Does Bates County Memorial Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Bates County Memorial Hospital. In a medical emergency, call 911.

Where is Bates County Memorial Hospital?

615 W Nursery St, Butler, MO 64730, in Bates County, Missouri.

What is the phone number of Bates County Memorial Hospital?

(660) 200-7000, as listed by Medicare (CMS).

What is the Medicare star rating of Bates County Memorial Hospital?

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

Bates County Memorial Hospital — Butler, MO

Quick answers

Does Bates County Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Bates County Memorial Hospital. In a medical emergency, call 911.
Where is Bates County Memorial Hospital?: 615 W Nursery St, Butler, MO 64730, in Bates County, Missouri.
What is the phone number of Bates County Memorial Hospital?: (660) 200-7000, as listed by Medicare (CMS).
What is the Medicare star rating of Bates County Memorial Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][7][15]

Treatments^[4][8][15]

Infusion
Cardiac-pulmonary rehabilitation
Physical, occupational and speech therapy
Nutrition counseling
Chemotherapy
Immunotherapy
Allergy injections
Outpatient IV antibiotic therapy
Appendectomy
Carpal tunnel surgery
Cataract surgery
Endoscopy procedures
Foot and ankle surgery
Tendon and joint repair
Total joint replacement
Gallbladder removal
Gastrointestinal and colon surgery
Hernia repair
Large and small bowel resection
Port placement
Nerve pain relief treatments
Hammertoe treatment

Procedures^{[4][6][9][10][11][12][13][14]}

Endoscopy
Cataract surgery
Surgical services
Biopsies (interventional radiology)
Kyphoplasty
Arthrography
Myelography
X-ray (diagnostic radiology)
CT scan
MRI
PET scan
Nuclear medicine scan
Myocardial perfusion stress test
Stress echocardiogram
Treadmill stress test
Ultrasound
Mammography
Bone densitometry
Fluoroscopy

Programs and centers^[5][8][17]

Long-Nissen Infusion Center
24-hour advanced life support ambulance service
Emergency telemedicine for stroke evaluation
Spiritual Care Program

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

Emergency room	Yes
Open 24/7	Yes
Stroke designation	AHA Get With The Guidelines-Stroke Rural Recognition GOLD

Visiting and practical information

Visiting	Visitors welcome; inpatient quiet hours 10 pm-6 am; call the nurses' desk before visiting^[17]
Parking	ER parking available; South parking lot is by the Emergency Entrance^[5][8][17]
Patient portal	Patient portal

Doctors and clinicians (87)

87 doctors and other clinicians list Bates County Memorial Hospital 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 (87)

Aaron L. Travis, DOInternal Medicine
Abigayle R. ShubertPhysician Assistant
Ahmed Babar, MDInternal Medicine
Amit Patel, MDHospitalist
Babar S. Ahmed, MDEmergency Medicine
Bangalore V. Deepak, MDInterventional Cardiology
Benjamin N. Crary, DOFamily Practice
Bhupinderjit Ballagan, PAPhysician Assistant
Brandon T. Johnson, MDOtolaryngology
Brooke Dougan, CNACertified Registered Nurse Anesthetist (CRNA)
Caitlin E. Rooney, DOGeneral Surgery
Caleb N. Pace, DPMPodiatry
Casey L. BrownNurse Practitioner
Cesar D. Rios, MDCardiovascular Disease (Cardiology)
Christopher Riffel, MDInternal Medicine
Cooper D. Rodgers, MDOphthalmology
Craig H. Lundgren, MDCardiovascular Disease (Cardiology)
Daniel J. Geha, MDInfectious Disease
Daniel K. Bixler, MDEmergency Medicine
Danny K. Carroll, MDOrthopedic Surgery
David J. Burkart, MDInterventional Radiology
Demi Dawkins, MDNeurosurgery
Doyle T. Witt, MDEmergency Medicine
Emily Johnston, NPNurse Practitioner

And 63 more: the button below opens the full list.

Other emergency rooms nearby

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

Ellett Memorial Hospital19 mi · Appleton City, MO · Critical Access Hospital
Cass Regional Medical Center29 mi · Harrisonville, MO · Critical Access Hospital
Nevada Regional Medical Center29 mi · Nevada, MO · Acute Care Hospital
Golden Valley Memorial Hospital32 mi · Clinton, MO · Acute Care Hospital
Cedar County Memorial Hospital32 mi · El Dorado Springs, MO · Critical Access Hospital

Other hospitals nearby

Miami County Medical Center35 mi · Paola, KS · 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

Butler Rehab and Healthcare Center0.2 mi · Butler, MO · 1 of 5 stars
ML Op Butler LLC0.6 mi · Butler, MO · 4 of 5 stars
Baptist Homes of Adrian10 mi · Adrian, MO · 4 of 5 stars

All nursing homes 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

Compass Health Bates County Dental Clinic0.9 mi · Butler, MO · Community health center
Compass Health Bates County Clinic1.1 mi · Butler, MO · Community health center
Community Health Center of Southeast Kansas/Pleasanton20 mi · Pleasanton, KS · Community health center

Clinics and urgent care

Butler Urgent Medicine3.2 mi · Butler, MO · Urgent care center
Family Care Clinic High3.2 mi · Butler, MO · Rural health clinic
Family Care Clinic Nursery3.2 mi · Butler, MO · Rural health clinic

Pharmacies

Summers Pharmacy3.2 mi · Butler, MO · Community/retail pharmacy
Wal-Mart Stores East LP3.2 mi · Butler, MO · Community/retail pharmacy

Assisted living nearby

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

Bristol Manor of Butler3.2 mi · Butler, MO

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 Bates County Memorial Hospital 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	94%National average: 72%
Would definitely recommend the hospital	89%National average: 71%
Nurses “always” communicated well	93%National average: 80%
Doctors “always” communicated well	95%National average: 80%
Staff “always” explained medicines before giving them	90%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	81%National average: 74%
Area around the room “always” quiet at night	77%National average: 60%
Completed surveys	66Response rate: 27%

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	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	15%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.98No different from the national rate
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	18.5%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	95 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	24%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 Missouri Best hospitals in Missouri

