 Aetna — Connected North Carolina Individual HMO: $4,423.32 Aetna — Medicare Advantage: $288.50 Aetna — North Carolina Preferred Plus Commercial: $4,791.93 Aetna — Whole Health HMO: $4,423.32 Aetna First Health — Commercial: $5,696.70 Alliance — Managed Medicaid: $278.98 Ambetter — CoBranded Commercial: $2,948.88 Ambetter — Individual Commercial: $3,686.10 Amerihealth Caritas — Managed Medicaid: $276.25
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT SCAN ABDOMEN AND PELVIS W CONTRAST	$6,702	$3,351	$1,950.28 – $6,366.90
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Broad Network: $3,377.81 Aetna — Connected North Carolina Individual HMO: $1,950.28 Aetna — North Carolina Preferred Plus Commercial: $3,082.92 Aetna — Whole Health HMO: $2,446.23 Aetna First Health — Commercial: $5,160.54 Beechstreet — Commercial: $6,165.84 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $3,267.23 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,483.09 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,995.12 Cigna — Commercial NB: $2,848.35
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE	$1,386	$693	$100.79 – $1,316.70
Ultrasound of the abdomen, complete: 10 of 45 insurance plan rates Aetna — Broad Network: $787.25 Aetna — Connected North Carolina Individual HMO: $353.43 Aetna — Medicare Advantage: $104.32 Aetna — North Carolina Preferred Plus Commercial: $720.72 Aetna — Whole Health HMO: $526.68 Aetna First Health — Commercial: $1,067.22 Alliance — Behavioral Health: $193.62 Alliance — Managed Medicaid: $193.62 Ambetter — CoBranded Commercial: $434.10 Ambetter — Individual Commercial: $493.42
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE	$1,386	$693	$105.98 – $1,247.40
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates Aetna — Broad Network: $1,039.50 Aetna — Connected North Carolina Individual HMO: $914.76 Aetna — Medicare Advantage: $109.92 Aetna — North Carolina Preferred Plus Commercial: $990.99 Aetna — Whole Health HMO: $914.76 Aetna First Health — Commercial: $1,178.10 Alliance — Managed Medicaid: $108.10 Ambetter — CoBranded Commercial: $609.84 Ambetter — Individual Commercial: $762.30 Amerihealth Caritas — Managed Medicaid: $107.04
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE	$1,386	$693	$403.33 – $1,316.70
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — Broad Network: $698.54 Aetna — Connected North Carolina Individual HMO: $403.33 Aetna — North Carolina Preferred Plus Commercial: $637.56 Aetna — Whole Health HMO: $505.89 Aetna First Health — Commercial: $1,067.22 Beechstreet — Commercial: $1,275.12 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $675.68 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $513.51 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $619.40 Cigna — Commercial NB: $589.05
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB >/= 14 WKS SNGL FETUS	$999	$499.50	$100.79 – $949.05
Pregnancy ultrasound (after the first trimester): 10 of 45 insurance plan rates Aetna — Broad Network: $567.43 Aetna — Connected North Carolina Individual HMO: $254.75 Aetna — Medicare Advantage: $104.32 Aetna — North Carolina Preferred Plus Commercial: $519.48 Aetna — Whole Health HMO: $379.62 Aetna First Health — Commercial: $769.23 Alliance — Behavioral Health: $139.56 Alliance — Managed Medicaid: $139.56 Ambetter — CoBranded Commercial: $312.89 Ambetter — Individual Commercial: $355.64
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: HC US OB >/= 14 WKS SNGL FETUS	$999	$499.50	$113.58 – $899.10
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates Aetna — Broad Network: $285.85 Aetna — Connected North Carolina Individual HMO: $659.34 Aetna — Medicare Advantage: $130.89 Aetna — North Carolina Preferred Plus Commercial: $266.86 Aetna — Whole Health HMO: $294.64 Aetna First Health — Commercial: $499 Alliance — Managed Medicaid: $115.85 Ambetter — CoBranded Commercial: $187.27 Ambetter — Individual Commercial: $239.07 Amerihealth Caritas — Managed Medicaid: $114.72
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB >/= 14 WKS SNGL FETUS	$999	$499.50	$290.71 – $949.05
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Aetna — Broad Network: $503.50 Aetna — Connected North Carolina Individual HMO: $290.71 Aetna — North Carolina Preferred Plus Commercial: $459.54 Aetna — Whole Health HMO: $364.64 Aetna First Health — Commercial: $769.23 Beechstreet — Commercial: $919.08 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $487.01 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $370.13 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $446.45 Cigna — Commercial NB: $424.58
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TRANSVAGINAL ULTRASOUND	$1,024	$512	$100.79 – $972.80
Transvaginal ultrasound: 10 of 45 insurance plan rates Aetna — Broad Network: $581.63 Aetna — Connected North Carolina Individual HMO: $261.12 Aetna — Medicare Advantage: $104.32 Aetna — North Carolina Preferred Plus Commercial: $532.48 Aetna — Whole Health HMO: $389.12 Aetna First Health — Commercial: $788.48 Alliance — Behavioral Health: $143.05 Alliance — Managed Medicaid: $143.05 Ambetter — CoBranded Commercial: $320.72 Ambetter — Individual Commercial: $364.54
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: HC TRANSVAGINAL ULTRASOUND	$1,024	$512	$93.02 – $921.60
Transvaginal ultrasound: 10 of 42 insurance plan rates Aetna — Broad Network: $253.71 Aetna — Connected North Carolina Individual HMO: $675.84 Aetna — Medicare Advantage: $112.81 Aetna — North Carolina Preferred Plus Commercial: $236.85 Aetna — Whole Health HMO: $210.44 Aetna First Health — Commercial: $354.98 Alliance — Managed Medicaid: $94.88 Ambetter — CoBranded Commercial: $163.99 Ambetter — Individual Commercial: $209.35 Amerihealth Caritas — Managed Medicaid: $93.95
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC TRANSVAGINAL ULTRASOUND	$1,024	$512	$297.98 – $972.80
Transvaginal ultrasound: 10 of 24 insurance plan rates Aetna — Broad Network: $516.10 Aetna — Connected North Carolina Individual HMO: $297.98 Aetna — North Carolina Preferred Plus Commercial: $471.04 Aetna — Whole Health HMO: $373.76 Aetna First Health — Commercial: $788.48 Beechstreet — Commercial: $942.08 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $499.20 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $379.39 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $457.63 Cigna — Commercial NB: $435.20
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$462	$231	$63.29 – $438.90
Diagnostic mammogram, one breast: 10 of 45 insurance plan rates Aetna — Broad Network: $262.42 Aetna — Connected North Carolina Individual HMO: $117.81 Aetna — Medicare Advantage: $120.88 Aetna — North Carolina Preferred Plus Commercial: $240.24 Aetna — Whole Health HMO: $175.56 Aetna First Health — Commercial: $355.74 Alliance — Behavioral Health: $64.54 Alliance — Managed Medicaid: $64.54 Ambetter — CoBranded Commercial: $144.70 Ambetter — Individual Commercial: $164.47
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$462	$231	$94.79 – $415.80
Diagnostic mammogram, one breast: 10 of 42 insurance plan rates Aetna — Broad Network: $346.50 Aetna — Connected North Carolina Individual HMO: $304.92 Aetna — Medicare Advantage: $119.13 Aetna — North Carolina Preferred Plus Commercial: $330.33 Aetna — Whole Health HMO: $304.92 Aetna First Health — Commercial: $392.70 Alliance — Managed Medicaid: $96.69 Ambetter — CoBranded Commercial: $203.28 Ambetter — Individual Commercial: $254.10 Amerihealth Caritas — Managed Medicaid: $95.74
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$462	$231	$134.44 – $438.90
Diagnostic mammogram, one breast: 10 of 24 insurance plan rates Aetna — Broad Network: $232.85 Aetna — Connected North Carolina Individual HMO: $134.44 Aetna — North Carolina Preferred Plus Commercial: $212.52 Aetna — Whole Health HMO: $168.63 Aetna First Health — Commercial: $355.74 Beechstreet — Commercial: $425.04 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $225.23 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $171.17 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $206.47 Cigna — Commercial NB: $196.35
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$922	$461	$126.31 – $875.90
Diagnostic mammogram, both breasts: 10 of 45 insurance plan rates Aetna — Broad Network: $523.70 Aetna — Connected North Carolina Individual HMO: $235.11 Aetna — Medicare Advantage: $153.05 Aetna — North Carolina Preferred Plus Commercial: $479.44 Aetna — Whole Health HMO: $350.36 Aetna First Health — Commercial: $709.94 Alliance — Behavioral Health: $128.80 Alliance — Managed Medicaid: $128.80 Ambetter — CoBranded Commercial: $288.77 Ambetter — Individual Commercial: $328.23
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$922	$461	$119.34 – $829.80
