Does Carle Eureka Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Carle Eureka Hospital. In a medical emergency, call 911.

Where is Carle Eureka Hospital?

101 S Major St, Eureka, IL 61530, in Woodford County, Illinois.

What is the phone number of Carle Eureka Hospital?

(309) 467-2371, as listed by Medicare (CMS).

What is the Medicare star rating of Carle Eureka Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Carle Eureka Hospital — Eureka, IL

Quick answers

Does Carle Eureka Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Carle Eureka Hospital. In a medical emergency, call 911.
Where is Carle Eureka Hospital?: 101 S Major St, Eureka, IL 61530, in Woodford County, Illinois.
What is the phone number of Carle Eureka Hospital?: (309) 467-2371, as listed by Medicare (CMS).
What is the Medicare star rating of Carle Eureka Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[5][6][7][10][11]}

Emergency care
Medical and surgical acute care
Skilled nursing (swing bed) care
Physical therapy
Occupational therapy
Speech therapy
Inpatient rehabilitation
Behavioral health counseling (on-site, Trillium Place)
Cardiology (visiting specialists)
Gastroenterology (visiting specialists)
General surgery (visiting specialists)
Neurosurgery (visiting specialists)
Orthopedics (visiting specialists)
Pain management (visiting specialists)
Pulmonology (visiting specialists)
Sleep medicine (visiting specialists)
Surgical podiatry (visiting specialists)

Conditions treated^[5][7]

Treatments^[5][7][10]

Physical therapy
Occupational therapy
Speech therapy
Intravenous therapy, including antibiotics
Skilled nursing care
Counseling services
Virtual visits

Programs and centers^{[4][5][7][10][11]}

Swing Bed Program
Walk-in care clinic
Rural Health Clinics
Specialty clinics (visiting specialists)

Emergency care (hospital website)^[5][8]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Acute Stroke Ready Hospital

Visiting and practical information

Visiting	Main entrance open to visitors 8 a.m. to 8 p.m.; use the Emergency Department entrance outside those hours^[6]
Parking	Visitor parking in lots south and west of the hospital^[6]
Patient portal	MyCarle

Recognition^[5][10]

Critical Access Hospital
Acute Stroke Ready Hospital
Critical Access Hospital (CMS)
340B provider

Doctors and clinicians (117)

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

Main specialties

Doctors with a page on this site (117)

Ahmad Jibawi, MDInternal Medicine
Aiyub Patel, MDPulmonary Disease
Aladdin Tarakji, MDDiagnostic Radiology
Alex W. Frantz, PAPhysician Assistant
Alexa Miller, DOFamily Practice
Alexander I. Huh, MDInternal Medicine
Amber N. Avila, MDFamily Practice
Amit R. Vyas, MDDiagnostic Radiology
Amy M. Davis, NPNurse Practitioner
Angela Massutti, NPNurse Practitioner
Anne R. WebsterNurse Practitioner
April L. Dickenson, MDDiagnostic Radiology
Arvind Kalyan Sundaram, MDCardiovascular Disease (Cardiology)
Arvind Reddy DevanabandaInternal Medicine
Barry J. Riskin, MDNeurology
Benjamin R. Coleman, MDPathology
Beth L. Tumilty, MDCardiovascular Disease (Cardiology)
Bijoy Kar, MDHospitalist
Brad A. Stoecker, MDFamily Practice
Brandon W. Ahlers, CNACertified Registered Nurse Anesthetist (CRNA)
Brian W. Gebhart, MDGeneral Surgery
Chang Hwan Park, MDInternal Medicine
Charles K. Boley, MDInternal Medicine
Christa Jaglinski, NPNurse Practitioner

And 93 more: the button below opens the full list.

Other emergency rooms nearby

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

Saint Francis Medical Center17 mi · Peoria, IL · Acute Care Hospital
Carle Health Proctor Hospital17 mi · Peoria, IL · Acute Care Hospital
Carle Health Methodist Hospital17 mi · Peoria, IL · Acute Care Hospital
Carle Bromenn Medical Center21 mi · Normal, IL · Acute Care Hospital
Carle Health Pekin Hospital22 mi · Pekin, IL · Acute Care Hospital

Other hospitals nearby

OSF Healthcare Divine Mercy Continuing Care Hospital17 mi · Peoria, IL · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Loft Rehabilitation & Nursing0.6 mi · Eureka, IL · 1 of 5 stars
Apostolic Christian Home of Eureka2.4 mi · Eureka, IL · 5 of 5 stars
Apostolic Christian Home6.0 mi · Roanoke, IL · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Elysian Hospice, Inc.12 mi · Morton, IL
Comfort Plus Hospice Inc18 mi · Peoria, IL
OSF Hospice21 mi · Peoria, IL · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Helping Hands Home Healthcare and Staffing, LLC12 mi · Morton, IL
Iris Home Health Services, LLC18 mi · Peoria, IL · 2 of 5 stars
St. Francis Medical Center21 mi · Peoria, IL

All home health agencies in the state →

Dialysis facilities

FKC - East Peoria Home14 mi · East Peoria, IL · 5 of 5 stars
FMC - East Peoria Dialysis14 mi · East Peoria, IL · 3 of 5 stars
Carle Health Home Dialysis Clinic18 mi · Peoria, IL

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Renal Intervention Center LLC12 mi · Morton, IL
Soderstrom Dermatology Center18 mi · Peoria, IL
Springfield Clinic Peoria ASC18 mi · Peoria, IL

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Heartland Community Health Clinic DBA: Heartland Health Services - Main1.2 mi · Eureka, IL · Community health center
Heartland Community Health Clinic DBA: Heartland Health Services - Wisconsin16 mi · Peoria, IL · Community health center
Heartland Community Health Clinic DBA: Heartland Health Services - Adams17 mi · Peoria, IL · Community health center

Clinics and urgent care

Carle Eureka Family Medicine-Eureka0.9 mi · Eureka, IL · Rural health clinic
Carle Eureka Family Medicine-Roanoke6.7 mi · Roanoke, IL · Rural health clinic
OSF Healthcare - Medical Group - Roanoke6.7 mi · Roanoke, IL · Rural health clinic

Pharmacies

Roanoke RX LLC6.7 mi · Roanoke, IL · Community/retail pharmacy
Oncology Hematology Associates of Central Illinois8.1 mi · Washington, IL · Community/retail pharmacy
Walgreen Co8.1 mi · Washington, IL · Pharmacy

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	80%National average: 72%
Would definitely recommend the hospital	82%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	64%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	81%National average: 74%
Area around the room “always” quiet at night	69%National average: 60%
Completed surveys	51Response rate: 40%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	16.1%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	18%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	90 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)	Too few cases to report

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 Illinois Best hospitals in Illinois

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Carle Eureka Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 4 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: Office/Outpatient New Low Mdm 30 Minutes	$303	$303	$58.66 – $254.52
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $186.04 Aetna — Medicare Advantage: $136.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $60.42 Aetna First Health PPO — PPO: $200.28 Blue Cross Blue Shield — Blue Choice/Options/PPO: $254.52 Blue Cross Blue Shield — HMO: $203.01 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $181.80 HealthLink — PPO: $196.95 Humana — Medicare Advantage: $136.35
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non-Emergent Care Lvl 3 New Pt	$405	$405	$58.66 – $340.20
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $248.67 Aetna — Medicare Advantage: $182.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $60.42 Aetna First Health PPO — PPO: $267.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $340.20 Blue Cross Blue Shield — HMO: $271.35 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $243 HealthLink — PPO: $263.25 Humana — Medicare Advantage: $182.25
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal New Low Mdm 30-44 Minutes	$303	$303	$58.66 – $254.52
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $186.04 Aetna — Medicare Advantage: $136.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $60.42 Aetna First Health PPO — PPO: $200.28 Blue Cross Blue Shield — Blue Choice/Options/PPO: $254.52 Blue Cross Blue Shield — HMO: $203.01 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $181.80 HealthLink — PPO: $196.95 Humana — Medicare Advantage: $136.35
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$463	$463	$82 – $388.92
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $284.28 Aetna — Medicare Advantage: $208.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.83 Aetna First Health PPO — PPO: $306.04 Blue Cross Blue Shield — Blue Choice/Options/PPO: $388.92 Blue Cross Blue Shield — HMO: $310.21 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $277.80 HealthLink — PPO: $300.95 Humana — Medicare Advantage: $208.35
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non-Emergent Care Lvl 4 New Pt	$530	$530	$82 – $445.20
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $325.42 Aetna — Medicare Advantage: $238.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.83 Aetna First Health PPO — PPO: $350.33 Blue Cross Blue Shield — Blue Choice/Options/PPO: $445.20 Blue Cross Blue Shield — HMO: $355.10 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $318 HealthLink — PPO: $344.50 Humana — Medicare Advantage: $238.50
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal New Moderate Mdm 45-59 Minutes	$463	$463	$82 – $388.92
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $284.28 Aetna — Medicare Advantage: $208.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.83 Aetna First Health PPO — PPO: $306.04 Blue Cross Blue Shield — Blue Choice/Options/PPO: $388.92 Blue Cross Blue Shield — HMO: $310.21 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $277.80 HealthLink — PPO: $300.95 Humana — Medicare Advantage: $208.35
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/Outpatient New High Mdm 60 Minutes	$585	$585	$82 – $491.40
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $359.19 Aetna — Medicare Advantage: $263.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $131.39 Aetna First Health PPO — PPO: $386.69 Blue Cross Blue Shield — Blue Choice/Options/PPO: $491.40 Blue Cross Blue Shield — HMO: $391.95 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $351 HealthLink — PPO: $380.25 Humana — Medicare Advantage: $263.25
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal New High Mdm 60-74 Minutes	$585	$585	$82 – $491.40
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $359.19 Aetna — Medicare Advantage: $263.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $131.39 Aetna First Health PPO — PPO: $386.69 Blue Cross Blue Shield — Blue Choice/Options/PPO: $491.40 Blue Cross Blue Shield — HMO: $391.95 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $351 HealthLink — PPO: $380.25 Humana — Medicare Advantage: $263.25
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non-Emergent Care Lvl 5 New Pt	$656	$656	$82 – $551.04
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $402.78 Aetna — Medicare Advantage: $295.20 Aetna Better Health — Medicare-Medicaid (D-SNP): $131.39 Aetna First Health PPO — PPO: $433.62 Blue Cross Blue Shield — Blue Choice/Options/PPO: $551.04 Blue Cross Blue Shield — HMO: $439.52 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $393.60 HealthLink — PPO: $426.40 Humana — Medicare Advantage: $295.20
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal Established Low Mdm 20-29 Min	$210	$210	$42 – $176.40
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $128.94 Aetna — Medicare Advantage: $94.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $47.82 Aetna First Health PPO — PPO: $138.81 Blue Cross Blue Shield — Blue Choice/Options/PPO: $176.40 Blue Cross Blue Shield — HMO: $140.70 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $126 HealthLink — PPO: $136.50 Humana — Medicare Advantage: $94.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/Outpatient Established Low Mdm 20 Min	$210	$210	$42 – $176.40
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $128.94 Aetna — Medicare Advantage: $94.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $47.82 Aetna First Health PPO — PPO: $138.81 Blue Cross Blue Shield — Blue Choice/Options/PPO: $176.40 Blue Cross Blue Shield — HMO: $140.70 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $126 HealthLink — PPO: $136.50 Humana — Medicare Advantage: $94.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non-Emergent Care Lvl 3 Est Pt	$299	$299	$46.43 – $251.16
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $183.59 Aetna — Medicare Advantage: $134.55 Aetna Better Health — Medicare-Medicaid (D-SNP): $47.82 Aetna First Health PPO — PPO: $197.64 Blue Cross Blue Shield — Blue Choice/Options/PPO: $251.16 Blue Cross Blue Shield — HMO: $200.33 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $179.40 HealthLink — PPO: $194.35 Humana — Medicare Advantage: $134.55
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non-Emergent Care Lvl 4 Est Pt	$347	$347	$68.51 – $291.48
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $213.06 Aetna — Medicare Advantage: $156.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $70.57 Aetna First Health PPO — PPO: $229.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $291.48 Blue Cross Blue Shield — HMO: $232.49 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $208.20 HealthLink — PPO: $225.55 Humana — Medicare Advantage: $156.15
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal Established Mod Mdm 30-39 Min	$309	$309	$61.80 – $259.56
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $189.73 Aetna — Medicare Advantage: $139.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $70.57 Aetna First Health PPO — PPO: $204.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $259.56 Blue Cross Blue Shield — HMO: $207.03 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $185.40 HealthLink — PPO: $200.85 Humana — Medicare Advantage: $139.05
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cdc Clinic	$347	$347	$68.51 – $291.48
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $213.06 Aetna — Medicare Advantage: $156.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $70.57 Aetna First Health PPO — PPO: $229.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $291.48 Blue Cross Blue Shield — HMO: $232.49 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $208.20 HealthLink — PPO: $225.55 Humana — Medicare Advantage: $156.15
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$91.23 – $165.80
Office consultation with a specialist (moderate): rates for 5 insurance plans Aetna — Commercial: $165.80 Aetna Better Health — Medicare-Medicaid (D-SNP): $93.97 Humana — Medicare-Medicaid (D-SNP): $91.23 United Healthcare (UHC) — VA CCN/Optum: $91.67 Wellcare — Medicare Advantage HMO: $110.39
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$91.23 – $93.97
Office consultation with a specialist (moderate): rates for 3 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $93.97 Humana — Medicare-Medicaid (D-SNP): $91.23 United Healthcare (UHC) — VA CCN/Optum: $91.67
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$139.12 – $250.70
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Aetna — Commercial: $250.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $143.29 Humana — Medicare-Medicaid (D-SNP): $139.12 United Healthcare (UHC) — VA CCN/Optum: $139.79 Wellcare — Medicare Advantage HMO: $158.49
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$139.12 – $143.29
Office consultation with a specialist (moderate to high): rates for 3 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $143.29 Humana — Medicare-Medicaid (D-SNP): $139.12 United Healthcare (UHC) — VA CCN/Optum: $139.79
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Preventive Visit,New,18-39	$286	$286	$57.20 – $240.24
Preventive checkup, new patient, age 18–39: 10 of 19 insurance plan rates Aetna — Commercial: $175.60 Aetna — Medicare Advantage: $128.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $78.67 Aetna First Health PPO — PPO: $189.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $240.24 Blue Cross Blue Shield — HMO: $191.62 Cigna — PPO: $177.32 Community Partners Health Plan (CPHP) — PPO: $171.60 HealthLink — PPO: $185.90 Humana — Medicare Advantage: $128.70
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Preventive Visit,New,18-39	$286	$286	$28.60 – $189.05
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $78.67 Aetna First Health PPO — PPO: $189.05 HealthLink — PPO: $185.90 Humana — Medicare-Medicaid (D-SNP): $76.38 Meridian — Medicare-Medicaid (D-SNP): $28.60 Molina — Managed Medicaid: $57.20 Molina — Medicare-Medicaid (D-SNP): $57.20 United Healthcare (UHC) — VA CCN/Optum: $97.34
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$176.60
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan Aetna — Commercial: $176.60
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Preventive Visit,New,40-64	$286	$286	$57.20 – $240.24
Preventive checkup, new patient, age 40–64: 10 of 19 insurance plan rates Aetna — Commercial: $175.60 Aetna — Medicare Advantage: $128.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $95.32 Aetna First Health PPO — PPO: $189.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $240.24 Blue Cross Blue Shield — HMO: $191.62 Cigna — PPO: $177.32 Community Partners Health Plan (CPHP) — PPO: $171.60 HealthLink — PPO: $185.90 Humana — Medicare Advantage: $128.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Preventive Visit,New,40-64	$286	$286	$28.60 – $189.05
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $95.32 Aetna First Health PPO — PPO: $189.05 HealthLink — PPO: $185.90 Humana — Medicare-Medicaid (D-SNP): $92.54 Meridian — Medicare-Medicaid (D-SNP): $28.60 Molina — Managed Medicaid: $57.20 Molina — Medicare-Medicaid (D-SNP): $57.20 United Healthcare (UHC) — VA CCN/Optum: $117.93
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$213.60
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan Aetna — Commercial: $213.60
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Room Level 3 Np/Pa	$835	$835	$51.73 – $701.40
Emergency room visit (moderate): 10 of 19 insurance plan rates Aetna — Commercial: $473.45 Aetna — Medicare Advantage: $375.75 Aetna Better Health — Medicare-Medicaid (D-SNP): $53.28 Aetna First Health PPO — PPO: $551.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $701.40 Blue Cross Blue Shield — HMO: $559.45 Cigna — PPO: $517.70 Community Partners Health Plan (CPHP) — PPO: $501 HealthLink — PPO: $542.75 Humana — Medicare Advantage: $375.75
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Room Level 3	$835	$835	$51.73 – $701.40
Emergency room visit (moderate): 10 of 19 insurance plan rates Aetna — Commercial: $473.45 Aetna — Medicare Advantage: $375.75 Aetna Better Health — Medicare-Medicaid (D-SNP): $53.28 Aetna First Health PPO — PPO: $551.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $701.40 Blue Cross Blue Shield — HMO: $559.45 Cigna — PPO: $517.70 Community Partners Health Plan (CPHP) — PPO: $501 HealthLink — PPO: $542.75 Humana — Medicare Advantage: $375.75
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB Emergency Room Level 3	$835	$835	$51.73 – $701.40
Emergency room visit (moderate): 10 of 19 insurance plan rates Aetna — Commercial: $473.45 Aetna — Medicare Advantage: $375.75 Aetna Better Health — Medicare-Medicaid (D-SNP): $53.28 Aetna First Health PPO — PPO: $551.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $701.40 Blue Cross Blue Shield — HMO: $559.45 Cigna — PPO: $517.70 Community Partners Health Plan (CPHP) — PPO: $501 HealthLink — PPO: $542.75 Humana — Medicare Advantage: $375.75
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Room Level 4	$1,337	$1,337	$86.76 – $1,123.08
Emergency room visit (moderately high): 10 of 19 insurance plan rates Aetna — Commercial: $758.08 Aetna — Medicare Advantage: $601.65 Aetna Better Health — Medicare-Medicaid (D-SNP): $89.36 Aetna First Health PPO — PPO: $883.76 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,123.08 Blue Cross Blue Shield — HMO: $895.79 Cigna — PPO: $828.94 Community Partners Health Plan (CPHP) — PPO: $802.20 HealthLink — PPO: $869.05 Humana — Medicare Advantage: $601.65
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB Emergency Room Level 4	$1,337	$1,337	$86.76 – $1,123.08
Emergency room visit (moderately high): 10 of 19 insurance plan rates Aetna — Commercial: $758.08 Aetna — Medicare Advantage: $601.65 Aetna Better Health — Medicare-Medicaid (D-SNP): $89.36 Aetna First Health PPO — PPO: $883.76 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,123.08 Blue Cross Blue Shield — HMO: $895.79 Cigna — PPO: $828.94 Community Partners Health Plan (CPHP) — PPO: $802.20 HealthLink — PPO: $869.05 Humana — Medicare Advantage: $601.65
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB Emergency Room Level 4	$1,337	$1,337	$86.76 – $883.76
Emergency room visit (moderately high): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $89.36 Aetna First Health PPO — PPO: $883.76 HealthLink — PPO: $869.05 Humana — Medicare-Medicaid (D-SNP): $86.76 Meridian — Medicare-Medicaid (D-SNP): $133.70 Molina — Managed Medicaid: $267.40 Molina — Medicare-Medicaid (D-SNP): $267.40
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB Emergency Room Level 5	$1,991	$1,991	$126.53 – $1,672.44
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — Commercial: $1,128.90 Aetna — Medicare Advantage: $895.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $130.33 Aetna First Health PPO — PPO: $1,316.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,672.44 Blue Cross Blue Shield — HMO: $1,333.97 Cigna — PPO: $1,234.42 Community Partners Health Plan (CPHP) — PPO: $1,194.60 HealthLink — PPO: $1,294.15 Humana — Medicare Advantage: $895.95
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Room Level 5	$1,991	$1,991	$126.53 – $1,672.44
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — Commercial: $1,128.90 Aetna — Medicare Advantage: $895.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $130.33 Aetna First Health PPO — PPO: $1,316.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,672.44 Blue Cross Blue Shield — HMO: $1,333.97 Cigna — PPO: $1,234.42 Community Partners Health Plan (CPHP) — PPO: $1,194.60 HealthLink — PPO: $1,294.15 Humana — Medicare Advantage: $895.95
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency Room Level 5	$1,991	$1,991	$126.53 – $1,316.05
Emergency room visit (high): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $130.33 Aetna First Health PPO — PPO: $1,316.05 HealthLink — PPO: $1,294.15 Humana — Medicare-Medicaid (D-SNP): $126.53 Meridian — Medicare-Medicaid (D-SNP): $199.10 Molina — Managed Medicaid: $398.20 Molina — Medicare-Medicaid (D-SNP): $398.20