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as Bates County Memorial 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 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT LEVEL 3 W/PROC.	$203.81	$142.67	$92.91 – $173.24
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $173.24 Aetna — Medicare Advantage: $109.32 Blue Cross Blue Shield — All PPO Plans: $173.24 Blue Cross Blue Shield — Medicare Advantage: $109.32 Blue Cross Blue Shield — Participating/Traditional: $173.24 Centene-Ambetter — Marketplace: $109.32 Cigna — Commercial: $173.24 Cigna — Medicare Advantage: $109.32 Healthy Blue — Managed Medicaid: $102.20 Home State Health Plan — Managed Medicaid: $92.91
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT LEVEL 3	$203.81	$142.67	$92.91 – $173.24
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $173.24 Aetna — Medicare Advantage: $109.32 Blue Cross Blue Shield — All PPO Plans: $173.24 Blue Cross Blue Shield — Medicare Advantage: $109.32 Blue Cross Blue Shield — Participating/Traditional: $173.24 Centene-Ambetter — Marketplace: $109.32 Cigna — Commercial: $173.24 Cigna — Medicare Advantage: $109.32 Healthy Blue — Managed Medicaid: $102.20 Home State Health Plan — Managed Medicaid: $92.91
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: NEW PAT. DETAILED	$195	$136.50	$69.59 – $165.75
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $165.75 Aetna — Medicare Advantage: $69.59 Blue Cross Blue Shield — All PPO Plans: $165.75 Blue Cross Blue Shield — Medicare Advantage: $69.59 Blue Cross Blue Shield — Participating/Traditional: $165.75 Centene-Ambetter — Marketplace: $69.59 Cigna — Commercial: $165.75 Cigna — Medicare Advantage: $69.59 Humana/Choice Care — Commercial: $69.59 Humana/Choice Care — Medicare Advantage: $69.59
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT LEVEL 4 W/PROC.	$304.52	$213.17	$138.56 – $258.84
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $258.84 Aetna — Medicare Advantage: $165.77 Blue Cross Blue Shield — All PPO Plans: $258.84 Blue Cross Blue Shield — Medicare Advantage: $165.77 Blue Cross Blue Shield — Participating/Traditional: $258.84 Centene-Ambetter — Marketplace: $165.77 Cigna — Commercial: $258.84 Cigna — Medicare Advantage: $165.77 Healthy Blue — Managed Medicaid: $152.42 Home State Health Plan — Managed Medicaid: $138.56
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT LEVEL 4	$304.52	$213.17	$138.56 – $258.84
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $258.84 Aetna — Medicare Advantage: $165.77 Blue Cross Blue Shield — All PPO Plans: $258.84 Blue Cross Blue Shield — Medicare Advantage: $165.77 Blue Cross Blue Shield — Participating/Traditional: $258.84 Centene-Ambetter — Marketplace: $165.77 Cigna — Commercial: $258.84 Cigna — Medicare Advantage: $165.77 Healthy Blue — Managed Medicaid: $152.42 Home State Health Plan — Managed Medicaid: $138.56
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: NEW PAT. COMPREHENSIVE MOD	$265	$185.50	$113.65 – $225.25
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $225.25 Aetna — Medicare Advantage: $113.65 Blue Cross Blue Shield — All PPO Plans: $225.25 Blue Cross Blue Shield — Medicare Advantage: $113.65 Blue Cross Blue Shield — Participating/Traditional: $225.25 Centene-Ambetter — Marketplace: $113.65 Cigna — Commercial: $225.25 Cigna — Medicare Advantage: $113.65 Humana/Choice Care — Commercial: $113.65 Humana/Choice Care — Medicare Advantage: $113.65
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: NEW PATIENT COMPREHENSIVE HIGH	$307	$214.90	$155.68 – $260.95
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $260.95 Aetna — Medicare Advantage: $155.68 Blue Cross Blue Shield — All PPO Plans: $260.95 Blue Cross Blue Shield — Medicare Advantage: $155.68 Blue Cross Blue Shield — Participating/Traditional: $260.95 Centene-Ambetter — Marketplace: $155.68 Cigna — Commercial: $260.95 Cigna — Medicare Advantage: $155.68 Humana/Choice Care — Commercial: $155.68 Humana/Choice Care — Medicare Advantage: $155.68
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: NEW PT MOD/HIGH	$425	$297.50	$155.68 – $361.25
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $361.25 Aetna — Medicare Advantage: $155.68 Blue Cross Blue Shield — All PPO Plans: $361.25 Blue Cross Blue Shield — Medicare Advantage: $155.68 Blue Cross Blue Shield — Participating/Traditional: $361.25 Centene-Ambetter — Marketplace: $155.68 Cigna — Commercial: $361.25 Cigna — Medicare Advantage: $155.68 Humana/Choice Care — Commercial: $155.68 Humana/Choice Care — Medicare Advantage: $155.68
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST. PATIENT LEVEL 3	$223	$156.10	$75.21 – $189.55
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $189.55 Aetna — Medicare Advantage: $88.38 Blue Cross Blue Shield — All PPO Plans: $189.55 Blue Cross Blue Shield — Medicare Advantage: $88.38 Blue Cross Blue Shield — Participating/Traditional: $189.55 Centene-Ambetter — Marketplace: $88.38 Cigna — Commercial: $189.55 Cigna — Medicare Advantage: $88.38 Healthy Blue — Managed Medicaid: $82.73 Home State Health Plan — Managed Medicaid: $75.21
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST. PATIENT LEVEL 3 W/PROC.	$223	$156.10	$75.21 – $189.55
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $189.55 Aetna — Medicare Advantage: $88.38 Blue Cross Blue Shield — All PPO Plans: $189.55 Blue Cross Blue Shield — Medicare Advantage: $88.38 Blue Cross Blue Shield — Participating/Traditional: $189.55 Centene-Ambetter — Marketplace: $88.38 Cigna — Commercial: $189.55 Cigna — Medicare Advantage: $88.38 Healthy Blue — Managed Medicaid: $82.73 Home State Health Plan — Managed Medicaid: $75.21
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: EXT PAT. EXPANDED	$223	$156.10	$55.85 – $189.55
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $189.55 Aetna — Medicare Advantage: $55.85 Blue Cross Blue Shield — All PPO Plans: $189.55 Blue Cross Blue Shield — Medicare Advantage: $55.85 Blue Cross Blue Shield — Participating/Traditional: $189.55 Centene-Ambetter — Marketplace: $55.85 Cigna — Commercial: $189.55 Cigna — Medicare Advantage: $55.85 Humana/Choice Care — Commercial: $55.85 Humana/Choice Care — Medicare Advantage: $55.85
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST. PATIENT LEVEL 4	$293.48	$205.44	$106.15 – $249.46
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $249.46 Aetna — Medicare Advantage: $126.27 Blue Cross Blue Shield — All PPO Plans: $249.46 Blue Cross Blue Shield — Medicare Advantage: $126.27 Blue Cross Blue Shield — Participating/Traditional: $249.46 Centene-Ambetter — Marketplace: $126.27 Cigna — Commercial: $249.46 Cigna — Medicare Advantage: $126.27 Healthy Blue — Managed Medicaid: $116.77 Home State Health Plan — Managed Medicaid: $106.15
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTB PATIENT LEVEL 4 W/PROC	$293.48	$205.44	$106.15 – $249.46
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $249.46 Aetna — Medicare Advantage: $126.27 Blue Cross Blue Shield — All PPO Plans: $249.46 Blue Cross Blue Shield — Medicare Advantage: $126.27 Blue Cross Blue Shield — Participating/Traditional: $249.46 Centene-Ambetter — Marketplace: $126.27 Cigna — Commercial: $249.46 Cigna — Medicare Advantage: $126.27 Healthy Blue — Managed Medicaid: $116.77 Home State Health Plan — Managed Medicaid: $106.15
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: EXT PAT. DETAILED	$319	$223.30	$82.22 – $271.15
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $271.15 Aetna — Medicare Advantage: $82.22 Blue Cross Blue Shield — All PPO Plans: $271.15 Blue Cross Blue Shield — Medicare Advantage: $82.22 Blue Cross Blue Shield — Participating/Traditional: $271.15 Centene-Ambetter — Marketplace: $82.22 Cigna — Commercial: $271.15 Cigna — Medicare Advantage: $82.22 Humana/Choice Care — Commercial: $82.22 Humana/Choice Care — Medicare Advantage: $82.22
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULT 40 MIN	$330	$231	$105.74 – $280.50
Office consultation with a specialist (moderate): 10 of 15 insurance plan rates Aetna — Commercial: $280.50 Aetna — Medicare Advantage: $105.74 Blue Cross Blue Shield — All PPO Plans: $280.50 Blue Cross Blue Shield — Medicare Advantage: $105.74 Blue Cross Blue Shield — Participating/Traditional: $280.50 Centene-Ambetter — Marketplace: $105.74 Cigna — Commercial: $280.50 Cigna — Medicare Advantage: $105.74 Healthy Blue — Managed Medicaid: $132.17 Home State Health Plan — Managed Medicaid: $120.15
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CONSULT 40 MIN	$330	$231	$280.50
Office consultation with a specialist (moderate): rates for 5 insurance plans Aetna — Commercial: $280.50 Blue Cross Blue Shield — All PPO Plans: $280.50 Blue Cross Blue Shield — Participating/Traditional: $280.50 Cigna — Commercial: $280.50 United Healthcare — Commercial: $280.50
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE OUTPATIENT CONSULTATION DETAILED	$203	$142.10	$172.55
Office consultation with a specialist (moderate): rates for 5 insurance plans Aetna — Commercial: $172.55 Blue Cross Blue Shield — All PPO Plans: $172.55 Blue Cross Blue Shield — Participating/Traditional: $172.55 Cigna — Commercial: $172.55 United Healthcare — Commercial: $172.55
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULT 60 MIN	$450	$315	$151.81 – $382.50
Office consultation with a specialist (moderate to high): 10 of 15 insurance plan rates Aetna — Commercial: $382.50 Aetna — Medicare Advantage: $151.81 Blue Cross Blue Shield — All PPO Plans: $382.50 Blue Cross Blue Shield — Medicare Advantage: $151.81 Blue Cross Blue Shield — Participating/Traditional: $382.50 Centene-Ambetter — Marketplace: $151.81 Cigna — Commercial: $382.50 Cigna — Medicare Advantage: $151.81 Healthy Blue — Managed Medicaid: $193.96 Home State Health Plan — Managed Medicaid: $176.33
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CONSULT 60 MIN	$450	$315	$382.50
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Aetna — Commercial: $382.50 Blue Cross Blue Shield — All PPO Plans: $382.50 Blue Cross Blue Shield — Participating/Traditional: $382.50 Cigna — Commercial: $382.50 United Healthcare — Commercial: $382.50
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: CONSULT 60 MIN PF	$320	$224	$272
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Aetna — Commercial: $272 Blue Cross Blue Shield — All PPO Plans: $272 Blue Cross Blue Shield — Participating/Traditional: $272 Cigna — Commercial: $272 United Healthcare — Commercial: $272
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY SERVICES LEVEL III	$908.89	$636.23	$59.80 – $772.56
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — Commercial: $772.56 Aetna — Medicare Advantage: $273.42 Blue Cross Blue Shield — All PPO Plans: $772.56 Blue Cross Blue Shield — Medicare Advantage: $273.42 Blue Cross Blue Shield — Participating/Traditional: $772.56 Centene-Ambetter — Marketplace: $273.42 Cigna — Commercial: $772.56 Cigna — Medicare Advantage: $273.42 Healthy Blue — Managed Medicaid: $65.78 Home State Health Plan — Managed Medicaid: $59.80
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY VISIT III W/ PROC.	$908.89	$636.23	$59.80 – $772.56
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — Commercial: $772.56 Aetna — Medicare Advantage: $273.42 Blue Cross Blue Shield — All PPO Plans: $772.56 Blue Cross Blue Shield — Medicare Advantage: $273.42 Blue Cross Blue Shield — Participating/Traditional: $772.56 Centene-Ambetter — Marketplace: $273.42 Cigna — Commercial: $772.56 Cigna — Medicare Advantage: $273.42 Healthy Blue — Managed Medicaid: $65.78 Home State Health Plan — Managed Medicaid: $59.80
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY SERVICES LEVEL III	$908.89	$636.23	$772.56
Emergency room visit (moderate): rates for 5 insurance plans Aetna — Commercial: $772.56 Blue Cross Blue Shield — All PPO Plans: $772.56 Blue Cross Blue Shield — Participating/Traditional: $772.56 Cigna — Commercial: $772.56 United Healthcare — Commercial: $772.56
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY SERVICES LEVEL IV	$1,475.82	$1,033.08	$100.99 – $1,254.45
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — Commercial: $1,254.45 Aetna — Medicare Advantage: $417.94 Blue Cross Blue Shield — All PPO Plans: $1,254.45 Blue Cross Blue Shield — Medicare Advantage: $417.94 Blue Cross Blue Shield — Participating/Traditional: $1,254.45 Centene-Ambetter — Marketplace: $417.94 Cigna — Commercial: $1,254.45 Cigna — Medicare Advantage: $417.94 Healthy Blue — Managed Medicaid: $111.09 Home State Health Plan — Managed Medicaid: $100.99
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY VISIT IV W/ PROC.	$1,475.82	$1,033.08	$100.99 – $1,254.45
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — Commercial: $1,254.45 Aetna — Medicare Advantage: $417.94 Blue Cross Blue Shield — All PPO Plans: $1,254.45 Blue Cross Blue Shield — Medicare Advantage: $417.94 Blue Cross Blue Shield — Participating/Traditional: $1,254.45 Centene-Ambetter — Marketplace: $417.94 Cigna — Commercial: $1,254.45 Cigna — Medicare Advantage: $417.94 Healthy Blue — Managed Medicaid: $111.09 Home State Health Plan — Managed Medicaid: $100.99
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY SERVICES LEVEL IV	$1,475.82	$1,033.08	$1,254.45
Emergency room visit (moderately high): rates for 5 insurance plans Aetna — Commercial: $1,254.45 Blue Cross Blue Shield — All PPO Plans: $1,254.45 Blue Cross Blue Shield — Participating/Traditional: $1,254.45 Cigna — Commercial: $1,254.45 United Healthcare — Commercial: $1,254.45
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMER. VISIT V	$2,072	$1,450.40	$146.64 – $1,761.20
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — Commercial: $1,761.20 Aetna — Medicare Advantage: $596.49 Blue Cross Blue Shield — All PPO Plans: $1,761.20 Blue Cross Blue Shield — Medicare Advantage: $596.49 Blue Cross Blue Shield — Participating/Traditional: $1,761.20 Centene-Ambetter — Marketplace: $596.49 Cigna — Commercial: $1,761.20 Cigna — Medicare Advantage: $596.49 Healthy Blue — Managed Medicaid: $161.30 Home State Health Plan — Managed Medicaid: $146.64
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY VISIT V W/ PROC.	$2,072	$1,450.40	$146.64 – $1,761.20
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — Commercial: $1,761.20 Aetna — Medicare Advantage: $596.49 Blue Cross Blue Shield — All PPO Plans: $1,761.20 Blue Cross Blue Shield — Medicare Advantage: $596.49 Blue Cross Blue Shield — Participating/Traditional: $1,761.20 Centene-Ambetter — Marketplace: $596.49 Cigna — Commercial: $1,761.20 Cigna — Medicare Advantage: $596.49 Healthy Blue — Managed Medicaid: $161.30 Home State Health Plan — Managed Medicaid: $146.64
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMER. VISIT V	$2,072	$1,450.40	$1,761.20
Emergency room visit (high): rates for 5 insurance plans Aetna — Commercial: $1,761.20 Blue Cross Blue Shield — All PPO Plans: $1,761.20 Blue Cross Blue Shield — Participating/Traditional: $1,761.20 Cigna — Commercial: $1,761.20 United Healthcare — Commercial: $1,761.20

