Does Carson Valley Health have an emergency room?

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

Where is Carson Valley Health?

1107 Highway 395, Gardnerville, NV 89410, in Douglas County, Nevada.

What is the phone number of Carson Valley Health?

(775) 782-1500, as listed by Medicare (CMS).

What is the Medicare star rating of Carson Valley Health?

5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Carson Valley Health — Phone, Address & ER

Quick answers

Does Carson Valley Health have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Carson Valley Health. In a medical emergency, call 911.
Where is Carson Valley Health?: 1107 Highway 395, Gardnerville, NV 89410, in Douglas County, Nevada.
What is the phone number of Carson Valley Health?: (775) 782-1500, as listed by Medicare (CMS).
What is the Medicare star rating of Carson Valley Health?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas^[4][5]

Conditions treated^[5]

Serious accidents with major injuries
Chest pain
Weakness of limbs or face drooping
Seizures
Head injury
Respiratory distress
Abdominal pain
Trauma
Post-operative infection or complications
Pneumonia
Diabetic complications

Procedures^[7]

Cardiac catheterization lab

Emergency care (hospital website)^[5]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	Open visitation at all times unless restricted; quiet hours 9 p.m. to 7 a.m.; after hours visitors enter via the emergency department^[6]
Patient portal	MyChart

Recognition^[5]

The Joint Commission Gold Seal of Approval (emergency department) 2026
American Heart Association Heart-Check Advanced Acute Heart Attack Ready Certification (emergency department) 2026

Doctors and clinicians (408)

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

Main specialties

And 384 more: the button below opens the full list.

Other emergency rooms nearby

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

Barton Memorial Hospital15 mi · South Lake Tahoe, CA · Acute Care Hospital
Carson Tahoe Regional Medical Center20 mi · Carson City, NV · Acute Care Hospital
Incline Village Community Hospital26 mi · Incline Village, NV · Critical Access Hospital
South Lyon Medical Center30 mi · Yerington, NV · Critical Access Hospital
Renown South Meadows Medical Center36 mi · Reno, NV · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Gardnerville

Reno Behavioral Healthcare Hospital, LLC38 mi · Reno, NV · Psychiatric Hospital

Hospitals in Douglas County · Hospitals near me

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

Gardnerville Health & Rehabilitation Center2.9 mi · Gardnerville, NV · 1 of 5 stars
Barton Hospital D/P SNF15 mi · South Lake Tahoe, CA · 5 of 5 stars
Mountain View Health and Rehabilitation15 mi · Carson City, NV · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Compassioncare Hospice of Reno17 mi · Reno, NV · 2 of 5 stars
Barton Healthcare System Hospice19 mi · South Lake Tahoe, CA

All hospice providers in the state →

Home health agencies

Mission Home Health of Carson City15 mi · Carson City, NV · 3.5 of 5 stars
Battle Born Home Health LLC17 mi · Carson City, NV · 4 of 5 stars
Barton Healthcare System Home Health19 mi · South Lake Tahoe, CA · 2.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

Gardnerville Dialysis (DCI)4.1 mi · Gardnerville, NV · 3 of 5 stars
DCI Carson Tahoe15 mi · Carson City, NV · 3 of 5 stars
Carson City Dialysis (DCI)21 mi · Carson City, NV · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Lake Tahoe Surgery Center12 mi · Zephyr Cove, NV
Sierra Center for Foot Surgery15 mi · Carson City, NV
Carson Endoscopy Center17 mi · Carson City, NV

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

El Dorado Community Health Center - South Lake Tahoe13 mi · South Lake Tahoe, CA · Community health center
Nevada Health Centers Carson City School Based17 mi · Carson City, NV · Community health center
Nevada Health Centers Mobile Medical Services 119 mi · Carson City, NV · Community health center

Clinics and urgent care

Carson Tahoe Regional Healthcare5.5 mi · Minden, NV · Urgent care center
Carson Valley Health Primary Care Minden Village5.5 mi · Minden, NV · Rural health clinic
Carson Tahoe Regional Healthcare15 mi · Carson City, NV · Urgent care center

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 Carson Valley Health 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)	5 of 5 stars
Overall rating of the hospital	5 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Patients got help quickly from staff	5 of 5 stars
Staff explained medicines	5 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Restfulness of Environment	5 of 5 stars
Care Coordination	4 of 5 stars
Symptoms After Stay	4 of 5 stars
Rated the hospital 9 or 10 out of 10	84%National average: 72%
Would definitely recommend the hospital	85%National average: 71%
Nurses “always” communicated well	85%National average: 80%
Doctors “always” communicated well	81%National average: 80%
“Always” got help as soon as they wanted	71%National average: 64%
Staff “always” explained medicines before giving them	70%National average: 62%
Were given information about recovery at home	90%National average: 86%
Room and bathroom “always” clean	87%National average: 73%
Completed surveys	287Response rate: 30%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart failure patients	13.4%
Deaths within 30 days: pneumonia patients	17.3%
Deaths within 30 days: COPD patients	9.5%
Deaths within 30 days: stroke patients	13.3%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90)
Too few cases to report	Deaths within 30 days: heart attack patients; Complications after hip or knee replacement

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)	16.3%
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	19%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: heart attack; Readmitted within 30 days: hip or knee replacement

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 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)	147 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Not reported to Medicare	Sepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

Not reported to Medicare: infections caught in the hospital. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

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 Nevada Best hospitals in Nevada

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 Carson Valley Health 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 →

