Does CHI St Lukes Health Memorial San Augustine have an emergency room?

Yes. Medicare (CMS) data lists emergency services at CHI St Lukes Health Memorial San Augustine. In a medical emergency, call 911.

Where is CHI St Lukes Health Memorial San Augustine?

511 Hospital St, San Augustine, TX 75972, in San Augustine County, Texas.

What is the phone number of CHI St Lukes Health Memorial San Augustine?

(936) 275-3446, as listed by Medicare (CMS).

What is the Medicare star rating of CHI St Lukes Health Memorial San Augustine?

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

CHI St Lukes Health Memorial San Augustine

Quick answers

Does CHI St Lukes Health Memorial San Augustine have an emergency room?: Yes. Medicare (CMS) data lists emergency services at CHI St Lukes Health Memorial San Augustine. In a medical emergency, call 911.
Where is CHI St Lukes Health Memorial San Augustine?: 511 Hospital St, San Augustine, TX 75972, in San Augustine County, Texas.
What is the phone number of CHI St Lukes Health Memorial San Augustine?: (936) 275-3446, as listed by Medicare (CMS).
What is the Medicare star rating of CHI St Lukes Health Memorial San Augustine?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4]

Conditions treated^[4]

Stroke and TIA

Treatments^[4]

Dialysis (on-campus center operated by Sankar Nephrology)

Procedures^[4]

MRI
CT
Digital mammography

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Recognition^[4]

Critical access hospital (as described on page)

Doctors and clinicians (49)

49 doctors and other clinicians list CHI St Lukes Health Memorial San Augustine 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 25 more: the button below opens the full list.

Other emergency rooms nearby

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

Sabine County Hospital21 mi · Hemphill, TX · Critical Access Hospital
Nacogdoches Memorial Hospital33 mi · Nacogdoches, TX · Acute Care Hospital
Nacogdoches Medical Center33 mi · Nacogdoches, TX · Acute Care Hospital
Sabine Medical Center37 mi · Many, LA · Acute Care Hospital
CHI St Lukes Health Memorial Lufkin40 mi · Lufkin, TX · Acute Care Hospital

Other hospitals nearby

Oceans Behavioral Hospital of Lufkin LLC41 mi · Lufkin, TX · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Avir at San Augustine0.4 mi · San Augustine, TX · 3 of 5 stars
Stonecreek Nursing & Rehabilitation1.3 mi · San Augustine, TX · 4 of 5 stars
Colonial Pines Healthcare Center3.0 mi · San Augustine, TX · 4 of 5 stars

All nursing homes in the state →

Home health agencies

Motherwell Home Health24 mi · Nacogdoches, TX

All home health agencies in the state →

Dialysis facilities

Aqua Dialysis San Augustine2.2 mi · San Augustine, TX · 1 of 5 stars
DCI Center14 mi · Center, TX · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Medical Arts Surgery Center LLC24 mi · Nacogdoches, TX
Nacogdoches Surgery Center24 mi · Nacogdoches, TX
The Surgery Center of Nacogdoches24 mi · Nacogdoches, TX

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

HOPE Community Medicine San Augustine0.1 mi · San Augustine, TX · Community health center
HOPE Behavioral Health and Administration19 mi · Center, TX · Community health center
Hope Community Medicine Mobile Clinic19 mi · Center, TX · Community health center

Clinics and urgent care

Texas Quick Care LLC2.2 mi · San Augustine, TX · Rural health clinic
Texas Quick Care LLC14 mi · Center, TX · Rural health clinic
Texas Quick Care21 mi · Etoile, TX · Rural health clinic

Pharmacies

Brookshire Brothers Inc2.2 mi · San Augustine, TX · Community/retail pharmacy
Economy Professional Pharmacy Inc2.2 mi · San Augustine, TX · Community/retail pharmacy
Health Opportunities for the People of East Texas, Inc.2.2 mi · San Augustine, TX · Community/retail pharmacy

Assisted living nearby

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

Hillcrest Assisted Living2.2 mi · San Augustine, TX
Lakeside Village Assisted Living14 mi · Center, TX

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 CHI St Lukes Health Memorial San Augustine 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.

