Does Cape Fear Valley Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Cape Fear Valley Medical Center. In a medical emergency, call 911.

Where is Cape Fear Valley Medical Center?

1638 Owen Drive P O Box 2000, Fayetteville, NC 28302, in Cumberland County, North Carolina.

What is the phone number of Cape Fear Valley Medical Center?

(910) 609-4000, as listed by Medicare (CMS).

What is the Medicare star rating of Cape Fear Valley Medical Center?

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

Cape Fear Valley Medical Center

Quick answers

Does Cape Fear Valley Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Cape Fear Valley Medical Center. In a medical emergency, call 911.
Where is Cape Fear Valley Medical Center?: 1638 Owen Drive P O Box 2000, Fayetteville, NC 28302, in Cumberland County, North Carolina.
What is the phone number of Cape Fear Valley Medical Center?: (910) 609-4000, as listed by Medicare (CMS).
What is the Medicare star rating of Cape Fear Valley Medical Center?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Treatments^[4]

In-hospital therapy

Procedures^[10]

Cardiac catheterization

Programs and centers^{[4][6][7][10][11]}

Heart & Vascular Center
Neonatal Intensive Care Unit (NICU)
Pediatric Intensive Care Unit (PICU)
Pediatric Emergency Department
Imaging Services
Rehabilitation Services
Lab Services
Surgical Services
Weight Loss Services
In-Hospital Therapy

Emergency care (hospital website)^[4][5][7]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Parking	Free parking in a lot at the corner of Owen Drive and Melrose Road^[4]
Patient portal	MyChart

Recognition^[4]

Accredited by The Joint Commission

Doctors and clinicians (930)

930 doctors and other clinicians list Cape Fear Valley Medical Center 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

And 906 more: the button below opens the full list.

Other emergency rooms nearby

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

Fayetteville NC VA Medical Center4.9 mi · Fayetteville, NC · Federal/VA Acute Care Hospital
Womack AMC (FT Bragg)9.0 mi · Fort Bragg, NC · Military Hospital (Department of Defense)
Cape Fear Valley Hoke Hospital18 mi · Raeford, NC · Acute Care Hospital
Betsy Johnson Regional Hospital26 mi · Dunn, NC · Acute Care Hospital
Southeastern Regional Medical Center28 mi · Lumberton, NC · Acute Care Hospital

Other hospitals nearby

Highsmith Rainey Memorial Hospital2.9 mi · Fayetteville, NC · Long-Term Acute Care Hospital
Good Hope Hospital, Inc25 mi · Erwin, NC · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Village Green Health and Rehabilitation0.7 mi · Fayetteville, NC · 5 of 5 stars
The Carrolton of Fayetteville1.9 mi · Fayetteville, NC · 3 of 5 stars
Carolina Rehab Center of Cumberland2.4 mi · Fayetteville, NC · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Cape Fear Valley Hospice and Palliative Care1.9 mi · Fayetteville, NC · 4 of 5 stars
3HC3.3 mi · Fayetteville, NC
Healthkeeperz, Inc3.3 mi · Fayetteville, NC

All hospice providers in the state →

Home health agencies

Amedisys Home Health of Fayetteville3.3 mi · Fayetteville, NC · 4 of 5 stars
Bayada Home Health Care, Inc.3.3 mi · Fayetteville, NC · 3 of 5 stars
Cape Fear Valley Home Health3.3 mi · Fayetteville, NC · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC of West Fayetteville3.3 mi · Fayetteville, NC · 1 of 5 stars
FMC Dialysis Services South Ramsey3.9 mi · Fayetteville, NC · 1 of 5 stars
Fresenius Kidney Care Rockfish5.0 mi · Fayetteville, NC · 2 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.

Digestive Health Endoscopy Center, LLC3.3 mi · Fayetteville, NC
Fayetteville Ambulatory Surger3.3 mi · Fayetteville, NC
Fayetteville Gastroenterology Associates, PA3.3 mi · Fayetteville, NC

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Goshen Medical Center - Cape Fear0.4 mi · Fayetteville, NC · Community health center
Goshen Medical Center-Fayetteville1.9 mi · Fayetteville, NC · Community health center
Wade Family Medical Center - Downtown4.0 mi · Fayetteville, NC · Community health center

Clinics and urgent care

Cape Fear Family Medical Care, PA3.3 mi · Fayetteville, NC · Urgent care center
CFV Express Care Billing Services LLC3.3 mi · Fayetteville, NC · Urgent care center
Divine Family Practice and Urgent Care, PLLC3.3 mi · Fayetteville, NC · Urgent care center

Pharmacies

A2A Elite Pharmacy3.3 mi · Fayetteville, NC · Pharmacy
Cumberland County Hospital System Inc3.3 mi · Fayetteville, NC · Community/retail pharmacy
Fayetteville Drugs LLC3.3 mi · Fayetteville, NC · Community/retail pharmacy

Assisted living nearby

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

Unbridled Living of Fayetteville3.9 mi · Fayetteville, NC
Carolina Inn at Village Green4.0 mi · Fayetteville, NC
TerraBella Fayetteville5.0 mi · Fayetteville, NC
Harmony at Hope Mills5.5 mi · Fayetteville, NC

About the Medicare star rating

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

Medicare quality data

What Cape Fear Valley Medical Center 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	2 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 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	3 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	55%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	60%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	70%National average: 74%
Area around the room “always” quiet at night	58%National average: 60%
Completed surveys	3,022Response rate: 17%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.8No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.291No different from the national benchmark
Surgical site infections after colon surgery	1.514No different from the national benchmark
Surgical site infections after abdominal hysterectomy	1.836No different from the national benchmark
MRSA bloodstream infections	0.423Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.53Better 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	13.4%
Deaths within 30 days: heart failure patients	10.2%
Deaths within 30 days: pneumonia patients	18.7%
Deaths within 30 days: COPD patients	7.7%
Deaths within 30 days: stroke patients	11%
Deaths within 30 days: coronary bypass surgery (CABG)	1.6%
Serious complications (patient safety indicator PSI-90)	1.06No different from the national rate
Complications after hip or knee replacement	3.6%

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	15.4%
Readmitted within 30 days: heart failure	23.2%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	21%
Readmitted within 30 days: coronary bypass surgery	10.2%
Readmitted within 30 days: hip or knee replacement	6.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	216 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	51%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in North Carolina Best hospitals in North Carolina

