Where is Atrium Health Navicent Rehabilitation Hospital?

3351 Northside Drive, Macon, GA 31210, in Bibb County, Georgia.

What is the phone number of Atrium Health Navicent Rehabilitation Hospital?

(478) 471-6500, as listed by Medicare (CMS).

Atrium Health Navicent Rehabilitation Hospital

Quick answers

Where is Atrium Health Navicent Rehabilitation Hospital?: 3351 Northside Drive, Macon, GA 31210, in Bibb County, Georgia.
What is the phone number of Atrium Health Navicent Rehabilitation Hospital?: (478) 471-6500, as listed by Medicare (CMS).

Specialties and care areas^[4][6]

Inpatient rehabilitation
Outpatient rehabilitation
Physical therapy
Occupational therapy
Speech therapy
Therapeutic recreation
Physical and Rehabilitation Medicine
Internal Medicine
Neurology

Conditions treated^[4][6][7]

Lymphedema
Vestibular disorders
Stroke
Brain injury
Spinal cord injury
Arthritis
Osteoporosis
Balance and dizziness
Gait dysfunction
Major multiple trauma
Amputation

Treatments^[4][6][7]

Chiropractic care
Pelvic floor therapy
Pain management
Balance and fall prevention
Physical therapy
Occupational therapy
Speech therapy
Alter G anti-gravity treadmill therapy
Dry needling
Manual therapy
Wheelchair seating
Wound care
Vestibular therapy

Procedures^[4][7][9]

Swallowing disorders program (vital stim therapy)
Voice therapy (LSVT)
Pelvic floor therapy

Programs and centers^[6][9]

Amputee Rehabilitation Program
Arthritis Rehabilitation Program
Brain Injury Rehabilitation Program
Cardiac Rehabilitation Program
General Rehabilitation Program
Geriatric Evaluation and Management Program
Medically Complex Rehabilitation Program
Orthopedics Rehabilitation Program
Pulmonary Rehabilitation Program
Spinal Cord Rehabilitation Program
Stroke Rehabilitation Program
Wound Rehabilitation Program
Lymphedema Management Program

Visiting and practical information

Interpreters and languages	Free language assistance services during visits, in 15 languages^[4]
Patient portal	MyAtriumHealth

Nearest emergency rooms

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

Piedmont Macon North Hospital1.9 mi · Macon, GA · Acute Care Hospital
Atrium Health Navicent the Medical Center5.0 mi · Macon, GA · Acute Care Hospital
Coliseum Medical Centers, LLC, dba5.0 mi · Macon, GA · Acute Care Hospital
Atrium Health Navicent Peach17 mi · Byron, GA · Critical Access Hospital
Monroe County Hospital18 mi · Forsyth, GA · Critical Access Hospital

Other hospitals nearby

Regency Hospital Company of Macon, LLC5.0 mi · Macon, GA · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Carlyle Place3.4 mi · Macon, GA · 1 of 5 stars
Zebulon Park Health and Rehabilitation4.5 mi · Macon, GA · 4 of 5 stars
Medical Management Health and Rehab Center4.5 mi · Macon, GA · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Amedisys Hospice3.2 mi · Macon, GA
Atrium Health Navicent Hospice Pine Pointe3.2 mi · Macon, GA · 5 of 5 stars
Compassus Hospice and Palliative Care-Macon3.2 mi · Macon, GA · 2 of 5 stars

All hospice providers in the state →

Home health agencies

Adoration Home Health3.2 mi · Macon, GA
Amedisys Home Health of Macon3.2 mi · Macon, GA · 4 of 5 stars
Atrium Health Navicent at Home3.2 mi · Macon, GA · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

Macon Eastside Dialysis Center5.0 mi · Macon, GA · 1 of 5 stars
DaVita Dialysis Center of Middle Georgia-Macon6.9 mi · Macon, GA · 1 of 5 stars
Macon Southside Dialysis Center6.9 mi · Macon, GA · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Macon Pain Center, PC3.2 mi · Macon, GA
Axis Surgery Center, LLC3.2 mi · Macon, GA
Bowman Pain Management, PC3.2 mi · Macon, GA

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

FCPC L.H. Williams4.0 mi · Macon, GA · Community health center
First Choice Primary Care Poplar St5.3 mi · Macon, GA · Community health center
Community Health Care Systems-Bibb5.3 mi · Macon, GA · Community health center

Clinics and urgent care

Avamed Health Care LLC3.2 mi · Macon, GA · Urgent care center
Navicare LLC3.2 mi · Macon, GA · Urgent care center
Houston Hospitals Inc17 mi · Warner Robins, GA · Urgent care center

Pharmacies

BWS Major Management Systems3.2 mi · Macon, GA · Pharmacy
Sams East Inc3.2 mi · Macon, GA · Community/retail pharmacy
Unionville Discount Pharmacy Inc3.2 mi · Macon, GA · Community/retail pharmacy

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 Macon Best hospitals in Macon

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 Navicent Rehabilitation Hospital 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	$71.13 – $350
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates Aetna — HMO: $137.72 Aetna — Medicare Advantage: $71.13 Aetna — POS: $137.72 Aetna — PPO: $143.51 Alliant — Solocare: $85.36 Ambetter — Managed Medicaid: $96.03 Anthem — HMO/PPO: $350 Anthem — Medicare Advantage: $71.13 Care Source — Medicare Advantage: $72.55 Cigna — Commercial: $138.60
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	$112.25 – $134.70
New patient office visit (about 30–44 minutes): rates for 10 insurance plans Aetna — Medicare Advantage: $112.25 Alliant — Solocare: $134.70 Anthem — Medicare Advantage: $112.25 Care Source — Medicare Advantage: $114.49 Clover — Medicare Advantage: $114.49 Eon Health — Medicare Advantage: $114.49 Georgia Health Advantage — Medicare Advantage: $112.25 Humana — Medicare Advantage: $112.25 Pruitt Health — Medicare Advantage: $112.25 United Healthcare — Medicare Advantage: $112.25
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$137.72 – $143.51
New patient office visit (about 30–44 minutes): rates for 3 insurance plans Aetna — HMO: $137.72 Aetna — POS: $137.72 Aetna — PPO: $143.51
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	$116.06 – $350
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates Aetna — HMO: $195.41 Aetna — Medicare Advantage: $116.06 Aetna — POS: $195.41 Aetna — PPO: $203.62 Alliant — Solocare: $139.27 Ambetter — Managed Medicaid: $156.68 Anthem — HMO/PPO: $350 Anthem — Medicare Advantage: $116.06 Care Source — Medicare Advantage: $118.38 Cigna — Commercial: $214.19
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	$169.99 – $203.99
New patient office visit (about 45–59 minutes): rates for 10 insurance plans Aetna — Medicare Advantage: $169.99 Alliant — Solocare: $203.99 Anthem — Medicare Advantage: $169.99 Care Source — Medicare Advantage: $173.39 Clover — Medicare Advantage: $173.39 Eon Health — Medicare Advantage: $173.39 Georgia Health Advantage — Medicare Advantage: $169.99 Humana — Medicare Advantage: $169.99 Pruitt Health — Medicare Advantage: $169.99 United Healthcare — Medicare Advantage: $169.99
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$195.41 – $203.62
New patient office visit (about 45–59 minutes): rates for 3 insurance plans Aetna — HMO: $195.41 Aetna — POS: $195.41 Aetna — PPO: $203.62
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	$159.24 – $350
New patient office visit (about 60–74 minutes): 10 of 22 insurance plan rates Aetna — HMO: $248.11 Aetna — Medicare Advantage: $159.24 Aetna — POS: $248.11 Aetna — PPO: $258.54 Alliant — Solocare: $191.09 Ambetter — Managed Medicaid: $214.97 Anthem — HMO/PPO: $350 Anthem — Medicare Advantage: $159.24 Care Source — Medicare Advantage: $162.42 Cigna — Commercial: $267.49
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	$227.47 – $272.96
New patient office visit (about 60–74 minutes): rates for 10 insurance plans Aetna — Medicare Advantage: $227.47 Alliant — Solocare: $272.96 Anthem — Medicare Advantage: $227.47 Care Source — Medicare Advantage: $232.02 Clover — Medicare Advantage: $232.02 Eon Health — Medicare Advantage: $232.02 Georgia Health Advantage — Medicare Advantage: $227.47 Humana — Medicare Advantage: $227.47 Pruitt Health — Medicare Advantage: $227.47 United Healthcare — Medicare Advantage: $227.47
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$248.11 – $258.54
New patient office visit (about 60–74 minutes): rates for 3 insurance plans Aetna — HMO: $248.11 Aetna — POS: $248.11 Aetna — PPO: $258.54
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	$56.84 – $350
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna — HMO: $77.49 Aetna — Medicare Advantage: $56.84 Aetna — POS: $77.49 Aetna — PPO: $85.04 Alliant — Solocare: $68.21 Ambetter — Managed Medicaid: $76.73 Anthem — HMO/PPO: $350 Anthem — Medicare Advantage: $56.84 Care Source — Medicare Advantage: $57.98 Cigna — Commercial: $93.67
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	$90.50 – $108.60
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — Medicare Advantage: $90.50 Alliant — Solocare: $108.60 Anthem — Medicare Advantage: $90.50 Care Source — Medicare Advantage: $92.31 Clover — Medicare Advantage: $92.31 Eon Health — Medicare Advantage: $92.31 Georgia Health Advantage — Medicare Advantage: $90.50 Humana — Medicare Advantage: $90.50 Pruitt Health — Medicare Advantage: $90.50 United Healthcare — Medicare Advantage: $90.50
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	$83.71 – $350
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — HMO: $120 Aetna — Medicare Advantage: $83.71 Aetna — POS: $120 Aetna — PPO: $134 Alliant — Solocare: $100.45 Ambetter — Managed Medicaid: $113.01 Anthem — HMO/PPO: $350 Anthem — Medicare Advantage: $83.71 Care Source — Medicare Advantage: $85.38 Cigna — Commercial: $138.53
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	$129.29 – $155.15
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — Medicare Advantage: $129.29 Alliant — Solocare: $155.15 Anthem — Medicare Advantage: $129.29 Care Source — Medicare Advantage: $131.88 Clover — Medicare Advantage: $131.88 Eon Health — Medicare Advantage: $131.88 Georgia Health Advantage — Medicare Advantage: $129.29 Humana — Medicare Advantage: $129.29 Pruitt Health — Medicare Advantage: $129.29 United Healthcare — Medicare Advantage: $129.29
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	$171.16 – $238.08
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — HMO: $174.54 Aetna — POS: $174.54 Aetna — PPO: $181.87 Cigna — Commercial: $171.16 Humana — HMO/POS: $208.61 Humana — PPO: $208.61 IBG — Commercial: $200.53 Kaiser — Commercial: $229.16 SecureHealth — Commercial: $238.08 United Healthcare — Commercial: $214.66
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	$108 – $129.60
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — Medicare Advantage: $108 Alliant — Solocare: $129.60 Anthem — Medicare Advantage: $108 Care Source — Medicare Advantage: $110.16 Clover — Medicare Advantage: $110.16 Eon Health — Medicare Advantage: $110.16 Georgia Health Advantage — Medicare Advantage: $108 Humana — Medicare Advantage: $108 Pruitt Health — Medicare Advantage: $108 United Healthcare — Medicare Advantage: $108
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$174.54 – $181.87
Office consultation with a specialist (moderate): rates for 3 insurance plans Aetna — HMO: $174.54 Aetna — POS: $174.54 Aetna — PPO: $181.87
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	$241.82 – $356.34
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — HMO: $246.60 Aetna — POS: $246.60 Aetna — PPO: $256.97 Cigna — Commercial: $241.82 Humana — HMO/POS: $294.75 Humana — PPO: $294.75 IBG — Commercial: $283.33 Kaiser — Commercial: $323.78 SecureHealth — Commercial: $356.34 United Healthcare — Commercial: $301.51
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	$155.01 – $186.01
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — Medicare Advantage: $155.01 Alliant — Solocare: $186.01 Anthem — Medicare Advantage: $155.01 Care Source — Medicare Advantage: $158.11 Clover — Medicare Advantage: $158.11 Eon Health — Medicare Advantage: $158.11 Georgia Health Advantage — Medicare Advantage: $155.01 Humana — Medicare Advantage: $155.01 Pruitt Health — Medicare Advantage: $155.01 United Healthcare — Medicare Advantage: $155.01
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	$246.60 – $256.97
Office consultation with a specialist (moderate to high): rates for 3 insurance plans Aetna — HMO: $246.60 Aetna — POS: $246.60 Aetna — PPO: $256.97
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$178.84 – $369.86
Preventive checkup, new patient, age 18–39: rates for 10 insurance plans Aetna — HMO: $185.28 Aetna — POS: $185.28 Aetna — PPO: $193.07 Cigna — Commercial: $178.84 Humana — HMO/POS: $218 Humana — PPO: $218 IBG — Commercial: $209.55 Kaiser — Commercial: $239.47 SecureHealth — Commercial: $332.68 United Healthcare — Commercial: $369.86
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$128.20 – $153.84
Preventive checkup, new patient, age 18–39: rates for 10 insurance plans Aetna — Medicare Advantage: $128.20 Alliant — Solocare: $153.84 Anthem — Medicare Advantage: $128.20 Care Source — Medicare Advantage: $130.76 Clover — Medicare Advantage: $130.76 Eon Health — Medicare Advantage: $130.76 Georgia Health Advantage — Medicare Advantage: $128.20 Humana — Medicare Advantage: $128.20 Pruitt Health — Medicare Advantage: $128.20 United Healthcare — Medicare Advantage: $128.20
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$182.63 – $369.86
Preventive checkup, new patient, age 40–64: rates for 10 insurance plans Aetna — HMO: $189.20 Aetna — POS: $189.20 Aetna — PPO: $197.15 Cigna — Commercial: $182.63 Humana — HMO/POS: $222.60 Humana — PPO: $222.60 IBG — Commercial: $283.98 Kaiser — Commercial: $244.53 SecureHealth — Commercial: $332.68 United Healthcare — Commercial: $369.86
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$148.75 – $178.50
Preventive checkup, new patient, age 40–64: rates for 10 insurance plans Aetna — Medicare Advantage: $148.75 Alliant — Solocare: $178.50 Anthem — Medicare Advantage: $148.75 Care Source — Medicare Advantage: $151.72 Clover — Medicare Advantage: $151.72 Eon Health — Medicare Advantage: $151.72 Georgia Health Advantage — Medicare Advantage: $148.75 Humana — Medicare Advantage: $148.75 Pruitt Health — Medicare Advantage: $148.75 United Healthcare — Medicare Advantage: $148.75
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$69.75 – $148.05
Emergency room visit (moderate): 10 of 21 insurance plan rates Aetna — HMO: $103.52 Aetna — Medicare Advantage: $69.75 Aetna — POS: $103.52 Aetna — PPO: $107.87 Alliant — Solocare: $83.70 Ambetter — Managed Medicaid: $94.16 Anthem — Medicare Advantage: $69.75 Care Source — Medicare Advantage: $71.15 Cigna — Commercial: $99.92 Clover — Medicare Advantage: $71.15
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$278.89 – $1,461
Emergency room visit (moderate): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $278.89 Alliant — Solocare: $934.37 Anthem — HMO/PPO: $1,277.45 Anthem — Medicare Advantage: $278.89 Care Source — Medicare Advantage: $284.47 Clover — Medicare Advantage: $284.47 Eon Health — Medicare Advantage: $284.47 Georgia Health Advantage — Medicare Advantage: $278.89 Humana — Medicare Advantage: $278.89 Pruitt Health — Medicare Advantage: $278.89
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$103.52 – $107.87
Emergency room visit (moderate): rates for 3 insurance plans Aetna — HMO: $103.52 Aetna — POS: $103.52 Aetna — PPO: $107.87
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$118.86 – $215.34
Emergency room visit (moderately high): 10 of 21 insurance plan rates Aetna — HMO: $159.45 Aetna — Medicare Advantage: $118.86 Aetna — POS: $159.45 Aetna — PPO: $166.15 Alliant — Solocare: $142.63 Ambetter — Managed Medicaid: $160.46 Anthem — Medicare Advantage: $118.86 Care Source — Medicare Advantage: $121.24 Cigna — Commercial: $153.92 Clover — Medicare Advantage: $121.24
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$426.30 – $3,753
Emergency room visit (moderately high): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $426.30 Alliant — Solocare: $1,486.83 Anthem — HMO/PPO: $2,191.24 Anthem — Medicare Advantage: $426.30 Care Source — Medicare Advantage: $434.83 Clover — Medicare Advantage: $434.83 Eon Health — Medicare Advantage: $434.83 Georgia Health Advantage — Medicare Advantage: $426.30 Humana — Medicare Advantage: $426.30 Pruitt Health — Medicare Advantage: $426.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$159.45 – $166.15
Emergency room visit (moderately high): rates for 3 insurance plans Aetna — HMO: $159.45 Aetna — POS: $159.45 Aetna — PPO: $166.15
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$172.08 – $333.93
Emergency room visit (high): 10 of 21 insurance plan rates Aetna — HMO: $249.89 Aetna — Medicare Advantage: $172.08 Aetna — POS: $249.89 Aetna — PPO: $260.39 Alliant — Solocare: $206.50 Ambetter — Managed Medicaid: $232.31 Anthem — Medicare Advantage: $172.08 Care Source — Medicare Advantage: $175.52 Cigna — Commercial: $241.22 Clover — Medicare Advantage: $175.52
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$608.43 – $3,753
Emergency room visit (high): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $608.43 Alliant — Solocare: $2,060.90 Anthem — HMO/PPO: $2,817.60 Anthem — Medicare Advantage: $608.43 Care Source — Medicare Advantage: $620.60 Clover — Medicare Advantage: $620.60 Eon Health — Medicare Advantage: $620.60 Georgia Health Advantage — Medicare Advantage: $608.43 Humana — Medicare Advantage: $608.43 Pruitt Health — Medicare Advantage: $608.43
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$249.89 – $260.39
Emergency room visit (high): rates for 3 insurance plans Aetna — HMO: $249.89 Aetna — POS: $249.89 Aetna — PPO: $260.39