Not reported to Medicare

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

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

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

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

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

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

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 Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 72 common services exactly as CHI St Lukes Health Memorial San Augustine 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 →

$ 2 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT 30 MIN	$398	$59.70	$71.64 – $641.18
New patient office visit (about 30–44 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $99.50 BCBS — Medicaid\|All Plans: $376.11 BCBS-TX — Commercial\|Blue Advantage HMO: $189.05 BCBS-TX — Commercial\|Blue Premier: $165.81 BCBS-TX — Commercial\|HMO: $189.83 BCBS-TX — Commercial\|PPO: $206.10 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $365.37 Entrust — Commercial\|All Plans: $413.92 Galaxy — Commercial\|All Plans: $358.20
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: WOUND CARE E&M NEW PT LVL 3	$456.96	$68.55	$82.26 – $736.17
New patient office visit (about 30–44 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $114.24 BCBS — Medicaid\|All Plans: $431.83 BCBS-TX — Commercial\|Blue Advantage HMO: $189.05 BCBS-TX — Commercial\|Blue Premier: $165.81 BCBS-TX — Commercial\|HMO: $189.83 BCBS-TX — Commercial\|PPO: $206.10 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $419.49 Entrust — Commercial\|All Plans: $475.24 Galaxy — Commercial\|All Plans: $411.27
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: BCCCP OFFICE VISIT NEW PATIENT	$126	$18.90	$22.68 – $131.04
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates Aetna — Commercial\|All Plans: $31.50 BCBS-TX — Commercial\|Blue Advantage HMO: $126 BCBS-TX — Commercial\|Blue Premier: $126 BCBS-TX — Commercial\|HMO: $126 BCBS-TX — Commercial\|PPO: $126 Entrust — Commercial\|All Plans: $131.04 Galaxy — Commercial\|All Plans: $113.40 Humana — Commercial\|All Plans: $88.20 Multiplan — Commercial\|All Plans: $88.20 PHCS — Commercial\|All Plans: $85.68
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT 45 MIN	$628.32	$94.25	$100 – $1,012.23
New patient office visit (about 45–59 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $157.08 BCBS — Medicaid\|All Plans: $593.77 BCBS-TX — Commercial\|Blue Advantage HMO: $320.08 BCBS-TX — Commercial\|Blue Premier: $280.73 BCBS-TX — Commercial\|HMO: $321.39 BCBS-TX — Commercial\|PPO: $348.94 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $576.80 Entrust — Commercial\|All Plans: $653.46 Galaxy — Commercial\|All Plans: $565.49
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: WOUND CARE E&M NEW PT LVL 4	$682.38	$102.36	$100 – $1,099.32
New patient office visit (about 45–59 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $170.60 BCBS — Medicaid\|All Plans: $644.85 BCBS-TX — Commercial\|Blue Advantage HMO: $320.08 BCBS-TX — Commercial\|Blue Premier: $280.73 BCBS-TX — Commercial\|HMO: $321.39 BCBS-TX — Commercial\|PPO: $348.94 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $626.43 Entrust — Commercial\|All Plans: $709.68 Galaxy — Commercial\|All Plans: $614.15
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT 45 MIN	$628.32	$94.25	$157.08 – $628.32
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Aetna — Commercial\|All Plans: $157.08 Galaxy — Commercial\|All Plans: $565.49 Humana — Commercial\|All Plans: $439.83 Multiplan — Commercial\|All Plans: $439.83 PHCS — Commercial\|All Plans: $502.66 United — Commercial\|Exchange: $628.32
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HFC NEW PATIENT EVAL 1-2 HR	$1,067	$160.05	$100 – $1,718.94
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $266.75 BCBS — Medicaid\|All Plans: $1,008.32 BCBS-TX — Commercial\|Blue Advantage HMO: $417.70 BCBS-TX — Commercial\|Blue Premier: $366.35 BCBS-TX — Commercial\|HMO: $419.42 BCBS-TX — Commercial\|PPO: $455.37 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $979.51 Entrust — Commercial\|All Plans: $1,109.68 Galaxy — Commercial\|All Plans: $960.30
