Does Beloit Health System have an emergency room?

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

Where is Beloit Health System?

1969 W Hart Rd, Beloit, WI 53511, in Rock County, Wisconsin.

What is the phone number of Beloit Health System?

(608) 364-5011, as listed by Medicare (CMS).

What is the Medicare star rating of Beloit Health System?

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

Beloit Health System — Beloit, WI

Quick answers

Does Beloit Health System have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Beloit Health System. In a medical emergency, call 911.
Where is Beloit Health System?: 1969 W Hart Rd, Beloit, WI 53511, in Rock County, Wisconsin.
What is the phone number of Beloit Health System?: (608) 364-5011, as listed by Medicare (CMS).
What is the Medicare star rating of Beloit Health System?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Procedures^[4]

Total hip and knee replacement

Programs and centers^[4]

Packard Family Care Center (birth center)
Hendricks Family Heart Hospital
Advanced Joint Care Center

Emergency care (hospital website)^[4]

Emergency room	Yes

Recognition^[4]

Joint Commission Advanced Certification in Total Hip and Knee Replacement

Doctors and clinicians (224)

224 doctors and other clinicians list Beloit Health System 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 (224)

Adam Brown, MDEmergency Medicine
Ajmal A. Matloob, MDOrthopedic Surgery
Alan J. Rehbein, ODOptometry
Alexander R. SagePodiatry
Alfred P. Rosche, MDPain Management
Alice M. Townshend, MDOphthalmology
Allen Katz, MDDiagnostic Radiology
Amy C. GentzClinical Social Worker
Andrea C. Holyszko, CNACertified Registered Nurse Anesthetist (CRNA)
Andrew F. Dean, MDEmergency Medicine
Andrew Kanarek, MDDiagnostic Radiology
Andrew Valliyil, MDHospitalist
Annabelle TolentinoInternal Medicine
Anne Marie C. Matelski, PAPhysician Assistant
Anny WicykNurse Practitioner
Arpan Patel, MDPain Management
Arthur H. Chiu, MDEmergency Medicine
Benjamin Ho, MDEmergency Medicine
Betsy R. Press, NPNurse Practitioner
Beverly J. La Madrid, CNACertified Registered Nurse Anesthetist (CRNA)
Binn M. Jatta, MDObstetrics/Gynecology
Bradley J. Hartmann, MDDiagnostic Radiology
Bradley Schmidt, MDNeurosurgery
Brandon A. Pelletier, MDInternal Medicine

And 200 more: the button below opens the full list.

Other emergency rooms nearby

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

SSM Health St Mary's Hospital - Janesville8.7 mi · Janesville, WI · Acute Care Hospital
Mercy Health System Corp9.7 mi · Janesville, WI · Acute Care Hospital
Saint Anthony Medical Center19 mi · Rockford, IL · Acute Care Hospital
UW Health20 mi · Rockford, IL · Acute Care Hospital
Edgerton Hospital and Health Services20 mi · Edgerton, WI · Critical Access Hospital

Other hospitals nearby

Van Matre Encompass Health Rehabilitation Institut…20 mi · Rockford, IL · Inpatient Rehabilitation 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

Beloit Health and Rehabilitation Center0.1 mi · Beloit, WI · 2 of 5 stars
Autumn Lake Healthcare at Beloit1.2 mi · Beloit, WI · 2 of 5 stars
Fair Oaks Rehab & Healthcare5.0 mi · South Beloit, IL · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Beloit Regional Hospice4.9 mi · Beloit, WI · 5 of 5 stars
Mercyhealth at Home12 mi · Janesville, WI · 4 of 5 stars
OSF Hospice15 mi · Loves Park, IL · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Mercyhealth at Home12 mi · Janesville, WI · 3 of 5 stars
OSF Healthcare Home Care15 mi · Loves Park, IL · 3 of 5 stars
Mercyhealth at Home15 mi · Rockford, IL

All home health agencies in the state →

Dialysis facilities

DaVita Beloit Dialysis4.9 mi · Beloit, WI
Mercyhealth Kidney Care and Dialysis Center12 mi · Janesville, WI · 1 of 5 stars
DaVita Machesney Park Dialysis13 mi · Machesney Park, IL · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

OrthoMidwest Surgery Center, LLC4.9 mi · Beloit, WI
Rockford Ambulatory Surgery Center18 mi · Rockford, IL
Rockford Endoscopy Center18 mi · Rockford, IL

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Beloit Area Community Health Center2.1 mi · Beloit, WI · Community health center
Beloit Area Community Health Center Behavioral Health Clinic2.1 mi · Beloit, WI · Community health center
Crusader Community Health-South Beloit Junior High School4.5 mi · South Beloit, IL · Community health center

Clinics and urgent care

OSF Healthcare - Medical Group - Rock Cut15 mi · Loves Park, IL · Rural health clinic
Edgerton Hospital and Health Services22 mi · Edgerton, WI · Urgent care center
Edgerton Hospital and Health Services, Inc23 mi · Whitewater, WI · Urgent care center

Pharmacies

Javon Bea Hospital4.9 mi · Beloit, WI · Pharmacy
Wal-Mart Stores East LP4.9 mi · Beloit, WI · Community/retail pharmacy
Walgreen Co4.9 mi · Beloit, WI · Pharmacy

Assisted living nearby

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

Beloit Senior Living4.9 mi · Beloit, WI
Dimensions Living Beloit I4.9 mi · Beloit, WI
Dimensions Living Beloit II4.9 mi · Beloit, WI
SV South Beloit East4.9 mi · Beloit, WI

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	58%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	74%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	64%National average: 74%
Area around the room “always” quiet at night	47%National average: 60%
Completed surveys	657Response rate: 22%

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)	0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	0No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.169Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.9%
Deaths within 30 days: heart failure patients	14.1%
Deaths within 30 days: pneumonia patients	15.8%
Deaths within 30 days: COPD patients	10.1%
Deaths within 30 days: stroke patients	21.6%
Deaths within 30 days: coronary bypass surgery (CABG)	Too few cases to report
Serious complications (patient safety indicator PSI-90)	1.29No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.6%
Readmitted within 30 days: heart failure	23.4%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	20.5%
Readmitted within 30 days: coronary bypass surgery	10.2%
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	129 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)	61%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 Wisconsin Best hospitals in Wisconsin