Show the prices of 86 common services

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: HCHG OFFICE VISIT-NEW-LEVEL 3	$320	$224	$86.40 – $288
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — All Products: $281.60 Aetna — Medicare Advantage: $86.40 Alignment — Medicare Advantage: $96 Anthem — Managed Medicaid: $70.88 Anthem_BCBS — All Products: $272 Anthem_Pathway — All Products_HMO: $272 Cigna_Greatwest — All Products: $288 Hometown Health — All Products (Fully Insured and Self-Funded): $259.20 Humana — Medicare Advantage: $86.40 Prominence — All Products: $272
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC WC NEW PATIENT LEVEL 3	$320	$224	$86.40 – $288
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — All Products: $281.60 Aetna — Medicare Advantage: $86.40 Alignment — Medicare Advantage: $96 Anthem — Managed Medicaid: $70.88 Anthem_BCBS — All Products: $272 Anthem_Pathway — All Products_HMO: $272 Cigna_Greatwest — All Products: $288 Hometown Health — All Products (Fully Insured and Self-Funded): $259.20 Humana — Medicare Advantage: $86.40 Prominence — All Products: $272
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U6 In the file: OFFICE O/P NEW LOW 30 MIN	Not listed in the file	Not listed in the file	$35.44
New patient office visit (about 30–44 minutes): rates for 2 insurance plans Anthem — Managed Medicaid: $35.44 Silver Summit — Managed Medicaid: $35.44
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OFFICE VISIT-NEW-LEVEL 4	$430	$301	$116.10 – $387
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — All Products: $378.40 Aetna — Medicare Advantage: $116.10 Alignment — Medicare Advantage: $129 Anthem — Managed Medicaid: $121.31 Anthem_BCBS — All Products: $365.50 Anthem_Pathway — All Products_HMO: $365.50 Cigna_Greatwest — All Products: $387 Hometown Health — All Products (Fully Insured and Self-Funded): $348.30 Humana — Medicare Advantage: $116.10 Prominence — All Products: $365.50
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC WC NEW PATIENT LEVEL 4	$370	$259	$99.90 – $333
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — All Products: $325.60 Aetna — Medicare Advantage: $99.90 Alignment — Medicare Advantage: $111 Anthem — Managed Medicaid: $121.31 Anthem_BCBS — All Products: $314.50 Anthem_Pathway — All Products_HMO: $314.50 Cigna_Greatwest — All Products: $333 Hometown Health — All Products (Fully Insured and Self-Funded): $299.70 Humana — Medicare Advantage: $99.90 Prominence — All Products: $314.50
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U6 In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$60.66
New patient office visit (about 45–59 minutes): rates for 2 insurance plans Anthem — Managed Medicaid: $60.66 Silver Summit — Managed Medicaid: $60.66
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC WC NEW PATIENT LEVEL 5	$500	$350	$135 – $450
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna — All Products: $440 Aetna — Medicare Advantage: $135 Alignment — Medicare Advantage: $150 Anthem — Managed Medicaid: $156.48 Anthem_BCBS — All Products: $425 Anthem_Pathway — All Products_HMO: $425 Cigna_Greatwest — All Products: $450 Hometown Health — All Products (Fully Insured and Self-Funded): $360 Humana — Medicare Advantage: $135 Prominence — All Products: $425
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U6 In the file: OFFICE O/P NEW HI 60 MIN	Not listed in the file	Not listed in the file	$78.24
New patient office visit (about 60–74 minutes): rates for 2 insurance plans Anthem — Managed Medicaid: $78.24 Silver Summit — Managed Medicaid: $78.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LEVEL III VISIT ESTABLISHED	$270	$189	$72.90 – $243
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates Aetna — All Products: $237.60 Aetna — Medicare Advantage: $72.90 Alignment — Medicare Advantage: $81 Anthem — Managed Medicaid: $47.41 Anthem_BCBS — All Products: $229.50 Anthem_Pathway — All Products_HMO: $229.50 Cigna_Behavioral Health — All Products: $200 Cigna_Greatwest — All Products: $243 Hometown Health — All Products (Fully Insured and Self-Funded): $218.70 Humana — Medicare Advantage: $72.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC WC ESTABLISHED PATIENT LEVEL 3	$265	$185.50	$71.55 – $238.50
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates Aetna — All Products: $233.20 Aetna — Medicare Advantage: $71.55 Alignment — Medicare Advantage: $79.50 Anthem — Managed Medicaid: $47.41 Anthem_BCBS — All Products: $225.25 Anthem_Pathway — All Products_HMO: $225.25 Cigna_Behavioral Health — All Products: $200 Cigna_Greatwest — All Products: $238.50 Hometown Health — All Products (Fully Insured and Self-Funded): $190.80 Humana — Medicare Advantage: $71.55
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U6 In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$23.71
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans Anthem — Managed Medicaid: $23.71 Silver Summit — Managed Medicaid: $23.71
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG EST PT FACILITY DETAILED	$340	$238	$91.80 – $306
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Aetna — All Products: $299.20 Aetna — Medicare Advantage: $91.80 Alignment — Medicare Advantage: $102 Anthem — Managed Medicaid: $72.73 Anthem_BCBS — All Products: $289 Anthem_Pathway — All Products_HMO: $289 Cigna_Behavioral Health — All Products: $250 Cigna_Greatwest — All Products: $306 Hometown Health — All Products (Fully Insured and Self-Funded): $275.40 Humana — Medicare Advantage: $91.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LEVEL IV VISIT ESTABLISHED PT	$340	$238	$91.80 – $306
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Aetna — All Products: $299.20 Aetna — Medicare Advantage: $91.80 Alignment — Medicare Advantage: $102 Anthem — Managed Medicaid: $72.73 Anthem_BCBS — All Products: $289 Anthem_Pathway — All Products_HMO: $289 Cigna_Behavioral Health — All Products: $250 Cigna_Greatwest — All Products: $306 Hometown Health — All Products (Fully Insured and Self-Funded): $275.40 Humana — Medicare Advantage: $91.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC WC ESTABLISHED PATIENT LEVEL 4	$320	$224	$86.40 – $288
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Aetna — All Products: $281.60 Aetna — Medicare Advantage: $86.40 Alignment — Medicare Advantage: $96 Anthem — Managed Medicaid: $72.73 Anthem_BCBS — All Products: $272 Anthem_Pathway — All Products_HMO: $272 Cigna_Behavioral Health — All Products: $250 Cigna_Greatwest — All Products: $288 Hometown Health — All Products (Fully Insured and Self-Funded): $230.40 Humana — Medicare Advantage: $86.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OFFICE-OP CONSULTATION NEW/ESTAB PATIENT 40 MIN	$180	$126	$48.60 – $162
Office consultation with a specialist (moderate): 10 of 15 insurance plan rates Aetna — All Products: $158.40 Aetna — Medicare Advantage: $48.60 Alignment — Medicare Advantage: $54 Anthem — Managed Medicaid: $90.89 Anthem_BCBS — All Products: $153 Anthem_Pathway — All Products_HMO: $153 Cigna_Greatwest — All Products: $162 Hometown Health — All Products (Fully Insured and Self-Funded): $129.60 Humana — Medicare Advantage: $48.60 Prominence — All Products: $153
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	$143.73
Office consultation with a specialist (moderate to high): rates for 2 insurance plans Anthem — Managed Medicaid: $143.73 Silver Summit — Managed Medicaid: $143.73
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	$91.42
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans Anthem — Managed Medicaid: $91.42 Silver Summit — Managed Medicaid: $91.42
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	$110.80
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans Anthem — Managed Medicaid: $110.80 Silver Summit — Managed Medicaid: $110.80
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LEVEL III INTERMEDIATE	$1,450	$1,015	$391.50 – $1,305
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — All Products: $1,276 Aetna — Medicare Advantage: $391.50 Alignment — Medicare Advantage: $435 Anthem — Managed Medicaid: $56.68 Anthem_BCBS — All Products: $1,232.50 Anthem_Pathway — All Products_HMO: $1,232.50 Cigna_Greatwest — All Products: $1,305 Hometown Health — All Products (Fully Insured and Self-Funded): $1,174.50 Humana — Medicare Advantage: $391.50 Prominence — All Products: $1,232.50
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LEVEL IV EXTENDED	$2,300	$1,610	$621 – $2,070
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — All Products: $2,024 Aetna — Medicare Advantage: $621 Alignment — Medicare Advantage: $690 Anthem — Managed Medicaid: $108.14 Anthem_BCBS — All Products: $1,955 Anthem_Pathway — All Products_HMO: $1,955 Cigna_Greatwest — All Products: $2,070 Hometown Health — All Products (Fully Insured and Self-Funded): $1,863 Humana — Medicare Advantage: $621 Prominence — All Products: $1,955
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LEVEL V COMPREHENSIVE	$3,160	$2,212	$853.20 – $2,844
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — All Products: $2,780.80 Aetna — Medicare Advantage: $853.20 Alignment — Medicare Advantage: $948 Anthem — Managed Medicaid: $158.84 Anthem_BCBS — All Products: $2,686 Anthem_Pathway — All Products_HMO: $2,686 Cigna_Greatwest — All Products: $2,844 Hometown Health — All Products (Fully Insured and Self-Funded): $2,559.60 Humana — Medicare Advantage: $853.20 Prominence — All Products: $2,686