Diagnostic mammogram, both breasts: 10 of 42 insurance plan rates Aetna — Broad Network: $691.50 Aetna — Connected North Carolina Individual HMO: $608.52 Aetna — Medicare Advantage: $150.83 Aetna — North Carolina Preferred Plus Commercial: $659.23 Aetna — Whole Health HMO: $608.52 Aetna First Health — Commercial: $783.70 Alliance — Managed Medicaid: $121.73 Ambetter — CoBranded Commercial: $405.68 Ambetter — Individual Commercial: $507.10 Amerihealth Caritas — Managed Medicaid: $120.53
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$922	$461	$268.30 – $875.90
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Broad Network: $464.69 Aetna — Connected North Carolina Individual HMO: $268.30 Aetna — North Carolina Preferred Plus Commercial: $424.12 Aetna — Whole Health HMO: $336.53 Aetna First Health — Commercial: $709.94 Beechstreet — Commercial: $848.24 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $449.48 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $341.60 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $412.04 Cigna — Commercial NB: $391.85
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$667	$333.50	$91.38 – $633.65
Screening mammogram, both breasts: 10 of 45 insurance plan rates Aetna — Broad Network: $378.86 Aetna — Connected North Carolina Individual HMO: $170.09 Aetna — Medicare Advantage: $123.12 Aetna — North Carolina Preferred Plus Commercial: $346.84 Aetna — Whole Health HMO: $253.46 Aetna First Health — Commercial: $513.59 Alliance — Behavioral Health: $93.18 Alliance — Managed Medicaid: $93.18 Ambetter — CoBranded Commercial: $208.90 Ambetter — Individual Commercial: $237.45
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$667	$333.50	$101.42 – $600.30
Screening mammogram, both breasts: 10 of 42 insurance plan rates Aetna — Broad Network: $500.25 Aetna — Connected North Carolina Individual HMO: $440.22 Aetna — Medicare Advantage: $121.34 Aetna — North Carolina Preferred Plus Commercial: $476.91 Aetna — Whole Health HMO: $440.22 Aetna First Health — Commercial: $566.95 Alliance — Managed Medicaid: $103.45 Ambetter — CoBranded Commercial: $293.48 Ambetter — Individual Commercial: $366.85 Amerihealth Caritas — Managed Medicaid: $102.43
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$667	$333.50	$194.10 – $633.65
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Broad Network: $336.17 Aetna — Connected North Carolina Individual HMO: $194.10 Aetna — North Carolina Preferred Plus Commercial: $306.82 Aetna — Whole Health HMO: $243.46 Aetna First Health — Commercial: $513.59 Beechstreet — Commercial: $613.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $325.16 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $247.12 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $298.08 Cigna — Commercial NB: $283.48

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.52 – $100.08
Electrocardiogram (ECG/EKG) with reading: 10 of 27 insurance plan rates Aetna — Broad Network: $29.89 Aetna — Medicare Advantage: $14.81 Aetna — North Carolina Preferred Plus Commercial: $27.90 Aetna — Whole Health HMO: $58.13 Aetna First Health — Commercial: $100.08 Alliance — Managed Medicaid: $16.67 Amerihealth Caritas — Managed Medicaid: $16.50 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $60.85 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $46.25 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $46.85
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.52 – $15.29
Electrocardiogram (ECG/EKG) with reading: rates for 6 insurance plans Aetna — Medicare Advantage: $15.03 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $14.52 Cigna Healthspring — Medicare Advantage: $15.24 Devoted Health — Medicare Advantage: $15.10 Humana — Medicare Advantage: $14.81 United Healthcare — Medicare Advantage: $15.29
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$24,533	$12,266.50	$3,125.54 – $23,306.35
Left heart catheterization (diagnostic): 10 of 45 insurance plan rates Aetna — Broad Network: $13,934.74 Aetna — Connected North Carolina Individual HMO: $6,255.92 Aetna — Medicare Advantage: $3,234.94 Aetna — North Carolina Preferred Plus Commercial: $12,757.16 Aetna — Whole Health HMO: $9,322.54 Aetna First Health — Commercial: $18,890.41 Alliance — Behavioral Health: $3,427.26 Alliance — Managed Medicaid: $3,427.26 Ambetter — CoBranded Commercial: $7,683.74 Ambetter — Individual Commercial: $8,733.75
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$24,533	$12,266.50	$675.12 – $22,079.70
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates Aetna — Broad Network: $18,399.75 Aetna — Connected North Carolina Individual HMO: $16,191.78 Aetna — Medicare Advantage: $834.76 Aetna — North Carolina Preferred Plus Commercial: $17,541.10 Aetna — Whole Health HMO: $16,191.78 Aetna First Health — Commercial: $20,853.05 Alliance — Managed Medicaid: $688.62 Ambetter — CoBranded Commercial: $10,794.52 Ambetter — Individual Commercial: $13,493.15 Amerihealth Caritas — Managed Medicaid: $681.87
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$24,533	$12,266.50	$7,139.10 – $23,306.35
Left heart catheterization (diagnostic): 10 of 24 insurance plan rates Aetna — Broad Network: $12,364.63 Aetna — Connected North Carolina Individual HMO: $7,139.10 Aetna — North Carolina Preferred Plus Commercial: $11,285.18 Aetna — Whole Health HMO: $8,954.55 Aetna First Health — Commercial: $18,890.41 Beechstreet — Commercial: $22,570.36 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $11,959.84 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $9,089.48 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $10,963.80 Cigna — Commercial NB: $10,426.53
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$556.90 – $652.51
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $622.02 Alliance — Managed Medicaid: $568.04 Amerihealth Caritas — Managed Medicaid: $562.47 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $609.82 Carolina Complete Health — Managed Medicaid: $562.47 Cigna Healthspring — Medicare Advantage: $652.51 Devoted Health — Medicare Advantage: $634.21 Healthy Blue — Managed Medicaid: $562.47 Humana — Medicare Advantage: $622.02 Partners — Managed Medicaid: $562.47
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$7,519.65 – $7,918.94
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans Aetna — Medicare Advantage: $7,782.84 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $7,519.65 Cigna Healthspring — Medicare Advantage: $7,895.63 Devoted Health — Medicare Advantage: $7,820.44 Humana — Medicare Advantage: $7,670.04 United Healthcare — Medicare Advantage: $7,918.94
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$335.77 – $377.62
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $359.98 Alliance — Managed Medicaid: $342.49 Amerihealth Caritas — Managed Medicaid: $339.13 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $352.92 Carolina Complete Health — Managed Medicaid: $339.13 Cigna Healthspring — Medicare Advantage: $377.62 Devoted Health — Medicare Advantage: $367.04 Healthy Blue — Managed Medicaid: $339.13 Humana — Medicare Advantage: $359.98 Partners — Managed Medicaid: $339.13
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EP EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN	$126,068	$63,034	$17,271.32 – $119,764.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 45 insurance plan rates Aetna — Broad Network: $71,606.62 Aetna — Connected North Carolina Individual HMO: $32,147.34 Aetna — Medicare Advantage: $26,081.47 Aetna — North Carolina Preferred Plus Commercial: $65,555.36 Aetna — Whole Health HMO: $47,905.84 Aetna First Health — Commercial: $97,072.36 Alliance — Behavioral Health: $17,611.70 Alliance — Managed Medicaid: $17,611.70 Ambetter — CoBranded Commercial: $39,484.50 Ambetter — Individual Commercial: $44,880.21
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: HC EP EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN	$126,068	$63,034	$751.30 – $113,461.20
Heart rhythm study with ablation for atrial fibrillation: 10 of 42 insurance plan rates Aetna — Broad Network: $2,348.50 Aetna — Connected North Carolina Individual HMO: $83,204.88 Aetna — Medicare Advantage: $766.33 Aetna — North Carolina Preferred Plus Commercial: $2,192.46 Aetna — Whole Health HMO: $83,204.88 Aetna First Health — Commercial: $107,157.80 Alliance — Managed Medicaid: $879.30 Ambetter — CoBranded Commercial: $1,553.52 Ambetter — Individual Commercial: $1,983.22 Amerihealth Caritas — Managed Medicaid: $870.68
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EP EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN	$126,068	$63,034	$36,685.79 – $119,764.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 24 insurance plan rates Aetna — Broad Network: $63,538.27 Aetna — Connected North Carolina Individual HMO: $36,685.79 Aetna — North Carolina Preferred Plus Commercial: $57,991.28 Aetna — Whole Health HMO: $46,014.82 Aetna First Health — Commercial: $97,072.36 Beechstreet — Commercial: $115,982.56 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $61,458.15 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $46,708.19 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $56,339.79 Cigna — Commercial NB: $53,578.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$6,630	$3,315	$827.91 – $6,298.50