Prices

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

What the prices mean

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

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$246	$147.60	$68.70 – $171.75
New patient office visit (about 30–44 minutes): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $70.07 Aetna Qualified Health Plan — Commercial: $171.75 Ambetter of NC Individual Market — Commercial: $137.40 Blue Medicare Partner Health Plan — Medicare: $68.70 First Carolina Care — Medicare Advantage: $70.07 Humana — Medicare Advantage: $75.57 Humana Choicecare — Medicare Advantage: $75.57 Liberty Advantage — Medicare Advantage: $70.07 Longevity — Medicare Advantage: $68.70 New Hanover — Medicare Advantage: $72.14
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GC_PO In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$246	$147.60	$68.70 – $171.75
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $70.07 Aetna Qualified Health Plan — Commercial: $171.75 Ambetter of NC Individual Market — Commercial: $137.40 Blue Medicare Partner Health Plan — Medicare: $68.70 First Carolina Care — Medicare Advantage: $70.07 Humana — Medicare Advantage: $75.57 Humana Choicecare — Medicare Advantage: $75.57 Liberty Advantage — Medicare Advantage: $70.07 Longevity — Medicare Advantage: $68.70 New Hanover — Medicare Advantage: $72.14
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$246	$147.60	$68.70 – $171.75
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $70.07 Aetna Qualified Health Plan — Commercial: $171.75 Ambetter of NC Individual Market — Commercial: $137.40 Blue Medicare Partner Health Plan — Medicare: $68.70 First Carolina Care — Medicare Advantage: $70.07 Humana — Medicare Advantage: $75.57 Humana Choicecare — Medicare Advantage: $75.57 Liberty Advantage — Medicare Advantage: $70.07 Longevity — Medicare Advantage: $68.70 New Hanover — Medicare Advantage: $72.14
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$406	$243.60	$112.53 – $281.32
New patient office visit (about 45–59 minutes): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $114.78 Aetna Qualified Health Plan — Commercial: $281.32 Ambetter of NC Individual Market — Commercial: $225.06 Blue Medicare Partner Health Plan — Medicare: $112.53 First Carolina Care — Medicare Advantage: $114.78 Humana — Medicare Advantage: $123.78 Humana Choicecare — Medicare Advantage: $123.78 Liberty Advantage — Medicare Advantage: $114.78 Longevity — Medicare Advantage: $112.53 New Hanover — Medicare Advantage: $118.16
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$406	$243.60	$112.53 – $281.32
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $114.78 Aetna Qualified Health Plan — Commercial: $281.32 Ambetter of NC Individual Market — Commercial: $225.06 Blue Medicare Partner Health Plan — Medicare: $112.53 First Carolina Care — Medicare Advantage: $114.78 Humana — Medicare Advantage: $123.78 Humana Choicecare — Medicare Advantage: $123.78 Liberty Advantage — Medicare Advantage: $114.78 Longevity — Medicare Advantage: $112.53 New Hanover — Medicare Advantage: $118.16
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_PO In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$406	$243.60	$112.53 – $281.32
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $114.78 Aetna Qualified Health Plan — Commercial: $281.32 Ambetter of NC Individual Market — Commercial: $225.06 Blue Medicare Partner Health Plan — Medicare: $112.53 First Carolina Care — Medicare Advantage: $114.78 Humana — Medicare Advantage: $123.78 Humana Choicecare — Medicare Advantage: $123.78 Liberty Advantage — Medicare Advantage: $114.78 Longevity — Medicare Advantage: $112.53 New Hanover — Medicare Advantage: $118.16
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$493	$295.80	$153.88 – $384.70
New patient office visit (about 60–74 minutes): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $156.96 Aetna Qualified Health Plan — Commercial: $384.70 Ambetter of NC Individual Market — Commercial: $307.76 Blue Medicare Partner Health Plan — Medicare: $153.88 First Carolina Care — Medicare Advantage: $156.96 Humana — Medicare Advantage: $169.27 Humana Choicecare — Medicare Advantage: $169.27 Liberty Advantage — Medicare Advantage: $156.96 Longevity — Medicare Advantage: $153.88 New Hanover — Medicare Advantage: $161.57
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$493	$295.80	$153.88 – $384.70
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $156.96 Aetna Qualified Health Plan — Commercial: $384.70 Ambetter of NC Individual Market — Commercial: $307.76 Blue Medicare Partner Health Plan — Medicare: $153.88 First Carolina Care — Medicare Advantage: $156.96 Humana — Medicare Advantage: $169.27 Humana Choicecare — Medicare Advantage: $169.27 Liberty Advantage — Medicare Advantage: $156.96 Longevity — Medicare Advantage: $153.88 New Hanover — Medicare Advantage: $161.57
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_PO In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$493	$295.80	$153.88 – $384.70
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $156.96 Aetna Qualified Health Plan — Commercial: $384.70 Ambetter of NC Individual Market — Commercial: $307.76 Blue Medicare Partner Health Plan — Medicare: $153.88 First Carolina Care — Medicare Advantage: $156.96 Humana — Medicare Advantage: $169.27 Humana Choicecare — Medicare Advantage: $169.27 Liberty Advantage — Medicare Advantage: $156.96 Longevity — Medicare Advantage: $153.88 New Hanover — Medicare Advantage: $161.57
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$229	$137.40	$55.63 – $139.07
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $56.74 Aetna Qualified Health Plan — Commercial: $139.07 Ambetter of NC Individual Market — Commercial: $111.26 Blue Medicare Partner Health Plan — Medicare: $55.63 First Carolina Care — Medicare Advantage: $56.74 Humana — Medicare Advantage: $61.19 Humana Choicecare — Medicare Advantage: $61.19 Liberty Advantage — Medicare Advantage: $56.74 Longevity — Medicare Advantage: $55.63 New Hanover — Medicare Advantage: $58.41
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$229	$137.40	$55.63 – $139.07
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $56.74 Aetna Qualified Health Plan — Commercial: $139.07 Ambetter of NC Individual Market — Commercial: $111.26 Blue Medicare Partner Health Plan — Medicare: $55.63 First Carolina Care — Medicare Advantage: $56.74 Humana — Medicare Advantage: $61.19 Humana Choicecare — Medicare Advantage: $61.19 Liberty Advantage — Medicare Advantage: $56.74 Longevity — Medicare Advantage: $55.63 New Hanover — Medicare Advantage: $58.41
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$229	$137.40	$55.63 – $139.07
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $56.74 Aetna Qualified Health Plan — Commercial: $139.07 Ambetter of NC Individual Market — Commercial: $111.26 Blue Medicare Partner Health Plan — Medicare: $55.63 First Carolina Care — Medicare Advantage: $56.74 Humana — Medicare Advantage: $61.19 Humana Choicecare — Medicare Advantage: $61.19 Liberty Advantage — Medicare Advantage: $56.74 Longevity — Medicare Advantage: $55.63 New Hanover — Medicare Advantage: $58.41
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$297	$178.20	$81.77 – $204.42
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $83.41 Aetna Qualified Health Plan — Commercial: $204.42 Ambetter of NC Individual Market — Commercial: $163.54 Blue Medicare Partner Health Plan — Medicare: $81.77 First Carolina Care — Medicare Advantage: $83.41 Humana — Medicare Advantage: $89.95 Humana Choicecare — Medicare Advantage: $89.95 Liberty Advantage — Medicare Advantage: $83.41 Longevity — Medicare Advantage: $81.77 New Hanover — Medicare Advantage: $85.86
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$297	$178.20	$81.77 – $204.42
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $83.41 Aetna Qualified Health Plan — Commercial: $204.42 Ambetter of NC Individual Market — Commercial: $163.54 Blue Medicare Partner Health Plan — Medicare: $81.77 First Carolina Care — Medicare Advantage: $83.41 Humana — Medicare Advantage: $89.95 Humana Choicecare — Medicare Advantage: $89.95 Liberty Advantage — Medicare Advantage: $83.41 Longevity — Medicare Advantage: $81.77 New Hanover — Medicare Advantage: $85.86
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_PO In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$297	$178.20	$81.77 – $204.42
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $83.41 Aetna Qualified Health Plan — Commercial: $204.42 Ambetter of NC Individual Market — Commercial: $163.54 Blue Medicare Partner Health Plan — Medicare: $81.77 First Carolina Care — Medicare Advantage: $83.41 Humana — Medicare Advantage: $89.95 Humana Choicecare — Medicare Advantage: $89.95 Liberty Advantage — Medicare Advantage: $83.41 Longevity — Medicare Advantage: $81.77 New Hanover — Medicare Advantage: $85.86
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,211	$726.60	$270.45 – $676.12
Emergency room visit (moderate): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $275.86 Aetna Qualified Health Plan — Commercial: $676.12 Ambetter of NC Individual Market — Commercial: $540.90 Blue Medicare Partner Health Plan — Medicare: $270.45 First Carolina Care — Medicare Advantage: $275.86 Humana — Medicare Advantage: $297.50 Humana Choicecare — Medicare Advantage: $297.50 Liberty Advantage — Medicare Advantage: $275.86 Longevity — Medicare Advantage: $270.45 New Hanover — Medicare Advantage: $283.97
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,211	$726.60	$270.45 – $676.12
Emergency room visit (moderate): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $275.86 Aetna Qualified Health Plan — Commercial: $676.12 Ambetter of NC Individual Market — Commercial: $540.90 Blue Medicare Partner Health Plan — Medicare: $270.45 First Carolina Care — Medicare Advantage: $275.86 Humana — Medicare Advantage: $297.50 Humana Choicecare — Medicare Advantage: $297.50 Liberty Advantage — Medicare Advantage: $275.86 Longevity — Medicare Advantage: $270.45 New Hanover — Medicare Advantage: $283.97
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,211	$726.60	$270.45 – $676.12
Emergency room visit (moderate): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $275.86 Aetna Qualified Health Plan — Commercial: $676.12 Ambetter of NC Individual Market — Commercial: $540.90 Blue Medicare Partner Health Plan — Medicare: $270.45 First Carolina Care — Medicare Advantage: $275.86 Humana — Medicare Advantage: $297.50 Humana Choicecare — Medicare Advantage: $297.50 Liberty Advantage — Medicare Advantage: $275.86 Longevity — Medicare Advantage: $270.45 New Hanover — Medicare Advantage: $283.97
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$2,053	$1,231.80	$413.39 – $1,033.47
Emergency room visit (moderately high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $421.66 Aetna Qualified Health Plan — Commercial: $1,033.47 Ambetter of NC Individual Market — Commercial: $826.78 Blue Medicare Partner Health Plan — Medicare: $413.39 First Carolina Care — Medicare Advantage: $421.66 Humana — Medicare Advantage: $454.73 Humana Choicecare — Medicare Advantage: $454.73 Liberty Advantage — Medicare Advantage: $421.66 Longevity — Medicare Advantage: $413.39 New Hanover — Medicare Advantage: $434.06
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_50 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$2,053	$1,231.80	$413.39 – $1,033.47
Emergency room visit (moderately high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $421.66 Aetna Qualified Health Plan — Commercial: $1,033.47 Ambetter of NC Individual Market — Commercial: $826.78 Blue Medicare Partner Health Plan — Medicare: $413.39 First Carolina Care — Medicare Advantage: $421.66 Humana — Medicare Advantage: $454.73 Humana Choicecare — Medicare Advantage: $454.73 Liberty Advantage — Medicare Advantage: $421.66 Longevity — Medicare Advantage: $413.39 New Hanover — Medicare Advantage: $434.06
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$2,053	$1,231.80	$413.39 – $1,033.47
Emergency room visit (moderately high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $421.66 Aetna Qualified Health Plan — Commercial: $1,033.47 Ambetter of NC Individual Market — Commercial: $826.78 Blue Medicare Partner Health Plan — Medicare: $413.39 First Carolina Care — Medicare Advantage: $421.66 Humana — Medicare Advantage: $454.73 Humana Choicecare — Medicare Advantage: $454.73 Liberty Advantage — Medicare Advantage: $421.66 Longevity — Medicare Advantage: $413.39 New Hanover — Medicare Advantage: $434.06
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$3,138	$1,882.80	$590.01 – $1,475.02
Emergency room visit (high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $601.81 Aetna Qualified Health Plan — Commercial: $1,475.02 Ambetter of NC Individual Market — Commercial: $1,180.02 Blue Medicare Partner Health Plan — Medicare: $590.01 First Carolina Care — Medicare Advantage: $601.81 Humana — Medicare Advantage: $649.01 Humana Choicecare — Medicare Advantage: $649.01 Liberty Advantage — Medicare Advantage: $601.81 Longevity — Medicare Advantage: $590.01 New Hanover — Medicare Advantage: $619.51
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$3,138	$1,882.80	$590.01 – $1,475.02
Emergency room visit (high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $601.81 Aetna Qualified Health Plan — Commercial: $1,475.02 Ambetter of NC Individual Market — Commercial: $1,180.02 Blue Medicare Partner Health Plan — Medicare: $590.01 First Carolina Care — Medicare Advantage: $601.81 Humana — Medicare Advantage: $649.01 Humana Choicecare — Medicare Advantage: $649.01 Liberty Advantage — Medicare Advantage: $601.81 Longevity — Medicare Advantage: $590.01 New Hanover — Medicare Advantage: $619.51
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$3,138	$1,882.80	$590.01 – $1,475.02
Emergency room visit (high): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $601.81 Aetna Qualified Health Plan — Commercial: $1,475.02 Ambetter of NC Individual Market — Commercial: $1,180.02 Blue Medicare Partner Health Plan — Medicare: $590.01 First Carolina Care — Medicare Advantage: $601.81 Humana — Medicare Advantage: $649.01 Humana Choicecare — Medicare Advantage: $649.01 Liberty Advantage — Medicare Advantage: $601.81 Longevity — Medicare Advantage: $590.01 New Hanover — Medicare Advantage: $619.51