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	$205	$102.50	$4.97 – $190.65
Basic metabolic panel (blood test): 10 of 27 insurance plan rates Aetna — HMO: $120.95 Aetna — Medicare Advantage: $8.46 Aetna — POS: $133.25 Aetna — PPO: $143.50 Alliant — Solocare: $8.46 Ambetter — Managed Medicaid: $61.50 Anthem — HMO/PPO: $10.39 Anthem — Medicare Advantage: $8.46 Beechstreet — Commercial: $190.65 Care Source — Medicare Advantage: $8.63
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$205	$102.50	$104.55 – $190.65
Basic metabolic panel (blood test): rates for 6 insurance plans Ambetter — Managed Medicaid: $104.55 Beechstreet — Commercial: $190.65 Multiplan — PHO Agreement Complimentary Network: $164 Multiplan — PHO Agreement Primary Network: $133.25 Novanet — Commercial: $164 Three Rivers Provider Network — Commercial: $174.25
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: METABOLIC PANEL TOTAL CA	Not listed in the file	Not listed in the file	$17.67 – $30.43
Basic metabolic panel (blood test): rates for 9 insurance plans Aetna — HMO: $21.55 Aetna — POS: $21.55 Aetna — PPO: $22.46 Cigna — Commercial: $17.67 Humana — HMO/POS: $21.54 Humana — PPO: $21.54 IBG — Commercial: $24.61 Kaiser — Commercial: $30.43 SecureHealth — Commercial: $21.21
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$228	$114	$6.20 – $212.04
Comprehensive metabolic panel (blood test): 10 of 27 insurance plan rates Aetna — HMO: $134.52 Aetna — Medicare Advantage: $10.56 Aetna — POS: $148.20 Aetna — PPO: $159.60 Alliant — Solocare: $10.56 Ambetter — Managed Medicaid: $68.40 Anthem — HMO/PPO: $13.14 Anthem — Medicare Advantage: $10.56 Beechstreet — Commercial: $212.04 Care Source — Medicare Advantage: $10.77
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$228	$114	$116.28 – $212.04
Comprehensive metabolic panel (blood test): rates for 6 insurance plans Ambetter — Managed Medicaid: $116.28 Beechstreet — Commercial: $212.04 Multiplan — PHO Agreement Complimentary Network: $182.40 Multiplan — PHO Agreement Primary Network: $148.20 Novanet — Commercial: $182.40 Three Rivers Provider Network — Commercial: $193.80
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$22.06 – $37.98
Comprehensive metabolic panel (blood test): rates for 9 insurance plans Aetna — HMO: $29.21 Aetna — POS: $29.21 Aetna — PPO: $30.44 Cigna — Commercial: $22.06 Humana — HMO/POS: $26.89 Humana — PPO: $26.89 IBG — Commercial: $30.72 Kaiser — Commercial: $37.98 SecureHealth — Commercial: $26.49
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	$20.85 – $69.32
Obstetric blood test panel: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $47.81 Alliant — Solocare: $47.81 Anthem — Medicare Advantage: $47.81 Care Source — Medicare Advantage: $48.77 Cigna — Commercial: $58.37 Clover — Medicare Advantage: $48.77 Eon Health — Medicare Advantage: $48.77 Georgia Health Advantage — Medicare Advantage: $47.81 Humana — Medicare Advantage: $47.81 Kaiser — Commercial: $69.32
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	$40.39 – $296.62
Obstetric blood test panel: rates for 10 insurance plans Aetna — HMO: $69.53 Aetna — POS: $69.53 Aetna — PPO: $72.45 Cigna — Commercial: $206.83 Humana — HMO/POS: $78.20 Humana — PPO: $78.20 IBG — Commercial: $40.39 Kaiser — Commercial: $83.65 SecureHealth — Commercial: $296.62 United Healthcare — Commercial: $93.97
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$78.20
Obstetric blood test panel: rates for 2 insurance plans Humana — HMO/POS: $78.20 Humana — PPO: $78.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$176	$88	$7.86 – $163.68
Cholesterol panel (lipid panel): 10 of 27 insurance plan rates Aetna — HMO: $103.84 Aetna — Medicare Advantage: $13.39 Aetna — POS: $114.40 Aetna — PPO: $123.20 Alliant — Solocare: $13.39 Ambetter — Managed Medicaid: $52.80 Anthem — HMO/PPO: $21.39 Anthem — Medicare Advantage: $13.39 Beechstreet — Commercial: $163.68 Care Source — Medicare Advantage: $13.66
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$176	$88	$89.76 – $163.68
Cholesterol panel (lipid panel): rates for 6 insurance plans Ambetter — Managed Medicaid: $89.76 Beechstreet — Commercial: $163.68 Multiplan — PHO Agreement Complimentary Network: $140.80 Multiplan — PHO Agreement Primary Network: $114.40 Novanet — Commercial: $140.80 Three Rivers Provider Network — Commercial: $149.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: LIPID PANEL	Not listed in the file	Not listed in the file	$27.96 – $72.91
Cholesterol panel (lipid panel): rates for 10 insurance plans Aetna — HMO: $41.11 Aetna — POS: $41.11 Aetna — PPO: $42.84 Cigna — Commercial: $27.96 Humana — HMO/POS: $34.08 Humana — PPO: $34.08 IBG — Commercial: $43.07 Kaiser — Commercial: $48.14 SecureHealth — Commercial: $33.57 United Healthcare — Commercial: $72.91
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$337	$168.50	$5.09 – $313.41
Kidney function panel: 10 of 27 insurance plan rates Aetna — HMO: $198.83 Aetna — Medicare Advantage: $8.68 Aetna — POS: $219.05 Aetna — PPO: $235.90 Alliant — Solocare: $8.68 Ambetter — Managed Medicaid: $101.10 Anthem — HMO/PPO: $10.69 Anthem — Medicare Advantage: $8.68 Beechstreet — Commercial: $313.41 Care Source — Medicare Advantage: $8.85
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$337	$168.50	$171.87 – $313.41
Kidney function panel: rates for 6 insurance plans Ambetter — Managed Medicaid: $171.87 Beechstreet — Commercial: $313.41 Multiplan — PHO Agreement Complimentary Network: $269.60 Multiplan — PHO Agreement Primary Network: $219.05 Novanet — Commercial: $269.60 Three Rivers Provider Network — Commercial: $286.45
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$18.11 – $31.19
Kidney function panel: rates for 9 insurance plans Aetna — HMO: $23.04 Aetna — POS: $23.04 Aetna — PPO: $24.01 Cigna — Commercial: $18.11 Humana — HMO/POS: $22.08 Humana — PPO: $22.08 IBG — Commercial: $25.24 Kaiser — Commercial: $31.19 SecureHealth — Commercial: $21.76
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$253	$126.50	$4.80 – $235.29
Liver function panel: 10 of 27 insurance plan rates Aetna — HMO: $149.27 Aetna — Medicare Advantage: $8.17 Aetna — POS: $164.45 Aetna — PPO: $177.10 Alliant — Solocare: $8.17 Ambetter — Managed Medicaid: $75.90 Anthem — HMO/PPO: $10.08 Anthem — Medicare Advantage: $8.17 Beechstreet — Commercial: $235.29 Care Source — Medicare Advantage: $8.33
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$253	$126.50	$129.03 – $235.29
Liver function panel: rates for 6 insurance plans Ambetter — Managed Medicaid: $129.03 Beechstreet — Commercial: $235.29 Multiplan — PHO Agreement Complimentary Network: $202.40 Multiplan — PHO Agreement Primary Network: $164.45 Novanet — Commercial: $202.40 Three Rivers Provider Network — Commercial: $215.05
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: HEPATIC FUNCTION PANEL	Not listed in the file	Not listed in the file	$17.05 – $29.36
Liver function panel: rates for 9 insurance plans Aetna — HMO: $20.62 Aetna — POS: $20.62 Aetna — PPO: $21.49 Cigna — Commercial: $17.05 Humana — HMO/POS: $20.79 Humana — PPO: $20.79 IBG — Commercial: $23.74 Kaiser — Commercial: $29.36 SecureHealth — Commercial: $20.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$72	$36	$1.86 – $66.96
Urine test (automated, with microscope): 10 of 27 insurance plan rates Aetna — HMO: $42.48 Aetna — Medicare Advantage: $3.17 Aetna — POS: $46.80 Aetna — PPO: $50.40 Alliant — Solocare: $3.17 Ambetter — Managed Medicaid: $21.60 Anthem — HMO/PPO: $3.97 Anthem — Medicare Advantage: $3.17 Beechstreet — Commercial: $66.96 Care Source — Medicare Advantage: $3.23
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$72	$36	$36.72 – $66.96
Urine test (automated, with microscope): rates for 6 insurance plans Ambetter — Managed Medicaid: $36.72 Beechstreet — Commercial: $66.96 Multiplan — PHO Agreement Complimentary Network: $57.60 Multiplan — PHO Agreement Primary Network: $46.80 Novanet — Commercial: $57.60 Three Rivers Provider Network — Commercial: $61.20
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$7.13 – $19.83
Urine test (automated, with microscope): rates for 9 insurance plans Aetna — HMO: $19.03 Aetna — POS: $19.03 Aetna — PPO: $19.83 Cigna — Commercial: $7.13 Humana — HMO/POS: $8.06 Humana — PPO: $8.06 IBG — Commercial: $17.50 Kaiser — Commercial: $8.99 SecureHealth — Commercial: $8.56
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$1.50 – $5.05
Urine test (manual, without microscope): 10 of 13 insurance plan rates Aetna — Medicare Advantage: $3.48 Alliant — Solocare: $3.48 Anthem — Medicare Advantage: $3.48 Care Source — Medicare Advantage: $3.55 Cigna — Commercial: $3.34 Clover — Medicare Advantage: $3.55 Eon Health — Medicare Advantage: $3.55 Georgia Health Advantage — Medicare Advantage: $3.48 Humana — Medicare Advantage: $3.48 Kaiser — Commercial: $5.05
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$5.74 – $24.32
Urine test (manual, without microscope): rates for 10 insurance plans Aetna — HMO: $9.82 Aetna — POS: $9.82 Aetna — PPO: $10.23 Cigna — Commercial: $5.74 Humana — HMO/POS: $6.50 Humana — PPO: $6.50 IBG — Commercial: $11.10 Kaiser — Commercial: $7.25 SecureHealth — Commercial: $6.90 United Healthcare — Commercial: $24.32
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$6.50
Urine test (manual, without microscope): rates for 2 insurance plans Humana — HMO/POS: $6.50 Humana — PPO: $6.50
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$48	$24	$1.32 – $44.64
Urine test (automated, without microscope): 10 of 27 insurance plan rates Aetna — HMO: $28.32 Aetna — Medicare Advantage: $2.25 Aetna — POS: $31.20 Aetna — PPO: $33.60 Alliant — Solocare: $2.25 Ambetter — Managed Medicaid: $14.40 Anthem — HMO/PPO: $2.75 Anthem — Medicare Advantage: $2.25 Beechstreet — Commercial: $44.64 Care Source — Medicare Advantage: $2.30
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$48	$24	$24.48 – $44.64
Urine test (automated, without microscope): rates for 6 insurance plans Ambetter — Managed Medicaid: $24.48 Beechstreet — Commercial: $44.64 Multiplan — PHO Agreement Complimentary Network: $38.40 Multiplan — PHO Agreement Primary Network: $31.20 Novanet — Commercial: $38.40 Three Rivers Provider Network — Commercial: $40.80
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/O SCOPE	Not listed in the file	Not listed in the file	$5.05 – $25.91
Urine test (automated, without microscope): rates for 10 insurance plans Aetna — HMO: $11.36 Aetna — POS: $11.36 Aetna — PPO: $11.84 Cigna — Commercial: $5.05 Humana — HMO/POS: $5.72 Humana — PPO: $5.72 IBG — Commercial: $6.53 Kaiser — Commercial: $6.37 SecureHealth — Commercial: $6.07 United Healthcare — Commercial: $25.91
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$172	$86	$10.79 – $159.96
PSA (prostate specific antigen) blood test: 10 of 27 insurance plan rates Aetna — HMO: $101.48 Aetna — Medicare Advantage: $18.39 Aetna — POS: $111.80 Aetna — PPO: $120.40 Alliant — Solocare: $18.39 Ambetter — Managed Medicaid: $51.60 Anthem — HMO/PPO: $22.61 Anthem — Medicare Advantage: $18.39 Beechstreet — Commercial: $159.96 Care Source — Medicare Advantage: $18.76
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$172	$86	$87.72 – $159.96
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Ambetter — Managed Medicaid: $87.72 Beechstreet — Commercial: $159.96 Multiplan — PHO Agreement Complimentary Network: $137.60 Multiplan — PHO Agreement Primary Network: $111.80 Novanet — Commercial: $137.60 Three Rivers Provider Network — Commercial: $146.20
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY OF PSA TOTAL	Not listed in the file	Not listed in the file	$38.38 – $108.54
PSA (prostate specific antigen) blood test: rates for 10 insurance plans Aetna — HMO: $63.43 Aetna — POS: $63.43 Aetna — PPO: $66.09 Cigna — Commercial: $38.38 Humana — HMO/POS: $46.78 Humana — PPO: $46.78 IBG — Commercial: $80.75 Kaiser — Commercial: $66.09 SecureHealth — Commercial: $46.09 United Healthcare — Commercial: $108.54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$237	$118.50	$9.86 – $220.41
Thyroid stimulating hormone (TSH) test: 10 of 27 insurance plan rates Aetna — HMO: $139.83 Aetna — Medicare Advantage: $16.80 Aetna — POS: $154.05 Aetna — PPO: $165.90 Alliant — Solocare: $16.80 Ambetter — Managed Medicaid: $71.10 Anthem — HMO/PPO: $20.78 Anthem — Medicare Advantage: $16.80 Beechstreet — Commercial: $220.41 Care Source — Medicare Advantage: $17.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$237	$118.50	$120.87 – $220.41
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans Ambetter — Managed Medicaid: $120.87 Beechstreet — Commercial: $220.41 Multiplan — PHO Agreement Complimentary Network: $189.60 Multiplan — PHO Agreement Primary Network: $154.05 Novanet — Commercial: $189.60 Three Rivers Provider Network — Commercial: $201.45
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$35.05 – $92.34
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans Aetna — HMO: $53.01 Aetna — POS: $53.01 Aetna — PPO: $55.24 Cigna — Commercial: $35.05 Humana — HMO/POS: $42.72 Humana — PPO: $42.72 IBG — Commercial: $59.96 Kaiser — Commercial: $60.36 SecureHealth — Commercial: $42.10 United Healthcare — Commercial: $92.34
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$169	$84.50	$4.56 – $157.17
Complete blood count (CBC) with differential: 10 of 27 insurance plan rates Aetna — HMO: $99.71 Aetna — Medicare Advantage: $7.77 Aetna — POS: $109.85 Aetna — PPO: $118.30 Alliant — Solocare: $7.77 Ambetter — Managed Medicaid: $50.70 Anthem — HMO/PPO: $9.47 Anthem — Medicare Advantage: $7.77 Beechstreet — Commercial: $157.17 Care Source — Medicare Advantage: $7.93
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$169	$84.50	$86.19 – $157.17
Complete blood count (CBC) with differential: rates for 6 insurance plans Ambetter — Managed Medicaid: $86.19 Beechstreet — Commercial: $157.17 Multiplan — PHO Agreement Complimentary Network: $135.20 Multiplan — PHO Agreement Primary Network: $109.85 Novanet — Commercial: $135.20 Three Rivers Provider Network — Commercial: $143.65
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	Not listed in the file	Not listed in the file	$17.47 – $27.93
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — HMO: $17.85 Aetna — POS: $17.85 Aetna — PPO: $18.60 Cigna — Commercial: $17.47 Humana — HMO/POS: $19.77 Humana — PPO: $19.77 IBG — Commercial: $26.92 Kaiser — Commercial: $27.93 SecureHealth — Commercial: $19.70 United Healthcare — Commercial: $27.54
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$123	$61.50	$3.80 – $114.39
Complete blood count (CBC), automated: 10 of 27 insurance plan rates Aetna — HMO: $72.57 Aetna — Medicare Advantage: $6.47 Aetna — POS: $79.95 Aetna — PPO: $86.10 Alliant — Solocare: $6.47 Ambetter — Managed Medicaid: $36.90 Anthem — HMO/PPO: $7.94 Anthem — Medicare Advantage: $6.47 Beechstreet — Commercial: $114.39 Care Source — Medicare Advantage: $6.60
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$123	$61.50	$62.73 – $114.39
Complete blood count (CBC), automated: rates for 6 insurance plans Ambetter — Managed Medicaid: $62.73 Beechstreet — Commercial: $114.39 Multiplan — PHO Agreement Complimentary Network: $98.40 Multiplan — PHO Agreement Primary Network: $79.95 Novanet — Commercial: $98.40 Three Rivers Provider Network — Commercial: $104.55
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC AUTOMATED	Not listed in the file	Not listed in the file	$14.53 – $24.32
Complete blood count (CBC), automated: rates for 10 insurance plans Aetna — HMO: $17.85 Aetna — POS: $17.85 Aetna — PPO: $18.60 Cigna — Commercial: $14.53 Humana — HMO/POS: $16.46 Humana — PPO: $16.46 IBG — Commercial: $17.75 Kaiser — Commercial: $22.57 SecureHealth — Commercial: $17.45 United Healthcare — Commercial: $24.32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$124	$62	$2.31 – $115.32
Blood clotting time test (prothrombin time, PT): 10 of 27 insurance plan rates Aetna — HMO: $73.16 Aetna — Medicare Advantage: $4.29 Aetna — POS: $80.60 Aetna — PPO: $86.80 Alliant — Solocare: $4.29 Ambetter — Managed Medicaid: $37.20 Anthem — HMO/PPO: $4.89 Anthem — Medicare Advantage: $4.29 Beechstreet — Commercial: $115.32 Care Source — Medicare Advantage: $4.38
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$124	$62	$63.24 – $115.32
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans Ambetter — Managed Medicaid: $63.24 Beechstreet — Commercial: $115.32 Multiplan — PHO Agreement Complimentary Network: $99.20 Multiplan — PHO Agreement Primary Network: $80.60 Novanet — Commercial: $99.20 Three Rivers Provider Network — Commercial: $105.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: PROTHROMBIN TIME	Not listed in the file	Not listed in the file	$8.83 – $35.65
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans Aetna — HMO: $17.31 Aetna — POS: $17.31 Aetna — PPO: $18.04 Cigna — Commercial: $8.83 Humana — HMO/POS: $9.99 Humana — PPO: $9.99 IBG — Commercial: $19.58 Kaiser — Commercial: $13.71 SecureHealth — Commercial: $10.61 United Healthcare — Commercial: $35.65
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$122	$61	$3.52 – $113.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 27 insurance plan rates Aetna — HMO: $71.98 Aetna — Medicare Advantage: $6.01 Aetna — POS: $79.30 Aetna — PPO: $85.40 Alliant — Solocare: $6.01 Ambetter — Managed Medicaid: $36.60 Anthem — HMO/PPO: $7.33 Anthem — Medicare Advantage: $6.01 Beechstreet — Commercial: $113.46 Care Source — Medicare Advantage: $6.13
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$122	$61	$62.22 – $113.46
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans Ambetter — Managed Medicaid: $62.22 Beechstreet — Commercial: $113.46 Multiplan — PHO Agreement Complimentary Network: $97.60 Multiplan — PHO Agreement Primary Network: $79.30 Novanet — Commercial: $97.60 Three Rivers Provider Network — Commercial: $103.70
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: THROMBOPLASTIN TIME PARTIAL	Not listed in the file	Not listed in the file	$13.47 – $22.67
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans Aetna — HMO: $17.08 Aetna — POS: $17.08 Aetna — PPO: $17.79 Cigna — Commercial: $13.47 Humana — HMO/POS: $15.26 Humana — PPO: $15.26 IBG — Commercial: $15.79 Kaiser — Commercial: $20.92 SecureHealth — Commercial: $16.19 United Healthcare — Commercial: $22.67