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 76 common services exactly as Beloit Health System lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level 3 New	$154	$46.20	$69.94 – $291.49
New patient office visit (about 30–44 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $152.15 Aetna — Gatekeeper/Not Gatekeeper: $137.74 Aetna — Managed Medicare: $69.94 Anthem — Medicare Advantage: $69.94 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $69.94 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $69.94 Cigna — Commercial: $152.15 Cook Children's Health Plan (CCHP) — Medicaid: $77.36 Dean Health — DHI/DHP/ASO: $69.94 Health EOS — Commercial: $145.75
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/OutPatient Visit, New 99203DSC	$165	$49.50	$69.94 – $291.49
New patient office visit (about 30–44 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $163.02 Aetna — Gatekeeper/Not Gatekeeper: $147.58 Aetna — Managed Medicare: $69.94 Anthem — Medicare Advantage: $69.94 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $69.94 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $69.94 Cigna — Commercial: $163.02 Cook Children's Health Plan (CCHP) — Medicaid: $77.36 Dean Health — DHI/DHP/ASO: $69.94 Health EOS — Commercial: $156.16
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office Visit New Pt Routine	$348	$104.40	$101.34 – $332.97
New patient office visit (about 30–44 minutes): 10 of 21 insurance plan rates Aetna — Commercial: $325.73 Aetna — Gatekeeper/Not Gatekeeper: $311.25 Aetna — Managed Medicare: $101.34 Anthem — Blue Access PPO/Blue Traditional: $235.25 Anthem — Blue Preferred/Blue Preferred Plus: $180.96 Anthem — Blue Priority WI/Blue Priority X-WI: $173.72 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $191.82 Cigna — Commercial: $332.97 Dean Health — DHI/DHP/ASO: $202.54 Health EOS — Commercial: $322.11
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level 4 New	$182	$54.60	$83.28 – $475.72
New patient office visit (about 45–59 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $179.82 Aetna — Gatekeeper/Not Gatekeeper: $162.78 Aetna — Managed Medicare: $114.85 Anthem — Medicare Advantage: $114.85 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $114.85 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $114.85 Cigna — Commercial: $179.82 Cook Children's Health Plan (CCHP) — Medicaid: $115.38 Dean Health — DHI/DHP/ASO: $114.85 Health EOS — Commercial: $172.24
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/OutPatient Visit, New 99204DSC	$308	$92.40	$114.85 – $475.72
New patient office visit (about 45–59 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $304.30 Aetna — Gatekeeper/Not Gatekeeper: $275.48 Aetna — Managed Medicare: $114.85 Anthem — Medicare Advantage: $114.85 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $114.85 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $114.85 Cigna — Commercial: $304.30 Cook Children's Health Plan (CCHP) — Medicaid: $115.38 Dean Health — DHI/DHP/ASO: $114.85 Health EOS — Commercial: $291.49
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Established Pt Consult Level 3	$350	$105	$101.92 – $459.39
New patient office visit (about 45–59 minutes): 10 of 21 insurance plan rates Aetna — Commercial: $327.60 Aetna — Gatekeeper/Not Gatekeeper: $313.04 Aetna — Managed Medicare: $101.92 Anthem — Blue Access PPO/Blue Traditional: $236.60 Anthem — Blue Preferred/Blue Preferred Plus: $182 Anthem — Blue Priority WI/Blue Priority X-WI: $174.72 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $192.92 Cigna — Commercial: $334.88 Dean Health — DHI/DHP/ASO: $203.70 Health EOS — Commercial: $323.96
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level 5 New	$550	$165	$152.27 – $645.94
New patient office visit (about 60–74 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $543.40 Aetna — Gatekeeper/Not Gatekeeper: $491.92 Aetna — Managed Medicare: $156.71 Anthem — Medicare Advantage: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $156.71 Cigna — Commercial: $543.40 Cook Children's Health Plan (CCHP) — Medicaid: $152.27 Dean Health — DHI/DHP/ASO: $156.71 Health EOS — Commercial: $520.52
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/OutPatient Visit, New 99205DSC	$396	$118.80	$152.27 – $645.94
New patient office visit (about 60–74 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $391.25 Aetna — Gatekeeper/Not Gatekeeper: $354.18 Aetna — Managed Medicare: $156.71 Anthem — Medicare Advantage: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $156.71 Cigna — Commercial: $391.25 Cook Children's Health Plan (CCHP) — Medicaid: $152.27 Dean Health — DHI/DHP/ASO: $156.71 Health EOS — Commercial: $374.77
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level New 99205HS	$550	$165	$152.27 – $645.94
New patient office visit (about 60–74 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $543.40 Aetna — Gatekeeper/Not Gatekeeper: $491.92 Aetna — Managed Medicare: $156.71 Anthem — Medicare Advantage: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $156.71 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $156.71 Cigna — Commercial: $543.40 Cook Children's Health Plan (CCHP) — Medicaid: $152.27 Dean Health — DHI/DHP/ASO: $156.71 Health EOS — Commercial: $520.52
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level 3 Established	$125	$37.50	$57.11 – $236.68
Established patient office visit (about 20–29 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $123.50 Aetna — Gatekeeper/Not Gatekeeper: $111.80 Aetna — Managed Medicare: $57.11 Anthem — Medicare Advantage: $57.11 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $57.11 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $57.11 Cigna — Commercial: $123.50 Cook Children's Health Plan (CCHP) — Medicaid: $62.84 Dean Health — DHI/DHP/ASO: $57.11 Health EOS — Commercial: $118.30
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/OutPatient Visit, Est 99213DSC	$119	$35.70	$54.45 – $236.68
Established patient office visit (about 20–29 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $117.57 Aetna — Gatekeeper/Not Gatekeeper: $106.43 Aetna — Managed Medicare: $57.11 Anthem — Medicare Advantage: $57.11 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $57.11 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $57.11 Cigna — Commercial: $117.57 Cook Children's Health Plan (CCHP) — Medicaid: $62.84 Dean Health — DHI/DHP/ASO: $57.11 Health EOS — Commercial: $112.62
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 3 - Labor Level	$3,808	$1,142.40	$228.43 – $3,643.49
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna — Commercial: $3,564.29 Aetna — Gatekeeper/Not Gatekeeper: $3,405.88 Aetna — Managed Medicare: $1,108.89 Anthem — Blue Access PPO/Blue Traditional: $2,574.21 Anthem — Blue Preferred/Blue Preferred Plus: $1,980.16 Anthem — Blue Priority WI/Blue Priority X-WI: $1,900.95 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,098.97 Cigna — Commercial: $3,643.49 Dean Health — DHI/DHP/ASO: $2,216.26 Health EOS — Commercial: $3,524.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/Outpatient Visit Level 4 Established	$178	$53.40	$81.45 – $350.20
Established patient office visit (about 30–39 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $175.86 Aetna — Gatekeeper/Not Gatekeeper: $159.20 Aetna — Managed Medicare: $83.83 Anthem — Medicare Advantage: $83.83 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $83.83 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $83.83 Cigna — Commercial: $175.86 Cook Children's Health Plan (CCHP) — Medicaid: $89 Dean Health — DHI/DHP/ASO: $83.83 Health EOS — Commercial: $168.46
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/OutPatient Visit, Est 99214DSC	$216	$64.80	$83.83 – $350.20
Established patient office visit (about 30–39 minutes): 10 of 25 insurance plan rates Aetna — Commercial: $213.41 Aetna — Gatekeeper/Not Gatekeeper: $193.19 Aetna — Managed Medicare: $83.83 Anthem — Medicare Advantage: $83.83 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $83.83 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $83.83 Cigna — Commercial: $213.41 Cook Children's Health Plan (CCHP) — Medicaid: $89 Dean Health — DHI/DHP/ASO: $83.83 Health EOS — Commercial: $204.42
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 4 - Labor Level	$4,712	$1,413.60	$335.34 – $4,508.44
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — Commercial: $4,410.43 Aetna — Gatekeeper/Not Gatekeeper: $4,214.41 Aetna — Managed Medicare: $1,372.13 Anthem — Blue Access PPO/Blue Traditional: $3,185.31 Anthem — Blue Preferred/Blue Preferred Plus: $2,450.24 Anthem — Blue Priority WI/Blue Priority X-WI: $2,352.23 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,597.25 Cigna — Commercial: $4,508.44 Dean Health — DHI/DHP/ASO: $2,742.38 Health EOS — Commercial: $4,361.43
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: Office Consultation Level 3	$490	$147	$87.94 – $484.12
Office consultation with a specialist (moderate): 10 of 17 insurance plan rates Aetna — Commercial: $484.12 Aetna — Gatekeeper/Not Gatekeeper: $438.26 Cigna — Commercial: $484.12 Cook Children's Health Plan (CCHP) — Medicaid: $87.94 Dean Health — DHI/DHP/ASO: $305.76 Health EOS — Commercial: $463.74 HFN — Commercial: $484.12 Humana — Commercial/EPO/HMO/POS/PPO: $332.21 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $332.21 Multiplan — Commercial: $407.68
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Established Pt Consult Level 4	$406	$121.80	$118.23 – $388.46
Office consultation with a specialist (moderate to high): 10 of 21 insurance plan rates Aetna — Commercial: $380.02 Aetna — Gatekeeper/Not Gatekeeper: $363.13 Aetna — Managed Medicare: $118.23 Anthem — Blue Access PPO/Blue Traditional: $274.46 Anthem — Blue Preferred/Blue Preferred Plus: $211.12 Anthem — Blue Priority WI/Blue Priority X-WI: $202.68 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $223.79 Cigna — Commercial: $388.46 Dean Health — DHI/DHP/ASO: $236.29 Health EOS — Commercial: $375.79
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: Office Consultation Level 4	$685	$205.50	$113.61 – $676.78
Office consultation with a specialist (moderate to high): 10 of 17 insurance plan rates Aetna — Commercial: $676.78 Aetna — Gatekeeper/Not Gatekeeper: $612.66 Cigna — Commercial: $676.78 Cook Children's Health Plan (CCHP) — Medicaid: $113.61 Dean Health — DHI/DHP/ASO: $427.44 Health EOS — Commercial: $648.28 HFN — Commercial: $676.78 Humana — Commercial/EPO/HMO/POS/PPO: $533.90 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $533.90 Multiplan — Commercial: $569.92
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Established Pt Consult Level 4	$406	$121.80	$206.90 – $388.46
Office consultation with a specialist (moderate to high): 10 of 12 insurance plan rates Aetna — Commercial: $380.02 Aetna — Gatekeeper/Not Gatekeeper: $363.13 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $223.79 Cigna — Commercial: $388.46 Health EOS — Commercial: $375.79 HFN — Commercial: $388.46 Multiplan — Commercial: $337.79 Preferred Network Access — Commercial: $388.46 Quartz — Beloit One Network: $206.90 Quartz — Commercial: $253.34
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial Comprehensive Preventive Medicine 18-39 Years New	$539	$161.70	$90.25 – $532.53
Preventive checkup, new patient, age 18–39: 10 of 17 insurance plan rates Aetna — Commercial: $532.53 Aetna — Gatekeeper/Not Gatekeeper: $482.08 Cigna — Commercial: $532.53 Cook Children's Health Plan (CCHP) — Medicaid: $90.25 Dean Health — DHI/DHP/ASO: $336.34 Health EOS — Commercial: $510.11 HFN — Commercial: $532.53 Humana — Commercial/EPO/HMO/POS/PPO: $340.94 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $340.94 Multiplan — Commercial: $448.45
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial Comprehensive Preventive Medicine 40-64 Years New	$397	$119.10	$104.03 – $414.29
Preventive checkup, new patient, age 40–64: 10 of 17 insurance plan rates Aetna — Commercial: $392.24 Aetna — Gatekeeper/Not Gatekeeper: $355.08 Cigna — Commercial: $392.24 Cook Children's Health Plan (CCHP) — Medicaid: $104.03 Dean Health — DHI/DHP/ASO: $247.73 Health EOS — Commercial: $375.72 HFN — Commercial: $392.24 Humana — Commercial/EPO/HMO/POS/PPO: $414.29 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $414.29 Multiplan — Commercial: $330.30
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99283 - Level 3 - Lynx Visit Level	$1,137	$341.10	$287.28 – $1,516.32
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — Commercial: $1,064.23 Aetna — Gatekeeper/Not Gatekeeper: $1,016.93 Aetna — Managed Medicare: $287.28 Anthem — Blue Access PPO/Blue Traditional: $1,516.32 Anthem — Blue Preferred/Blue Preferred Plus: $955.76 Anthem — Blue Priority WI/Blue Priority X-WI: $907.92 Anthem — Medicare Advantage: $287.28 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $626.71 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $287.28 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $287.28
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 3 - 99283	$1,137	$341.10	$287.28 – $1,516.32
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — Commercial: $1,064.23 Aetna — Gatekeeper/Not Gatekeeper: $1,016.93 Aetna — Managed Medicare: $287.28 Anthem — Blue Access PPO/Blue Traditional: $1,516.32 Anthem — Blue Preferred/Blue Preferred Plus: $955.76 Anthem — Blue Priority WI/Blue Priority X-WI: $907.92 Anthem — Medicare Advantage: $287.28 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $626.71 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $287.28 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $287.28
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99283 - Level 3 - Lynx Visit Level	$1,137	$341.10	$579.42 – $1,087.88
Emergency room visit (moderate): 10 of 12 insurance plan rates Aetna — Commercial: $1,064.23 Aetna — Gatekeeper/Not Gatekeeper: $1,016.93 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $626.71 Cigna — Commercial: $1,087.88 Health EOS — Commercial: $1,052.41 HFN — Commercial: $1,087.88 Multiplan — Commercial: $945.98 Preferred Network Access — Commercial: $1,087.88 Quartz — Beloit One Network: $579.42 Quartz — Commercial: $709.49
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284 - Level 4 - Lynx Visit Level	$1,768	$530.40	$439.12 – $4,546.88
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna — Commercial: $1,654.85 Aetna — Gatekeeper/Not Gatekeeper: $1,581.30 Aetna — Managed Medicare: $439.12 Anthem — Blue Access PPO/Blue Traditional: $4,546.88 Anthem — Blue Preferred/Blue Preferred Plus: $3,434.08 Anthem — Blue Priority WI/Blue Priority X-WI: $3,263.52 Anthem — Medicare Advantage: $439.12 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $974.52 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $439.12 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $439.12
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 4 - 99284	$1,793	$537.90	$439.12 – $4,546.88
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna — Commercial: $1,678.25 Aetna — Gatekeeper/Not Gatekeeper: $1,603.66 Aetna — Managed Medicare: $439.12 Anthem — Blue Access PPO/Blue Traditional: $4,546.88 Anthem — Blue Preferred/Blue Preferred Plus: $3,434.08 Anthem — Blue Priority WI/Blue Priority X-WI: $3,263.52 Anthem — Medicare Advantage: $439.12 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $988.30 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $439.12 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $439.12
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99284 - Level 4 - Lynx Visit Level	$1,768	$530.40	$900.97 – $1,691.62
Emergency room visit (moderately high): 10 of 12 insurance plan rates Aetna — Commercial: $1,654.85 Aetna — Gatekeeper/Not Gatekeeper: $1,581.30 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $974.52 Cigna — Commercial: $1,691.62 Health EOS — Commercial: $1,636.46 HFN — Commercial: $1,691.62 Multiplan — Commercial: $1,470.98 Preferred Network Access — Commercial: $1,691.62 Quartz — Beloit One Network: $900.97 Quartz — Commercial: $1,103.23
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285 - Level 5 - Lynx Visit Level	$3,158	$947.40	$626.74 – $4,546.88
Emergency room visit (high): 10 of 33 insurance plan rates Aetna — Commercial: $2,955.89 Aetna — Gatekeeper/Not Gatekeeper: $2,824.52 Aetna — Managed Medicare: $626.74 Anthem — Blue Access PPO/Blue Traditional: $4,546.88 Anthem — Blue Preferred/Blue Preferred Plus: $3,434.08 Anthem — Blue Priority WI/Blue Priority X-WI: $3,263.52 Anthem — Medicare Advantage: $626.74 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,740.69 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $626.74 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $626.74
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 5 - 99285	$3,158	$947.40	$626.74 – $4,546.88
Emergency room visit (high): 10 of 33 insurance plan rates Aetna — Commercial: $2,955.89 Aetna — Gatekeeper/Not Gatekeeper: $2,824.52 Aetna — Managed Medicare: $626.74 Anthem — Blue Access PPO/Blue Traditional: $4,546.88 Anthem — Blue Preferred/Blue Preferred Plus: $3,434.08 Anthem — Blue Priority WI/Blue Priority X-WI: $3,263.52 Anthem — Medicare Advantage: $626.74 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,740.69 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $626.74 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $626.74
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99285 - Level 5 - Lynx Visit Level	$3,158	$947.40	$1,609.32 – $3,021.57
Emergency room visit (high): 10 of 12 insurance plan rates Aetna — Commercial: $2,955.89 Aetna — Gatekeeper/Not Gatekeeper: $2,824.52 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,740.69 Cigna — Commercial: $3,021.57 Health EOS — Commercial: $2,923.04 HFN — Commercial: $3,021.57 Multiplan — Commercial: $2,627.46 Preferred Network Access — Commercial: $3,021.57 Quartz — Beloit One Network: $1,609.32 Quartz — Commercial: $1,970.59