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HFC NEW PATIENT EVAL 2-4 HR	$1,646	$246.90	$100 – $2,651.71
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $411.50 BCBS — Medicaid\|All Plans: $1,555.47 BCBS-TX — Commercial\|Blue Advantage HMO: $417.70 BCBS-TX — Commercial\|Blue Premier: $366.35 BCBS-TX — Commercial\|HMO: $419.42 BCBS-TX — Commercial\|PPO: $455.37 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $1,511.03 Entrust — Commercial\|All Plans: $1,711.84 Galaxy — Commercial\|All Plans: $1,481.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT 60 MIN	$746.64	$112	$100 – $1,202.84
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $186.66 BCBS — Medicaid\|All Plans: $705.58 BCBS-TX — Commercial\|Blue Advantage HMO: $417.70 BCBS-TX — Commercial\|Blue Premier: $366.35 BCBS-TX — Commercial\|HMO: $419.42 BCBS-TX — Commercial\|PPO: $455.37 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $685.42 Entrust — Commercial\|All Plans: $776.51 Galaxy — Commercial\|All Plans: $671.98
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: FOLLOW UP OFFICE VISIT EST PT 15M	$418.20	$62.73	$75.28 – $673.73
Established patient office visit (about 20–29 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $104.55 BCBS — Medicaid\|All Plans: $395.20 BCBS-TX — Commercial\|Blue Advantage HMO: $126.64 BCBS-TX — Commercial\|Blue Premier: $111.07 BCBS-TX — Commercial\|HMO: $127.16 BCBS-TX — Commercial\|PPO: $138.05 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $383.91 Entrust — Commercial\|All Plans: $434.93 Galaxy — Commercial\|All Plans: $376.38
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: WOUND CARE E&M EST PT LVL 3	$445.74	$66.87	$80.24 – $718.09
Established patient office visit (about 20–29 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $111.44 BCBS — Medicaid\|All Plans: $421.23 BCBS-TX — Commercial\|Blue Advantage HMO: $126.64 BCBS-TX — Commercial\|Blue Premier: $111.07 BCBS-TX — Commercial\|HMO: $127.16 BCBS-TX — Commercial\|PPO: $138.05 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $409.19 Entrust — Commercial\|All Plans: $463.57 Galaxy — Commercial\|All Plans: $401.17
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: BCCCP OFFFICE VISIT ESTAB 15 MIN	$82	$12.30	$14.76 – $85.28
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates Aetna — Commercial\|All Plans: $20.50 BCBS-TX — Commercial\|Blue Advantage HMO: $82 BCBS-TX — Commercial\|Blue Premier: $82 BCBS-TX — Commercial\|HMO: $82 BCBS-TX — Commercial\|PPO: $82 Entrust — Commercial\|All Plans: $85.28 Galaxy — Commercial\|All Plans: $73.80 Humana — Commercial\|All Plans: $57.40 Multiplan — Commercial\|All Plans: $57.40 PHCS — Commercial\|All Plans: $55.76
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: FOLLOW UP OFFICE VISIT EST PT 25M	$491.64	$73.75	$88.50 – $792.04
Established patient office visit (about 30–39 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $122.91 BCBS — Medicaid\|All Plans: $464.60 BCBS-TX — Commercial\|Blue Advantage HMO: $195.22 BCBS-TX — Commercial\|Blue Premier: $171.22 BCBS-TX — Commercial\|HMO: $196.02 BCBS-TX — Commercial\|PPO: $212.83 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $451.33 Entrust — Commercial\|All Plans: $511.31 Galaxy — Commercial\|All Plans: $442.48
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: WOUND CARE E&M EST PT LVL 4	$555.90	$83.39	$100 – $895.56
Established patient office visit (about 30–39 minutes): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $138.98 BCBS — Medicaid\|All Plans: $525.33 BCBS-TX — Commercial\|Blue Advantage HMO: $195.22 BCBS-TX — Commercial\|Blue Premier: $171.22 BCBS-TX — Commercial\|HMO: $196.02 BCBS-TX — Commercial\|PPO: $212.83 Cigna — Commercial\|All Plans: $100 CIGNA HEALTHSPRING — Medicaid\|STARPLUS: $510.32 Entrust — Commercial\|All Plans: $578.14 Galaxy — Commercial\|All Plans: $500.31
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: FOLLOW UP OFFICE VISIT EST PT 25M	$491.64	$73.75	$122.91 – $491.64