Sleep study (overnight, in a sleep lab): 10 of 45 insurance plan rates Aetna — Broad Network: $3,765.84 Aetna — Connected North Carolina Individual HMO: $1,690.65 Aetna — Medicare Advantage: $856.89 Aetna — North Carolina Preferred Plus Commercial: $3,447.60 Aetna — Whole Health HMO: $2,519.40 Aetna First Health — Commercial: $5,105.10 Alliance — Behavioral Health: $926.21 Alliance — Managed Medicaid: $926.21 Ambetter — CoBranded Commercial: $2,076.52 Ambetter — Individual Commercial: $2,360.28
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$6,630	$3,315	$168.98 – $5,967
Sleep study (overnight, in a sleep lab): 10 of 42 insurance plan rates Aetna — Broad Network: $1,258.35 Aetna — Connected North Carolina Individual HMO: $4,375.80 Aetna — Medicare Advantage: $644.10 Aetna — North Carolina Preferred Plus Commercial: $1,174.75 Aetna — Whole Health HMO: $1,766.13 Aetna First Health — Commercial: $3,004.47 Alliance — Managed Medicaid: $610.08 Ambetter — CoBranded Commercial: $168.98 Ambetter — Individual Commercial: $1,034.16 Amerihealth Caritas — Managed Medicaid: $604.10
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$6,630	$3,315	$1,929.33 – $6,298.50
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates Aetna — Broad Network: $3,341.52 Aetna — Connected North Carolina Individual HMO: $1,929.33 Aetna — North Carolina Preferred Plus Commercial: $3,049.80 Aetna — Whole Health HMO: $2,419.95 Aetna First Health — Commercial: $5,105.10 Beechstreet — Commercial: $6,099.60 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $3,232.13 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,456.42 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,962.95 Cigna — Commercial NB: $2,817.75

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THERAPEUTIC RECREATION IND TIMED	$200	$100	$27.40 – $190
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 45 insurance plan rates Aetna — Broad Network: $113.60 Aetna — Connected North Carolina Individual HMO: $51 Aetna — Medicare Advantage: $29 Aetna — North Carolina Preferred Plus Commercial: $104 Aetna — Whole Health HMO: $76 Aetna First Health — Commercial: $154 Alliance — Behavioral Health: $27.94 Alliance — Managed Medicaid: $27.94 Ambetter — CoBranded Commercial: $62.64 Ambetter — Individual Commercial: $71.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT THERAPEUTIC EXERCISES	$196	$98	$26.85 – $186.20
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 45 insurance plan rates Aetna — Broad Network: $111.33 Aetna — Connected North Carolina Individual HMO: $49.98 Aetna — Medicare Advantage: $29 Aetna — North Carolina Preferred Plus Commercial: $101.92 Aetna — Whole Health HMO: $74.48 Aetna First Health — Commercial: $150.92 Alliance — Behavioral Health: $27.38 Alliance — Managed Medicaid: $27.38 Ambetter — CoBranded Commercial: $61.39 Ambetter — Individual Commercial: $69.78
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OT THERAPEUTIC EXERCISES	$196	$98	$26.85 – $186.20
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 45 insurance plan rates Aetna — Broad Network: $111.33 Aetna — Connected North Carolina Individual HMO: $49.98 Aetna — Medicare Advantage: $29 Aetna — North Carolina Preferred Plus Commercial: $101.92 Aetna — Whole Health HMO: $74.48 Aetna First Health — Commercial: $150.92 Alliance — Behavioral Health: $27.38 Alliance — Managed Medicaid: $27.38 Ambetter — CoBranded Commercial: $61.39 Ambetter — Individual Commercial: $69.78
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$421	$210.50	$57.68 – $399.95
Physical therapy evaluation (low complexity): 10 of 45 insurance plan rates Aetna — Broad Network: $239.13 Aetna — Connected North Carolina Individual HMO: $107.36 Aetna — Medicare Advantage: $97.97 Aetna — North Carolina Preferred Plus Commercial: $218.92 Aetna — Whole Health HMO: $159.98 Aetna First Health — Commercial: $324.17 Alliance — Behavioral Health: $58.81 Alliance — Managed Medicaid: $58.81 Ambetter — CoBranded Commercial: $131.86 Ambetter — Individual Commercial: $149.88
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$421	$210.50	$122.51 – $399.95
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates Aetna — Broad Network: $212.18 Aetna — Connected North Carolina Individual HMO: $122.51 Aetna — North Carolina Preferred Plus Commercial: $193.66 Aetna — Whole Health HMO: $153.67 Aetna First Health — Commercial: $324.17 Beechstreet — Commercial: $387.32 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $205.24 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $155.98 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $188.14 Cigna — Commercial NB: $178.93
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$67.46 – $266.69
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates Aetna — Broad Network: $213.04 Aetna — Medicare Advantage: $96.55 Aetna — North Carolina Preferred Plus Commercial: $198.88 Aetna — Whole Health HMO: $176.67 Alliance — Managed Medicaid: $68.81 Ambetter — CoBranded Commercial: $117.17 Ambetter — Individual Commercial: $149.58 Amerihealth Caritas — Managed Medicaid: $68.13 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $149.04 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $113.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$632	$316	$86.58 – $600.40
Physical therapy evaluation (moderate complexity): 10 of 45 insurance plan rates Aetna — Broad Network: $358.98 Aetna — Connected North Carolina Individual HMO: $161.16 Aetna — Medicare Advantage: $97.97 Aetna — North Carolina Preferred Plus Commercial: $328.64 Aetna — Whole Health HMO: $240.16 Aetna First Health — Commercial: $486.64 Alliance — Behavioral Health: $88.29 Alliance — Managed Medicaid: $88.29 Ambetter — CoBranded Commercial: $197.94 Ambetter — Individual Commercial: $224.99
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$632	$316	$183.91 – $600.40
Physical therapy evaluation (moderate complexity): 10 of 24 insurance plan rates Aetna — Broad Network: $318.53 Aetna — Connected North Carolina Individual HMO: $183.91 Aetna — North Carolina Preferred Plus Commercial: $290.72 Aetna — Whole Health HMO: $230.68 Aetna First Health — Commercial: $486.64 Beechstreet — Commercial: $581.44 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $308.10 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $234.16 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $282.44 Cigna — Commercial NB: $268.60
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$67.46 – $266.69
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates Aetna — Broad Network: $213.04 Aetna — Medicare Advantage: $96.55 Aetna — North Carolina Preferred Plus Commercial: $198.88 Aetna — Whole Health HMO: $176.67 Alliance — Managed Medicaid: $68.81 Ambetter — CoBranded Commercial: $117.17 Ambetter — Individual Commercial: $149.58 Amerihealth Caritas — Managed Medicaid: $68.13 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $149.04 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $113.27
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$842	$421	$94.66 – $799.90
Physical therapy evaluation (high complexity): 10 of 45 insurance plan rates Aetna — Broad Network: $478.26 Aetna — Connected North Carolina Individual HMO: $214.71 Aetna — Medicare Advantage: $97.97 Aetna — North Carolina Preferred Plus Commercial: $437.84 Aetna — Whole Health HMO: $319.96 Aetna First Health — Commercial: $648.34 Alliance — Behavioral Health: $117.63 Alliance — Managed Medicaid: $117.63 Ambetter — CoBranded Commercial: $263.71 Ambetter — Individual Commercial: $299.75
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$842	$421	$245.02 – $799.90
Physical therapy evaluation (high complexity): 10 of 24 insurance plan rates Aetna — Broad Network: $424.37 Aetna — Connected North Carolina Individual HMO: $245.02 Aetna — North Carolina Preferred Plus Commercial: $387.32 Aetna — Whole Health HMO: $307.33 Aetna First Health — Commercial: $648.34 Beechstreet — Commercial: $774.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $410.48 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $311.96 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $376.29 Cigna — Commercial NB: $357.85
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$67.46 – $266.69
Physical therapy evaluation (high complexity): 10 of 27 insurance plan rates Aetna — Broad Network: $213.04 Aetna — Medicare Advantage: $96.55 Aetna — North Carolina Preferred Plus Commercial: $198.88 Aetna — Whole Health HMO: $176.67 Alliance — Managed Medicaid: $68.81 Ambetter — CoBranded Commercial: $117.17 Ambetter — Individual Commercial: $149.58 Amerihealth Caritas — Managed Medicaid: $68.13 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $149.04 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $113.27
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY W/PATIENT 30 MINUTES	$170	$85	$23.29 – $180.21
