Does Avita Ontario have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Avita Ontario. In a medical emergency, call 911.

Where is Avita Ontario?

715 Richland Mall, Ontario, OH 44906, in Richland County, Ohio.

What is the phone number of Avita Ontario?

(419) 462-4534, as listed by Medicare (CMS).

What is the Medicare star rating of Avita Ontario?

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

Avita Ontario — Ontario, OH

Quick answers

Does Avita Ontario have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Avita Ontario. In a medical emergency, call 911.
Where is Avita Ontario?: 715 Richland Mall, Ontario, OH 44906, in Richland County, Ohio.
What is the phone number of Avita Ontario?: (419) 462-4534, as listed by Medicare (CMS).
What is the Medicare star rating of Avita Ontario?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5][6][8][9]

Emergency Medicine
Heart & Vascular Care (Cardiology)
Obstetrics & Gynecology (Labor & Delivery)
Critical Care (Intensive Care Unit)
Surgery
Radiology / Imaging
Forensic Nursing Services

Conditions treated^[6]

Heart attack (STEMI)

Treatments^[6][9]

Emergency heart attack care
Forensic exams (sexual assault, domestic violence, child abuse, human trafficking)
Telestroke care in the emergency department
Labor, delivery, recovery and postpartum care

Procedures^{[5][6][8][9][10]}

Cardiac catheterization
Angioplasty
Inferior vena cava (IVC) filter placement
Blood clot removal
Pacemaker implantation (including Micra leadless pacemaker)
Implantable cardioverter defibrillator (ICD) implantation
Heart rhythm monitor implantation
3T MRI
3D mammography
DEXA bone density scan
Knee replacement

Programs and centers^[5][6][8][9]

Level II cardiac catheterization lab with 24/7 heart attack care
Avita Heart Cardiac Device Clinic
Labor, Delivery, Recovery and Postpartum (LDRP) unit
Forensic program (SANE/forensic nurse examiners)
Telestroke network (OSU Telestroke)

Emergency care (hospital website)^[6]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Visiting hours are 8 a.m. to 8 p.m.; ICU allows 2 visitors at a time, age 16 or older^[5]
Interpreters and languages	Free language assistance services are available^[5]
Patient portal	MyChart

Doctors and clinicians (275)

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

Main specialties

Doctors with a page on this site (275)

Aaron R. Becker, PSYClinical Psychologist
Abdallah Al-Shahed, MDInternal Medicine
Abhay S. Gokhale, MDDiagnostic Radiology
Adam J. Bihl, MDFamily Practice
Adam T. Leyda, CNACertified Registered Nurse Anesthetist (CRNA)
Ahmed HammoudaInternal Medicine
Ahmed M. Ghany, MDHematology
Ahmed M. Mosalem, MDHospitalist
Ahmed Salem, MDInternal Medicine
Ajay Chawla, MDInternal Medicine
Alejandro Diez, MDNephrology
Alexander A. Chapman, MDGeneral Surgery
Alexander C. YaneyRadiation Oncology
Allison M. Pruett, MDObstetrics/Gynecology
Alyssa R. Sickle, MDObstetrics/Gynecology
Amber CampbellNurse Practitioner
Amber V. DillsNurse Practitioner
Ami L. HayNurse Practitioner
Amy H. Martin, MDDiagnostic Radiology
Andrew J. Lee, MDInternal Medicine
Angela M. Novy, MDEndocrinology
Anil E. Paul, MDInternal Medicine
Anjuli M. Eagleston, MDInternal Medicine
Anna E. GantzNurse Practitioner

And 251 more: the button below opens the full list.

Other emergency rooms nearby

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

OhioHealth Mansfield Hospital3.5 mi · Mansfield, OH · Acute Care Hospital
OhioHealth Shelby Hospital8.1 mi · Shelby, OH · Critical Access Hospital
Galion Community Hospital11 mi · Galion, OH · Critical Access Hospital
University Hospitals Samaritan Medical Center16 mi · Ashland, OH · Acute Care Hospital
Bucyrus Community Hospital20 mi · Bucyrus, OH · Critical Access Hospital

Other hospitals nearby

OhioHealth Morrow County Hospital20 mi · Mount Gilead, OH · Critical Access 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

Crystal Care Center of Mansfie1.9 mi · Mansfield, OH · 3 of 5 stars
Jag Healthcare Mansfield3.6 mi · Mansfield, OH · 1 of 5 stars
Liberty Nursing Center of Mansfield4.0 mi · Mansfield, OH · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Avita Home Health and Hospice12 mi · Galion, OH

All hospice providers in the state →

Home health agencies

Cambridge Home Health Care, Inc1.0 mi · Ontario, OH · 3 of 5 stars
Central Star Home Health Service1.0 mi · Ontario, OH
First Choice Home Health of Ohio, Inc1.0 mi · Ontario, OH

All home health agencies in the state →

Dialysis facilities

DaVita Mid Ohio Dialysis1.0 mi · Ontario, OH · 3 of 5 stars
FMC - Mansfield Kidney Center1.0 mi · Mansfield, OH · 3 of 5 stars
FMC Dialysis Services Richland County1.0 mi · Mansfield, OH · 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.