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Panel	$107	$107	$7.28 – $89.88
Basic metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — Commercial: $65.70 Aetna — Medicare Advantage: $48.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $7.50 Aetna First Health PPO — PPO: $70.73 Blue Cross Blue Shield — Blue Choice/Options/PPO: $89.88 Blue Cross Blue Shield — HMO: $71.69 Cigna — PPO: $66.34 Community Partners Health Plan (CPHP) — PPO: $64.20 HealthLink — PPO: $69.55 Humana — Medicare Advantage: $48.15
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel	$107	$107	$7.28 – $70.73
Basic metabolic panel (blood test): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $7.50 Aetna First Health PPO — PPO: $70.73 HealthLink — PPO: $69.55 Humana — Medicare-Medicaid (D-SNP): $7.28 Meridian — Medicare-Medicaid (D-SNP): $10.70 Molina — Managed Medicaid: $21.40 Molina — Medicare-Medicaid (D-SNP): $21.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel (Itc Lab)	$322	$322	$9.08 – $270.48
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — Commercial: $197.71 Aetna — Medicare Advantage: $144.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $9.35 Aetna First Health PPO — PPO: $212.84 Blue Cross Blue Shield — Blue Choice/Options/PPO: $270.48 Blue Cross Blue Shield — HMO: $215.74 Cigna — PPO: $199.64 Community Partners Health Plan (CPHP) — PPO: $193.20 HealthLink — PPO: $209.30 Humana — Medicare Advantage: $144.90
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$144	$144	$9.08 – $120.96
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — Commercial: $88.42 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Medicare-Medicaid (D-SNP): $9.35 Aetna First Health PPO — PPO: $95.18 Blue Cross Blue Shield — Blue Choice/Options/PPO: $120.96 Blue Cross Blue Shield — HMO: $96.48 Cigna — PPO: $89.28 Community Partners Health Plan (CPHP) — PPO: $86.40 HealthLink — PPO: $93.60 Humana — Medicare Advantage: $64.80
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cmp Panel	$110	$110	$9.08 – $92.40
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — Commercial: $67.54 Aetna — Medicare Advantage: $49.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $9.35 Aetna First Health PPO — PPO: $72.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $92.40 Blue Cross Blue Shield — HMO: $73.70 Cigna — PPO: $68.20 Community Partners Health Plan (CPHP) — PPO: $66 HealthLink — PPO: $71.50 Humana — Medicare Advantage: $49.50
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric Panel	$512	$512	$41.12 – $430.08
Obstetric blood test panel: 10 of 19 insurance plan rates Aetna — Commercial: $314.37 Aetna — Medicare Advantage: $230.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $42.35 Aetna First Health PPO — PPO: $338.43 Blue Cross Blue Shield — Blue Choice/Options/PPO: $430.08 Blue Cross Blue Shield — HMO: $343.04 Cigna — PPO: $317.44 Community Partners Health Plan (CPHP) — PPO: $307.20 HealthLink — PPO: $332.80 Humana — Medicare Advantage: $230.40
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Obstetric Panel	$512	$512	$41.12 – $338.43
Obstetric blood test panel: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $42.35 Aetna First Health PPO — PPO: $338.43 HealthLink — PPO: $332.80 Humana — Medicare-Medicaid (D-SNP): $41.12 Meridian — Medicare-Medicaid (D-SNP): $51.20 Molina — Managed Medicaid: $102.40 Molina — Medicare-Medicaid (D-SNP): $102.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Profile	$144	$144	$11.52 – $120.96
Cholesterol panel (lipid panel): 10 of 19 insurance plan rates Aetna — Commercial: $88.42 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Medicare-Medicaid (D-SNP): $11.87 Aetna First Health PPO — PPO: $95.18 Blue Cross Blue Shield — Blue Choice/Options/PPO: $120.96 Blue Cross Blue Shield — HMO: $96.48 Cigna — PPO: $89.28 Community Partners Health Plan (CPHP) — PPO: $86.40 HealthLink — PPO: $93.60 Humana — Medicare Advantage: $64.80
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lipid Profile	$144	$144	$11.52 – $95.18
Cholesterol panel (lipid panel): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $11.87 Aetna First Health PPO — PPO: $95.18 HealthLink — PPO: $93.60 Humana — Medicare-Medicaid (D-SNP): $11.52 Meridian — Medicare-Medicaid (D-SNP): $14.40 Molina — Managed Medicaid: $28.80 Molina — Medicare-Medicaid (D-SNP): $28.80
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$131	$131	$7.46 – $110.04
Kidney function panel: 10 of 19 insurance plan rates Aetna — Commercial: $80.43 Aetna — Medicare Advantage: $58.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $7.68 Aetna First Health PPO — PPO: $86.59 Blue Cross Blue Shield — Blue Choice/Options/PPO: $110.04 Blue Cross Blue Shield — HMO: $87.77 Cigna — PPO: $81.22 Community Partners Health Plan (CPHP) — PPO: $78.60 HealthLink — PPO: $85.15 Humana — Medicare Advantage: $58.95
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Function Panel	$131	$131	$7.46 – $86.59
Kidney function panel: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $7.68 Aetna First Health PPO — PPO: $86.59 HealthLink — PPO: $85.15 Humana — Medicare-Medicaid (D-SNP): $7.46 Meridian — Medicare-Medicaid (D-SNP): $13.10 Molina — Managed Medicaid: $26.20 Molina — Medicare-Medicaid (D-SNP): $26.20
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$110	$110	$7.03 – $92.40
Liver function panel: 10 of 19 insurance plan rates Aetna — Commercial: $67.54 Aetna — Medicare Advantage: $49.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $7.24 Aetna First Health PPO — PPO: $72.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $92.40 Blue Cross Blue Shield — HMO: $73.70 Cigna — PPO: $68.20 Community Partners Health Plan (CPHP) — PPO: $66 HealthLink — PPO: $71.50 Humana — Medicare Advantage: $49.50
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$110	$110	$7.03 – $72.71
Liver function panel: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $7.24 Aetna First Health PPO — PPO: $72.71 HealthLink — PPO: $71.50 Humana — Medicare-Medicaid (D-SNP): $7.03 Meridian — Medicare-Medicaid (D-SNP): $11 Molina — Managed Medicaid: $22 Molina — Medicare-Medicaid (D-SNP): $22
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Auto W/Microscopy	$111	$111	$2.73 – $93.24
Urine test (automated, with microscope): 10 of 19 insurance plan rates Aetna — Commercial: $68.15 Aetna — Medicare Advantage: $49.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $2.81 Aetna First Health PPO — PPO: $73.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $93.24 Blue Cross Blue Shield — HMO: $74.37 Cigna — PPO: $68.82 Community Partners Health Plan (CPHP) — PPO: $66.60 HealthLink — PPO: $72.15 Humana — Medicare Advantage: $49.95
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis Auto W/Microscopy	$111	$111	$2.73 – $73.37
Urine test (automated, with microscope): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $2.81 Aetna First Health PPO — PPO: $73.37 HealthLink — PPO: $72.15 Humana — Medicare-Medicaid (D-SNP): $2.73 Meridian — Medicare-Medicaid (D-SNP): $11.10 Molina — Managed Medicaid: $22.20 Molina — Medicare-Medicaid (D-SNP): $22.20
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis -Specific Gravity	$26	$26	$2.99 – $21.84
Urine test (manual, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $15.96 Aetna — Medicare Advantage: $11.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.08 Aetna First Health PPO — PPO: $17.19 Blue Cross Blue Shield — Blue Choice/Options/PPO: $21.84 Blue Cross Blue Shield — HMO: $17.42 Cigna — PPO: $16.12 Community Partners Health Plan (CPHP) — PPO: $15.60 HealthLink — PPO: $16.90 Humana — Medicare Advantage: $11.70
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Protein	$46	$46	$2.99 – $38.64
Urine test (manual, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $28.24 Aetna — Medicare Advantage: $20.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.08 Aetna First Health PPO — PPO: $30.41 Blue Cross Blue Shield — Blue Choice/Options/PPO: $38.64 Blue Cross Blue Shield — HMO: $30.82 Cigna — PPO: $28.52 Community Partners Health Plan (CPHP) — PPO: $27.60 HealthLink — PPO: $29.90 Humana — Medicare Advantage: $20.70
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ph (Dipstick Non Automated)	$46	$46	$2.99 – $38.64
Urine test (manual, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $28.24 Aetna — Medicare Advantage: $20.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.08 Aetna First Health PPO — PPO: $30.41 Blue Cross Blue Shield — Blue Choice/Options/PPO: $38.64 Blue Cross Blue Shield — HMO: $30.82 Cigna — PPO: $28.52 Community Partners Health Plan (CPHP) — PPO: $27.60 HealthLink — PPO: $29.90 Humana — Medicare Advantage: $20.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Protein Urine	$47	$47	$1.94 – $39.48
Urine test (automated, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $28.86 Aetna — Medicare Advantage: $21.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $2 Aetna First Health PPO — PPO: $31.07 Blue Cross Blue Shield — Blue Choice/Options/PPO: $39.48 Blue Cross Blue Shield — HMO: $31.49 Cigna — PPO: $29.14 Community Partners Health Plan (CPHP) — PPO: $28.20 HealthLink — PPO: $30.55 Humana — Medicare Advantage: $21.15
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ua-Dipstick Only (Itc Lab)	$71	$71	$1.94 – $59.64
Urine test (automated, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $43.59 Aetna — Medicare Advantage: $31.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $2 Aetna First Health PPO — PPO: $46.93 Blue Cross Blue Shield — Blue Choice/Options/PPO: $59.64 Blue Cross Blue Shield — HMO: $47.57 Cigna — PPO: $44.02 Community Partners Health Plan (CPHP) — PPO: $42.60 HealthLink — PPO: $46.15 Humana — Medicare Advantage: $31.95
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, Auto, W/O Scope	$67	$67	$1.94 – $56.28
Urine test (automated, without microscope): 10 of 19 insurance plan rates Aetna — Commercial: $41.14 Aetna — Medicare Advantage: $30.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $2 Aetna First Health PPO — PPO: $44.29 Blue Cross Blue Shield — Blue Choice/Options/PPO: $56.28 Blue Cross Blue Shield — HMO: $44.89 Cigna — PPO: $41.54 Community Partners Health Plan (CPHP) — PPO: $40.20 HealthLink — PPO: $43.55 Humana — Medicare Advantage: $30.15
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total Psa Ref	$131	$131	$15.82 – $110.04
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates Aetna — Commercial: $80.43 Aetna — Medicare Advantage: $58.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $16.29 Aetna First Health PPO — PPO: $86.59 Blue Cross Blue Shield — Blue Choice/Options/PPO: $110.04 Blue Cross Blue Shield — HMO: $87.77 Cigna — PPO: $81.22 Community Partners Health Plan (CPHP) — PPO: $78.60 HealthLink — PPO: $85.15 Humana — Medicare Advantage: $58.95
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa, Ultrasensitive Ref	$90	$90	$15.82 – $75.60
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates Aetna — Commercial: $55.26 Aetna — Medicare Advantage: $40.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $16.29 Aetna First Health PPO — PPO: $59.49 Blue Cross Blue Shield — Blue Choice/Options/PPO: $75.60 Blue Cross Blue Shield — HMO: $60.30 Cigna — PPO: $55.80 Community Partners Health Plan (CPHP) — PPO: $54 HealthLink — PPO: $58.50 Humana — Medicare Advantage: $40.50
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total	$222	$222	$15.82 – $186.48
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates Aetna — Commercial: $136.31 Aetna — Medicare Advantage: $99.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $16.29 Aetna First Health PPO — PPO: $146.74 Blue Cross Blue Shield — Blue Choice/Options/PPO: $186.48 Blue Cross Blue Shield — HMO: $148.74 Cigna — PPO: $137.64 Community Partners Health Plan (CPHP) — PPO: $133.20 HealthLink — PPO: $144.30 Humana — Medicare Advantage: $99.90
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$131	$131	$14.45 – $110.04
Thyroid stimulating hormone (TSH) test: 10 of 19 insurance plan rates Aetna — Commercial: $80.43 Aetna — Medicare Advantage: $58.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $14.88 Aetna First Health PPO — PPO: $86.59 Blue Cross Blue Shield — Blue Choice/Options/PPO: $110.04 Blue Cross Blue Shield — HMO: $87.77 Cigna — PPO: $81.22 Community Partners Health Plan (CPHP) — PPO: $78.60 HealthLink — PPO: $85.15 Humana — Medicare Advantage: $58.95
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Nbs-Hypyothyroidism Scrn Ref	$67	$67	$13.40 – $56.28
Thyroid stimulating hormone (TSH) test: 10 of 19 insurance plan rates Aetna — Commercial: $41.14 Aetna — Medicare Advantage: $30.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $14.88 Aetna First Health PPO — PPO: $44.29 Blue Cross Blue Shield — Blue Choice/Options/PPO: $56.28 Blue Cross Blue Shield — HMO: $44.89 Cigna — PPO: $41.54 Community Partners Health Plan (CPHP) — PPO: $40.20 HealthLink — PPO: $43.55 Humana — Medicare Advantage: $30.15
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Nbs-Hypyothyroidism Scrn Ref	$67	$67	$6.70 – $44.29
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $14.88 Aetna First Health PPO — PPO: $44.29 HealthLink — PPO: $43.55 Humana — Medicare-Medicaid (D-SNP): $14.45 Meridian — Medicare-Medicaid (D-SNP): $6.70 Molina — Managed Medicaid: $13.40 Molina — Medicare-Medicaid (D-SNP): $13.40
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W/Auto Diff	$83	$83	$6.68 – $69.72
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates Aetna — Commercial: $50.96 Aetna — Medicare Advantage: $37.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $6.88 Aetna First Health PPO — PPO: $54.86 Blue Cross Blue Shield — Blue Choice/Options/PPO: $69.72 Blue Cross Blue Shield — HMO: $55.61 Cigna — PPO: $51.46 Community Partners Health Plan (CPHP) — PPO: $49.80 HealthLink — PPO: $53.95 Humana — Medicare Advantage: $37.35
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W/Automated Differential	$61	$61	$6.68 – $51.24
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates Aetna — Commercial: $37.45 Aetna — Medicare Advantage: $27.45 Aetna Better Health — Medicare-Medicaid (D-SNP): $6.88 Aetna First Health PPO — PPO: $40.32 Blue Cross Blue Shield — Blue Choice/Options/PPO: $63 Blue Cross Blue Shield — HMO: $40.87 Cigna — PPO: $37.82 Community Partners Health Plan (CPHP) — PPO: $36.60 HealthLink — PPO: $48.75 Humana — Medicare Advantage: $33.75
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cbc W/Auto Diff	$83	$83	$6.68 – $54.86
Complete blood count (CBC) with differential: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $6.88 Aetna First Health PPO — PPO: $54.86 HealthLink — PPO: $53.95 Humana — Medicare-Medicaid (D-SNP): $6.68 Meridian — Medicare-Medicaid (D-SNP): $8.30 Molina — Managed Medicaid: $16.60 Molina — Medicare-Medicaid (D-SNP): $16.60
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W/O Differential	$49	$49	$5.56 – $41.16
Complete blood count (CBC), automated: 10 of 19 insurance plan rates Aetna — Commercial: $30.09 Aetna — Medicare Advantage: $22.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $5.73 Aetna First Health PPO — PPO: $32.39 Blue Cross Blue Shield — Blue Choice/Options/PPO: $41.16 Blue Cross Blue Shield — HMO: $32.83 Cigna — PPO: $30.38 Community Partners Health Plan (CPHP) — PPO: $29.40 HealthLink — PPO: $31.85 Humana — Medicare Advantage: $22.05
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc (Itc Lab)	$125	$125	$5.56 – $105
Complete blood count (CBC), automated: 10 of 19 insurance plan rates Aetna — Commercial: $76.75 Aetna — Medicare Advantage: $56.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $5.73 Aetna First Health PPO — PPO: $82.63 Blue Cross Blue Shield — Blue Choice/Options/PPO: $105 Blue Cross Blue Shield — HMO: $83.75 Cigna — PPO: $77.50 Community Partners Health Plan (CPHP) — PPO: $75 HealthLink — PPO: $81.25 Humana — Medicare Advantage: $56.25
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cbc (Itc Lab)	$125	$125	$5.56 – $82.63
Complete blood count (CBC), automated: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $5.73 Aetna First Health PPO — PPO: $82.63 HealthLink — PPO: $81.25 Humana — Medicare-Medicaid (D-SNP): $5.56 Meridian — Medicare-Medicaid (D-SNP): $12.50 Molina — Managed Medicaid: $25 Molina — Medicare-Medicaid (D-SNP): $25
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT	$118	$118	$3.69 – $99.12
Blood clotting time test (prothrombin time, PT): 10 of 19 insurance plan rates Aetna — Commercial: $72.45 Aetna — Medicare Advantage: $53.10 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.80 Aetna First Health PPO — PPO: $78 Blue Cross Blue Shield — Blue Choice/Options/PPO: $99.12 Blue Cross Blue Shield — HMO: $79.06 Cigna — PPO: $73.16 Community Partners Health Plan (CPHP) — PPO: $70.80 HealthLink — PPO: $76.70 Humana — Medicare Advantage: $53.10
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$65	$65	$3.69 – $54.60
Blood clotting time test (prothrombin time, PT): 10 of 19 insurance plan rates Aetna — Commercial: $39.91 Aetna — Medicare Advantage: $29.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.80 Aetna First Health PPO — PPO: $42.97 Blue Cross Blue Shield — Blue Choice/Options/PPO: $54.60 Blue Cross Blue Shield — HMO: $43.55 Cigna — PPO: $40.30 Community Partners Health Plan (CPHP) — PPO: $39 HealthLink — PPO: $42.25 Humana — Medicare Advantage: $29.25
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time Ref	$127	$127	$3.69 – $106.68
Blood clotting time test (prothrombin time, PT): 10 of 19 insurance plan rates Aetna — Commercial: $77.98 Aetna — Medicare Advantage: $57.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $3.80 Aetna First Health PPO — PPO: $83.95 Blue Cross Blue Shield — Blue Choice/Options/PPO: $106.68 Blue Cross Blue Shield — HMO: $85.09 Cigna — PPO: $78.74 Community Partners Health Plan (CPHP) — PPO: $76.20 HealthLink — PPO: $82.55 Humana — Medicare Advantage: $57.15
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin Time, Ptl (Ptt)	$82	$82	$5.17 – $68.88
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates Aetna — Commercial: $50.35 Aetna — Medicare Advantage: $36.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $5.33 Aetna First Health PPO — PPO: $54.20 Blue Cross Blue Shield — Blue Choice/Options/PPO: $68.88 Blue Cross Blue Shield — HMO: $54.94 Cigna — PPO: $50.84 Community Partners Health Plan (CPHP) — PPO: $49.20 HealthLink — PPO: $53.30 Humana — Medicare Advantage: $36.90
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin Time, Ptl (Ptt)-Incubated	$110	$110	$5.17 – $92.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates Aetna — Commercial: $67.54 Aetna — Medicare Advantage: $49.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $5.33 Aetna First Health PPO — PPO: $72.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $92.40 Blue Cross Blue Shield — HMO: $73.70 Cigna — PPO: $68.20 Community Partners Health Plan (CPHP) — PPO: $66 HealthLink — PPO: $71.50 Humana — Medicare Advantage: $49.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplstn Time,Ptl(Ptt) Ref	$144	$144	$5.17 – $120.96
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates Aetna — Commercial: $88.42 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Medicare-Medicaid (D-SNP): $5.33 Aetna First Health PPO — PPO: $95.18 Blue Cross Blue Shield — Blue Choice/Options/PPO: $120.96 Blue Cross Blue Shield — HMO: $96.48 Cigna — PPO: $89.28 Community Partners Health Plan (CPHP) — PPO: $86.40 HealthLink — PPO: $93.60 Humana — Medicare Advantage: $64.80