Psychotherapy, 30 minutes: 10 of 45 insurance plan rates Aetna — Broad Network: $96.56 Aetna — Connected North Carolina Individual HMO: $43.35 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $88.40 Aetna — Whole Health HMO: $64.60 Aetna First Health — Commercial: $130.90 Alliance — Behavioral Health: $23.75 Alliance — Managed Medicaid: $23.75 Ambetter — CoBranded Commercial: $53.24 Ambetter — Individual Commercial: $60.52
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$170	$85	$23.29 – $180.21
Psychotherapy, 30 minutes: 10 of 45 insurance plan rates Aetna — Broad Network: $96.56 Aetna — Connected North Carolina Individual HMO: $43.35 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $88.40 Aetna — Whole Health HMO: $64.60 Aetna First Health — Commercial: $130.90 Alliance — Behavioral Health: $23.75 Alliance — Managed Medicaid: $23.75 Ambetter — CoBranded Commercial: $53.24 Ambetter — Individual Commercial: $60.52
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: HC PSYCHOTHERAPY W/PATIENT 30 MINUTES	$170	$85	$40.15 – $170.87
Psychotherapy, 30 minutes: 10 of 42 insurance plan rates Aetna — Broad Network: $164.66 Aetna — Connected North Carolina Individual HMO: $112.20 Aetna — Medicare Advantage: $70.44 Aetna — North Carolina Preferred Plus Commercial: $153.72 Aetna — Whole Health HMO: $141.18 Aetna First Health — Commercial: $144.50 Alliance — Managed Medicaid: $40.95 Ambetter — CoBranded Commercial: $87.34 Ambetter — Individual Commercial: $111.50 Amerihealth Caritas — Managed Medicaid: $40.55
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$196	$98	$26.85 – $186.20
Psychotherapy, 45 minutes: 10 of 45 insurance plan rates Aetna — Broad Network: $111.33 Aetna — Connected North Carolina Individual HMO: $49.98 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $101.92 Aetna — Whole Health HMO: $74.48 Aetna First Health — Commercial: $150.92 Alliance — Behavioral Health: $27.38 Alliance — Managed Medicaid: $27.38 Ambetter — CoBranded Commercial: $61.39 Ambetter — Individual Commercial: $69.78
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE	$236	$118	$60.29 – $228.05
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates Aetna — Broad Network: $217.34 Aetna — Connected North Carolina Individual HMO: $155.76 Aetna — Medicare Advantage: $93.05 Aetna — North Carolina Preferred Plus Commercial: $202.90 Aetna — Whole Health HMO: $183.38 Aetna First Health — Commercial: $200.60 Alliance — Managed Medicaid: $61.50 Ambetter — CoBranded Commercial: $116.45 Ambetter — Individual Commercial: $148.66 Amerihealth Caritas — Managed Medicaid: $60.89
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$196	$98	$60.29 – $228.05
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates Aetna — Broad Network: $217.34 Aetna — Connected North Carolina Individual HMO: $129.36 Aetna — Medicare Advantage: $93.05 Aetna — North Carolina Preferred Plus Commercial: $202.90 Aetna — Whole Health HMO: $183.38 Aetna First Health — Commercial: $166.60 Alliance — Managed Medicaid: $61.50 Ambetter — CoBranded Commercial: $116.45 Ambetter — Individual Commercial: $148.66 Amerihealth Caritas — Managed Medicaid: $60.89
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN	$229	$114.50	$31.37 – $217.55
Psychotherapy, 60 minutes: 10 of 45 insurance plan rates Aetna — Broad Network: $130.07 Aetna — Connected North Carolina Individual HMO: $58.40 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $119.08 Aetna — Whole Health HMO: $87.02 Aetna First Health — Commercial: $176.33 Alliance — Behavioral Health: $31.99 Alliance — Managed Medicaid: $31.99 Ambetter — CoBranded Commercial: $71.72 Ambetter — Individual Commercial: $81.52
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN	$229	$114.50	$90.91 – $342.39
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates Aetna — Broad Network: $319.36 Aetna — Connected North Carolina Individual HMO: $151.14 Aetna — Medicare Advantage: $137.16 Aetna — North Carolina Preferred Plus Commercial: $298.13 Aetna — Whole Health HMO: $268.73 Aetna First Health — Commercial: $194.65 Alliance — Managed Medicaid: $92.73 Ambetter — CoBranded Commercial: $174.30 Ambetter — Individual Commercial: $222.51 Amerihealth Caritas — Managed Medicaid: $91.82
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN	$229	$114.50	$66.64 – $217.55
Psychotherapy, 60 minutes: 10 of 24 insurance plan rates Aetna — Broad Network: $115.42 Aetna — Connected North Carolina Individual HMO: $66.64 Aetna — North Carolina Preferred Plus Commercial: $105.34 Aetna — Whole Health HMO: $83.59 Aetna First Health — Commercial: $176.33 Beechstreet — Commercial: $210.68 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $111.64 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $84.84 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $102.34 Cigna — Commercial NB: $97.33
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN	$58	$29	$7.95 – $180.21
Family psychotherapy, without the patient: 10 of 45 insurance plan rates Aetna — Broad Network: $32.94 Aetna — Connected North Carolina Individual HMO: $14.79 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $30.16 Aetna — Whole Health HMO: $22.04 Aetna First Health — Commercial: $44.66 Alliance — Behavioral Health: $8.10 Alliance — Managed Medicaid: $8.10 Ambetter — CoBranded Commercial: $18.17 Ambetter — Individual Commercial: $20.65
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIC PSYTX FAMILY W/O PT FAC 50 MIN	$58	$29	$7.95 – $180.21
Family psychotherapy, without the patient: 10 of 45 insurance plan rates Aetna — Broad Network: $32.94 Aetna — Connected North Carolina Individual HMO: $14.79 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $30.16 Aetna — Whole Health HMO: $22.04 Aetna First Health — Commercial: $44.66 Alliance — Behavioral Health: $8.10 Alliance — Managed Medicaid: $8.10 Ambetter — CoBranded Commercial: $18.17 Ambetter — Individual Commercial: $20.65
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAC PSYTX CRISIS EA ADD 16-45 MIN	$119	$59.50	$16.30 – $180.21
Family psychotherapy, without the patient: 10 of 45 insurance plan rates Aetna — Broad Network: $67.59 Aetna — Connected North Carolina Individual HMO: $30.35 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $61.88 Aetna — Whole Health HMO: $45.22 Aetna First Health — Commercial: $91.63 Alliance — Behavioral Health: $16.62 Alliance — Managed Medicaid: $16.62 Ambetter — CoBranded Commercial: $37.27 Ambetter — Individual Commercial: $42.36
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIC PSYTX FAMILY W/PT FAC	$58	$29	$7.95 – $180.21
Family psychotherapy, with the patient: 10 of 45 insurance plan rates Aetna — Broad Network: $32.94 Aetna — Connected North Carolina Individual HMO: $14.79 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $30.16 Aetna — Whole Health HMO: $22.04 Aetna First Health — Commercial: $44.66 Alliance — Behavioral Health: $8.10 Alliance — Managed Medicaid: $8.10 Ambetter — CoBranded Commercial: $18.17 Ambetter — Individual Commercial: $20.65
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY FAMILY W/PT 50 MIN	$58	$29	$7.95 – $180.21
Family psychotherapy, with the patient: 10 of 45 insurance plan rates Aetna — Broad Network: $32.94 Aetna — Connected North Carolina Individual HMO: $14.79 Aetna — Medicare Advantage: $177.11 Aetna — North Carolina Preferred Plus Commercial: $30.16 Aetna — Whole Health HMO: $22.04 Aetna First Health — Commercial: $44.66 Alliance — Behavioral Health: $8.10 Alliance — Managed Medicaid: $8.10 Ambetter — CoBranded Commercial: $18.17 Ambetter — Individual Commercial: $20.65
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: HC LIC PSYTX FAMILY W/PT FAC	$58	$29	$29 – $282.98
Family psychotherapy, with the patient: 10 of 42 insurance plan rates Aetna — Broad Network: $216.67 Aetna — Connected North Carolina Individual HMO: $38.28 Aetna — Medicare Advantage: $104.23 Aetna — North Carolina Preferred Plus Commercial: $202.28 Aetna — Whole Health HMO: $38.28 Aetna First Health — Commercial: $49.30 Alliance — Managed Medicaid: $85.41 Ambetter — CoBranded Commercial: $146.12 Ambetter — Individual Commercial: $31.90 Amerihealth Caritas — Managed Medicaid: $84.58
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIC GRP PSYTX FAC-INT	$210	$105	$28.77 – $199.50
Group psychotherapy: 10 of 45 insurance plan rates Aetna — Broad Network: $119.28 Aetna — Connected North Carolina Individual HMO: $53.55 Aetna — Medicare Advantage: $101.37 Aetna — North Carolina Preferred Plus Commercial: $109.20 Aetna — Whole Health HMO: $79.80 Aetna First Health — Commercial: $161.70 Alliance — Behavioral Health: $29.34 Alliance — Managed Medicaid: $29.34 Ambetter — CoBranded Commercial: $65.77 Ambetter — Individual Commercial: $74.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY	$210	$105	$28.77 – $199.50