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: BASIC METABOLIC PANEL	$280.13	$196.10	$8.46 – $238.11
Basic metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Commercial: $238.11 Aetna — Medicare Advantage: $8.46 Blue Cross Blue Shield — All PPO Plans: $238.11 Blue Cross Blue Shield — Medicare Advantage: $8.46 Blue Cross Blue Shield — Participating/Traditional: $238.11 Centene-Ambetter — Marketplace: $8.46 Cigna — Commercial: $238.11 Cigna — Medicare Advantage: $8.46 Humana/Choice Care — Commercial: $8.46 Humana/Choice Care — Medicare Advantage: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$280.13	$196.10	$238.11
Basic metabolic panel (blood test): rates for 5 insurance plans Aetna — Commercial: $238.11 Blue Cross Blue Shield — All PPO Plans: $238.11 Blue Cross Blue Shield — Participating/Traditional: $238.11 Cigna — Commercial: $238.11 United Healthcare — Commercial: $238.11
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$355.85	$249.10	$10.56 – $302.47
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Commercial: $302.47 Aetna — Medicare Advantage: $10.56 Blue Cross Blue Shield — All PPO Plans: $302.47 Blue Cross Blue Shield — Medicare Advantage: $10.56 Blue Cross Blue Shield — Participating/Traditional: $302.47 Centene-Ambetter — Marketplace: $10.56 Cigna — Commercial: $302.47 Cigna — Medicare Advantage: $10.56 Humana/Choice Care — Commercial: $10.56 Humana/Choice Care — Medicare Advantage: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$355.85	$249.10	$302.47
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Aetna — Commercial: $302.47 Blue Cross Blue Shield — All PPO Plans: $302.47 Blue Cross Blue Shield — Participating/Traditional: $302.47 Cigna — Commercial: $302.47 United Healthcare — Commercial: $302.47
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PROFILE	$184.95	$129.47	$13.39 – $157.21
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates Aetna — Commercial: $157.21 Aetna — Medicare Advantage: $13.39 Blue Cross Blue Shield — All PPO Plans: $157.21 Blue Cross Blue Shield — Medicare Advantage: $13.39 Blue Cross Blue Shield — Participating/Traditional: $157.21 Centene-Ambetter — Marketplace: $13.39 Cigna — Commercial: $157.21 Cigna — Medicare Advantage: $13.39 Humana/Choice Care — Commercial: $13.39 Humana/Choice Care — Medicare Advantage: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PROFILE	$184.95	$129.47	$157.21
Cholesterol panel (lipid panel): rates for 5 insurance plans Aetna — Commercial: $157.21 Blue Cross Blue Shield — All PPO Plans: $157.21 Blue Cross Blue Shield — Participating/Traditional: $157.21 Cigna — Commercial: $157.21 United Healthcare — Commercial: $157.21
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL PANEL	$377.48	$264.24	$8.68 – $320.86
Kidney function panel: 10 of 12 insurance plan rates Aetna — Commercial: $320.86 Aetna — Medicare Advantage: $8.68 Blue Cross Blue Shield — All PPO Plans: $320.86 Blue Cross Blue Shield — Medicare Advantage: $8.68 Blue Cross Blue Shield — Participating/Traditional: $320.86 Centene-Ambetter — Marketplace: $8.68 Cigna — Commercial: $320.86 Cigna — Medicare Advantage: $8.68 Humana/Choice Care — Commercial: $8.68 Humana/Choice Care — Medicare Advantage: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL PANEL	$377.48	$264.24	$320.86
Kidney function panel: rates for 5 insurance plans Aetna — Commercial: $320.86 Blue Cross Blue Shield — All PPO Plans: $320.86 Blue Cross Blue Shield — Participating/Traditional: $320.86 Cigna — Commercial: $320.86 United Healthcare — Commercial: $320.86
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER PROFILE	$471.58	$330.11	$8.17 – $400.84
Liver function panel: 10 of 12 insurance plan rates Aetna — Commercial: $400.84 Aetna — Medicare Advantage: $8.17 Blue Cross Blue Shield — All PPO Plans: $400.84 Blue Cross Blue Shield — Medicare Advantage: $8.17 Blue Cross Blue Shield — Participating/Traditional: $400.84 Centene-Ambetter — Marketplace: $8.17 Cigna — Commercial: $400.84 Cigna — Medicare Advantage: $8.17 Humana/Choice Care — Commercial: $8.17 Humana/Choice Care — Medicare Advantage: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIVER PROFILE	$471.58	$330.11	$400.84
Liver function panel: rates for 5 insurance plans Aetna — Commercial: $400.84 Blue Cross Blue Shield — All PPO Plans: $400.84 Blue Cross Blue Shield — Participating/Traditional: $400.84 Cigna — Commercial: $400.84 United Healthcare — Commercial: $400.84
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS	$184.95	$129.47	$3.17 – $157.21
Urine test (automated, with microscope): 10 of 12 insurance plan rates Aetna — Commercial: $157.21 Aetna — Medicare Advantage: $3.17 Blue Cross Blue Shield — All PPO Plans: $157.21 Blue Cross Blue Shield — Medicare Advantage: $3.17 Blue Cross Blue Shield — Participating/Traditional: $157.21 Centene-Ambetter — Marketplace: $3.17 Cigna — Commercial: $157.21 Cigna — Medicare Advantage: $3.17 Humana/Choice Care — Commercial: $3.17 Humana/Choice Care — Medicare Advantage: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS MICRO	$19	$13.30	$3.17 – $16.15
Urine test (automated, with microscope): 10 of 12 insurance plan rates Aetna — Commercial: $16.15 Aetna — Medicare Advantage: $3.17 Blue Cross Blue Shield — All PPO Plans: $16.15 Blue Cross Blue Shield — Medicare Advantage: $3.17 Blue Cross Blue Shield — Participating/Traditional: $16.15 Centene-Ambetter — Marketplace: $3.17 Cigna — Commercial: $16.15 Cigna — Medicare Advantage: $3.17 Humana/Choice Care — Commercial: $3.17 Humana/Choice Care — Medicare Advantage: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS	$184.95	$129.47	$157.21
Urine test (automated, with microscope): rates for 5 insurance plans Aetna — Commercial: $157.21 Blue Cross Blue Shield — All PPO Plans: $157.21 Blue Cross Blue Shield — Participating/Traditional: $157.21 Cigna — Commercial: $157.21 United Healthcare — Commercial: $157.21
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PH UA	$31.84	$22.29	$3.48 – $27.06
Urine test (manual, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $27.06 Aetna — Medicare Advantage: $3.48 Blue Cross Blue Shield — All PPO Plans: $27.06 Blue Cross Blue Shield — Medicare Advantage: $3.48 Blue Cross Blue Shield — Participating/Traditional: $27.06 Centene-Ambetter — Marketplace: $3.48 Cigna — Commercial: $27.06 Cigna — Medicare Advantage: $3.48 Humana/Choice Care — Commercial: $3.48 Humana/Choice Care — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE KETONES	$53.74	$37.62	$3.48 – $45.68
Urine test (manual, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $45.68 Aetna — Medicare Advantage: $3.48 Blue Cross Blue Shield — All PPO Plans: $45.68 Blue Cross Blue Shield — Medicare Advantage: $3.48 Blue Cross Blue Shield — Participating/Traditional: $45.68 Centene-Ambetter — Marketplace: $3.48 Cigna — Commercial: $45.68 Cigna — Medicare Advantage: $3.48 Humana/Choice Care — Commercial: $3.48 Humana/Choice Care — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NON-AUTOMATED	$13	$9.10	$3.48 – $11.05
Urine test (manual, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $11.05 Aetna — Medicare Advantage: $3.48 Blue Cross Blue Shield — All PPO Plans: $11.05 Blue Cross Blue Shield — Medicare Advantage: $3.48 Blue Cross Blue Shield — Participating/Traditional: $11.05 Centene-Ambetter — Marketplace: $3.48 Cigna — Commercial: $11.05 Cigna — Medicare Advantage: $3.48 Humana/Choice Care — Commercial: $3.48 Humana/Choice Care — Medicare Advantage: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIPSTICK UA	$60.75	$42.53	$2.25 – $51.64
Urine test (automated, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $51.64 Aetna — Medicare Advantage: $2.25 Blue Cross Blue Shield — All PPO Plans: $51.64 Blue Cross Blue Shield — Medicare Advantage: $2.25 Blue Cross Blue Shield — Participating/Traditional: $51.64 Centene-Ambetter — Marketplace: $2.25 Cigna — Commercial: $51.64 Cigna — Medicare Advantage: $2.25 Humana/Choice Care — Commercial: $2.25 Humana/Choice Care — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY (SPGR) UA	$59.61	$41.73	$2.25 – $50.67
Urine test (automated, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $50.67 Aetna — Medicare Advantage: $2.25 Blue Cross Blue Shield — All PPO Plans: $50.67 Blue Cross Blue Shield — Medicare Advantage: $2.25 Blue Cross Blue Shield — Participating/Traditional: $50.67 Centene-Ambetter — Marketplace: $2.25 Cigna — Commercial: $50.67 Cigna — Medicare Advantage: $2.25 Humana/Choice Care — Commercial: $2.25 Humana/Choice Care — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTOMATED W/O MICROSCOPY	$23	$16.10	$2.25 – $19.55
Urine test (automated, without microscope): 10 of 12 insurance plan rates Aetna — Commercial: $19.55 Aetna — Medicare Advantage: $2.25 Blue Cross Blue Shield — All PPO Plans: $19.55 Blue Cross Blue Shield — Medicare Advantage: $2.25 Blue Cross Blue Shield — Participating/Traditional: $19.55 Centene-Ambetter — Marketplace: $2.25 Cigna — Commercial: $19.55 Cigna — Medicare Advantage: $2.25 Humana/Choice Care — Commercial: $2.25 Humana/Choice Care — Medicare Advantage: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA ULTRASENSITIVE	$129.79	$90.86	$18.39 – $110.32
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — Commercial: $110.32 Aetna — Medicare Advantage: $18.39 Blue Cross Blue Shield — All PPO Plans: $110.32 Blue Cross Blue Shield — Medicare Advantage: $18.39 Blue Cross Blue Shield — Participating/Traditional: $110.32 Centene-Ambetter — Marketplace: $18.39 Cigna — Commercial: $110.32 Cigna — Medicare Advantage: $18.39 Humana/Choice Care — Commercial: $18.39 Humana/Choice Care — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC	$114.43	$80.11	$18.39 – $97.27
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — Commercial: $97.27 Aetna — Medicare Advantage: $18.39 Blue Cross Blue Shield — All PPO Plans: $97.27 Blue Cross Blue Shield — Medicare Advantage: $18.39 Blue Cross Blue Shield — Participating/Traditional: $97.27 Centene-Ambetter — Marketplace: $18.39 Cigna — Commercial: $97.27 Cigna — Medicare Advantage: $18.39 Humana/Choice Care — Commercial: $18.39 Humana/Choice Care — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA ULTRASENSITIVE	$129.79	$90.86	$110.32
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Aetna — Commercial: $110.32 Blue Cross Blue Shield — All PPO Plans: $110.32 Blue Cross Blue Shield — Participating/Traditional: $110.32 Cigna — Commercial: $110.32 United Healthcare — Commercial: $110.32
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$194.69	$136.29	$16.80 – $165.49
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates Aetna — Commercial: $165.49 Aetna — Medicare Advantage: $16.80 Blue Cross Blue Shield — All PPO Plans: $165.49 Blue Cross Blue Shield — Medicare Advantage: $16.80 Blue Cross Blue Shield — Participating/Traditional: $165.49 Centene-Ambetter — Marketplace: $16.80 Cigna — Commercial: $165.49 Cigna — Medicare Advantage: $16.80 Humana/Choice Care — Commercial: $16.80 Humana/Choice Care — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH	$194.69	$136.29	$165.49
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Aetna — Commercial: $165.49 Blue Cross Blue Shield — All PPO Plans: $165.49 Blue Cross Blue Shield — Participating/Traditional: $165.49 Cigna — Commercial: $165.49 United Healthcare — Commercial: $165.49
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH DIFF	$270.40	$189.28	$7.77 – $229.84
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — Commercial: $229.84 Aetna — Medicare Advantage: $7.77 Blue Cross Blue Shield — All PPO Plans: $229.84 Blue Cross Blue Shield — Medicare Advantage: $7.77 Blue Cross Blue Shield — Participating/Traditional: $229.84 Centene-Ambetter — Marketplace: $7.77 Cigna — Commercial: $229.84 Cigna — Medicare Advantage: $7.77 Humana/Choice Care — Commercial: $7.77 Humana/Choice Care — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC-POCHI	$152.25	$106.58	$7.77 – $129.41
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — Commercial: $129.41 Aetna — Medicare Advantage: $7.77 Blue Cross Blue Shield — All PPO Plans: $129.41 Blue Cross Blue Shield — Medicare Advantage: $7.77 Blue Cross Blue Shield — Participating/Traditional: $129.41 Centene-Ambetter — Marketplace: $7.77 Cigna — Commercial: $129.41 Cigna — Medicare Advantage: $7.77 Humana/Choice Care — Commercial: $7.77 Humana/Choice Care — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC WITH DIFF	$270.40	$189.28	$229.84
Complete blood count (CBC) with differential: rates for 5 insurance plans Aetna — Commercial: $229.84 Blue Cross Blue Shield — All PPO Plans: $229.84 Blue Cross Blue Shield — Participating/Traditional: $229.84 Cigna — Commercial: $229.84 United Healthcare — Commercial: $229.84
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEMOGRAM BILLING	$165.48	$115.84	$6.47 – $140.66
Complete blood count (CBC), automated: 10 of 12 insurance plan rates Aetna — Commercial: $140.66 Aetna — Medicare Advantage: $6.47 Blue Cross Blue Shield — All PPO Plans: $140.66 Blue Cross Blue Shield — Medicare Advantage: $6.47 Blue Cross Blue Shield — Participating/Traditional: $140.66 Centene-Ambetter — Marketplace: $6.47 Cigna — Commercial: $140.66 Cigna — Medicare Advantage: $6.47 Humana/Choice Care — Commercial: $6.47 Humana/Choice Care — Medicare Advantage: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEMOGRAM BILLING	$165.48	$115.84	$140.66
Complete blood count (CBC), automated: rates for 5 insurance plans Aetna — Commercial: $140.66 Blue Cross Blue Shield — All PPO Plans: $140.66 Blue Cross Blue Shield — Participating/Traditional: $140.66 Cigna — Commercial: $140.66 United Healthcare — Commercial: $140.66
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTIME POC	$110.32	$77.23	$4.29 – $93.77
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — Commercial: $93.77 Aetna — Medicare Advantage: $4.29 Blue Cross Blue Shield — All PPO Plans: $93.77 Blue Cross Blue Shield — Medicare Advantage: $4.29 Blue Cross Blue Shield — Participating/Traditional: $93.77 Centene-Ambetter — Marketplace: $4.29 Cigna — Commercial: $93.77 Cigna — Medicare Advantage: $4.29 Humana/Choice Care — Commercial: $4.29 Humana/Choice Care — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTIME	$110.32	$77.23	$4.29 – $93.77
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — Commercial: $93.77 Aetna — Medicare Advantage: $4.29 Blue Cross Blue Shield — All PPO Plans: $93.77 Blue Cross Blue Shield — Medicare Advantage: $4.29 Blue Cross Blue Shield — Participating/Traditional: $93.77 Centene-Ambetter — Marketplace: $4.29 Cigna — Commercial: $93.77 Cigna — Medicare Advantage: $4.29 Humana/Choice Care — Commercial: $4.29 Humana/Choice Care — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT MIXING STUDIES	$287.58	$201.31	$4.29 – $244.44
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — Commercial: $244.44 Aetna — Medicare Advantage: $4.29 Blue Cross Blue Shield — All PPO Plans: $244.44 Blue Cross Blue Shield — Medicare Advantage: $4.29 Blue Cross Blue Shield — Participating/Traditional: $244.44 Centene-Ambetter — Marketplace: $4.29 Cigna — Commercial: $244.44 Cigna — Medicare Advantage: $4.29 Humana/Choice Care — Commercial: $4.29 Humana/Choice Care — Medicare Advantage: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT	$142.77	$99.94	$6.01 – $121.35
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates Aetna — Commercial: $121.35 Aetna — Medicare Advantage: $6.01 Blue Cross Blue Shield — All PPO Plans: $121.35 Blue Cross Blue Shield — Medicare Advantage: $6.01 Blue Cross Blue Shield — Participating/Traditional: $121.35 Centene-Ambetter — Marketplace: $6.01 Cigna — Commercial: $121.35 Cigna — Medicare Advantage: $6.01 Humana/Choice Care — Commercial: $6.01 Humana/Choice Care — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT MIXING STUDIES	$131.35	$91.95	$6.01 – $111.65
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates Aetna — Commercial: $111.65 Aetna — Medicare Advantage: $6.01 Blue Cross Blue Shield — All PPO Plans: $111.65 Blue Cross Blue Shield — Medicare Advantage: $6.01 Blue Cross Blue Shield — Participating/Traditional: $111.65 Centene-Ambetter — Marketplace: $6.01 Cigna — Commercial: $111.65 Cigna — Medicare Advantage: $6.01 Humana/Choice Care — Commercial: $6.01 Humana/Choice Care — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: APTT	$142.77	$99.94	$121.35
Blood clotting test (partial thromboplastin time, PTT): rates for 5 insurance plans Aetna — Commercial: $121.35 Blue Cross Blue Shield — All PPO Plans: $121.35 Blue Cross Blue Shield — Participating/Traditional: $121.35 Cigna — Commercial: $121.35 United Healthcare — Commercial: $121.35