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	$259	$77.70	$8.80 – $247.81
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Commercial: $242.42 Aetna — Gatekeeper/Not Gatekeeper: $231.65 Aetna — Managed Medicare: $8.80 Anthem — Blue Access PPO/Blue Traditional: $32.99 Anthem — Blue Preferred/Blue Preferred Plus: $15.40 Anthem — Blue Priority WI/Blue Priority X-WI: $14.61 Anthem — Medicare Advantage: $8.80 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $142.76 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.80 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.80
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: Basic Metabolic Panel	$259	$77.70	$8.80 – $255.89
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Commercial: $255.89 Aetna — Gatekeeper/Not Gatekeeper: $231.65 Aetna — Managed Medicare: $8.80 Anthem — Medicare Advantage: $8.80 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.80 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.80 Cigna — Commercial: $255.89 Cook Children's Health Plan (CCHP) — Medicaid: $134.68 Dean Health — DHI/DHP/ASO: $8.80 Health EOS — Commercial: $245.12
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel	$259	$77.70	$131.99 – $247.81
Basic metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Commercial: $242.42 Aetna — Gatekeeper/Not Gatekeeper: $231.65 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $142.76 Cigna — Commercial: $247.81 Health EOS — Commercial: $239.73 HFN — Commercial: $247.81 Multiplan — Commercial: $215.49 Preferred Network Access — Commercial: $247.81 Quartz — Beloit One Network: $131.99 Quartz — Commercial: $161.62
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$337	$101.10	$10.98 – $322.44
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Commercial: $315.43 Aetna — Gatekeeper/Not Gatekeeper: $301.41 Aetna — Managed Medicare: $10.98 Anthem — Blue Access PPO/Blue Traditional: $41.18 Anthem — Blue Preferred/Blue Preferred Plus: $19.22 Anthem — Blue Priority WI/Blue Priority X-WI: $18.23 Anthem — Medicare Advantage: $10.98 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $185.75 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $10.98 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $10.98
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: Comprehensive Metabolic Panel	$337	$101.10	$10.98 – $332.96
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Commercial: $332.96 Aetna — Gatekeeper/Not Gatekeeper: $301.41 Aetna — Managed Medicare: $10.98 Anthem — Medicare Advantage: $10.98 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $10.98 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $10.98 Cigna — Commercial: $332.96 Cook Children's Health Plan (CCHP) — Medicaid: $175.24 Dean Health — DHI/DHP/ASO: $10.98 Health EOS — Commercial: $318.94
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$337	$101.10	$171.74 – $322.44
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Commercial: $315.43 Aetna — Gatekeeper/Not Gatekeeper: $301.41 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $185.75 Cigna — Commercial: $322.44 Health EOS — Commercial: $311.93 HFN — Commercial: $322.44 Multiplan — Commercial: $280.38 Preferred Network Access — Commercial: $322.44 Quartz — Beloit One Network: $171.74 Quartz — Commercial: $210.29
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric Panel	$1,035	$310.50	$49.72 – $990.29
Obstetric blood test panel: 10 of 33 insurance plan rates Aetna — Commercial: $968.76 Aetna — Gatekeeper/Not Gatekeeper: $925.70 Aetna — Managed Medicare: $49.72 Anthem — Blue Access PPO/Blue Traditional: $186.46 Anthem — Blue Preferred/Blue Preferred Plus: $87.01 Anthem — Blue Priority WI/Blue Priority X-WI: $82.54 Anthem — Medicare Advantage: $49.72 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $570.49 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $49.72 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $49.72
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: Obstetric Panel	$1,035	$310.50	$49.72 – $1,022.58
Obstetric blood test panel: 10 of 24 insurance plan rates Aetna — Commercial: $1,022.58 Aetna — Gatekeeper/Not Gatekeeper: $925.70 Aetna — Managed Medicare: $49.72 Anthem — Medicare Advantage: $49.72 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $49.72 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $49.72 Cigna — Commercial: $1,022.58 Cook Children's Health Plan (CCHP) — Medicaid: $538.20 Dean Health — DHI/DHP/ASO: $49.72 Health EOS — Commercial: $979.52
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Obstetric Panel	$1,035	$310.50	$527.44 – $990.29
Obstetric blood test panel: 10 of 12 insurance plan rates Aetna — Commercial: $968.76 Aetna — Gatekeeper/Not Gatekeeper: $925.70 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $570.49 Cigna — Commercial: $990.29 Health EOS — Commercial: $958 HFN — Commercial: $990.29 Multiplan — Commercial: $861.12 Preferred Network Access — Commercial: $990.29 Quartz — Beloit One Network: $527.44 Quartz — Commercial: $645.84
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$315	$94.50	$13.93 – $301.39
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Commercial: $294.84 Aetna — Gatekeeper/Not Gatekeeper: $281.74 Aetna — Managed Medicare: $13.93 Anthem — Blue Access PPO/Blue Traditional: $52.22 Anthem — Blue Preferred/Blue Preferred Plus: $24.37 Anthem — Blue Priority WI/Blue Priority X-WI: $23.12 Anthem — Medicare Advantage: $13.93 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $173.63 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $13.93 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $13.93
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cardio IQ Adv Lipid / 92145	$89	$26.70	$13.93 – $85.16
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Commercial: $83.30 Aetna — Gatekeeper/Not Gatekeeper: $79.60 Aetna — Managed Medicare: $13.93 Anthem — Blue Access PPO/Blue Traditional: $52.22 Anthem — Blue Preferred/Blue Preferred Plus: $24.37 Anthem — Blue Priority WI/Blue Priority X-WI: $23.12 Anthem — Medicare Advantage: $13.93 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $49.06 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $13.93 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $13.93
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipoprotein B	$79	$23.70	$13.93 – $75.59
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Commercial: $73.94 Aetna — Gatekeeper/Not Gatekeeper: $70.66 Aetna — Managed Medicare: $13.93 Anthem — Blue Access PPO/Blue Traditional: $52.22 Anthem — Blue Preferred/Blue Preferred Plus: $24.37 Anthem — Blue Priority WI/Blue Priority X-WI: $23.12 Anthem — Medicare Advantage: $13.93 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $43.54 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $13.93 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $13.93
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Func Pnl	$225	$67.50	$9.03 – $215.28
Kidney function panel: 10 of 33 insurance plan rates Aetna — Commercial: $210.60 Aetna — Gatekeeper/Not Gatekeeper: $201.24 Aetna — Managed Medicare: $9.03 Anthem — Blue Access PPO/Blue Traditional: $33.85 Anthem — Blue Preferred/Blue Preferred Plus: $15.80 Anthem — Blue Priority WI/Blue Priority X-WI: $14.99 Anthem — Medicare Advantage: $9.03 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $124.02 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $9.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $9.03
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: Renal Func Pnl	$225	$67.50	$9.03 – $222.30
Kidney function panel: 10 of 24 insurance plan rates Aetna — Commercial: $222.30 Aetna — Gatekeeper/Not Gatekeeper: $201.24 Aetna — Managed Medicare: $9.03 Anthem — Medicare Advantage: $9.03 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $9.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $9.03 Cigna — Commercial: $222.30 Cook Children's Health Plan (CCHP) — Medicaid: $117 Dean Health — DHI/DHP/ASO: $9.03 Health EOS — Commercial: $212.94
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Func Pnl	$225	$67.50	$114.66 – $215.28
Kidney function panel: 10 of 12 insurance plan rates Aetna — Commercial: $210.60 Aetna — Gatekeeper/Not Gatekeeper: $201.24 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $124.02 Cigna — Commercial: $215.28 Health EOS — Commercial: $208.26 HFN — Commercial: $215.28 Multiplan — Commercial: $187.20 Preferred Network Access — Commercial: $215.28 Quartz — Beloit One Network: $114.66 Quartz — Commercial: $140.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hep Func Panel	$281	$84.30	$8.50 – $268.86
Liver function panel: 10 of 33 insurance plan rates Aetna — Commercial: $263.02 Aetna — Gatekeeper/Not Gatekeeper: $251.33 Aetna — Managed Medicare: $8.50 Anthem — Blue Access PPO/Blue Traditional: $31.86 Anthem — Blue Preferred/Blue Preferred Plus: $14.87 Anthem — Blue Priority WI/Blue Priority X-WI: $14.10 Anthem — Medicare Advantage: $8.50 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $154.89 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.50 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.50
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: Hep Func Panel	$281	$84.30	$8.50 – $277.63
Liver function panel: 10 of 24 insurance plan rates Aetna — Commercial: $277.63 Aetna — Gatekeeper/Not Gatekeeper: $251.33 Aetna — Managed Medicare: $8.50 Anthem — Medicare Advantage: $8.50 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.50 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.50 Cigna — Commercial: $277.63 Cook Children's Health Plan (CCHP) — Medicaid: $146.12 Dean Health — DHI/DHP/ASO: $8.50 Health EOS — Commercial: $265.94
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hep Func Panel	$281	$84.30	$143.20 – $268.86
Liver function panel: 10 of 12 insurance plan rates Aetna — Commercial: $263.02 Aetna — Gatekeeper/Not Gatekeeper: $251.33 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $154.89 Cigna — Commercial: $268.86 Health EOS — Commercial: $260.09 HFN — Commercial: $268.86 Multiplan — Commercial: $233.79 Preferred Network Access — Commercial: $268.86 Quartz — Beloit One Network: $143.20 Quartz — Commercial: $175.34
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .Urine Microscopic	$131	$39.30	$3.30 – $125.34
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — Commercial: $122.62 Aetna — Gatekeeper/Not Gatekeeper: $117.17 Aetna — Managed Medicare: $3.30 Anthem — Blue Access PPO/Blue Traditional: $12.36 Anthem — Blue Preferred/Blue Preferred Plus: $5.77 Anthem — Blue Priority WI/Blue Priority X-WI: $5.47 Anthem — Medicare Advantage: $3.30 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $72.21 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3.30 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3.30
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: .Urine Microscopic	$131	$39.30	$3.30 – $129.43
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — Commercial: $129.43 Aetna — Gatekeeper/Not Gatekeeper: $117.17 Aetna — Managed Medicare: $3.30 Anthem — Medicare Advantage: $3.30 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3.30 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3.30 Cigna — Commercial: $129.43 Cook Children's Health Plan (CCHP) — Medicaid: $68.12 Dean Health — DHI/DHP/ASO: $3.30 Health EOS — Commercial: $123.98
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: .Urine Microscopic	$131	$39.30	$66.76 – $125.34
Urine test (automated, with microscope): 10 of 12 insurance plan rates Aetna — Commercial: $122.62 Aetna — Gatekeeper/Not Gatekeeper: $117.17 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $72.21 Cigna — Commercial: $125.34 Health EOS — Commercial: $121.25 HFN — Commercial: $125.34 Multiplan — Commercial: $108.99 Preferred Network Access — Commercial: $125.34 Quartz — Beloit One Network: $66.76 Quartz — Commercial: $81.74
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Macroscopic	$87	$26.10	$2.34 – $83.24
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Commercial: $81.43 Aetna — Gatekeeper/Not Gatekeeper: $77.81 Aetna — Managed Medicare: $2.34 Anthem — Blue Access PPO/Blue Traditional: $8.78 Anthem — Blue Preferred/Blue Preferred Plus: $4.09 Anthem — Blue Priority WI/Blue Priority X-WI: $3.88 Anthem — Medicare Advantage: $2.34 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $47.95 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $2.34 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $2.34
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis with Microscopic if Indicated	$88	$26.40	$2.34 – $84.20
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Commercial: $82.37 Aetna — Gatekeeper/Not Gatekeeper: $78.71 Aetna — Managed Medicare: $2.34 Anthem — Blue Access PPO/Blue Traditional: $8.78 Anthem — Blue Preferred/Blue Preferred Plus: $4.09 Anthem — Blue Priority WI/Blue Priority X-WI: $3.88 Anthem — Medicare Advantage: $2.34 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $48.51 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $2.34 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $2.34
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Dipstick POC Amb	$86	$25.80	$2.34 – $82.28
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Commercial: $80.50 Aetna — Gatekeeper/Not Gatekeeper: $76.92 Aetna — Managed Medicare: $2.34 Anthem — Blue Access PPO/Blue Traditional: $8.78 Anthem — Blue Preferred/Blue Preferred Plus: $4.09 Anthem — Blue Priority WI/Blue Priority X-WI: $3.88 Anthem — Medicare Advantage: $2.34 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $47.40 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $2.34 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $2.34
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA w/ Rfx Free PSA	$305	$91.50	$19.13 – $291.82
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Commercial: $285.48 Aetna — Gatekeeper/Not Gatekeeper: $272.79 Aetna — Managed Medicare: $19.13 Anthem — Blue Access PPO/Blue Traditional: $71.72 Anthem — Blue Preferred/Blue Preferred Plus: $33.47 Anthem — Blue Priority WI/Blue Priority X-WI: $31.75 Anthem — Medicare Advantage: $19.13 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $168.12 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $19.13 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $19.13
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA, Quest Free	$305	$91.50	$19.13 – $291.82
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Commercial: $285.48 Aetna — Gatekeeper/Not Gatekeeper: $272.79 Aetna — Managed Medicare: $19.13 Anthem — Blue Access PPO/Blue Traditional: $71.72 Anthem — Blue Preferred/Blue Preferred Plus: $33.47 Anthem — Blue Priority WI/Blue Priority X-WI: $31.75 Anthem — Medicare Advantage: $19.13 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $168.12 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $19.13 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $19.13
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA, Total to Quest w/ Reflex Free PSA	$305	$91.50	$19.13 – $291.82
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Commercial: $285.48 Aetna — Gatekeeper/Not Gatekeeper: $272.79 Aetna — Managed Medicare: $19.13 Anthem — Blue Access PPO/Blue Traditional: $71.72 Anthem — Blue Preferred/Blue Preferred Plus: $33.47 Anthem — Blue Priority WI/Blue Priority X-WI: $31.75 Anthem — Medicare Advantage: $19.13 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $168.12 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $19.13 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $19.13
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid Stimulating Hormone	$298	$89.40	$17.47 – $285.13
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Commercial: $278.93 Aetna — Gatekeeper/Not Gatekeeper: $266.53 Aetna — Managed Medicare: $17.47 Anthem — Blue Access PPO/Blue Traditional: $65.52 Anthem — Blue Preferred/Blue Preferred Plus: $30.58 Anthem — Blue Priority WI/Blue Priority X-WI: $29 Anthem — Medicare Advantage: $17.47 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $164.26 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $17.47 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $17.47
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH, Sensitive to Mayo	$61	$18.30	$17.47 – $69.89
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Commercial: $57.10 Aetna — Gatekeeper/Not Gatekeeper: $54.56 Aetna — Managed Medicare: $17.47 Anthem — Blue Access PPO/Blue Traditional: $65.52 Anthem — Blue Preferred/Blue Preferred Plus: $30.58 Anthem — Blue Priority WI/Blue Priority X-WI: $29 Anthem — Medicare Advantage: $17.47 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $33.62 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $17.47 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $17.47
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: Thyroid Stimulating Hormone	$298	$89.40	$17.47 – $294.42
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — Commercial: $294.42 Aetna — Gatekeeper/Not Gatekeeper: $266.53 Aetna — Managed Medicare: $17.47 Anthem — Medicare Advantage: $17.47 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $17.47 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $17.47 Cigna — Commercial: $294.42 Cook Children's Health Plan (CCHP) — Medicaid: $154.96 Dean Health — DHI/DHP/ASO: $17.47 Health EOS — Commercial: $282.03
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .Auto Diff	$209	$62.70	$8.08 – $199.97
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Commercial: $195.62 Aetna — Gatekeeper/Not Gatekeeper: $186.93 Aetna — Managed Medicare: $8.08 Anthem — Blue Access PPO/Blue Traditional: $30.30 Anthem — Blue Preferred/Blue Preferred Plus: $14.14 Anthem — Blue Priority WI/Blue Priority X-WI: $13.41 Anthem — Medicare Advantage: $8.08 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $115.20 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.08 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.08
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: .Auto Diff	$209	$62.70	$8.08 – $206.49
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — Commercial: $206.49 Aetna — Gatekeeper/Not Gatekeeper: $186.93 Aetna — Managed Medicare: $8.08 Anthem — Medicare Advantage: $8.08 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8.08 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8.08 Cigna — Commercial: $206.49 Cook Children's Health Plan (CCHP) — Medicaid: $108.68 Dean Health — DHI/DHP/ASO: $8.08 Health EOS — Commercial: $197.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: .Auto Diff	$209	$62.70	$106.51 – $199.97
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — Commercial: $195.62 Aetna — Gatekeeper/Not Gatekeeper: $186.93 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $115.20 Cigna — Commercial: $199.97 Health EOS — Commercial: $193.45 HFN — Commercial: $199.97 Multiplan — Commercial: $173.89 Preferred Network Access — Commercial: $199.97 Quartz — Beloit One Network: $106.51 Quartz — Commercial: $130.42
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hemogram	$174	$52.20	$6.73 – $166.48
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Commercial: $162.86 Aetna — Gatekeeper/Not Gatekeeper: $155.63 Aetna — Managed Medicare: $6.73 Anthem — Blue Access PPO/Blue Traditional: $25.23 Anthem — Blue Preferred/Blue Preferred Plus: $11.78 Anthem — Blue Priority WI/Blue Priority X-WI: $11.17 Anthem — Medicare Advantage: $6.73 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $95.91 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6.73 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6.73
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: Hemogram	$174	$52.20	$6.73 – $171.91
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — Commercial: $171.91 Aetna — Gatekeeper/Not Gatekeeper: $155.63 Aetna — Managed Medicare: $6.73 Anthem — Medicare Advantage: $6.73 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6.73 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6.73 Cigna — Commercial: $171.91 Cook Children's Health Plan (CCHP) — Medicaid: $90.48 Dean Health — DHI/DHP/ASO: $6.73 Health EOS — Commercial: $164.67
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hemogram	$174	$52.20	$88.67 – $166.48
Complete blood count (CBC), automated: 10 of 12 insurance plan rates Aetna — Commercial: $162.86 Aetna — Gatekeeper/Not Gatekeeper: $155.63 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $95.91 Cigna — Commercial: $166.48 Health EOS — Commercial: $161.05 HFN — Commercial: $166.48 Multiplan — Commercial: $144.77 Preferred Network Access — Commercial: $166.48 Quartz — Beloit One Network: $88.67 Quartz — Commercial: $108.58
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$107	$32.10	$4.46 – $102.38
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Commercial: $100.15 Aetna — Gatekeeper/Not Gatekeeper: $95.70 Aetna — Managed Medicare: $4.46 Anthem — Blue Access PPO/Blue Traditional: $16.73 Anthem — Blue Preferred/Blue Preferred Plus: $7.81 Anthem — Blue Priority WI/Blue Priority X-WI: $7.41 Anthem — Medicare Advantage: $4.46 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $58.98 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $4.46 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $4.46
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Finger	$52	$15.60	$4.46 – $49.75
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Commercial: $48.67 Aetna — Gatekeeper/Not Gatekeeper: $46.51 Aetna — Managed Medicare: $4.46 Anthem — Blue Access PPO/Blue Traditional: $16.73 Anthem — Blue Preferred/Blue Preferred Plus: $7.81 Anthem — Blue Priority WI/Blue Priority X-WI: $7.41 Anthem — Medicare Advantage: $4.46 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $28.66 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $4.46 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $4.46
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mix PT Immed	$107	$32.10	$4.46 – $102.38
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Commercial: $100.15 Aetna — Gatekeeper/Not Gatekeeper: $95.70 Aetna — Managed Medicare: $4.46 Anthem — Blue Access PPO/Blue Traditional: $16.73 Anthem — Blue Preferred/Blue Preferred Plus: $7.81 Anthem — Blue Priority WI/Blue Priority X-WI: $7.41 Anthem — Medicare Advantage: $4.46 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $58.98 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $4.46 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $4.46
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Partial Thromboplastin Time	$152	$45.60	$6.25 – $145.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Commercial: $142.27 Aetna — Gatekeeper/Not Gatekeeper: $135.95 Aetna — Managed Medicare: $6.25 Anthem — Blue Access PPO/Blue Traditional: $23.44 Anthem — Blue Preferred/Blue Preferred Plus: $10.94 Anthem — Blue Priority WI/Blue Priority X-WI: $10.38 Anthem — Medicare Advantage: $6.25 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $83.78 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6.25 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lupus Anticoagulant Evaluation w/ Reflex	$75	$22.50	$6.25 – $71.76
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Commercial: $70.20 Aetna — Gatekeeper/Not Gatekeeper: $67.08 Aetna — Managed Medicare: $6.25 Anthem — Blue Access PPO/Blue Traditional: $23.44 Anthem — Blue Preferred/Blue Preferred Plus: $10.94 Anthem — Blue Priority WI/Blue Priority X-WI: $10.38 Anthem — Medicare Advantage: $6.25 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $41.34 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6.25 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: von Willebrand Comprehensive Panel	$152	$45.60	$6.25 – $145.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Commercial: $142.27 Aetna — Gatekeeper/Not Gatekeeper: $135.95 Aetna — Managed Medicare: $6.25 Anthem — Blue Access PPO/Blue Traditional: $23.44 Anthem — Blue Preferred/Blue Preferred Plus: $10.94 Anthem — Blue Priority WI/Blue Priority X-WI: $10.38 Anthem — Medicare Advantage: $6.25 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $83.78 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6.25 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6.25