Advanced Eye Care Surgery Center1.0 mi · Mansfield, OH
Avita Ontario Asc1.0 mi · Ontario, OH
Ohio Eye Associates Eye Surgery & Laser Center1.0 mi · Mansfield, OH

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

Hawkins Medical Center1.0 mi · Mansfield, OH · Community health center
Mobile Medical & Dental Unit1.7 mi · Ontario, OH · Community health center
Mansfield Care Connect2.5 mi · Mansfield, OH · Community health center

Clinics and urgent care

Ontario Physician Practices1.0 mi · Ontario, OH · Rural health clinic
Samaritan Regional Health System6.5 mi · Mansfield, OH · Urgent care center
GCH Physician Practice Crestline9.3 mi · Crestline, OH · Rural health clinic

Pharmacies

Galion Community Hospital1.0 mi · Mansfield, OH · Pharmacy
Ohio CVS Stores LLC1.0 mi · Ontario, OH · Pharmacy
The Cleveland Clinic Foundation1.0 mi · Mansfield, OH · Community/retail pharmacy

Assisted living nearby

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

Ontario Estates Senior Living1.0 mi · Mansfield, OH
Ontario Pointe1.0 mi · Mansfield, OH
Primrose Retirement Community of Mansfield1.0 mi · Mansfield, OH
The Waterford at Mansfield1.0 mi · Mansfield, OH

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	78%National average: 72%
Would definitely recommend the hospital	83%National average: 71%
Nurses “always” communicated well	87%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	79%National average: 74%
Area around the room “always” quiet at night	61%National average: 60%
Completed surveys	246Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.255No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	13%
Deaths within 30 days: heart failure patients	8.7%
Deaths within 30 days: pneumonia patients	17.7%
Deaths within 30 days: COPD patients	9.5%
Deaths within 30 days: stroke patients	12.7%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.92No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14%
Readmitted within 30 days: heart failure	22%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	21%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	148 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	46%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Ohio Best hospitals in Ohio

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Avita Ontario 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 →

$ 7 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

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 · modifier 0 In the file: HC CLINIC VISIT NEW PT LEVEL 3	$127	$107.95	$43.18 – $116.84
New patient office visit (about 30–44 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $107.95 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $887.60 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $80.01 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $77.46 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $887.60 Anthem — Pathway_Group_HMO_Pathway_X: $84.20
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · modifier 0 In the file: HC CLINIC VISIT NEW PT LEVEL 4	$140	$119	$47.60 – $128.80
New patient office visit (about 45–59 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $119 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $342.65 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $88.20 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $85.39 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $342.65 Anthem — Pathway_Group_HMO_Pathway_X: $92.82
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · modifier 0 In the file: HC CLINIC VISIT NEW PT LEVEL 5	$154	$130.90	$52.36 – $141.68
New patient office visit (about 60–74 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $130.90 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $586.60 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $97.02 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $93.93 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $586.60 Anthem — Pathway_Group_HMO_Pathway_X: $102.10
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · modifier 0 In the file: HC CLINIC VISIT ESTABLISHED PT LEVEL 3	$127	$107.95	$43.18 – $116.84
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $107.95 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $44.45 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $80.01 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $77.46 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $44.45 Anthem — Pathway_Group_HMO_Pathway_X: $84.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · modifier 0 In the file: HC CLINIC VISIT ESTABLISHED PT LEVEL 4	$150	$127.50	$51 – $138
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $127.50 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $49 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $94.50 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $91.49 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $49 Anthem — Pathway_Group_HMO_Pathway_X: $99.45
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 0 In the file: HC EMERGENCY ROOM LEVEL 3	$639	$543.15	$217.26 – $587.88
Emergency room visit (moderate): 10 of 37 insurance plan rates Aetna — All_Commercial: $543.15 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $187.60 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $358.56 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $389.76 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $187.60 Anthem — Pathway_Group_HMO_Pathway_X: $423.66
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier 0 In the file: HC EMERGENCY ROOM LEVEL 4	$1,023	$869.55	$347.82 – $941.16
Emergency room visit (moderately high): 10 of 37 insurance plan rates Aetna — All_Commercial: $869.55 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $187.60 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $463.14 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $623.99 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $187.60 Anthem — Pathway_Group_HMO_Pathway_X: $678.25
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier 0 In the file: HC EMERGENCY ROOM LEVEL 5	$1,527	$1,297.95	$519.18 – $1,404.84
Emergency room visit (high): 10 of 37 insurance plan rates Aetna — All_Commercial: $1,297.95 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $187.60 AmeriHealth — Medicaid_Outpatient: $121.79 Anthem — Blue_Access_Blue_Preferred: $761.94 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $931.41 Anthem — Medicaid_Outpatient: $119.47 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $187.60 Anthem — Pathway_Group_HMO_Pathway_X: $1,012.40