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head/Brain W/O Contrast	$3,303	$3,303	$112.03 – $2,774.52
CT scan of the head or brain, without contrast: 10 of 19 insurance plan rates Aetna — Commercial: $927 Aetna — Medicare Advantage: $1,486.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $115.55 Aetna First Health PPO — PPO: $2,183.28 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,774.52 Blue Cross Blue Shield — HMO: $2,213.01 Cigna — PPO: $600 Community Partners Health Plan (CPHP) — PPO: $1,981.80 HealthLink — PPO: $2,146.95 Humana — Medicare Advantage: $1,486.35
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Head/Brain W/O Contrast	$3,303	$3,303	$112.18 – $2,183.28
CT scan of the head or brain, without contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $115.55 Aetna First Health PPO — PPO: $2,183.28 HealthLink — PPO: $2,146.95 Humana — Medicare-Medicaid (D-SNP): $112.18 Meridian — Medicare-Medicaid (D-SNP): $330.30 Molina — Managed Medicaid: $660.60 Molina — Medicare-Medicaid (D-SNP): $660.60
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$75.32
CT scan of the head or brain, without contrast: rates for 1 insurance plan Aetna — Commercial: $75.32
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain W/O & W/Contrast	$6,869	$6,869	$373.86 – $5,769.96
MRI of the brain, before and after contrast: 10 of 19 insurance plan rates Aetna — Commercial: $1,507 Aetna — Medicare Advantage: $3,091.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $404.43 Aetna First Health PPO — PPO: $4,540.41 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,769.96 Blue Cross Blue Shield — HMO: $4,602.23 Cigna — PPO: $1,200 Community Partners Health Plan (CPHP) — PPO: $4,121.40 HealthLink — PPO: $4,464.85 Humana — Medicare Advantage: $3,091.05
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Brain W/O & W/Contrast	$6,869	$6,869	$392.65 – $4,540.41
MRI of the brain, before and after contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $404.43 Aetna First Health PPO — PPO: $4,540.41 HealthLink — PPO: $4,464.85 Humana — Medicare-Medicaid (D-SNP): $392.65 Meridian — Medicare-Medicaid (D-SNP): $686.90 Molina — Managed Medicaid: $1,373.80 Molina — Medicare-Medicaid (D-SNP): $1,373.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$204
MRI of the brain, before and after contrast: rates for 1 insurance plan Aetna — Commercial: $204
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic Exam Chest 2 Views	$340	$340	$21.87 – $285.60
Chest X-ray, 2 views: 10 of 19 insurance plan rates Aetna — Commercial: $21.87 Aetna — Medicare Advantage: $153 Aetna Better Health — Medicare-Medicaid (D-SNP): $29.45 Aetna First Health PPO — PPO: $224.74 Blue Cross Blue Shield — Blue Choice/Options/PPO: $285.60 Blue Cross Blue Shield — HMO: $227.80 Cigna — PPO: $210.80 Community Partners Health Plan (CPHP) — PPO: $204 HealthLink — PPO: $221 Humana — Medicare Advantage: $153
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Radiologic Exam Chest 2 Views	$340	$340	$28.59 – $224.74
Chest X-ray, 2 views: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $29.45 Aetna First Health PPO — PPO: $224.74 HealthLink — PPO: $221 Humana — Medicare-Medicaid (D-SNP): $28.59 Meridian — Medicare-Medicaid (D-SNP): $34 Molina — Managed Medicaid: $68 Molina — Medicare-Medicaid (D-SNP): $68
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$19.44
Chest X-ray, 2 views: rates for 1 insurance plan Aetna — Commercial: $19.44
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lumbosacral Xrays 4/> Views	$632	$632	$26.71 – $530.88
X-ray of the lower spine, at least 4 views: 10 of 19 insurance plan rates Aetna — Commercial: $26.71 Aetna — Medicare Advantage: $284.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $44.57 Aetna First Health PPO — PPO: $417.75 Blue Cross Blue Shield — Blue Choice/Options/PPO: $530.88 Blue Cross Blue Shield — HMO: $423.44 Cigna — PPO: $391.84 Community Partners Health Plan (CPHP) — PPO: $379.20 HealthLink — PPO: $410.80 Humana — Medicare Advantage: $284.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lumbosacral Xrays 4/> Views	$632	$632	$43.27 – $417.75
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $44.57 Aetna First Health PPO — PPO: $417.75 HealthLink — PPO: $410.80 Humana — Medicare-Medicaid (D-SNP): $43.27 Meridian — Medicare-Medicaid (D-SNP): $63.20 Molina — Managed Medicaid: $126.40 Molina — Medicare-Medicaid (D-SNP): $126.40
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$23.74
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan Aetna — Commercial: $23.74
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI L Spine W/O Contrast	$4,579	$4,579	$235.43 – $3,846.36
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates Aetna — Commercial: $1,507 Aetna — Medicare Advantage: $2,060.55 Aetna Better Health — Medicare-Medicaid (D-SNP): $242.49 Aetna First Health PPO — PPO: $3,026.72 Blue Cross Blue Shield — Blue Choice/Options/PPO: $3,846.36 Blue Cross Blue Shield — HMO: $3,067.93 Cigna — PPO: $1,200 Community Partners Health Plan (CPHP) — PPO: $2,747.40 HealthLink — PPO: $2,976.35 Humana — Medicare Advantage: $2,060.55
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI L Spine W/O Contrast	$4,579	$4,579	$235.43 – $3,026.72
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $242.49 Aetna First Health PPO — PPO: $3,026.72 HealthLink — PPO: $2,976.35 Humana — Medicare-Medicaid (D-SNP): $235.43 Meridian — Medicare-Medicaid (D-SNP): $457.90 Molina — Managed Medicaid: $915.80 Molina — Medicare-Medicaid (D-SNP): $915.80
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$131.18
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan Aetna — Commercial: $131.18
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W/Contrast	$4,388	$4,388	$187.96 – $3,685.92
CT scan of the pelvis, with contrast: 10 of 19 insurance plan rates Aetna — Commercial: $927 Aetna — Medicare Advantage: $1,974.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $241.98 Aetna First Health PPO — PPO: $2,900.47 Blue Cross Blue Shield — Blue Choice/Options/PPO: $3,685.92 Blue Cross Blue Shield — HMO: $2,939.96 Cigna — PPO: $600 Community Partners Health Plan (CPHP) — PPO: $2,632.80 HealthLink — PPO: $2,852.20 Humana — Medicare Advantage: $1,974.60
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Pelvis W/Contrast	$4,388	$4,388	$234.93 – $2,900.47
CT scan of the pelvis, with contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $241.98 Aetna First Health PPO — PPO: $2,900.47 HealthLink — PPO: $2,852.20 Humana — Medicare-Medicaid (D-SNP): $234.93 Meridian — Medicare-Medicaid (D-SNP): $438.80 Molina — Managed Medicaid: $877.60 Molina — Medicare-Medicaid (D-SNP): $877.60
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$102.18
CT scan of the pelvis, with contrast: rates for 1 insurance plan Aetna — Commercial: $102.18
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lwr Ext Joint W/O Contrast	$4,830	$4,830	$248.21 – $4,057.20
MRI of a leg joint (such as the knee), without contrast: 10 of 19 insurance plan rates Aetna — Commercial: $1,507 Aetna — Medicare Advantage: $2,173.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $255.66 Aetna First Health PPO — PPO: $3,192.63 Blue Cross Blue Shield — Blue Choice/Options/PPO: $4,057.20 Blue Cross Blue Shield — HMO: $3,236.10 Cigna — PPO: $1,200 Community Partners Health Plan (CPHP) — PPO: $2,898 HealthLink — PPO: $3,139.50 Humana — Medicare Advantage: $2,173.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Lwr Ext Joint W/O Contrast	$4,830	$4,830	$248.21 – $3,192.63
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $255.66 Aetna First Health PPO — PPO: $3,192.63 HealthLink — PPO: $3,139.50 Humana — Medicare-Medicaid (D-SNP): $248.21 Meridian — Medicare-Medicaid (D-SNP): $483 Molina — Managed Medicaid: $966 Molina — Medicare-Medicaid (D-SNP): $966
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$119.76
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan Aetna — Commercial: $119.76
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abd & Pelvis W/ Contrast	$6,523	$6,523	$322.23 – $5,479.32
CT scan of the abdomen and pelvis, with contrast: 10 of 19 insurance plan rates Aetna — Commercial: $927 Aetna — Medicare Advantage: $2,935.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $331.90 Aetna First Health PPO — PPO: $4,311.70 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,479.32 Blue Cross Blue Shield — HMO: $4,370.41 Cigna — PPO: $600 Community Partners Health Plan (CPHP) — PPO: $3,913.80 HealthLink — PPO: $4,239.95 Humana — Medicare Advantage: $2,935.35
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Abd & Pelvis W/ Contrast	$6,523	$6,523	$322.23 – $4,311.70
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $331.90 Aetna First Health PPO — PPO: $4,311.70 HealthLink — PPO: $4,239.95 Humana — Medicare-Medicaid (D-SNP): $322.23 Meridian — Medicare-Medicaid (D-SNP): $652.30 Molina — Managed Medicaid: $1,304.60 Molina — Medicare-Medicaid (D-SNP): $1,304.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	Not listed in the file	$162.32
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan Aetna — Commercial: $162.32
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound Abdmnl Complete W/O Contrast	$966	$966	$99.25 – $811.44
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates Aetna — Commercial: $593.12 Aetna — Medicare Advantage: $434.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $102.23 Aetna First Health PPO — PPO: $638.53 Blue Cross Blue Shield — Blue Choice/Options/PPO: $811.44 Blue Cross Blue Shield — HMO: $647.22 Cigna — PPO: $598.92 Community Partners Health Plan (CPHP) — PPO: $579.60 HealthLink — PPO: $627.90 Humana — Medicare Advantage: $434.70
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$966	$966	$99.25 – $811.44
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates Aetna — Commercial: $593.12 Aetna — Medicare Advantage: $434.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $102.23 Aetna First Health PPO — PPO: $638.53 Blue Cross Blue Shield — Blue Choice/Options/PPO: $811.44 Blue Cross Blue Shield — HMO: $647.22 Cigna — PPO: $598.92 Community Partners Health Plan (CPHP) — PPO: $579.60 HealthLink — PPO: $627.90 Humana — Medicare Advantage: $434.70
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Abdomen Complete	$966	$966	$96.60 – $638.53
Ultrasound of the abdomen, complete: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $102.23 Aetna First Health PPO — PPO: $638.53 HealthLink — PPO: $627.90 Humana — Medicare-Medicaid (D-SNP): $99.25 Meridian — Medicare-Medicaid (D-SNP): $96.60 Molina — Managed Medicaid: $193.20 Molina — Medicare-Medicaid (D-SNP): $193.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine Scrn OB Sono > 14 Wks	$1,085	$1,085	$112.03 – $911.40
Pregnancy ultrasound (after the first trimester): 10 of 19 insurance plan rates Aetna — Commercial: $666.19 Aetna — Medicare Advantage: $488.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $118.99 Aetna First Health PPO — PPO: $717.19 Blue Cross Blue Shield — Blue Choice/Options/PPO: $911.40 Blue Cross Blue Shield — HMO: $726.95 Cigna — PPO: $672.70 Community Partners Health Plan (CPHP) — PPO: $651 HealthLink — PPO: $705.25 Humana — Medicare Advantage: $488.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Routine Scrn OB Sono > 14 Wks	$1,085	$1,085	$108.50 – $717.19
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $118.99 Aetna First Health PPO — PPO: $717.19 HealthLink — PPO: $705.25 Humana — Medicare-Medicaid (D-SNP): $115.52 Meridian — Medicare-Medicaid (D-SNP): $108.50 Molina — Managed Medicaid: $217 Molina — Medicare-Medicaid (D-SNP): $217
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$88.24
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan Aetna — Commercial: $88.24
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound Transvaginal	$1,085	$1,085	$101.68 – $911.40
Transvaginal ultrasound: 10 of 19 insurance plan rates Aetna — Commercial: $666.19 Aetna — Medicare Advantage: $488.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $104.73 Aetna First Health PPO — PPO: $717.19 Blue Cross Blue Shield — Blue Choice/Options/PPO: $911.40 Blue Cross Blue Shield — HMO: $726.95 Cigna — PPO: $672.70 Community Partners Health Plan (CPHP) — PPO: $651 HealthLink — PPO: $705.25 Humana — Medicare Advantage: $488.25
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Ultrasound Transvaginal	$1,085	$1,085	$101.68 – $717.19
Transvaginal ultrasound: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $104.73 Aetna First Health PPO — PPO: $717.19 HealthLink — PPO: $705.25 Humana — Medicare-Medicaid (D-SNP): $101.68 Meridian — Medicare-Medicaid (D-SNP): $108.50 Molina — Managed Medicaid: $217 Molina — Medicare-Medicaid (D-SNP): $217
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$61.40
Transvaginal ultrasound: rates for 1 insurance plan Aetna — Commercial: $61.40
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic Mammography Unilat W/Cad	$328	$328	$65.60 – $275.52
Diagnostic mammogram, one breast: 10 of 19 insurance plan rates Aetna — Commercial: $201.39 Aetna — Medicare Advantage: $147.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $109.31 Aetna First Health PPO — PPO: $216.81 Blue Cross Blue Shield — Blue Choice/Options/PPO: $275.52 Blue Cross Blue Shield — HMO: $219.76 Cigna — PPO: $203.36 Community Partners Health Plan (CPHP) — PPO: $196.80 HealthLink — PPO: $213.20 Humana — Medicare Advantage: $147.60
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Diagnostic Mammography Unilat W/Cad	$328	$328	$32.80 – $216.81
Diagnostic mammogram, one breast: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $109.31 Aetna First Health PPO — PPO: $216.81 HealthLink — PPO: $213.20 Humana — Medicare-Medicaid (D-SNP): $106.13 Meridian — Medicare-Medicaid (D-SNP): $32.80 Molina — Managed Medicaid: $65.60 Molina — Medicare-Medicaid (D-SNP): $65.60
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$71.62
Diagnostic mammogram, one breast: rates for 1 insurance plan Aetna — Commercial: $71.62
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic Mammography Bilat W/Cad	$465	$465	$93 – $390.60
Diagnostic mammogram, both breasts: 10 of 19 insurance plan rates Aetna — Commercial: $285.51 Aetna — Medicare Advantage: $209.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $137.60 Aetna First Health PPO — PPO: $307.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $390.60 Blue Cross Blue Shield — HMO: $311.55 Cigna — PPO: $288.30 Community Partners Health Plan (CPHP) — PPO: $279 HealthLink — PPO: $302.25 Humana — Medicare Advantage: $209.25
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Diagnostic Mammography Bilat W/Cad	$465	$465	$46.50 – $307.37
Diagnostic mammogram, both breasts: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $137.60 Aetna First Health PPO — PPO: $307.37 HealthLink — PPO: $302.25 Humana — Medicare-Medicaid (D-SNP): $133.59 Meridian — Medicare-Medicaid (D-SNP): $46.50 Molina — Managed Medicaid: $93 Molina — Medicare-Medicaid (D-SNP): $93
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$87.70
Diagnostic mammogram, both breasts: rates for 1 insurance plan Aetna — Commercial: $87.70
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Screening Mammography Bilat W/Cad	$530	$530	$106 – $445.20
Screening mammogram, both breasts: 10 of 19 insurance plan rates Aetna — Commercial: $325.42 Aetna — Medicare Advantage: $238.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $111.72 Aetna First Health PPO — PPO: $350.33 Blue Cross Blue Shield — Blue Choice/Options/PPO: $445.20 Blue Cross Blue Shield — HMO: $355.10 Cigna — PPO: $328.60 Community Partners Health Plan (CPHP) — PPO: $318 HealthLink — PPO: $344.50 Humana — Medicare Advantage: $238.50
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Screening Mammography Bilat W/Cad	$530	$530	$53 – $350.33
Screening mammogram, both breasts: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $111.72 Aetna First Health PPO — PPO: $350.33 HealthLink — PPO: $344.50 Humana — Medicare-Medicaid (D-SNP): $108.47 Meridian — Medicare-Medicaid (D-SNP): $53 Molina — Managed Medicaid: $106 Molina — Medicare-Medicaid (D-SNP): $106
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$67.88
Screening mammogram, both breasts: rates for 1 insurance plan Aetna — Commercial: $67.88