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$98.64 – $633.75
CT scan of the head or brain, without contrast: 10 of 21 insurance plan rates Aetna — HMO: $499.69 Aetna — Medicare Advantage: $98.64 Aetna — POS: $499.69 Aetna — PPO: $520.69 Alliant — Solocare: $118.37 Ambetter — Managed Medicaid: $133.16 Anthem — Medicare Advantage: $98.64 Care Source — Medicare Advantage: $100.61 Cigna — Commercial: $397.94 Clover — Medicare Advantage: $100.61
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$106.81 – $528.84
CT scan of the head or brain, without contrast: 10 of 13 insurance plan rates Aetna — HMO: $528.84 Aetna — Medicare Advantage: $106.81 Aetna — POS: $528.84 Alliant — Solocare: $128.17 Anthem — Medicare Advantage: $106.81 Care Source — Medicare Advantage: $108.95 Cigna — Commercial: $296.55 Clover — Medicare Advantage: $108.95 Eon Health — Medicare Advantage: $108.95 Georgia Health Advantage — Medicare Advantage: $106.81
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$38.65 – $172.10
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — HMO: $133.15 Aetna — Medicare Advantage: $38.65 Aetna — POS: $133.15 Aetna — PPO: $138.74 Alliant — Solocare: $46.38 Ambetter — Managed Medicaid: $52.18 Anthem — Medicare Advantage: $38.65 Care Source — Medicare Advantage: $39.42 Cigna — Commercial: $128.52 Clover — Medicare Advantage: $39.42
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$292.39 – $2,861.27
MRI of the brain, before and after contrast: 10 of 21 insurance plan rates Aetna — HMO: $2,377.92 Aetna — Medicare Advantage: $292.39 Aetna — POS: $2,377.92 Aetna — PPO: $2,477.83 Alliant — Solocare: $350.87 Ambetter — Managed Medicaid: $394.73 Anthem — Medicare Advantage: $292.39 Care Source — Medicare Advantage: $298.24 Cigna — Commercial: $1,893.67 Clover — Medicare Advantage: $298.24
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$356.43 – $1,582.54
MRI of the brain, before and after contrast: 10 of 13 insurance plan rates Aetna — HMO: $1,582.54 Aetna — Medicare Advantage: $356.43 Aetna — POS: $1,582.54 Alliant — Solocare: $427.72 Anthem — Medicare Advantage: $356.43 Care Source — Medicare Advantage: $363.56 Cigna — Commercial: $1,063.18 Clover — Medicare Advantage: $363.56 Eon Health — Medicare Advantage: $363.56 Georgia Health Advantage — Medicare Advantage: $356.43
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$103.20 – $478
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — HMO: $369.85 Aetna — Medicare Advantage: $103.20 Aetna — POS: $369.85 Aetna — PPO: $385.39 Alliant — Solocare: $123.84 Ambetter — Managed Medicaid: $139.32 Anthem — Medicare Advantage: $103.20 Care Source — Medicare Advantage: $105.26 Cigna — Commercial: $357.02 Clover — Medicare Advantage: $105.26
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$560	$280	$21.43 – $712
Chest X-ray, 2 views: 10 of 27 insurance plan rates Aetna — HMO: $330.40 Aetna — Medicare Advantage: $88.91 Aetna — POS: $364 Aetna — PPO: $386.40 Alliant — Solocare: $106.69 Ambetter — Managed Medicaid: $168 Anthem — HMO/PPO: $21.43 Anthem — Medicare Advantage: $88.91 Beechstreet — Commercial: $520.80 Care Source — Medicare Advantage: $90.69
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$560	$280	$285.60 – $520.80
Chest X-ray, 2 views: rates for 6 insurance plans Ambetter — Managed Medicaid: $285.60 Beechstreet — Commercial: $520.80 Multiplan — PHO Agreement Complimentary Network: $448 Multiplan — PHO Agreement Primary Network: $364 Novanet — Commercial: $448 Three Rivers Provider Network — Commercial: $476
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$30.45 – $76.32
Chest X-ray, 2 views: 10 of 18 insurance plan rates Aetna — HMO: $73.24 Aetna — Medicare Advantage: $30.45 Aetna — POS: $73.24 Aetna — PPO: $76.32 Alliant — Solocare: $36.54 Ambetter — Managed Medicaid: $41.11 Anthem — HMO/PPO: $60.15 Anthem — Medicare Advantage: $30.45 Care Source — Medicare Advantage: $31.06 Clover — Medicare Advantage: $31.06
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	$568	$284	$37.40 – $712
X-ray of the lower spine, at least 4 views: 10 of 27 insurance plan rates Aetna — HMO: $335.12 Aetna — Medicare Advantage: $106.81 Aetna — POS: $369.20 Aetna — PPO: $391.92 Alliant — Solocare: $128.17 Ambetter — Managed Medicaid: $170.40 Anthem — HMO/PPO: $37.40 Anthem — Medicare Advantage: $106.81 Beechstreet — Commercial: $528.24 Care Source — Medicare Advantage: $108.95
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	$568	$284	$289.68 – $528.24
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans Ambetter — Managed Medicaid: $289.68 Beechstreet — Commercial: $528.24 Multiplan — PHO Agreement Complimentary Network: $454.40 Multiplan — PHO Agreement Primary Network: $369.20 Novanet — Commercial: $454.40 Three Rivers Provider Network — Commercial: $482.80
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$48.87 – $137.66
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates Aetna — HMO: $114.41 Aetna — Medicare Advantage: $48.87 Aetna — POS: $114.41 Aetna — PPO: $119.21 Alliant — Solocare: $58.64 Ambetter — Managed Medicaid: $65.97 Anthem — Medicare Advantage: $48.87 Care Source — Medicare Advantage: $49.85 Cigna — Commercial: $91.11 Clover — Medicare Advantage: $49.85
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$177.21 – $1,472.77
MRI of the lower back (lumbar spine), without contrast: 10 of 21 insurance plan rates Aetna — HMO: $1,127.26 Aetna — Medicare Advantage: $177.21 Aetna — POS: $1,127.26 Aetna — PPO: $1,174.63 Alliant — Solocare: $212.65 Ambetter — Managed Medicaid: $239.23 Anthem — Medicare Advantage: $177.21 Care Source — Medicare Advantage: $180.75 Cigna — Commercial: $974.72 Clover — Medicare Advantage: $180.75
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$243.77 – $1,005.34
MRI of the lower back (lumbar spine), without contrast: 10 of 13 insurance plan rates Aetna — HMO: $1,005.34 Aetna — Medicare Advantage: $243.77 Aetna — POS: $1,005.34 Alliant — Solocare: $292.52 Anthem — Medicare Advantage: $243.77 Care Source — Medicare Advantage: $248.65 Cigna — Commercial: $600.30 Clover — Medicare Advantage: $248.65 Eon Health — Medicare Advantage: $248.65 Georgia Health Advantage — Medicare Advantage: $243.77
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$67.07 – $248.72
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — HMO: $161.29 Aetna — Medicare Advantage: $67.07 Aetna — POS: $161.29 Aetna — PPO: $168.07 Alliant — Solocare: $80.48 Ambetter — Managed Medicaid: $90.54 Anthem — Medicare Advantage: $67.07 Care Source — Medicare Advantage: $68.41 Cigna — Commercial: $155.70 Clover — Medicare Advantage: $68.41
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$206.38 – $860
CT scan of the pelvis, with contrast: 10 of 21 insurance plan rates Aetna — HMO: $714.73 Aetna — Medicare Advantage: $206.38 Aetna — POS: $714.73 Aetna — PPO: $744.76 Alliant — Solocare: $247.66 Ambetter — Managed Medicaid: $278.61 Anthem — Medicare Advantage: $206.38 Care Source — Medicare Advantage: $210.51 Cigna — Commercial: $569.17 Clover — Medicare Advantage: $210.51
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$179.20 – $805.41
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates Aetna — HMO: $805.41 Aetna — Medicare Advantage: $179.20 Aetna — POS: $805.41 Alliant — Solocare: $215.04 Anthem — Medicare Advantage: $179.20 Care Source — Medicare Advantage: $182.78 Cigna — Commercial: $679.86 Clover — Medicare Advantage: $182.78 Eon Health — Medicare Advantage: $182.78 Georgia Health Advantage — Medicare Advantage: $179.20
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$52.45 – $233.91
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — HMO: $180.98 Aetna — Medicare Advantage: $52.45 Aetna — POS: $180.98 Aetna — PPO: $188.58 Alliant — Solocare: $62.94 Ambetter — Managed Medicaid: $70.81 Anthem — Medicare Advantage: $52.45 Care Source — Medicare Advantage: $53.50 Cigna — Commercial: $174.68 Clover — Medicare Advantage: $53.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$188 – $1,307.91
MRI of a leg joint (such as the knee), without contrast: 10 of 21 insurance plan rates Aetna — HMO: $970.64 Aetna — Medicare Advantage: $188 Aetna — POS: $970.64 Aetna — PPO: $1,011.42 Alliant — Solocare: $225.60 Ambetter — Managed Medicaid: $253.80 Anthem — Medicare Advantage: $188 Care Source — Medicare Advantage: $191.76 Cigna — Commercial: $865.61 Clover — Medicare Advantage: $191.76
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$243.77 – $1,080.78
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — HMO: $1,080.78 Aetna — Medicare Advantage: $243.77 Aetna — POS: $1,080.78 Alliant — Solocare: $292.52 Anthem — Medicare Advantage: $243.77 Care Source — Medicare Advantage: $248.65 Cigna — Commercial: $681.30 Clover — Medicare Advantage: $248.65 Eon Health — Medicare Advantage: $248.65 Georgia Health Advantage — Medicare Advantage: $243.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$61.48 – $244.56
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — HMO: $129.16 Aetna — Medicare Advantage: $61.48 Aetna — POS: $129.16 Aetna — PPO: $134.59 Alliant — Solocare: $73.78 Ambetter — Managed Medicaid: $83 Anthem — Medicare Advantage: $61.48 Care Source — Medicare Advantage: $62.71 Cigna — Commercial: $124.67 Clover — Medicare Advantage: $62.71
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELV W/CONTRAST	Not listed in the file	Not listed in the file	$275.53 – $1,026.08
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — Medicare Advantage: $275.53 Alliant — Solocare: $330.64 Ambetter — Managed Medicaid: $371.97 Anthem — Medicare Advantage: $275.53 Care Source — Medicare Advantage: $281.04 Cigna — Commercial: $688.08 Clover — Medicare Advantage: $281.04 Eon Health — Medicare Advantage: $281.04 Georgia Health Advantage — Medicare Advantage: $275.53 Humana — HMO/POS: $976.96
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELV W/CONTRAST	Not listed in the file	Not listed in the file	$356.43 – $948.28
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Aetna — HMO: $948.28 Aetna — Medicare Advantage: $356.43 Aetna — POS: $948.28 Alliant — Solocare: $427.72 Anthem — Medicare Advantage: $356.43 Care Source — Medicare Advantage: $363.56 Cigna — Commercial: $889.59 Clover — Medicare Advantage: $363.56 Eon Health — Medicare Advantage: $363.56 Georgia Health Advantage — Medicare Advantage: $356.43
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: CT ABD & PELV W/CONTRAST	Not listed in the file	Not listed in the file	$193.26 – $976.96
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $193.26 Alliant — Solocare: $231.91 Ambetter — Managed Medicaid: $260.90 Anthem — Medicare Advantage: $193.26 Care Source — Medicare Advantage: $197.13 Clover — Medicare Advantage: $197.13 Eon Health — Medicare Advantage: $197.13 Georgia Health Advantage — Medicare Advantage: $193.26 Humana — HMO/POS: $976.96 Humana — Medicare Advantage: $193.26
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	$612	$306	$106.81 – $939
Ultrasound of the abdomen, complete: 10 of 27 insurance plan rates Aetna — HMO: $361.08 Aetna — Medicare Advantage: $106.81 Aetna — POS: $397.80 Aetna — PPO: $422.28 Alliant — Solocare: $128.17 Ambetter — Managed Medicaid: $183.60 Anthem — HMO/PPO: $112.20 Anthem — Medicare Advantage: $106.81 Beechstreet — Commercial: $569.16 Care Source — Medicare Advantage: $108.95
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	$612	$306	$312.12 – $569.16
Ultrasound of the abdomen, complete: rates for 6 insurance plans Ambetter — Managed Medicaid: $312.12 Beechstreet — Commercial: $569.16 Multiplan — PHO Agreement Complimentary Network: $489.60 Multiplan — PHO Agreement Primary Network: $397.80 Novanet — Commercial: $489.60 Three Rivers Provider Network — Commercial: $520.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$105.35 – $318.05
Ultrasound of the abdomen, complete: 10 of 21 insurance plan rates Aetna — HMO: $246.39 Aetna — Medicare Advantage: $105.35 Aetna — POS: $246.39 Aetna — PPO: $256.74 Alliant — Solocare: $126.42 Ambetter — Managed Medicaid: $142.22 Anthem — Medicare Advantage: $105.35 Care Source — Medicare Advantage: $107.46 Cigna — Commercial: $210.49 Clover — Medicare Advantage: $107.46
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$125.46 – $357.79
Pregnancy ultrasound (after the first trimester): 10 of 21 insurance plan rates Aetna — HMO: $245.79 Aetna — Medicare Advantage: $125.46 Aetna — POS: $245.79 Aetna — PPO: $256.12 Alliant — Solocare: $150.55 Ambetter — Managed Medicaid: $169.37 Anthem — Medicare Advantage: $125.46 Care Source — Medicare Advantage: $127.97 Cigna — Commercial: $236.80 Clover — Medicare Advantage: $127.97
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$106.81 – $374.65
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Aetna — HMO: $235.24 Aetna — Medicare Advantage: $106.81 Aetna — POS: $235.24 Alliant — Solocare: $128.17 Anthem — Medicare Advantage: $106.81 Care Source — Medicare Advantage: $108.95 Cigna — Commercial: $374.65 Clover — Medicare Advantage: $108.95 Eon Health — Medicare Advantage: $108.95 Georgia Health Advantage — Medicare Advantage: $106.81
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$46.01 – $160.31
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — HMO: $108.39 Aetna — Medicare Advantage: $46.01 Aetna — POS: $108.39 Aetna — PPO: $112.94 Alliant — Solocare: $55.21 Ambetter — Managed Medicaid: $62.11 Anthem — Medicare Advantage: $46.01 Care Source — Medicare Advantage: $46.93 Cigna — Commercial: $104.62 Clover — Medicare Advantage: $46.93
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$107.89 – $292.15
Transvaginal ultrasound: 10 of 21 insurance plan rates Aetna — HMO: $182.22 Aetna — Medicare Advantage: $107.89 Aetna — POS: $182.22 Aetna — PPO: $189.88 Alliant — Solocare: $129.47 Ambetter — Managed Medicaid: $145.65 Anthem — Medicare Advantage: $107.89 Care Source — Medicare Advantage: $110.05 Cigna — Commercial: $169.45 Clover — Medicare Advantage: $110.05
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$106.81 – $357.28
Transvaginal ultrasound: 10 of 13 insurance plan rates Aetna — HMO: $211.25 Aetna — Medicare Advantage: $106.81 Aetna — POS: $211.25 Alliant — Solocare: $128.17 Anthem — Medicare Advantage: $106.81 Care Source — Medicare Advantage: $108.95 Cigna — Commercial: $357.28 Clover — Medicare Advantage: $108.95 Eon Health — Medicare Advantage: $108.95 Georgia Health Advantage — Medicare Advantage: $106.81
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$31.72 – $125.85
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — HMO: $70.91 Aetna — Medicare Advantage: $31.72 Aetna — POS: $70.91 Aetna — PPO: $73.89 Alliant — Solocare: $38.06 Ambetter — Managed Medicaid: $42.82 Anthem — Medicare Advantage: $31.72 Care Source — Medicare Advantage: $32.35 Cigna — Commercial: $68.45 Clover — Medicare Advantage: $32.35
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$113.99 – $287.51
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $113.99 Alliant — Solocare: $136.79 Ambetter — Managed Medicaid: $153.89 Anthem — HMO/PPO: $223.48 Anthem — Medicare Advantage: $113.99 Care Source — Medicare Advantage: $116.27 Clover — Medicare Advantage: $116.27 Eon Health — Medicare Advantage: $116.27 Georgia Health Advantage — Medicare Advantage: $113.99 Humana — HMO/POS: $287.51
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$113.99 – $247.70
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates Aetna — HMO: $247.70 Aetna — Medicare Advantage: $113.99 Aetna — POS: $247.70 Alliant — Solocare: $136.78 Anthem — Medicare Advantage: $113.99 Care Source — Medicare Advantage: $116.26 Clover — Medicare Advantage: $116.26 Eon Health — Medicare Advantage: $116.26 Georgia Health Advantage — Medicare Advantage: $113.99 Humana — Medicare Advantage: $113.99
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$76.97 – $197.61
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $76.97 Alliant — Solocare: $92.36 Ambetter — Managed Medicaid: $103.91 Anthem — HMO/PPO: $151.02 Anthem — Medicare Advantage: $76.97 Care Source — Medicare Advantage: $78.51 Clover — Medicare Advantage: $78.51 Eon Health — Medicare Advantage: $78.51 Georgia Health Advantage — Medicare Advantage: $76.97 Humana — HMO/POS: $197.61
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$144.37 – $364.47
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $144.37 Alliant — Solocare: $173.24 Ambetter — Managed Medicaid: $194.90 Anthem — HMO/PPO: $282.82 Anthem — Medicare Advantage: $144.37 Care Source — Medicare Advantage: $147.26 Clover — Medicare Advantage: $147.26 Eon Health — Medicare Advantage: $147.26 Georgia Health Advantage — Medicare Advantage: $144.37 Humana — HMO/POS: $364.47
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$144.37 – $316.85
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates Aetna — HMO: $316.85 Aetna — Medicare Advantage: $144.37 Aetna — POS: $316.85 Alliant — Solocare: $173.24 Anthem — Medicare Advantage: $144.37 Care Source — Medicare Advantage: $147.25 Clover — Medicare Advantage: $147.25 Eon Health — Medicare Advantage: $147.25 Georgia Health Advantage — Medicare Advantage: $144.37 Humana — Medicare Advantage: $144.37
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$98.82 – $252.78
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $98.82 Alliant — Solocare: $118.58 Ambetter — Managed Medicaid: $133.41 Anthem — HMO/PPO: $193.80 Anthem — Medicare Advantage: $98.82 Care Source — Medicare Advantage: $100.80 Clover — Medicare Advantage: $100.80 Eon Health — Medicare Advantage: $100.80 Georgia Health Advantage — Medicare Advantage: $98.82 Humana — HMO/POS: $252.78
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$115.79 – $293.72
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $115.79 Alliant — Solocare: $138.95 Ambetter — Managed Medicaid: $156.32 Anthem — HMO/PPO: $227.70 Anthem — Medicare Advantage: $115.79 Care Source — Medicare Advantage: $118.11 Clover — Medicare Advantage: $118.11 Eon Health — Medicare Advantage: $118.11 Georgia Health Advantage — Medicare Advantage: $115.79 Humana — HMO/POS: $293.72
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$115.79 – $261.71
Screening mammogram, both breasts: 10 of 12 insurance plan rates Aetna — HMO: $261.71 Aetna — Medicare Advantage: $115.79 Aetna — POS: $261.71 Alliant — Solocare: $138.95 Anthem — Medicare Advantage: $115.79 Care Source — Medicare Advantage: $118.11 Clover — Medicare Advantage: $118.11 Eon Health — Medicare Advantage: $118.11 Georgia Health Advantage — Medicare Advantage: $115.79 Humana — Medicare Advantage: $115.79
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$81.44 – $208.79
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $81.44 Alliant — Solocare: $97.73 Ambetter — Managed Medicaid: $109.94 Anthem — HMO/PPO: $159.67 Anthem — Medicare Advantage: $81.44 Care Source — Medicare Advantage: $83.07 Clover — Medicare Advantage: $83.07 Eon Health — Medicare Advantage: $83.07 Georgia Health Advantage — Medicare Advantage: $81.44 Humana — HMO/POS: $208.79