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: METABOLIC PANEL TOTAL CA	$23.50	$14.10	$8.46 – $91
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.63 Aetna Qualified Health Plan — Commercial: $21.15 Ambetter of NC Individual Market — Commercial: $16.92 Blue Medicare Partner Health Plan — Medicare: $8.46 First Carolina Care — Medicare Advantage: $8.63 Humana — Medicare Advantage: $9.31 Humana Choicecare — Medicare Advantage: $9.31 Liberty Advantage — Medicare Advantage: $8.63 Longevity — Medicare Advantage: $8.46 New Hanover — Medicare Advantage: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$203	$121.80	$8.46 – $91
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.63 Aetna Qualified Health Plan — Commercial: $21.15 Ambetter of NC Individual Market — Commercial: $16.92 Blue Medicare Partner Health Plan — Medicare: $8.46 First Carolina Care — Medicare Advantage: $8.63 Humana — Medicare Advantage: $9.31 Humana Choicecare — Medicare Advantage: $9.31 Liberty Advantage — Medicare Advantage: $8.63 Longevity — Medicare Advantage: $8.46 New Hanover — Medicare Advantage: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$203	$121.80	$8.46 – $91
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.63 Aetna Qualified Health Plan — Commercial: $21.15 Ambetter of NC Individual Market — Commercial: $16.92 Blue Medicare Partner Health Plan — Medicare: $8.46 First Carolina Care — Medicare Advantage: $8.63 Humana — Medicare Advantage: $9.31 Humana Choicecare — Medicare Advantage: $9.31 Liberty Advantage — Medicare Advantage: $8.63 Longevity — Medicare Advantage: $8.46 New Hanover — Medicare Advantage: $8.88
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$3.85	$2.31	$10.56 – $91
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $10.77 Aetna Qualified Health Plan — Commercial: $26.40 Ambetter of NC Individual Market — Commercial: $21.12 Blue Medicare Partner Health Plan — Medicare: $10.56 First Carolina Care — Medicare Advantage: $10.77 Humana — Medicare Advantage: $11.62 Humana Choicecare — Medicare Advantage: $11.62 Liberty Advantage — Medicare Advantage: $10.77 Longevity — Medicare Advantage: $10.56 New Hanover — Medicare Advantage: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$270	$162	$10.56 – $91
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $10.77 Aetna Qualified Health Plan — Commercial: $26.40 Ambetter of NC Individual Market — Commercial: $21.12 Blue Medicare Partner Health Plan — Medicare: $10.56 First Carolina Care — Medicare Advantage: $10.77 Humana — Medicare Advantage: $11.62 Humana Choicecare — Medicare Advantage: $11.62 Liberty Advantage — Medicare Advantage: $10.77 Longevity — Medicare Advantage: $10.56 New Hanover — Medicare Advantage: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$270	$162	$10.56 – $91
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $10.77 Aetna Qualified Health Plan — Commercial: $26.40 Ambetter of NC Individual Market — Commercial: $21.12 Blue Medicare Partner Health Plan — Medicare: $10.56 First Carolina Care — Medicare Advantage: $10.77 Humana — Medicare Advantage: $11.62 Humana Choicecare — Medicare Advantage: $11.62 Liberty Advantage — Medicare Advantage: $10.77 Longevity — Medicare Advantage: $10.56 New Hanover — Medicare Advantage: $11.09
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$280	$168	$47.81 – $119.52
Obstetric blood test panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $48.77 Aetna Qualified Health Plan — Commercial: $119.52 Ambetter of NC Individual Market — Commercial: $95.62 Blue Medicare Partner Health Plan — Medicare: $47.81 First Carolina Care — Medicare Advantage: $48.77 Humana — Medicare Advantage: $52.59 Humana Choicecare — Medicare Advantage: $52.59 Liberty Advantage — Medicare Advantage: $48.77 Longevity — Medicare Advantage: $47.81 New Hanover — Medicare Advantage: $50.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$4.55	$2.73	$13.39 – $91
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $13.66 Aetna Qualified Health Plan — Commercial: $33.48 Ambetter of NC Individual Market — Commercial: $26.78 Blue Medicare Partner Health Plan — Medicare: $13.39 First Carolina Care — Medicare Advantage: $13.66 Humana — Medicare Advantage: $14.73 Humana Choicecare — Medicare Advantage: $14.73 Liberty Advantage — Medicare Advantage: $13.66 Longevity — Medicare Advantage: $13.39 New Hanover — Medicare Advantage: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$140	$84	$13.39 – $91
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $13.66 Aetna Qualified Health Plan — Commercial: $33.48 Ambetter of NC Individual Market — Commercial: $26.78 Blue Medicare Partner Health Plan — Medicare: $13.39 First Carolina Care — Medicare Advantage: $13.66 Humana — Medicare Advantage: $14.73 Humana Choicecare — Medicare Advantage: $14.73 Liberty Advantage — Medicare Advantage: $13.66 Longevity — Medicare Advantage: $13.39 New Hanover — Medicare Advantage: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$140	$84	$13.39 – $91
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $13.66 Aetna Qualified Health Plan — Commercial: $33.48 Ambetter of NC Individual Market — Commercial: $26.78 Blue Medicare Partner Health Plan — Medicare: $13.39 First Carolina Care — Medicare Advantage: $13.66 Humana — Medicare Advantage: $14.73 Humana Choicecare — Medicare Advantage: $14.73 Liberty Advantage — Medicare Advantage: $13.66 Longevity — Medicare Advantage: $13.39 New Hanover — Medicare Advantage: $14.06
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$3.35	$2.01	$8.68 – $91
Kidney function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.85 Aetna Qualified Health Plan — Commercial: $21.70 Ambetter of NC Individual Market — Commercial: $17.36 Blue Medicare Partner Health Plan — Medicare: $8.68 First Carolina Care — Medicare Advantage: $8.85 Humana — Medicare Advantage: $9.55 Humana Choicecare — Medicare Advantage: $9.55 Liberty Advantage — Medicare Advantage: $8.85 Longevity — Medicare Advantage: $8.68 New Hanover — Medicare Advantage: $9.11
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$239	$143.40	$8.68 – $91
Kidney function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.85 Aetna Qualified Health Plan — Commercial: $21.70 Ambetter of NC Individual Market — Commercial: $17.36 Blue Medicare Partner Health Plan — Medicare: $8.68 First Carolina Care — Medicare Advantage: $8.85 Humana — Medicare Advantage: $9.55 Humana Choicecare — Medicare Advantage: $9.55 Liberty Advantage — Medicare Advantage: $8.85 Longevity — Medicare Advantage: $8.68 New Hanover — Medicare Advantage: $9.11
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$239	$143.40	$8.68 – $91
Kidney function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.85 Aetna Qualified Health Plan — Commercial: $21.70 Ambetter of NC Individual Market — Commercial: $17.36 Blue Medicare Partner Health Plan — Medicare: $8.68 First Carolina Care — Medicare Advantage: $8.85 Humana — Medicare Advantage: $9.55 Humana Choicecare — Medicare Advantage: $9.55 Liberty Advantage — Medicare Advantage: $8.85 Longevity — Medicare Advantage: $8.68 New Hanover — Medicare Advantage: $9.11
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$22.70	$13.62	$8.17 – $91
Liver function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.33 Aetna Qualified Health Plan — Commercial: $20.42 Ambetter of NC Individual Market — Commercial: $16.34 Blue Medicare Partner Health Plan — Medicare: $8.17 First Carolina Care — Medicare Advantage: $8.33 Humana — Medicare Advantage: $8.99 Humana Choicecare — Medicare Advantage: $8.99 Liberty Advantage — Medicare Advantage: $8.33 Longevity — Medicare Advantage: $8.17 New Hanover — Medicare Advantage: $8.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$186	$111.60	$8.17 – $91
Liver function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.33 Aetna Qualified Health Plan — Commercial: $20.42 Ambetter of NC Individual Market — Commercial: $16.34 Blue Medicare Partner Health Plan — Medicare: $8.17 First Carolina Care — Medicare Advantage: $8.33 Humana — Medicare Advantage: $8.99 Humana Choicecare — Medicare Advantage: $8.99 Liberty Advantage — Medicare Advantage: $8.33 Longevity — Medicare Advantage: $8.17 New Hanover — Medicare Advantage: $8.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AY In the file: LIVER FUNCTION BLOOD TEST PANEL	$186	$111.60	$8.17 – $91
Liver function panel: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $8.33 Aetna Qualified Health Plan — Commercial: $20.42 Ambetter of NC Individual Market — Commercial: $16.34 Blue Medicare Partner Health Plan — Medicare: $8.17 First Carolina Care — Medicare Advantage: $8.33 Humana — Medicare Advantage: $8.99 Humana Choicecare — Medicare Advantage: $8.99 Liberty Advantage — Medicare Advantage: $8.33 Longevity — Medicare Advantage: $8.17 New Hanover — Medicare Advantage: $8.58
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$2.40	$1.44	$3.17 – $91
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.23 Aetna Qualified Health Plan — Commercial: $7.93 Ambetter of NC Individual Market — Commercial: $6.34 Blue Medicare Partner Health Plan — Medicare: $3.17 First Carolina Care — Medicare Advantage: $3.23 Humana — Medicare Advantage: $3.49 Humana Choicecare — Medicare Advantage: $3.49 Liberty Advantage — Medicare Advantage: $3.23 Longevity — Medicare Advantage: $3.17 New Hanover — Medicare Advantage: $3.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$100	$60	$3.17 – $91
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.23 Aetna Qualified Health Plan — Commercial: $7.92 Ambetter of NC Individual Market — Commercial: $6.34 Blue Medicare Partner Health Plan — Medicare: $3.17 First Carolina Care — Medicare Advantage: $3.23 Humana — Medicare Advantage: $3.49 Humana Choicecare — Medicare Advantage: $3.49 Liberty Advantage — Medicare Advantage: $3.23 Longevity — Medicare Advantage: $3.17 New Hanover — Medicare Advantage: $3.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$100	$60	$3.17 – $91
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.23 Aetna Qualified Health Plan — Commercial: $7.92 Ambetter of NC Individual Market — Commercial: $6.34 Blue Medicare Partner Health Plan — Medicare: $3.17 First Carolina Care — Medicare Advantage: $3.23 Humana — Medicare Advantage: $3.49 Humana Choicecare — Medicare Advantage: $3.49 Liberty Advantage — Medicare Advantage: $3.23 Longevity — Medicare Advantage: $3.17 New Hanover — Medicare Advantage: $3.33
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$8.70	$5.22	$3.48 – $91
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.55 Aetna Qualified Health Plan — Commercial: $8.70 Ambetter of NC Individual Market — Commercial: $6.96 Blue Medicare Partner Health Plan — Medicare: $3.48 First Carolina Care — Medicare Advantage: $3.55 Humana — Medicare Advantage: $3.83 Humana Choicecare — Medicare Advantage: $3.83 Liberty Advantage — Medicare Advantage: $3.55 Longevity — Medicare Advantage: $3.48 New Hanover — Medicare Advantage: $3.65
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST	$60	$36	$3.48 – $91
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.55 Aetna Qualified Health Plan — Commercial: $8.70 Ambetter of NC Individual Market — Commercial: $6.96 Blue Medicare Partner Health Plan — Medicare: $3.48 First Carolina Care — Medicare Advantage: $3.55 Humana — Medicare Advantage: $3.83 Humana Choicecare — Medicare Advantage: $3.83 Liberty Advantage — Medicare Advantage: $3.55 Longevity — Medicare Advantage: $3.48 New Hanover — Medicare Advantage: $3.65
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: URINALYSIS; MANUAL TEST	$60	$36	$3.48 – $91
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3.55 Aetna Qualified Health Plan — Commercial: $8.70 Ambetter of NC Individual Market — Commercial: $6.96 Blue Medicare Partner Health Plan — Medicare: $3.48 First Carolina Care — Medicare Advantage: $3.55 Humana — Medicare Advantage: $3.83 Humana Choicecare — Medicare Advantage: $3.83 Liberty Advantage — Medicare Advantage: $3.55 Longevity — Medicare Advantage: $3.48 New Hanover — Medicare Advantage: $3.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$1.95	$1.17	$2.25 – $91
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $2.30 Aetna Qualified Health Plan — Commercial: $5.62 Ambetter of NC Individual Market — Commercial: $4.50 Blue Medicare Partner Health Plan — Medicare: $2.25 First Carolina Care — Medicare Advantage: $2.30 Humana — Medicare Advantage: $2.48 Humana Choicecare — Medicare Advantage: $2.48 Liberty Advantage — Medicare Advantage: $2.30 Longevity — Medicare Advantage: $2.25 New Hanover — Medicare Advantage: $2.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$58	$34.80	$2.25 – $91
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $2.30 Aetna Qualified Health Plan — Commercial: $5.62 Ambetter of NC Individual Market — Commercial: $4.50 Blue Medicare Partner Health Plan — Medicare: $2.25 First Carolina Care — Medicare Advantage: $2.30 Humana — Medicare Advantage: $2.48 Humana Choicecare — Medicare Advantage: $2.48 Liberty Advantage — Medicare Advantage: $2.30 Longevity — Medicare Advantage: $2.25 New Hanover — Medicare Advantage: $2.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GC_PO_QW In the file: AUTOMATED URINALYSIS TEST	$58	$34.80	$2.25 – $91
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $2.30 Aetna Qualified Health Plan — Commercial: $5.62 Ambetter of NC Individual Market — Commercial: $4.50 Blue Medicare Partner Health Plan — Medicare: $2.25 First Carolina Care — Medicare Advantage: $2.30 Humana — Medicare Advantage: $2.48 Humana Choicecare — Medicare Advantage: $2.48 Liberty Advantage — Medicare Advantage: $2.30 Longevity — Medicare Advantage: $2.25 New Hanover — Medicare Advantage: $2.36
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$8.20	$4.92	$18.39 – $91
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $18.76 Aetna Qualified Health Plan — Commercial: $45.98 Ambetter of NC Individual Market — Commercial: $36.78 Blue Medicare Partner Health Plan — Medicare: $18.39 First Carolina Care — Medicare Advantage: $18.76 Humana — Medicare Advantage: $20.23 Humana Choicecare — Medicare Advantage: $20.23 Liberty Advantage — Medicare Advantage: $18.76 Longevity — Medicare Advantage: $18.39 New Hanover — Medicare Advantage: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$184	$110.40	$18.39 – $91
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $18.76 Aetna Qualified Health Plan — Commercial: $45.98 Ambetter of NC Individual Market — Commercial: $36.78 Blue Medicare Partner Health Plan — Medicare: $18.39 First Carolina Care — Medicare Advantage: $18.76 Humana — Medicare Advantage: $20.23 Humana Choicecare — Medicare Advantage: $20.23 Liberty Advantage — Medicare Advantage: $18.76 Longevity — Medicare Advantage: $18.39 New Hanover — Medicare Advantage: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91_GZ In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$184	$110.40	$18.39 – $91
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $18.76 Aetna Qualified Health Plan — Commercial: $45.98 Ambetter of NC Individual Market — Commercial: $36.78 Blue Medicare Partner Health Plan — Medicare: $18.39 First Carolina Care — Medicare Advantage: $18.76 Humana — Medicare Advantage: $20.23 Humana Choicecare — Medicare Advantage: $20.23 Liberty Advantage — Medicare Advantage: $18.76 Longevity — Medicare Advantage: $18.39 New Hanover — Medicare Advantage: $19.31
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$46.68	$28.01	$16.80 – $91
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $17.14 Aetna Qualified Health Plan — Commercial: $42 Ambetter of NC Individual Market — Commercial: $33.60 Blue Medicare Partner Health Plan — Medicare: $16.80 First Carolina Care — Medicare Advantage: $17.14 Humana — Medicare Advantage: $18.48 Humana Choicecare — Medicare Advantage: $18.48 Liberty Advantage — Medicare Advantage: $17.14 Longevity — Medicare Advantage: $16.80 New Hanover — Medicare Advantage: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$253	$151.80	$16.80 – $91
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $17.14 Aetna Qualified Health Plan — Commercial: $42 Ambetter of NC Individual Market — Commercial: $33.60 Blue Medicare Partner Health Plan — Medicare: $16.80 First Carolina Care — Medicare Advantage: $17.14 Humana — Medicare Advantage: $18.48 Humana Choicecare — Medicare Advantage: $18.48 Liberty Advantage — Medicare Advantage: $17.14 Longevity — Medicare Advantage: $16.80 New Hanover — Medicare Advantage: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$253	$151.80	$16.80 – $91
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $17.14 Aetna Qualified Health Plan — Commercial: $42 Ambetter of NC Individual Market — Commercial: $33.60 Blue Medicare Partner Health Plan — Medicare: $16.80 First Carolina Care — Medicare Advantage: $17.14 Humana — Medicare Advantage: $18.48 Humana Choicecare — Medicare Advantage: $18.48 Liberty Advantage — Medicare Advantage: $17.14 Longevity — Medicare Advantage: $16.80 New Hanover — Medicare Advantage: $17.64
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$3.05	$1.83	$7.77 – $91
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $7.93 Aetna Qualified Health Plan — Commercial: $19.42 Ambetter of NC Individual Market — Commercial: $15.54 Blue Medicare Partner Health Plan — Medicare: $7.77 First Carolina Care — Medicare Advantage: $7.93 Humana — Medicare Advantage: $8.55 Humana Choicecare — Medicare Advantage: $8.55 Liberty Advantage — Medicare Advantage: $7.93 Longevity — Medicare Advantage: $7.77 New Hanover — Medicare Advantage: $8.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$169	$101.40	$7.77 – $91
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $7.93 Aetna Qualified Health Plan — Commercial: $19.42 Ambetter of NC Individual Market — Commercial: $15.54 Blue Medicare Partner Health Plan — Medicare: $7.77 First Carolina Care — Medicare Advantage: $7.93 Humana — Medicare Advantage: $8.55 Humana Choicecare — Medicare Advantage: $8.55 Liberty Advantage — Medicare Advantage: $7.93 Longevity — Medicare Advantage: $7.77 New Hanover — Medicare Advantage: $8.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$169	$101.40	$7.77 – $91
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $7.93 Aetna Qualified Health Plan — Commercial: $19.42 Ambetter of NC Individual Market — Commercial: $15.54 Blue Medicare Partner Health Plan — Medicare: $7.77 First Carolina Care — Medicare Advantage: $7.93 Humana — Medicare Advantage: $8.55 Humana Choicecare — Medicare Advantage: $8.55 Liberty Advantage — Medicare Advantage: $7.93 Longevity — Medicare Advantage: $7.77 New Hanover — Medicare Advantage: $8.16
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$17.95	$10.77	$6.47 – $91
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.60 Aetna Qualified Health Plan — Commercial: $16.18 Ambetter of NC Individual Market — Commercial: $12.94 Blue Medicare Partner Health Plan — Medicare: $6.47 First Carolina Care — Medicare Advantage: $6.60 Humana — Medicare Advantage: $7.12 Humana Choicecare — Medicare Advantage: $7.12 Liberty Advantage — Medicare Advantage: $6.60 Longevity — Medicare Advantage: $6.47 New Hanover — Medicare Advantage: $6.79
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$109	$65.40	$6.47 – $91
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.60 Aetna Qualified Health Plan — Commercial: $16.18 Ambetter of NC Individual Market — Commercial: $12.94 Blue Medicare Partner Health Plan — Medicare: $6.47 First Carolina Care — Medicare Advantage: $6.60 Humana — Medicare Advantage: $7.12 Humana Choicecare — Medicare Advantage: $7.12 Liberty Advantage — Medicare Advantage: $6.60 Longevity — Medicare Advantage: $6.47 New Hanover — Medicare Advantage: $6.79
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$109	$65.40	$6.47 – $91
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.60 Aetna Qualified Health Plan — Commercial: $16.18 Ambetter of NC Individual Market — Commercial: $12.94 Blue Medicare Partner Health Plan — Medicare: $6.47 First Carolina Care — Medicare Advantage: $6.60 Humana — Medicare Advantage: $7.12 Humana Choicecare — Medicare Advantage: $7.12 Liberty Advantage — Medicare Advantage: $6.60 Longevity — Medicare Advantage: $6.47 New Hanover — Medicare Advantage: $6.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$10.93	$6.56	$4.29 – $91
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $4.38 Aetna Qualified Health Plan — Commercial: $10.72 Ambetter of NC Individual Market — Commercial: $8.58 Blue Medicare Partner Health Plan — Medicare: $4.29 First Carolina Care — Medicare Advantage: $4.38 Humana — Medicare Advantage: $4.72 Humana Choicecare — Medicare Advantage: $4.72 Liberty Advantage — Medicare Advantage: $4.38 Longevity — Medicare Advantage: $4.29 New Hanover — Medicare Advantage: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$84	$50.40	$4.29 – $91
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $4.38 Aetna Qualified Health Plan — Commercial: $10.72 Ambetter of NC Individual Market — Commercial: $8.58 Blue Medicare Partner Health Plan — Medicare: $4.29 First Carolina Care — Medicare Advantage: $4.38 Humana — Medicare Advantage: $4.72 Humana Choicecare — Medicare Advantage: $4.72 Liberty Advantage — Medicare Advantage: $4.38 Longevity — Medicare Advantage: $4.29 New Hanover — Medicare Advantage: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_QW In the file: BLOOD TEST; CLOTTING TIME	$84	$50.40	$4.29 – $91
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $4.38 Aetna Qualified Health Plan — Commercial: $10.72 Ambetter of NC Individual Market — Commercial: $8.58 Blue Medicare Partner Health Plan — Medicare: $4.29 First Carolina Care — Medicare Advantage: $4.38 Humana — Medicare Advantage: $4.72 Humana Choicecare — Medicare Advantage: $4.72 Liberty Advantage — Medicare Advantage: $4.38 Longevity — Medicare Advantage: $4.29 New Hanover — Medicare Advantage: $4.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$2.70	$1.62	$6.01 – $91
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.13 Aetna Qualified Health Plan — Commercial: $15.03 Ambetter of NC Individual Market — Commercial: $12.02 Blue Medicare Partner Health Plan — Medicare: $6.01 First Carolina Care — Medicare Advantage: $6.13 Humana — Medicare Advantage: $6.61 Humana Choicecare — Medicare Advantage: $6.61 Liberty Advantage — Medicare Advantage: $6.13 Longevity — Medicare Advantage: $6.01 New Hanover — Medicare Advantage: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$117	$70.20	$6.01 – $91
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.13 Aetna Qualified Health Plan — Commercial: $15.03 Ambetter of NC Individual Market — Commercial: $12.02 Blue Medicare Partner Health Plan — Medicare: $6.01 First Carolina Care — Medicare Advantage: $6.13 Humana — Medicare Advantage: $6.61 Humana Choicecare — Medicare Advantage: $6.61 Liberty Advantage — Medicare Advantage: $6.13 Longevity — Medicare Advantage: $6.01 New Hanover — Medicare Advantage: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$117	$70.20	$6.01 – $91
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6.13 Aetna Qualified Health Plan — Commercial: $15.03 Ambetter of NC Individual Market — Commercial: $12.02 Blue Medicare Partner Health Plan — Medicare: $6.01 First Carolina Care — Medicare Advantage: $6.13 Humana — Medicare Advantage: $6.61 Humana Choicecare — Medicare Advantage: $6.61 Liberty Advantage — Medicare Advantage: $6.13 Longevity — Medicare Advantage: $6.01 New Hanover — Medicare Advantage: $6.31