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: HCHG BASIC METABOLIC PANEL TOTAL CA LAB	$110	$77	$29.70 – $99
Basic metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — All Products: $96.80 Aetna — Medicare Advantage: $29.70 Alignment — Medicare Advantage: $33 Anthem — Managed Medicaid: $5.77 Anthem_BCBS — All Products: $93.50 Anthem_Pathway — All Products_HMO: $93.50 Cigna_Greatwest — All Products: $99 Hometown Health — All Products (Fully Insured and Self-Funded): $10.15 Humana — Medicare Advantage: $29.70 Prominence — All Products: $93.50
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMP METABOLIC PANEL LAB	$180	$126	$48.60 – $162
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — All Products: $158.40 Aetna — Medicare Advantage: $48.60 Alignment — Medicare Advantage: $54 Anthem — Managed Medicaid: $7.21 Anthem_BCBS — All Products: $153 Anthem_Pathway — All Products_HMO: $153 Cigna_Greatwest — All Products: $162 Hometown Health — All Products (Fully Insured and Self-Funded): $12.67 Humana — Medicare Advantage: $48.60 Prominence — All Products: $153
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC PRENATAL PAN H	$650	$455	$175.50 – $585
Obstetric blood test panel: 10 of 15 insurance plan rates Aetna — All Products: $572 Aetna — Medicare Advantage: $175.50 Alignment — Medicare Advantage: $195 Anthem — Managed Medicaid: $32.56 Anthem_BCBS — All Products: $552.50 Anthem_Pathway — All Products_HMO: $552.50 Cigna_Greatwest — All Products: $585 Hometown Health — All Products (Fully Insured and Self-Funded): $62.15 Humana — Medicare Advantage: $175.50 Prominence — All Products: $552.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL LAB	$220	$154	$59.40 – $198
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates Aetna — All Products: $193.60 Aetna — Medicare Advantage: $59.40 Alignment — Medicare Advantage: $66 Anthem — Managed Medicaid: $9.14 Anthem_BCBS — All Products: $187 Anthem_Pathway — All Products_HMO: $187 Cigna_Greatwest — All Products: $198 Hometown Health — All Products (Fully Insured and Self-Funded): $16.07 Humana — Medicare Advantage: $59.40 Prominence — All Products: $187
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL LAB	$160	$112	$43.20 – $144
Kidney function panel: 10 of 15 insurance plan rates Aetna — All Products: $140.80 Aetna — Medicare Advantage: $43.20 Alignment — Medicare Advantage: $48 Anthem — Managed Medicaid: $5.93 Anthem_BCBS — All Products: $136 Anthem_Pathway — All Products_HMO: $136 Cigna_Greatwest — All Products: $144 Hometown Health — All Products (Fully Insured and Self-Funded): $10.42 Humana — Medicare Advantage: $43.20 Prominence — All Products: $136
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL LAB	$120	$84	$32.40 – $108
Liver function panel: 10 of 15 insurance plan rates Aetna — All Products: $105.60 Aetna — Medicare Advantage: $32.40 Alignment — Medicare Advantage: $36 Anthem — Managed Medicaid: $5.57 Anthem_BCBS — All Products: $102 Anthem_Pathway — All Products_HMO: $102 Cigna_Greatwest — All Products: $108 Hometown Health — All Products (Fully Insured and Self-Funded): $9.80 Humana — Medicare Advantage: $32.40 Prominence — All Products: $102
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$2.16
Urine test (automated, with microscope): rates for 3 insurance plans Anthem — Managed Medicaid: $2.16 Hometown Health — All Products (Fully Insured and Self-Funded): $3.80 Silver Summit — Managed Medicaid: $2.16
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$1.75
Urine test (manual, without microscope): rates for 3 insurance plans Anthem — Managed Medicaid: $1.75 Hometown Health — All Products (Fully Insured and Self-Funded): $4.18 Silver Summit — Managed Medicaid: $1.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BMH/CVMC URINALYSIS, AUTO, W/O SCOPE	$40	$28	$10.80 – $36
Urine test (automated, without microscope): 10 of 15 insurance plan rates Aetna — All Products: $35.20 Aetna — Medicare Advantage: $10.80 Alignment — Medicare Advantage: $12 Anthem — Managed Medicaid: $1.53 Anthem_BCBS — All Products: $34 Anthem_Pathway — All Products_HMO: $34 Cigna_Greatwest — All Products: $36 Hometown Health — All Products (Fully Insured and Self-Funded): $2.93 Humana — Medicare Advantage: $10.80 Prominence — All Products: $34
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS AUTO W/O SCOPE LAB	$43	$30.10	$11.61 – $38.70
Urine test (automated, without microscope): 10 of 15 insurance plan rates Aetna — All Products: $37.84 Aetna — Medicare Advantage: $11.61 Alignment — Medicare Advantage: $12.90 Anthem — Managed Medicaid: $1.53 Anthem_BCBS — All Products: $36.55 Anthem_Pathway — All Products_HMO: $36.55 Cigna_Greatwest — All Products: $38.70 Hometown Health — All Products (Fully Insured and Self-Funded): $2.93 Humana — Medicare Advantage: $11.61 Prominence — All Products: $36.55
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA DIAGNOSTIC TOTAL REF	$180	$126	$48.60 – $162
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Aetna — All Products: $158.40 Aetna — Medicare Advantage: $48.60 Alignment — Medicare Advantage: $54 Anthem — Managed Medicaid: $12.55 Anthem_BCBS — All Products: $153 Anthem_Pathway — All Products_HMO: $153 Cigna_Greatwest — All Products: $162 Hometown Health — All Products (Fully Insured and Self-Funded): $23.91 Humana — Medicare Advantage: $48.60 Prominence — All Products: $153
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA SCREENING TOTAL LAB	$180	$126	$48.60 – $162
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Aetna — All Products: $158.40 Aetna — Medicare Advantage: $48.60 Alignment — Medicare Advantage: $54 Anthem — Managed Medicaid: $12.55 Anthem_BCBS — All Products: $153 Anthem_Pathway — All Products_HMO: $153 Cigna_Greatwest — All Products: $162 Hometown Health — All Products (Fully Insured and Self-Funded): $23.91 Humana — Medicare Advantage: $48.60 Prominence — All Products: $153
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA DIAGNOSTIC TOTAL LAB	$180	$126	$48.60 – $162
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Aetna — All Products: $158.40 Aetna — Medicare Advantage: $48.60 Alignment — Medicare Advantage: $54 Anthem — Managed Medicaid: $12.55 Anthem_BCBS — All Products: $153 Anthem_Pathway — All Products_HMO: $153 Cigna_Greatwest — All Products: $162 Hometown Health — All Products (Fully Insured and Self-Funded): $23.91 Humana — Medicare Advantage: $48.60 Prominence — All Products: $153
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSH REF	$220	$154	$59.40 – $198
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates Aetna — All Products: $193.60 Aetna — Medicare Advantage: $59.40 Alignment — Medicare Advantage: $66 Anthem — Managed Medicaid: $11.47 Anthem_BCBS — All Products: $187 Anthem_Pathway — All Products_HMO: $187 Cigna_Greatwest — All Products: $198 Hometown Health — All Products (Fully Insured and Self-Funded): $20.16 Humana — Medicare Advantage: $59.40 Prominence — All Products: $187
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSH LAB	$260	$182	$70.20 – $234
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates Aetna — All Products: $228.80 Aetna — Medicare Advantage: $70.20 Alignment — Medicare Advantage: $78 Anthem — Managed Medicaid: $11.47 Anthem_BCBS — All Products: $221 Anthem_Pathway — All Products_HMO: $221 Cigna_Greatwest — All Products: $234 Hometown Health — All Products (Fully Insured and Self-Funded): $21.84 Humana — Medicare Advantage: $70.20 Prominence — All Products: $221
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPLETE CBC W/AUTO DIFF WBC LAB	$100	$70	$27 – $90
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates Aetna — All Products: $88 Aetna — Medicare Advantage: $27 Alignment — Medicare Advantage: $30 Anthem — Managed Medicaid: $5.31 Anthem_BCBS — All Products: $85 Anthem_Pathway — All Products_HMO: $85 Cigna_Greatwest — All Products: $90 Hometown Health — All Products (Fully Insured and Self-Funded): $10.10 Humana — Medicare Advantage: $27 Prominence — All Products: $85
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPLETE CBC AUTOMATED LAB	$98	$68.60	$26.46 – $88.20
Complete blood count (CBC), automated: 10 of 15 insurance plan rates Aetna — All Products: $86.24 Aetna — Medicare Advantage: $26.46 Alignment — Medicare Advantage: $29.40 Anthem — Managed Medicaid: $4.42 Anthem_BCBS — All Products: $83.30 Anthem_Pathway — All Products_HMO: $83.30 Cigna_Greatwest — All Products: $88.20 Hometown Health — All Products (Fully Insured and Self-Funded): $8.41 Humana — Medicare Advantage: $26.46 Prominence — All Products: $83.30
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTHROMBIN TIME (PT) LAB	$43	$30.10	$11.61 – $38.70
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Aetna — All Products: $37.84 Aetna — Medicare Advantage: $11.61 Alignment — Medicare Advantage: $12.90 Anthem — Managed Medicaid: $2.69 Anthem_BCBS — All Products: $36.55 Anthem_Pathway — All Products_HMO: $36.55 Cigna_Greatwest — All Products: $38.70 Hometown Health — All Products (Fully Insured and Self-Funded): $5.58 Humana — Medicare Advantage: $11.61 Prominence — All Products: $36.55
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG THROMBOPLASTIN TIME PARTIAL (PTT) PLASMA LAB	$98	$68.60	$26.46 – $88.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates Aetna — All Products: $86.24 Aetna — Medicare Advantage: $26.46 Alignment — Medicare Advantage: $29.40 Anthem — Managed Medicaid: $4.10 Anthem_BCBS — All Products: $83.30 Anthem_Pathway — All Products_HMO: $83.30 Cigna_Greatwest — All Products: $88.20 Hometown Health — All Products (Fully Insured and Self-Funded): $7.81 Humana — Medicare Advantage: $26.46 Prominence — All Products: $83.30