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: COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL	$116.64	$81.65	$38.66 – $99.14
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Aetna — Commercial: $99.14 Aetna — Medicare Advantage: $95.90 Blue Cross Blue Shield — All PPO Plans: $99.14 Blue Cross Blue Shield — Medicare Advantage: $95.90 Blue Cross Blue Shield — Participating/Traditional: $99.14 Centene-Ambetter — Marketplace: $95.90 Cigna — Commercial: $99.14 Cigna — Medicare Advantage: $95.90 Healthy Blue — Managed Medicaid: $42.53 Home State Health Plan — Managed Medicaid: $38.66
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT BRAIN WO	$2,759.16	$1,931.42	$104.71 – $2,345.29
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $2,345.29 Aetna — Medicare Advantage: $104.71 Blue Cross Blue Shield — All PPO Plans: $2,345.29 Blue Cross Blue Shield — Medicare Advantage: $104.71 Blue Cross Blue Shield — Participating/Traditional: $2,345.29 Centene-Ambetter — Marketplace: $104.71 Cigna — Commercial: $2,345.29 Cigna — Medicare Advantage: $104.71 Humana/Choice Care — Commercial: $104.71 Humana/Choice Care — Medicare Advantage: $104.71
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT BRAIN WO	$2,759.16	$1,931.42	$2,345.29
CT scan of the head or brain, without contrast: rates for 5 insurance plans Aetna — Commercial: $2,345.29 Blue Cross Blue Shield — All PPO Plans: $2,345.29 Blue Cross Blue Shield — Participating/Traditional: $2,345.29 Cigna — Commercial: $2,345.29 United Healthcare — Commercial: $2,345.29
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES	$314.96	$220.48	$106.39 – $284.11
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates Aetna — Commercial: $267.72 Aetna — Medicare Advantage: $284.11 Blue Cross Blue Shield — All PPO Plans: $267.72 Blue Cross Blue Shield — Medicare Advantage: $284.11 Blue Cross Blue Shield — Participating/Traditional: $267.72 Centene-Ambetter — Marketplace: $284.11 Cigna — Commercial: $267.72 Cigna — Medicare Advantage: $284.11 Healthy Blue — Managed Medicaid: $117.03 Home State Health Plan — Managed Medicaid: $106.39
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN WO / W	$5,321.47	$3,725.03	$349.44 – $4,523.25
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates Aetna — Commercial: $4,523.25 Aetna — Medicare Advantage: $349.44 Blue Cross Blue Shield — All PPO Plans: $4,523.25 Blue Cross Blue Shield — Medicare Advantage: $349.44 Blue Cross Blue Shield — Participating/Traditional: $4,523.25 Centene-Ambetter — Marketplace: $349.44 Cigna — Commercial: $4,523.25 Cigna — Medicare Advantage: $349.44 Humana/Choice Care — Commercial: $349.44 Humana/Choice Care — Medicare Advantage: $349.44
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN WO / W	$5,321.47	$3,725.03	$4,523.25
MRI of the brain, before and after contrast: rates for 5 insurance plans Aetna — Commercial: $4,523.25 Blue Cross Blue Shield — All PPO Plans: $4,523.25 Blue Cross Blue Shield — Participating/Traditional: $4,523.25 Cigna — Commercial: $4,523.25 United Healthcare — Commercial: $4,523.25
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS	$32.14	$22.50	$7.97 – $29.55
Chest X-ray, 2 views: 10 of 15 insurance plan rates Aetna — Commercial: $27.32 Aetna — Medicare Advantage: $29.55 Blue Cross Blue Shield — All PPO Plans: $27.32 Blue Cross Blue Shield — Medicare Advantage: $29.55 Blue Cross Blue Shield — Participating/Traditional: $27.32 Centene-Ambetter — Marketplace: $29.55 Cigna — Commercial: $27.32 Cigna — Medicare Advantage: $29.55 Healthy Blue — Managed Medicaid: $8.77 Home State Health Plan — Managed Medicaid: $7.97
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX CHEST PA & LAT 2 VIEW	$751.71	$526.20	$87.17 – $638.95
Chest X-ray, 2 views: 10 of 12 insurance plan rates Aetna — Commercial: $638.95 Aetna — Medicare Advantage: $87.17 Blue Cross Blue Shield — All PPO Plans: $638.95 Blue Cross Blue Shield — Medicare Advantage: $87.17 Blue Cross Blue Shield — Participating/Traditional: $638.95 Centene-Ambetter — Marketplace: $87.17 Cigna — Commercial: $638.95 Cigna — Medicare Advantage: $87.17 Humana/Choice Care — Commercial: $87.17 Humana/Choice Care — Medicare Advantage: $87.17
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX CHEST DECUB 2 VIEWS	$632.86	$443.01	$87.17 – $537.93
Chest X-ray, 2 views: 10 of 12 insurance plan rates Aetna — Commercial: $537.93 Aetna — Medicare Advantage: $87.17 Blue Cross Blue Shield — All PPO Plans: $537.93 Blue Cross Blue Shield — Medicare Advantage: $87.17 Blue Cross Blue Shield — Participating/Traditional: $537.93 Centene-Ambetter — Marketplace: $87.17 Cigna — Commercial: $537.93 Cigna — Medicare Advantage: $87.17 Humana/Choice Care — Commercial: $87.17 Humana/Choice Care — Medicare Advantage: $87.17
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF 4 VIEWS	$39.21	$27.45	$13.60 – $47.33
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Aetna — Commercial: $33.33 Aetna — Medicare Advantage: $47.33 Blue Cross Blue Shield — All PPO Plans: $33.33 Blue Cross Blue Shield — Medicare Advantage: $47.33 Blue Cross Blue Shield — Participating/Traditional: $33.33 Centene-Ambetter — Marketplace: $47.33 Cigna — Commercial: $33.33 Cigna — Medicare Advantage: $47.33 Healthy Blue — Managed Medicaid: $14.96 Home State Health Plan — Managed Medicaid: $13.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX LUMBAR SPINE COMPLETE	$1,012.38	$708.67	$104.71 – $860.52
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates Aetna — Commercial: $860.52 Aetna — Medicare Advantage: $104.71 Blue Cross Blue Shield — All PPO Plans: $860.52 Blue Cross Blue Shield — Medicare Advantage: $104.71 Blue Cross Blue Shield — Participating/Traditional: $860.52 Centene-Ambetter — Marketplace: $104.71 Cigna — Commercial: $860.52 Cigna — Medicare Advantage: $104.71 Humana/Choice Care — Commercial: $104.71 Humana/Choice Care — Medicare Advantage: $104.71
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX LUMBAR SPINE COMPLETE	$1,012.38	$708.67	$860.52
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Aetna — Commercial: $860.52 Blue Cross Blue Shield — All PPO Plans: $860.52 Blue Cross Blue Shield — Participating/Traditional: $860.52 Cigna — Commercial: $860.52 United Healthcare — Commercial: $860.52
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL	$203.06	$142.15	$66.80 – $172.60
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates Aetna — Commercial: $172.60 Aetna — Medicare Advantage: $172.28 Blue Cross Blue Shield — All PPO Plans: $172.60 Blue Cross Blue Shield — Medicare Advantage: $172.28 Blue Cross Blue Shield — Participating/Traditional: $172.60 Centene-Ambetter — Marketplace: $172.28 Cigna — Commercial: $172.60 Cigna — Medicare Advantage: $172.28 Healthy Blue — Managed Medicaid: $73.48 Home State Health Plan — Managed Medicaid: $66.80
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR WO	$4,092.77	$2,864.94	$238.99 – $3,478.85
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $3,478.85 Aetna — Medicare Advantage: $238.99 Blue Cross Blue Shield — All PPO Plans: $3,478.85 Blue Cross Blue Shield — Medicare Advantage: $238.99 Blue Cross Blue Shield — Participating/Traditional: $3,478.85 Centene-Ambetter — Marketplace: $238.99 Cigna — Commercial: $3,478.85 Cigna — Medicare Advantage: $238.99 Humana/Choice Care — Commercial: $238.99 Humana/Choice Care — Medicare Advantage: $238.99
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LUMBAR WO	$4,092.77	$2,864.94	$3,478.85
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans Aetna — Commercial: $3,478.85 Blue Cross Blue Shield — All PPO Plans: $3,478.85 Blue Cross Blue Shield — Participating/Traditional: $3,478.85 Cigna — Commercial: $3,478.85 United Healthcare — Commercial: $3,478.85
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)	$158.44	$110.91	$50.60 – $200.18
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Aetna — Commercial: $134.67 Aetna — Medicare Advantage: $200.18 Blue Cross Blue Shield — All PPO Plans: $134.67 Blue Cross Blue Shield — Medicare Advantage: $200.18 Blue Cross Blue Shield — Participating/Traditional: $134.67 Centene-Ambetter — Marketplace: $200.18 Cigna — Commercial: $134.67 Cigna — Medicare Advantage: $200.18 Healthy Blue — Managed Medicaid: $55.66 Home State Health Plan — Managed Medicaid: $50.60
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W	$3,733.51	$2,613.46	$175.68 – $3,173.48
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Commercial: $3,173.48 Aetna — Medicare Advantage: $175.68 Blue Cross Blue Shield — All PPO Plans: $3,173.48 Blue Cross Blue Shield — Medicare Advantage: $175.68 Blue Cross Blue Shield — Participating/Traditional: $3,173.48 Centene-Ambetter — Marketplace: $175.68 Cigna — Commercial: $3,173.48 Cigna — Medicare Advantage: $175.68 Humana/Choice Care — Commercial: $175.68 Humana/Choice Care — Medicare Advantage: $175.68
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W	$3,733.51	$2,613.46	$3,173.48
CT scan of the pelvis, with contrast: rates for 5 insurance plans Aetna — Commercial: $3,173.48 Blue Cross Blue Shield — All PPO Plans: $3,173.48 Blue Cross Blue Shield — Participating/Traditional: $3,173.48 Cigna — Commercial: $3,173.48 United Healthcare — Commercial: $3,173.48
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL	$185.48	$129.84	$60.72 – $182.63
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Aetna — Commercial: $157.66 Aetna — Medicare Advantage: $182.63 Blue Cross Blue Shield — All PPO Plans: $157.66 Blue Cross Blue Shield — Medicare Advantage: $182.63 Blue Cross Blue Shield — Participating/Traditional: $157.66 Centene-Ambetter — Marketplace: $182.63 Cigna — Commercial: $157.66 Cigna — Medicare Advantage: $182.63 Healthy Blue — Managed Medicaid: $66.79 Home State Health Plan — Managed Medicaid: $60.72
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI HIP WO RIGHT	$4,092.77	$2,864.94	$238.99 – $3,478.85
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $3,478.85 Aetna — Medicare Advantage: $238.99 Blue Cross Blue Shield — All PPO Plans: $3,478.85 Blue Cross Blue Shield — Medicare Advantage: $238.99 Blue Cross Blue Shield — Participating/Traditional: $3,478.85 Centene-Ambetter — Marketplace: $238.99 Cigna — Commercial: $3,478.85 Cigna — Medicare Advantage: $238.99 Humana/Choice Care — Commercial: $238.99 Humana/Choice Care — Medicare Advantage: $238.99
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI KNEE WO RIGHT	$4,092.77	$2,864.94	$238.99 – $3,478.85
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $3,478.85 Aetna — Medicare Advantage: $238.99 Blue Cross Blue Shield — All PPO Plans: $3,478.85 Blue Cross Blue Shield — Medicare Advantage: $238.99 Blue Cross Blue Shield — Participating/Traditional: $3,478.85 Centene-Ambetter — Marketplace: $238.99 Cigna — Commercial: $3,478.85 Cigna — Medicare Advantage: $238.99 Humana/Choice Care — Commercial: $238.99 Humana/Choice Care — Medicare Advantage: $238.99
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)	$250.90	$175.63	$66.03 – $267.77
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — Commercial: $213.27 Aetna — Medicare Advantage: $267.77 Blue Cross Blue Shield — All PPO Plans: $213.27 Blue Cross Blue Shield — Medicare Advantage: $267.77 Blue Cross Blue Shield — Participating/Traditional: $213.27 Centene-Ambetter — Marketplace: $267.77 Cigna — Commercial: $213.27 Cigna — Medicare Advantage: $267.77 Healthy Blue — Managed Medicaid: $72.63 Home State Health Plan — Managed Medicaid: $66.03
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ENTEROGRAPHY	$3,094.50	$2,166.15	$349.44 – $2,630.33
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Commercial: $2,630.33 Aetna — Medicare Advantage: $349.44 Blue Cross Blue Shield — All PPO Plans: $2,630.33 Blue Cross Blue Shield — Medicare Advantage: $349.44 Blue Cross Blue Shield — Participating/Traditional: $2,630.33 Centene-Ambetter — Marketplace: $349.44 Cigna — Commercial: $2,630.33 Cigna — Medicare Advantage: $349.44 Humana/Choice Care — Commercial: $349.44 Humana/Choice Care — Medicare Advantage: $349.44
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD/PELVIS W	$4,867.95	$3,407.57	$349.44 – $4,137.76
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Commercial: $4,137.76 Aetna — Medicare Advantage: $349.44 Blue Cross Blue Shield — All PPO Plans: $4,137.76 Blue Cross Blue Shield — Medicare Advantage: $349.44 Blue Cross Blue Shield — Participating/Traditional: $4,137.76 Centene-Ambetter — Marketplace: $349.44 Cigna — Commercial: $4,137.76 Cigna — Medicare Advantage: $349.44 Humana/Choice Care — Commercial: $349.44 Humana/Choice Care — Medicare Advantage: $349.44
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$110.81	$77.57	$29.30 – $102.33
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Aetna — Commercial: $94.19 Aetna — Medicare Advantage: $102.33 Blue Cross Blue Shield — All PPO Plans: $94.19 Blue Cross Blue Shield — Medicare Advantage: $102.33 Blue Cross Blue Shield — Participating/Traditional: $94.19 Centene-Ambetter — Marketplace: $102.33 Cigna — Commercial: $94.19 Cigna — Medicare Advantage: $102.33 Healthy Blue — Managed Medicaid: $32.23 Home State Health Plan — Managed Medicaid: $29.30
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$1,539.12	$1,077.39	$104.71 – $1,308.25
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates Aetna — Commercial: $1,308.25 Aetna — Medicare Advantage: $104.71 Blue Cross Blue Shield — All PPO Plans: $1,308.25 Blue Cross Blue Shield — Medicare Advantage: $104.71 Blue Cross Blue Shield — Participating/Traditional: $1,308.25 Centene-Ambetter — Marketplace: $104.71 Cigna — Commercial: $1,308.25 Cigna — Medicare Advantage: $104.71 Humana/Choice Care — Commercial: $104.71 Humana/Choice Care — Medicare Advantage: $104.71
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$1,539.12	$1,077.39	$1,308.25
Ultrasound of the abdomen, complete: rates for 5 insurance plans Aetna — Commercial: $1,308.25 Blue Cross Blue Shield — All PPO Plans: $1,308.25 Blue Cross Blue Shield — Participating/Traditional: $1,308.25 Cigna — Commercial: $1,308.25 United Healthcare — Commercial: $1,308.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, AFTER FIRST TRIMESTER (> OR = 14 WEEKS 0 DAY	$136.81	$95.77	$35.99 – $121.63
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Aetna — Commercial: $116.29 Aetna — Medicare Advantage: $121.63 Blue Cross Blue Shield — All PPO Plans: $116.29 Blue Cross Blue Shield — Medicare Advantage: $121.63 Blue Cross Blue Shield — Participating/Traditional: $116.29 Centene-Ambetter — Marketplace: $121.63 Cigna — Commercial: $116.29 Cigna — Medicare Advantage: $121.63 Healthy Blue — Managed Medicaid: $39.59 Home State Health Plan — Managed Medicaid: $35.99
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US OB > 14 WEEKS	$1,362.82	$953.98	$104.71 – $1,158.40
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates Aetna — Commercial: $1,158.40 Aetna — Medicare Advantage: $104.71 Blue Cross Blue Shield — All PPO Plans: $1,158.40 Blue Cross Blue Shield — Medicare Advantage: $104.71 Blue Cross Blue Shield — Participating/Traditional: $1,158.40 Centene-Ambetter — Marketplace: $104.71 Cigna — Commercial: $1,158.40 Cigna — Medicare Advantage: $104.71 Humana/Choice Care — Commercial: $104.71 Humana/Choice Care — Medicare Advantage: $104.71
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US OB > 14 WEEKS	$1,362.82	$953.98	$1,158.40
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Aetna — Commercial: $1,158.40 Blue Cross Blue Shield — All PPO Plans: $1,158.40 Blue Cross Blue Shield — Participating/Traditional: $1,158.40 Cigna — Commercial: $1,158.40 United Healthcare — Commercial: $1,158.40
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: ULTRASOUND, TRANSVAGINAL	$95.16	$66.62	$31.63 – $104.66
Transvaginal ultrasound: 10 of 15 insurance plan rates Aetna — Commercial: $80.89 Aetna — Medicare Advantage: $104.66 Blue Cross Blue Shield — All PPO Plans: $80.89 Blue Cross Blue Shield — Medicare Advantage: $104.66 Blue Cross Blue Shield — Participating/Traditional: $80.89 Centene-Ambetter — Marketplace: $104.66 Cigna — Commercial: $80.89 Cigna — Medicare Advantage: $104.66 Healthy Blue — Managed Medicaid: $34.79 Home State Health Plan — Managed Medicaid: $31.63
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PELVIS TRANSVAGINAL	$1,323.88	$926.72	$104.71 – $1,125.30
Transvaginal ultrasound: 10 of 12 insurance plan rates Aetna — Commercial: $1,125.30 Aetna — Medicare Advantage: $104.71 Blue Cross Blue Shield — All PPO Plans: $1,125.30 Blue Cross Blue Shield — Medicare Advantage: $104.71 Blue Cross Blue Shield — Participating/Traditional: $1,125.30 Centene-Ambetter — Marketplace: $104.71 Cigna — Commercial: $1,125.30 Cigna — Medicare Advantage: $104.71 Humana/Choice Care — Commercial: $104.71 Humana/Choice Care — Medicare Advantage: $104.71
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PELVIS TRANSVAGINAL	$1,323.88	$926.72	$1,125.30
Transvaginal ultrasound: rates for 5 insurance plans Aetna — Commercial: $1,125.30 Blue Cross Blue Shield — All PPO Plans: $1,125.30 Blue Cross Blue Shield — Participating/Traditional: $1,125.30 Cigna — Commercial: $1,125.30 United Healthcare — Commercial: $1,125.30
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$110.81	$77.57	$32.42 – $110.68
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Aetna — Commercial: $94.19 Aetna — Medicare Advantage: $110.68 Blue Cross Blue Shield — All PPO Plans: $94.19 Blue Cross Blue Shield — Medicare Advantage: $110.68 Blue Cross Blue Shield — Participating/Traditional: $94.19 Centene-Ambetter — Marketplace: $110.68 Cigna — Commercial: $94.19 Cigna — Medicare Advantage: $110.68 Healthy Blue — Managed Medicaid: $35.66 Home State Health Plan — Managed Medicaid: $32.42
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIAGNOSTIC LEFT WITH CAD UNILATERAL	$513.76	$359.64	$110.68 – $436.70
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates Aetna — Commercial: $436.70 Aetna — Medicare Advantage: $110.68 Blue Cross Blue Shield — All PPO Plans: $436.70 Blue Cross Blue Shield — Medicare Advantage: $110.68 Blue Cross Blue Shield — Participating/Traditional: $436.70 Centene-Ambetter — Marketplace: $110.68 Cigna — Commercial: $436.70 Cigna — Medicare Advantage: $110.68 Humana/Choice Care — Commercial: $110.68 Humana/Choice Care — Medicare Advantage: $110.68
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIAGNOSTIC RIGHT WITH CAD UNILATERAL	$513.76	$359.64	$110.68 – $436.70
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates Aetna — Commercial: $436.70 Aetna — Medicare Advantage: $110.68 Blue Cross Blue Shield — All PPO Plans: $436.70 Blue Cross Blue Shield — Medicare Advantage: $110.68 Blue Cross Blue Shield — Participating/Traditional: $436.70 Centene-Ambetter — Marketplace: $110.68 Cigna — Commercial: $436.70 Cigna — Medicare Advantage: $110.68 Humana/Choice Care — Commercial: $110.68 Humana/Choice Care — Medicare Advantage: $110.68
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$136.08	$95.26	$40.09 – $140.14
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Aetna — Commercial: $115.67 Aetna — Medicare Advantage: $140.14 Blue Cross Blue Shield — All PPO Plans: $115.67 Blue Cross Blue Shield — Medicare Advantage: $140.14 Blue Cross Blue Shield — Participating/Traditional: $115.67 Centene-Ambetter — Marketplace: $140.14 Cigna — Commercial: $115.67 Cigna — Medicare Advantage: $140.14 Healthy Blue — Managed Medicaid: $44.10 Home State Health Plan — Managed Medicaid: $40.09
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIAGNOSTIC BILAT WITH CAD	$627.33	$439.14	$140.14 – $533.23
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Commercial: $533.23 Aetna — Medicare Advantage: $140.14 Blue Cross Blue Shield — All PPO Plans: $533.23 Blue Cross Blue Shield — Medicare Advantage: $140.14 Blue Cross Blue Shield — Participating/Traditional: $533.23 Centene-Ambetter — Marketplace: $140.14 Cigna — Commercial: $533.23 Cigna — Medicare Advantage: $140.14 Humana/Choice Care — Commercial: $140.14 Humana/Choice Care — Medicare Advantage: $140.14
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MG MAMMO DIAGNOSTIC BILAT WITH CAD	$627.33	$439.14	$533.23
Diagnostic mammogram, both breasts: rates for 5 insurance plans Aetna — Commercial: $533.23 Blue Cross Blue Shield — All PPO Plans: $533.23 Blue Cross Blue Shield — Participating/Traditional: $533.23 Cigna — Commercial: $533.23 United Healthcare — Commercial: $533.23
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED	$104.88	$73.42	$30.42 – $112.43
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — Commercial: $89.15 Aetna — Medicare Advantage: $112.43 Blue Cross Blue Shield — All PPO Plans: $89.15 Blue Cross Blue Shield — Medicare Advantage: $112.43 Blue Cross Blue Shield — Participating/Traditional: $89.15 Centene-Ambetter — Marketplace: $112.43 Cigna — Commercial: $89.15 Cigna — Medicare Advantage: $112.43 Healthy Blue — Managed Medicaid: $33.46 Home State Health Plan — Managed Medicaid: $30.42
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO SCREEN WITH CAD SPEC COUPON	$315.83	$221.09	$112.43 – $268.46
Screening mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Commercial: $268.46 Aetna — Medicare Advantage: $112.43 Blue Cross Blue Shield — All PPO Plans: $268.46 Blue Cross Blue Shield — Medicare Advantage: $112.43 Blue Cross Blue Shield — Participating/Traditional: $268.46 Centene-Ambetter — Marketplace: $112.43 Cigna — Commercial: $268.46 Cigna — Medicare Advantage: $112.43 Humana/Choice Care — Commercial: $112.43 Humana/Choice Care — Medicare Advantage: $112.43
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO ROUTINE SCREENING WITH CAD	$499.70	$349.79	$112.43 – $424.75
Screening mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Commercial: $424.75 Aetna — Medicare Advantage: $112.43 Blue Cross Blue Shield — All PPO Plans: $424.75 Blue Cross Blue Shield — Medicare Advantage: $112.43 Blue Cross Blue Shield — Participating/Traditional: $424.75 Centene-Ambetter — Marketplace: $112.43 Cigna — Commercial: $424.75 Cigna — Medicare Advantage: $112.43 Humana/Choice Care — Commercial: $112.43 Humana/Choice Care — Medicare Advantage: $112.43