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier 0 In the file: HC METABOLIC PANEL TOTAL CA	$234	$198.90	$79.56 – $215.28
Basic metabolic panel (blood test): 10 of 37 insurance plan rates Aetna — All_Commercial: $198.90 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $22.75 AmeriHealth — Medicaid_Outpatient: $34.86 Anthem — Blue_Access_Blue_Preferred: $138.61 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $142.73 Anthem — Medicaid_Outpatient: $34.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $22.75 Anthem — Pathway_Group_HMO_Pathway_X: $155.14
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier 0 In the file: HC COMPREHEN METABOLIC PANEL	$442	$375.70	$150.28 – $406.64
Comprehensive metabolic panel (blood test): 10 of 37 insurance plan rates Aetna — All_Commercial: $375.70 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $33.25 AmeriHealth — Medicaid_Outpatient: $34.86 Anthem — Blue_Access_Blue_Preferred: $63.08 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $269.60 Anthem — Medicaid_Outpatient: $34.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $33.25 Anthem — Pathway_Group_HMO_Pathway_X: $293.05
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · modifier 0 In the file: HC OBSTETRIC PANEL	$561	$476.85	$190.74 – $516.12
Obstetric blood test panel: 10 of 37 insurance plan rates Aetna — All_Commercial: $476.85 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $243.95 AmeriHealth — Medicaid_Outpatient: $34.86 Anthem — Blue_Access_Blue_Preferred: $39.84 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $342.19 Anthem — Medicaid_Outpatient: $34.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $243.95 Anthem — Pathway_Group_HMO_Pathway_X: $371.94
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier 0 In the file: HC RENAL FUNCTION PANEL	$282	$239.70	$95.88 – $259.44
Kidney function panel: 10 of 37 insurance plan rates Aetna — All_Commercial: $239.70 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $154.70 AmeriHealth — Medicaid_Outpatient: $34.86 Anthem — Blue_Access_Blue_Preferred: $119.52 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $172.01 Anthem — Medicaid_Outpatient: $34.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $154.70 Anthem — Pathway_Group_HMO_Pathway_X: $186.97
Liver function panel CPT 80076 · Inpatient or outpatient · modifier 0 In the file: HC HEPATIC FUNCTION PANEL	$315	$267.75	$107.10 – $289.80
Liver function panel: 10 of 37 insurance plan rates Aetna — All_Commercial: $267.75 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $98.70 AmeriHealth — Medicaid_Outpatient: $34.86 Anthem — Blue_Access_Blue_Preferred: $422.47 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $192.14 Anthem — Medicaid_Outpatient: $34.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $98.70 Anthem — Pathway_Group_HMO_Pathway_X: $208.85
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier 0 In the file: HC URINALYSIS TOTAL AUTOMATED W/ MICRO	$50	$42.50	$17 – $46
Urine test (automated, with microscope): 10 of 37 insurance plan rates Aetna — All_Commercial: $42.50 Aetna — Medicare_Inpatient: $3,588.41 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — Medicare_Outpatient: $52.50 AmeriHealth — Medicaid_Outpatient: $11.30 Anthem — Blue_Access_Blue_Preferred: $176.79 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $30.50 Anthem — Medicaid_Outpatient: $11.09 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $52.50 Anthem — Pathway_Group_HMO_Pathway_X: $33.15
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · modifier 0 In the file: HC URINALYSIS TOTAL NON-AUTOMATED W/O MICRO	$57	$48.45	$19.38 – $52.44
Urine test (manual, without microscope): 10 of 37 insurance plan rates Aetna — All_Commercial: $48.45 Aetna — Medicare_Inpatient: $3,588.41 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — Medicare_Outpatient: $10.50 AmeriHealth — Medicaid_Outpatient: $11.30 Anthem — Blue_Access_Blue_Preferred: $80.51 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $34.77 Anthem — Medicaid_Outpatient: $11.09 Anthem — Medicare_Inpatient: $3,518.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Anthem — Medicare_Outpatient: $10.50 Anthem — Pathway_Group_HMO_Pathway_X: $37.79
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier 0 In the file: HC URINALYSIS TOTAL AUTOMATED W/O MICRO	$36	$30.60	$12.24 – $33.12
Urine test (automated, without microscope): 10 of 37 insurance plan rates Aetna — All_Commercial: $30.60 Aetna — Medicare_Inpatient: $3,588.41 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — Medicare_Outpatient: $220.85 AmeriHealth — Medicaid_Outpatient: $11.30 Anthem — Blue_Access_Blue_Preferred: $140.27 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $21.96 Anthem — Medicaid_Outpatient: $11.09 Anthem — Medicare_Inpatient: $3,518.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Anthem — Medicare_Outpatient: $220.85 Anthem — Pathway_Group_HMO_Pathway_X: $23.87
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · modifier 0 In the file: HC PSA TOTAL	$195	$165.75	$66.30 – $179.40
PSA (prostate specific antigen) blood test: 10 of 37 insurance plan rates Aetna — All_Commercial: $165.75 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $60.20 AmeriHealth — Medicaid_Outpatient: $32.16 Anthem — Blue_Access_Blue_Preferred: $122.84 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $118.94 Anthem — Medicaid_Outpatient: $31.55 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $60.20 Anthem — Pathway_Group_HMO_Pathway_X: $129.29
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 0 In the file: HC THYROID STIMULATING HORMONE	$245	$208.25	$83.30 – $225.40
Thyroid stimulating hormone (TSH) test: 10 of 37 insurance plan rates Aetna — All_Commercial: $208.25 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $61.95 AmeriHealth — Medicaid_Outpatient: $38.99 Anthem — Blue_Access_Blue_Preferred: $189.24 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $149.44 Anthem — Medicaid_Outpatient: $38.25 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $61.95 Anthem — Pathway_Group_HMO_Pathway_X: $162.44
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier 0 In the file: HC CBC EDIFF & PLATELET	$124	$105.40	$42.16 – $114.08
Complete blood count (CBC) with differential: 10 of 37 insurance plan rates Aetna — All_Commercial: $105.40 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $15.40 AmeriHealth — Medicaid_Outpatient: $15.05 Anthem — Blue_Access_Blue_Preferred: $129.48 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $75.64 Anthem — Medicaid_Outpatient: $14.76 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $15.40 Anthem — Pathway_Group_HMO_Pathway_X: $82.21
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier 0 In the file: HC CBC & PLATELET	$86	$73.10	$29.24 – $79.12
Complete blood count (CBC), automated: 10 of 37 insurance plan rates Aetna — All_Commercial: $73.10 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $37.80 AmeriHealth — Medicaid_Outpatient: $15.05 Anthem — Blue_Access_Blue_Preferred: $56.44 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $52.46 Anthem — Medicaid_Outpatient: $14.76 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $37.80 Anthem — Pathway_Group_HMO_Pathway_X: $57.02
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier 0 In the file: HC PROTHOMBIN TIME	$59	$50.15	$20.06 – $54.28
Blood clotting time test (prothrombin time, PT): 10 of 37 insurance plan rates Aetna — All_Commercial: $50.15 Aetna — Medicare_Inpatient: $3,588.41 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — Medicare_Outpatient: $90.65 AmeriHealth — Medicaid_Outpatient: $17.22 Anthem — Blue_Access_Blue_Preferred: $166 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $35.99 Anthem — Medicaid_Outpatient: $16.89 Anthem — Medicare_Inpatient: $3,518.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Anthem — Medicare_Outpatient: $90.65 Anthem — Pathway_Group_HMO_Pathway_X: $39.12
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier 0 In the file: HC PTT PLASMA OR WHOLE BLOOD	$78	$66.30	$26.52 – $71.76
Blood clotting test (partial thromboplastin time, PTT): 10 of 37 insurance plan rates Aetna — All_Commercial: $66.30 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $18.55 AmeriHealth — Medicaid_Outpatient: $17.22 Anthem — Blue_Access_Blue_Preferred: $54.78 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $47.58 Anthem — Medicaid_Outpatient: $16.89 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $18.55 Anthem — Pathway_Group_HMO_Pathway_X: $51.71