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans Aetna — Commercial\|All Plans: $122.91 Galaxy — Commercial\|All Plans: $442.48 Humana — Commercial\|All Plans: $344.15 Multiplan — Commercial\|All Plans: $344.15 PHCS — Commercial\|All Plans: $393.32 United — Commercial\|Exchange: $491.64
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LEVEL 2 -COMPREHENSIVE EXAM	$344.04	$51.61	$61.93 – $1,638
Emergency room visit (moderate): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $86.01 AETNA — Medicare\|All Plans: $251.59 Angelina County — Commercial\|All Plans: $686.84 BCBS — Medicaid\|All Plans: $180.63 BCBS — Medicare\|All Plans: $274.81 BCBS-TX — Commercial\|Blue Advantage HMO: $539 BCBS-TX — Commercial\|Blue Premier: $344.04 BCBS-TX — Commercial\|HMO: $344.04 BCBS-TX — Commercial\|PPO: $344.04 Brookshire Brothers — Commercial\|All Plans: $754.77
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LEVEL 3-INTERMEDIATE CARE	$2,046	$306.90	$251.59 – $2,127.84
Emergency room visit (moderate): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $511.50 AETNA — Medicare\|All Plans: $251.59 Angelina County — Commercial\|All Plans: $686.84 BCBS — Medicaid\|All Plans: $1,074.15 BCBS — Medicare\|All Plans: $274.81 BCBS-TX — Commercial\|Blue Advantage HMO: $539 BCBS-TX — Commercial\|Blue Premier: $477.95 BCBS-TX — Commercial\|HMO: $547.18 BCBS-TX — Commercial\|PPO: $594.08 Brookshire Brothers — Commercial\|All Plans: $754.77
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: SA EXAMINER FEE-COMPREHENSIVE	$273	$40.95	$49.14 – $1,638
Emergency room visit (moderate): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $68.25 AETNA — Medicare\|All Plans: $251.59 Angelina County — Commercial\|All Plans: $686.84 BCBS — Medicaid\|All Plans: $143.33 BCBS — Medicare\|All Plans: $274.81 BCBS-TX — Commercial\|Blue Advantage HMO: $539 BCBS-TX — Commercial\|Blue Premier: $273 BCBS-TX — Commercial\|HMO: $273 BCBS-TX — Commercial\|PPO: $273 Brookshire Brothers — Commercial\|All Plans: $754.77
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LEVEL 4-COMPREHENSIVE CARE	$3,209	$481.35	$390.55 – $5,169.70
Emergency room visit (moderately high): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $802.25 AETNA — Medicare\|All Plans: $390.55 Angelina County — Commercial\|All Plans: $1,066.20 BCBS — Medicaid\|All Plans: $3,032.51 BCBS — Medicare\|All Plans: $422.61 BCBS-TX — Commercial\|Blue Advantage HMO: $858.37 BCBS-TX — Commercial\|Blue Premier: $752.83 BCBS-TX — Commercial\|HMO: $861.89 BCBS-TX — Commercial\|PPO: $935.76 Brookshire Brothers — Commercial\|All Plans: $1,171.65
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: LEVEL 4-COMPREHENSIVE CARE	$3,209	$481.35	$802.25 – $3,209
Emergency room visit (moderately high): rates for 6 insurance plans Aetna — Commercial\|All Plans: $802.25 Galaxy — Commercial\|All Plans: $2,888.10 Humana — Commercial\|All Plans: $2,246.30 Multiplan — Commercial\|All Plans: $2,246.30 PHCS — Commercial\|All Plans: $2,567.20 United — Commercial\|Exchange: $3,209
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LEVEL 5-INTENSIVE CARE	$4,650	$697.50	$566.38 – $7,491.15
Emergency room visit (high): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $1,162.50 AETNA — Medicare\|All Plans: $566.38 Angelina County — Commercial\|All Plans: $1,546.22 BCBS — Medicaid\|All Plans: $4,394.25 BCBS — Medicare\|All Plans: $608.49 BCBS-TX — Commercial\|Blue Advantage HMO: $1,231 BCBS-TX — Commercial\|Blue Premier: $1,079.65 BCBS-TX — Commercial\|HMO: $1,236.05 BCBS-TX — Commercial\|PPO: $1,342 Brookshire Brothers — Commercial\|All Plans: $1,699.14
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: LEVEL 5-INTENSIVE CARE	$4,650	$697.50	$1,162.50 – $4,650
Emergency room visit (high): rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,162.50 Galaxy — Commercial\|All Plans: $4,185 Humana — Commercial\|All Plans: $3,255 Multiplan — Commercial\|All Plans: $3,255 PHCS — Commercial\|All Plans: $3,720 United — Commercial\|Exchange: $4,650