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 – $76.30
Electrocardiogram (ECG/EKG) with reading: 10 of 21 insurance plan rates Aetna — HMO: $51.82 Aetna — Medicare Advantage: $14.52 Aetna — POS: $51.82 Aetna — PPO: $54 Alliant — Solocare: $17.42 Ambetter — Managed Medicaid: $19.60 Anthem — Medicare Advantage: $14.52 Care Source — Medicare Advantage: $14.81 Cigna — Commercial: $50.02 Clover — Medicare Advantage: $14.81
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 – $17.42
Electrocardiogram (ECG/EKG) with reading: rates for 10 insurance plans Aetna — Medicare Advantage: $14.52 Alliant — Solocare: $17.42 Anthem — Medicare Advantage: $14.52 Care Source — Medicare Advantage: $14.81 Clover — Medicare Advantage: $14.81 Eon Health — Medicare Advantage: $14.81 Georgia Health Advantage — Medicare Advantage: $14.52 Humana — Medicare Advantage: $14.52 Pruitt Health — Medicare Advantage: $14.52 United Healthcare — Medicare Advantage: $14.52
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$60.97
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Humana — HMO/POS: $60.97 Humana — PPO: $60.97
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$806.34 – $12,578.95
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $806.34 Alliant — Solocare: $967.61 Ambetter — Managed Medicaid: $1,088.56 Anthem — Medicare Advantage: $806.34 Care Source — Medicare Advantage: $822.47 Cigna — Commercial: $2,331.48 Clover — Medicare Advantage: $822.47 Eon Health — Medicare Advantage: $822.47 Georgia Health Advantage — Medicare Advantage: $806.34 Humana — HMO/POS: $2,355.52
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$3,312.15 – $18,209
Left heart catheterization (diagnostic): 10 of 13 insurance plan rates Aetna — Medicare Advantage: $3,312.15 Alliant — Solocare: $7,709.75 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $3,312.15 Care Source — Medicare Advantage: $3,378.39 Cigna — Commercial: $18,035 Clover — Medicare Advantage: $3,378.39 Eon Health — Medicare Advantage: $3,378.39 Georgia Health Advantage — Medicare Advantage: $3,312.15 Humana — Medicare Advantage: $3,312.15
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$575.82 – $2,355.52
Left heart catheterization (diagnostic): 10 of 13 insurance plan rates Aetna — Medicare Advantage: $575.82 Alliant — Solocare: $690.98 Ambetter — Managed Medicaid: $777.36 Anthem — Medicare Advantage: $575.82 Care Source — Medicare Advantage: $587.34 Clover — Medicare Advantage: $587.34 Eon Health — Medicare Advantage: $587.34 Georgia Health Advantage — Medicare Advantage: $575.82 Humana — HMO/POS: $2,355.52 Humana — Medicare Advantage: $575.82
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	$648.90 – $2,159.42
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates Aetna — HMO: $1,606.55 Aetna — Medicare Advantage: $648.90 Aetna — POS: $1,606.55 Aetna — PPO: $1,674.05 Alliant — Solocare: $778.68 Ambetter — Managed Medicaid: $876.02 Anthem — Medicare Advantage: $648.90 Care Source — Medicare Advantage: $661.88 Cigna — Commercial: $1,550.77 Clover — Medicare Advantage: $661.88
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	$7,968.60 – $12,095.96
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans Aetna — Medicare Advantage: $7,968.60 Alliant — Solocare: $12,095.96 Anthem — Medicare Advantage: $7,968.60 Care Source — Medicare Advantage: $8,127.97 Clover — Medicare Advantage: $8,127.97 Eon Health — Medicare Advantage: $8,127.97 Georgia Health Advantage — Medicare Advantage: $7,968.60 Humana — Medicare Advantage: $7,968.60 Pruitt Health — Medicare Advantage: $7,968.60 United Healthcare — Medicare Advantage: $7,968.60
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	$373.32 – $1,179.69
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates Aetna — HMO: $912.75 Aetna — Medicare Advantage: $373.32 Aetna — POS: $912.75 Aetna — PPO: $951.10 Alliant — Solocare: $447.98 Ambetter — Managed Medicaid: $503.98 Anthem — Medicare Advantage: $373.32 Care Source — Medicare Advantage: $380.79 Cigna — Commercial: $881.07 Clover — Medicare Advantage: $380.79
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$818.50 – $3,235.31
Heart rhythm study with ablation for atrial fibrillation: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $818.50 Alliant — Solocare: $982.20 Ambetter — Managed Medicaid: $1,104.98 Anthem — Medicare Advantage: $818.50 Care Source — Medicare Advantage: $834.87 Cigna — Commercial: $3,181.46 Clover — Medicare Advantage: $834.87 Eon Health — Medicare Advantage: $834.87 Georgia Health Advantage — Medicare Advantage: $818.50 Humana — HMO/POS: $3,235.31
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$6,829.20 – $27,238.07
Heart rhythm study with ablation for atrial fibrillation: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $26,703.99 Alliant — Solocare: $12,095.96 Anthem — HMO/PPO: $6,829.20 Anthem — Medicare Advantage: $26,703.99 Care Source — Medicare Advantage: $27,238.07 Clover — Medicare Advantage: $27,238.07 Eon Health — Medicare Advantage: $27,238.07 Georgia Health Advantage — Medicare Advantage: $26,703.99 Humana — Medicare Advantage: $26,703.99 Pruitt Health — Medicare Advantage: $26,703.99
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$612.34 – $1,647.43
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates Aetna — HMO: $1,050.18 Aetna — Medicare Advantage: $612.34 Aetna — POS: $1,050.18 Aetna — PPO: $1,094.30 Alliant — Solocare: $734.81 Ambetter — Managed Medicaid: $826.66 Anthem — Medicare Advantage: $612.34 Care Source — Medicare Advantage: $624.59 Cigna — Commercial: $1,013.71 Clover — Medicare Advantage: $624.59
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$877.34 – $1,052.81
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Aetna — Medicare Advantage: $877.34 Alliant — Solocare: $1,052.81 Anthem — Medicare Advantage: $877.34 Care Source — Medicare Advantage: $894.89 Clover — Medicare Advantage: $894.89 Eon Health — Medicare Advantage: $894.89 Georgia Health Advantage — Medicare Advantage: $877.34 Humana — Medicare Advantage: $877.34 Pruitt Health — Medicare Advantage: $877.34 United Healthcare — Medicare Advantage: $877.34
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$116.57 – $587.35
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — HMO: $454.45 Aetna — Medicare Advantage: $116.57 Aetna — POS: $454.45 Aetna — PPO: $473.54 Alliant — Solocare: $139.88 Ambetter — Managed Medicaid: $157.37 Anthem — Medicare Advantage: $116.57 Care Source — Medicare Advantage: $118.90 Cigna — Commercial: $438.68 Clover — Medicare Advantage: $118.90