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: HCHG CT SCAN,HEAD/BRAIN,W/O CONTRA*	$2,200	$1,540	$594 – $1,980
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Aetna — All Products: $1,936 Aetna — Medicare Advantage: $594 Alignment — Medicare Advantage: $660 Anthem — Managed Medicaid: $130.35 Anthem_BCBS — All Products: $1,537.99 Anthem_Pathway — All Products_HMO: $1,238.78 Cigna_Greatwest — All Products: $1,980 Hometown Health — All Products (Fully Insured and Self-Funded): $1,914 Humana — Medicare Advantage: $594 Prominence — All Products: $1,870
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT SCAN,HEAD/BRAIN,W/O CONTRA*	$2,200	$1,540	$1,496 – $1,848
CT scan of the head or brain, without contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $1,496
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$43.78
CT scan of the head or brain, without contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $43.78 Silver Summit — Managed Medicaid: $43.78
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG MRI BRAIN COMBO	$3,300	$2,310	$891 – $2,970
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates Aetna — All Products: $2,904 Aetna — Medicare Advantage: $891 Alignment — Medicare Advantage: $990 Anthem — Managed Medicaid: $414.96 Anthem_BCBS — All Products: $1,151.08 Anthem_Pathway — All Products_HMO: $978.15 Cigna_Greatwest — All Products: $2,970 Hometown Health — All Products (Fully Insured and Self-Funded): $2,277 Humana — Medicare Advantage: $891 Prominence — All Products: $2,805
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG MRI BRAIN COMBO	$3,300	$2,310	$2,244 – $2,871
MRI of the brain, before and after contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $2,871
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$119.02
MRI of the brain, before and after contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $119.02 Silver Summit — Managed Medicaid: $119.02
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CHEST XRAY 2 VIEWS	$510	$357	$137.70 – $459
Chest X-ray, 2 views: 10 of 15 insurance plan rates Aetna — All Products: $448.80 Aetna — Medicare Advantage: $137.70 Alignment — Medicare Advantage: $153 Anthem — Managed Medicaid: $31.13 Anthem_BCBS — All Products: $433.50 Anthem_Pathway — All Products_HMO: $433.50 Cigna_Greatwest — All Products: $459 Hometown Health — All Products (Fully Insured and Self-Funded): $413.10 Humana — Medicare Advantage: $137.70 Prominence — All Products: $433.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$11.13
Chest X-ray, 2 views: rates for 2 insurance plans Anthem — Managed Medicaid: $11.13 Silver Summit — Managed Medicaid: $11.13
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$19.99
Chest X-ray, 2 views: rates for 2 insurance plans Anthem — Managed Medicaid: $19.99 Silver Summit — Managed Medicaid: $19.99
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG X-RAY LUMBAR SPINE 4 VW	$740	$518	$199.80 – $666
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Aetna — All Products: $651.20 Aetna — Medicare Advantage: $199.80 Alignment — Medicare Advantage: $222 Anthem — Managed Medicaid: $52.76 Anthem_BCBS — All Products: $629 Anthem_Pathway — All Products_HMO: $629 Cigna_Greatwest — All Products: $666 Hometown Health — All Products (Fully Insured and Self-Funded): $599.40 Humana — Medicare Advantage: $199.80 Prominence — All Products: $629
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$16.84
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Anthem — Managed Medicaid: $16.84 Silver Summit — Managed Medicaid: $16.84
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$35.92
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Anthem — Managed Medicaid: $35.92 Silver Summit — Managed Medicaid: $35.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG MRI, LUMBAR SPINE	$2,275	$1,592.50	$614.25 – $2,047.50
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates Aetna — All Products: $2,002 Aetna — Medicare Advantage: $614.25 Alignment — Medicare Advantage: $682.50 Anthem — Managed Medicaid: $256.98 Anthem_BCBS — All Products: $1,151.08 Anthem_Pathway — All Products_HMO: $978.15 Cigna_Greatwest — All Products: $2,047.50 Hometown Health — All Products (Fully Insured and Self-Funded): $1,979.25 Humana — Medicare Advantage: $614.25 Prominence — All Products: $1,933.75
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG MRI, LUMBAR SPINE	$2,275	$1,592.50	$1,547 – $1,979.25
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $1,547
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$77.82
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $77.82 Silver Summit — Managed Medicaid: $77.82
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT SCAN OF PELVIS CONTRAST	$2,500	$1,750	$675 – $2,250
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Aetna — All Products: $2,200 Aetna — Medicare Advantage: $675 Alignment — Medicare Advantage: $750 Anthem — Managed Medicaid: $248.85 Anthem_BCBS — All Products: $1,537.99 Anthem_Pathway — All Products_HMO: $1,238.78 Cigna_Greatwest — All Products: $2,250 Hometown Health — All Products (Fully Insured and Self-Funded): $2,175 Humana — Medicare Advantage: $675 Prominence — All Products: $2,125
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT SCAN OF PELVIS CONTRAST	$2,500	$1,750	$1,700 – $2,100
CT scan of the pelvis, with contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $1,700
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$60.62
CT scan of the pelvis, with contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $60.62 Silver Summit — Managed Medicaid: $60.62
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG MRI LOWER EXTREM JT, W/O CONT*	$2,790	$1,953	$753.30 – $2,511
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Aetna — All Products: $2,455.20 Aetna — Medicare Advantage: $753.30 Alignment — Medicare Advantage: $837 Anthem — Managed Medicaid: $269.33 Anthem_BCBS — All Products: $1,151.08 Anthem_Pathway — All Products_HMO: $978.15 Cigna_Greatwest — All Products: $2,511 Hometown Health — All Products (Fully Insured and Self-Funded): $2,427.30 Humana — Medicare Advantage: $753.30 Prominence — All Products: $2,371.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG MRI LOWER EXTREM JT, W/O CONT*	$2,790	$1,953	$1,897.20 – $2,427.30
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $1,897.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$71.65
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $71.65 Silver Summit — Managed Medicaid: $71.65
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT SCAN,ABD & PELVIS,W CONTRAST	$2,450	$1,715	$661.50 – $2,205
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — All Products: $2,156 Aetna — Medicare Advantage: $661.50 Alignment — Medicare Advantage: $735 Anthem — Managed Medicaid: $342.11 Anthem_BCBS — All Products: $1,537.99 Anthem_Pathway — All Products_HMO: $1,238.78 Cigna_Greatwest — All Products: $2,205 Hometown Health — All Products (Fully Insured and Self-Funded): $1,690.50 Humana — Medicare Advantage: $661.50 Prominence — All Products: $2,082.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT SCAN,ABD & PELVIS,W CONTRAST	$2,450	$1,715	$1,666 – $2,058
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan Hometown Health — All Products (Fully Insured and Self-Funded): $2,058
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	Not listed in the file	$94.55
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans Anthem — Managed Medicaid: $94.55 Silver Summit — Managed Medicaid: $94.55
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ABDOM,B-SCAN &/OR REAL TIME,C*	$920	$644	$248.40 – $828
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Aetna — All Products: $809.60 Aetna — Medicare Advantage: $248.40 Alignment — Medicare Advantage: $276 Anthem — Managed Medicaid: $149.32 Anthem_BCBS — All Products: $782 Anthem_Pathway — All Products_HMO: $782 Cigna_Greatwest — All Products: $828 Hometown Health — All Products (Fully Insured and Self-Funded): $662.40 Humana — Medicare Advantage: $248.40 Prominence — All Products: $782
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$41.97
Ultrasound of the abdomen, complete: rates for 2 insurance plans Anthem — Managed Medicaid: $41.97 Silver Summit — Managed Medicaid: $41.97
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$107.35
Ultrasound of the abdomen, complete: rates for 2 insurance plans Anthem — Managed Medicaid: $107.35 Silver Summit — Managed Medicaid: $107.35
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OB >/= 14 WKS, SNGL FETUS	$1,400	$980	$378 – $1,260
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Aetna — All Products: $1,232 Aetna — Medicare Advantage: $378 Alignment — Medicare Advantage: $420 Anthem — Managed Medicaid: $154.24 Anthem_BCBS — All Products: $1,190 Anthem_Pathway — All Products_HMO: $1,190 Cigna_Greatwest — All Products: $1,260 Hometown Health — All Products (Fully Insured and Self-Funded): $1,134 Humana — Medicare Advantage: $378 Prominence — All Products: $1,190
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$51.05
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Anthem — Managed Medicaid: $51.05 Silver Summit — Managed Medicaid: $51.05
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$103.19
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Anthem — Managed Medicaid: $103.19 Silver Summit — Managed Medicaid: $103.19
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ECHOGRAPHY,TRANSVAGINAL	$1,000	$700	$270 – $900
Transvaginal ultrasound: 10 of 15 insurance plan rates Aetna — All Products: $880 Aetna — Medicare Advantage: $270 Alignment — Medicare Advantage: $300 Anthem — Managed Medicaid: $133.66 Anthem_BCBS — All Products: $850 Anthem_Pathway — All Products_HMO: $850 Cigna_Greatwest — All Products: $900 Hometown Health — All Products (Fully Insured and Self-Funded): $810 Humana — Medicare Advantage: $270 Prominence — All Products: $850
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$35.76
Transvaginal ultrasound: rates for 2 insurance plans Anthem — Managed Medicaid: $35.76 Silver Summit — Managed Medicaid: $35.76
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$97.90
Transvaginal ultrasound: rates for 2 insurance plans Anthem — Managed Medicaid: $97.90 Silver Summit — Managed Medicaid: $97.90
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DX MAMMO UNILATERAL W/WO CAD	$410	$287	$110.70 – $369
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Aetna — All Products: $360.80 Aetna — Medicare Advantage: $110.70 Alignment — Medicare Advantage: $123 Anthem — Managed Medicaid: $138.86 Anthem_BCBS — All Products: $348.50 Anthem_Pathway — All Products_HMO: $348.50 Cigna_Greatwest — All Products: $369 Hometown Health — All Products (Fully Insured and Self-Funded): $332.10 Humana — Medicare Advantage: $110.70 Prominence — All Products: $348.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$41.63
Diagnostic mammogram, one breast: rates for 2 insurance plans Anthem — Managed Medicaid: $41.63 Silver Summit — Managed Medicaid: $41.63
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$97.23
Diagnostic mammogram, one breast: rates for 2 insurance plans Anthem — Managed Medicaid: $97.23 Silver Summit — Managed Medicaid: $97.23
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DX MAMMO BILAT W/WO CAD	$520	$364	$140.40 – $468
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Aetna — All Products: $457.60 Aetna — Medicare Advantage: $140.40 Alignment — Medicare Advantage: $156 Anthem — Managed Medicaid: $175.52 Anthem_BCBS — All Products: $442 Anthem_Pathway — All Products_HMO: $442 Cigna_Greatwest — All Products: $468 Hometown Health — All Products (Fully Insured and Self-Funded): $421.20 Humana — Medicare Advantage: $140.40 Prominence — All Products: $442
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$51.32
Diagnostic mammogram, both breasts: rates for 2 insurance plans Anthem — Managed Medicaid: $51.32 Silver Summit — Managed Medicaid: $51.32
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$124.19
Diagnostic mammogram, both breasts: rates for 2 insurance plans Anthem — Managed Medicaid: $124.19 Silver Summit — Managed Medicaid: $124.19
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SCREENING MAMMO BILAT W/WO CAD	$420	$294	$113.40 – $378
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — All Products: $369.60 Aetna — Medicare Advantage: $113.40 Alignment — Medicare Advantage: $126 Anthem — Managed Medicaid: $141.48 Anthem_BCBS — All Products: $357 Anthem_Pathway — All Products_HMO: $357 Cigna_Greatwest — All Products: $378 Hometown Health — All Products (Fully Insured and Self-Funded): $340.20 Humana — Medicare Advantage: $113.40 Prominence — All Products: $357
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: HCHG SCRN MAMMO UNI W/WO CAD (52MOD)	$420	$294	$113.40 – $378
Screening mammogram, both breasts: 10 of 13 insurance plan rates Aetna — All Products: $369.60 Aetna — Medicare Advantage: $113.40 Alignment — Medicare Advantage: $126 Anthem_BCBS — All Products: $357 Anthem_Pathway — All Products_HMO: $357 Cigna_Greatwest — All Products: $378 Hometown Health — All Products (Fully Insured and Self-Funded): $340.20 Humana — Medicare Advantage: $113.40 Prominence — All Products: $357 Silver Summit — All Products _Ambetter: $340.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$38.78
Screening mammogram, both breasts: rates for 2 insurance plans Anthem — Managed Medicaid: $38.78 Silver Summit — Managed Medicaid: $38.78