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head or Brain w/o Contrast	$2,362	$708.60	$110.02 – $2,259.96
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates Aetna — Commercial: $2,210.83 Aetna — Gatekeeper/Not Gatekeeper: $2,112.57 Aetna — Managed Medicare: $110.02 Anthem — Blue Access PPO/Blue Traditional: $1,596.71 Anthem — Blue Preferred/Blue Preferred Plus: $1,228.24 Anthem — Blue Priority WI/Blue Priority X-WI: $1,179.11 Anthem — Medicare Advantage: $110.02 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,301.93 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $110.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $110.02
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: CT Head or Brain w/o Contrast	$2,362	$708.60	$106.02 – $2,333.66
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — Commercial: $2,333.66 Aetna — Gatekeeper/Not Gatekeeper: $2,112.57 Aetna — Managed Medicare: $106.02 Anthem — Medicare Advantage: $106.02 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $106.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $106.02 Cigna — Commercial: $2,333.66 Cook Children's Health Plan (CCHP) — Medicaid: $1,228.24 Dean Health — DHI/DHP/ASO: $106.02 Health EOS — Commercial: $2,235.40
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Head or Brain w/o Contrast	$2,362	$708.60	$1,203.68 – $2,259.96
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $2,210.83 Aetna — Gatekeeper/Not Gatekeeper: $2,112.57 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,301.93 Cigna — Commercial: $2,259.96 Health EOS — Commercial: $2,186.27 HFN — Commercial: $2,259.96 Multiplan — Commercial: $1,965.18 Preferred Network Access — Commercial: $2,259.96 Quartz — Beloit One Network: $1,203.68 Quartz — Commercial: $1,473.89
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain w/ + w/o Contrast	$6,280	$1,884	$367.15 – $6,008.70
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates Aetna — Commercial: $5,878.08 Aetna — Gatekeeper/Not Gatekeeper: $5,616.83 Aetna — Managed Medicare: $367.15 Anthem — Blue Access PPO/Blue Traditional: $4,245.28 Anthem — Blue Preferred/Blue Preferred Plus: $3,265.60 Anthem — Blue Priority WI/Blue Priority X-WI: $3,134.98 Anthem — Medicare Advantage: $367.15 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $3,461.54 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $367.15 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $367.15
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain, IAC w + w/o	$6,385	$1,915.50	$367.15 – $6,109.17
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates Aetna — Commercial: $5,976.36 Aetna — Gatekeeper/Not Gatekeeper: $5,710.74 Aetna — Managed Medicare: $367.15 Anthem — Blue Access PPO/Blue Traditional: $4,316.26 Anthem — Blue Preferred/Blue Preferred Plus: $3,320.20 Anthem — Blue Priority WI/Blue Priority X-WI: $3,187.39 Anthem — Medicare Advantage: $367.15 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $3,519.41 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $367.15 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $367.15
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI Brain w/ + w/o Contrast	$6,280	$1,884	$315.45 – $6,204.64
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Aetna — Commercial: $6,204.64 Aetna — Gatekeeper/Not Gatekeeper: $5,616.83 Aetna — Managed Medicare: $315.45 Anthem — Medicare Advantage: $315.45 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $315.45 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $315.45 Cigna — Commercial: $6,204.64 Cook Children's Health Plan (CCHP) — Medicaid: $3,265.60 Dean Health — DHI/DHP/ASO: $315.45 Health EOS — Commercial: $5,943.39
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest 2 Views	$478	$143.40	$91.58 – $457.35
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Commercial: $447.41 Aetna — Gatekeeper/Not Gatekeeper: $427.52 Aetna — Managed Medicare: $91.58 Anthem — Blue Access PPO/Blue Traditional: $350.30 Anthem — Blue Preferred/Blue Preferred Plus: $280.24 Anthem — Blue Priority WI/Blue Priority X-WI: $266.23 Anthem — Medicare Advantage: $91.58 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $263.47 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $91.58 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $91.58
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest 2 Views w/ Fluoroscopy	$1,190	$357	$91.58 – $1,138.59
Chest X-ray, 2 views: 10 of 32 insurance plan rates Aetna — Commercial: $1,113.84 Aetna — Gatekeeper/Not Gatekeeper: $1,064.34 Aetna — Managed Medicare: $91.58 Anthem — Blue Access PPO/Blue Traditional: $804.44 Anthem — Blue Preferred/Blue Preferred Plus: $618.80 Anthem — Blue Priority WI/Blue Priority X-WI: $594.05 Anthem — Medicare Advantage: $91.58 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $655.93 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $91.58 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $91.58
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: XR Chest 2 Views	$478	$143.40	$32.80 – $472.26
Chest X-ray, 2 views: 10 of 24 insurance plan rates Aetna — Commercial: $472.26 Aetna — Gatekeeper/Not Gatekeeper: $427.52 Aetna — Managed Medicare: $32.80 Anthem — Medicare Advantage: $32.80 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $32.80 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $32.80 Cigna — Commercial: $472.26 Cook Children's Health Plan (CCHP) — Medicaid: $248.56 Dean Health — DHI/DHP/ASO: $32.80 Health EOS — Commercial: $452.38
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Spine Lumbosacral Minimum 4 Views	$940	$282	$110.02 – $899.39
X-ray of the lower spine, at least 4 views: 10 of 32 insurance plan rates Aetna — Commercial: $879.84 Aetna — Gatekeeper/Not Gatekeeper: $840.74 Aetna — Managed Medicare: $110.02 Anthem — Blue Access PPO/Blue Traditional: $635.44 Anthem — Blue Preferred/Blue Preferred Plus: $488.80 Anthem — Blue Priority WI/Blue Priority X-WI: $469.25 Anthem — Medicare Advantage: $110.02 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $518.13 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $110.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $110.02
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: XR Spine Lumbosacral Minimum 4 Views	$940	$282	$52.94 – $928.72
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — Commercial: $928.72 Aetna — Gatekeeper/Not Gatekeeper: $840.74 Aetna — Managed Medicare: $52.94 Anthem — Medicare Advantage: $52.94 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $52.94 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $52.94 Cigna — Commercial: $928.72 Cook Children's Health Plan (CCHP) — Medicaid: $488.80 Dean Health — DHI/DHP/ASO: $52.94 Health EOS — Commercial: $889.62
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY Lumbar 4 Views 72110	$108	$32.40	$49.42 – $264.68
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — Commercial: $106.70 Aetna — Gatekeeper/Not Gatekeeper: $96.60 Aetna — Managed Medicare: $52.94 Anthem — Medicare Advantage: $52.94 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $52.94 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $52.94 Cigna — Commercial: $106.70 Cook Children's Health Plan (CCHP) — Medicaid: $56.16 Dean Health — DHI/DHP/ASO: $52.94 Health EOS — Commercial: $102.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$4,644	$1,393.20	$251.10 – $4,443.38
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates Aetna — Commercial: $4,346.78 Aetna — Gatekeeper/Not Gatekeeper: $4,153.59 Aetna — Managed Medicare: $251.10 Anthem — Blue Access PPO/Blue Traditional: $3,139.34 Anthem — Blue Preferred/Blue Preferred Plus: $2,414.88 Anthem — Blue Priority WI/Blue Priority X-WI: $2,318.28 Anthem — Medicare Advantage: $251.10 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,559.77 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $251.10 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $251.10
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI Spine Lumbar w/o Contrast	$4,644	$1,393.20	$190.86 – $4,588.27
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — Commercial: $4,588.27 Aetna — Gatekeeper/Not Gatekeeper: $4,153.59 Aetna — Managed Medicare: $190.86 Anthem — Medicare Advantage: $190.86 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $190.86 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $190.86 Cigna — Commercial: $4,588.27 Cook Children's Health Plan (CCHP) — Medicaid: $2,414.88 Dean Health — DHI/DHP/ASO: $190.86 Health EOS — Commercial: $4,395.08
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$4,644	$1,393.20	$2,366.58 – $4,443.38
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates Aetna — Commercial: $4,346.78 Aetna — Gatekeeper/Not Gatekeeper: $4,153.59 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,559.77 Cigna — Commercial: $4,443.38 Health EOS — Commercial: $4,298.49 HFN — Commercial: $4,443.38 Multiplan — Commercial: $3,863.81 Preferred Network Access — Commercial: $4,443.38 Quartz — Beloit One Network: $2,366.58 Quartz — Commercial: $2,897.86
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis w/ Contrast	$3,162	$948.60	$184.59 – $3,025.40
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates Aetna — Commercial: $2,959.63 Aetna — Gatekeeper/Not Gatekeeper: $2,828.09 Aetna — Managed Medicare: $184.59 Anthem — Blue Access PPO/Blue Traditional: $2,137.51 Anthem — Blue Preferred/Blue Preferred Plus: $1,644.24 Anthem — Blue Priority WI/Blue Priority X-WI: $1,578.47 Anthem — Medicare Advantage: $184.59 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,742.89 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $184.59 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $184.59
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: CT Pelvis w/ Contrast	$3,162	$948.60	$224.58 – $3,124.06
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Commercial: $3,124.06 Aetna — Gatekeeper/Not Gatekeeper: $2,828.09 Aetna — Managed Medicare: $224.58 Anthem — Medicare Advantage: $224.58 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $224.58 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $224.58 Cigna — Commercial: $3,124.06 Cook Children's Health Plan (CCHP) — Medicaid: $1,644.24 Dean Health — DHI/DHP/ASO: $224.58 Health EOS — Commercial: $2,992.52
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Pelvis w/ Contrast	$3,162	$948.60	$1,611.36 – $3,025.40
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Commercial: $2,959.63 Aetna — Gatekeeper/Not Gatekeeper: $2,828.09 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $1,742.89 Cigna — Commercial: $3,025.40 Health EOS — Commercial: $2,926.75 HFN — Commercial: $3,025.40 Multiplan — Commercial: $2,630.78 Preferred Network Access — Commercial: $3,025.40 Quartz — Beloit One Network: $1,611.36 Quartz — Commercial: $1,973.09
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Ankle w/o Contrast Bilateral	$9,048	$2,714.40	$251.10 – $8,657.13
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates Aetna — Commercial: $8,468.93 Aetna — Gatekeeper/Not Gatekeeper: $8,092.53 Aetna — Managed Medicare: $251.10 Anthem — Blue Access PPO/Blue Traditional: $6,116.45 Anthem — Blue Preferred/Blue Preferred Plus: $4,704.96 Anthem — Blue Priority WI/Blue Priority X-WI: $4,516.76 Anthem — Medicare Advantage: $251.10 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $4,987.26 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $251.10 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $251.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Ankle w/o Contrast Left	$4,524	$1,357.20	$251.10 – $4,328.56
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates Aetna — Commercial: $4,234.46 Aetna — Gatekeeper/Not Gatekeeper: $4,046.27 Aetna — Managed Medicare: $251.10 Anthem — Blue Access PPO/Blue Traditional: $3,058.22 Anthem — Blue Preferred/Blue Preferred Plus: $2,352.48 Anthem — Blue Priority WI/Blue Priority X-WI: $2,258.38 Anthem — Medicare Advantage: $251.10 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,493.63 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $251.10 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $251.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Ankle w/o Contrast Right	$4,524	$1,357.20	$251.10 – $4,328.56
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates Aetna — Commercial: $4,234.46 Aetna — Gatekeeper/Not Gatekeeper: $4,046.27 Aetna — Managed Medicare: $251.10 Anthem — Blue Access PPO/Blue Traditional: $3,058.22 Anthem — Blue Preferred/Blue Preferred Plus: $2,352.48 Anthem — Blue Priority WI/Blue Priority X-WI: $2,258.38 Anthem — Medicare Advantage: $251.10 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $2,493.63 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $251.10 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $251.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abdomen, Pelvis w/ Contrast	$6,089	$1,826.70	$367.15 – $5,825.96
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates Aetna — Commercial: $5,699.30 Aetna — Gatekeeper/Not Gatekeeper: $5,446 Aetna — Managed Medicare: $367.15 Anthem — Blue Access PPO/Blue Traditional: $4,116.16 Anthem — Blue Preferred/Blue Preferred Plus: $3,166.28 Anthem — Blue Priority WI/Blue Priority X-WI: $3,039.63 Anthem — Medicare Advantage: $367.15 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $3,356.26 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $367.15 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $367.15
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT Abdomen, Pelvis w/ Contrast	$6,089	$1,826.70	$298.81 – $6,015.93
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Commercial: $6,015.93 Aetna — Gatekeeper/Not Gatekeeper: $5,446 Aetna — Managed Medicare: $298.81 Anthem — Medicare Advantage: $298.81 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $298.81 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $298.81 Cigna — Commercial: $6,015.93 Cook Children's Health Plan (CCHP) — Medicaid: $3,166.28 Dean Health — DHI/DHP/ASO: $298.81 Health EOS — Commercial: $5,762.63
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Abdomen, Pelvis w/ Contrast	$6,089	$1,826.70	$3,102.95 – $5,825.96
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Commercial: $5,699.30 Aetna — Gatekeeper/Not Gatekeeper: $5,446 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $3,356.26 Cigna — Commercial: $5,825.96 Health EOS — Commercial: $5,635.98 HFN — Commercial: $5,825.96 Multiplan — Commercial: $5,066.05 Preferred Network Access — Commercial: $5,825.96 Quartz — Beloit One Network: $3,102.95 Quartz — Commercial: $3,799.54
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,427	$428.10	$110.02 – $1,365.35
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates Aetna — Commercial: $1,335.67 Aetna — Gatekeeper/Not Gatekeeper: $1,276.31 Aetna — Managed Medicare: $110.02 Anthem — Blue Access PPO/Blue Traditional: $964.65 Anthem — Blue Preferred/Blue Preferred Plus: $742.04 Anthem — Blue Priority WI/Blue Priority X-WI: $712.36 Anthem — Medicare Advantage: $110.02 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $786.56 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $110.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $110.02
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US Abdomen Complete	$1,427	$428.10	$113.61 – $1,409.88
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — Commercial: $1,409.88 Aetna — Gatekeeper/Not Gatekeeper: $1,276.31 Aetna — Managed Medicare: $113.61 Anthem — Medicare Advantage: $113.61 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $113.61 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $113.61 Cigna — Commercial: $1,409.88 Cook Children's Health Plan (CCHP) — Medicaid: $742.04 Dean Health — DHI/DHP/ASO: $113.61 Health EOS — Commercial: $1,350.51
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,427	$428.10	$727.20 – $1,365.35
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates Aetna — Commercial: $1,335.67 Aetna — Gatekeeper/Not Gatekeeper: $1,276.31 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $786.56 Cigna — Commercial: $1,365.35 Health EOS — Commercial: $1,320.83 HFN — Commercial: $1,365.35 Multiplan — Commercial: $1,187.26 Preferred Network Access — Commercial: $1,365.35 Quartz — Beloit One Network: $727.20 Quartz — Commercial: $890.45
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Pregnancy After 1st Trimester	$1,709	$512.70	$110.02 – $1,635.17
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates Aetna — Commercial: $1,599.62 Aetna — Gatekeeper/Not Gatekeeper: $1,528.53 Aetna — Managed Medicare: $110.02 Anthem — Blue Access PPO/Blue Traditional: $1,155.28 Anthem — Blue Preferred/Blue Preferred Plus: $888.68 Anthem — Blue Priority WI/Blue Priority X-WI: $853.13 Anthem — Medicare Advantage: $110.02 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $942 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $110.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $110.02
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: US Pregnancy After 1st Trimester	$1,709	$512.70	$135.27 – $1,688.49
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Aetna — Commercial: $1,688.49 Aetna — Gatekeeper/Not Gatekeeper: $1,528.53 Aetna — Managed Medicare: $135.27 Anthem — Medicare Advantage: $135.27 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $135.27 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $135.27 Cigna — Commercial: $1,688.49 Cook Children's Health Plan (CCHP) — Medicaid: $888.68 Dean Health — DHI/DHP/ASO: $135.27 Health EOS — Commercial: $1,617.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Pregnancy After 1st Trimester	$1,709	$512.70	$870.91 – $1,635.17
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates Aetna — Commercial: $1,599.62 Aetna — Gatekeeper/Not Gatekeeper: $1,528.53 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $942 Cigna — Commercial: $1,635.17 Health EOS — Commercial: $1,581.85 HFN — Commercial: $1,635.17 Multiplan — Commercial: $1,421.89 Preferred Network Access — Commercial: $1,635.17 Quartz — Beloit One Network: $870.91 Quartz — Commercial: $1,066.42
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non-OB	$1,030	$309	$110.02 – $985.50
Transvaginal ultrasound: 10 of 32 insurance plan rates Aetna — Commercial: $964.08 Aetna — Gatekeeper/Not Gatekeeper: $921.23 Aetna — Managed Medicare: $110.02 Anthem — Blue Access PPO/Blue Traditional: $696.28 Anthem — Blue Preferred/Blue Preferred Plus: $535.60 Anthem — Blue Priority WI/Blue Priority X-WI: $514.18 Anthem — Medicare Advantage: $110.02 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $567.74 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $110.02 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $110.02
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: US Transvaginal Non-OB	$1,030	$309	$116.76 – $1,017.64
Transvaginal ultrasound: 10 of 24 insurance plan rates Aetna — Commercial: $1,017.64 Aetna — Gatekeeper/Not Gatekeeper: $921.23 Aetna — Managed Medicare: $116.76 Anthem — Medicare Advantage: $116.76 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $116.76 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $116.76 Cigna — Commercial: $1,017.64 Cook Children's Health Plan (CCHP) — Medicaid: $535.60 Dean Health — DHI/DHP/ASO: $116.76 Health EOS — Commercial: $974.79
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Transvaginal Non-OB	$1,030	$309	$524.89 – $985.50
Transvaginal ultrasound: 10 of 12 insurance plan rates Aetna — Commercial: $964.08 Aetna — Gatekeeper/Not Gatekeeper: $921.23 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $567.74 Cigna — Commercial: $985.50 Health EOS — Commercial: $953.37 HFN — Commercial: $985.50 Multiplan — Commercial: $856.96 Preferred Network Access — Commercial: $985.50 Quartz — Beloit One Network: $524.89 Quartz — Commercial: $642.72
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT,TC In the file: MA Mammogram Digital Diagnostic Left	$491	$147.30	$142.98 – $469.79
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates Aetna — Commercial: $459.58 Aetna — Gatekeeper/Not Gatekeeper: $439.15 Aetna — Managed Medicare: $142.98 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $269.36 Anthem — Blue Priority WI/Blue Priority X-WI: $255.84 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $270.64 Cigna — Commercial: $469.79 Dean Health — DHI/DHP/ASO: $285.76 Health EOS — Commercial: $454.47
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT,TC In the file: MA Mammogram Digital Diagnostic Right	$491	$147.30	$142.98 – $469.79
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates Aetna — Commercial: $459.58 Aetna — Gatekeeper/Not Gatekeeper: $439.15 Aetna — Managed Medicare: $142.98 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $269.36 Anthem — Blue Priority WI/Blue Priority X-WI: $255.84 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $270.64 Cigna — Commercial: $469.79 Dean Health — DHI/DHP/ASO: $285.76 Health EOS — Commercial: $454.47
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MA Mammogram Digital WWHSP Diag LT	$393	$117.90	$114.44 – $376.02
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates Aetna — Commercial: $367.85 Aetna — Gatekeeper/Not Gatekeeper: $351.50 Aetna — Managed Medicare: $114.44 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $269.36 Anthem — Blue Priority WI/Blue Priority X-WI: $255.84 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $216.62 Cigna — Commercial: $376.02 Dean Health — DHI/DHP/ASO: $228.73 Health EOS — Commercial: $363.76
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: MA Mammogram Digital WWHSP Diag Bilat	$445	$133.50	$156.03 – $780.16
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Commercial: $439.66 Aetna — Gatekeeper/Not Gatekeeper: $398.01 Aetna — Managed Medicare: $156.03 Anthem — Medicare Advantage: $156.03 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $156.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $156.03 Cigna — Commercial: $439.66 Cook Children's Health Plan (CCHP) — Medicaid: $231.40 Dean Health — DHI/DHP/ASO: $156.03 Health EOS — Commercial: $421.15
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: MA Mam Digital WWHSP Diag Bilat w/ CAD	$445	$133.50	$156.03 – $780.16
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Commercial: $439.66 Aetna — Gatekeeper/Not Gatekeeper: $398.01 Aetna — Managed Medicare: $156.03 Anthem — Medicare Advantage: $156.03 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $156.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $156.03 Cigna — Commercial: $439.66 Cook Children's Health Plan (CCHP) — Medicaid: $231.40 Dean Health — DHI/DHP/ASO: $156.03 Health EOS — Commercial: $421.15
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mammogram Digital WWHSP Diag Bilat	$445	$133.50	$129.58 – $624.12
Diagnostic mammogram, both breasts: 10 of 22 insurance plan rates Aetna — Commercial: $416.52 Aetna — Gatekeeper/Not Gatekeeper: $398.01 Aetna — Managed Medicare: $129.58 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $269.36 Anthem — Blue Priority WI/Blue Priority X-WI: $255.84 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $245.28 Cigna — Commercial: $425.78 Dean Health — DHI/DHP/ASO: $258.99 Health EOS — Commercial: $411.89
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: MA Mam Digital WWHSP Screen Bilat	$405	$121.50	$125.75 – $628.73
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Commercial: $400.14 Aetna — Gatekeeper/Not Gatekeeper: $362.23 Aetna — Managed Medicare: $125.75 Anthem — Medicare Advantage: $125.75 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $125.75 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $125.75 Cigna — Commercial: $400.14 Cook Children's Health Plan (CCHP) — Medicaid: $210.60 Dean Health — DHI/DHP/ASO: $125.75 Health EOS — Commercial: $383.29
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: MA Mam Digital WWHSP Screen Bilat w/ CAD	$405	$121.50	$125.75 – $628.73
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Commercial: $400.14 Aetna — Gatekeeper/Not Gatekeeper: $362.23 Aetna — Managed Medicare: $125.75 Anthem — Medicare Advantage: $125.75 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $125.75 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $125.75 Cigna — Commercial: $400.14 Cook Children's Health Plan (CCHP) — Medicaid: $210.60 Dean Health — DHI/DHP/ASO: $125.75 Health EOS — Commercial: $383.29
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mam Digital WWHSP Screen Bilat	$405	$121.50	$117.94 – $502.99
Screening mammogram, both breasts: 10 of 22 insurance plan rates Aetna — Commercial: $379.08 Aetna — Gatekeeper/Not Gatekeeper: $362.23 Aetna — Managed Medicare: $117.94 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $269.36 Anthem — Blue Priority WI/Blue Priority X-WI: $255.84 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $223.24 Cigna — Commercial: $387.50 Dean Health — DHI/DHP/ASO: $235.71 Health EOS — Commercial: $374.87