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 · modifier 0 In the file: HC CT HEAD/BRAIN W/O CONTRAST	$1,978	$1,681.30	$672.52 – $1,819.76
CT scan of the head or brain, without contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $1,681.30 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $430.50 AmeriHealth — Medicaid_Outpatient: $697.67 Anthem — Blue_Access_Blue_Preferred: $2,689.20 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $1,206.50 Anthem — Medicaid_Outpatient: $684.38 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $430.50 Anthem — Pathway_Group_HMO_Pathway_X: $1,311.41
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier 0 In the file: HC MRI BRAIN W/ & W/O CONTRAST	$4,726	$4,017.10	$1,606.84 – $4,347.92
MRI of the brain, before and after contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $4,017.10 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,644.30 AmeriHealth — Medicaid_Outpatient: $684.09 Anthem — Blue_Access_Blue_Preferred: $2,977.38 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,882.67 Anthem — Medicaid_Outpatient: $671.06 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,644.30 Anthem — Pathway_Group_HMO_Pathway_X: $3,133.34
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier 0 In the file: HC RADIOLOGY X-RAY CHEST 2 VIEWS	$339	$288.15	$115.26 – $311.88
Chest X-ray, 2 views: 10 of 37 insurance plan rates Aetna — All_Commercial: $288.15 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $2,503.55 AmeriHealth — Medicaid_Outpatient: $100.62 Anthem — Blue_Access_Blue_Preferred: $1,342.94 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $206.78 Anthem — Medicaid_Outpatient: $98.70 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $2,503.55 Anthem — Pathway_Group_HMO_Pathway_X: $224.76
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier 0 In the file: HC RADIOLOGY EXAM LUMBOSACRAL SPINE MIN 4 VIEWS	$776	$659.60	$263.84 – $713.92
X-ray of the lower spine, at least 4 views: 10 of 37 insurance plan rates Aetna — All_Commercial: $659.60 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $313.60 AmeriHealth — Medicaid_Outpatient: $100.62 Anthem — Blue_Access_Blue_Preferred: $795.14 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $473.33 Anthem — Medicaid_Outpatient: $98.70 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $313.60 Anthem — Pathway_Group_HMO_Pathway_X: $514.49
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier 0 In the file: HC MRI SPINE W/O CONTRAST LUMBAR	$4,713	$4,006.05	$1,602.42 – $4,335.96
MRI of the lower back (lumbar spine), without contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $4,006.05 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,605.10 AmeriHealth — Medicaid_Outpatient: $452.68 Anthem — Blue_Access_Blue_Preferred: $2,969.19 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,874.74 Anthem — Medicaid_Outpatient: $444.06 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,605.10 Anthem — Pathway_Group_HMO_Pathway_X: $3,124.72
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier 0 In the file: HC CT PELVIS W/ CONTRAST	$3,775	$3,208.75	$1,283.50 – $3,473
CT scan of the pelvis, with contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $3,208.75 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,051.40 AmeriHealth — Medicaid_Outpatient: $697.67 Anthem — Blue_Access_Blue_Preferred: $1,725.57 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,302.60 Anthem — Medicaid_Outpatient: $684.38 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,051.40 Anthem — Pathway_Group_HMO_Pathway_X: $2,502.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier 0 In the file: HC MRI LOWER EXTREMITY JOINT W/O CONTRAST	$4,286	$3,643.10	$1,457.24 – $3,943.12
MRI of a leg joint (such as the knee), without contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $3,643.10 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,552.95 AmeriHealth — Medicaid_Outpatient: $452.68 Anthem — Blue_Access_Blue_Preferred: $2,700.18 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,614.29 Anthem — Medicaid_Outpatient: $444.06 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,552.95 Anthem — Pathway_Group_HMO_Pathway_X: $2,841.62
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier 0 In the file: HC CT ABDOMEN & PELVIS W/ CONTRAST	$4,682	$3,979.70	$1,591.88 – $4,307.44
CT scan of the abdomen and pelvis, with contrast: 10 of 37 insurance plan rates Aetna — All_Commercial: $3,979.70 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $727.65 AmeriHealth — Medicaid_Outpatient: $697.67 Anthem — Blue_Access_Blue_Preferred: $3,385.57 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,855.83 Anthem — Medicaid_Outpatient: $684.38 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $727.65 Anthem — Pathway_Group_HMO_Pathway_X: $3,104.17
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier 0 In the file: HC US ABDOMINAL COMPLETE	$1,277	$1,085.45	$434.18 – $1,174.84
Ultrasound of the abdomen, complete: 10 of 37 insurance plan rates Aetna — All_Commercial: $1,085.45 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $430.85 AmeriHealth — Medicaid_Outpatient: $266.26 Anthem — Blue_Access_Blue_Preferred: $185.92 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $778.92 Anthem — Medicaid_Outpatient: $261.19 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $430.85 Anthem — Pathway_Group_HMO_Pathway_X: $846.65
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier 0 In the file: HC US OB AFTER 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION	$1,743	$1,481.55	$592.62 – $1,603.56
Pregnancy ultrasound (after the first trimester): 10 of 37 insurance plan rates Aetna — All_Commercial: $1,481.55 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $324.80 AmeriHealth — Medicaid_Outpatient: $207.12 Anthem — Blue_Access_Blue_Preferred: $405.04 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $1,063.16 Anthem — Medicaid_Outpatient: $203.18 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $324.80 Anthem — Pathway_Group_HMO_Pathway_X: $1,155.61
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier 0 In the file: HC US TRANSVAGINAL	$861	$731.85	$292.74 – $792.12
Transvaginal ultrasound: 10 of 37 insurance plan rates Aetna — All_Commercial: $731.85 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $197.75 AmeriHealth — Medicaid_Outpatient: $173.13 Anthem — Blue_Access_Blue_Preferred: $610.05 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $525.18 Anthem — Medicaid_Outpatient: $169.83 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $197.75 Anthem — Pathway_Group_HMO_Pathway_X: $570.84
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier 0 In the file: HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD	$601	$510.85	$204.34 – $552.92
Diagnostic mammogram, one breast: 10 of 37 insurance plan rates Aetna — All_Commercial: $510.85 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $74.55 AmeriHealth — Medicaid_Outpatient: $91.85 Anthem — Blue_Access_Blue_Preferred: $587.64 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $366.59 Anthem — Medicaid_Outpatient: $90.10 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $74.55 Anthem — Pathway_Group_HMO_Pathway_X: $398.46
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier 0 In the file: HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD	$780	$663	$265.20 – $717.60
Diagnostic mammogram, both breasts: 10 of 37 insurance plan rates Aetna — All_Commercial: $663 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $254.80 AmeriHealth — Medicaid_Outpatient: $91.85 Anthem — Blue_Access_Blue_Preferred: $532.03 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $475.77 Anthem — Medicaid_Outpatient: $90.10 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $254.80 Anthem — Pathway_Group_HMO_Pathway_X: $517.14
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 0 In the file: HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD	$214	$181.90	$72.76 – $196.88
Screening mammogram, both breasts: 10 of 37 insurance plan rates Aetna — All_Commercial: $181.90 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $229.95 AmeriHealth — Medicaid_Outpatient: $91.85 Anthem — Blue_Access_Blue_Preferred: $439.07 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $130.53 Anthem — Medicaid_Outpatient: $90.10 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $229.95 Anthem — Pathway_Group_HMO_Pathway_X: $141.88