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM	$97	$67.90	$14.10 – $82.45
Electrocardiogram (ECG/EKG) with reading: 10 of 15 insurance plan rates Aetna — Commercial: $82.45 Aetna — Medicare Advantage: $14.10 Blue Cross Blue Shield — All PPO Plans: $82.45 Blue Cross Blue Shield — Medicare Advantage: $14.10 Blue Cross Blue Shield — Participating/Traditional: $82.45 Centene-Ambetter — Marketplace: $14.10 Cigna — Commercial: $82.45 Cigna — Medicare Advantage: $14.10 Healthy Blue — Managed Medicaid: $20.63 Home State Health Plan — Managed Medicaid: $18.75
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM	$97	$67.90	$82.45
Electrocardiogram (ECG/EKG) with reading: rates for 5 insurance plans Aetna — Commercial: $82.45 Blue Cross Blue Shield — All PPO Plans: $82.45 Blue Cross Blue Shield — Participating/Traditional: $82.45 Cigna — Commercial: $82.45 United Healthcare — Commercial: $82.45
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY FULL	$5,310.70	$3,717.49	$509.03 – $4,514.10
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates Aetna — Commercial: $4,514.10 Aetna — Medicare Advantage: $860.13 Blue Cross Blue Shield — All PPO Plans: $4,514.10 Blue Cross Blue Shield — Medicare Advantage: $860.13 Blue Cross Blue Shield — Participating/Traditional: $4,514.10 Centene-Ambetter — Marketplace: $860.13 Cigna — Commercial: $4,514.10 Cigna — Medicare Advantage: $860.13 Healthy Blue — Managed Medicaid: $559.93 Home State Health Plan — Managed Medicaid: $509.03
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SLEEP STUDY FULL	$5,310.70	$3,717.49	$4,514.10
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Aetna — Commercial: $4,514.10 Blue Cross Blue Shield — All PPO Plans: $4,514.10 Blue Cross Blue Shield — Participating/Traditional: $4,514.10 Cigna — Commercial: $4,514.10 United Healthcare — Commercial: $4,514.10