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL	$568.14	$85.23	$8.46 – $511.33
Basic metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $142.04 AETNA — Medicare\|All Plans: $8.46 Angelina County — Commercial\|All Plans: $23.10 BCBS — Medicaid\|All Plans: $12.17 BCBS — Medicare\|All Plans: $8.88 BCBS-TX — Commercial\|Blue Advantage HMO: $16.07 BCBS-TX — Commercial\|Blue Premier: $27.92 BCBS-TX — Commercial\|HMO: $29.61 BCBS-TX — Commercial\|PPO: $34.18 Brookshire Brothers — Commercial\|All Plans: $25.38
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: ED CHEM 8	$569	$85.35	$8.46 – $512.10
Basic metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $142.25 AETNA — Medicare\|All Plans: $8.46 Angelina County — Commercial\|All Plans: $23.10 BCBS — Medicaid\|All Plans: $12.17 BCBS — Medicare\|All Plans: $8.88 BCBS-TX — Commercial\|Blue Advantage HMO: $16.07 BCBS-TX — Commercial\|Blue Premier: $27.92 BCBS-TX — Commercial\|HMO: $29.61 BCBS-TX — Commercial\|PPO: $34.18 Brookshire Brothers — Commercial\|All Plans: $25.38
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: EL BASIC METABOLIC (CHEM 7)	$29	$4.35	$5.22 – $35.91
Basic metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $7.25 AETNA — Medicare\|All Plans: $8.46 Angelina County — Commercial\|All Plans: $23.10 BCBS — Medicaid\|All Plans: $12.17 BCBS — Medicare\|All Plans: $8.88 BCBS-TX — Commercial\|Blue Advantage HMO: $16.07 BCBS-TX — Commercial\|Blue Premier: $27.92 BCBS-TX — Commercial\|HMO: $29 BCBS-TX — Commercial\|PPO: $29 Brookshire Brothers — Commercial\|All Plans: $25.38
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL	$1,329	$199.35	$10.56 – $1,196.10
Comprehensive metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $332.25 AETNA — Medicare\|All Plans: $10.56 Angelina County — Commercial\|All Plans: $28.83 BCBS — Medicaid\|All Plans: $15.18 BCBS — Medicare\|All Plans: $11.09 BCBS-TX — Commercial\|Blue Advantage HMO: $20.06 BCBS-TX — Commercial\|Blue Premier: $34.85 BCBS-TX — Commercial\|HMO: $36.96 BCBS-TX — Commercial\|PPO: $42.66 Brookshire Brothers — Commercial\|All Plans: $31.68
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: EL COMPREHENSIVE METABOLIC PNL (C	$40	$6	$7.20 – $46.37
Comprehensive metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $10 AETNA — Medicare\|All Plans: $10.56 Angelina County — Commercial\|All Plans: $28.83 BCBS — Medicaid\|All Plans: $15.18 BCBS — Medicare\|All Plans: $11.09 BCBS-TX — Commercial\|Blue Advantage HMO: $20.06 BCBS-TX — Commercial\|Blue Premier: $34.85 BCBS-TX — Commercial\|HMO: $36.96 BCBS-TX — Commercial\|PPO: $40 Brookshire Brothers — Commercial\|All Plans: $31.68
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: LHF CMP	$22	$3.30	$3.96 – $46.37
Comprehensive metabolic panel (blood test): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $5.50 AETNA — Medicare\|All Plans: $10.56 Angelina County — Commercial\|All Plans: $28.83 BCBS — Medicaid\|All Plans: $15.18 BCBS — Medicare\|All Plans: $11.09 BCBS-TX — Commercial\|Blue Advantage HMO: $20.06 BCBS-TX — Commercial\|Blue Premier: $22 BCBS-TX — Commercial\|HMO: $22 BCBS-TX — Commercial\|PPO: $22 Brookshire Brothers — Commercial\|All Plans: $31.68
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: CORONARY RISK	$682.38	$102.36	$7.66 – $614.15
Cholesterol panel (lipid panel): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $170.60 AETNA — Medicare\|All Plans: $13.39 Angelina County — Commercial\|All Plans: $36.55 BCBS — Medicaid\|All Plans: $19.27 BCBS — Medicare\|All Plans: $14.06 BCBS-TX — Commercial\|Blue Advantage HMO: $25.44 BCBS-TX — Commercial\|Blue Premier: $44.19 BCBS-TX — Commercial\|HMO: $46.87 BCBS-TX — Commercial\|PPO: $54.10 Brookshire Brothers — Commercial\|All Plans: $40.17
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: CORONARY RISK (HF LUF)	$15	$2.25	$2.70 – $58.34
Cholesterol panel (lipid panel): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $3.75 AETNA — Medicare\|All Plans: $13.39 Angelina County — Commercial\|All Plans: $36.55 BCBS — Medicaid\|All Plans: $19.27 BCBS — Medicare\|All Plans: $14.06 BCBS-TX — Commercial\|Blue Advantage HMO: $15 BCBS-TX — Commercial\|Blue Premier: $15 BCBS-TX — Commercial\|HMO: $15 BCBS-TX — Commercial\|PPO: $15 Brookshire Brothers — Commercial\|All Plans: $40.17