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	$14.85
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Anthem — Managed Medicaid: $14.85 Silver Summit — Managed Medicaid: $14.85
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CATH LEFT HEART W/VENTRCL GRA*	$24,000	$16,800	$6,480 – $21,600
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $21,120 Aetna — Medicare Advantage: $6,480 Alignment — Medicare Advantage: $7,200 Anthem — Managed Medicaid: $788.91 Anthem_BCBS — All Products: $10,816 Anthem_Pathway — All Products_HMO: $8,988.80 Cigna_Greatwest — All Products: $21,600 Hometown Health — All Products (Fully Insured and Self-Funded): $17,280 Humana — Medicare Advantage: $6,480 Prominence — All Products: $20,400
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$231.51
Left heart catheterization (diagnostic): rates for 2 insurance plans Anthem — Managed Medicaid: $231.51 Silver Summit — Managed Medicaid: $231.51
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$557.40
Left heart catheterization (diagnostic): rates for 2 insurance plans Anthem — Managed Medicaid: $557.40 Silver Summit — Managed Medicaid: $557.40
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	$617.22
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Anthem — Managed Medicaid: $617.22 Hometown Health — All Products (Fully Insured and Self-Funded): $10,359.18 Silver Summit — Managed Medicaid: $617.22
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$269.17
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans Anthem — Managed Medicaid: $269.17 Silver Summit — Managed Medicaid: $269.17
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	Not listed in the file	Not listed in the file	$1,008.08
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans Anthem — Managed Medicaid: $1,008.08 Hometown Health — All Products (Fully Insured and Self-Funded): $34,715.19 Silver Summit — Managed Medicaid: $1,008.08
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY, 4 OR MORE	$4,200	$2,940	$1,134 – $3,780
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates Aetna — All Products: $3,696 Aetna — Medicare Advantage: $1,134 Alignment — Medicare Advantage: $1,260 Anthem — Managed Medicaid: $553.25 Anthem_BCBS — All Products: $3,570 Anthem_Pathway — All Products_HMO: $3,570 Cigna_Greatwest — All Products: $3,780 Hometown Health — All Products (Fully Insured and Self-Funded): $3,024 Humana — Medicare Advantage: $1,134 Prominence — All Products: $3,570
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$107.19
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Anthem — Managed Medicaid: $107.19 Silver Summit — Managed Medicaid: $107.19
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$446.05
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Anthem — Managed Medicaid: $446.05 Silver Summit — Managed Medicaid: $446.05