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: THERAPEUTIC EXERCISE	$189.52	$132.67	$24.65 – $161.09
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $161.09 Aetna — Medicare Advantage: $27.16 Blue Cross Blue Shield — All PPO Plans: $161.09 Blue Cross Blue Shield — Medicare Advantage: $27.16 Blue Cross Blue Shield — Participating/Traditional: $161.09 Centene-Ambetter — Marketplace: $27.16 Cigna — Commercial: $161.09 Cigna — Medicare Advantage: $27.16 Healthy Blue — Managed Medicaid: $27.12 Home State Health Plan — Managed Medicaid: $24.65
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THER.PRO/EX/STRENGTH/ROM/MAINT	$241.20	$168.84	$24.65 – $205.02
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Aetna — Commercial: $205.02 Aetna — Medicare Advantage: $27.16 Blue Cross Blue Shield — All PPO Plans: $205.02 Blue Cross Blue Shield — Medicare Advantage: $27.16 Blue Cross Blue Shield — Participating/Traditional: $205.02 Centene-Ambetter — Marketplace: $27.16 Cigna — Commercial: $205.02 Cigna — Medicare Advantage: $27.16 Healthy Blue — Managed Medicaid: $27.12 Home State Health Plan — Managed Medicaid: $24.65
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISE	$189.52	$132.67	$161.09
Physical therapy: therapeutic exercise (each 15 minutes): rates for 5 insurance plans Aetna — Commercial: $161.09 Blue Cross Blue Shield — All PPO Plans: $161.09 Blue Cross Blue Shield — Participating/Traditional: $161.09 Cigna — Commercial: $161.09 United Healthcare — Commercial: $161.09
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - LOW COMPLEXITY	$400.20	$280.14	$75.78 – $340.17
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Aetna — Commercial: $340.17 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $340.17 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $340.17 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $340.17 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION LOW COMPLEXITY	$508.35	$355.85	$75.78 – $432.10
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Aetna — Commercial: $432.10 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $432.10 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $432.10 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $432.10 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL - LOW COMPLEXITY	$400.20	$280.14	$340.17
Physical therapy evaluation (low complexity): rates for 5 insurance plans Aetna — Commercial: $340.17 Blue Cross Blue Shield — All PPO Plans: $340.17 Blue Cross Blue Shield — Participating/Traditional: $340.17 Cigna — Commercial: $340.17 United Healthcare — Commercial: $340.17
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MODERATE COMPLEXITY	$468	$327.60	$75.78 – $397.80
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Aetna — Commercial: $397.80 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $397.80 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $397.80 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $397.80 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION-MODERATE COMPLEXITY	$547.29	$383.11	$75.78 – $465.20
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Aetna — Commercial: $465.20 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $465.20 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $465.20 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $465.20 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL MODERATE COMPLEXITY	$468	$327.60	$397.80
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans Aetna — Commercial: $397.80 Blue Cross Blue Shield — All PPO Plans: $397.80 Blue Cross Blue Shield — Participating/Traditional: $397.80 Cigna — Commercial: $397.80 United Healthcare — Commercial: $397.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEXITY	$466.44	$326.51	$75.78 – $396.47
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Aetna — Commercial: $396.47 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $396.47 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $396.47 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $396.47 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION- HIGH COMPLEXITY	$592.72	$414.91	$75.78 – $503.81
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Aetna — Commercial: $503.81 Aetna — Medicare Advantage: $91.50 Blue Cross Blue Shield — All PPO Plans: $503.81 Blue Cross Blue Shield — Medicare Advantage: $91.50 Blue Cross Blue Shield — Participating/Traditional: $503.81 Centene-Ambetter — Marketplace: $91.50 Cigna — Commercial: $503.81 Cigna — Medicare Advantage: $91.50 Healthy Blue — Managed Medicaid: $83.36 Home State Health Plan — Managed Medicaid: $75.78
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEXITY	$466.44	$326.51	$396.47
Physical therapy evaluation (high complexity): rates for 5 insurance plans Aetna — Commercial: $396.47 Blue Cross Blue Shield — All PPO Plans: $396.47 Blue Cross Blue Shield — Participating/Traditional: $396.47 Cigna — Commercial: $396.47 United Healthcare — Commercial: $396.47