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier 0 In the file: HC LHC W/ LV	$11,044	$9,387.40	$3,754.96 – $10,160.48
Left heart catheterization (diagnostic): 10 of 37 insurance plan rates Aetna — All_Commercial: $9,387.40 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $2,141.65 AmeriHealth — Medicaid_Outpatient: $3,451.28 Anthem — Blue_Access_Blue_Preferred: $19,409.23 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $6,736.40 Anthem — Medicaid_Outpatient: $3,385.55 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $2,141.65 Anthem — Pathway_Group_HMO_Pathway_X: $7,322.17
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · modifier 0 In the file: HC EP EVALUATION COMPREHENSIVE W/O INDUCTION RA & RV	$13,074	$11,112.90	$4,445.16 – $12,028.08
Heart rhythm study (electrophysiology evaluation): 10 of 37 insurance plan rates Aetna — All_Commercial: $11,112.90 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,957.55 AmeriHealth — Medicaid_Outpatient: $21,479.14 Anthem — Blue_Access_Blue_Preferred: $4,791.14 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $7,974.62 Anthem — Medicaid_Outpatient: $21,070.02 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,957.55 Anthem — Pathway_Group_HMO_Pathway_X: $8,668.06
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier 0 In the file: HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS	$5,219	$4,436.15	$1,774.46 – $4,801.48
Sleep study (overnight, in a sleep lab): 10 of 37 insurance plan rates Aetna — All_Commercial: $4,436.15 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $231 AmeriHealth — Medicaid_Outpatient: $1,248.48 Anthem — Blue_Access_Blue_Preferred: $3,287.97 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $3,183.38 Anthem — Medicaid_Outpatient: $1,224.70 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $231 Anthem — Pathway_Group_HMO_Pathway_X: $3,460.20

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 0 In the file: HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS	$148	$125.80	$50.32 – $136.16
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $125.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $37.80 AmeriHealth — Medicaid_Outpatient: $150.75 Anthem — Blue_Access_Blue_Preferred: $113.71 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $90.27 Anthem — Medicaid_Outpatient: $147.88 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $37.80 Anthem — Pathway_Group_HMO_Pathway_X: $98.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 0 In the file: HC CCH CONTINUOUS PASSIVE MOTION ADJUST EACH 15 MINS	$148	$125.80	$50.32 – $136.16
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $125.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $46.90 AmeriHealth — Medicaid_Outpatient: $150.75 Anthem — Blue_Access_Blue_Preferred: $97.11 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $90.27 Anthem — Medicaid_Outpatient: $147.88 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $46.90 Anthem — Pathway_Group_HMO_Pathway_X: $98.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 0 In the file: HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT	$148	$125.80	$50.32 – $136.16
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates Aetna — All_Commercial: $125.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $39.55 AmeriHealth — Medicaid_Outpatient: $150.75 Anthem — Blue_Access_Blue_Preferred: $85.49 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $90.27 Anthem — Medicaid_Outpatient: $147.88 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $39.55 Anthem — Pathway_Group_HMO_Pathway_X: $98.12
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier 0 In the file: HC PT EVALUATION LOW COMPLEXITY	$332	$282.20	$112.88 – $305.44
Physical therapy evaluation (low complexity): 10 of 37 insurance plan rates Aetna — All_Commercial: $282.20 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $43.75 AmeriHealth — Medicaid_Outpatient: $165.12 Anthem — Blue_Access_Blue_Preferred: $146.91 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $202.51 Anthem — Medicaid_Outpatient: $161.98 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $43.75 Anthem — Pathway_Group_HMO_Pathway_X: $220.12
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier 0 In the file: HC PT EVALUATION MODERATE COMPLEXITY	$410	$348.50	$139.40 – $377.20
Physical therapy evaluation (moderate complexity): 10 of 37 insurance plan rates Aetna — All_Commercial: $348.50 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $48.30 AmeriHealth — Medicaid_Outpatient: $165.12 Anthem — Blue_Access_Blue_Preferred: $122.84 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $250.08 Anthem — Medicaid_Outpatient: $161.98 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $48.30 Anthem — Pathway_Group_HMO_Pathway_X: $271.83
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier 0 In the file: HC PT EVALUATION HIGH COMPLEXITY	$486	$413.10	$165.24 – $447.12
Physical therapy evaluation (high complexity): 10 of 37 insurance plan rates Aetna — All_Commercial: $413.10 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $40.95 AmeriHealth — Medicaid_Outpatient: $165.12 Anthem — Blue_Access_Blue_Preferred: $120.35 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $296.44 Anthem — Medicaid_Outpatient: $161.98 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $40.95 Anthem — Pathway_Group_HMO_Pathway_X: $322.22