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 OT THERAPEUTIC EXERCISES	$153	$76.50	$27.64 – $294
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 27 insurance plan rates Aetna — HMO: $90.27 Aetna — Medicare Advantage: $27.64 Aetna — POS: $99.45 Aetna — PPO: $105.57 Alliant — Solocare: $67.32 Ambetter — Managed Medicaid: $45.90 Anthem — HMO/PPO: $72.89 Anthem — Medicare Advantage: $27.64 Beechstreet — Commercial: $142.29 Care Source — Medicare Advantage: $28.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT THERAPEUTIC EXERCISES	$153	$76.50	$27.64 – $294
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 27 insurance plan rates Aetna — HMO: $90.27 Aetna — Medicare Advantage: $27.64 Aetna — POS: $99.45 Aetna — PPO: $105.57 Alliant — Solocare: $67.32 Ambetter — Managed Medicaid: $45.90 Anthem — HMO/PPO: $72.89 Anthem — Medicare Advantage: $27.64 Beechstreet — Commercial: $142.29 Care Source — Medicare Advantage: $28.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THERAPEUTIC RECREATION IND TIMED	$203	$101.50	$27.64 – $188.79
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates Aetna — HMO: $119.77 Aetna — Medicare Advantage: $27.64 Aetna — POS: $131.95 Aetna — PPO: $140.07 Alliant — Solocare: $89.32 Ambetter — Managed Medicaid: $60.90 Anthem — HMO/PPO: $96.71 Anthem — Medicare Advantage: $27.64 Beechstreet — Commercial: $188.79 Care Source — Medicare Advantage: $28.20
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	$484	$242	$92.95 – $450.12
Physical therapy evaluation (low complexity): 10 of 27 insurance plan rates Aetna — HMO: $285.56 Aetna — Medicare Advantage: $92.95 Aetna — POS: $314.60 Aetna — PPO: $333.96 Alliant — Solocare: $212.96 Ambetter — Managed Medicaid: $145.20 Anthem — HMO/PPO: $230.58 Anthem — Medicare Advantage: $92.95 Beechstreet — Commercial: $450.12 Care Source — Medicare Advantage: $94.81
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	$484	$242	$246.84 – $450.12
Physical therapy evaluation (low complexity): rates for 6 insurance plans Ambetter — Managed Medicaid: $246.84 Beechstreet — Commercial: $450.12 Multiplan — PHO Agreement Complimentary Network: $387.20 Multiplan — PHO Agreement Primary Network: $314.60 Novanet — Commercial: $387.20 Three Rivers Provider Network — Commercial: $411.40
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	$92.95 – $125.48
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Kaiser — Commercial: $95.46
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	$491	$245.50	$92.95 – $456.63
Physical therapy evaluation (moderate complexity): 10 of 27 insurance plan rates Aetna — HMO: $289.69 Aetna — Medicare Advantage: $92.95 Aetna — POS: $319.15 Aetna — PPO: $338.79 Alliant — Solocare: $216.04 Ambetter — Managed Medicaid: $147.30 Anthem — HMO/PPO: $233.91 Anthem — Medicare Advantage: $92.95 Beechstreet — Commercial: $456.63 Care Source — Medicare Advantage: $94.81
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	$491	$245.50	$250.41 – $456.63
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Ambetter — Managed Medicaid: $250.41 Beechstreet — Commercial: $456.63 Multiplan — PHO Agreement Complimentary Network: $392.80 Multiplan — PHO Agreement Primary Network: $319.15 Novanet — Commercial: $392.80 Three Rivers Provider Network — Commercial: $417.35
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	$92.95 – $125.48
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Pruitt Health — Medicare Advantage: $97.60
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	$498	$249	$92.95 – $463.14
Physical therapy evaluation (high complexity): 10 of 27 insurance plan rates Aetna — HMO: $293.82 Aetna — Medicare Advantage: $92.95 Aetna — POS: $323.70 Aetna — PPO: $343.62 Alliant — Solocare: $219.12 Ambetter — Managed Medicaid: $149.40 Anthem — HMO/PPO: $237.25 Anthem — Medicare Advantage: $92.95 Beechstreet — Commercial: $463.14 Care Source — Medicare Advantage: $94.81
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	$498	$249	$253.98 – $463.14
Physical therapy evaluation (high complexity): rates for 6 insurance plans Ambetter — Managed Medicaid: $253.98 Beechstreet — Commercial: $463.14 Multiplan — PHO Agreement Complimentary Network: $398.40 Multiplan — PHO Agreement Primary Network: $323.70 Novanet — Commercial: $398.40 Three Rivers Provider Network — Commercial: $423.30
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	$92.95 – $125.48
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Pruitt Health — Medicare Advantage: $97.60
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$69.07 – $99.60
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $69.07 Alliant — Solocare: $82.88 Ambetter — Managed Medicaid: $93.24 Anthem — Medicare Advantage: $69.07 Care Source — Medicare Advantage: $70.45 Cigna — Commercial: $92.94 Clover — Medicare Advantage: $70.45 Eon Health — Medicare Advantage: $70.45 Georgia Health Advantage — Medicare Advantage: $69.07 Humana — HMO/POS: $81.95
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$181.34 – $217.61
Psychotherapy, 30 minutes: rates for 10 insurance plans Aetna — Medicare Advantage: $181.34 Alliant — Solocare: $217.61 Anthem — Medicare Advantage: $181.34 Care Source — Medicare Advantage: $184.97 Clover — Medicare Advantage: $184.97 Eon Health — Medicare Advantage: $184.97 Georgia Health Advantage — Medicare Advantage: $181.34 Humana — Medicare Advantage: $181.34 Pruitt Health — Medicare Advantage: $181.34 United Healthcare — Medicare Advantage: $181.34
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$91.37 – $137.99
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates Aetna — Medicare Advantage: $91.37 Alliant — Solocare: $109.64 Ambetter — Managed Medicaid: $123.35 Anthem — Medicare Advantage: $91.37 Care Source — Medicare Advantage: $93.20 Cigna — Commercial: $123.31 Clover — Medicare Advantage: $93.20 Eon Health — Medicare Advantage: $93.20 Georgia Health Advantage — Medicare Advantage: $91.37 Humana — HMO/POS: $109.27
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$181.34 – $217.61
Psychotherapy, 45 minutes: rates for 10 insurance plans Aetna — Medicare Advantage: $181.34 Alliant — Solocare: $217.61 Anthem — Medicare Advantage: $181.34 Care Source — Medicare Advantage: $184.97 Clover — Medicare Advantage: $184.97 Eon Health — Medicare Advantage: $184.97 Georgia Health Advantage — Medicare Advantage: $181.34 Humana — Medicare Advantage: $181.34 Pruitt Health — Medicare Advantage: $181.34 United Healthcare — Medicare Advantage: $181.34
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$134.50 – $204.70
Psychotherapy, 60 minutes: 10 of 16 insurance plan rates Aetna — Medicare Advantage: $134.50 Alliant — Solocare: $161.40 Ambetter — Managed Medicaid: $181.58 Anthem — Medicare Advantage: $134.50 Care Source — Medicare Advantage: $137.19 Cigna — Commercial: $184.48 Clover — Medicare Advantage: $137.19 Eon Health — Medicare Advantage: $137.19 Georgia Health Advantage — Medicare Advantage: $134.50 Humana — HMO/POS: $164.32
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$181.34 – $217.61
Psychotherapy, 60 minutes: rates for 10 insurance plans Aetna — Medicare Advantage: $181.34 Alliant — Solocare: $217.61 Anthem — Medicare Advantage: $181.34 Care Source — Medicare Advantage: $184.97 Clover — Medicare Advantage: $184.97 Eon Health — Medicare Advantage: $184.97 Georgia Health Advantage — Medicare Advantage: $181.34 Humana — Medicare Advantage: $181.34 Pruitt Health — Medicare Advantage: $181.34 United Healthcare — Medicare Advantage: $181.34
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$98.67 – $212.65
Family psychotherapy, without the patient: 10 of 20 insurance plan rates Aetna — HMO: $158.27 Aetna — Medicare Advantage: $98.67 Aetna — POS: $158.27 Aetna — PPO: $164.92 Alliant — Solocare: $118.40 Ambetter — Managed Medicaid: $133.20 Anthem — Medicare Advantage: $98.67 Care Source — Medicare Advantage: $100.64 Cigna — Commercial: $152.77 Clover — Medicare Advantage: $100.64
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$181.34 – $217.61
Family psychotherapy, without the patient: rates for 10 insurance plans Aetna — Medicare Advantage: $181.34 Alliant — Solocare: $217.61 Anthem — Medicare Advantage: $181.34 Care Source — Medicare Advantage: $184.97 Clover — Medicare Advantage: $184.97 Eon Health — Medicare Advantage: $184.97 Georgia Health Advantage — Medicare Advantage: $181.34 Humana — Medicare Advantage: $181.34 Pruitt Health — Medicare Advantage: $181.34 United Healthcare — Medicare Advantage: $181.34
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$158.27 – $164.92
Family psychotherapy, without the patient: rates for 3 insurance plans Aetna — HMO: $158.27 Aetna — POS: $158.27 Aetna — PPO: $164.92
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$102.28 – $243.03
Family psychotherapy, with the patient: 10 of 21 insurance plan rates Aetna — HMO: $180.88 Aetna — Medicare Advantage: $102.28 Aetna — POS: $180.88 Aetna — PPO: $188.48 Alliant — Solocare: $122.74 Ambetter — Managed Medicaid: $138.08 Anthem — Medicare Advantage: $102.28 Care Source — Medicare Advantage: $104.33 Cigna — Commercial: $174.60 Clover — Medicare Advantage: $104.33
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$181.34 – $217.61
Family psychotherapy, with the patient: rates for 10 insurance plans Aetna — Medicare Advantage: $181.34 Alliant — Solocare: $217.61 Anthem — Medicare Advantage: $181.34 Care Source — Medicare Advantage: $184.97 Clover — Medicare Advantage: $184.97 Eon Health — Medicare Advantage: $184.97 Georgia Health Advantage — Medicare Advantage: $181.34 Humana — Medicare Advantage: $181.34 Pruitt Health — Medicare Advantage: $181.34 United Healthcare — Medicare Advantage: $181.34
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$180.88 – $188.48
Family psychotherapy, with the patient: rates for 3 insurance plans Aetna — HMO: $180.88 Aetna — POS: $180.88 Aetna — PPO: $188.48
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$24.27 – $60.78
Group psychotherapy: 10 of 21 insurance plan rates Aetna — HMO: $45.45 Aetna — Medicare Advantage: $24.27 Aetna — POS: $45.45 Aetna — PPO: $47.36 Alliant — Solocare: $29.12 Ambetter — Managed Medicaid: $32.76 Anthem — Medicare Advantage: $24.27 Care Source — Medicare Advantage: $24.76 Cigna — Commercial: $43.86 Clover — Medicare Advantage: $24.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$103.79 – $124.55
Group psychotherapy: rates for 10 insurance plans Aetna — Medicare Advantage: $103.79 Alliant — Solocare: $124.55 Anthem — Medicare Advantage: $103.79 Care Source — Medicare Advantage: $105.87 Clover — Medicare Advantage: $105.87 Eon Health — Medicare Advantage: $105.87 Georgia Health Advantage — Medicare Advantage: $103.79 Humana — Medicare Advantage: $103.79 Pruitt Health — Medicare Advantage: $103.79 United Healthcare — Medicare Advantage: $103.79
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$45.45 – $47.36
Group psychotherapy: rates for 3 insurance plans Aetna — HMO: $45.45 Aetna — POS: $45.45 Aetna — PPO: $47.36