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: EL CORONARY RISK	$29	$4.35	$5.22 – $58.34
Cholesterol panel (lipid panel): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $7.25 AETNA — Medicare\|All Plans: $13.39 Angelina County — Commercial\|All Plans: $36.55 BCBS — Medicaid\|All Plans: $19.27 BCBS — Medicare\|All Plans: $14.06 BCBS-TX — Commercial\|Blue Advantage HMO: $25.44 BCBS-TX — Commercial\|Blue Premier: $29 BCBS-TX — Commercial\|HMO: $29 BCBS-TX — Commercial\|PPO: $29 Brookshire Brothers — Commercial\|All Plans: $40.17
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: EL RENAL PANEL	$35	$5.25	$6.30 – $37.38
Kidney function panel: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $8.75 AETNA — Medicare\|All Plans: $8.68 Angelina County — Commercial\|All Plans: $23.70 BCBS — Medicaid\|All Plans: $12.48 BCBS — Medicare\|All Plans: $9.11 BCBS-TX — Commercial\|Blue Advantage HMO: $16.49 BCBS-TX — Commercial\|Blue Premier: $28.64 BCBS-TX — Commercial\|HMO: $30.38 BCBS-TX — Commercial\|PPO: $35 Brookshire Brothers — Commercial\|All Plans: $26.04
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$948.75	$142.32	$8.68 – $853.88
Kidney function panel: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $237.19 AETNA — Medicare\|All Plans: $8.68 Angelina County — Commercial\|All Plans: $23.70 BCBS — Medicaid\|All Plans: $12.48 BCBS — Medicare\|All Plans: $9.11 BCBS-TX — Commercial\|Blue Advantage HMO: $16.49 BCBS-TX — Commercial\|Blue Premier: $28.64 BCBS-TX — Commercial\|HMO: $30.38 BCBS-TX — Commercial\|PPO: $35.07 Brookshire Brothers — Commercial\|All Plans: $26.04
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: EL RENAL PANEL	$35	$5.25	$8.75 – $35
Kidney function panel: rates for 6 insurance plans Aetna — Commercial\|All Plans: $8.75 Galaxy — Commercial\|All Plans: $31.50 Humana — Commercial\|All Plans: $24.50 Multiplan — Commercial\|All Plans: $24.50 PHCS — Commercial\|All Plans: $28 United — Commercial\|Exchange: $35
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: EL HEPATIC FUNCTION	$35	$5.25	$6.30 – $35.91
Liver function panel: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $8.75 AETNA — Medicare\|All Plans: $8.17 Angelina County — Commercial\|All Plans: $22.30 BCBS — Medicaid\|All Plans: $11.75 BCBS — Medicare\|All Plans: $8.58 BCBS-TX — Commercial\|Blue Advantage HMO: $15.52 BCBS-TX — Commercial\|Blue Premier: $26.96 BCBS-TX — Commercial\|HMO: $28.60 BCBS-TX — Commercial\|PPO: $33.01 Brookshire Brothers — Commercial\|All Plans: $24.51
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: LIVER FUNCTION PANEL	$768	$115.20	$8.17 – $691.20
Liver function panel: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $192 AETNA — Medicare\|All Plans: $8.17 Angelina County — Commercial\|All Plans: $22.30 BCBS — Medicaid\|All Plans: $11.75 BCBS — Medicare\|All Plans: $8.58 BCBS-TX — Commercial\|Blue Advantage HMO: $15.52 BCBS-TX — Commercial\|Blue Premier: $26.96 BCBS-TX — Commercial\|HMO: $28.60 BCBS-TX — Commercial\|PPO: $33.01 Brookshire Brothers — Commercial\|All Plans: $24.51
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: EL HEPATIC FUNCTION	$35	$5.25	$8.75 – $35
Liver function panel: rates for 6 insurance plans Aetna — Commercial\|All Plans: $8.75 Galaxy — Commercial\|All Plans: $31.50 Humana — Commercial\|All Plans: $24.50 Multiplan — Commercial\|All Plans: $24.50 PHCS — Commercial\|All Plans: $28 United — Commercial\|Exchange: $35
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: EL URINALYSIS	$17	$2.55	$2.66 – $15.30
Urine test (automated, with microscope): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $4.25 AETNA — Medicare\|All Plans: $3.17 Angelina County — Commercial\|All Plans: $8.65 BCBS — Medicaid\|All Plans: $4.56 BCBS — Medicare\|All Plans: $3.33 BCBS-TX — Commercial\|Blue Advantage HMO: $6.02 BCBS-TX — Commercial\|Blue Premier: $10.46 BCBS-TX — Commercial\|HMO: $11.10 BCBS-TX — Commercial\|PPO: $12.81 Brookshire Brothers — Commercial\|All Plans: $9.51
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS WITH MICROSCOPIC	$385	$57.75	$2.66 – $346.50