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 0 In the file: Removal of breast lesion	$7,476.06	$6,354.65	$383.23 – $7,476.06
Removal of breast growth (open surgery): 10 of 26 insurance plan rates Aetna — All_Commercial: $7,476.06 Aetna — Medicare_Outpatient: $4,000.24 AmeriHealth — Medicaid_Outpatient: $383.23 Anthem — Blue_Access_Blue_Preferred: $5,330.43 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $4,709.92 Anthem — Medicaid_Outpatient: $945.48 Anthem — Medicare_Outpatient: $4,000.24 Anthem — Pathway_Group_HMO_Pathway_X: $4,709.92 Anthem — Traditional_Blue_Access_Blue_Preferred: $5,330.43 Buckeye — Medicaid_Outpatient: $945.48
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 0 In the file: Total hip arthroplasty	$80,698.23	$68,593.50	$2,121.70 – $80,698.23
Total hip replacement: 10 of 26 insurance plan rates Aetna — All_Commercial: $80,698.23 Aetna — Medicare_Outpatient: $13,116.76 AmeriHealth — Medicaid_Outpatient: $2,637.63 Anthem — Blue_Access_Blue_Preferred: $57,537.84 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $50,839.88 Anthem — Medicaid_Outpatient: $2,121.70 Anthem — Medicare_Outpatient: $13,116.76 Anthem — Pathway_Group_HMO_Pathway_X: $50,839.88 Anthem — Traditional_Blue_Access_Blue_Preferred: $57,537.84 Buckeye — Medicaid_Outpatient: $2,121.70
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 0 In the file: Total knee arthroplasty	$97,591.01	$82,952.36	$1,544.92 – $97,591.01
Total knee replacement: 10 of 26 insurance plan rates Aetna — All_Commercial: $97,591.01 Aetna — Medicare_Outpatient: $13,116.76 AmeriHealth — Medicaid_Outpatient: $2,637.63 Anthem — Blue_Access_Blue_Preferred: $69,582.39 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $61,482.34 Anthem — Medicaid_Outpatient: $1,544.92 Anthem — Medicare_Outpatient: $13,116.76 Anthem — Pathway_Group_HMO_Pathway_X: $61,482.34 Anthem — Traditional_Blue_Access_Blue_Preferred: $69,582.39 Buckeye — Medicaid_Outpatient: $1,544.92
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 0 In the file: Knee arthroscopy/surgery	$44,798.52	$38,078.74	$630.92 – $44,798.52
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 26 insurance plan rates Aetna — All_Commercial: $44,798.52 Aetna — Medicare_Outpatient: $3,342.87 AmeriHealth — Medicaid_Outpatient: $630.92 Anthem — Blue_Access_Blue_Preferred: $31,941.34 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $28,223.07 Anthem — Medicaid_Outpatient: $630.92 Anthem — Medicare_Outpatient: $3,342.87 Anthem — Pathway_Group_HMO_Pathway_X: $28,223.07 Anthem — Traditional_Blue_Access_Blue_Preferred: $31,941.34 Buckeye — Medicaid_Outpatient: $630.92
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 0 In the file: Remove tonsils and adenoids	$11,516.67	$9,789.17	$567.75 – $11,516.67
Removal of tonsils and adenoids (under age 12): 10 of 26 insurance plan rates Aetna — All_Commercial: $11,516.67 Aetna — Medicare_Outpatient: $6,048.05 AmeriHealth — Medicaid_Outpatient: $567.75 Anthem — Blue_Access_Blue_Preferred: $8,211.39 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $7,255.50 Anthem — Medicaid_Outpatient: $1,232.56 Anthem — Medicare_Outpatient: $6,048.05 Anthem — Pathway_Group_HMO_Pathway_X: $7,255.50 Anthem — Traditional_Blue_Access_Blue_Preferred: $8,211.39 Buckeye — Medicaid_Outpatient: $1,232.56
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · modifier 0 In the file: HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC	$4,136	$3,515.60	$1,406.24 – $3,805.12
Upper GI endoscopy (diagnostic): 10 of 37 insurance plan rates Aetna — All_Commercial: $3,515.60 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $2,760.80 AmeriHealth — Medicaid_Outpatient: $1,382.57 Anthem — Blue_Access_Blue_Preferred: $2,605.68 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,522.79 Anthem — Medicaid_Outpatient: $1,356.23 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $2,760.80 Anthem — Pathway_Group_HMO_Pathway_X: $2,742.17
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · modifier 0 In the file: HC EGD FLEXIBLE TRANSORAL W/ BX	$4,136	$3,515.60	$1,406.24 – $3,805.12
Upper GI endoscopy with biopsy: 10 of 37 insurance plan rates Aetna — All_Commercial: $3,515.60 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $2,760.80 AmeriHealth — Medicaid_Outpatient: $1,382.57 Anthem — Blue_Access_Blue_Preferred: $2,605.68 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,522.79 Anthem — Medicaid_Outpatient: $1,356.23 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $2,760.80 Anthem — Pathway_Group_HMO_Pathway_X: $2,742.17
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · modifier 0 In the file: HC COLONOSCOPY FLEXIBLE DIAGNOSTIC	$3,945	$3,353.25	$1,341.30 – $3,629.40
Colonoscopy (diagnostic): 10 of 37 insurance plan rates Aetna — All_Commercial: $3,353.25 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,815.80 AmeriHealth — Medicaid_Outpatient: $1,577.36 Anthem — Blue_Access_Blue_Preferred: $2,485.35 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,406.29 Anthem — Medicaid_Outpatient: $1,547.32 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,815.80 Anthem — Pathway_Group_HMO_Pathway_X: $2,615.54