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: EKG Global 93000	$547	$164.10	$15.10 – $540.44
Electrocardiogram (ECG/EKG) with reading: 10 of 25 insurance plan rates Aetna — Commercial: $540.44 Aetna — Gatekeeper/Not Gatekeeper: $489.24 Aetna — Managed Medicare: $15.10 Anthem — Medicare Advantage: $15.10 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $15.10 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $15.10 Cigna — Commercial: $540.44 Cook Children's Health Plan (CCHP) — Medicaid: $19.97 Dean Health — DHI/DHP/ASO: $15.10 Health EOS — Commercial: $517.68
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EKG Global 93000	$547	$164.10	$60.40 – $523.37
Electrocardiogram (ECG/EKG) with reading: 10 of 22 insurance plan rates Aetna — Commercial: $511.99 Aetna — Gatekeeper/Not Gatekeeper: $489.24 Aetna — Managed Medicare: $159.29 Anthem — Blue Access PPO/Blue Traditional: $369.77 Anthem — Blue Preferred/Blue Preferred Plus: $284.44 Anthem — Blue Priority WI/Blue Priority X-WI: $273.06 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $301.51 Cigna — Commercial: $523.37 Dean Health — DHI/DHP/ASO: $318.35 Health EOS — Commercial: $506.30
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EKG Global 93000	$547	$164.10	$278.75 – $523.37
Electrocardiogram (ECG/EKG) with reading: 10 of 12 insurance plan rates Aetna — Commercial: $511.99 Aetna — Gatekeeper/Not Gatekeeper: $489.24 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $301.51 Cigna — Commercial: $523.37 Health EOS — Commercial: $506.30 HFN — Commercial: $523.37 Multiplan — Commercial: $455.10 Preferred Network Access — Commercial: $523.37 Quartz — Beloit One Network: $278.75 Quartz — Commercial: $341.33
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LHC w/wo LV	$18,729	$5,618.70	$3,411.77 – $18,182.32
Left heart catheterization (diagnostic): 10 of 33 insurance plan rates Aetna — Commercial: $17,530.34 Aetna — Gatekeeper/Not Gatekeeper: $16,751.22 Aetna — Managed Medicare: $3,411.77 Anthem — Blue Access PPO/Blue Traditional: $18,182.32 Anthem — Blue Preferred/Blue Preferred Plus: $15,530.32 Anthem — Blue Priority WI/Blue Priority X-WI: $14,753.44 Anthem — Medicare Advantage: $3,411.77 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $10,323.42 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3,411.77 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3,411.77
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LHC w/wo LV	$18,729	$5,618.70	$9,544.30 – $17,919.91
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates Aetna — Commercial: $17,530.34 Aetna — Gatekeeper/Not Gatekeeper: $16,751.22 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $10,323.42 Cigna — Commercial: $17,919.91 Health EOS — Commercial: $17,335.56 HFN — Commercial: $17,919.91 Multiplan — Commercial: $15,582.53 Preferred Network Access — Commercial: $17,919.91 Quartz — Beloit One Network: $9,544.30 Quartz — Commercial: $11,686.90
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP Comprehensive Study w/o Induction	$18,016	$5,404.80	$8,208.28 – $32,833.13
Heart rhythm study (electrophysiology evaluation): 10 of 32 insurance plan rates Aetna — Commercial: $16,862.98 Aetna — Gatekeeper/Not Gatekeeper: $16,113.51 Aetna — Managed Medicare: $8,208.28 Anthem — Blue Access PPO/Blue Traditional: $30,304.56 Anthem — Blue Preferred/Blue Preferred Plus: $27,476.80 Anthem — Blue Priority WI/Blue Priority X-WI: $26,104 Anthem — Medicare Advantage: $8,208.28 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $9,930.42 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $8,208.28 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $8,208.28
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP Comprehensive Study w/o Induction	$18,016	$5,404.80	$9,180.95 – $17,237.71
Heart rhythm study (electrophysiology evaluation): 10 of 12 insurance plan rates Aetna — Commercial: $16,862.98 Aetna — Gatekeeper/Not Gatekeeper: $16,113.51 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $9,930.42 Cigna — Commercial: $17,237.71 Health EOS — Commercial: $16,675.61 HFN — Commercial: $17,237.71 Multiplan — Commercial: $14,989.31 Preferred Network Access — Commercial: $17,237.71 Quartz — Beloit One Network: $9,180.95 Quartz — Commercial: $11,241.98
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP STUDY W/PULM VEIN ABLATION (PVI)-AF	$15,470	$4,641	$7,883.51 – $110,028.80
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates Aetna — Commercial: $14,479.92 Aetna — Gatekeeper/Not Gatekeeper: $13,836.37 Aetna — Managed Medicare: $27,507.20 Anthem — Blue Access PPO/Blue Traditional: $30,304.56 Anthem — Blue Preferred/Blue Preferred Plus: $27,476.80 Anthem — Blue Priority WI/Blue Priority X-WI: $26,104 Anthem — Medicare Advantage: $27,507.20 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $8,527.06 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $27,507.20 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $27,507.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP STUDY W/PULM VEIN ABLATION (PVI)-AF	$15,470	$4,641	$7,883.51 – $14,801.70
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates Aetna — Commercial: $14,479.92 Aetna — Gatekeeper/Not Gatekeeper: $13,836.37 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $8,527.06 Cigna — Commercial: $14,801.70 Health EOS — Commercial: $14,319.03 HFN — Commercial: $14,801.70 Multiplan — Commercial: $12,871.04 Preferred Network Access — Commercial: $14,801.70 Quartz — Beloit One Network: $7,883.51 Quartz — Commercial: $9,653.28
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnogram - Sleep Test	$7,737	$2,321.10	$903.73 – $7,402.76
Sleep study (overnight, in a sleep lab): 10 of 33 insurance plan rates Aetna — Commercial: $7,241.83 Aetna — Gatekeeper/Not Gatekeeper: $6,919.97 Aetna — Managed Medicare: $903.73 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $903.73 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $4,264.63 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $903.73 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $903.73
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnogram	$7,000	$2,100	$903.73 – $6,697.60
Sleep study (overnight, in a sleep lab): 10 of 33 insurance plan rates Aetna — Commercial: $6,552 Aetna — Gatekeeper/Not Gatekeeper: $6,260.80 Aetna — Managed Medicare: $903.73 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $903.73 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $3,858.40 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $903.73 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $903.73
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Polysomnogram - Sleep Test	$7,737	$2,321.10	$3,942.78 – $7,402.76
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates Aetna — Commercial: $7,241.83 Aetna — Gatekeeper/Not Gatekeeper: $6,919.97 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $4,264.63 Cigna — Commercial: $7,402.76 Health EOS — Commercial: $7,161.37 HFN — Commercial: $7,402.76 Multiplan — Commercial: $6,437.18 Preferred Network Access — Commercial: $7,402.76 Quartz — Beloit One Network: $3,942.78 Quartz — Commercial: $4,827.89