Group psychotherapy: 10 of 45 insurance plan rates Aetna — Broad Network: $119.28 Aetna — Connected North Carolina Individual HMO: $53.55 Aetna — Medicare Advantage: $101.37 Aetna — North Carolina Preferred Plus Commercial: $109.20 Aetna — Whole Health HMO: $79.80 Aetna First Health — Commercial: $161.70 Alliance — Behavioral Health: $29.34 Alliance — Managed Medicaid: $29.34 Ambetter — CoBranded Commercial: $65.77 Ambetter — Individual Commercial: $74.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC IOP TX ISSUEGROUP45-50	$210	$105	$28.77 – $394
Group psychotherapy: 10 of 45 insurance plan rates Aetna — Broad Network: $119.28 Aetna — Connected North Carolina Individual HMO: $53.55 Aetna — Medicare Advantage: $101.37 Aetna — North Carolina Preferred Plus Commercial: $109.20 Aetna — Whole Health HMO: $79.80 Aetna First Health — Commercial: $161.70 Alliance — Behavioral Health: $29.34 Alliance — Managed Medicaid: $29.34 Ambetter — CoBranded Commercial: $65.77 Ambetter — Individual Commercial: $74.76

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE	$9,648	$4,824	$1,321.78 – $9,165.60
Removal of breast growth (open surgery): 10 of 45 insurance plan rates Aetna — Broad Network: $5,480.06 Aetna — Connected North Carolina Individual HMO: $2,460.24 Aetna — Medicare Advantage: $3,906.99 Aetna — North Carolina Preferred Plus Commercial: $5,016.96 Aetna — Whole Health HMO: $3,666.24 Aetna First Health — Commercial: $7,428.96 Alliance — Behavioral Health: $1,347.83 Alliance — Managed Medicaid: $1,347.83 Ambetter — CoBranded Commercial: $3,021.75 Ambetter — Individual Commercial: $3,434.69
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE	$9,648	$4,824	$284.35 – $8,683.20
Removal of breast growth (open surgery): 10 of 42 insurance plan rates Aetna — Broad Network: $1,098.19 Aetna — Connected North Carolina Individual HMO: $6,367.68 Aetna — Medicare Advantage: $386.75 Aetna — North Carolina Preferred Plus Commercial: $1,025.22 Aetna — Whole Health HMO: $6,367.68 Aetna First Health — Commercial: $8,200.80 Alliance — Managed Medicaid: $290.04 Ambetter — CoBranded Commercial: $568.67 Ambetter — Individual Commercial: $5,306.40 Amerihealth Caritas — Managed Medicaid: $287.19
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE	$9,648	$4,824	$2,807.57 – $9,165.60
Removal of breast growth (open surgery): 10 of 24 insurance plan rates Aetna — Broad Network: $4,862.59 Aetna — Connected North Carolina Individual HMO: $2,807.57 Aetna — North Carolina Preferred Plus Commercial: $4,438.08 Aetna — Whole Health HMO: $3,521.52 Aetna First Health — Commercial: $7,428.96 Beechstreet — Commercial: $8,876.16 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $4,703.40 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $3,574.58 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $4,311.69 Cigna — Commercial NB: $4,100.40
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,072.82 – $4,421.34
Total hip replacement: 10 of 21 insurance plan rates Aetna — Broad Network: $2,710.17 Aetna — Medicare Advantage: $1,108.90 Aetna — North Carolina Preferred Plus Commercial: $2,530.10 Alliance — Managed Medicaid: $1,094.28 Amerihealth Caritas — Managed Medicaid: $1,083.55 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $3,800.36 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,888.23 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,936.22 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,087.16 Carolina Complete Health — Managed Medicaid: $1,083.55
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$12,377.76 – $13,035.02
Total hip replacement: rates for 6 insurance plans Aetna — Medicare Advantage: $12,810.98 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $12,377.76 Cigna Healthspring — Medicare Advantage: $12,996.65 Devoted Health — Medicare Advantage: $12,872.87 Humana — Medicare Advantage: $12,625.32 United Healthcare — Medicare Advantage: $13,035.02
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,084.96 – $4,419.33
Total knee replacement: 10 of 23 insurance plan rates Aetna — Broad Network: $2,707.47 Aetna — Medicare Advantage: $1,106.66 Aetna — North Carolina Preferred Plus Commercial: $2,527.58 Alliance — Managed Medicaid: $1,171.46 Amerihealth Caritas — Managed Medicaid: $1,159.97 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $4,079.68 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $3,100.50 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $3,152.02 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,084.96 Carolina Complete Health — Managed Medicaid: $1,159.97
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$12,377.76 – $13,035.02
Total knee replacement: rates for 6 insurance plans Aetna — Medicare Advantage: $12,810.98 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $12,377.76 Cigna Healthspring — Medicare Advantage: $12,996.65 Devoted Health — Medicare Advantage: $12,872.87 Humana — Medicare Advantage: $12,625.32 United Healthcare — Medicare Advantage: $13,035.02
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$138.60 – $2,002.15
Shoulder arthroscopy: shaving of shoulder bone: 10 of 23 insurance plan rates Aetna — Broad Network: $365.04 Aetna — Medicare Advantage: $141.37 Aetna — North Carolina Preferred Plus Commercial: $340.79 Alliance — Managed Medicaid: $499.83 Amerihealth Caritas — Managed Medicaid: $494.93 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $2,002.15 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,521.65 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,544.52 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $138.60 Carolina Complete Health — Managed Medicaid: $494.93
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$138.60 – $145.96
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans Aetna — Medicare Advantage: $143.45 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $138.60 Cigna Healthspring — Medicare Advantage: $145.53 Devoted Health — Medicare Advantage: $144.15 Humana — Medicare Advantage: $141.37 United Healthcare — Medicare Advantage: $145.96
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$465.87 – $1,890.93
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates Aetna — Broad Network: $1,144.54 Aetna — Medicare Advantage: $492.39 Aetna — North Carolina Preferred Plus Commercial: $1,068.49 Alliance — Managed Medicaid: $475.19 Amerihealth Caritas — Managed Medicaid: $470.53 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,890.93 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,437.13 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,458.73 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $482.74 Carolina Complete Health — Managed Medicaid: $470.53
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$3,154.53 – $3,322.04
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans Aetna — Medicare Advantage: $3,264.94 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $3,154.53 Cigna Healthspring — Medicare Advantage: $3,312.26 Devoted Health — Medicare Advantage: $3,280.71 Humana — Medicare Advantage: $3,217.62 United Healthcare — Medicare Advantage: $3,322.04
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$216.27 – $264.07
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $251.73 Alliance — Managed Medicaid: $220.60 Amerihealth Caritas — Managed Medicaid: $218.43 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $246.79 Carolina Complete Health — Managed Medicaid: $218.43 Cigna Healthspring — Medicare Advantage: $264.07 Devoted Health — Medicare Advantage: $256.66 Healthy Blue — Managed Medicaid: $218.43 Humana — Medicare Advantage: $251.73 Partners — Managed Medicaid: $218.43
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$5,707.30 – $6,010.36
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans Aetna — Medicare Advantage: $5,907.06 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $5,707.30 Cigna Healthspring — Medicare Advantage: $5,992.67 Devoted Health — Medicare Advantage: $5,935.60 Humana — Medicare Advantage: $5,821.45 United Healthcare — Medicare Advantage: $6,010.36
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$105.36 – $1,287.16
Upper GI endoscopy (diagnostic): 10 of 25 insurance plan rates Aetna — Broad Network: $639.77 Aetna — Medicare Advantage: $107.47 Aetna — North Carolina Preferred Plus Commercial: $597.27 Aetna First Health — Commercial: $1,287.16 Alliance — Managed Medicaid: $114.55 Amerihealth Caritas — Managed Medicaid: $113.42 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $433.58 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $329.52 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $334.48 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $105.36
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$874.42 – $920.86
Upper GI endoscopy (diagnostic): rates for 6 insurance plans Aetna — Medicare Advantage: $905.03 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $874.42 Cigna Healthspring — Medicare Advantage: $918.14 Devoted Health — Medicare Advantage: $909.40 Humana — Medicare Advantage: $891.91 United Healthcare — Medicare Advantage: $920.86
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$117.87 – $1,418.93