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.96 – $26.64
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Aetna — Commercial: $26.64 Aetna Better Health — Medicare-Medicaid (D-SNP): $15.63 Humana — Medicare-Medicaid (D-SNP): $15.17 Wellcare — Medicare Advantage HMO: $14.96
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$15.17 – $15.63
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $15.63 Humana — Medicare-Medicaid (D-SNP): $15.17
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left Heart Catheterization	$11,363	$11,363	$927.06 – $9,544.92
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $6,976.88 Aetna — Medicare Advantage: $5,113.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $954.87 Aetna First Health PPO — PPO: $7,510.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $9,544.92 Blue Cross Blue Shield — HMO: $7,613.21 Cigna — PPO: $7,045.06 Community Partners Health Plan (CPHP) — PPO: $6,817.80 HealthLink — PPO: $7,385.95 Humana — Medicare Advantage: $5,113.35
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Left Heart Catheterization	$11,363	$11,363	$927.06 – $7,510.94
Left heart catheterization (diagnostic): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $954.87 Aetna First Health PPO — PPO: $7,510.94 HealthLink — PPO: $7,385.95 Humana — Medicare-Medicaid (D-SNP): $927.06 Meridian — Medicare-Medicaid (D-SNP): $1,136.30 Molina — Managed Medicaid: $2,272.60 Molina — Medicare-Medicaid (D-SNP): $2,272.60
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$449.16
Left heart catheterization (diagnostic): rates for 1 insurance plan Aetna — Commercial: $449.16
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Ep Eval	$14,845	$14,845	$707.10 – $12,469.80
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates Aetna — Commercial: $9,114.83 Aetna — Medicare Advantage: $6,680.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $728.31 Aetna First Health PPO — PPO: $9,812.55 Blue Cross Blue Shield — Blue Choice/Options/PPO: $12,469.80 Blue Cross Blue Shield — HMO: $9,946.15 Cigna — PPO: $9,203.90 Community Partners Health Plan (CPHP) — PPO: $8,907 HealthLink — PPO: $9,649.25 Humana — Medicare Advantage: $6,680.25
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comprehensive Ep Eval	$14,845	$14,845	$707.10 – $9,812.55
Heart rhythm study (electrophysiology evaluation): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $728.31 Aetna First Health PPO — PPO: $9,812.55 HealthLink — PPO: $9,649.25 Humana — Medicare-Medicaid (D-SNP): $707.10 Meridian — Medicare-Medicaid (D-SNP): $1,484.50 Molina — Managed Medicaid: $2,969 Molina — Medicare-Medicaid (D-SNP): $2,969
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$726.16
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan Aetna — Commercial: $726.16
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation	$5,998	$5,998	$1,040.84 – $28,009.82
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates Aetna — Commercial: $3,682.77 Aetna — Medicare Advantage: $2,699.10 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,072.07 Aetna First Health PPO — PPO: $3,964.68 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,038.32 Blue Cross Blue Shield — HMO: $4,018.66 Cigna — PPO: $3,718.76 Community Partners Health Plan (CPHP) — PPO: $3,598.80 HealthLink — PPO: $3,898.70 Humana — Medicare Advantage: $2,699.10
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Ep Eval W/Ablation for a-Fib	$32,432	$32,432	$1,040.84 – $28,009.82
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates Aetna — Commercial: $19,913.25 Aetna — Medicare Advantage: $14,594.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,072.07 Aetna First Health PPO — PPO: $21,437.55 Blue Cross Blue Shield — Blue Choice/Options/PPO: $27,242.88 Blue Cross Blue Shield — HMO: $21,729.44 Cigna — PPO: $20,107.84 Community Partners Health Plan (CPHP) — PPO: $19,459.20 HealthLink — PPO: $21,080.80 Humana — Medicare Advantage: $14,594.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comp Ep Eval W/Ablation for a-Fib	$32,432	$32,432	$1,040.84 – $21,437.55
Heart rhythm study with ablation for atrial fibrillation: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,072.07 Aetna First Health PPO — PPO: $21,437.55 HealthLink — PPO: $21,080.80 Humana — Medicare-Medicaid (D-SNP): $1,040.84 Meridian — Medicare-Medicaid (D-SNP): $3,243.20 Molina — Managed Medicaid: $6,486.40 Molina — Medicare-Medicaid (D-SNP): $6,486.40
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: All Night Polysomnography	$7,143	$7,143	$216.86 – $6,000.12
Sleep study (overnight, in a sleep lab): 10 of 19 insurance plan rates Aetna — Commercial: $216.86 Aetna — Medicare Advantage: $3,214.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $582.65 Aetna First Health PPO — PPO: $4,721.52 Blue Cross Blue Shield — Blue Choice/Options/PPO: $6,000.12 Blue Cross Blue Shield — HMO: $4,785.81 Cigna — PPO: $4,428.66 Community Partners Health Plan (CPHP) — PPO: $4,285.80 HealthLink — PPO: $4,642.95 Humana — Medicare Advantage: $3,214.35
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$2,933	$2,933	$82 – $2,463.72
Sleep study (overnight, in a sleep lab): 10 of 19 insurance plan rates Aetna — Commercial: $216.86 Aetna — Medicare Advantage: $1,319.85 Aetna Better Health — Medicare-Medicaid (D-SNP): $582.65 Aetna First Health PPO — PPO: $1,938.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,463.72 Blue Cross Blue Shield — HMO: $1,965.11 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,759.80 HealthLink — PPO: $1,906.45 Humana — Medicare Advantage: $1,319.85
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$2,933	$2,933	$293.30 – $1,938.71
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $582.65 Aetna First Health PPO — PPO: $1,938.71 HealthLink — PPO: $1,906.45 Humana — Medicare-Medicaid (D-SNP): $565.68 Meridian — Medicare-Medicaid (D-SNP): $293.30 Molina — Managed Medicaid: $586.60 Molina — Medicare-Medicaid (D-SNP): $586.60