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 SCAN HEAD OR BRAIN WITHOUT CONTRAST	$2,190	$1,314	$103.58 – $258.95
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$2,190	$1,314	$103.58 – $258.95
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$2,190	$1,314	$103.58 – $258.95
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$6,884	$4,130.40	$345.64 – $864.10
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $352.55 Aetna Qualified Health Plan — Commercial: $864.10 Ambetter of NC Individual Market — Commercial: $691.28 Blue Medicare Partner Health Plan — Medicare: $345.64 First Carolina Care — Medicare Advantage: $352.55 Humana — Medicare Advantage: $380.20 Humana Choicecare — Medicare Advantage: $380.20 Liberty Advantage — Medicare Advantage: $352.55 Longevity — Medicare Advantage: $345.64 New Hanover — Medicare Advantage: $362.92
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$6,884	$4,130.40	$345.64 – $864.10
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $352.55 Aetna Qualified Health Plan — Commercial: $864.10 Ambetter of NC Individual Market — Commercial: $691.28 Blue Medicare Partner Health Plan — Medicare: $345.64 First Carolina Care — Medicare Advantage: $352.55 Humana — Medicare Advantage: $380.20 Humana Choicecare — Medicare Advantage: $380.20 Liberty Advantage — Medicare Advantage: $352.55 Longevity — Medicare Advantage: $345.64 New Hanover — Medicare Advantage: $362.92
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$327	$196.20	$86.22 – $215.55
Chest X-ray, 2 views: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $87.94 Aetna Qualified Health Plan — Commercial: $215.55 Ambetter of NC Individual Market — Commercial: $172.44 Blue Medicare Partner Health Plan — Medicare: $86.22 First Carolina Care — Medicare Advantage: $87.94 Humana — Medicare Advantage: $94.84 Humana Choicecare — Medicare Advantage: $94.84 Liberty Advantage — Medicare Advantage: $87.94 Longevity — Medicare Advantage: $86.22 New Hanover — Medicare Advantage: $90.53
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier FY In the file: X-RAY OF CHEST; 2 VIEWS	$327	$196.20	$77.60 – $194
Chest X-ray, 2 views: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $79.15 Aetna Qualified Health Plan — Commercial: $194 Ambetter of NC Individual Market — Commercial: $155.20 Blue Medicare Partner Health Plan — Medicare: $77.60 First Carolina Care — Medicare Advantage: $79.15 Humana — Medicare Advantage: $85.36 Humana Choicecare — Medicare Advantage: $85.36 Liberty Advantage — Medicare Advantage: $79.15 Longevity — Medicare Advantage: $77.60 New Hanover — Medicare Advantage: $81.48
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: X-RAY OF CHEST; 2 VIEWS	$327	$196.20	$86.22 – $215.55
Chest X-ray, 2 views: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $87.94 Aetna Qualified Health Plan — Commercial: $215.55 Ambetter of NC Individual Market — Commercial: $172.44 Blue Medicare Partner Health Plan — Medicare: $86.22 First Carolina Care — Medicare Advantage: $87.94 Humana — Medicare Advantage: $94.84 Humana Choicecare — Medicare Advantage: $94.84 Liberty Advantage — Medicare Advantage: $87.94 Longevity — Medicare Advantage: $86.22 New Hanover — Medicare Advantage: $90.53
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$766	$459.60	$103.58 – $258.95
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier FY In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$766	$459.60	$93.22 – $233.05
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $95.08 Aetna Qualified Health Plan — Commercial: $233.05 Ambetter of NC Individual Market — Commercial: $186.44 Blue Medicare Partner Health Plan — Medicare: $93.22 First Carolina Care — Medicare Advantage: $95.08 Humana — Medicare Advantage: $102.54 Humana Choicecare — Medicare Advantage: $102.54 Liberty Advantage — Medicare Advantage: $95.08 Longevity — Medicare Advantage: $93.22 New Hanover — Medicare Advantage: $97.88
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$766	$459.60	$103.58 – $258.95
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$5,120	$3,072	$236.39 – $590.98
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $241.12 Aetna Qualified Health Plan — Commercial: $590.98 Ambetter of NC Individual Market — Commercial: $472.78 Blue Medicare Partner Health Plan — Medicare: $236.39 First Carolina Care — Medicare Advantage: $241.12 Humana — Medicare Advantage: $260.03 Humana Choicecare — Medicare Advantage: $260.03 Liberty Advantage — Medicare Advantage: $241.12 Longevity — Medicare Advantage: $236.39 New Hanover — Medicare Advantage: $248.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$5,120	$3,072	$236.39 – $590.98
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $241.12 Aetna Qualified Health Plan — Commercial: $590.98 Ambetter of NC Individual Market — Commercial: $472.78 Blue Medicare Partner Health Plan — Medicare: $236.39 First Carolina Care — Medicare Advantage: $241.12 Humana — Medicare Advantage: $260.03 Humana Choicecare — Medicare Advantage: $260.03 Liberty Advantage — Medicare Advantage: $241.12 Longevity — Medicare Advantage: $236.39 New Hanover — Medicare Advantage: $248.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$5,120	$3,072	$236.39 – $590.98
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $241.12 Aetna Qualified Health Plan — Commercial: $590.98 Ambetter of NC Individual Market — Commercial: $472.78 Blue Medicare Partner Health Plan — Medicare: $236.39 First Carolina Care — Medicare Advantage: $241.12 Humana — Medicare Advantage: $260.03 Humana Choicecare — Medicare Advantage: $260.03 Liberty Advantage — Medicare Advantage: $241.12 Longevity — Medicare Advantage: $236.39 New Hanover — Medicare Advantage: $248.21
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST	$2,919	$1,751.40	$173.77 – $434.42
CT scan of the pelvis, with contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $177.25 Aetna Qualified Health Plan — Commercial: $434.42 Ambetter of NC Individual Market — Commercial: $347.54 Blue Medicare Partner Health Plan — Medicare: $173.77 First Carolina Care — Medicare Advantage: $177.25 Humana — Medicare Advantage: $191.15 Humana Choicecare — Medicare Advantage: $191.15 Liberty Advantage — Medicare Advantage: $177.25 Longevity — Medicare Advantage: $173.77 New Hanover — Medicare Advantage: $182.46
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN OF PELVIS WITH CONTRAST	$2,919	$1,751.40	$173.77 – $434.42
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $177.25 Aetna Qualified Health Plan — Commercial: $434.42 Ambetter of NC Individual Market — Commercial: $347.54 Blue Medicare Partner Health Plan — Medicare: $173.77 First Carolina Care — Medicare Advantage: $177.25 Humana — Medicare Advantage: $191.15 Humana Choicecare — Medicare Advantage: $191.15 Liberty Advantage — Medicare Advantage: $177.25 Longevity — Medicare Advantage: $173.77 New Hanover — Medicare Advantage: $182.46
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,559	$2,135.40	$236.39 – $590.98
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $241.12 Aetna Qualified Health Plan — Commercial: $590.98 Ambetter of NC Individual Market — Commercial: $472.78 Blue Medicare Partner Health Plan — Medicare: $236.39 First Carolina Care — Medicare Advantage: $241.12 Humana — Medicare Advantage: $260.03 Humana Choicecare — Medicare Advantage: $260.03 Liberty Advantage — Medicare Advantage: $241.12 Longevity — Medicare Advantage: $236.39 New Hanover — Medicare Advantage: $248.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$10,678.50	$6,407.10	$521.56 – $1,303.90
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $531.99 Aetna Qualified Health Plan — Commercial: $1,303.90 Ambetter of NC Individual Market — Commercial: $1,043.12 Blue Medicare Partner Health Plan — Medicare: $521.56 First Carolina Care — Medicare Advantage: $531.99 Humana — Medicare Advantage: $573.72 Humana Choicecare — Medicare Advantage: $573.72 Liberty Advantage — Medicare Advantage: $531.99 Longevity — Medicare Advantage: $521.56 New Hanover — Medicare Advantage: $547.64
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$3,559	$2,135.40	$236.39 – $590.98
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $241.12 Aetna Qualified Health Plan — Commercial: $590.98 Ambetter of NC Individual Market — Commercial: $472.78 Blue Medicare Partner Health Plan — Medicare: $236.39 First Carolina Care — Medicare Advantage: $241.12 Humana — Medicare Advantage: $260.03 Humana Choicecare — Medicare Advantage: $260.03 Liberty Advantage — Medicare Advantage: $241.12 Longevity — Medicare Advantage: $236.39 New Hanover — Medicare Advantage: $248.21
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$6,017	$3,610.20	$345.64 – $864.10
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $352.55 Aetna Qualified Health Plan — Commercial: $864.10 Ambetter of NC Individual Market — Commercial: $691.28 Blue Medicare Partner Health Plan — Medicare: $345.64 First Carolina Care — Medicare Advantage: $352.55 Humana — Medicare Advantage: $380.20 Humana Choicecare — Medicare Advantage: $380.20 Liberty Advantage — Medicare Advantage: $352.55 Longevity — Medicare Advantage: $345.64 New Hanover — Medicare Advantage: $362.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GY In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$6,017	$3,610.20	$345.64 – $864.10
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $352.55 Aetna Qualified Health Plan — Commercial: $864.10 Ambetter of NC Individual Market — Commercial: $691.28 Blue Medicare Partner Health Plan — Medicare: $345.64 First Carolina Care — Medicare Advantage: $352.55 Humana — Medicare Advantage: $380.20 Humana Choicecare — Medicare Advantage: $380.20 Liberty Advantage — Medicare Advantage: $352.55 Longevity — Medicare Advantage: $345.64 New Hanover — Medicare Advantage: $362.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$6,017	$3,610.20	$345.64 – $864.10
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $352.55 Aetna Qualified Health Plan — Commercial: $864.10 Ambetter of NC Individual Market — Commercial: $691.28 Blue Medicare Partner Health Plan — Medicare: $345.64 First Carolina Care — Medicare Advantage: $352.55 Humana — Medicare Advantage: $380.20 Humana Choicecare — Medicare Advantage: $380.20 Liberty Advantage — Medicare Advantage: $352.55 Longevity — Medicare Advantage: $345.64 New Hanover — Medicare Advantage: $362.92
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,342	$805.20	$103.58 – $258.95
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,342	$805.20	$103.58 – $258.95
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,342	$805.20	$103.58 – $258.95
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,070	$642	$103.58 – $258.95
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GC_PO In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,070	$642	$103.58 – $258.95
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,070	$642	$103.58 – $258.95
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$907	$544.20	$103.58 – $258.95
Transvaginal ultrasound: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$907	$544.20	$103.58 – $258.95
Transvaginal ultrasound: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$907	$544.20	$103.58 – $258.95
Transvaginal ultrasound: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $105.65 Aetna Qualified Health Plan — Commercial: $258.95 Ambetter of NC Individual Market — Commercial: $207.16 Blue Medicare Partner Health Plan — Medicare: $103.58 First Carolina Care — Medicare Advantage: $105.65 Humana — Medicare Advantage: $113.94 Humana Choicecare — Medicare Advantage: $113.94 Liberty Advantage — Medicare Advantage: $105.65 Longevity — Medicare Advantage: $103.58 New Hanover — Medicare Advantage: $108.76
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	$362	$217.20	$36.49 – $91.22
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $37.22 Aetna Qualified Health Plan — Commercial: $91.22 Ambetter of NC Individual Market — Commercial: $72.98 Blue Medicare Partner Health Plan — Medicare: $36.49 First Carolina Care — Medicare Advantage: $37.22 Humana — Medicare Advantage: $40.14 Humana Choicecare — Medicare Advantage: $40.14 Liberty Advantage — Medicare Advantage: $37.22 Longevity — Medicare Advantage: $36.49 New Hanover — Medicare Advantage: $38.31
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$362	$217.20	$36.49 – $91.22
Diagnostic mammogram, one breast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $37.22 Aetna Qualified Health Plan — Commercial: $91.22 Ambetter of NC Individual Market — Commercial: $72.98 Blue Medicare Partner Health Plan — Medicare: $36.49 First Carolina Care — Medicare Advantage: $37.22 Humana — Medicare Advantage: $40.14 Humana Choicecare — Medicare Advantage: $40.14 Liberty Advantage — Medicare Advantage: $37.22 Longevity — Medicare Advantage: $36.49 New Hanover — Medicare Advantage: $38.31
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$362	$217.20	$36.49 – $91.22
Diagnostic mammogram, one breast: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $37.22 Aetna Qualified Health Plan — Commercial: $91.22 Ambetter of NC Individual Market — Commercial: $72.98 Blue Medicare Partner Health Plan — Medicare: $36.49 First Carolina Care — Medicare Advantage: $37.22 Humana — Medicare Advantage: $40.14 Humana Choicecare — Medicare Advantage: $40.14 Liberty Advantage — Medicare Advantage: $37.22 Longevity — Medicare Advantage: $36.49 New Hanover — Medicare Advantage: $38.31
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$461	$276.60	$44.92 – $112.30
Diagnostic mammogram, both breasts: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $45.82 Aetna Qualified Health Plan — Commercial: $112.30 Ambetter of NC Individual Market — Commercial: $89.84 Blue Medicare Partner Health Plan — Medicare: $44.92 First Carolina Care — Medicare Advantage: $45.82 Humana — Medicare Advantage: $49.41 Humana Choicecare — Medicare Advantage: $49.41 Liberty Advantage — Medicare Advantage: $45.82 Longevity — Medicare Advantage: $44.92 New Hanover — Medicare Advantage: $47.17
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$461	$276.60	$44.92 – $112.30
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $45.82 Aetna Qualified Health Plan — Commercial: $112.30 Ambetter of NC Individual Market — Commercial: $89.84 Blue Medicare Partner Health Plan — Medicare: $44.92 First Carolina Care — Medicare Advantage: $45.82 Humana — Medicare Advantage: $49.41 Humana Choicecare — Medicare Advantage: $49.41 Liberty Advantage — Medicare Advantage: $45.82 Longevity — Medicare Advantage: $44.92 New Hanover — Medicare Advantage: $47.17
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY	$381	$228.60	$33.99 – $84.98
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $34.67 Aetna Qualified Health Plan — Commercial: $84.98 Ambetter of NC Individual Market — Commercial: $67.98 Blue Medicare Partner Health Plan — Medicare: $33.99 First Carolina Care — Medicare Advantage: $34.67 Humana — Medicare Advantage: $37.39 Humana Choicecare — Medicare Advantage: $37.39 Liberty Advantage — Medicare Advantage: $34.67 Longevity — Medicare Advantage: $33.99 New Hanover — Medicare Advantage: $35.69
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SCREENING MAMMOGRAPHY	$381	$228.60	$33.99 – $84.98
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $34.67 Aetna Qualified Health Plan — Commercial: $84.98 Ambetter of NC Individual Market — Commercial: $67.98 Blue Medicare Partner Health Plan — Medicare: $33.99 First Carolina Care — Medicare Advantage: $34.67 Humana — Medicare Advantage: $37.39 Humana Choicecare — Medicare Advantage: $37.39 Liberty Advantage — Medicare Advantage: $34.67 Longevity — Medicare Advantage: $33.99 New Hanover — Medicare Advantage: $35.69
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SCREENING MAMMOGRAPHY	$381	$228.60	$33.99 – $84.98
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $34.67 Aetna Qualified Health Plan — Commercial: $84.98 Ambetter of NC Individual Market — Commercial: $67.98 Blue Medicare Partner Health Plan — Medicare: $33.99 First Carolina Care — Medicare Advantage: $34.67 Humana — Medicare Advantage: $37.39 Humana Choicecare — Medicare Advantage: $37.39 Liberty Advantage — Medicare Advantage: $34.67 Longevity — Medicare Advantage: $33.99 New Hanover — Medicare Advantage: $35.69