Upper GI endoscopy with biopsy: 10 of 26 insurance plan rates Aetna — Broad Network: $817.41 Aetna — Medicare Advantage: $120.23 Aetna — North Carolina Preferred Plus Commercial: $763.10 Aetna — Whole Health HMO: $729.52 Aetna First Health — Commercial: $1,418.93 Alliance — Managed Medicaid: $135.65 Amerihealth Caritas — Managed Medicaid: $134.32 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $515.38 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $391.70 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $397.59
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$874.42 – $920.86
Upper GI endoscopy with biopsy: rates for 6 insurance plans Aetna — Medicare Advantage: $905.03 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $874.42 Cigna Healthspring — Medicare Advantage: $918.14 Devoted Health — Medicare Advantage: $909.40 Humana — Medicare Advantage: $891.91 United Healthcare — Medicare Advantage: $920.86
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$156.72 – $1,836.30
Colonoscopy (diagnostic): 10 of 27 insurance plan rates Aetna — Broad Network: $730.17 Aetna — Medicare Advantage: $159.85 Aetna — North Carolina Preferred Plus Commercial: $681.65 Aetna — Whole Health HMO: $841.15 Aetna First Health — Commercial: $1,836.30 Alliance — Managed Medicaid: $170.49 Amerihealth Caritas — Managed Medicaid: $168.82 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $650.19 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $494.15 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $501.58
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$896.57 – $944.18
Colonoscopy (diagnostic): rates for 6 insurance plans Aetna — Medicare Advantage: $927.95 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $896.57 Cigna Healthspring — Medicare Advantage: $941.40 Devoted Health — Medicare Advantage: $932.43 Humana — Medicare Advantage: $914.50 United Healthcare — Medicare Advantage: $944.18
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$78.47 – $365.08
Colonoscopy (diagnostic): rates for 7 insurance plans Aetna — Broad Network: $365.08 Aetna — Medicare Advantage: $80.04 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $78.47 Cigna Healthspring — Medicare Advantage: $83.96 Devoted Health — Medicare Advantage: $81.61 Humana — Medicare Advantage: $80.04 United Healthcare — Medicare Advantage: $81.44
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$169.43 – $2,018.53
Colonoscopy with biopsy: 10 of 27 insurance plan rates Aetna — Broad Network: $938.41 Aetna — Medicare Advantage: $172.82 Aetna — North Carolina Preferred Plus Commercial: $876.06 Aetna — Whole Health HMO: $994.51 Aetna First Health — Commercial: $2,018.53 Alliance — Managed Medicaid: $205.43 Amerihealth Caritas — Managed Medicaid: $203.41 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $780.60 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $593.27 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $602.19
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$1,153.68 – $1,214.94
Colonoscopy with biopsy: rates for 6 insurance plans Aetna — Medicare Advantage: $1,194.06 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,153.68 Cigna Healthspring — Medicare Advantage: $1,211.37 Devoted Health — Medicare Advantage: $1,199.83 Humana — Medicare Advantage: $1,176.75 United Healthcare — Medicare Advantage: $1,214.94
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$213.45 – $2,286.08
Colonoscopy with removal of polyps (snare): 10 of 27 insurance plan rates Aetna — Broad Network: $979.54 Aetna — Medicare Advantage: $217.72 Aetna — North Carolina Preferred Plus Commercial: $914.45 Aetna — Whole Health HMO: $1,124.63 Aetna First Health — Commercial: $2,286.08 Alliance — Managed Medicaid: $243.90 Amerihealth Caritas — Managed Medicaid: $241.51 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $925.98 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $703.76 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $714.34
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$1,153.68 – $1,214.94
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans Aetna — Medicare Advantage: $1,194.06 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,153.68 Cigna Healthspring — Medicare Advantage: $1,211.37 Devoted Health — Medicare Advantage: $1,199.83 Humana — Medicare Advantage: $1,176.75 United Healthcare — Medicare Advantage: $1,214.94
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$216.28 – $236
Ultrasound of the lower bowel by endoscope: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $220.61 Alliance — Managed Medicaid: $236 Amerihealth Caritas — Managed Medicaid: $233.68 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $216.28 Carolina Complete Health — Managed Medicaid: $233.68 Cigna Healthspring — Medicare Advantage: $231.42 Devoted Health — Medicare Advantage: $224.93 Healthy Blue — Managed Medicaid: $233.68 Humana — Medicare Advantage: $220.61 Partners — Managed Medicaid: $233.68
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$1,153.68 – $1,214.94
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans Aetna — Medicare Advantage: $1,194.06 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,153.68 Cigna Healthspring — Medicare Advantage: $1,211.37 Devoted Health — Medicare Advantage: $1,199.83 Humana — Medicare Advantage: $1,176.75 United Healthcare — Medicare Advantage: $1,214.94
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$156.94 – $801.95
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates Aetna — Broad Network: $544.70 Aetna — Medicare Advantage: $160.08 Aetna — North Carolina Preferred Plus Commercial: $509.17 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $559.47 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $156.94 Cigna Healthspring — Medicare Advantage: $167.93 Devoted Health — Medicare Advantage: $163.22 Humana — Medicare Advantage: $160.08 United Healthcare — HMO-PPO Managed Care: $801.95 United Healthcare — IEX Commercial: $604.29
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$896.57 – $944.18
Screening colonoscopy (not high risk): rates for 6 insurance plans Aetna — Medicare Advantage: $927.95 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $896.57 Cigna Healthspring — Medicare Advantage: $941.40 Devoted Health — Medicare Advantage: $932.43 Humana — Medicare Advantage: $914.50 United Healthcare — Medicare Advantage: $944.18
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$78.47 – $272.57
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — Broad Network: $272.57 Aetna — Medicare Advantage: $80.04 Aetna — North Carolina Preferred Plus Commercial: $254.79 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $78.47 Cigna Healthspring — Medicare Advantage: $83.96 Devoted Health — Medicare Advantage: $81.61 Humana — Medicare Advantage: $80.04 United Healthcare — Medicare Advantage: $81.44
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$528.57 – $2,505.35
Gallbladder removal by laparoscope: 10 of 27 insurance plan rates Aetna — Broad Network: $1,405.79 Aetna — Medicare Advantage: $597.95 Aetna — North Carolina Preferred Plus Commercial: $1,312.38 Aetna — Whole Health HMO: $1,460.18 Aetna First Health — Commercial: $2,505.35 Alliance — Managed Medicaid: $539.14 Amerihealth Caritas — Managed Medicaid: $533.86 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,998.15 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,518.61 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $1,537.78
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$5,828.49 – $6,137.98
Gallbladder removal by laparoscope: rates for 6 insurance plans Aetna — Medicare Advantage: $6,032.48 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $5,828.49 Cigna Healthspring — Medicare Advantage: $6,119.91 Devoted Health — Medicare Advantage: $6,061.63 Humana — Medicare Advantage: $5,945.06 United Healthcare — Medicare Advantage: $6,137.98
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$368.03 – $1,898.61
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates Aetna — Broad Network: $1,113 Aetna — Medicare Advantage: $480.64 Aetna — North Carolina Preferred Plus Commercial: $1,039.05 Alliance — Managed Medicaid: $375.39 Amerihealth Caritas — Managed Medicaid: $371.71 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,396.07 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,061.02 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $471.22 Carolina Complete Health — Managed Medicaid: $371.71 Cigna Healthspring — Medicare Advantage: $504.21
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$3,451.86 – $3,635.15
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans Aetna — Medicare Advantage: $3,572.68 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $3,451.86 Cigna Healthspring — Medicare Advantage: $3,624.45 Devoted Health — Medicare Advantage: $3,589.94 Humana — Medicare Advantage: $3,520.90 United Healthcare — Medicare Advantage: $3,635.15
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$114.28 – $116.57