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: 15' Therapeutic Exercise	$191	$191	$21.50 – $160.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $54.56 Aetna — Medicare Advantage: $85.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $22.15 Aetna First Health PPO — PPO: $126.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $160.44 Blue Cross Blue Shield — HMO: $127.97 Cigna — PPO: $118.42 Community Partners Health Plan (CPHP) — PPO: $114.60 HealthLink — PPO: $124.15 Humana — Medicare Advantage: $85.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 15' Individual Therapeutic Proc-Offsite	$191	$191	$21.50 – $160.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $54.56 Aetna — Medicare Advantage: $85.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $22.15 Aetna First Health PPO — PPO: $126.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $160.44 Blue Cross Blue Shield — HMO: $127.97 Cigna — PPO: $118.42 Community Partners Health Plan (CPHP) — PPO: $114.60 HealthLink — PPO: $124.15 Humana — Medicare Advantage: $85.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 15' Therapeutic Exercise Go	$191	$191	$21.50 – $160.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $54.56 Aetna — Medicare Advantage: $85.95 Aetna Better Health — Medicare-Medicaid (D-SNP): $22.15 Aetna First Health PPO — PPO: $126.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $160.44 Blue Cross Blue Shield — HMO: $127.97 Cigna — PPO: $118.42 Community Partners Health Plan (CPHP) — PPO: $114.60 HealthLink — PPO: $124.15 Humana — Medicare Advantage: $85.95
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 15' Evaluation-Offsite	$394	$394	$73.36 – $330.96
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $177.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $260.43 Blue Cross Blue Shield — Blue Choice/Options/PPO: $330.96 Blue Cross Blue Shield — HMO: $263.98 Cigna — PPO: $244.28 Community Partners Health Plan (CPHP) — PPO: $236.40 HealthLink — PPO: $256.10 Humana — Medicare Advantage: $177.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Low Complexity	$394	$394	$73.36 – $330.96
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $177.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $260.43 Blue Cross Blue Shield — Blue Choice/Options/PPO: $330.96 Blue Cross Blue Shield — HMO: $263.98 Cigna — PPO: $244.28 Community Partners Health Plan (CPHP) — PPO: $236.40 HealthLink — PPO: $256.10 Humana — Medicare Advantage: $177.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Occupational Therapy Eval	$394	$394	$73.36 – $330.96
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $177.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $260.43 Blue Cross Blue Shield — Blue Choice/Options/PPO: $330.96 Blue Cross Blue Shield — HMO: $263.98 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $236.40 HealthLink — PPO: $256.10 Humana — Medicare Advantage: $177.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Moderate Complexity (0-30 Minutes)	$333	$333	$66.60 – $279.72
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $149.85 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $220.11 Blue Cross Blue Shield — Blue Choice/Options/PPO: $279.72 Blue Cross Blue Shield — HMO: $223.11 Cigna — PPO: $206.46 Community Partners Health Plan (CPHP) — PPO: $199.80 HealthLink — PPO: $216.45 Humana — Medicare Advantage: $149.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Moderate Complexity (31-60 Minutes)	$333	$333	$66.60 – $279.72
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $149.85 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $220.11 Blue Cross Blue Shield — Blue Choice/Options/PPO: $279.72 Blue Cross Blue Shield — HMO: $223.11 Cigna — PPO: $206.46 Community Partners Health Plan (CPHP) — PPO: $199.80 HealthLink — PPO: $216.45 Humana — Medicare Advantage: $149.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval - Mod Complexity	$333	$333	$66.60 – $279.72
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $149.85 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $220.11 Blue Cross Blue Shield — Blue Choice/Options/PPO: $279.72 Blue Cross Blue Shield — HMO: $223.11 Cigna — PPO: $206.46 Community Partners Health Plan (CPHP) — PPO: $199.80 HealthLink — PPO: $216.45 Humana — Medicare Advantage: $149.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval High Complexity (31-60 Minutes)	$382	$382	$73.36 – $320.88
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $171.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $252.50 Blue Cross Blue Shield — Blue Choice/Options/PPO: $320.88 Blue Cross Blue Shield — HMO: $255.94 Cigna — PPO: $236.84 Community Partners Health Plan (CPHP) — PPO: $229.20 HealthLink — PPO: $248.30 Humana — Medicare Advantage: $171.90
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval - High Complexity	$382	$382	$73.36 – $320.88
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $171.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $252.50 Blue Cross Blue Shield — Blue Choice/Options/PPO: $320.88 Blue Cross Blue Shield — HMO: $255.94 Cigna — PPO: $236.84 Community Partners Health Plan (CPHP) — PPO: $229.20 HealthLink — PPO: $248.30 Humana — Medicare Advantage: $171.90
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval High Complexity 61-90 Minutes)	$382	$382	$73.36 – $320.88
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — Commercial: $185.96 Aetna — Medicare Advantage: $171.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $75.56 Aetna First Health PPO — PPO: $252.50 Blue Cross Blue Shield — Blue Choice/Options/PPO: $320.88 Blue Cross Blue Shield — HMO: $255.94 Cigna — PPO: $236.84 Community Partners Health Plan (CPHP) — PPO: $229.20 HealthLink — PPO: $248.30 Humana — Medicare Advantage: $171.90
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 30 Minutes	$204	$204	$40.80 – $190.21
Psychotherapy, 30 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $125.26 Aetna — Medicare Advantage: $91.80 Aetna Better Health — Medicare-Medicaid (D-SNP): $68.13 Aetna First Health PPO — PPO: $134.84 Blue Cross Blue Shield — Blue Choice/Options/PPO: $171.36 Blue Cross Blue Shield — HMO: $136.68 Cigna — PPO: $126.48 Community Partners Health Plan (CPHP) — PPO: $122.40 HealthLink — PPO: $132.60 Humana — Medicare Advantage: $91.80
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Medical Service	$208	$208	$41.60 – $190.21
Psychotherapy, 30 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $127.71 Aetna — Medicare Advantage: $93.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $68.13 Aetna First Health PPO — PPO: $137.49 Blue Cross Blue Shield — Blue Choice/Options/PPO: $174.72 Blue Cross Blue Shield — HMO: $139.36 Cigna — PPO: $128.96 Community Partners Health Plan (CPHP) — PPO: $124.80 HealthLink — PPO: $135.20 Humana — Medicare Advantage: $93.60
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Medical Service	$208	$208	$20.80 – $137.49
Psychotherapy, 30 minutes: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $68.13 Aetna First Health PPO — PPO: $137.49 HealthLink — PPO: $135.20 Humana — Medicare-Medicaid (D-SNP): $66.15 Meridian — Medicare-Medicaid (D-SNP): $20.80 Molina — Managed Medicaid: $41.60 Molina — Medicare-Medicaid (D-SNP): $41.60 United Healthcare (UHC) — VA CCN/Optum: $69.12
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 45 Minutes	$265	$265	$53 – $222.60
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $162.71 Aetna — Medicare Advantage: $119.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $90.42 Aetna First Health PPO — PPO: $175.17 Blue Cross Blue Shield — Blue Choice/Options/PPO: $222.60 Blue Cross Blue Shield — HMO: $177.55 Cigna — PPO: $164.30 Community Partners Health Plan (CPHP) — PPO: $159 HealthLink — PPO: $172.25 Humana — Medicare Advantage: $119.25
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Medical Service	$292	$292	$58.40 – $245.28
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $179.29 Aetna — Medicare Advantage: $131.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $90.42 Aetna First Health PPO — PPO: $193.01 Blue Cross Blue Shield — Blue Choice/Options/PPO: $245.28 Blue Cross Blue Shield — HMO: $195.64 Cigna — PPO: $181.04 Community Partners Health Plan (CPHP) — PPO: $175.20 HealthLink — PPO: $189.80 Humana — Medicare Advantage: $131.40
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 45 Minutes	$265	$265	$26.50 – $175.17
Psychotherapy, 45 minutes: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $90.42 Aetna First Health PPO — PPO: $175.17 HealthLink — PPO: $172.25 Humana — Medicare-Medicaid (D-SNP): $87.79 Meridian — Medicare-Medicaid (D-SNP): $26.50 Molina — Managed Medicaid: $53 Molina — Medicare-Medicaid (D-SNP): $53 United Healthcare (UHC) — VA CCN/Optum: $91.74
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 60 Minutes	$397	$397	$79.40 – $333.48
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $243.76 Aetna — Medicare Advantage: $178.65 Aetna Better Health — Medicare-Medicaid (D-SNP): $132.80 Aetna First Health PPO — PPO: $262.42 Blue Cross Blue Shield — Blue Choice/Options/PPO: $333.48 Blue Cross Blue Shield — HMO: $265.99 Cigna — PPO: $246.14 Community Partners Health Plan (CPHP) — PPO: $238.20 HealthLink — PPO: $258.05 Humana — Medicare Advantage: $178.65
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Medical Service	$347	$347	$69.40 – $291.48
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $213.06 Aetna — Medicare Advantage: $156.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $132.80 Aetna First Health PPO — PPO: $229.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $291.48 Blue Cross Blue Shield — HMO: $232.49 Cigna — PPO: $215.14 Community Partners Health Plan (CPHP) — PPO: $208.20 HealthLink — PPO: $225.55 Humana — Medicare Advantage: $156.15
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Medical Service	$347	$347	$34.70 – $229.37
Psychotherapy, 60 minutes: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $132.80 Aetna First Health PPO — PPO: $229.37 HealthLink — PPO: $225.55 Humana — Medicare-Medicaid (D-SNP): $128.93 Meridian — Medicare-Medicaid (D-SNP): $34.70 Molina — Managed Medicaid: $69.40 Molina — Medicare-Medicaid (D-SNP): $69.40 United Healthcare (UHC) — VA CCN/Optum: $134.73
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Psytx W/O Patient	$250	$250	$50 – $210
Family psychotherapy, without the patient: 10 of 19 insurance plan rates Aetna — Commercial: $153.50 Aetna — Medicare Advantage: $112.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $97.73 Aetna First Health PPO — PPO: $165.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $210 Blue Cross Blue Shield — HMO: $167.50 Cigna — PPO: $155 Community Partners Health Plan (CPHP) — PPO: $150 HealthLink — PPO: $162.50 Humana — Medicare Advantage: $112.50
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Fam Ther WO Pt 50 Min MCR	$250	$250	$50 – $210
Family psychotherapy, without the patient: 10 of 19 insurance plan rates Aetna — Commercial: $153.50 Aetna — Medicare Advantage: $112.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $97.73 Aetna First Health PPO — PPO: $165.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $210 Blue Cross Blue Shield — HMO: $167.50 Cigna — PPO: $155 Community Partners Health Plan (CPHP) — PPO: $150 HealthLink — PPO: $162.50 Humana — Medicare Advantage: $112.50
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Fam Ther WO Pt 50 Min MCR	$250	$250	$25 – $165.25
Family psychotherapy, without the patient: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $97.73 Aetna First Health PPO — PPO: $165.25 HealthLink — PPO: $162.50 Humana — Medicare-Medicaid (D-SNP): $94.88 Meridian — Medicare-Medicaid (D-SNP): $25 Molina — Managed Medicaid: $50 Molina — Medicare-Medicaid (D-SNP): $50 United Healthcare (UHC) — VA CCN/Optum: $99.15
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Fam Ther W Pt 50 Min MCR	$250	$250	$50 – $210
Family psychotherapy, with the patient: 10 of 19 insurance plan rates Aetna — Commercial: $153.50 Aetna — Medicare Advantage: $112.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $101.85 Aetna First Health PPO — PPO: $165.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $210 Blue Cross Blue Shield — HMO: $167.50 Cigna — PPO: $155 Community Partners Health Plan (CPHP) — PPO: $150 HealthLink — PPO: $162.50 Humana — Medicare Advantage: $112.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Psytx W/Patient	$250	$250	$50 – $210
Family psychotherapy, with the patient: 10 of 19 insurance plan rates Aetna — Commercial: $153.50 Aetna — Medicare Advantage: $112.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $101.85 Aetna First Health PPO — PPO: $165.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $210 Blue Cross Blue Shield — HMO: $167.50 Cigna — PPO: $155 Community Partners Health Plan (CPHP) — PPO: $150 HealthLink — PPO: $162.50 Humana — Medicare Advantage: $112.50
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Family Psytx W/Patient	$250	$250	$25 – $165.25
Family psychotherapy, with the patient: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $101.85 Aetna First Health PPO — PPO: $165.25 HealthLink — PPO: $162.50 Humana — Medicare-Medicaid (D-SNP): $98.88 Meridian — Medicare-Medicaid (D-SNP): $25 Molina — Managed Medicaid: $50 Molina — Medicare-Medicaid (D-SNP): $50 United Healthcare (UHC) — VA CCN/Optum: $103.33
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group Psychotherapy	$80	$80	$16 – $108.87
Group psychotherapy: 10 of 19 insurance plan rates Aetna — Commercial: $49.12 Aetna — Medicare Advantage: $36 Aetna Better Health — Medicare-Medicaid (D-SNP): $24.03 Aetna First Health PPO — PPO: $52.88 Blue Cross Blue Shield — Blue Choice/Options/PPO: $67.20 Blue Cross Blue Shield — HMO: $53.60 Cigna — PPO: $49.60 Community Partners Health Plan (CPHP) — PPO: $48 HealthLink — PPO: $52 Humana — Medicare Advantage: $36
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group Therapy per Unit	$250	$250	$23.33 – $210
Group psychotherapy: 10 of 19 insurance plan rates Aetna — Commercial: $153.50 Aetna — Medicare Advantage: $112.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $24.03 Aetna First Health PPO — PPO: $165.25 Blue Cross Blue Shield — Blue Choice/Options/PPO: $210 Blue Cross Blue Shield — HMO: $167.50 Cigna — PPO: $155 Community Partners Health Plan (CPHP) — PPO: $150 HealthLink — PPO: $162.50 Humana — Medicare Advantage: $112.50
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Group Psychotherapy	$250	$250	$23.33 – $165.25
Group psychotherapy: rates for 8 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $24.03 Aetna First Health PPO — PPO: $165.25 HealthLink — PPO: $162.50 Humana — Medicare-Medicaid (D-SNP): $23.33 Meridian — Medicare-Medicaid (D-SNP): $25 Molina — Managed Medicaid: $50 Molina — Medicare-Medicaid (D-SNP): $50 United Healthcare (UHC) — VA CCN/Optum: $24.38