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	$7,023	$4,213.80	$3,211.87 – $8,029.68
Left heart catheterization (diagnostic): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $3,276.11 Aetna Qualified Health Plan — Commercial: $8,029.68 Ambetter of NC Individual Market — Commercial: $6,423.74 Blue Medicare Partner Health Plan — Medicare: $3,211.87 First Carolina Care — Medicare Advantage: $3,276.11 Humana — Medicare Advantage: $3,533.06 Humana Choicecare — Medicare Advantage: $3,533.06 Liberty Advantage — Medicare Advantage: $3,276.11 Longevity — Medicare Advantage: $3,211.87 New Hanover — Medicare Advantage: $3,372.46
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	$15,982	$9,589.20	$7,727.35 – $19,318.38
Heart rhythm study (electrophysiology evaluation): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $7,881.90 Aetna Qualified Health Plan — Commercial: $19,318.38 Ambetter of NC Individual Market — Commercial: $15,454.70 Blue Medicare Partner Health Plan — Medicare: $7,727.35 First Carolina Care — Medicare Advantage: $7,881.90 Humana — Medicare Advantage: $8,500.08 Humana Choicecare — Medicare Advantage: $8,500.08 Liberty Advantage — Medicare Advantage: $7,881.90 Longevity — Medicare Advantage: $7,727.35 New Hanover — Medicare Advantage: $8,113.72
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION	$45,144	$27,086.40	$25,895.53 – $64,738.82
Heart rhythm study with ablation for atrial fibrillation: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $26,413.44 Aetna Qualified Health Plan — Commercial: $64,738.82 Ambetter of NC Individual Market — Commercial: $51,791.06 Blue Medicare Partner Health Plan — Medicare: $25,895.53 First Carolina Care — Medicare Advantage: $26,413.44 Humana — Medicare Advantage: $28,485.08 Humana Choicecare — Medicare Advantage: $28,485.08 Liberty Advantage — Medicare Advantage: $26,413.44 Longevity — Medicare Advantage: $25,895.53 New Hanover — Medicare Advantage: $27,190.31
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$3,958	$2,374.80	$850.78 – $2,126.95
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $867.80 Aetna Qualified Health Plan — Commercial: $2,126.95 Ambetter of NC Individual Market — Commercial: $1,701.56 Blue Medicare Partner Health Plan — Medicare: $850.78 First Carolina Care — Medicare Advantage: $867.80 Humana — Medicare Advantage: $935.86 Humana Choicecare — Medicare Advantage: $935.86 Liberty Advantage — Medicare Advantage: $867.80 Longevity — Medicare Advantage: $850.78 New Hanover — Medicare Advantage: $893.32
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$1,979	$1,187.40	$425.39 – $1,063.47
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $433.90 Aetna Qualified Health Plan — Commercial: $1,063.47 Ambetter of NC Individual Market — Commercial: $850.78 Blue Medicare Partner Health Plan — Medicare: $425.39 First Carolina Care — Medicare Advantage: $433.90 Humana — Medicare Advantage: $467.93 Humana Choicecare — Medicare Advantage: $467.93 Liberty Advantage — Medicare Advantage: $433.90 Longevity — Medicare Advantage: $425.39 New Hanover — Medicare Advantage: $446.66
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$3,958	$2,374.80	$850.78 – $2,126.95
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $867.80 Aetna Qualified Health Plan — Commercial: $2,126.95 Ambetter of NC Individual Market — Commercial: $1,701.56 Blue Medicare Partner Health Plan — Medicare: $850.78 First Carolina Care — Medicare Advantage: $867.80 Humana — Medicare Advantage: $935.86 Humana Choicecare — Medicare Advantage: $935.86 Liberty Advantage — Medicare Advantage: $867.80 Longevity — Medicare Advantage: $850.78 New Hanover — Medicare Advantage: $893.32