Prostate biopsy: rates for 9 insurance plans Alliance — Managed Medicaid: $116.57 Amerihealth Caritas — Managed Medicaid: $115.42 Carolina Complete Health — Managed Medicaid: $115.42 Healthy Blue — Managed Medicaid: $115.42 Partners — Managed Medicaid: $115.42 Trillium — Managed Medicaid: $114.28 United Healthcare — Managed Medicaid: $115.42 Vaya — Managed Medicaid: $115.42 Wellcare — Managed Medicaid: $115.42
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$1,030.59 – $4,698.26
Prostate removal by laparoscope (radical prostatectomy): 10 of 16 insurance plan rates Aetna — Medicare Advantage: $1,051.20 Alliance — Managed Medicaid: $1,487.04 Amerihealth Caritas — Managed Medicaid: $1,472.46 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $4,698.26 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $1,030.59 Carolina Complete Health — Managed Medicaid: $1,472.46 Cigna Healthspring — Medicare Advantage: $1,102.73 Devoted Health — Medicare Advantage: $1,071.81 Healthy Blue — Managed Medicaid: $1,472.46 Humana — Medicare Advantage: $1,051.20
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$10,248.21 – $10,792.39
Prostate removal by laparoscope (radical prostatectomy): rates for 6 insurance plans Aetna — Medicare Advantage: $10,606.90 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $10,248.21 Cigna Healthspring — Medicare Advantage: $10,760.62 Devoted Health — Medicare Advantage: $10,658.14 Humana — Medicare Advantage: $10,453.18 United Healthcare — Medicare Advantage: $10,792.39
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HYSTEROSC BX ENDOMETRIAL	$6,342	$3,171	$868.85 – $6,024.90
Hysteroscopy with biopsy of the uterus lining: 10 of 45 insurance plan rates Aetna — Broad Network: $3,602.26 Aetna — Connected North Carolina Individual HMO: $1,617.21 Aetna — Medicare Advantage: $3,230.14 Aetna — North Carolina Preferred Plus Commercial: $3,297.84 Aetna — Whole Health HMO: $2,409.96 Aetna First Health — Commercial: $4,883.34 Alliance — Behavioral Health: $885.98 Alliance — Managed Medicaid: $885.98 Ambetter — CoBranded Commercial: $1,986.31 Ambetter — Individual Commercial: $2,257.75
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HC HYSTEROSC BX ENDOMETRIAL	$6,342	$3,171	$192.76 – $5,707.80
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates Aetna — Broad Network: $2,900.58 Aetna — Connected North Carolina Individual HMO: $4,185.72 Aetna — Medicare Advantage: $196.62 Aetna — North Carolina Preferred Plus Commercial: $2,707.85 Aetna — Whole Health HMO: $625.68 Aetna First Health — Commercial: $1,266.88 Alliance — Managed Medicaid: $210.16 Ambetter — CoBranded Commercial: $323.59 Ambetter — Individual Commercial: $413.09 Amerihealth Caritas — Managed Medicaid: $208.10
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HYSTEROSC BX ENDOMETRIAL	$6,342	$3,171	$1,845.52 – $6,024.90
Hysteroscopy with biopsy of the uterus lining: 10 of 24 insurance plan rates Aetna — Broad Network: $3,196.37 Aetna — Connected North Carolina Individual HMO: $1,845.52 Aetna — North Carolina Preferred Plus Commercial: $2,917.32 Aetna — Whole Health HMO: $2,314.83 Aetna First Health — Commercial: $4,883.34 Beechstreet — Commercial: $5,834.64 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $3,091.73 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,349.71 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,834.24 Cigna — Commercial NB: $2,695.35
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ EPI SUBAR LUM/SAC W/IMAGE	$4,600	$2,300	$630.20 – $4,370
Spinal injection, lower back (epidural), with imaging guidance: 10 of 45 insurance plan rates Aetna — Broad Network: $2,612.80 Aetna — Connected North Carolina Individual HMO: $1,173 Aetna — Medicare Advantage: $704.36 Aetna — North Carolina Preferred Plus Commercial: $2,392 Aetna — Whole Health HMO: $1,748 Aetna First Health — Commercial: $3,542 Alliance — Behavioral Health: $642.62 Alliance — Managed Medicaid: $642.62 Ambetter — CoBranded Commercial: $1,440.72 Ambetter — Individual Commercial: $1,637.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: HC INJ EPI SUBAR LUM/SAC W/IMAGE	$4,600	$2,300	$85.47 – $4,140
Spinal injection, lower back (epidural), with imaging guidance: 10 of 42 insurance plan rates Aetna — Broad Network: $549.89 Aetna — Connected North Carolina Individual HMO: $3,036 Aetna — Medicare Advantage: $257.18 Aetna — North Carolina Preferred Plus Commercial: $513.35 Aetna — Whole Health HMO: $257.18 Aetna First Health — Commercial: $3,910 Alliance — Managed Medicaid: $87.36 Ambetter — CoBranded Commercial: $156.06 Ambetter — Individual Commercial: $254.03 Amerihealth Caritas — Managed Medicaid: $86.51
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJ EPI SUBAR LUM/SAC W/IMAGE	$4,600	$2,300	$1,338.60 – $4,370
Spinal injection, lower back (epidural), with imaging guidance: 10 of 24 insurance plan rates Aetna — Broad Network: $2,318.40 Aetna — Connected North Carolina Individual HMO: $1,338.60 Aetna — North Carolina Preferred Plus Commercial: $2,116 Aetna — Whole Health HMO: $1,679 Aetna First Health — Commercial: $3,542 Beechstreet — Commercial: $4,232 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $2,242.50 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,704.30 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,055.74 Cigna — Commercial NB: $1,955
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL	$4,599	$2,299.50	$630.06 – $4,369.05
Nerve root injection, lower back, with imaging guidance: 10 of 45 insurance plan rates Aetna — Broad Network: $2,612.23 Aetna — Connected North Carolina Individual HMO: $1,172.75 Aetna — Medicare Advantage: $882.56 Aetna — North Carolina Preferred Plus Commercial: $2,391.48 Aetna — Whole Health HMO: $1,747.62 Aetna First Health — Commercial: $3,541.23 Alliance — Behavioral Health: $642.48 Alliance — Managed Medicaid: $642.48 Ambetter — CoBranded Commercial: $1,440.41 Ambetter — Individual Commercial: $1,637.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL	$4,599	$2,299.50	$81.67 – $4,139.10
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates Aetna — Broad Network: $524.77 Aetna — Connected North Carolina Individual HMO: $3,035.34 Aetna — Medicare Advantage: $97.25 Aetna — North Carolina Preferred Plus Commercial: $489.91 Aetna — Whole Health HMO: $815.93 Aetna First Health — Commercial: $933.95 Alliance — Managed Medicaid: $83.30 Ambetter — CoBranded Commercial: $174.90 Ambetter — Individual Commercial: $284.69 Amerihealth Caritas — Managed Medicaid: $82.49
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL	$4,599	$2,299.50	$1,338.31 – $4,369.05
Nerve root injection, lower back, with imaging guidance: 10 of 24 insurance plan rates Aetna — Broad Network: $2,317.90 Aetna — Connected North Carolina Individual HMO: $1,338.31 Aetna — North Carolina Preferred Plus Commercial: $2,115.54 Aetna — Whole Health HMO: $1,678.64 Aetna First Health — Commercial: $3,541.23 Beechstreet — Commercial: $4,231.08 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $2,242.01 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $1,703.93 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $2,055.29 Cigna — Commercial NB: $1,954.58
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC NEUROPLASTY MEDIAN NERVE CARPAL TUNNEL	$7,299	$3,649.50	$999.96 – $6,934.05
Carpal tunnel release: 10 of 45 insurance plan rates Aetna — Broad Network: $4,145.83 Aetna — Connected North Carolina Individual HMO: $1,861.25 Aetna — Medicare Advantage: $1,948.51 Aetna — North Carolina Preferred Plus Commercial: $3,795.48 Aetna — Whole Health HMO: $2,773.62 Aetna First Health — Commercial: $5,620.23 Alliance — Behavioral Health: $1,019.67 Alliance — Managed Medicaid: $1,019.67 Ambetter — CoBranded Commercial: $2,286.05 Ambetter — Individual Commercial: $2,598.44
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: HC NEUROPLASTY MEDIAN NERVE CARPAL TUNNEL	$7,299	$3,649.50	$296.90 – $6,569.10
Carpal tunnel release: 10 of 42 insurance plan rates Aetna — Broad Network: $935.71 Aetna — Connected North Carolina Individual HMO: $4,817.34 Aetna — Medicare Advantage: $403.89 Aetna — North Carolina Preferred Plus Commercial: $873.54 Aetna — Whole Health HMO: $853.22 Aetna First Health — Commercial: $6,204.15 Alliance — Managed Medicaid: $302.84 Ambetter — CoBranded Commercial: $586.33 Ambetter — Individual Commercial: $748.50 Amerihealth Caritas — Managed Medicaid: $299.87
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC NEUROPLASTY MEDIAN NERVE CARPAL TUNNEL	$7,299	$3,649.50	$2,124.01 – $6,934.05
Carpal tunnel release: 10 of 24 insurance plan rates Aetna — Broad Network: $3,678.70 Aetna — Connected North Carolina Individual HMO: $2,124.01 Aetna — North Carolina Preferred Plus Commercial: $3,357.54 Aetna — Whole Health HMO: $2,664.14 Aetna First Health — Commercial: $5,620.23 Beechstreet — Commercial: $6,715.08 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $3,558.26 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $2,704.28 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $3,261.92 Cigna — Commercial NB: $3,102.08