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 In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$2,602	$2,602	$82 – $4,195.85
Removal of breast growth (open surgery): 10 of 19 insurance plan rates Aetna — Commercial: $1,597.63 Aetna — Medicare Advantage: $1,170.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $370.56 Aetna First Health PPO — PPO: $1,719.92 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,185.68 Blue Cross Blue Shield — HMO: $1,743.34 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,561.20 HealthLink — PPO: $1,691.30 Humana — Medicare Advantage: $1,170.90
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$2,602	$2,602	$260.20 – $1,719.92
Removal of breast growth (open surgery): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $370.56 Aetna First Health PPO — PPO: $1,719.92 HealthLink — PPO: $1,691.30 Humana — Medicare-Medicaid (D-SNP): $359.77 Meridian — Medicare-Medicaid (D-SNP): $260.20 Molina — Managed Medicaid: $520.40 Molina — Medicare-Medicaid (D-SNP): $520.40
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$820.12
Removal of breast growth (open surgery): rates for 1 insurance plan Aetna — Commercial: $820.12
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$7,090	$7,090	$82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $13,758.17
Total hip replacement: 10 of 19 insurance plan rates Aetna — Commercial: $4,353.26 Aetna — Medicare Advantage: $3,190.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,239.81 Aetna First Health PPO — PPO: $4,686.49 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,955.60 Blue Cross Blue Shield — HMO: $4,750.30 Cigna — PPO: $82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Community Partners Health Plan (CPHP) — PPO: $4,254 HealthLink — PPO: $4,608.50 Humana — Medicare Advantage: $3,190.50
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$7,090	$7,090	$709 – $4,686.49
Total hip replacement: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,239.81 Aetna First Health PPO — PPO: $4,686.49 HealthLink — PPO: $4,608.50 Humana — Medicare-Medicaid (D-SNP): $1,203.70 Meridian — Medicare-Medicaid (D-SNP): $709 Molina — Managed Medicaid: $1,418 Molina — Medicare-Medicaid (D-SNP): $1,418
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$2,494.02
Total hip replacement: rates for 1 insurance plan Aetna — Commercial: $2,494.02
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$7,078	$7,078	$82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $13,758.17
Total knee replacement: 10 of 19 insurance plan rates Aetna — Commercial: $4,345.89 Aetna — Medicare Advantage: $3,185.10 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,238.50 Aetna First Health PPO — PPO: $4,678.56 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,945.52 Blue Cross Blue Shield — HMO: $4,742.26 Cigna — PPO: $82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Community Partners Health Plan (CPHP) — PPO: $4,246.80 HealthLink — PPO: $4,600.70 Humana — Medicare Advantage: $3,185.10
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$7,078	$7,078	$707.80 – $4,678.56
Total knee replacement: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,238.50 Aetna First Health PPO — PPO: $4,678.56 HealthLink — PPO: $4,600.70 Humana — Medicare-Medicaid (D-SNP): $1,202.43 Meridian — Medicare-Medicaid (D-SNP): $707.80 Molina — Managed Medicaid: $1,415.60 Molina — Medicare-Medicaid (D-SNP): $1,415.60
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$2,490.76
Total knee replacement: rates for 1 insurance plan Aetna — Commercial: $2,490.76
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$926	$926	$82 – $777.84
Shoulder arthroscopy: shaving of shoulder bone: 10 of 19 insurance plan rates Aetna — Commercial: $568.56 Aetna — Medicare Advantage: $416.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $166.81 Aetna First Health PPO — PPO: $612.09 Blue Cross Blue Shield — Blue Choice/Options/PPO: $777.84 Blue Cross Blue Shield — HMO: $620.42 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $555.60 HealthLink — PPO: $601.90 Humana — Medicare Advantage: $416.70
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$926	$926	$92.60 – $612.09
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $166.81 Aetna First Health PPO — PPO: $612.09 HealthLink — PPO: $601.90 Humana — Medicare-Medicaid (D-SNP): $161.95 Meridian — Medicare-Medicaid (D-SNP): $92.60 Molina — Managed Medicaid: $185.20 Molina — Medicare-Medicaid (D-SNP): $185.20
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$333.40
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan Aetna — Commercial: $333.40
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$2,790	$2,790	$82 – $3,506.34
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates Aetna — Commercial: $1,713.06 Aetna — Medicare Advantage: $1,255.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $519.85 Aetna First Health PPO — PPO: $1,844.19 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,343.60 Blue Cross Blue Shield — HMO: $1,869.30 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,674 HealthLink — PPO: $1,813.50 Humana — Medicare Advantage: $1,255.50
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$2,790	$2,790	$279 – $1,844.19
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $519.85 Aetna First Health PPO — PPO: $1,844.19 HealthLink — PPO: $1,813.50 Humana — Medicare-Medicaid (D-SNP): $504.71 Meridian — Medicare-Medicaid (D-SNP): $279 Molina — Managed Medicaid: $558 Molina — Medicare-Medicaid (D-SNP): $558
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$1,051.22
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan Aetna — Commercial: $1,051.22
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy & Adenoidectomy <Age 12	$1,489	$1,489	$82 – $6,343.80
Removal of tonsils and adenoids (under age 12): 10 of 19 insurance plan rates Aetna — Commercial: $914.25 Aetna — Medicare Advantage: $670.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $293.45 Aetna First Health PPO — PPO: $984.23 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,250.76 Blue Cross Blue Shield — HMO: $997.63 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $893.40 HealthLink — PPO: $967.85 Humana — Medicare Advantage: $670.05
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Tonsillectomy & Adenoidectomy <Age 12	$1,489	$1,489	$148.90 – $984.23
Removal of tonsils and adenoids (under age 12): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $293.45 Aetna First Health PPO — PPO: $984.23 HealthLink — PPO: $967.85 Humana — Medicare-Medicaid (D-SNP): $284.90 Meridian — Medicare-Medicaid (D-SNP): $148.90 Molina — Managed Medicaid: $297.80 Molina — Medicare-Medicaid (D-SNP): $297.80
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$559.40
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan Aetna — Commercial: $559.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$1,389	$1,389	$82 – $1,166.76
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $852.85 Aetna — Medicare Advantage: $625.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $121.89 Aetna First Health PPO — PPO: $918.13 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,166.76 Blue Cross Blue Shield — HMO: $930.63 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $833.40 HealthLink — PPO: $902.85 Humana — Medicare Advantage: $625.05
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Upper GI Endoscopy,Diagnosis	$1,478	$1,478	$82 – $1,241.52
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $907.49 Aetna — Medicare Advantage: $665.10 Aetna Better Health — Medicare-Medicaid (D-SNP): $121.89 Aetna First Health PPO — PPO: $976.96 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,241.52 Blue Cross Blue Shield — HMO: $990.26 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $886.80 HealthLink — PPO: $960.70 Humana — Medicare Advantage: $665.10
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Upper GI Endoscopy,Diagnosis	$1,478	$1,478	$118.34 – $976.96
Upper GI endoscopy (diagnostic): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $121.89 Aetna First Health PPO — PPO: $976.96 HealthLink — PPO: $960.70 Humana — Medicare-Medicaid (D-SNP): $118.34 Meridian — Medicare-Medicaid (D-SNP): $147.80 Molina — Managed Medicaid: $295.60 Molina — Medicare-Medicaid (D-SNP): $295.60
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Upper GI Endoscopy,Biopsy	$2,170	$2,170	$82 – $1,822.80
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Commercial: $1,332.38 Aetna — Medicare Advantage: $976.50 Aetna Better Health — Medicare-Medicaid (D-SNP): $137.52 Aetna First Health PPO — PPO: $1,434.37 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,822.80 Blue Cross Blue Shield — HMO: $1,453.90 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,302 HealthLink — PPO: $1,410.50 Humana — Medicare Advantage: $976.50
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd Transoral Biopsy Single/Multiple	$1,842	$1,842	$82 – $1,547.28
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Commercial: $1,130.99 Aetna — Medicare Advantage: $828.90 Aetna Better Health — Medicare-Medicaid (D-SNP): $137.52 Aetna First Health PPO — PPO: $1,217.56 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,547.28 Blue Cross Blue Shield — HMO: $1,234.14 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,105.20 HealthLink — PPO: $1,197.30 Humana — Medicare Advantage: $828.90
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Egd Transoral Biopsy Single/Multiple	$1,842	$1,842	$133.51 – $1,217.56
Upper GI endoscopy with biopsy: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $137.52 Aetna First Health PPO — PPO: $1,217.56 HealthLink — PPO: $1,197.30 Humana — Medicare-Medicaid (D-SNP): $133.51 Meridian — Medicare-Medicaid (D-SNP): $184.20 Molina — Managed Medicaid: $368.40 Molina — Medicare-Medicaid (D-SNP): $368.40
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,654	$1,654	$82 – $1,389.36
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $1,015.56 Aetna — Medicare Advantage: $744.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $184.21 Aetna First Health PPO — PPO: $1,093.29 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,389.36 Blue Cross Blue Shield — HMO: $1,108.18 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $992.40 HealthLink — PPO: $1,075.10 Humana — Medicare Advantage: $744.30
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy,Diagnostic	$2,409	$2,409	$82 – $2,023.56
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $1,479.13 Aetna — Medicare Advantage: $1,084.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $184.21 Aetna First Health PPO — PPO: $1,592.35 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,023.56 Blue Cross Blue Shield — HMO: $1,614.03 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,445.40 HealthLink — PPO: $1,565.85 Humana — Medicare Advantage: $1,084.05
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colonoscopy,Diagnostic	$2,409	$2,409	$178.84 – $1,592.35
Colonoscopy (diagnostic): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $184.21 Aetna First Health PPO — PPO: $1,592.35 HealthLink — PPO: $1,565.85 Humana — Medicare-Medicaid (D-SNP): $178.84 Meridian — Medicare-Medicaid (D-SNP): $240.90 Molina — Managed Medicaid: $481.80 Molina — Medicare-Medicaid (D-SNP): $481.80
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy,Biopsy	$3,172	$3,172	$82 – $2,664.48
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Commercial: $1,947.61 Aetna — Medicare Advantage: $1,427.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $200.03 Aetna First Health PPO — PPO: $2,096.69 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,664.48 Blue Cross Blue Shield — HMO: $2,125.24 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,903.20 HealthLink — PPO: $2,061.80 Humana — Medicare Advantage: $1,427.40
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy W/Biopsy Single/Multiple	$2,117	$2,117	$82 – $1,778.28
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Commercial: $1,299.84 Aetna — Medicare Advantage: $952.65 Aetna Better Health — Medicare-Medicaid (D-SNP): $200.03 Aetna First Health PPO — PPO: $1,399.34 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,778.28 Blue Cross Blue Shield — HMO: $1,418.39 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,270.20 HealthLink — PPO: $1,376.05 Humana — Medicare Advantage: $952.65
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colonoscopy W/Biopsy Single/Multiple	$2,117	$2,117	$194.20 – $1,399.34
Colonoscopy with biopsy: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $200.03 Aetna First Health PPO — PPO: $1,399.34 HealthLink — PPO: $1,376.05 Humana — Medicare-Medicaid (D-SNP): $194.20 Meridian — Medicare-Medicaid (D-SNP): $211.70 Molina — Managed Medicaid: $423.40 Molina — Medicare-Medicaid (D-SNP): $423.40
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy,Remv Lesn,Snare	$3,232	$3,232	$82 – $2,714.88
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Commercial: $1,984.45 Aetna — Medicare Advantage: $1,454.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $253.12 Aetna First Health PPO — PPO: $2,136.35 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,714.88 Blue Cross Blue Shield — HMO: $2,165.44 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,939.20 HealthLink — PPO: $2,100.80 Humana — Medicare Advantage: $1,454.40
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$2,227	$2,227	$82 – $1,870.68
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Commercial: $1,367.38 Aetna — Medicare Advantage: $1,002.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $253.12 Aetna First Health PPO — PPO: $1,472.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,870.68 Blue Cross Blue Shield — HMO: $1,492.09 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,336.20 HealthLink — PPO: $1,447.55 Humana — Medicare Advantage: $1,002.15
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$2,227	$2,227	$222.70 – $1,472.05
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $253.12 Aetna First Health PPO — PPO: $1,472.05 HealthLink — PPO: $1,447.55 Humana — Medicare-Medicaid (D-SNP): $245.75 Meridian — Medicare-Medicaid (D-SNP): $222.70 Molina — Managed Medicaid: $445.40 Molina — Medicare-Medicaid (D-SNP): $445.40
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$249.17 – $1,282.34
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans Aetna — Commercial: $483.38 Aetna Better Health — Medicare-Medicaid (D-SNP): $256.65 Humana — Medicare-Medicaid (D-SNP): $249.17 Wellcare — Medicare Advantage HMO: $1,282.34
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$249.17 – $256.65
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $256.65 Humana — Medicare-Medicaid (D-SNP): $249.17
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon Ca Scrn Not Hi Rsk Ind	$2,409	$2,409	$82 – $2,023.56
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — Commercial: $1,479.13 Aetna — Medicare Advantage: $1,084.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $188.42 Aetna First Health PPO — PPO: $1,592.35 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,023.56 Blue Cross Blue Shield — HMO: $1,614.03 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,445.40 HealthLink — PPO: $1,565.85 Humana — Medicare Advantage: $1,084.05
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	$1,654	$1,654	$82 – $1,389.36
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — Commercial: $349.92 Aetna — Medicare Advantage: $744.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $188.42 Aetna First Health PPO — PPO: $1,093.29 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,389.36 Blue Cross Blue Shield — HMO: $1,108.18 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $992.40 HealthLink — PPO: $1,075.10 Humana — Medicare Advantage: $744.30
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	$1,654	$1,654	$165.40 – $1,093.29
Screening colonoscopy (not high risk): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $188.42 Aetna First Health PPO — PPO: $1,093.29 HealthLink — PPO: $1,075.10 Humana — Medicare-Medicaid (D-SNP): $182.93 Meridian — Medicare-Medicaid (D-SNP): $165.40 Molina — Managed Medicaid: $330.80 Molina — Medicare-Medicaid (D-SNP): $330.80
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy Surg Cholecystectomy	$3,506	$3,506	$82 – $6,478.50
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates Aetna — Commercial: $2,152.68 Aetna — Medicare Advantage: $1,577.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $680.35 Aetna First Health PPO — PPO: $2,317.47 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,945.04 Blue Cross Blue Shield — HMO: $2,349.02 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $2,103.60 HealthLink — PPO: $2,278.90 Humana — Medicare Advantage: $1,577.70
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Laparoscopy Surg Cholecystectomy	$3,506	$3,506	$350.60 – $2,317.47
Gallbladder removal by laparoscope: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $680.35 Aetna First Health PPO — PPO: $2,317.47 HealthLink — PPO: $2,278.90 Humana — Medicare-Medicaid (D-SNP): $660.53 Meridian — Medicare-Medicaid (D-SNP): $350.60 Molina — Managed Medicaid: $701.20 Molina — Medicare-Medicaid (D-SNP): $701.20
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$1,303.68
Gallbladder removal by laparoscope: rates for 1 insurance plan Aetna — Commercial: $1,303.68
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$2,768	$2,768	$82 – $3,836.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — Commercial: $1,699.55 Aetna — Medicare Advantage: $1,245.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $538.98 Aetna First Health PPO — PPO: $1,829.65 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,325.12 Blue Cross Blue Shield — HMO: $1,854.56 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,660.80 HealthLink — PPO: $1,799.20 Humana — Medicare Advantage: $1,245.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$2,768	$2,768	$276.80 – $1,829.65
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $538.98 Aetna First Health PPO — PPO: $1,829.65 HealthLink — PPO: $1,799.20 Humana — Medicare-Medicaid (D-SNP): $523.28 Meridian — Medicare-Medicaid (D-SNP): $276.80 Molina — Managed Medicaid: $553.60 Molina — Medicare-Medicaid (D-SNP): $553.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$1,031.74
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan Aetna — Commercial: $1,031.74
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bx Prostate Needle or Punch, Singl or Mult	$3,363	$3,363	$128.97 – $2,824.92
Prostate biopsy: 10 of 18 insurance plan rates Aetna — Commercial: $2,064.88 Aetna — Medicare Advantage: $1,513.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $132.84 Aetna First Health PPO — PPO: $2,222.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,824.92 Blue Cross Blue Shield — HMO: $2,253.21 Cigna — PPO: $2,085.06 Community Partners Health Plan (CPHP) — PPO: $2,017.80 HealthLink — PPO: $2,185.95 Humana — Medicare Advantage: $1,513.35
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Bx Prostate Needle or Punch, Singl or Mult	$3,363	$3,363	$128.97 – $2,222.94
Prostate biopsy: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $132.84 Aetna First Health PPO — PPO: $2,222.94 HealthLink — PPO: $2,185.95 Humana — Medicare-Medicaid (D-SNP): $128.97 Meridian — Medicare-Medicaid (D-SNP): $336.30 Molina — Managed Medicaid: $672.60 Molina — Medicare-Medicaid (D-SNP): $672.60
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sleep Studies: CPT codes	Not listed in the file	Not listed in the file	$246.24
Prostate biopsy: rates for 1 insurance plan Aetna — Commercial: $246.24
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$7,541	$7,541	$82 – $11,391.13
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates Aetna — Commercial: $4,630.17 Aetna — Medicare Advantage: $3,393.45 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,223.45 Aetna First Health PPO — PPO: $4,984.60 Blue Cross Blue Shield — Blue Choice/Options/PPO: $6,334.44 Blue Cross Blue Shield — HMO: $5,052.47 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $4,524.60 HealthLink — PPO: $4,901.65 Humana — Medicare Advantage: $3,393.45
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$7,541	$7,541	$754.10 – $4,984.60
Prostate removal by laparoscope (radical prostatectomy): rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,223.45 Aetna First Health PPO — PPO: $4,984.60 HealthLink — PPO: $4,901.65 Humana — Medicare-Medicaid (D-SNP): $1,187.82 Meridian — Medicare-Medicaid (D-SNP): $754.10 Molina — Managed Medicaid: $1,508.20 Molina — Medicare-Medicaid (D-SNP): $1,508.20
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$2,280.16
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan Aetna — Commercial: $2,280.16
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy,W/Endo Bx	$9,026	$9,026	$82 – $7,581.84
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates Aetna — Commercial: $5,541.96 Aetna — Medicare Advantage: $4,061.70 Aetna Better Health — Medicare-Medicaid (D-SNP): $207.30 Aetna First Health PPO — PPO: $5,966.19 Blue Cross Blue Shield — Blue Choice/Options/PPO: $7,581.84 Blue Cross Blue Shield — HMO: $6,047.42 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $5,415.60 HealthLink — PPO: $5,866.90 Humana — Medicare Advantage: $4,061.70
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$6,725	$6,725	$82 – $5,649
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates Aetna — Commercial: $4,129.15 Aetna — Medicare Advantage: $3,026.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $207.30 Aetna First Health PPO — PPO: $4,445.23 Blue Cross Blue Shield — Blue Choice/Options/PPO: $5,649 Blue Cross Blue Shield — HMO: $4,505.75 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $4,035 HealthLink — PPO: $4,371.25 Humana — Medicare Advantage: $3,026.25
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$6,725	$6,725	$201.26 – $4,445.23
Hysteroscopy with biopsy of the uterus lining: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $207.30 Aetna First Health PPO — PPO: $4,445.23 HealthLink — PPO: $4,371.25 Humana — Medicare-Medicaid (D-SNP): $201.26 Meridian — Medicare-Medicaid (D-SNP): $672.50 Molina — Managed Medicaid: $1,345 Molina — Medicare-Medicaid (D-SNP): $1,345
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Dx/Ther Sbst Intrlmnr Lmbr/Sac W/ Img Gdn	$1,717	$1,717	$82 – $1,442.28
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $1,054.24 Aetna — Medicare Advantage: $772.65 Aetna Better Health — Medicare-Medicaid (D-SNP): $86.70 Aetna First Health PPO — PPO: $1,134.94 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,442.28 Blue Cross Blue Shield — HMO: $1,150.39 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,030.20 HealthLink — PPO: $1,116.05 Humana — Medicare Advantage: $772.65
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Epid Inj L/S/C Ea Lvl W Image	$1,945	$1,945	$84.17 – $1,633.80
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $1,194.23 Aetna — Medicare Advantage: $875.25 Aetna Better Health — Medicare-Medicaid (D-SNP): $86.70 Aetna First Health PPO — PPO: $1,285.65 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,633.80 Blue Cross Blue Shield — HMO: $1,303.15 Cigna — PPO: $1,205.90 Community Partners Health Plan (CPHP) — PPO: $1,167 HealthLink — PPO: $1,264.25 Humana — Medicare Advantage: $875.25
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn	$1,268	$1,268	$82 – $1,065.12
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $778.55 Aetna — Medicare Advantage: $570.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $86.70 Aetna First Health PPO — PPO: $838.15 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,065.12 Blue Cross Blue Shield — HMO: $849.56 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $760.80 HealthLink — PPO: $824.20 Humana — Medicare Advantage: $570.60
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj,Foramen,L/S,1 Level	$2,552	$2,552	$82 – $2,143.68
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $1,566.93 Aetna — Medicare Advantage: $1,148.40 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.54 Aetna First Health PPO — PPO: $1,686.87 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,143.68 Blue Cross Blue Shield — HMO: $1,709.84 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,531.20 HealthLink — PPO: $1,658.80 Humana — Medicare Advantage: $1,148.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$1,169	$1,169	$82 – $981.96
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $717.77 Aetna — Medicare Advantage: $526.05 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.54 Aetna First Health PPO — PPO: $772.71 Blue Cross Blue Shield — Blue Choice/Options/PPO: $981.96 Blue Cross Blue Shield — HMO: $783.23 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $701.40 HealthLink — PPO: $759.85 Humana — Medicare Advantage: $526.05
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transf Inj L/S Sing Lvl W Gui	$2,408	$2,408	$93.73 – $2,022.72
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Commercial: $1,478.51 Aetna — Medicare Advantage: $1,083.60 Aetna Better Health — Medicare-Medicaid (D-SNP): $96.54 Aetna First Health PPO — PPO: $1,591.69 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,022.72 Blue Cross Blue Shield — HMO: $1,613.36 Cigna — PPO: $1,492.96 Community Partners Health Plan (CPHP) — PPO: $1,444.80 HealthLink — PPO: $1,565.20 Humana — Medicare Advantage: $1,083.60
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$2,227	$2,227	$82 – $2,092.58
Carpal tunnel release: 10 of 19 insurance plan rates Aetna — Commercial: $1,367.38 Aetna — Medicare Advantage: $1,002.15 Aetna Better Health — Medicare-Medicaid (D-SNP): $385.26 Aetna First Health PPO — PPO: $1,472.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,870.68 Blue Cross Blue Shield — HMO: $1,492.09 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,336.20 HealthLink — PPO: $1,447.55 Humana — Medicare Advantage: $1,002.15
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$2,227	$2,227	$222.70 – $1,472.05
Carpal tunnel release: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $385.26 Aetna First Health PPO — PPO: $1,472.05 HealthLink — PPO: $1,447.55 Humana — Medicare-Medicaid (D-SNP): $374.04 Meridian — Medicare-Medicaid (D-SNP): $222.70 Molina — Managed Medicaid: $445.40 Molina — Medicare-Medicaid (D-SNP): $445.40
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$845.24
Carpal tunnel release: rates for 1 insurance plan Aetna — Commercial: $845.24
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Post-Cataract Laser Surgery	$1,643	$1,643	$82 – $1,380.12
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Commercial: $1,008.80 Aetna — Medicare Advantage: $739.35 Aetna Better Health — Medicare-Medicaid (D-SNP): $315.46 Aetna First Health PPO — PPO: $1,086.02 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,380.12 Blue Cross Blue Shield — HMO: $1,100.81 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $985.80 HealthLink — PPO: $1,067.95 Humana — Medicare Advantage: $739.35
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Discission Secondary Membranous Cataract; Laser (1+ Stages)	$1,896	$1,896	$82 – $1,592.64
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Commercial: $1,164.14 Aetna — Medicare Advantage: $853.20 Aetna Better Health — Medicare-Medicaid (D-SNP): $315.46 Aetna First Health PPO — PPO: $1,253.26 Blue Cross Blue Shield — Blue Choice/Options/PPO: $1,592.64 Blue Cross Blue Shield — HMO: $1,270.32 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,137.60 HealthLink — PPO: $1,232.40 Humana — Medicare Advantage: $853.20
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Discission Secondary Membranous Cataract; Laser (1+ Stages)	$1,896	$1,896	$189.60 – $1,253.26
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $315.46 Aetna First Health PPO — PPO: $1,253.26 HealthLink — PPO: $1,232.40 Humana — Medicare-Medicaid (D-SNP): $306.27 Meridian — Medicare-Medicaid (D-SNP): $189.60 Molina — Managed Medicaid: $379.20 Molina — Medicare-Medicaid (D-SNP): $379.20
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$2,734	$2,734	$82 – $2,473.11
Cataract removal with lens implant: 10 of 19 insurance plan rates Aetna — Commercial: $1,678.68 Aetna — Medicare Advantage: $1,230.30 Aetna Better Health — Medicare-Medicaid (D-SNP): $554.84 Aetna First Health PPO — PPO: $1,807.17 Blue Cross Blue Shield — Blue Choice/Options/PPO: $2,296.56 Blue Cross Blue Shield — HMO: $1,831.78 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $1,640.40 HealthLink — PPO: $1,777.10 Humana — Medicare Advantage: $1,230.30
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$2,734	$2,734	$273.40 – $1,807.17
Cataract removal with lens implant: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $554.84 Aetna First Health PPO — PPO: $1,807.17 HealthLink — PPO: $1,777.10 Humana — Medicare-Medicaid (D-SNP): $538.68 Meridian — Medicare-Medicaid (D-SNP): $273.40 Molina — Managed Medicaid: $546.80 Molina — Medicare-Medicaid (D-SNP): $546.80
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$996.88
Cataract removal with lens implant: rates for 1 insurance plan Aetna — Commercial: $996.88