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$399.12 – $1,022.19
Removal of breast growth (open surgery): 10 of 21 insurance plan rates Aetna — HMO: $774.09 Aetna — Medicare Advantage: $399.12 Aetna — POS: $774.09 Aetna — PPO: $806.62 Alliant — Solocare: $478.94 Ambetter — Managed Medicaid: $538.81 Anthem — Medicare Advantage: $399.12 Care Source — Medicare Advantage: $407.10 Cigna — Commercial: $747.22 Clover — Medicare Advantage: $407.10
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$1,747 – $4,453.06
Removal of breast growth (open surgery): 10 of 18 insurance plan rates Aetna — HMO: $1,747 Aetna — Medicare Advantage: $4,000.24 Aetna — POS: $2,022 Aetna — PPO: $2,266 Alliant — Solocare: $2,459.58 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $4,000.24 Care Source — Medicare Advantage: $4,080.24 Cigna — Commercial: $3,157 Clover — Medicare Advantage: $4,080.24
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	$1,146.04 – $5,639.25
Total hip replacement: 10 of 21 insurance plan rates Aetna — HMO: $4,363.23 Aetna — Medicare Advantage: $1,146.04 Aetna — POS: $4,363.23 Aetna — PPO: $4,546.56 Alliant — Solocare: $1,375.25 Ambetter — Managed Medicaid: $1,547.15 Anthem — Medicare Advantage: $1,146.04 Care Source — Medicare Advantage: $1,168.96 Cigna — Commercial: $4,211.75 Clover — Medicare Advantage: $1,168.96
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	$1,777 – $13,379.10
Total hip replacement: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $13,116.76 Alliant — Solocare: $4,475.08 Anthem — HMO/PPO: $6,301.73 Anthem — Medicare Advantage: $13,116.76 Care Source — Medicare Advantage: $13,379.10 Clover — Medicare Advantage: $13,379.10 Eon Health — Medicare Advantage: $13,379.10 Georgia Health Advantage — Medicare Advantage: $13,116.76 Humana — HMO/POS: $4,453.06 Humana — Medicare Advantage: $13,116.76
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	$1,143.35 – $5,795.49
Total knee replacement: 10 of 21 insurance plan rates Aetna — HMO: $4,287.50 Aetna — Medicare Advantage: $1,143.35 Aetna — POS: $4,287.50 Aetna — PPO: $4,467.65 Alliant — Solocare: $1,372.02 Ambetter — Managed Medicaid: $1,543.52 Anthem — Medicare Advantage: $1,143.35 Care Source — Medicare Advantage: $1,166.22 Cigna — Commercial: $4,138.65 Clover — Medicare Advantage: $1,166.22
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	$1,777 – $13,379.10
Total knee replacement: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $13,116.76 Alliant — Solocare: $4,475.08 Anthem — HMO/PPO: $6,521.17 Anthem — Medicare Advantage: $13,116.76 Care Source — Medicare Advantage: $13,379.10 Clover — Medicare Advantage: $13,379.10 Eon Health — Medicare Advantage: $13,379.10 Georgia Health Advantage — Medicare Advantage: $13,116.76 Humana — HMO/POS: $4,453.06 Humana — Medicare Advantage: $13,116.76
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	$148.07 – $2,776.53
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates Aetna — HMO: $2,144.38 Aetna — Medicare Advantage: $148.07 Aetna — POS: $2,144.38 Aetna — PPO: $2,234.48 Alliant — Solocare: $177.68 Ambetter — Managed Medicaid: $199.89 Anthem — Medicare Advantage: $148.07 Care Source — Medicare Advantage: $151.03 Cigna — Commercial: $2,069.93 Clover — Medicare Advantage: $151.03
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	$148.07 – $4,453.06
Shoulder arthroscopy: shaving of shoulder bone: 10 of 16 insurance plan rates Aetna — HMO: $1,747 Aetna — Medicare Advantage: $148.07 Aetna — POS: $2,022 Aetna — PPO: $2,266 Alliant — Solocare: $2,773.42 Anthem — Medicare Advantage: $148.07 Care Source — Medicare Advantage: $151.03 Cigna — Commercial: $3,157 Clover — Medicare Advantage: $151.03 Eon Health — Medicare Advantage: $151.03
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	$498.75 – $2,352.58
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 21 insurance plan rates Aetna — HMO: $1,714.06 Aetna — Medicare Advantage: $498.75 Aetna — POS: $1,714.06 Aetna — PPO: $1,786.08 Alliant — Solocare: $598.50 Ambetter — Managed Medicaid: $673.31 Anthem — Medicare Advantage: $498.75 Care Source — Medicare Advantage: $508.73 Cigna — Commercial: $1,654.56 Clover — Medicare Advantage: $508.73
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	$2,099 – $4,453.06
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 18 insurance plan rates Aetna — HMO: $2,099 Aetna — Medicare Advantage: $3,342.87 Aetna — POS: $2,425 Aetna — PPO: $2,719 Alliant — Solocare: $2,773.42 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $3,342.87 Care Source — Medicare Advantage: $3,409.73 Cigna — Commercial: $3,830 Clover — Medicare Advantage: $3,409.73
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	$253.43 – $916.82
Removal of tonsils and adenoids (under age 12): 10 of 21 insurance plan rates Aetna — HMO: $599.76 Aetna — Medicare Advantage: $253.43 Aetna — POS: $599.76 Aetna — PPO: $624.96 Alliant — Solocare: $304.12 Ambetter — Managed Medicaid: $342.13 Anthem — Medicare Advantage: $253.43 Care Source — Medicare Advantage: $258.50 Cigna — Commercial: $578.94 Clover — Medicare Advantage: $258.50
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	$1,747 – $6,169.01
Removal of tonsils and adenoids (under age 12): 10 of 18 insurance plan rates Aetna — HMO: $1,747 Aetna — Medicare Advantage: $6,048.05 Aetna — POS: $2,022 Aetna — PPO: $2,266 Alliant — Solocare: $2,459.58 Anthem — HMO/PPO: $3,905.49 Anthem — Medicare Advantage: $6,048.05 Care Source — Medicare Advantage: $6,169.01 Cigna — Commercial: $3,157 Clover — Medicare Advantage: $6,169.01
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	$108.38 – $599.83
Upper GI endoscopy (diagnostic): 10 of 21 insurance plan rates Aetna — HMO: $464.10 Aetna — Medicare Advantage: $108.38 Aetna — POS: $464.10 Aetna — PPO: $483.60 Alliant — Solocare: $130.06 Ambetter — Managed Medicaid: $146.31 Anthem — Medicare Advantage: $108.38 Care Source — Medicare Advantage: $110.55 Cigna — Commercial: $447.99 Clover — Medicare Advantage: $110.55
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	$926.63 – $4,453.06
Upper GI endoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — HMO: $1,214 Aetna — Medicare Advantage: $926.63 Aetna — POS: $1,409 Aetna — PPO: $1,581 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $926.63 Care Source — Medicare Advantage: $945.16 Cigna — Commercial: $1,681 Clover — Medicare Advantage: $945.16
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	$121.35 – $692.10
Upper GI endoscopy with biopsy: 10 of 21 insurance plan rates Aetna — HMO: $535.50 Aetna — Medicare Advantage: $121.35 Aetna — POS: $535.50 Aetna — PPO: $558 Alliant — Solocare: $145.62 Ambetter — Managed Medicaid: $163.82 Anthem — Medicare Advantage: $121.35 Care Source — Medicare Advantage: $123.78 Cigna — Commercial: $516.91 Clover — Medicare Advantage: $123.78
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	$926.63 – $4,453.06
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $926.63 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $926.63 Care Source — Medicare Advantage: $945.16 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $945.16
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	$162.46 – $892.48
Colonoscopy (diagnostic): 10 of 21 insurance plan rates Aetna — HMO: $642.60 Aetna — Medicare Advantage: $162.46 Aetna — POS: $642.60 Aetna — PPO: $669.60 Alliant — Solocare: $194.95 Ambetter — Managed Medicaid: $219.32 Anthem — Medicare Advantage: $162.46 Care Source — Medicare Advantage: $165.71 Cigna — Commercial: $620.29 Clover — Medicare Advantage: $165.71
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	$950.10 – $4,453.06
Colonoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $950.10 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $950.10 Care Source — Medicare Advantage: $969.10 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $969.10
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	$81.43 – $109.93
Colonoscopy (diagnostic): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $81.43 Alliant — Solocare: $97.72 Ambetter — Managed Medicaid: $109.93 Anthem — Medicare Advantage: $81.43 Care Source — Medicare Advantage: $83.06 Clover — Medicare Advantage: $83.06 Eon Health — Medicare Advantage: $83.06 Georgia Health Advantage — Medicare Advantage: $81.43 Humana — Medicare Advantage: $81.43 Pruitt Health — Medicare Advantage: $85.50
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	$175.23 – $963.57
Colonoscopy with biopsy: 10 of 21 insurance plan rates Aetna — HMO: $725.90 Aetna — Medicare Advantage: $175.23 Aetna — POS: $725.90 Aetna — PPO: $756.40 Alliant — Solocare: $210.28 Ambetter — Managed Medicaid: $236.56 Anthem — Medicare Advantage: $175.23 Care Source — Medicare Advantage: $178.73 Cigna — Commercial: $700.70 Clover — Medicare Advantage: $178.73
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	$1,222.56 – $4,453.06
Colonoscopy with biopsy: 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $1,222.56 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $1,222.56 Care Source — Medicare Advantage: $1,247.01 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $1,247.01
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	$220.52 – $1,253.46
Colonoscopy with removal of polyps (snare): 10 of 21 insurance plan rates Aetna — HMO: $928.20 Aetna — Medicare Advantage: $220.52 Aetna — POS: $928.20 Aetna — PPO: $967.20 Alliant — Solocare: $264.62 Ambetter — Managed Medicaid: $297.70 Anthem — Medicare Advantage: $220.52 Care Source — Medicare Advantage: $224.93 Cigna — Commercial: $895.97 Clover — Medicare Advantage: $224.93
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	$1,222.56 – $4,453.06
Colonoscopy with removal of polyps (snare): 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $1,222.56 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $1,222.56 Care Source — Medicare Advantage: $1,247.01 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $1,247.01
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	$222.92 – $432.20
Ultrasound of the lower bowel by endoscope: 10 of 19 insurance plan rates Aetna — HMO: $326.20 Aetna — Medicare Advantage: $222.92 Aetna — POS: $326.20 Aetna — PPO: $339.91 Alliant — Solocare: $267.50 Ambetter — Managed Medicaid: $300.94 Anthem — Medicare Advantage: $222.92 Care Source — Medicare Advantage: $227.38 Cigna — Commercial: $314.88 Clover — Medicare Advantage: $227.38
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	$1,222.56 – $4,453.06
Ultrasound of the lower bowel by endoscope: 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $1,222.56 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $1,222.56 Care Source — Medicare Advantage: $1,247.01 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $1,247.01
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	$950.10 – $4,453.06
Screening colonoscopy (not high risk): 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $950.10 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $1,727.99 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $950.10 Care Source — Medicare Advantage: $969.10 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $969.10
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	$162.86 – $961.61
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Aetna — Medicare Advantage: $162.86 Alliant — Solocare: $195.43 Ambetter — Managed Medicaid: $219.86 Anthem — Medicare Advantage: $162.86 Care Source — Medicare Advantage: $166.12 Clover — Medicare Advantage: $166.12 Eon Health — Medicare Advantage: $166.12 Georgia Health Advantage — Medicare Advantage: $162.86 Humana — HMO/POS: $259.69 Humana — Medicare Advantage: $162.86
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	$81.43 – $109.93
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $81.43 Alliant — Solocare: $97.72 Ambetter — Managed Medicaid: $109.93 Anthem — Medicare Advantage: $81.43 Care Source — Medicare Advantage: $83.06 Clover — Medicare Advantage: $83.06 Eon Health — Medicare Advantage: $83.06 Georgia Health Advantage — Medicare Advantage: $81.43 Humana — Medicare Advantage: $81.43 Pruitt Health — Medicare Advantage: $85.50
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	$627.28 – $2,100.73
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — HMO: $1,258.18 Aetna — Medicare Advantage: $627.28 Aetna — POS: $1,258.18 Aetna — PPO: $1,311.04 Alliant — Solocare: $752.74 Ambetter — Managed Medicaid: $846.83 Anthem — Medicare Advantage: $627.28 Care Source — Medicare Advantage: $639.83 Cigna — Commercial: $1,214.50 Clover — Medicare Advantage: $639.83
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	$4,378.35 – $12,922
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $6,176.47 Alliant — Solocare: $5,627.55 Anthem — HMO/PPO: $4,378.35 Anthem — Medicare Advantage: $6,176.47 Care Source — Medicare Advantage: $6,300 Cigna — Commercial: $6,480 Clover — Medicare Advantage: $6,300 Eon Health — Medicare Advantage: $6,300 Georgia Health Advantage — Medicare Advantage: $6,176.47 Humana — HMO/POS: $4,453.06
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	$501.69 – $1,293.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 21 insurance plan rates Aetna — HMO: $868.22 Aetna — Medicare Advantage: $501.69 Aetna — POS: $868.22 Aetna — PPO: $904.70 Alliant — Solocare: $602.03 Ambetter — Managed Medicaid: $677.28 Anthem — Medicare Advantage: $501.69 Care Source — Medicare Advantage: $511.72 Cigna — Commercial: $838.08 Clover — Medicare Advantage: $511.72
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	$2,099 – $4,453.06
Groin (inguinal) hernia repair, age 5 or older: 10 of 18 insurance plan rates Aetna — HMO: $2,099 Aetna — Medicare Advantage: $3,657.95 Aetna — POS: $2,425 Aetna — PPO: $2,719 Alliant — Solocare: $2,773.42 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $3,657.95 Care Source — Medicare Advantage: $3,731.11 Cigna — Commercial: $3,830 Clover — Medicare Advantage: $3,731.11
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	$315.89 – $422.96
Prostate biopsy: rates for 10 insurance plans Aetna — HMO: $327.25 Aetna — POS: $327.25 Aetna — PPO: $341 Cigna — Commercial: $315.89 Humana — HMO/POS: $385.03 Humana — PPO: $385.03 IBG — Commercial: $370.11 Kaiser — Commercial: $422.96 SecureHealth — Commercial: $379.39 United Healthcare — Commercial: $347.45
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$1,456 – $4,453.06
Prostate biopsy: rates for 9 insurance plans Aetna — HMO: $1,456 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,241.57 Anthem — HMO/PPO: $3,156.53 Cigna — Commercial: $2,875 Humana — HMO/POS: $4,453.06 Humana — PPO: $2,802.34 Kaiser — Commercial: $1,884
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	$1,072.37 – $4,621.06
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates Aetna — HMO: $3,575.43 Aetna — Medicare Advantage: $1,072.37 Aetna — POS: $3,575.43 Aetna — PPO: $3,725.65 Alliant — Solocare: $1,286.84 Ambetter — Managed Medicaid: $1,447.70 Anthem — Medicare Advantage: $1,072.37 Care Source — Medicare Advantage: $1,093.82 Cigna — Commercial: $3,451.30 Clover — Medicare Advantage: $1,093.82
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	$1,884 – $11,077.27
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $10,860.07 Alliant — Solocare: $5,627.55 Anthem — HMO/PPO: $6,521.17 Anthem — Medicare Advantage: $10,860.07 Care Source — Medicare Advantage: $11,077.27 Cigna — Commercial: $6,480 Clover — Medicare Advantage: $11,077.27 Eon Health — Medicare Advantage: $11,077.27 Georgia Health Advantage — Medicare Advantage: $10,860.07 Humana — HMO/POS: $4,453.06
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$204.23 – $2,436.20
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna — HMO: $516.51 Aetna — Medicare Advantage: $204.23 Aetna — POS: $516.51 Aetna — PPO: $538.21 Alliant — Solocare: $245.08 Ambetter — Managed Medicaid: $275.71 Anthem — Medicare Advantage: $204.23 Care Source — Medicare Advantage: $208.31 Cigna — Commercial: $498.58 Clover — Medicare Advantage: $208.31
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$1,747 – $4,453.06
Hysteroscopy with biopsy of the uterus lining: 10 of 18 insurance plan rates Aetna — HMO: $1,747 Aetna — Medicare Advantage: $3,307.24 Aetna — POS: $2,022 Aetna — PPO: $2,266 Alliant — Solocare: $2,459.58 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $3,307.24 Care Source — Medicare Advantage: $3,373.38 Cigna — Commercial: $3,157 Clover — Medicare Advantage: $3,373.38
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	$2,539	$1,269.50	$721.17 – $5,756.44
Spinal injection, lower back (epidural), with imaging guidance: 10 of 27 insurance plan rates Aetna — HMO: $1,498.01 Aetna — Medicare Advantage: $721.17 Aetna — POS: $1,650.35 Aetna — PPO: $1,751.91 Alliant — Solocare: $5,289.33 Ambetter — Managed Medicaid: $761.70 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $721.17 Beechstreet — Commercial: $2,361.27 Care Source — Medicare Advantage: $735.59
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	$2,539	$1,269.50	$1,294.89 – $2,361.27
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans Ambetter — Managed Medicaid: $1,294.89 Beechstreet — Commercial: $2,361.27 Multiplan — PHO Agreement Complimentary Network: $2,031.20 Multiplan — PHO Agreement Primary Network: $1,650.35 Novanet — Commercial: $2,031.20 Three Rivers Provider Network — Commercial: $2,158.15
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$87.60 – $118.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $87.60 Alliant — Solocare: $105.12 Ambetter — Managed Medicaid: $118.26 Anthem — Medicare Advantage: $87.60 Care Source — Medicare Advantage: $89.35 Clover — Medicare Advantage: $89.35 Eon Health — Medicare Advantage: $89.35 Georgia Health Advantage — Medicare Advantage: $87.60 Humana — Medicare Advantage: $87.60 Pruitt Health — Medicare Advantage: $91.98
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$97.16 – $732.04
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates Aetna — HMO: $476.06 Aetna — Medicare Advantage: $97.16 Aetna — POS: $476.06 Aetna — PPO: $496.06 Alliant — Solocare: $116.59 Ambetter — Managed Medicaid: $131.17 Anthem — Medicare Advantage: $97.16 Care Source — Medicare Advantage: $99.10 Cigna — Commercial: $459.53 Clover — Medicare Advantage: $99.10
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$903.63 – $4,453.06
Nerve root injection, lower back, with imaging guidance: 10 of 18 insurance plan rates Aetna — HMO: $1,214 Aetna — Medicare Advantage: $903.63 Aetna — POS: $1,409 Aetna — PPO: $1,581 Alliant — Solocare: $1,727.99 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $903.63 Care Source — Medicare Advantage: $921.70 Cigna — Commercial: $1,681 Clover — Medicare Advantage: $921.70
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$404.90 – $1,736.26
Carpal tunnel release: 10 of 21 insurance plan rates Aetna — HMO: $1,181.13 Aetna — Medicare Advantage: $404.90 Aetna — POS: $1,181.13 Aetna — PPO: $1,230.76 Alliant — Solocare: $485.88 Ambetter — Managed Medicaid: $546.62 Anthem — Medicare Advantage: $404.90 Care Source — Medicare Advantage: $413 Cigna — Commercial: $1,140.13 Clover — Medicare Advantage: $413
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,456 – $4,453.06
Carpal tunnel release: 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $1,995.02 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $2,459.58 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $1,995.02 Care Source — Medicare Advantage: $2,034.92 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $2,034.92
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	$260.02 – $703.34
Laser treatment of clouding after cataract surgery: 10 of 21 insurance plan rates Aetna — HMO: $437.98 Aetna — Medicare Advantage: $260.02 Aetna — POS: $437.98 Aetna — PPO: $456.38 Alliant — Solocare: $312.02 Ambetter — Managed Medicaid: $351.03 Anthem — Medicare Advantage: $260.02 Care Source — Medicare Advantage: $265.22 Cigna — Commercial: $525.30 Clover — Medicare Advantage: $265.22
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	$561.91 – $4,453.06
Laser treatment of clouding after cataract surgery: 10 of 18 insurance plan rates Aetna — HMO: $1,456 Aetna — Medicare Advantage: $561.91 Aetna — POS: $1,684 Aetna — PPO: $1,889 Alliant — Solocare: $1,727.99 Anthem — HMO/PPO: $2,433.33 Anthem — Medicare Advantage: $561.91 Care Source — Medicare Advantage: $573.15 Cigna — Commercial: $2,875 Clover — Medicare Advantage: $573.15
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	$443.92 – $3,565.54
Cataract removal with lens implant: 10 of 21 insurance plan rates Aetna — HMO: $1,608.70 Aetna — Medicare Advantage: $443.92 Aetna — POS: $1,608.70 Aetna — PPO: $1,676.29 Alliant — Solocare: $532.70 Ambetter — Managed Medicaid: $599.29 Anthem — Medicare Advantage: $443.92 Care Source — Medicare Advantage: $452.80 Cigna — Commercial: $1,552.85 Clover — Medicare Advantage: $452.80
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	$2,251 – $6,858.01
Cataract removal with lens implant: 10 of 18 insurance plan rates Aetna — HMO: $3,562 Aetna — Medicare Advantage: $2,357.81 Aetna — POS: $4,117 Aetna — PPO: $4,617 Alliant — Solocare: $2,459.58 Anthem — HMO/PPO: $3,156.53 Anthem — Medicare Advantage: $2,357.81 Care Source — Medicare Advantage: $2,404.97 Cigna — Commercial: $6,305 Clover — Medicare Advantage: $2,404.97