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: OT Therapeutic Exercise Charge	$194	$58.20	$56.49 – $362.96
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates Aetna — Commercial: $181.58 Aetna — Gatekeeper/Not Gatekeeper: $173.51 Aetna — Managed Medicare: $56.49 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $106.93 Cigna — Commercial: $185.62 Dean Health — DHI/DHP/ASO: $112.91 Health EOS — Commercial: $179.57
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Therapeutic Exercise Charges	$236	$70.80	$68.72 – $362.96
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates Aetna — Commercial: $220.90 Aetna — Gatekeeper/Not Gatekeeper: $211.08 Aetna — Managed Medicare: $68.72 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $130.08 Cigna — Commercial: $225.80 Dean Health — DHI/DHP/ASO: $137.35 Health EOS — Commercial: $218.44
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OT Therapeutic Exercise Charge	$194	$58.20	$98.86 – $185.62
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates Aetna — Commercial: $181.58 Aetna — Gatekeeper/Not Gatekeeper: $173.51 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $106.93 Cigna — Commercial: $185.62 Health EOS — Commercial: $179.57 HFN — Commercial: $185.62 Multiplan — Commercial: $161.41 Preferred Network Access — Commercial: $185.62 Quartz — Beloit One Network: $98.86 Quartz — Commercial: $121.06
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Evaluation Low Complexity	$415	$124.50	$120.85 – $398.11
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates Aetna — Commercial: $388.44 Aetna — Gatekeeper/Not Gatekeeper: $371.18 Aetna — Managed Medicare: $120.85 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $228.75 Cigna — Commercial: $397.07 Dean Health — DHI/DHP/ASO: $241.53 Health EOS — Commercial: $384.12
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Evaluation Low Complexity	$415	$124.50	$211.48 – $397.07
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates Aetna — Commercial: $388.44 Aetna — Gatekeeper/Not Gatekeeper: $371.18 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $228.75 Cigna — Commercial: $397.07 Health EOS — Commercial: $384.12 HFN — Commercial: $397.07 Multiplan — Commercial: $345.28 Preferred Network Access — Commercial: $397.07 Quartz — Beloit One Network: $211.48 Quartz — Commercial: $258.96
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Yes - PT Evaluation Low Charge	$415	$124.50	$120.85 – $397.07
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates Aetna — Commercial: $388.44 Aetna — Gatekeeper/Not Gatekeeper: $371.18 Aetna — Managed Medicare: $120.85 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $228.75 Cigna — Commercial: $397.07 Dean Health — DHI/DHP/ASO: $241.53 Health EOS — Commercial: $384.12
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Evaluation Moderate Complex 30 min	$640	$192	$186.37 – $612.35
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates Aetna — Commercial: $599.04 Aetna — Gatekeeper/Not Gatekeeper: $572.42 Aetna — Managed Medicare: $186.37 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $352.77 Cigna — Commercial: $612.35 Dean Health — DHI/DHP/ASO: $372.48 Health EOS — Commercial: $592.38
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Evaluation Moderate Complex 30 min	$640	$192	$326.14 – $612.35
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates Aetna — Commercial: $599.04 Aetna — Gatekeeper/Not Gatekeeper: $572.42 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $352.77 Cigna — Commercial: $612.35 Health EOS — Commercial: $592.38 HFN — Commercial: $612.35 Multiplan — Commercial: $532.48 Preferred Network Access — Commercial: $612.35 Quartz — Beloit One Network: $326.14 Quartz — Commercial: $399.36
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Yes - PT Evaluation Moderate Charge	$640	$192	$186.37 – $612.35
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates Aetna — Commercial: $599.04 Aetna — Gatekeeper/Not Gatekeeper: $572.42 Aetna — Managed Medicare: $186.37 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $352.77 Cigna — Commercial: $612.35 Dean Health — DHI/DHP/ASO: $372.48 Health EOS — Commercial: $592.38
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Evaluation High Complexity	$702	$210.60	$204.42 – $671.67
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates Aetna — Commercial: $657.07 Aetna — Gatekeeper/Not Gatekeeper: $627.87 Aetna — Managed Medicare: $204.42 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $386.94 Cigna — Commercial: $671.67 Dean Health — DHI/DHP/ASO: $408.56 Health EOS — Commercial: $649.77
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Evaluation High Complexity	$702	$210.60	$357.74 – $671.67
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates Aetna — Commercial: $657.07 Aetna — Gatekeeper/Not Gatekeeper: $627.87 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $386.94 Cigna — Commercial: $671.67 Health EOS — Commercial: $649.77 HFN — Commercial: $671.67 Multiplan — Commercial: $584.06 Preferred Network Access — Commercial: $671.67 Quartz — Beloit One Network: $357.74 Quartz — Commercial: $438.05
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Yes - PT Evaluation High Charge	$702	$210.60	$204.42 – $671.67
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates Aetna — Commercial: $657.07 Aetna — Gatekeeper/Not Gatekeeper: $627.87 Aetna — Managed Medicare: $204.42 Anthem — Blue Access PPO/Blue Traditional: $362.96 Anthem — Blue Preferred/Blue Preferred Plus: $298.48 Anthem — Blue Priority WI/Blue Priority X-WI: $282.88 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $386.94 Cigna — Commercial: $671.67 Dean Health — DHI/DHP/ASO: $408.56 Health EOS — Commercial: $649.77
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy 30 minutes w/ patient and/or family 90832	$333	$99.90	$71.82 – $329
Psychotherapy, 30 minutes: 10 of 24 insurance plan rates Aetna — Commercial: $329 Aetna — Gatekeeper/Not Gatekeeper: $297.84 Aetna — Managed Medicare: $71.82 Anthem — Medicare Advantage: $71.82 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $71.82 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $71.82 Cigna — Commercial: $329 Cook Children's Health Plan (CCHP) — Medicaid: $173.16 Dean Health — DHI/DHP/ASO: $71.82 Health EOS — Commercial: $315.15
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy 30 min (16-37) 90832	$333	$99.90	$71.82 – $329
Psychotherapy, 30 minutes: 10 of 24 insurance plan rates Aetna — Commercial: $329 Aetna — Gatekeeper/Not Gatekeeper: $297.84 Aetna — Managed Medicare: $71.82 Anthem — Medicare Advantage: $71.82 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $71.82 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $71.82 Cigna — Commercial: $329 Cook Children's Health Plan (CCHP) — Medicaid: $173.16 Dean Health — DHI/DHP/ASO: $71.82 Health EOS — Commercial: $315.15
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy 45 minute w/ patient and/or family 90834	$220	$66	$94.80 – $379.18
Psychotherapy, 45 minutes: 10 of 24 insurance plan rates Aetna — Commercial: $217.36 Aetna — Gatekeeper/Not Gatekeeper: $196.77 Aetna — Managed Medicare: $94.80 Anthem — Medicare Advantage: $94.80 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $94.80 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $94.80 Cigna — Commercial: $217.36 Cook Children's Health Plan (CCHP) — Medicaid: $114.40 Dean Health — DHI/DHP/ASO: $94.80 Health EOS — Commercial: $208.21
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy 60 min w/ patient and/or family 90837	$485	$145.50	$139.84 – $559.35
Psychotherapy, 60 minutes: 10 of 24 insurance plan rates Aetna — Commercial: $479.18 Aetna — Gatekeeper/Not Gatekeeper: $433.78 Aetna — Managed Medicare: $139.84 Anthem — Medicare Advantage: $139.84 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $139.84 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $139.84 Cigna — Commercial: $479.18 Cook Children's Health Plan (CCHP) — Medicaid: $252.20 Dean Health — DHI/DHP/ASO: $139.84 Health EOS — Commercial: $459