Urine test (automated, with microscope): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $96.25 AETNA — Medicare\|All Plans: $3.17 Angelina County — Commercial\|All Plans: $8.65 BCBS — Medicaid\|All Plans: $4.56 BCBS — Medicare\|All Plans: $3.33 BCBS-TX — Commercial\|Blue Advantage HMO: $6.02 BCBS-TX — Commercial\|Blue Premier: $10.46 BCBS-TX — Commercial\|HMO: $11.10 BCBS-TX — Commercial\|PPO: $12.81 Brookshire Brothers — Commercial\|All Plans: $9.51
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: EL URINALYSIS	$17	$2.55	$4.25 – $17
Urine test (automated, with microscope): rates for 6 insurance plans Aetna — Commercial\|All Plans: $4.25 Galaxy — Commercial\|All Plans: $15.30 Humana — Commercial\|All Plans: $11.90 Multiplan — Commercial\|All Plans: $11.90 PHCS — Commercial\|All Plans: $13.60 United — Commercial\|Exchange: $17
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: PH URINE	$102	$15.30	$1.89 – $91.80
Urine test (automated, without microscope): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $25.50 AETNA — Medicare\|All Plans: $2.25 Angelina County — Commercial\|All Plans: $6.14 BCBS — Medicaid\|All Plans: $3.23 BCBS — Medicare\|All Plans: $2.36 BCBS-TX — Commercial\|Blue Advantage HMO: $4.28 BCBS-TX — Commercial\|Blue Premier: $7.43 BCBS-TX — Commercial\|HMO: $7.88 BCBS-TX — Commercial\|PPO: $9.09 Brookshire Brothers — Commercial\|All Plans: $6.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: SP GRAVITY URINE	$94	$14.10	$1.89 – $84.60
Urine test (automated, without microscope): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $23.50 AETNA — Medicare\|All Plans: $2.25 Angelina County — Commercial\|All Plans: $6.14 BCBS — Medicaid\|All Plans: $3.23 BCBS — Medicare\|All Plans: $2.36 BCBS-TX — Commercial\|Blue Advantage HMO: $4.28 BCBS-TX — Commercial\|Blue Premier: $7.43 BCBS-TX — Commercial\|HMO: $7.88 BCBS-TX — Commercial\|PPO: $9.09 Brookshire Brothers — Commercial\|All Plans: $6.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: STAT LAB URINE DIPSTICK	$167.50	$25.13	$1.89 – $150.75
Urine test (automated, without microscope): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $41.88 AETNA — Medicare\|All Plans: $2.25 Angelina County — Commercial\|All Plans: $6.14 BCBS — Medicaid\|All Plans: $3.23 BCBS — Medicare\|All Plans: $2.36 BCBS-TX — Commercial\|Blue Advantage HMO: $4.28 BCBS-TX — Commercial\|Blue Premier: $7.43 BCBS-TX — Commercial\|HMO: $7.88 BCBS-TX — Commercial\|PPO: $9.09 Brookshire Brothers — Commercial\|All Plans: $6.75
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: EL PROSTATE SPECIFIC ANTIGEN	$50	$7.50	$9 – $79.25
PSA (prostate specific antigen) blood test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $12.50 AETNA — Medicare\|All Plans: $18.39 Angelina County — Commercial\|All Plans: $50.20 BCBS — Medicaid\|All Plans: $26.45 BCBS — Medicare\|All Plans: $19.31 BCBS-TX — Commercial\|Blue Advantage HMO: $34.94 BCBS-TX — Commercial\|Blue Premier: $50 BCBS-TX — Commercial\|HMO: $50 BCBS-TX — Commercial\|PPO: $50 Brookshire Brothers — Commercial\|All Plans: $55.17
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: EL PSA ULTRASENSITIVE	$58	$8.70	$10.44 – $79.25
PSA (prostate specific antigen) blood test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $14.50 AETNA — Medicare\|All Plans: $18.39 Angelina County — Commercial\|All Plans: $50.20 BCBS — Medicaid\|All Plans: $26.45 BCBS — Medicare\|All Plans: $19.31 BCBS-TX — Commercial\|Blue Advantage HMO: $34.94 BCBS-TX — Commercial\|Blue Premier: $58 BCBS-TX — Commercial\|HMO: $58 BCBS-TX — Commercial\|PPO: $58 Brookshire Brothers — Commercial\|All Plans: $55.17
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA ULTRASENSITIVE	$665	$99.75	$15.45 – $598.50
PSA (prostate specific antigen) blood test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $166.25 AETNA — Medicare\|All Plans: $18.39 Angelina County — Commercial\|All Plans: $50.20 BCBS — Medicaid\|All Plans: $26.45 BCBS — Medicare\|All Plans: $19.31 BCBS-TX — Commercial\|Blue Advantage HMO: $34.94 BCBS-TX — Commercial\|Blue Premier: $60.69 BCBS-TX — Commercial\|HMO: $64.37 BCBS-TX — Commercial\|PPO: $74.30 Brookshire Brothers — Commercial\|All Plans: $55.17