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	$2,214.40 – $3,949.86
Vaginal delivery, with care before and after: 10 of 21 insurance plan rates Aetna — HMO: $3,114 Aetna — Medicare Advantage: $2,214.40 Aetna — POS: $3,114 Aetna — PPO: $2,914 Alliant — Solocare: $2,657.28 Ambetter — Managed Medicaid: $2,989.44 Anthem — Medicare Advantage: $2,214.40 Care Source — Medicare Advantage: $2,258.69 Cigna — Commercial: $2,699.41 Clover — Medicare Advantage: $2,258.69
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	$2,214.40 – $5,756.44
Vaginal delivery, with care before and after: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $2,214.40 Alliant — Solocare: $5,289.33 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $2,214.40 Care Source — Medicare Advantage: $2,258.69 Clover — Medicare Advantage: $2,258.69 Eon Health — Medicare Advantage: $2,258.69 Georgia Health Advantage — Medicare Advantage: $2,214.40 Humana — HMO/POS: $4,453.06 Humana — Medicare Advantage: $2,214.40
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	$2,484.56 – $4,453.61
Cesarean delivery (C-section), with care before and after: 10 of 21 insurance plan rates Aetna — HMO: $3,335 Aetna — Medicare Advantage: $2,484.56 Aetna — POS: $3,335 Aetna — PPO: $3,142.78 Alliant — Solocare: $2,981.47 Ambetter — Managed Medicaid: $3,354.16 Anthem — Medicare Advantage: $2,484.56 Care Source — Medicare Advantage: $2,534.25 Cigna — Commercial: $2,911.34 Clover — Medicare Advantage: $2,534.25
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	$1,884 – $5,756.44
Cesarean delivery (C-section), with care before and after: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $2,484.56 Alliant — Solocare: $5,289.33 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $2,484.56 Care Source — Medicare Advantage: $2,534.25 Clover — Medicare Advantage: $2,534.25 Eon Health — Medicare Advantage: $2,534.25 Georgia Health Advantage — Medicare Advantage: $2,484.56 Humana — HMO/POS: $4,453.06 Humana — Medicare Advantage: $2,484.56
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	$2,343.29 – $5,420.48
Vaginal delivery after a previous C-section, with care before and after: 10 of 21 insurance plan rates Aetna — HMO: $3,626 Aetna — Medicare Advantage: $2,343.29 Aetna — POS: $3,626 Aetna — PPO: $3,441.62 Alliant — Solocare: $2,811.95 Ambetter — Managed Medicaid: $3,163.44 Anthem — Medicare Advantage: $2,343.29 Care Source — Medicare Advantage: $2,390.16 Cigna — Commercial: $3,188.18 Clover — Medicare Advantage: $2,390.16
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	$1,884 – $5,756.44
Vaginal delivery after a previous C-section, with care before and after: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $2,343.29 Alliant — Solocare: $5,289.33 Anthem — HMO/PPO: $3,463.53 Anthem — Medicare Advantage: $2,343.29 Care Source — Medicare Advantage: $2,390.15 Clover — Medicare Advantage: $2,390.15 Eon Health — Medicare Advantage: $2,390.15 Georgia Health Advantage — Medicare Advantage: $2,343.29 Humana — HMO/POS: $4,453.06 Humana — Medicare Advantage: $2,343.29