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB Care Antepartum Vag Dlvr & Postpartum	$11,201	$11,201	$82 – $9,408.84
Vaginal delivery, with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $6,877.41 Aetna — Medicare Advantage: $5,040.45 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,844.92 Aetna First Health PPO — PPO: $7,403.86 Blue Cross Blue Shield — Blue Choice/Options/PPO: $9,408.84 Blue Cross Blue Shield — HMO: $7,504.67 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $6,720.60 HealthLink — PPO: $7,280.65 Humana — Medicare Advantage: $5,040.45
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB Care Antepartum Vag Dlvr & Postpartum	$11,201	$11,201	$1,120.10 – $7,403.86
Vaginal delivery, with care before and after: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,844.92 Aetna First Health PPO — PPO: $7,403.86 HealthLink — PPO: $7,280.65 Humana — Medicare-Medicaid (D-SNP): $1,791.18 Meridian — Medicare-Medicaid (D-SNP): $1,120.10 Molina — Managed Medicaid: $2,240.20 Molina — Medicare-Medicaid (D-SNP): $2,240.20
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$4,745.24
Vaginal delivery, with care before and after: rates for 1 insurance plan Aetna — Commercial: $4,745.24
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB Antepartum Care Cesarean Dlvr & Postpartum	$12,458	$12,458	$82 – $10,464.72
Cesarean delivery (C-section), with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $7,649.21 Aetna — Medicare Advantage: $5,606.10 Aetna Better Health — Medicare-Medicaid (D-SNP): $2,051.49 Aetna First Health PPO — PPO: $8,234.74 Blue Cross Blue Shield — Blue Choice/Options/PPO: $10,464.72 Blue Cross Blue Shield — HMO: $8,346.86 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $7,474.80 HealthLink — PPO: $8,097.70 Humana — Medicare Advantage: $5,606.10
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB Antepartum Care Cesarean Dlvr & Postpartum	$12,458	$12,458	$1,245.80 – $8,234.74
Cesarean delivery (C-section), with care before and after: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $2,051.49 Aetna First Health PPO — PPO: $8,234.74 HealthLink — PPO: $8,097.70 Humana — Medicare-Medicaid (D-SNP): $1,991.74 Meridian — Medicare-Medicaid (D-SNP): $1,245.80 Molina — Managed Medicaid: $2,491.60 Molina — Medicare-Medicaid (D-SNP): $2,491.60
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$5,305.04
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan Aetna — Commercial: $5,305.04
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine OB Care Vag Dlvry & Postpartum Care Vb	$11,819	$11,819	$82 – $9,927.96
Vaginal delivery after a previous C-section, with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $7,256.87 Aetna — Medicare Advantage: $5,318.55 Aetna Better Health — Medicare-Medicaid (D-SNP): $1,943.07 Aetna First Health PPO — PPO: $7,812.36 Blue Cross Blue Shield — Blue Choice/Options/PPO: $9,927.96 Blue Cross Blue Shield — HMO: $7,918.73 Cigna — PPO: $82 Community Partners Health Plan (CPHP) — PPO: $7,091.40 HealthLink — PPO: $7,682.35 Humana — Medicare Advantage: $5,318.55
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Routine OB Care Vag Dlvry & Postpartum Care Vb	$11,819	$11,819	$1,181.90 – $7,812.36
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans Aetna Better Health — Medicare-Medicaid (D-SNP): $1,943.07 Aetna First Health PPO — PPO: $7,812.36 HealthLink — PPO: $7,682.35 Humana — Medicare-Medicaid (D-SNP): $1,886.48 Meridian — Medicare-Medicaid (D-SNP): $1,181.90 Molina — Managed Medicaid: $2,363.80 Molina — Medicare-Medicaid (D-SNP): $2,363.80
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$5,006.98
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan Aetna — Commercial: $5,006.98