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	$150	$90	$28.02 – $70.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $28.58 Aetna Qualified Health Plan — Commercial: $70.05 Ambetter of NC Individual Market — Commercial: $56.04 Blue Medicare Partner Health Plan — Medicare: $28.02 First Carolina Care — Medicare Advantage: $28.58 Humana — Medicare Advantage: $30.82 Humana Choicecare — Medicare Advantage: $30.82 Liberty Advantage — Medicare Advantage: $28.58 Longevity — Medicare Advantage: $28.02 New Hanover — Medicare Advantage: $29.42
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_CO_GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$450	$270	$28.02 – $70.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $28.58 Aetna Qualified Health Plan — Commercial: $70.05 Ambetter of NC Individual Market — Commercial: $56.04 Blue Medicare Partner Health Plan — Medicare: $28.02 First Carolina Care — Medicare Advantage: $28.58 Humana — Medicare Advantage: $30.82 Humana Choicecare — Medicare Advantage: $30.82 Liberty Advantage — Medicare Advantage: $28.58 Longevity — Medicare Advantage: $28.02 New Hanover — Medicare Advantage: $29.42
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CO_GO_KX In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$150	$90	$28.02 – $70.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $28.58 Aetna Qualified Health Plan — Commercial: $70.05 Ambetter of NC Individual Market — Commercial: $56.04 Blue Medicare Partner Health Plan — Medicare: $28.02 First Carolina Care — Medicare Advantage: $28.58 Humana — Medicare Advantage: $30.82 Humana Choicecare — Medicare Advantage: $30.82 Liberty Advantage — Medicare Advantage: $28.58 Longevity — Medicare Advantage: $28.02 New Hanover — Medicare Advantage: $29.42
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$244	$146.40	$94.65 – $236.62
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 97_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$244	$146.40	$94.65 – $236.62
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$244	$146.40	$94.65 – $236.62
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$360	$216	$94.65 – $236.62
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP_KX In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$360	$216	$94.65 – $236.62
Physical therapy evaluation (moderate complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 97_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$360	$216	$94.65 – $236.62
Physical therapy evaluation (moderate complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	$487	$292.20	$94.65 – $236.62
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$487	$292.20	$94.65 – $236.62
Physical therapy evaluation (high complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 97_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$487	$292.20	$94.65 – $236.62
Physical therapy evaluation (high complexity): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $96.54 Aetna Qualified Health Plan — Commercial: $236.62 Ambetter of NC Individual Market — Commercial: $189.30 Blue Medicare Partner Health Plan — Medicare: $94.65 First Carolina Care — Medicare Advantage: $96.54 Humana — Medicare Advantage: $104.12 Humana Choicecare — Medicare Advantage: $104.12 Liberty Advantage — Medicare Advantage: $96.54 Longevity — Medicare Advantage: $94.65 New Hanover — Medicare Advantage: $99.38
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	$240	$144	$175.85 – $439.62
Psychotherapy, 30 minutes: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $179.37 Aetna Qualified Health Plan — Commercial: $439.62 Ambetter of NC Individual Market — Commercial: $351.70 Blue Medicare Partner Health Plan — Medicare: $175.85 First Carolina Care — Medicare Advantage: $179.37 Humana — Medicare Advantage: $193.44 Humana Choicecare — Medicare Advantage: $193.44 Liberty Advantage — Medicare Advantage: $179.37 Longevity — Medicare Advantage: $175.85 New Hanover — Medicare Advantage: $184.64
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	$304	$182.40	$175.85 – $439.62
Psychotherapy, 45 minutes: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $179.37 Aetna Qualified Health Plan — Commercial: $439.62 Ambetter of NC Individual Market — Commercial: $351.70 Blue Medicare Partner Health Plan — Medicare: $175.85 First Carolina Care — Medicare Advantage: $179.37 Humana — Medicare Advantage: $193.44 Humana Choicecare — Medicare Advantage: $193.44 Liberty Advantage — Medicare Advantage: $179.37 Longevity — Medicare Advantage: $175.85 New Hanover — Medicare Advantage: $184.64
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	$360	$216	$175.85 – $439.62
Psychotherapy, 60 minutes: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $179.37 Aetna Qualified Health Plan — Commercial: $439.62 Ambetter of NC Individual Market — Commercial: $351.70 Blue Medicare Partner Health Plan — Medicare: $175.85 First Carolina Care — Medicare Advantage: $179.37 Humana — Medicare Advantage: $193.44 Humana Choicecare — Medicare Advantage: $193.44 Liberty Advantage — Medicare Advantage: $179.37 Longevity — Medicare Advantage: $175.85 New Hanover — Medicare Advantage: $184.64
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	$322	$193.20	$175.85 – $439.62
Family psychotherapy, without the patient: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $179.37 Aetna Qualified Health Plan — Commercial: $439.62 Ambetter of NC Individual Market — Commercial: $351.70 Blue Medicare Partner Health Plan — Medicare: $175.85 First Carolina Care — Medicare Advantage: $179.37 Humana — Medicare Advantage: $193.44 Humana Choicecare — Medicare Advantage: $193.44 Liberty Advantage — Medicare Advantage: $179.37 Longevity — Medicare Advantage: $175.85 New Hanover — Medicare Advantage: $184.64
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	$264	$158.40	$175.85 – $439.62
Family psychotherapy, with the patient: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $179.37 Aetna Qualified Health Plan — Commercial: $439.62 Ambetter of NC Individual Market — Commercial: $351.70 Blue Medicare Partner Health Plan — Medicare: $175.85 First Carolina Care — Medicare Advantage: $179.37 Humana — Medicare Advantage: $193.44 Humana Choicecare — Medicare Advantage: $193.44 Liberty Advantage — Medicare Advantage: $179.37 Longevity — Medicare Advantage: $175.85 New Hanover — Medicare Advantage: $184.64
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	$367	$220.20	$100.64 – $251.60
Group psychotherapy: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $102.65 Aetna Qualified Health Plan — Commercial: $251.60 Ambetter of NC Individual Market — Commercial: $201.28 Blue Medicare Partner Health Plan — Medicare: $100.64 First Carolina Care — Medicare Advantage: $102.65 Humana — Medicare Advantage: $110.70 Humana Choicecare — Medicare Advantage: $110.70 Liberty Advantage — Medicare Advantage: $102.65 Longevity — Medicare Advantage: $100.64 New Hanover — Medicare Advantage: $105.67