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION 19120	$1,684	$505.20	$318.16 – $1,719.01
Removal of breast growth (open surgery): 10 of 25 insurance plan rates Aetna — Commercial: $1,663.79 Aetna — Gatekeeper/Not Gatekeeper: $1,506.17 Aetna — Managed Medicare: $382 Anthem — Medicare Advantage: $382 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $382 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $382 Cigna — Commercial: $1,663.79 Cook Children's Health Plan (CCHP) — Medicaid: $318.16 Dean Health — DHI/DHP/ASO: $382 Health EOS — Commercial: $1,593.74
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19	Not listed in the file	Not listed in the file	$4,120.56 – $16,482.25
Removal of breast growth (open surgery): 10 of 21 insurance plan rates Aetna — Managed Medicare: $4,120.56 Anthem — Blue Access PPO/Blue Traditional: $10,303.28 Anthem — Blue Preferred/Blue Preferred Plus: $8,364.72 Anthem — Blue Priority WI/Blue Priority X-WI: $7,944.56 Anthem — Medicare Advantage: $4,120.56 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $4,120.56 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $4,120.56 Cook Children's Health Plan (CCHP) — Commercial: $4,120.56 Dean Health — DHI/DHP/ASO: $6,807.99 Dean Health — Medicare Advantage/Medicare Select: $4,120.56
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: Removal of Breast Lesion 1912050	$3,369	$1,010.70	$318.16 – $3,328.57
Removal of breast growth (open surgery): 10 of 17 insurance plan rates Aetna — Commercial: $3,328.57 Aetna — Gatekeeper/Not Gatekeeper: $3,013.23 Cigna — Commercial: $3,328.57 Cook Children's Health Plan (CCHP) — Medicaid: $318.16 Dean Health — DHI/DHP/ASO: $2,102.26 Health EOS — Commercial: $3,188.42 HFN — Commercial: $3,328.57 Humana — Commercial/EPO/HMO/POS/PPO: $1,411.54 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $1,411.54 Multiplan — Commercial: $2,803.01
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$8,790.08 – $54,045.18
Total hip replacement: 10 of 21 insurance plan rates Aetna — Managed Medicare: $13,511.30 Anthem — Blue Access PPO/Blue Traditional: $18,182.32 Anthem — Blue Preferred/Blue Preferred Plus: $16,724.24 Anthem — Blue Priority WI/Blue Priority X-WI: $15,889.12 Anthem — Medicare Advantage: $13,511.30 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $13,511.30 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $13,511.30 Cook Children's Health Plan (CCHP) — Commercial: $13,511.30 Dean Health — DHI/DHP/ASO: $12,349.86 Dean Health — Medicare Advantage/Medicare Select: $13,511.30
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)	Not listed in the file	Not listed in the file	$9,979.84 – $54,045.18
Total knee replacement: 10 of 21 insurance plan rates Aetna — Managed Medicare: $13,511.30 Anthem — Blue Access PPO/Blue Traditional: $19,394.96 Anthem — Blue Preferred/Blue Preferred Plus: $19,394.96 Anthem — Blue Priority WI/Blue Priority X-WI: $17,919.20 Anthem — Medicare Advantage: $13,511.30 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $13,511.30 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $13,511.30 Cook Children's Health Plan (CCHP) — Commercial: $13,511.30 Dean Health — DHI/DHP/ASO: $12,349.86 Dean Health — Medicare Advantage/Medicare Select: $13,511.30
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) re	Not listed in the file	Not listed in the file	$553.07 – $10,279.44
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans Dean Health — DHI/DHP/ASO: $10,279.44 The Alliance — Commercial: $553.07
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articula	Not listed in the file	Not listed in the file	$3,443.42 – $13,773.68
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 21 insurance plan rates Aetna — Managed Medicare: $3,443.42 Anthem — Blue Access PPO/Blue Traditional: $10,303.28 Anthem — Blue Preferred/Blue Preferred Plus: $8,364.72 Anthem — Blue Priority WI/Blue Priority X-WI: $7,944.56 Anthem — Medicare Advantage: $3,443.42 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3,443.42 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3,443.42 Cook Children's Health Plan (CCHP) — Commercial: $3,443.42 Dean Health — DHI/DHP/ASO: $10,279.44 Dean Health — Medicare Advantage/Medicare Select: $3,443.42
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy and adenoidectomy; younger than age 12	Not listed in the file	Not listed in the file	$4,409.60 – $24,919.86
Removal of tonsils and adenoids (under age 12): 10 of 21 insurance plan rates Aetna — Managed Medicare: $6,229.96 Anthem — Blue Access PPO/Blue Traditional: $12,727.52 Anthem — Blue Preferred/Blue Preferred Plus: $11,350.56 Anthem — Blue Priority WI/Blue Priority X-WI: $10,781.68 Anthem — Medicare Advantage: $6,229.96 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6,229.96 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6,229.96 Cook Children's Health Plan (CCHP) — Commercial: $6,229.96 Dean Health — DHI/DHP/ASO: $8,673.35 Dean Health — Medicare Advantage/Medicare Select: $6,229.96
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: UPPR GI ENDOSCOPY, DIAGNOSIS 43235	$1,581	$474.30	$107.70 – $1,562.03
Upper GI endoscopy (diagnostic): 10 of 25 insurance plan rates Aetna — Commercial: $1,562.03 Aetna — Gatekeeper/Not Gatekeeper: $1,414.05 Aetna — Managed Medicare: $107.70 Anthem — Medicare Advantage: $107.70 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $107.70 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $107.70 Cigna — Commercial: $1,562.03 Cook Children's Health Plan (CCHP) — Medicaid: $270.82 Dean Health — DHI/DHP/ASO: $107.70 Health EOS — Commercial: $1,496.26
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep	Not listed in the file	Not listed in the file	$954.50 – $4,386.95
Upper GI endoscopy (diagnostic): 10 of 21 insurance plan rates Aetna — Managed Medicare: $954.50 Anthem — Blue Access PPO/Blue Traditional: $3,030.56 Anthem — Blue Preferred/Blue Preferred Plus: $2,388.88 Anthem — Blue Priority WI/Blue Priority X-WI: $2,270.32 Anthem — Medicare Advantage: $954.50 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $954.50 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $954.50 Cook Children's Health Plan (CCHP) — Commercial: $954.50 Dean Health — DHI/DHP/ASO: $4,386.95 Dean Health — Medicare Advantage/Medicare Select: $954.50
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee · modifier 22 In the file: UPPR GI ENDOSCOPY, DIAGNOSIS, EXTENDED 4323522	$1,897	$569.10	$270.82 – $1,874.24
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — Commercial: $1,874.24 Aetna — Gatekeeper/Not Gatekeeper: $1,696.68 Cigna — Commercial: $1,874.24 Cook Children's Health Plan (CCHP) — Medicaid: $270.82 Dean Health — DHI/DHP/ASO: $1,183.73 Health EOS — Commercial: $1,795.32 HFN — Commercial: $1,874.24 Humana — Commercial/EPO/HMO/POS/PPO: $425.64 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $425.64 Multiplan — Commercial: $1,578.30
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Esophagogastroduodenoscopy, flexible, transoral; w/ biopsy, single or multiple	$1,119	$335.70	$313.04 – $4,947.89
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Commercial: $1,047.38 Aetna — Gatekeeper/Not Gatekeeper: $1,000.83 Aetna — Managed Medicare: $954.50 Anthem — Blue Access PPO/Blue Traditional: $756.44 Anthem — Blue Preferred/Blue Preferred Plus: $581.88 Anthem — Blue Priority WI/Blue Priority X-WI: $558.60 Anthem — Medicare Advantage: $954.50 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $616.79 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $954.50 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $954.50
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY, BIOPSY 43239	$1,747	$524.10	$120.43 – $1,726.04
Upper GI endoscopy with biopsy: 10 of 25 insurance plan rates Aetna — Commercial: $1,726.04 Aetna — Gatekeeper/Not Gatekeeper: $1,562.52 Aetna — Managed Medicare: $120.43 Anthem — Medicare Advantage: $120.43 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $120.43 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $120.43 Cigna — Commercial: $1,726.04 Cook Children's Health Plan (CCHP) — Medicaid: $313.81 Dean Health — DHI/DHP/ASO: $120.43 Health EOS — Commercial: $1,653.36
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Esophagogastroduodenoscopy, flexible, transoral; w/ biopsy, single or multiple	$1,119	$335.70	$570.24 – $1,070.66
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates Aetna — Commercial: $1,047.38 Aetna — Gatekeeper/Not Gatekeeper: $1,000.83 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $616.79 Cigna — Commercial: $1,070.66 Health EOS — Commercial: $1,035.75 HFN — Commercial: $1,070.66 Multiplan — Commercial: $931.01 Preferred Network Access — Commercial: $1,070.66 Quartz — Beloit One Network: $570.24 Quartz — Commercial: $698.26
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC COLONOSCOPY 45378	$2,188	$656.40	$159.44 – $2,161.74
Colonoscopy (diagnostic): 10 of 25 insurance plan rates Aetna — Commercial: $2,161.74 Aetna — Gatekeeper/Not Gatekeeper: $1,956.95 Aetna — Managed Medicare: $159.44 Anthem — Medicare Advantage: $159.44 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $159.44 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $159.44 Cigna — Commercial: $2,161.74 Cook Children's Health Plan (CCHP) — Medicaid: $358.58 Dean Health — DHI/DHP/ASO: $159.44 Health EOS — Commercial: $2,070.72
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$978.68 – $4,947.89
Colonoscopy (diagnostic): 10 of 21 insurance plan rates Aetna — Managed Medicare: $978.68 Anthem — Blue Access PPO/Blue Traditional: $3,030.56 Anthem — Blue Preferred/Blue Preferred Plus: $2,388.88 Anthem — Blue Priority WI/Blue Priority X-WI: $2,270.32 Anthem — Medicare Advantage: $978.68 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $978.68 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $978.68 Cook Children's Health Plan (CCHP) — Commercial: $978.68 Dean Health — DHI/DHP/ASO: $4,947.89 Dean Health — Medicare Advantage/Medicare Select: $978.68
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 22 In the file: DIAGNOSTIC COLONOSCOPY, EXTENDED 4537822	$2,626	$787.80	$358.58 – $2,594.49
Colonoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — Commercial: $2,594.49 Aetna — Gatekeeper/Not Gatekeeper: $2,348.69 Cigna — Commercial: $2,594.49 Cook Children's Health Plan (CCHP) — Medicaid: $358.58 Dean Health — DHI/DHP/ASO: $1,638.62 Health EOS — Commercial: $2,485.25 HFN — Commercial: $2,594.49 Humana — Commercial/EPO/HMO/POS/PPO: $641.91 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $641.91 Multiplan — Commercial: $2,184.83
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY 45380	$2,432	$729.60	$172.62 – $2,402.82
Colonoscopy with biopsy: 10 of 25 insurance plan rates Aetna — Commercial: $2,402.82 Aetna — Gatekeeper/Not Gatekeeper: $2,175.18 Aetna — Managed Medicare: $172.62 Anthem — Medicare Advantage: $172.62 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $172.62 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $172.62 Cigna — Commercial: $2,402.82 Cook Children's Health Plan (CCHP) — Medicaid: $430.63 Dean Health — DHI/DHP/ASO: $172.62 Health EOS — Commercial: $2,301.64
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,259.34 – $5,037.34
Colonoscopy with biopsy: 10 of 21 insurance plan rates Aetna — Managed Medicare: $1,259.34 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $1,259.34 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $1,259.34 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $1,259.34 Cook Children's Health Plan (CCHP) — Commercial: $1,259.34 Dean Health — DHI/DHP/ASO: $4,947.89 Dean Health — Medicare Advantage/Medicare Select: $1,259.34
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: LESION REMOVAL VIA A COLONOSCOPY 45385	$2,777	$833.10	$217.62 – $2,743.68
Colonoscopy with removal of polyps (snare): 10 of 25 insurance plan rates Aetna — Commercial: $2,743.68 Aetna — Gatekeeper/Not Gatekeeper: $2,483.75 Aetna — Managed Medicare: $217.62 Anthem — Medicare Advantage: $217.62 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $217.62 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $217.62 Cigna — Commercial: $2,743.68 Cook Children's Health Plan (CCHP) — Medicaid: $486.11 Dean Health — DHI/DHP/ASO: $217.62 Health EOS — Commercial: $2,628.15
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$1,259.34 – $5,037.34
Colonoscopy with removal of polyps (snare): 10 of 21 insurance plan rates Aetna — Managed Medicare: $1,259.34 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $1,259.34 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $1,259.34 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $1,259.34 Cook Children's Health Plan (CCHP) — Commercial: $1,259.34 Dean Health — DHI/DHP/ASO: $4,947.89 Dean Health — Medicare Advantage/Medicare Select: $1,259.34
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$5,476.64 – $25,449.01
Gallbladder removal by laparoscope: 10 of 21 insurance plan rates Aetna — Managed Medicare: $6,362.25 Anthem — Blue Access PPO/Blue Traditional: $15,758.08 Anthem — Blue Preferred/Blue Preferred Plus: $13,140.40 Anthem — Blue Priority WI/Blue Priority X-WI: $12,483.12 Anthem — Medicare Advantage: $6,362.25 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $6,362.25 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $6,362.25 Cook Children's Health Plan (CCHP) — Commercial: $6,362.25 Dean Health — DHI/DHP/ASO: $12,490.12 Dean Health — Medicare Advantage/Medicare Select: $6,362.25
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Repair initial inguinal hernia, age 5 years or older; reducible	Not listed in the file	Not listed in the file	$3,767.97 – $15,071.89
Groin (inguinal) hernia repair, age 5 or older: 10 of 21 insurance plan rates Aetna — Managed Medicare: $3,767.97 Anthem — Blue Access PPO/Blue Traditional: $10,303.28 Anthem — Blue Preferred/Blue Preferred Plus: $8,364.72 Anthem — Blue Priority WI/Blue Priority X-WI: $7,944.56 Anthem — Medicare Advantage: $3,767.97 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3,767.97 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3,767.97 Cook Children's Health Plan (CCHP) — Commercial: $3,767.97 Dean Health — DHI/DHP/ASO: $8,107.14 Dean Health — Medicare Advantage/Medicare Select: $3,767.97
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Biopsy, Prostate needle or punch	$426	$127.80	$124.05 – $4,947.89
Prostate biopsy: 10 of 22 insurance plan rates Aetna — Commercial: $398.74 Aetna — Gatekeeper/Not Gatekeeper: $381.01 Aetna — Managed Medicare: $124.05 Anthem — Blue Access PPO/Blue Traditional: $287.98 Anthem — Blue Preferred/Blue Preferred Plus: $221.52 Anthem — Blue Priority WI/Blue Priority X-WI: $212.66 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $234.81 Cigna — Commercial: $407.60 Dean Health — DHI/DHP/ASO: $4,947.89 Health EOS — Commercial: $394.31
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy, Prostate needle or punch 55700	$920	$276	$420.99 – $908.96
Prostate biopsy: 10 of 16 insurance plan rates Aetna — Commercial: $908.96 Aetna — Gatekeeper/Not Gatekeeper: $822.85 Cigna — Commercial: $908.96 Cook Children's Health Plan (CCHP) — Medicaid: $478.40 Dean Health — DHI/DHP/ASO: $574.08 Health EOS — Commercial: $870.69 HFN — Commercial: $908.96 Humana — Commercial/EPO/HMO/POS/PPO: $451.52 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $451.52 Multiplan — Commercial: $765.44
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Biopsy, Prostate needle or punch	$426	$127.80	$217.09 – $407.60
Prostate biopsy: 10 of 12 insurance plan rates Aetna — Commercial: $398.74 Aetna — Gatekeeper/Not Gatekeeper: $381.01 Blue Cross Blue Shield of Illinois — Blue Cross PPO: $234.81 Cigna — Commercial: $407.60 Health EOS — Commercial: $394.31 HFN — Commercial: $407.60 Multiplan — Commercial: $354.43 Preferred Network Access — Commercial: $407.60 Quartz — Beloit One Network: $217.09 Quartz — Commercial: $265.82
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY, BIOPSY 58558	$3,678	$1,103.40	$184.86 – $3,633.86
Hysteroscopy with biopsy of the uterus lining: 10 of 25 insurance plan rates Aetna — Commercial: $3,633.86 Aetna — Gatekeeper/Not Gatekeeper: $3,289.60 Aetna — Managed Medicare: $193.35 Anthem — Medicare Advantage: $193.35 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $193.35 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $193.35 Cigna — Commercial: $3,633.86 Cook Children's Health Plan (CCHP) — Medicaid: $184.86 Dean Health — DHI/DHP/ASO: $193.35 Health EOS — Commercial: $3,480.86
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C	Not listed in the file	Not listed in the file	$2,835.04 – $13,626.87
Hysteroscopy with biopsy of the uterus lining: 10 of 21 insurance plan rates Aetna — Managed Medicare: $3,406.72 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $3,406.72 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $3,406.72 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $3,406.72 Cook Children's Health Plan (CCHP) — Commercial: $3,406.72 Dean Health — DHI/DHP/ASO: $6,807.99 Dean Health — Medicare Advantage/Medicare Select: $3,406.72
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: Injection W/Image Spine Lumbar/Sacral 62323	$882	$264.60	$87.58 – $871.42
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates Aetna — Commercial: $871.42 Aetna — Gatekeeper/Not Gatekeeper: $788.86 Aetna — Managed Medicare: $87.58 Anthem — Medicare Advantage: $87.58 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $87.58 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $87.58 Cigna — Commercial: $871.42 Cook Children's Health Plan (CCHP) — Medicaid: $197.20 Dean Health — DHI/DHP/ASO: $87.58 Health EOS — Commercial: $834.72
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including ne	Not listed in the file	Not listed in the file	$742.86 – $4,386.95
Spinal injection, lower back (epidural), with imaging guidance: 10 of 21 insurance plan rates Aetna — Managed Medicare: $742.86 Anthem — Blue Access PPO/Blue Traditional: $3,030.56 Anthem — Blue Preferred/Blue Preferred Plus: $2,388.88 Anthem — Blue Priority WI/Blue Priority X-WI: $2,270.32 Anthem — Medicare Advantage: $742.86 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $742.86 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $742.86 Cook Children's Health Plan (CCHP) — Commercial: $742.86 Dean Health — DHI/DHP/ASO: $4,386.95 Dean Health — Medicare Advantage/Medicare Select: $742.86
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: Injection Foramen Epidural L/S 64483	$1,320	$396	$98.03 – $1,304.16
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates Aetna — Commercial: $1,304.16 Aetna — Gatekeeper/Not Gatekeeper: $1,180.61 Aetna — Managed Medicare: $98.03 Anthem — Medicare Advantage: $98.03 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $98.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $98.03 Cigna — Commercial: $1,304.16 Cook Children's Health Plan (CCHP) — Medicaid: $209.87 Dean Health — DHI/DHP/ASO: $98.03 Health EOS — Commercial: $1,249.25
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: Injection Foramen Epidural L/S 6448350	$2,640	$792	$209.87 – $2,608.32
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates Aetna — Commercial: $2,608.32 Aetna — Gatekeeper/Not Gatekeeper: $2,361.22 Cigna — Commercial: $2,608.32 Cook Children's Health Plan (CCHP) — Medicaid: $209.87 Dean Health — DHI/DHP/ASO: $1,647.36 Health EOS — Commercial: $2,498.50 HFN — Commercial: $2,608.32 Humana — Commercial/EPO/HMO/POS/PPO: $392.24 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $392.24 Multiplan — Commercial: $2,196.48
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY 64721	$2,989	$896.70	$362.71 – $2,953.13
Carpal tunnel release: 10 of 25 insurance plan rates Aetna — Commercial: $2,953.13 Aetna — Gatekeeper/Not Gatekeeper: $2,673.36 Aetna — Managed Medicare: $406.36 Anthem — Medicare Advantage: $406.36 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $406.36 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $406.36 Cigna — Commercial: $2,953.13 Cook Children's Health Plan (CCHP) — Medicaid: $362.71 Dean Health — DHI/DHP/ASO: $406.36 Health EOS — Commercial: $2,828.79
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel	Not listed in the file	Not listed in the file	$2,055.03 – $8,220.12
Carpal tunnel release: 10 of 21 insurance plan rates Aetna — Managed Medicare: $2,055.03 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $2,055.03 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $2,055.03 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $2,055.03 Cook Children's Health Plan (CCHP) — Commercial: $2,055.03 Dean Health — DHI/DHP/ASO: $4,947.89 Dean Health — Medicare Advantage/Medicare Select: $2,055.03
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: Laser Surgery Of Lens; YAG	$1,117	$335.10	$267.20 – $1,230.42
Laser treatment of clouding after cataract surgery: 10 of 25 insurance plan rates Aetna — Commercial: $1,103.60 Aetna — Gatekeeper/Not Gatekeeper: $999.04 Aetna — Managed Medicare: $273.43 Anthem — Medicare Advantage: $273.43 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $273.43 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $273.43 Cigna — Commercial: $1,103.60 Cook Children's Health Plan (CCHP) — Medicaid: $267.20 Dean Health — DHI/DHP/ASO: $273.43 Health EOS — Commercial: $1,057.13
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: Laser Surgery of Lens; YAG 6682150	$2,233	$669.90	$267.20 – $2,206.20
Laser treatment of clouding after cataract surgery: 10 of 17 insurance plan rates Aetna — Commercial: $2,206.20 Aetna — Gatekeeper/Not Gatekeeper: $1,997.20 Cigna — Commercial: $2,206.20 Cook Children's Health Plan (CCHP) — Medicaid: $267.20 Dean Health — DHI/DHP/ASO: $1,393.39 Health EOS — Commercial: $2,113.31 HFN — Commercial: $2,206.20 Humana — Commercial/EPO/HMO/POS/PPO: $1,094.38 Humana — Medicare EPO/Medicare HMO/Medicare PPO: $1,094.38 Multiplan — Commercial: $1,857.86
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irri	Not listed in the file	Not listed in the file	$2,428.73 – $12,349.86
Cataract removal with lens implant: 10 of 21 insurance plan rates Aetna — Managed Medicare: $2,428.73 Anthem — Blue Access PPO/Blue Traditional: $3,635.84 Anthem — Blue Preferred/Blue Preferred Plus: $2,985.84 Anthem — Blue Priority WI/Blue Priority X-WI: $2,835.04 Anthem — Medicare Advantage: $2,428.73 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $2,428.73 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $2,428.73 Cook Children's Health Plan (CCHP) — Commercial: $2,428.73 Dean Health — DHI/DHP/ASO: $12,349.86 Dean Health — Medicare Advantage/Medicare Select: $2,428.73