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT	$3,557.80	$2,490.46	$1,104.57 – $3,024.13
Total hip replacement: 10 of 12 insurance plan rates Aetna — Commercial: $3,024.13 Aetna — Medicare Advantage: $1,104.57 Blue Cross Blue Shield — All PPO Plans: $3,024.13 Blue Cross Blue Shield — Medicare Advantage: $1,104.57 Blue Cross Blue Shield — Participating/Traditional: $3,024.13 Centene-Ambetter — Marketplace: $1,104.57 Cigna — Commercial: $3,024.13 Cigna — Medicare Advantage: $1,104.57 Humana/Choice Care — Commercial: $1,104.57 Humana/Choice Care — Medicare Advantage: $1,104.57
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)	$3,553.50	$2,487.45	$772.22 – $3,020.48
Total knee replacement: 10 of 15 insurance plan rates Aetna — Commercial: $3,020.48 Aetna — Medicare Advantage: $1,102.77 Blue Cross Blue Shield — All PPO Plans: $3,020.48 Blue Cross Blue Shield — Medicare Advantage: $1,102.77 Blue Cross Blue Shield — Participating/Traditional: $3,020.48 Centene-Ambetter — Marketplace: $1,102.77 Cigna — Commercial: $3,020.48 Cigna — Medicare Advantage: $1,102.77 Healthy Blue — Managed Medicaid: $849.44 Home State Health Plan — Managed Medicaid: $772.22
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITH CORACOACROMIAL LIGAMENT (IE, ARCH) RELE	$477	$333.90	$142.93 – $405.45
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — Commercial: $405.45 Aetna — Medicare Advantage: $142.93 Blue Cross Blue Shield — All PPO Plans: $405.45 Blue Cross Blue Shield — Medicare Advantage: $142.93 Blue Cross Blue Shield — Participating/Traditional: $405.45 Centene-Ambetter — Marketplace: $142.93 Cigna — Commercial: $405.45 Cigna — Medicare Advantage: $142.93 Healthy Blue — Managed Medicaid: $273.24 Home State Health Plan — Managed Medicaid: $248.40
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULA	$1,535	$1,074.50	$327.64 – $1,304.75
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — Commercial: $1,304.75 Aetna — Medicare Advantage: $481.64 Blue Cross Blue Shield — All PPO Plans: $1,304.75 Blue Cross Blue Shield — Medicare Advantage: $481.64 Blue Cross Blue Shield — Participating/Traditional: $1,304.75 Centene-Ambetter — Marketplace: $481.64 Cigna — Commercial: $1,304.75 Cigna — Medicare Advantage: $481.64 Healthy Blue — Managed Medicaid: $360.40 Home State Health Plan — Managed Medicaid: $327.64
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12	$670	$469	$181.23 – $569.50
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — Commercial: $569.50 Aetna — Medicare Advantage: $246.01 Blue Cross Blue Shield — All PPO Plans: $569.50 Blue Cross Blue Shield — Medicare Advantage: $246.01 Blue Cross Blue Shield — Participating/Traditional: $569.50 Centene-Ambetter — Marketplace: $246.01 Cigna — Commercial: $569.50 Cigna — Medicare Advantage: $246.01 Healthy Blue — Managed Medicaid: $199.35 Home State Health Plan — Managed Medicaid: $181.23
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDUR	$832	$582.40	$105.60 – $707.20
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — Commercial: $707.20 Aetna — Medicare Advantage: $105.60 Blue Cross Blue Shield — All PPO Plans: $707.20 Blue Cross Blue Shield — Medicare Advantage: $105.60 Blue Cross Blue Shield — Participating/Traditional: $707.20 Centene-Ambetter — Marketplace: $105.60 Cigna — Commercial: $707.20 Cigna — Medicare Advantage: $105.60 Healthy Blue — Managed Medicaid: $203.28 Home State Health Plan — Managed Medicaid: $184.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD WITH BIOPSY, SINGLE OR MULTIPLE	$1,092	$764.40	$118.28 – $928.20
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — Commercial: $928.20 Aetna — Medicare Advantage: $118.28 Blue Cross Blue Shield — All PPO Plans: $928.20 Blue Cross Blue Shield — Medicare Advantage: $118.28 Blue Cross Blue Shield — Participating/Traditional: $928.20 Centene-Ambetter — Marketplace: $118.28 Cigna — Commercial: $928.20 Cigna — Medicare Advantage: $118.28 Healthy Blue — Managed Medicaid: $260.03 Home State Health Plan — Managed Medicaid: $236.39
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY DIAGNOSTIC INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING WHEN PERFORMED (SEPARATE PROCEDURE)	$1,092	$764.40	$158.13 – $928.20
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — Commercial: $928.20 Aetna — Medicare Advantage: $158.13 Blue Cross Blue Shield — All PPO Plans: $928.20 Blue Cross Blue Shield — Medicare Advantage: $158.13 Blue Cross Blue Shield — Participating/Traditional: $928.20 Centene-Ambetter — Marketplace: $158.13 Cigna — Commercial: $928.20 Cigna — Medicare Advantage: $158.13 Healthy Blue — Managed Medicaid: $255.70 Home State Health Plan — Managed Medicaid: $232.45
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	$79.23
Colonoscopy (diagnostic): rates for 7 insurance plans Aetna — Medicare Advantage: $79.23 Blue Cross Blue Shield — Medicare Advantage: $79.23 Centene-Ambetter — Marketplace: $79.23 Cigna — Medicare Advantage: $79.23 Humana/Choice Care — Commercial: $79.23 Humana/Choice Care — Medicare Advantage: $79.23 United Healthcare — Medicare Advantage: $79.23
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY WITH BIOPSY SINGLE OR MULTIPLE	$1,404	$982.80	$170.74 – $1,193.40
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — Commercial: $1,193.40 Aetna — Medicare Advantage: $170.74 Blue Cross Blue Shield — All PPO Plans: $1,193.40 Blue Cross Blue Shield — Medicare Advantage: $170.74 Blue Cross Blue Shield — Participating/Traditional: $1,193.40 Centene-Ambetter — Marketplace: $170.74 Cigna — Commercial: $1,193.40 Cigna — Medicare Advantage: $170.74 Healthy Blue — Managed Medicaid: $329.36 Home State Health Plan — Managed Medicaid: $299.42
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE	$1,404	$982.80	$170.74 – $1,193.40
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — Commercial: $1,193.40 Aetna — Medicare Advantage: $170.74 Blue Cross Blue Shield — All PPO Plans: $1,193.40 Blue Cross Blue Shield — Medicare Advantage: $170.74 Blue Cross Blue Shield — Participating/Traditional: $1,193.40 Centene-Ambetter — Marketplace: $170.74 Cigna — Commercial: $1,193.40 Cigna — Medicare Advantage: $170.74 Healthy Blue — Managed Medicaid: $329.36 Home State Health Plan — Managed Medicaid: $299.42
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY WITH REMOVAL OF TUMOR(S) POLYP(S) OR OTHER LESION(S) BY SNARE TECHNIQUE	$1,508	$1,055.60	$215.08 – $1,281.80
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Aetna — Commercial: $1,281.80 Aetna — Medicare Advantage: $215.08 Blue Cross Blue Shield — All PPO Plans: $1,281.80 Blue Cross Blue Shield — Medicare Advantage: $215.08 Blue Cross Blue Shield — Participating/Traditional: $1,281.80 Centene-Ambetter — Marketplace: $215.08 Cigna — Commercial: $1,281.80 Cigna — Medicare Advantage: $215.08 Healthy Blue — Managed Medicaid: $342.77 Home State Health Plan — Managed Medicaid: $311.61
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: SCREENING COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,092	$764.40	$158.46 – $928.20
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates Aetna — Commercial: $928.20 Aetna — Medicare Advantage: $158.46 Blue Cross Blue Shield — All PPO Plans: $928.20 Blue Cross Blue Shield — Medicare Advantage: $158.46 Blue Cross Blue Shield — Participating/Traditional: $928.20 Centene-Ambetter — Marketplace: $158.46 Cigna — Commercial: $928.20 Cigna — Medicare Advantage: $158.46 Humana/Choice Care — Commercial: $158.46 Humana/Choice Care — Medicare Advantage: $158.46
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	$79.23
Screening colonoscopy (not high risk): rates for 7 insurance plans Aetna — Medicare Advantage: $79.23 Blue Cross Blue Shield — Medicare Advantage: $79.23 Centene-Ambetter — Marketplace: $79.23 Cigna — Medicare Advantage: $79.23 Humana/Choice Care — Commercial: $79.23 Humana/Choice Care — Medicare Advantage: $79.23 United Healthcare — Medicare Advantage: $79.23
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$2,288	$1,601.60	$400.94 – $1,944.80
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Aetna — Commercial: $1,944.80 Aetna — Medicare Advantage: $601.46 Blue Cross Blue Shield — All PPO Plans: $1,944.80 Blue Cross Blue Shield — Medicare Advantage: $601.46 Blue Cross Blue Shield — Participating/Traditional: $1,944.80 Centene-Ambetter — Marketplace: $601.46 Cigna — Commercial: $1,944.80 Cigna — Medicare Advantage: $601.46 Healthy Blue — Managed Medicaid: $441.03 Home State Health Plan — Managed Medicaid: $400.94
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH	$839	$587.30	$147.04 – $713.15
Prostate biopsy: rates for 8 insurance plans Aetna — Commercial: $713.15 Blue Cross Blue Shield — All PPO Plans: $713.15 Blue Cross Blue Shield — Participating/Traditional: $713.15 Cigna — Commercial: $713.15 Healthy Blue — Managed Medicaid: $161.74 Home State Health Plan — Managed Medicaid: $147.04 United Healthcare — Commercial: $713.15 United Healthcare — Managed Medicaid: $161.74
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTI	$2,240	$1,568	$1,904
Prostate biopsy: rates for 5 insurance plans Aetna — Commercial: $1,904 Blue Cross Blue Shield — All PPO Plans: $1,904 Blue Cross Blue Shield — Participating/Traditional: $1,904 Cigna — Commercial: $1,904 United Healthcare — Commercial: $1,904
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PROSTATE BIOPSY	$2,620.72	$1,834.51	$2,227.61
Prostate biopsy: rates for 5 insurance plans Aetna — Commercial: $2,227.61 Blue Cross Blue Shield — All PPO Plans: $2,227.61 Blue Cross Blue Shield — Participating/Traditional: $2,227.61 Cigna — Commercial: $2,227.61 United Healthcare — Commercial: $2,227.61
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: INJECT SUBSTANCE INTERLAMINAR EPIDURAL OR SUBARACHNOID, LUMBAR OR SACRAL (CAUDAL); WITH IMAGING GUIDANCE	$1,082	$757.40	$85.62 – $919.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates Aetna — Commercial: $919.70 Aetna — Medicare Advantage: $85.62 Blue Cross Blue Shield — All PPO Plans: $919.70 Blue Cross Blue Shield — Medicare Advantage: $85.62 Blue Cross Blue Shield — Participating/Traditional: $919.70 Centene-Ambetter — Marketplace: $85.62 Cigna — Commercial: $919.70 Cigna — Medicare Advantage: $85.62 Healthy Blue — Managed Medicaid: $174.71 Home State Health Plan — Managed Medicaid: $158.83
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX SP EPIDURAL INJ LUMB/SAC W IMAGING	$2,757	$1,929.90	$707.02 – $2,343.45
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates Aetna — Commercial: $2,343.45 Aetna — Medicare Advantage: $707.02 Blue Cross Blue Shield — All PPO Plans: $2,343.45 Blue Cross Blue Shield — Medicare Advantage: $707.02 Blue Cross Blue Shield — Participating/Traditional: $2,343.45 Centene-Ambetter — Marketplace: $707.02 Cigna — Commercial: $2,343.45 Cigna — Medicare Advantage: $707.02 Humana/Choice Care — Commercial: $707.02 Humana/Choice Care — Medicare Advantage: $707.02
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX SP EPIDURAL INJ LUMB/SAC W IMAGING	$2,757	$1,929.90	$2,343.45
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Aetna — Commercial: $2,343.45 Blue Cross Blue Shield — All PPO Plans: $2,343.45 Blue Cross Blue Shield — Participating/Traditional: $2,343.45 Cigna — Commercial: $2,343.45 United Healthcare — Commercial: $2,343.45
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: INJECTION TRANSFORAMINAL EPIDURAL, W IMAGING ; LUMBAR OR SACRAL, SINGLE LEVEL	$1,560	$1,092	$94.96 – $1,326
Nerve root injection, lower back, with imaging guidance: 10 of 15 insurance plan rates Aetna — Commercial: $1,326 Aetna — Medicare Advantage: $94.96 Blue Cross Blue Shield — All PPO Plans: $1,326 Blue Cross Blue Shield — Medicare Advantage: $94.96 Blue Cross Blue Shield — Participating/Traditional: $1,326 Centene-Ambetter — Marketplace: $94.96 Cigna — Commercial: $1,326 Cigna — Medicare Advantage: $94.96 Healthy Blue — Managed Medicaid: $166.52 Home State Health Plan — Managed Medicaid: $151.38
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX SP TRANSFORAMINAL INJ LUMB/SAC BILAT	$1,735.97	$1,215.18	$885.90 – $1,475.57
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna — Commercial: $1,475.57 Aetna — Medicare Advantage: $885.90 Blue Cross Blue Shield — All PPO Plans: $1,475.57 Blue Cross Blue Shield — Medicare Advantage: $885.90 Blue Cross Blue Shield — Participating/Traditional: $1,475.57 Centene-Ambetter — Marketplace: $885.90 Cigna — Commercial: $1,475.57 Cigna — Medicare Advantage: $885.90 Humana/Choice Care — Commercial: $885.90 Humana/Choice Care — Medicare Advantage: $885.90
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX SP TRANSFORAMINAL INJ, LUMB/SAC, SINGLE	$1,159.48	$811.64	$885.90 – $985.56
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna — Commercial: $985.56 Aetna — Medicare Advantage: $885.90 Blue Cross Blue Shield — All PPO Plans: $985.56 Blue Cross Blue Shield — Medicare Advantage: $885.90 Blue Cross Blue Shield — Participating/Traditional: $985.56 Centene-Ambetter — Marketplace: $885.90 Cigna — Commercial: $985.56 Cigna — Medicare Advantage: $885.90 Humana/Choice Care — Commercial: $885.90 Humana/Choice Care — Medicare Advantage: $885.90
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL	$1,228.50	$859.95	$268.60 – $1,044.23
Carpal tunnel release: 10 of 15 insurance plan rates Aetna — Commercial: $1,044.23 Aetna — Medicare Advantage: $390.85 Blue Cross Blue Shield — All PPO Plans: $1,044.23 Blue Cross Blue Shield — Medicare Advantage: $390.85 Blue Cross Blue Shield — Participating/Traditional: $1,044.23 Centene-Ambetter — Marketplace: $390.85 Cigna — Commercial: $1,044.23 Cigna — Medicare Advantage: $390.85 Healthy Blue — Managed Medicaid: $295.46 Home State Health Plan — Managed Medicaid: $268.60