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	$77,063.83 – $221,627.86
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 21 insurance plan rates Aetna — HMO: $116,083.43 Aetna — Medicare Advantage: $77,063.83 Aetna — POS: $116,083.43 Aetna — PPO: $136,997.36 Alliant — Solocare: $87,265.63 Anthem — HMO/PPO: $135,741.85 Anthem — Medicare Advantage: $77,063.83 Care Source — Medicare Advantage: $78,605.11 Cigna — Commercial: $112,628.34 Clover — Medicare Advantage: $78,605.11
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	$17,048.77 – $43,298.62
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates Aetna — HMO: $22,678.79 Aetna — Medicare Advantage: $17,213.90 Aetna — POS: $22,678.79 Aetna — PPO: $26,764.67 Alliant — Solocare: $17,048.77 Anthem — HMO/PPO: $26,519.39 Anthem — Medicare Advantage: $17,213.90 Care Source — Medicare Advantage: $17,558.18 Cigna — Commercial: $22,003.79 Clover — Medicare Advantage: $17,558.18
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	$20,927.94 – $54,364.97
Neck (cervical) spinal fusion, without complications: 10 of 21 insurance plan rates Aetna — HMO: $28,475.09 Aetna — Medicare Advantage: $20,927.94 Aetna — POS: $28,475.09 Aetna — PPO: $33,605.24 Alliant — Solocare: $21,406.13 Anthem — HMO/PPO: $33,297.27 Anthem — Medicare Advantage: $20,927.94 Care Source — Medicare Advantage: $21,346.50 Cigna — Commercial: $27,627.56 Clover — Medicare Advantage: $21,346.50
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	$10,838.69 – $27,526.95
Uterus and ovary surgery (not for cancer), without complications: 10 of 21 insurance plan rates Aetna — HMO: $14,417.96 Aetna — Medicare Advantage: $11,920.69 Aetna — POS: $14,417.96 Aetna — PPO: $17,015.55 Alliant — Solocare: $10,838.69 Anthem — HMO/PPO: $16,859.61 Anthem — Medicare Advantage: $11,920.69 Care Source — Medicare Advantage: $12,159.10 Cigna — Commercial: $13,988.83 Clover — Medicare Advantage: $12,159.10

Source: Atrium Health Navicent Rehabilitation Hospital’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 30, 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	Inpatient Rehabilitation Hospital
Address	3351 Northside Drive, Macon, GA 31210
County	Bibb County
State	Georgia
Phone	(478) 471‑6500
Ownership	Proprietary
CMS Certification Number	113029
Name in Medicare records	ATRIUM HEALTH NAVICENT REHABILITATION HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(478) 201‑6500^[4]
Name on the hospital’s website	Rehabilitation Hospital - Atrium Health Navicent
Official website	navicenthealth.org
Corrections	Report an error or suggest an update →

Sources

Inpatient Rehabilitation Facility - General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-08-12, retrieved 2026-10-29
Medicare Care Compare — official Medicare tool to look up and compare this type of 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.

Our Services - Rehabilitation Hospital — navicenthealth.org
Intpatient Therapies - Rehabilitation Hospital | Atrium Health Navicent — navicenthealth.org
Outpatient Therapies - Rehabilitation Hospital | Atrium Health Navicent — navicenthealth.org
Resources - Rehabilitation Hospital | Atrium Health Navicent — navicenthealth.org

Atrium Health Navicent Rehabilitation Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^[4][6]

Conditions treated^[4][6][7]

Treatments^[4][6][7]

Procedures^[4][7][9]

Programs and centers^[6][9]

Visiting and practical information

Nearest emergency rooms

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Hospice providers

Home health agencies

Dialysis facilities

Outpatient surgery centers nearby

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Atrium Health Navicent Rehabilitation Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[4][6]

Conditions treated[4][6][7]

Treatments[4][6][7]

Procedures[4][7][9]

Programs and centers[6][9]

Visiting and practical information

Nearest emergency rooms

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Hospice providers

Home health agencies

Dialysis facilities

Outpatient surgery centers nearby

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Specialties and care areas^[4][6]

Conditions treated^[4][6][7]

Treatments^[4][6][7]

Procedures^[4][7][9]

Programs and centers^[6][9]