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	$75,425.39 – $268,678.80
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 21 insurance plan rates Aetna — Managed Medicare: $75,425.39 Anthem — Blue Access PPO/Blue Traditional: $213,452.87 Anthem — Blue Preferred/Blue Preferred Plus: $163,609.90 Anthem — Blue Priority WI/Blue Priority X-WI: $155,440.08 Anthem — Medicare Advantage: $75,425.39 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $75,425.39 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $75,425.39 Cook Children's Health Plan (CCHP) — Commercial: $75,425.39 Dean Health — DHI/DHP/ASO: $172,552.74 Dean Health — Medicare Advantage/Medicare Select: $75,425.39
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$15,278.68 – $52,360.88
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates Aetna — Managed Medicare: $15,278.68 Anthem — Blue Access PPO/Blue Traditional: $42,087.05 Anthem — Blue Preferred/Blue Preferred Plus: $32,259.39 Anthem — Blue Priority WI/Blue Priority X-WI: $30,648.52 Anthem — Medicare Advantage: $15,278.68 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $15,278.68 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $15,278.68 Cook Children's Health Plan (CCHP) — Commercial: $15,278.68 Dean Health — DHI/DHP/ASO: $34,022.67 Dean Health — Medicare Advantage/Medicare Select: $15,278.68
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	$25,535.24 – $68,367.52
Neck (cervical) spinal fusion, without complications: 10 of 21 insurance plan rates Aetna — Managed Medicare: $25,535.24 Anthem — Blue Access PPO/Blue Traditional: $53,267.21 Anthem — Blue Preferred/Blue Preferred Plus: $40,828.89 Anthem — Blue Priority WI/Blue Priority X-WI: $38,790.11 Anthem — Medicare Advantage: $25,535.24 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $25,535.24 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $25,535.24 Cook Children's Health Plan (CCHP) — Commercial: $25,535.24 Dean Health — DHI/DHP/ASO: $43,060.58 Dean Health — Medicare Advantage/Medicare Select: $25,535.24
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$10,008.30 – $32,461.52
Uterus and ovary surgery (not for cancer), without complications: 10 of 21 insurance plan rates Aetna — Managed Medicare: $10,008.30 Anthem — Blue Access PPO/Blue Traditional: $27,071.08 Anthem — Blue Preferred/Blue Preferred Plus: $20,749.76 Anthem — Blue Priority WI/Blue Priority X-WI: $19,713.63 Anthem — Medicare Advantage: $10,008.30 Blue Cross Blue Shield of Illinois — Medicare Advantage HMO: $10,008.30 Blue Cross Blue Shield of Illinois — Medicare Advantage PPO: $10,008.30 Cook Children's Health Plan (CCHP) — Commercial: $10,008.30 Dean Health — DHI/DHP/ASO: $21,883.94 Dean Health — Medicare Advantage/Medicare Select: $10,008.30

Source: Beloit Health System’s standard charges file (pricetransparency.healthcare, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 12, 2026; retrieved November 5, 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	1969 W Hart Rd, Beloit, WI 53511
County	Rock County
State	Wisconsin
Phone	(608) 364‑5011
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	520100
Name in Medicare records	BELOIT HEALTH SYSTEM
Profile level	Medicare data + hospital website
Name on the hospital’s website	Beloit Memorial Hospital (Beloit Health System)
Official website	beloithealthsystem.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

Beloit Memorial Hospital | Beloit Health System — beloithealthsystem.org

Beloit Health System

Summary

Profile from official sources

At a glance