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: HCHG THERAPEUTIC EXERCISE EA 15 MIN	$157	$109.90	$42.39 – $141.30
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Aetna — All Products: $138.16 Aetna — Medicare Advantage: $42.39 Alignment — Medicare Advantage: $47.10 Anthem — Managed Medicaid: $28.19 Anthem_BCBS — All Products: $133.45 Anthem_Pathway — All Products_HMO: $133.45 Cigna_Greatwest — All Products: $141.30 Hometown Health — All Products (Fully Insured and Self-Funded): $127.17 Humana — Medicare Advantage: $42.39 Prominence — All Products: $133.45
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEX 20 MIN	$285	$199.50	$76.95 – $256.50
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Aetna — All Products: $250.80 Aetna — Medicare Advantage: $76.95 Alignment — Medicare Advantage: $85.50 Anthem — Managed Medicaid: $70.55 Anthem_BCBS — All Products: $242.25 Anthem_Pathway — All Products_HMO: $242.25 Cigna_Greatwest — All Products: $256.50 Hometown Health — All Products (Fully Insured and Self-Funded): $230.85 Humana — Medicare Advantage: $76.95 Prominence — All Products: $242.25
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEX 30 MIN	$335	$234.50	$90.45 – $301.50
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Aetna — All Products: $294.80 Aetna — Medicare Advantage: $90.45 Alignment — Medicare Advantage: $100.50 Anthem — Managed Medicaid: $70.55 Anthem_BCBS — All Products: $284.75 Anthem_Pathway — All Products_HMO: $284.75 Cigna_Greatwest — All Products: $301.50 Hometown Health — All Products (Fully Insured and Self-Funded): $271.35 Humana — Medicare Advantage: $90.45 Prominence — All Products: $284.75
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEX 45 MIN	$415	$290.50	$112.05 – $373.50
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Aetna — All Products: $365.20 Aetna — Medicare Advantage: $112.05 Alignment — Medicare Advantage: $124.50 Anthem — Managed Medicaid: $70.55 Anthem_BCBS — All Products: $352.75 Anthem_Pathway — All Products_HMO: $352.75 Cigna_Greatwest — All Products: $373.50 Hometown Health — All Products (Fully Insured and Self-Funded): $336.15 Humana — Medicare Advantage: $112.05 Prominence — All Products: $352.75
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY M	$460	$322	$124.20 – $414
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Aetna — All Products: $404.80 Aetna — Medicare Advantage: $124.20 Alignment — Medicare Advantage: $138 Anthem — Managed Medicaid: $57.78 Anthem_BCBS — All Products: $391 Anthem_Pathway — All Products_HMO: $391 Cigna_Behavioral Health — All Products: $85 Cigna_Greatwest — All Products: $414 Hometown Health — All Products (Fully Insured and Self-Funded): $331.20 Humana — Medicare Advantage: $124.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY M	$460	$322	$124.20 – $414
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates Aetna — All Products: $404.80 Aetna — Medicare Advantage: $124.20 Alignment — Medicare Advantage: $138 Anthem — Managed Medicaid: $73.92 Anthem_BCBS — All Products: $391 Anthem_Pathway — All Products_HMO: $391 Cigna_Behavioral Health — All Products: $125 Cigna_Greatwest — All Products: $414 Hometown Health — All Products (Fully Insured and Self-Funded): $372.60 Humana — Medicare Advantage: $124.20
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY M	$500	$350	$135 – $450
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates Aetna — All Products: $440 Aetna — Medicare Advantage: $135 Alignment — Medicare Advantage: $150 Anthem — Managed Medicaid: $108.15 Anthem_BCBS — All Products: $425 Anthem_Pathway — All Products_HMO: $425 Cigna_Behavioral Health — All Products: $160 Cigna_Greatwest — All Products: $450 Hometown Health — All Products (Fully Insured and Self-Funded): $360 Humana — Medicare Advantage: $135
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IOP FAMILY THERAPY W/O PT	$460	$322	$124.20 – $414
Family psychotherapy, without the patient: 10 of 15 insurance plan rates Aetna — All Products: $404.80 Aetna — Medicare Advantage: $124.20 Alignment — Medicare Advantage: $138 Anthem — Managed Medicaid: $81.42 Anthem_BCBS — All Products: $391 Anthem_Pathway — All Products_HMO: $391 Cigna_Behavioral Health — All Products: $395 Cigna_Greatwest — All Products: $414 Hometown Health — All Products (Fully Insured and Self-Funded): $372.60 Humana — Medicare Advantage: $124.20
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PHP FAMILY THERAPY W/ PATIENT	$460	$322	$124.20 – $414
Family psychotherapy, with the patient: 10 of 16 insurance plan rates Aetna — All Products: $404.80 Aetna — Medicare Advantage: $124.20 Alignment — Medicare Advantage: $138 Anthem — Managed Medicaid: $91.76 Anthem_BCBS — All Products: $391 Anthem_Pathway — All Products_HMO: $391 Cigna_Behavioral Health — All Products: $150 Cigna_Greatwest — All Products: $414 Hometown Health — All Products (Fully Insured and Self-Funded): $331.20 Humana — Medicare Advantage: $124.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IOP GROUP THERAPY-CD	$400	$280	$108 – $360
Group psychotherapy: 10 of 16 insurance plan rates Aetna — All Products: $352 Aetna — Medicare Advantage: $108 Alignment — Medicare Advantage: $120 Anthem — Managed Medicaid: $22.21 Anthem_BCBS — All Products: $340 Anthem_Pathway — All Products_HMO: $340 Cigna_Behavioral Health — All Products: $395 Cigna_Greatwest — All Products: $360 Hometown Health — All Products (Fully Insured and Self-Funded): $288 Humana — Medicare Advantage: $108