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · modifier 0 In the file: HC COLONOSCOPY FLEXIBLE W/ BX	$5,188	$4,409.80	$1,763.92 – $4,772.96
Colonoscopy with biopsy: 10 of 37 insurance plan rates Aetna — All_Commercial: $4,409.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,815.80 AmeriHealth — Medicaid_Outpatient: $1,577.36 Anthem — Blue_Access_Blue_Preferred: $3,268.44 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $3,164.47 Anthem — Medicaid_Outpatient: $1,547.32 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,815.80 Anthem — Pathway_Group_HMO_Pathway_X: $3,439.64
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · modifier 0 In the file: HC COLONOSCOPY FLEXIBLE W/ REMOVAL TUMOR POLYP LESION BY SNARE	$5,188	$4,409.80	$1,763.92 – $4,772.96
Colonoscopy with removal of polyps (snare): 10 of 37 insurance plan rates Aetna — All_Commercial: $4,409.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,815.80 AmeriHealth — Medicaid_Outpatient: $1,577.36 Anthem — Blue_Access_Blue_Preferred: $3,268.44 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $3,164.47 Anthem — Medicaid_Outpatient: $1,547.32 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,815.80 Anthem — Pathway_Group_HMO_Pathway_X: $3,439.64
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · modifier 0 In the file: HC COLONOSCOPY FLEXIBLE W/ ENDOSCOPIC ULTRASOUND	$5,188	$4,409.80	$1,763.92 – $4,772.96
Ultrasound of the lower bowel by endoscope: 10 of 37 insurance plan rates Aetna — All_Commercial: $4,409.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,815.80 AmeriHealth — Medicaid_Outpatient: $1,577.36 Anthem — Blue_Access_Blue_Preferred: $3,268.44 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $3,164.47 Anthem — Medicaid_Outpatient: $1,547.32 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,815.80 Anthem — Pathway_Group_HMO_Pathway_X: $3,439.64
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · modifier 0 In the file: HC COLONOSCOPY SCREENING	$3,948	$3,355.80	$1,342.32 – $3,632.16
Screening colonoscopy (not high risk): 10 of 37 insurance plan rates Aetna — All_Commercial: $3,355.80 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $1,335.25 AmeriHealth — Medicaid_Outpatient: $1,577.36 Anthem — Blue_Access_Blue_Preferred: $2,487.24 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,408.12 Anthem — Medicaid_Outpatient: $1,547.32 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $1,335.25 Anthem — Pathway_Group_HMO_Pathway_X: $2,617.52
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 0 In the file: Laparoscopic cholecystectomy	$43,268.42	$36,778.16	$1,000.23 – $43,268.42
Gallbladder removal by laparoscope: 10 of 26 insurance plan rates Aetna — All_Commercial: $43,268.42 Aetna — Medicare_Outpatient: $6,176.47 AmeriHealth — Medicaid_Outpatient: $1,000.23 Anthem — Blue_Access_Blue_Preferred: $30,850.38 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $27,259.10 Anthem — Medicaid_Outpatient: $1,000.23 Anthem — Medicare_Outpatient: $6,176.47 Anthem — Pathway_Group_HMO_Pathway_X: $27,259.10 Anthem — Traditional_Blue_Access_Blue_Preferred: $30,850.38 Buckeye — Medicaid_Outpatient: $1,000.23
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 0 In the file: Prp i/hern init reduc >5 yr	$37,227.12	$31,643.05	$1,011.28 – $37,227.12
Groin (inguinal) hernia repair, age 5 or older: 10 of 26 insurance plan rates Aetna — All_Commercial: $37,227.12 Aetna — Medicare_Outpatient: $3,657.95 AmeriHealth — Medicaid_Outpatient: $1,011.28 Anthem — Blue_Access_Blue_Preferred: $26,542.94 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $23,453.09 Anthem — Medicaid_Outpatient: $1,011.28 Anthem — Medicare_Outpatient: $3,657.95 Anthem — Pathway_Group_HMO_Pathway_X: $23,453.09 Anthem — Traditional_Blue_Access_Blue_Preferred: $26,542.94 Buckeye — Medicaid_Outpatient: $1,011.28
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 0 In the file: Biopsy of prostate	$11,944.07	$10,152.46	$458.96 – $11,944.07
Prostate biopsy: 10 of 26 insurance plan rates Aetna — All_Commercial: $11,944.07 Aetna — Medicare_Outpatient: $2,135.66 AmeriHealth — Medicaid_Outpatient: $458.96 Anthem — Blue_Access_Blue_Preferred: $8,516.12 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $7,524.76 Anthem — Medicaid_Outpatient: $493.55 Anthem — Medicare_Outpatient: $2,135.66 Anthem — Pathway_Group_HMO_Pathway_X: $7,524.76 Anthem — Traditional_Blue_Access_Blue_Preferred: $8,516.12 Buckeye — Medicaid_Outpatient: $493.55
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · modifier 0 In the file: Laparo radical prostatectomy	$62,549.52	$53,167.09	$1,267.69 – $62,549.52
Prostate removal by laparoscope (radical prostatectomy): 10 of 26 insurance plan rates Aetna — All_Commercial: $62,549.52 Aetna — Medicare_Outpatient: $10,860.07 AmeriHealth — Medicaid_Outpatient: $1,267.69 Anthem — Blue_Access_Blue_Preferred: $44,597.81 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $39,406.20 Anthem — Medicaid_Outpatient: $1,726.03 Anthem — Medicare_Outpatient: $10,860.07 Anthem — Pathway_Group_HMO_Pathway_X: $39,406.20 Anthem — Traditional_Blue_Access_Blue_Preferred: $44,597.81 Buckeye — Medicaid_Outpatient: $1,726.03