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$4,794	$2,876.40	$3,879.13 – $9,697.83
Removal of breast growth (open surgery): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,956.71 Aetna Qualified Health Plan — Commercial: $9,697.83 Ambetter of NC Individual Market — Commercial: $7,758.26 Blue Medicare Partner Health Plan — Medicare: $3,879.13 First Carolina Care — Medicare Advantage: $3,956.71 Humana — Medicare Advantage: $4,267.04 Humana Choicecare — Medicare Advantage: $4,267.04 Liberty Advantage — Medicare Advantage: $3,956.71 Longevity — Medicare Advantage: $3,879.13 New Hanover — Medicare Advantage: $4,073.09
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$6,116	$3,669.60	$3,879.13 – $9,697.83
Removal of breast growth (open surgery): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,956.71 Aetna Qualified Health Plan — Commercial: $9,697.83 Ambetter of NC Individual Market — Commercial: $7,758.26 Blue Medicare Partner Health Plan — Medicare: $3,879.13 First Carolina Care — Medicare Advantage: $3,956.71 Humana — Medicare Advantage: $4,267.04 Humana Choicecare — Medicare Advantage: $4,267.04 Liberty Advantage — Medicare Advantage: $3,956.71 Longevity — Medicare Advantage: $3,879.13 New Hanover — Medicare Advantage: $4,073.09
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$8,127	$4,876.20	$12,719.65 – $31,799.12
Total hip replacement: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $12,974.04 Aetna Qualified Health Plan — Commercial: $31,799.12 Ambetter of NC Individual Market — Commercial: $25,439.30 Blue Medicare Partner Health Plan — Medicare: $12,719.65 First Carolina Care — Medicare Advantage: $12,974.04 Humana — Medicare Advantage: $13,991.61 Humana Choicecare — Medicare Advantage: $13,991.61 Liberty Advantage — Medicare Advantage: $12,974.04 Longevity — Medicare Advantage: $12,719.65 New Hanover — Medicare Advantage: $13,355.63
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$10,554	$6,332.40	$12,719.65 – $31,799.13
Total hip replacement: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $12,974.04 Aetna Qualified Health Plan — Commercial: $31,799.13 Ambetter of NC Individual Market — Commercial: $25,439.30 Blue Medicare Partner Health Plan — Medicare: $12,719.65 First Carolina Care — Medicare Advantage: $12,974.04 Humana — Medicare Advantage: $13,991.62 Humana Choicecare — Medicare Advantage: $13,991.62 Liberty Advantage — Medicare Advantage: $12,974.04 Longevity — Medicare Advantage: $12,719.65 New Hanover — Medicare Advantage: $13,355.63
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$6,410	$3,846	$12,719.65 – $31,799.13
Total knee replacement: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $12,974.04 Aetna Qualified Health Plan — Commercial: $31,799.13 Ambetter of NC Individual Market — Commercial: $25,439.30 Blue Medicare Partner Health Plan — Medicare: $12,719.65 First Carolina Care — Medicare Advantage: $12,974.04 Humana — Medicare Advantage: $13,991.61 Humana Choicecare — Medicare Advantage: $13,991.61 Liberty Advantage — Medicare Advantage: $12,974.04 Longevity — Medicare Advantage: $12,719.65 New Hanover — Medicare Advantage: $13,355.63
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22_LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$8,926	$5,355.60	$12,719.65 – $31,799.12
Total knee replacement: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $12,974.04 Aetna Qualified Health Plan — Commercial: $31,799.12 Ambetter of NC Individual Market — Commercial: $25,439.30 Blue Medicare Partner Health Plan — Medicare: $12,719.65 First Carolina Care — Medicare Advantage: $12,974.04 Humana — Medicare Advantage: $13,991.62 Humana Choicecare — Medicare Advantage: $13,991.62 Liberty Advantage — Medicare Advantage: $12,974.04 Longevity — Medicare Advantage: $12,719.65 New Hanover — Medicare Advantage: $13,355.63
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_RT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$3,968	$2,380.80	$12,719.65 – $31,799.12
Total knee replacement: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $12,974.04 Aetna Qualified Health Plan — Commercial: $31,799.12 Ambetter of NC Individual Market — Commercial: $25,439.30 Blue Medicare Partner Health Plan — Medicare: $12,719.65 First Carolina Care — Medicare Advantage: $12,974.04 Humana — Medicare Advantage: $13,991.62 Humana Choicecare — Medicare Advantage: $13,991.62 Liberty Advantage — Medicare Advantage: $12,974.04 Longevity — Medicare Advantage: $12,719.65 New Hanover — Medicare Advantage: $13,355.63
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$138.60 – $346.50
Shoulder arthroscopy: shaving of shoulder bone: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $141.37 Aetna Qualified Health Plan — Commercial: $346.50 Ambetter of NC Individual Market — Commercial: $277.20 Blue Medicare Partner Health Plan — Medicare: $138.60 First Carolina Care — Medicare Advantage: $141.37 Humana — Medicare Advantage: $152.46 Humana Choicecare — Medicare Advantage: $152.46 Liberty Advantage — Medicare Advantage: $141.37 Longevity — Medicare Advantage: $138.60 New Hanover — Medicare Advantage: $145.53
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$138.60 – $346.50
Shoulder arthroscopy: shaving of shoulder bone: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $141.37 Aetna Qualified Health Plan — Commercial: $346.50 Ambetter of NC Individual Market — Commercial: $277.20 Blue Medicare Partner Health Plan — Medicare: $138.60 First Carolina Care — Medicare Advantage: $141.37 Humana — Medicare Advantage: $152.46 Humana Choicecare — Medicare Advantage: $152.46 Liberty Advantage — Medicare Advantage: $141.37 Longevity — Medicare Advantage: $138.60 New Hanover — Medicare Advantage: $145.53
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,175	$3,105	$3,241.67 – $8,104.18
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,306.50 Aetna Qualified Health Plan — Commercial: $8,104.18 Ambetter of NC Individual Market — Commercial: $6,483.34 Blue Medicare Partner Health Plan — Medicare: $3,241.67 First Carolina Care — Medicare Advantage: $3,306.50 Humana — Medicare Advantage: $3,565.84 Humana Choicecare — Medicare Advantage: $3,565.84 Liberty Advantage — Medicare Advantage: $3,306.50 Longevity — Medicare Advantage: $3,241.67 New Hanover — Medicare Advantage: $3,403.75
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$6,255	$3,753	$3,241.67 – $8,104.18
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,306.50 Aetna Qualified Health Plan — Commercial: $8,104.18 Ambetter of NC Individual Market — Commercial: $6,483.34 Blue Medicare Partner Health Plan — Medicare: $3,241.67 First Carolina Care — Medicare Advantage: $3,306.50 Humana — Medicare Advantage: $3,565.84 Humana Choicecare — Medicare Advantage: $3,565.84 Liberty Advantage — Medicare Advantage: $3,306.50 Longevity — Medicare Advantage: $3,241.67 New Hanover — Medicare Advantage: $3,403.75
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,170	$1,902	$5,864.94 – $14,662.35
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $5,982.24 Aetna Qualified Health Plan — Commercial: $14,662.35 Ambetter of NC Individual Market — Commercial: $11,729.88 Blue Medicare Partner Health Plan — Medicare: $5,864.94 First Carolina Care — Medicare Advantage: $5,982.24 Humana — Medicare Advantage: $6,451.43 Humana Choicecare — Medicare Advantage: $6,451.43 Liberty Advantage — Medicare Advantage: $5,982.24 Longevity — Medicare Advantage: $5,864.94 New Hanover — Medicare Advantage: $6,158.19
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy (diagnostic): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_62 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,208	$1,324.80	$898.58 – $2,246.45
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $916.55 Aetna Qualified Health Plan — Commercial: $2,246.45 Ambetter of NC Individual Market — Commercial: $1,797.16 Blue Medicare Partner Health Plan — Medicare: $898.58 First Carolina Care — Medicare Advantage: $916.55 Humana — Medicare Advantage: $988.44 Humana Choicecare — Medicare Advantage: $988.44 Liberty Advantage — Medicare Advantage: $916.55 Longevity — Medicare Advantage: $898.58 New Hanover — Medicare Advantage: $943.51
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,230	$1,338	$921.33 – $2,303.32
Colonoscopy (diagnostic): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $939.76 Aetna Qualified Health Plan — Commercial: $2,303.32 Ambetter of NC Individual Market — Commercial: $1,842.66 Blue Medicare Partner Health Plan — Medicare: $921.33 First Carolina Care — Medicare Advantage: $939.76 Humana — Medicare Advantage: $1,013.46 Humana Choicecare — Medicare Advantage: $1,013.46 Liberty Advantage — Medicare Advantage: $939.76 Longevity — Medicare Advantage: $921.33 New Hanover — Medicare Advantage: $967.40
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,230	$1,338	$921.33 – $2,303.32
Colonoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $939.76 Aetna Qualified Health Plan — Commercial: $2,303.32 Ambetter of NC Individual Market — Commercial: $1,842.66 Blue Medicare Partner Health Plan — Medicare: $921.33 First Carolina Care — Medicare Advantage: $939.76 Humana — Medicare Advantage: $1,013.46 Humana Choicecare — Medicare Advantage: $1,013.46 Liberty Advantage — Medicare Advantage: $939.76 Longevity — Medicare Advantage: $921.33 New Hanover — Medicare Advantage: $967.40
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$6,369	$3,821.40	$921.33 – $2,303.32
Colonoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $939.76 Aetna Qualified Health Plan — Commercial: $2,303.32 Ambetter of NC Individual Market — Commercial: $1,842.66 Blue Medicare Partner Health Plan — Medicare: $921.33 First Carolina Care — Medicare Advantage: $939.76 Humana — Medicare Advantage: $1,013.46 Humana Choicecare — Medicare Advantage: $1,013.46 Liberty Advantage — Medicare Advantage: $939.76 Longevity — Medicare Advantage: $921.33 New Hanover — Medicare Advantage: $967.40
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with biopsy: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with removal of polyps (snare): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,666	$1,599.60	$1,185.54 – $2,963.85
Colonoscopy with removal of polyps (snare): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	$2,651	$1,590.60	$1,185.54 – $2,963.85
Ultrasound of the lower bowel by endoscope: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $1,209.25 Aetna Qualified Health Plan — Commercial: $2,963.85 Ambetter of NC Individual Market — Commercial: $2,371.08 Blue Medicare Partner Health Plan — Medicare: $1,185.54 First Carolina Care — Medicare Advantage: $1,209.25 Humana — Medicare Advantage: $1,304.09 Humana Choicecare — Medicare Advantage: $1,304.09 Liberty Advantage — Medicare Advantage: $1,209.25 Longevity — Medicare Advantage: $1,185.54 New Hanover — Medicare Advantage: $1,244.82
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$2,230	$1,338	$921.33 – $2,303.32
Screening colonoscopy (not high risk): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $939.76 Aetna Qualified Health Plan — Commercial: $2,303.32 Ambetter of NC Individual Market — Commercial: $1,842.66 Blue Medicare Partner Health Plan — Medicare: $921.33 First Carolina Care — Medicare Advantage: $939.76 Humana — Medicare Advantage: $1,013.46 Humana Choicecare — Medicare Advantage: $1,013.46 Liberty Advantage — Medicare Advantage: $939.76 Longevity — Medicare Advantage: $921.33 New Hanover — Medicare Advantage: $967.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$8,919	$5,351.40	$5,989.48 – $14,973.70
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $6,109.27 Aetna Qualified Health Plan — Commercial: $14,973.70 Ambetter of NC Individual Market — Commercial: $11,978.96 Blue Medicare Partner Health Plan — Medicare: $5,989.48 First Carolina Care — Medicare Advantage: $6,109.27 Humana — Medicare Advantage: $6,588.43 Humana Choicecare — Medicare Advantage: $6,588.43 Liberty Advantage — Medicare Advantage: $6,109.27 Longevity — Medicare Advantage: $5,989.48 New Hanover — Medicare Advantage: $6,288.95
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22 In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$10,071	$6,042.60	$5,989.48 – $14,973.70
Gallbladder removal by laparoscope: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6,109.27 Aetna Qualified Health Plan — Commercial: $14,973.70 Ambetter of NC Individual Market — Commercial: $11,978.96 Blue Medicare Partner Health Plan — Medicare: $5,989.48 First Carolina Care — Medicare Advantage: $6,109.27 Humana — Medicare Advantage: $6,588.43 Humana Choicecare — Medicare Advantage: $6,588.43 Liberty Advantage — Medicare Advantage: $6,109.27 Longevity — Medicare Advantage: $5,989.48 New Hanover — Medicare Advantage: $6,288.95
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$13,425	$8,055	$3,547.20 – $8,868
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $3,618.14 Aetna Qualified Health Plan — Commercial: $8,868 Ambetter of NC Individual Market — Commercial: $7,094.40 Blue Medicare Partner Health Plan — Medicare: $3,547.20 First Carolina Care — Medicare Advantage: $3,618.14 Humana — Medicare Advantage: $3,901.92 Humana Choicecare — Medicare Advantage: $3,901.92 Liberty Advantage — Medicare Advantage: $3,618.14 Longevity — Medicare Advantage: $3,547.20 New Hanover — Medicare Advantage: $3,724.56
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$16,259	$9,755.40	$6,014.61 – $15,036.52
Groin (inguinal) hernia repair, age 5 or older: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $6,134.90 Aetna Qualified Health Plan — Commercial: $15,036.52 Ambetter of NC Individual Market — Commercial: $12,029.22 Blue Medicare Partner Health Plan — Medicare: $6,014.61 First Carolina Care — Medicare Advantage: $6,134.90 Humana — Medicare Advantage: $6,616.07 Humana Choicecare — Medicare Advantage: $6,616.07 Liberty Advantage — Medicare Advantage: $6,134.90 Longevity — Medicare Advantage: $6,014.61 New Hanover — Medicare Advantage: $6,315.34
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$4,794	$2,876.40	$3,547.20 – $8,868
Groin (inguinal) hernia repair, age 5 or older: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,618.14 Aetna Qualified Health Plan — Commercial: $8,868 Ambetter of NC Individual Market — Commercial: $7,094.40 Blue Medicare Partner Health Plan — Medicare: $3,547.20 First Carolina Care — Medicare Advantage: $3,618.14 Humana — Medicare Advantage: $3,901.92 Humana Choicecare — Medicare Advantage: $3,901.92 Liberty Advantage — Medicare Advantage: $3,618.14 Longevity — Medicare Advantage: $3,547.20 New Hanover — Medicare Advantage: $3,724.56
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: BIOPSY OF PROSTATE GLAND	$4,576	$2,745.60	Not listed in the file
Prostate biopsy: 10 of 11 insurance plan rates Aetna — Commercial: 55% (a percentage in the contract, not a dollar amount) Aetna NC State Health Plan — Commercial: 50% (a percentage in the contract, not a dollar amount) Aetna New Business — Commerical: 58% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of NC — Commercial: 63.08% (a percentage in the contract, not a dollar amount) Cigna — Commercial: 60% (a percentage in the contract, not a dollar amount) Humana — Commercial: 75% (a percentage in the contract, not a dollar amount) Humana Choicecare — Commercial: 75% (a percentage in the contract, not a dollar amount) MedCost — Commercial: 60% (a percentage in the contract, not a dollar amount) MultiPlan — Commercial: 82% (a percentage in the contract, not a dollar amount) United Healthcare — Commercial: 76.9% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$13,734	$8,240.40	$10,531.28 – $26,328.20
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates Aetna — Medicare Advantage: $10,741.91 Aetna Qualified Health Plan — Commercial: $26,328.20 Ambetter of NC Individual Market — Commercial: $21,062.56 Blue Medicare Partner Health Plan — Medicare: $10,531.28 First Carolina Care — Medicare Advantage: $10,741.91 Humana — Medicare Advantage: $11,584.41 Humana Choicecare — Medicare Advantage: $11,584.41 Liberty Advantage — Medicare Advantage: $10,741.91 Longevity — Medicare Advantage: $10,531.28 New Hanover — Medicare Advantage: $11,057.84
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$9,293	$5,575.80	$10,531.28 – $26,328.20
Prostate removal by laparoscope (radical prostatectomy): 10 of 24 insurance plan rates Aetna — Medicare Advantage: $10,741.91 Aetna Qualified Health Plan — Commercial: $26,328.20 Ambetter of NC Individual Market — Commercial: $21,062.56 Blue Medicare Partner Health Plan — Medicare: $10,531.28 First Carolina Care — Medicare Advantage: $10,741.91 Humana — Medicare Advantage: $11,584.41 Humana Choicecare — Medicare Advantage: $11,584.41 Liberty Advantage — Medicare Advantage: $10,741.91 Longevity — Medicare Advantage: $10,531.28 New Hanover — Medicare Advantage: $11,057.84
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$3,655	$2,193	$3,207.12 – $8,017.80
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $3,271.26 Aetna Qualified Health Plan — Commercial: $8,017.80 Ambetter of NC Individual Market — Commercial: $6,414.24 Blue Medicare Partner Health Plan — Medicare: $3,207.12 First Carolina Care — Medicare Advantage: $3,271.26 Humana — Medicare Advantage: $3,527.83 Humana Choicecare — Medicare Advantage: $3,527.83 Liberty Advantage — Medicare Advantage: $3,271.26 Longevity — Medicare Advantage: $3,207.12 New Hanover — Medicare Advantage: $3,367.48
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$2,918	$1,750.80	$3,207.12 – $8,017.80
Hysteroscopy with biopsy of the uterus lining: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $3,271.26 Aetna Qualified Health Plan — Commercial: $8,017.80 Ambetter of NC Individual Market — Commercial: $6,414.24 Blue Medicare Partner Health Plan — Medicare: $3,207.12 First Carolina Care — Medicare Advantage: $3,271.26 Humana — Medicare Advantage: $3,527.83 Humana Choicecare — Medicare Advantage: $3,527.83 Liberty Advantage — Medicare Advantage: $3,271.26 Longevity — Medicare Advantage: $3,207.12 New Hanover — Medicare Advantage: $3,367.48
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$1,407	$844.20	$699.34 – $1,748.35
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $713.33 Aetna Qualified Health Plan — Commercial: $1,748.35 Ambetter of NC Individual Market — Commercial: $1,398.68 Blue Medicare Partner Health Plan — Medicare: $699.34 First Carolina Care — Medicare Advantage: $713.33 Humana — Medicare Advantage: $769.27 Humana Choicecare — Medicare Advantage: $769.27 Liberty Advantage — Medicare Advantage: $713.33 Longevity — Medicare Advantage: $699.34 New Hanover — Medicare Advantage: $734.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$1,883	$1,129.80	$876.28 – $2,190.70
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates Aetna — Medicare Advantage: $893.81 Aetna Qualified Health Plan — Commercial: $2,190.70 Ambetter of NC Individual Market — Commercial: $1,752.56 Blue Medicare Partner Health Plan — Medicare: $876.28 First Carolina Care — Medicare Advantage: $893.81 Humana — Medicare Advantage: $963.91 Humana Choicecare — Medicare Advantage: $963.91 Liberty Advantage — Medicare Advantage: $893.81 Longevity — Medicare Advantage: $876.28 New Hanover — Medicare Advantage: $920.09
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$3,786	$2,271.60	$1,934.62 – $4,836.55
Carpal tunnel release: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,973.31 Aetna Qualified Health Plan — Commercial: $4,836.55 Ambetter of NC Individual Market — Commercial: $3,869.24 Blue Medicare Partner Health Plan — Medicare: $1,934.62 First Carolina Care — Medicare Advantage: $1,973.31 Humana — Medicare Advantage: $2,128.08 Humana Choicecare — Medicare Advantage: $2,128.08 Liberty Advantage — Medicare Advantage: $1,973.31 Longevity — Medicare Advantage: $1,934.62 New Hanover — Medicare Advantage: $2,031.35
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$1,934.62 – $4,836.55
Carpal tunnel release: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $1,973.31 Aetna Qualified Health Plan — Commercial: $4,836.55 Ambetter of NC Individual Market — Commercial: $3,869.24 Blue Medicare Partner Health Plan — Medicare: $1,934.62 First Carolina Care — Medicare Advantage: $1,973.31 Humana — Medicare Advantage: $2,128.08 Humana Choicecare — Medicare Advantage: $2,128.08 Liberty Advantage — Medicare Advantage: $1,973.31 Longevity — Medicare Advantage: $1,934.62 New Hanover — Medicare Advantage: $2,031.35