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: HCHG EXC CYST ABERRANT BREAST TISSUE OPEN 1/> LESION	$5,800	$4,060	$1,566 – $5,220
Removal of breast growth (open surgery): 10 of 15 insurance plan rates Aetna — All Products: $5,104 Aetna — Medicare Advantage: $1,566 Alignment — Medicare Advantage: $1,740 Anthem — Managed Medicaid: $967.04 Anthem_BCBS — All Products: $4,872 Anthem_Pathway — All Products_HMO: $4,872 Cigna_Greatwest — All Products: $5,220 Hometown Health — All Products (Fully Insured and Self-Funded): $4,292 Humana — Medicare Advantage: $1,566 Prominence — All Products: $4,930
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TOTAL HIP ARTHROPLASTY W OR WO GRAFT	$12,000	$8,400	$3,240 – $10,800
Total hip replacement: 10 of 15 insurance plan rates Aetna — All Products: $10,560 Aetna — Medicare Advantage: $3,240 Alignment — Medicare Advantage: $3,600 Anthem — Managed Medicaid: $1,294.96 Anthem_BCBS — All Products: $7,571.20 Anthem_Pathway — All Products_HMO: $6,292.16 Cigna_Greatwest — All Products: $10,800 Hometown Health — All Products (Fully Insured and Self-Funded): $8,880 Humana — Medicare Advantage: $3,240 Prominence — All Products: $10,200
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TOTAL KNEE ARTHROPLASTY MEDIAL AND LATERAL	$12,600	$8,820	$3,402 – $11,340
Total knee replacement: 10 of 15 insurance plan rates Aetna — All Products: $11,088 Aetna — Medicare Advantage: $3,402 Alignment — Medicare Advantage: $3,780 Anthem — Managed Medicaid: $1,294.26 Anthem_BCBS — All Products: $7,571.20 Anthem_Pathway — All Products_HMO: $6,292.16 Cigna_Greatwest — All Products: $11,340 Hometown Health — All Products (Fully Insured and Self-Funded): $9,324 Humana — Medicare Advantage: $3,402 Prominence — All Products: $10,710
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE	$4,300	$3,010	$1,161 – $3,870
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — All Products: $3,784 Aetna — Medicare Advantage: $1,161 Alignment — Medicare Advantage: $1,290 Anthem — Managed Medicaid: $168.17 Anthem_BCBS — All Products: $3,612 Anthem_Pathway — All Products_HMO: $3,612 Cigna_Greatwest — All Products: $3,870 Hometown Health — All Products (Fully Insured and Self-Funded): $3,612 Humana — Medicare Advantage: $1,161 Prominence — All Products: $3,655
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$7,100	$4,970	$1,917 – $6,390
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — All Products: $6,248 Aetna — Medicare Advantage: $1,917 Alignment — Medicare Advantage: $2,130 Anthem — Managed Medicaid: $1,058.82 Anthem_BCBS — All Products: $5,964 Anthem_Pathway — All Products_HMO: $5,964 Cigna_Greatwest — All Products: $6,390 Hometown Health — All Products (Fully Insured and Self-Funded): $5,964 Humana — Medicare Advantage: $1,917 Prominence — All Products: $6,035
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$5,100	$3,570	$1,377 – $4,590
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — All Products: $4,488 Aetna — Medicare Advantage: $1,377 Alignment — Medicare Advantage: $1,530 Anthem — Managed Medicaid: $714.65 Anthem_BCBS — All Products: $4,284 Anthem_Pathway — All Products_HMO: $4,284 Cigna_Greatwest — All Products: $4,590 Hometown Health — All Products (Fully Insured and Self-Funded): $4,284 Humana — Medicare Advantage: $1,377 Prominence — All Products: $4,335
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMACH	$2,300	$1,610	$621 – $2,070
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $2,024 Aetna — Medicare Advantage: $621 Alignment — Medicare Advantage: $690 Anthem — Managed Medicaid: $329.44 Anthem_BCBS — All Products: $1,932 Anthem_Pathway — All Products_HMO: $1,932 Cigna_Greatwest — All Products: $2,070 Hometown Health — All Products (Fully Insured and Self-Funded): $1,932 Humana — Medicare Advantage: $621 Prominence — All Products: $1,955
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMA	$2,300	$1,610	$621 – $2,070
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $2,024 Aetna — Medicare Advantage: $621 Alignment — Medicare Advantage: $690 Anthem — Managed Medicaid: $329.44 Anthem_BCBS — All Products: $1,932 Anthem_Pathway — All Products_HMO: $1,932 Cigna_Greatwest — All Products: $2,070 Hometown Health — All Products (Fully Insured and Self-Funded): $1,932 Humana — Medicare Advantage: $621 Prominence — All Products: $1,955
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC UPPER GI ENDOSCOPY, DIAGNOSTIC	$2,300	$1,610	$621 – $2,070
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Products: $2,024 Aetna — Medicare Advantage: $621 Alignment — Medicare Advantage: $690 Anthem_BCBS — All Products: $1,955 Anthem_Pathway — All Products_HMO: $1,955 Cigna_Greatwest — All Products: $2,070 Hometown Health — All Products (Fully Insured and Self-Funded): $1,863 Humana — Medicare Advantage: $621 Prominence — All Products: $1,955 Silver Summit — All Products _Ambetter: $1,863
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY WITH BIOPSY	$4,000	$2,800	$1,080 – $3,600
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Products: $3,520 Aetna — Medicare Advantage: $1,080 Alignment — Medicare Advantage: $1,200 Anthem — Managed Medicaid: $329.44 Anthem_BCBS — All Products: $3,360 Anthem_Pathway — All Products_HMO: $3,360 Cigna_Greatwest — All Products: $3,600 Hometown Health — All Products (Fully Insured and Self-Funded): $3,360 Humana — Medicare Advantage: $1,080 Prominence — All Products: $3,400
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY WITH BIOPSY	$2,000	$1,400	$540 – $1,800
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Products: $1,760 Aetna — Medicare Advantage: $540 Alignment — Medicare Advantage: $600 Anthem — Managed Medicaid: $329.44 Anthem_BCBS — All Products: $1,680 Anthem_Pathway — All Products_HMO: $1,680 Cigna_Greatwest — All Products: $1,800 Hometown Health — All Products (Fully Insured and Self-Funded): $1,680 Humana — Medicare Advantage: $540 Prominence — All Products: $1,700
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC COLONOSCOPY,FLEXIBLE,PROXIMAL TO SPLENIC FLEXURE,DIAGN	$3,000	$2,100	$810 – $2,700
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $2,640 Aetna — Medicare Advantage: $810 Alignment — Medicare Advantage: $900 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $2,520 Anthem_Pathway — All Products_HMO: $2,520 Cigna_Greatwest — All Products: $2,700 Hometown Health — All Products (Fully Insured and Self-Funded): $2,520 Humana — Medicare Advantage: $810 Prominence — All Products: $2,550
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC 2-COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE D	$3,000	$2,100	$810 – $2,700
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $2,640 Aetna — Medicare Advantage: $810 Alignment — Medicare Advantage: $900 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $2,520 Anthem_Pathway — All Products_HMO: $2,520 Cigna_Greatwest — All Products: $2,700 Hometown Health — All Products (Fully Insured and Self-Funded): $2,520 Humana — Medicare Advantage: $810 Prominence — All Products: $2,550
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: HCHG CVMC COLONOSCOPY,FLEXIBLE,PROXIMAL TO SPLENIC FLEXURE,DIAGN	$2,824	$1,976.80	$762.48 – $2,541.60
Colonoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Products: $2,485.12 Aetna — Medicare Advantage: $762.48 Alignment — Medicare Advantage: $847.20 Anthem_BCBS — All Products: $2,372.16 Anthem_Pathway — All Products_HMO: $2,372.16 Cigna_Greatwest — All Products: $2,541.60 Hometown Health — All Products (Fully Insured and Self-Funded): $2,372.16 Humana — Medicare Advantage: $762.48 Prominence — All Products: $2,400.40 Silver Summit — All Products _Ambetter: $2,287.44
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVM COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE	$2,865	$2,005.50	$773.55 – $2,578.50
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Products: $2,521.20 Aetna — Medicare Advantage: $773.55 Alignment — Medicare Advantage: $859.50 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $2,406.60 Anthem_Pathway — All Products_HMO: $2,406.60 Cigna_Greatwest — All Products: $2,578.50 Hometown Health — All Products (Fully Insured and Self-Funded): $2,406.60 Humana — Medicare Advantage: $773.55 Prominence — All Products: $2,435.25
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVM 2-COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE	$3,350	$2,345	$904.50 – $3,015
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Products: $2,948 Aetna — Medicare Advantage: $904.50 Alignment — Medicare Advantage: $1,005 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $2,814 Anthem_Pathway — All Products_HMO: $2,814 Cigna_Greatwest — All Products: $3,015 Hometown Health — All Products (Fully Insured and Self-Funded): $2,814 Humana — Medicare Advantage: $904.50 Prominence — All Products: $2,847.50
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE	$1,500	$1,050	$405 – $1,350
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Products: $1,320 Aetna — Medicare Advantage: $405 Alignment — Medicare Advantage: $450 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $1,260 Anthem_Pathway — All Products_HMO: $1,260 Cigna_Greatwest — All Products: $1,350 Hometown Health — All Products (Fully Insured and Self-Funded): $1,260 Humana — Medicare Advantage: $405 Prominence — All Products: $1,275
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC COLONOSCOPY,WITH REMOVAL OF TUMOR,POLYP,OR LESION	$2,877	$2,013.90	$776.79 – $2,589.30
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Aetna — All Products: $2,531.76 Aetna — Medicare Advantage: $776.79 Alignment — Medicare Advantage: $863.10 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $2,416.68 Anthem_Pathway — All Products_HMO: $2,416.68 Cigna_Greatwest — All Products: $2,589.30 Hometown Health — All Products (Fully Insured and Self-Funded): $2,416.68 Humana — Medicare Advantage: $776.79 Prominence — All Products: $2,445.45
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CVMC 2-COLONOSCOPY W/REMOVAL OF TUMOR,POLYP OR LESION	$1,700	$1,190	$459 – $1,530
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Aetna — All Products: $1,496 Aetna — Medicare Advantage: $459 Alignment — Medicare Advantage: $510 Anthem — Managed Medicaid: $332.71 Anthem_BCBS — All Products: $1,428 Anthem_Pathway — All Products_HMO: $1,428 Cigna_Greatwest — All Products: $1,530 Hometown Health — All Products (Fully Insured and Self-Funded): $1,428 Humana — Medicare Advantage: $459 Prominence — All Products: $1,445
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	$278.37
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans Anthem — Managed Medicaid: $278.37 Hometown Health — All Products (Fully Insured and Self-Funded): $1,589.33 Silver Summit — Managed Medicaid: $278.37
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CANCER SCN-COLONOSCOPY-NON HR	$3,000	$2,100	$810 – $2,700
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — All Products: $2,640 Aetna — Medicare Advantage: $810 Alignment — Medicare Advantage: $900 Anthem_BCBS — All Products: $2,550 Anthem_Pathway — All Products_HMO: $2,550 Cigna_Greatwest — All Products: $2,700 Hometown Health — All Products (Fully Insured and Self-Funded): $2,160 Humana — Medicare Advantage: $810 Prominence — All Products: $2,550 Silver Summit — All Products _Ambetter: $2,430
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SCREENING COLONOSCOPY, PT NOT HIGH RISK	$2,800	$1,960	$756 – $2,520
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — All Products: $2,464 Aetna — Medicare Advantage: $756 Alignment — Medicare Advantage: $840 Anthem_BCBS — All Products: $2,352 Anthem_Pathway — All Products_HMO: $2,352 Cigna_Greatwest — All Products: $2,520 Hometown Health — All Products (Fully Insured and Self-Funded): $2,352 Humana — Medicare Advantage: $756 Prominence — All Products: $2,380 Silver Summit — All Products _Ambetter: $2,268
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LAPAROSCOPY SURG CHOLECYSTECTOMY	$9,100	$6,370	$2,457 – $8,190
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Aetna — All Products: $8,008 Aetna — Medicare Advantage: $2,457 Alignment — Medicare Advantage: $2,730 Anthem — Managed Medicaid: $1,589.51 Anthem_BCBS — All Products: $7,571.20 Anthem_Pathway — All Products_HMO: $6,292.16 Cigna_Greatwest — All Products: $8,190 Hometown Health — All Products (Fully Insured and Self-Funded): $7,644 Humana — Medicare Advantage: $2,457 Prominence — All Products: $7,735
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$8,000	$5,600	$2,160 – $7,200
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Aetna — All Products: $7,040 Aetna — Medicare Advantage: $2,160 Alignment — Medicare Advantage: $2,400 Anthem — Managed Medicaid: $1,154.72 Anthem_BCBS — All Products: $6,720 Anthem_Pathway — All Products_HMO: $6,292.16 Cigna_Greatwest — All Products: $7,200 Hometown Health — All Products (Fully Insured and Self-Funded): $6,720 Humana — Medicare Advantage: $2,160 Prominence — All Products: $6,800
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$665.81
Prostate biopsy: rates for 2 insurance plans Anthem — Managed Medicaid: $665.81 Silver Summit — Managed Medicaid: $665.81
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	$1,378.71
Prostate removal by laparoscope (radical prostatectomy): rates for 3 insurance plans Anthem — Managed Medicaid: $1,378.71 Hometown Health — All Products (Fully Insured and Self-Funded): $14,118.09 Silver Summit — Managed Medicaid: $1,378.71
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HYSTEROSCOPY BX ENDOMETRIUM POLYPC W/WO D&C	$6,300	$4,410	$1,701 – $5,670
Hysteroscopy with biopsy of the uterus lining: 10 of 15 insurance plan rates Aetna — All Products: $5,544 Aetna — Medicare Advantage: $1,701 Alignment — Medicare Advantage: $1,890 Anthem — Managed Medicaid: $822.61 Anthem_BCBS — All Products: $5,292 Anthem_Pathway — All Products_HMO: $5,292 Cigna_Greatwest — All Products: $5,670 Hometown Health — All Products (Fully Insured and Self-Funded): $5,292 Humana — Medicare Advantage: $1,701 Prominence — All Products: $5,355
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ,EPI LUMB/SAC SINGLE W IG	$1,900	$1,330	$513 – $1,710
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Aetna — All Products: $1,672 Aetna — Medicare Advantage: $513 Alignment — Medicare Advantage: $570 Anthem_BCBS — All Products: $1,615 Anthem_Pathway — All Products_HMO: $1,615 Cigna_Greatwest — All Products: $1,710 Hometown Health — All Products (Fully Insured and Self-Funded): $1,539 Humana — Medicare Advantage: $513 Prominence — All Products: $1,615 Silver Summit — All Products _Ambetter: $1,539
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ,FORAMEN,L/S,1 LEVEL	$2,400	$1,680	$648 – $2,160
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates Aetna — All Products: $2,112 Aetna — Medicare Advantage: $648 Alignment — Medicare Advantage: $720 Anthem_BCBS — All Products: $2,040 Anthem_Pathway — All Products_HMO: $2,040 Cigna_Greatwest — All Products: $2,160 Hometown Health — All Products (Fully Insured and Self-Funded): $1,944 Humana — Medicare Advantage: $648 Prominence — All Products: $2,040 Silver Summit — All Products _Ambetter: $1,944
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG NEUROPLASTY & OR TRANSPOS MEDIAN NRV CARPAL TUN	$4,700	$3,290	$1,269 – $4,230
Carpal tunnel release: 10 of 15 insurance plan rates Aetna — All Products: $4,136 Aetna — Medicare Advantage: $1,269 Alignment — Medicare Advantage: $1,410 Anthem — Managed Medicaid: $615.49 Anthem_BCBS — All Products: $3,948 Anthem_Pathway — All Products_HMO: $3,948 Cigna_Greatwest — All Products: $4,230 Hometown Health — All Products (Fully Insured and Self-Funded): $3,948 Humana — Medicare Advantage: $1,269 Prominence — All Products: $3,995
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$194.64
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans Anthem — Managed Medicaid: $194.64 Hometown Health — All Products (Fully Insured and Self-Funded): $730.48 Silver Summit — Managed Medicaid: $194.64
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	$771.57
Cataract removal with lens implant: rates for 3 insurance plans Anthem — Managed Medicaid: $771.57 Hometown Health — All Products (Fully Insured and Self-Funded): $3,065.15 Silver Summit — Managed Medicaid: $771.57