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$83,519.49 – $197,221.25
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 8 insurance plans Aetna — Commercial: $112,502.20 Blue Cross Blue Shield — Blue Choice/Options/PPO: $139,101.30 Blue Cross Blue Shield — HMO: $119,229.69 Cigna — PPO: $107,610.80 Community Partners Health Plan (CPHP) — PPO: $130,844.95 Multiplan/PHCS — PPO: $197,221.25 United Healthcare (UHC) — PPO: $138,534.23 Wellcare — Medicare Advantage HMO: $83,519.49
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$17,419.08 – $38,886.62
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans Aetna — Commercial: $22,182.35 Blue Cross Blue Shield — Blue Choice/Options/PPO: $27,175.71 Blue Cross Blue Shield — HMO: $23,293.47 Cigna — PPO: $21,217.90 Community Partners Health Plan (CPHP) — PPO: $25,799.04 Multiplan/PHCS — PPO: $38,886.62 United Healthcare (UHC) — PPO: $27,315.15 Wellcare — Medicare Advantage HMO: $17,419.08
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$21,731.56 – $49,216.61
Neck (cervical) spinal fusion, without complications: rates for 8 insurance plans Aetna — Commercial: $28,074.95 Blue Cross Blue Shield — Blue Choice/Options/PPO: $34,121.34 Blue Cross Blue Shield — HMO: $29,246.86 Cigna — PPO: $26,854.30 Community Partners Health Plan (CPHP) — PPO: $32,652.39 Multiplan/PHCS — PPO: $49,216.61 United Healthcare (UHC) — PPO: $34,571.25 Wellcare — Medicare Advantage HMO: $21,731.56
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$11,627 – $25,012.51
Uterus and ovary surgery (not for cancer), without complications: rates for 8 insurance plans Aetna — Commercial: $14,268.05 Blue Cross Blue Shield — Blue Choice/Options/PPO: $17,276.86 Blue Cross Blue Shield — HMO: $14,808.74 Cigna — PPO: $13,647.70 Community Partners Health Plan (CPHP) — PPO: $16,594.36 Multiplan/PHCS — PPO: $25,012.51 United Healthcare (UHC) — PPO: $17,569.55 Wellcare — Medicare Advantage HMO: $11,627

Source: Carle Eureka Hospital’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 15, 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	Critical Access Hospital
Address	101 S Major St, Eureka, IL 61530
County	Woodford County
State	Illinois
Phone	(309) 467‑2371
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	141309
Name in Medicare records	CARLE EUREKA HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(309) 304‑2021^[9]
Official website	carle.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Carle Eureka Hospital — carle.org
Carle Eureka Hospital quality — carle.org
Visiting Hours, Parking, and Amenities — carle.org
Swing Bed Program — carle.org
Carle.org — carle.org
Refer a Patient - Expedite a Transfer | Carle Health — carle.org
Carle Eureka Hospital 2026-2028 Implementation Strategy — carle.org
Refer a Patient - Expedite a Transfer | Carle Health — carle.org

Carle Eureka Hospital

Summary

Profile from official sources

At a glance