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 & OTH MAJ CARDIOTHORACIC PROC WITH CARD CATH WITH COMORBITY	Not listed in the file	Not listed in the file	$895.63 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $213,110.30
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $86,949 Aetna Qualified Health Plan — Commercial: $213,110.30 Ambetter of NC Individual Market — Commercial: $170,488.24 Blue Medicare Partner Health Plan — Medicare: $85,244.12 Carolina Complete Health — Managed Medicaid: $93,913.60 First Carolina Care — Medicare Advantage: $86,949 Healthy Blue — Managed Medicaid: $93,913.60 Humana — Medicare Advantage: $93,768.53 Humana Choicecare — Medicare Advantage: $93,768.53 Liberty Advantage — Medicare Advantage: $86,949
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 COMORBITY	Not listed in the file	Not listed in the file	$895.63 – $45,454.10
Hip or knee replacement (major joint of the leg), without major complications: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $18,545.27 Aetna Qualified Health Plan — Commercial: $45,454.10 Ambetter of NC Individual Market — Commercial: $36,363.28 Blue Medicare Partner Health Plan — Medicare: $18,181.64 Carolina Complete Health — Managed Medicaid: $18,347.56 First Carolina Care — Medicare Advantage: $18,545.27 Healthy Blue — Managed Medicaid: $18,347.56 Humana — Medicare Advantage: $19,999.80 Humana Choicecare — Medicare Advantage: $19,999.80 Liberty Advantage — Medicare Advantage: $18,545.27
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$895.63 – $56,392.18
Neck (cervical) spinal fusion, without complications: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $23,008.01 Aetna Qualified Health Plan — Commercial: $56,392.18 Ambetter of NC Individual Market — Commercial: $45,113.74 Blue Medicare Partner Health Plan — Medicare: $22,556.87 Carolina Complete Health — Managed Medicaid: $23,036.86 First Carolina Care — Medicare Advantage: $23,008.01 Healthy Blue — Managed Medicaid: $23,036.86 Humana — Medicare Advantage: $24,812.56 Humana Choicecare — Medicare Advantage: $24,812.56 Liberty Advantage — Medicare Advantage: $23,008.01
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$895.63 – $30,763.15
Uterus and ovary surgery (not for cancer), without complications: 10 of 24 insurance plan rates Aetna — Medicare Advantage: $12,551.37 Aetna Qualified Health Plan — Commercial: $30,763.15 Ambetter of NC Individual Market — Commercial: $24,610.52 Blue Medicare Partner Health Plan — Medicare: $12,305.26 Carolina Complete Health — Managed Medicaid: $11,664.39 First Carolina Care — Medicare Advantage: $12,551.37 Healthy Blue — Managed Medicaid: $11,664.39 Humana — Medicare Advantage: $13,535.79 Humana Choicecare — Medicare Advantage: $13,535.79 Liberty Advantage — Medicare Advantage: $12,551.37

Source: Cape Fear Valley Medical Center’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 21, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1638 Owen Drive P O Box 2000, Fayetteville, NC 28302
County	Cumberland County
State	North Carolina
Phone	(910) 609‑4000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	340028
Name in Medicare records	CAPE FEAR VALLEY MEDICAL CENTER
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(910) 615‑4000^[7]
Official website	capefearvalley.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Cape Fear Valley Medical Center — capefearvalley.com
Emergency Department | Cape Fear Valley Health — capefearvalley.com
Pediatric Emergency Department | Cape Fear Valley Health — capefearvalley.com
Pediatric Emergency Medicine | Cape Fear Valley Health — capefearvalley.com
Heart & Vascular Care | Cape Fear Valley Health — capefearvalley.com
Imaging Services | Cape Fear Valley Health — capefearvalley.com