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$201.56 – $622.51
Laser treatment of clouding after cataract surgery: 10 of 16 insurance plan rates Aetna — Medicare Advantage: $267.02 Alliance — Managed Medicaid: $205.59 Amerihealth Caritas — Managed Medicaid: $203.58 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $622.51 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $261.78 Carolina Complete Health — Managed Medicaid: $203.58 Cigna Healthspring — Medicare Advantage: $280.10 Devoted Health — Medicare Advantage: $272.25 Healthy Blue — Managed Medicaid: $203.58 Humana — Medicare Advantage: $267.02
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$530.25 – $558.41
Laser treatment of clouding after cataract surgery: rates for 6 insurance plans Aetna — Medicare Advantage: $548.81 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $530.25 Cigna Healthspring — Medicare Advantage: $556.76 Devoted Health — Medicare Advantage: $551.46 Humana — Medicare Advantage: $540.86 United Healthcare — Medicare Advantage: $558.41
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$442.35 – $1,572.94
Cataract removal with lens implant: 10 of 17 insurance plan rates Aetna — Broad Network: $1,126.83 Aetna — Medicare Advantage: $451.20 Alliance — Managed Medicaid: $525.84 Amerihealth Caritas — Managed Medicaid: $520.69 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $1,572.94 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $442.35 Carolina Complete Health — Managed Medicaid: $520.69 Cigna Healthspring — Medicare Advantage: $473.31 Devoted Health — Medicare Advantage: $460.04 Healthy Blue — Managed Medicaid: $520.69
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$2,224.97 – $2,343.12
Cataract removal with lens implant: rates for 6 insurance plans Aetna — Medicare Advantage: $2,302.84 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $2,224.97 Cigna Healthspring — Medicare Advantage: $2,336.22 Devoted Health — Medicare Advantage: $2,313.97 Humana — Medicare Advantage: $2,269.47 United Healthcare — Medicare Advantage: $2,343.12

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$1,747.98 – $6,049.90
Vaginal delivery, with care before and after: 10 of 27 insurance plan rates Aetna — Broad Network: $5,050.56 Aetna — Medicare Advantage: $2,086.32 Aetna — North Carolina Preferred Plus Commercial: $4,714.98 Aetna — Whole Health HMO: $3,578.40 Aetna First Health — Commercial: $6,049.90 Alliance — Managed Medicaid: $1,782.94 Amerihealth Caritas — Managed Medicaid: $1,765.46 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $4,490.24 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $3,412.54 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $3,461.74
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$2,045.41 – $2,154.02
Vaginal delivery, with care before and after: rates for 6 insurance plans Aetna — Medicare Advantage: $2,117 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $2,045.41 Cigna Healthspring — Medicare Advantage: $2,147.68 Devoted Health — Medicare Advantage: $2,127.23 Humana — Medicare Advantage: $2,086.32 United Healthcare — Medicare Advantage: $2,154.02
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$1,747.98 – $6,890.98
Cesarean delivery (C-section), with care before and after: 10 of 27 insurance plan rates Aetna — Broad Network: $5,569.11 Aetna — Medicare Advantage: $2,317.27 Aetna — North Carolina Preferred Plus Commercial: $5,199.07 Aetna — Whole Health HMO: $4,055.62 Aetna First Health — Commercial: $6,890.98 Alliance — Managed Medicaid: $1,782.94 Amerihealth Caritas — Managed Medicaid: $1,765.46 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $5,082.95 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $3,862.99 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $3,918.67
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,271.83 – $2,392.46
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans Aetna — Medicare Advantage: $2,351.34 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $2,271.83 Cigna Healthspring — Medicare Advantage: $2,385.42 Devoted Health — Medicare Advantage: $2,362.70 Humana — Medicare Advantage: $2,317.27 United Healthcare — Medicare Advantage: $2,392.46
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,003.80 – $5,273.23
Vaginal delivery after a previous C-section, with care before and after: 10 of 20 insurance plan rates Aetna — Broad Network: $5,273.23 Aetna — Medicare Advantage: $2,181.81 Aetna — North Carolina Preferred Plus Commercial: $4,922.86 Alliance — Managed Medicaid: $2,043.88 Amerihealth Caritas — Managed Medicaid: $2,023.84 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $4,724.42 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $3,590.51 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $2,139.03 Carolina Complete Health — Managed Medicaid: $2,023.84 Cigna Healthspring — Medicare Advantage: $2,288.76
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,139.03 – $2,252.61
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans Aetna — Medicare Advantage: $2,213.89 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $2,139.03 Cigna Healthspring — Medicare Advantage: $2,245.98 Devoted Health — Medicare Advantage: $2,224.59 Humana — Medicare Advantage: $2,181.81 United Healthcare — Medicare Advantage: $2,252.61

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$71,684.13 – $176,399.06
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 21 insurance plan rates Aetna — Medicare Advantage: $74,551.50 Alliance — Managed Medicaid: $120,823.69 Ambetter — CoBranded Commercial: $119,134.94 Ambetter — Individual Commercial: $135,012.42 Amerihealth Caritas — Managed Medicaid: $100,704.14 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $176,399.06 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $125,650.28 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $140,999.50 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $71,684.13 Carolina Complete Health — Managed Medicaid: $121,534.51
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$15,849.63 – $36,421.60
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates Aetna — Medicare Advantage: $16,483.62 Alliance — Managed Medicaid: $22,780.62 Ambetter — CoBranded Commercial: $23,490.14 Ambetter — Individual Commercial: $26,620.75 Amerihealth Caritas — Managed Medicaid: $19,856.10 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $35,427 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $26,924 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $27,801.24 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $15,849.63 Carolina Complete Health — Managed Medicaid: $22,914.64
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$19,492.34 – $43,777.13
Neck (cervical) spinal fusion, without complications: 10 of 21 insurance plan rates Aetna — Medicare Advantage: $20,272.03 Alliance — Managed Medicaid: $24,983.52 Ambetter — CoBranded Commercial: $29,730.15 Ambetter — Individual Commercial: $33,692.38 Amerihealth Caritas — Managed Medicaid: $25,130.74 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $43,777.13 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $31,356.06 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $35,186.46 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $19,492.34 Carolina Complete Health — Managed Medicaid: $25,130.50
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$9,733.85 – $23,149.67
Uterus and ovary surgery (not for cancer), without complications: 10 of 21 insurance plan rates Aetna — Medicare Advantage: $11,395.39 Alliance — Managed Medicaid: $10,533.17 Ambetter — CoBranded Commercial: $15,109.24 Ambetter — Individual Commercial: $17,122.90 Amerihealth Caritas — Managed Medicaid: $12,771.77 Blue Cross Blue Shield of North Carolina — HMO-PPO Managed Care: $23,149.67 Blue Cross Blue Shield of North Carolina — Local Group Commercial: $15,935.55 Blue Cross Blue Shield of North Carolina — Local Individual Commercial: $17,882.21 Blue Cross Blue Shield of North Carolina — Medicare Advantage: $10,957.11 Carolina Complete Health — Managed Medicaid: $10,595.13

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

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

Hospital information

Hospital type	Acute Care Hospital
Address	201 E Grover St, Shelby, NC 28150
County	Cleveland County
State	North Carolina
Phone	(704) 487‑3000
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	340021
Name in Medicare records	ATRIUM HEALTH CLEVELAND
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(980) 487‑3000^[4]
Official website	atriumhealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Atrium Health Cleveland — atriumhealth.org
Atrium Health Cleveland Medical Services — atriumhealth.org
Cleveland Emergency Department - Shelby, NC | Atrium Health — atriumhealth.org
Maternity Center | Atrium Health Cleveland — atriumhealth.org

Atrium Health Cleveland

Summary

Profile from official sources

At a glance