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: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$2,031.86
Vaginal delivery, with care before and after: rates for 2 insurance plans Anthem — Managed Medicaid: $2,031.86 Silver Summit — Managed Medicaid: $2,031.86
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	$2,247.10
Cesarean delivery (C-section), with care before and after: rates for 2 insurance plans Anthem — Managed Medicaid: $2,247.10 Silver Summit — Managed Medicaid: $2,247.10
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	$2,130.82
Vaginal delivery after a previous C-section, with care before and after: rates for 2 insurance plans Anthem — Managed Medicaid: $2,130.82 Silver Summit — Managed Medicaid: $2,130.82

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	$108,401.25 – $131,853.17
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 7 insurance plans Anthem_BCBS — All Products: $131,853.17 Anthem_Pathway — All Products_HMO: $108,401.25 Hometown Health — All Products (Fully Insured and Self-Funded): $8,446 United Healthcare — All Products: $5,408 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Cigna_Greatwest — All Products: 90% (a percentage in the contract, not a dollar amount) Silver Summit — All Products _Ambetter: 81% (a percentage in the contract, not a dollar amount)
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 joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$21,373.76 – $25,997.83
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans Anthem_BCBS — All Products: $25,997.83 Anthem_Pathway — All Products_HMO: $21,373.76 Hometown Health — All Products (Fully Insured and Self-Funded): $6,334.50 United Healthcare — All Products: $5,408 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Cigna_Greatwest — All Products: 90% (a percentage in the contract, not a dollar amount) Silver Summit — All Products _Ambetter: 81% (a percentage in the contract, not a dollar amount)
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	$27,051.56 – $32,903.99
Neck (cervical) spinal fusion, without complications: rates for 7 insurance plans Anthem_BCBS — All Products: $32,903.99 Anthem_Pathway — All Products_HMO: $27,051.56 Hometown Health — All Products (Fully Insured and Self-Funded): $6,334.50 United Healthcare — All Products: $5,408 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Cigna_Greatwest — All Products: 90% (a percentage in the contract, not a dollar amount) Silver Summit — All Products _Ambetter: 81% (a percentage in the contract, not a dollar amount)
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	$13,747.95 – $16,722.23
Uterus and ovary surgery (not for cancer), without complications: rates for 7 insurance plans Anthem_BCBS — All Products: $16,722.23 Anthem_Pathway — All Products_HMO: $13,747.95 Hometown Health — All Products (Fully Insured and Self-Funded): $6,334.50 United Healthcare — All Products: $5,408 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Cigna_Greatwest — All Products: 90% (a percentage in the contract, not a dollar amount) Silver Summit — All Products _Ambetter: 81% (a percentage in the contract, not a dollar amount)

Source: Carson Valley Health’s standard charges file (carsonvalleyhealth.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 27, 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	1107 Highway 395, Gardnerville, NV 89410
County	Douglas County
State	Nevada
Phone	(775) 782‑1500
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
CMS Certification Number	291306
Name in Medicare records	CARSON VALLEY HEALTH
Profile level	Medicare data + hospital website
Official website	carsonvalleyhealth.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
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.

Carson Valley Health — carsonvalleyhealth.org
Emergency Care — carsonvalleyhealth.org
Visiting Hours — carsonvalleyhealth.org
Healthcare Services in Gardnerville, NV | Carson Valley Health — carsonvalleyhealth.org

Carson Valley Health

Summary

Profile from official sources

At a glance