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 0 In the file: Hysteroscopy biopsy	$34,808.71	$29,587.40	$579.17 – $34,808.71
Hysteroscopy with biopsy of the uterus lining: 10 of 26 insurance plan rates Aetna — All_Commercial: $34,808.71 Aetna — Medicare_Outpatient: $3,307.24 AmeriHealth — Medicaid_Outpatient: $652.54 Anthem — Blue_Access_Blue_Preferred: $24,818.61 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $21,929.49 Anthem — Medicaid_Outpatient: $579.17 Anthem — Medicare_Outpatient: $3,307.24 Anthem — Pathway_Group_HMO_Pathway_X: $21,929.49 Anthem — Traditional_Blue_Access_Blue_Preferred: $24,818.61 Buckeye — Medicaid_Outpatient: $579.17
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier 0 In the file: HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/ IMAGING GUIDANCE	$1,785	$1,517.25	$606.90 – $1,642.20
Spinal injection, lower back (epidural), with imaging guidance: 10 of 37 insurance plan rates Aetna — All_Commercial: $1,517.25 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $226.45 AmeriHealth — Medicaid_Outpatient: $1,002.06 Anthem — Blue_Access_Blue_Preferred: $1,124.55 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $1,088.78 Anthem — Medicaid_Outpatient: $982.97 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $226.45 Anthem — Pathway_Group_HMO_Pathway_X: $1,183.46
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 0 In the file: HC INJECTION(S) TRANSFORAMINAL LUMBAR SACRAL SINGLE LEVEL	$4,620	$3,927	$1,570.80 – $4,250.40
Nerve root injection, lower back, with imaging guidance: 10 of 37 insurance plan rates Aetna — All_Commercial: $3,927 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $201.60 AmeriHealth — Medicaid_Outpatient: $1,002.06 Anthem — Blue_Access_Blue_Preferred: $2,910.60 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $2,818.02 Anthem — Medicaid_Outpatient: $982.97 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $201.60 Anthem — Pathway_Group_HMO_Pathway_X: $3,063.06
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 0 In the file: Carpal tunnel surgery	$19,347.67	$16,445.52	$396.44 – $19,347.67
Carpal tunnel release: 10 of 26 insurance plan rates Aetna — All_Commercial: $19,347.67 Aetna — Medicare_Outpatient: $1,995.02 AmeriHealth — Medicaid_Outpatient: $396.44 Anthem — Blue_Access_Blue_Preferred: $13,794.89 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $12,189.03 Anthem — Medicaid_Outpatient: $396.44 Anthem — Medicare_Outpatient: $1,995.02 Anthem — Pathway_Group_HMO_Pathway_X: $12,189.03 Anthem — Traditional_Blue_Access_Blue_Preferred: $13,794.89 Buckeye — Medicaid_Outpatient: $396.44
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 0 In the file: HC DISCISSION SEC MEMB CATARACT BY LASER	$1,015	$862.75	$345.10 – $933.80
Laser treatment of clouding after cataract surgery: 10 of 37 insurance plan rates Aetna — All_Commercial: $862.75 Aetna — Medicare_Inpatient: $3,588.41 Aetna — Medicare_Outpatient: $121.80 AmeriHealth — Medicaid_Outpatient: $564.11 Anthem — Blue_Access_Blue_Preferred: $639.45 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $619.11 Anthem — Medicaid_Outpatient: $553.36 Anthem — Medicare_Inpatient: $3,518.05 Anthem — Medicare_Outpatient: $121.80 Anthem — Pathway_Group_HMO_Pathway_X: $672.95
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 0 In the file: Xcapsl ctrc rmvl w/o ecp	$8,804.80	$7,484.08	$493.55 – $8,804.80
Cataract removal with lens implant: 10 of 26 insurance plan rates Aetna — All_Commercial: $8,804.80 Aetna — Medicare_Outpatient: $2,357.81 AmeriHealth — Medicaid_Outpatient: $493.55 Anthem — Blue_Access_Blue_Preferred: $6,277.82 Anthem — Blue_Access_I-II_Enhanced_Choice_Pathway_X: $5,547.02 Anthem — Medicaid_Outpatient: $523.59 Anthem — Medicare_Outpatient: $2,357.81 Anthem — Pathway_Group_HMO_Pathway_X: $5,547.02 Anthem — Traditional_Blue_Access_Blue_Preferred: $6,277.82 Buckeye — Medicaid_Outpatient: $523.59

Source: Avita Ontario’s standard charges file (avitahealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 23, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	715 Richland Mall, Ontario, OH 44906
County	Richland County
State	Ohio
Phone	(419) 462‑4534
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	360365
Name in Medicare records	AVITA ONTARIO
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(567) 307‑7557^[4]
Name on the hospital’s website	Avita Ontario Hospital
Official website	avitahealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Avita Health System Locations — avitahealth.org
About Us — avitahealth.org
Emergency Medicine — avitahealth.org
Heart & Vascular Care | Avita Health System — avitahealth.org
Women's Health | Avita Health System — avitahealth.org
Orthopedics | Avita Health System — avitahealth.org

Avita Ontario

Summary

Profile from official sources

At a glance