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	$96,198.80
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 7 insurance plans Aetna — Medicare Advantage: $96,198.80 Blue Cross Blue Shield — Medicare Advantage: $96,198.80 Centene-Ambetter — Marketplace: $96,198.80 Cigna — Medicare Advantage: $96,198.80 Humana/Choice Care — Commercial: $96,198.80 Humana/Choice Care — Medicare Advantage: $96,198.80 United Healthcare — Medicare Advantage: $96,198.80
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	$18,967.77
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans Aetna — Medicare Advantage: $18,967.77 Blue Cross Blue Shield — Medicare Advantage: $18,967.77 Centene-Ambetter — Marketplace: $18,967.77 Cigna — Medicare Advantage: $18,967.77 Humana/Choice Care — Commercial: $18,967.77 Humana/Choice Care — Medicare Advantage: $18,967.77 United Healthcare — Medicare Advantage: $18,967.77
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	$24,006.43
Neck (cervical) spinal fusion, without complications: rates for 7 insurance plans Aetna — Medicare Advantage: $24,006.43 Blue Cross Blue Shield — Medicare Advantage: $24,006.43 Centene-Ambetter — Marketplace: $24,006.43 Cigna — Medicare Advantage: $24,006.43 Humana/Choice Care — Commercial: $24,006.43 Humana/Choice Care — Medicare Advantage: $24,006.43 United Healthcare — Medicare Advantage: $24,006.43
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	$12,843.93
Uterus and ovary surgery (not for cancer), without complications: rates for 7 insurance plans Aetna — Medicare Advantage: $12,843.93 Blue Cross Blue Shield — Medicare Advantage: $12,843.93 Centene-Ambetter — Marketplace: $12,843.93 Cigna — Medicare Advantage: $12,843.93 Humana/Choice Care — Commercial: $12,843.93 Humana/Choice Care — Medicare Advantage: $12,843.93 United Healthcare — Medicare Advantage: $12,843.93

Source: Bates County Memorial 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 April 20, 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	615 W Nursery St, Butler, MO 64730
County	Bates County
State	Missouri
Phone	(660) 200‑7000
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	3 of 5 stars
CMS Certification Number	260034
Name in Medicare records	BATES COUNTY MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	bcmhospital.com
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.

Bates County Memorial Hospital — bcmhospital.com
Emergency Department — bcmhospital.com
Imaging Services - Bates County Memorial Hospital — bcmhospital.com
Services - Bates County Memorial Hospital — bcmhospital.com
Infusion Center - Bates County Memorial Hospital — bcmhospital.com
Diagnostic Radiology - Bates County Memorial Hospital — bcmhospital.com
Interventional Radiology - Bates County Memorial Hospital — bcmhospital.com
CT Scan - Bates County Memorial Hospital — bcmhospital.com
MRI - Bates County Memorial Hospital — bcmhospital.com
Nuclear Medicine - Bates County Memorial Hospital — bcmhospital.com
Ultrasound - Bates County Memorial Hospital — bcmhospital.com
Surgical Services - Bates County Memorial Hospital — bcmhospital.com
Patients and Visitors - Bates County Memorial Hospital — bcmhospital.com

Bates County Memorial Hospital

Summary

Profile from official sources

At a glance