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: EL TSH (ULTRA SENSITIVE)	$35	$5.25	$6.30 – $73.29
Thyroid stimulating hormone (TSH) test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $8.75 AETNA — Medicare\|All Plans: $16.80 Angelina County — Commercial\|All Plans: $45.86 BCBS — Medicaid\|All Plans: $24.17 BCBS — Medicare\|All Plans: $17.64 BCBS-TX — Commercial\|Blue Advantage HMO: $31.92 BCBS-TX — Commercial\|Blue Premier: $35 BCBS-TX — Commercial\|HMO: $35 BCBS-TX — Commercial\|PPO: $35 Brookshire Brothers — Commercial\|All Plans: $50.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: LHF TSH	$23	$3.45	$4.14 – $73.29
Thyroid stimulating hormone (TSH) test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $5.75 AETNA — Medicare\|All Plans: $16.80 Angelina County — Commercial\|All Plans: $45.86 BCBS — Medicaid\|All Plans: $24.17 BCBS — Medicare\|All Plans: $17.64 BCBS-TX — Commercial\|Blue Advantage HMO: $23 BCBS-TX — Commercial\|Blue Premier: $23 BCBS-TX — Commercial\|HMO: $23 BCBS-TX — Commercial\|PPO: $23 Brookshire Brothers — Commercial\|All Plans: $50.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: SAHF TSH	$13	$1.95	$2.34 – $73.29
Thyroid stimulating hormone (TSH) test: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $3.25 AETNA — Medicare\|All Plans: $13 Angelina County — Commercial\|All Plans: $35.49 BCBS — Medicaid\|All Plans: $24.17 BCBS — Medicare\|All Plans: $13.65 BCBS-TX — Commercial\|Blue Advantage HMO: $13 BCBS-TX — Commercial\|Blue Premier: $13 BCBS-TX — Commercial\|HMO: $13 BCBS-TX — Commercial\|PPO: $13 Brookshire Brothers — Commercial\|All Plans: $39
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC WITH AUTO DIFF	$359.04	$53.86	$6.53 – $323.14
Complete blood count (CBC) with differential: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $89.76 AETNA — Medicare\|All Plans: $7.77 Angelina County — Commercial\|All Plans: $21.21 BCBS — Medicaid\|All Plans: $11.17 BCBS — Medicare\|All Plans: $8.16 BCBS-TX — Commercial\|Blue Advantage HMO: $14.76 BCBS-TX — Commercial\|Blue Premier: $25.64 BCBS-TX — Commercial\|HMO: $27.20 BCBS-TX — Commercial\|PPO: $31.39 Brookshire Brothers — Commercial\|All Plans: $23.31
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: EL CBC & PLATELET	$23	$3.45	$4.14 – $32.89
Complete blood count (CBC) with differential: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $5.75 AETNA — Medicare\|All Plans: $7.77 Angelina County — Commercial\|All Plans: $21.21 BCBS — Medicaid\|All Plans: $11.17 BCBS — Medicare\|All Plans: $8.16 BCBS-TX — Commercial\|Blue Advantage HMO: $14.76 BCBS-TX — Commercial\|Blue Premier: $23 BCBS-TX — Commercial\|HMO: $23 BCBS-TX — Commercial\|PPO: $23 Brookshire Brothers — Commercial\|All Plans: $23.31
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: STAT LAB CBC W AUTO DIFF	$440	$66	$6.53 – $396
Complete blood count (CBC) with differential: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $110 AETNA — Medicare\|All Plans: $7.77 Angelina County — Commercial\|All Plans: $21.21 BCBS — Medicaid\|All Plans: $11.17 BCBS — Medicare\|All Plans: $8.16 BCBS-TX — Commercial\|Blue Advantage HMO: $14.76 BCBS-TX — Commercial\|Blue Premier: $25.64 BCBS-TX — Commercial\|HMO: $27.20 BCBS-TX — Commercial\|PPO: $31.39 Brookshire Brothers — Commercial\|All Plans: $23.31
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC (HEMOGRAM ONLY)	$282.54	$42.39	$5.43 – $254.29
Complete blood count (CBC), automated: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $70.64 AETNA — Medicare\|All Plans: $6.47 Angelina County — Commercial\|All Plans: $17.66 BCBS — Medicaid\|All Plans: $9.30 BCBS — Medicare\|All Plans: $6.79 BCBS-TX — Commercial\|Blue Advantage HMO: $12.29 BCBS-TX — Commercial\|Blue Premier: $21.35 BCBS-TX — Commercial\|HMO: $22.65 BCBS-TX — Commercial\|PPO: $26.14 Brookshire Brothers — Commercial\|All Plans: $19.41
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: EL HEMOGRAM	$17	$2.55	$3.06 – $28.43
Complete blood count (CBC), automated: 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $4.25 AETNA — Medicare\|All Plans: $6.47 Angelina County — Commercial\|All Plans: $17.66 BCBS — Medicaid\|All Plans: $9.30 BCBS — Medicare\|All Plans: $6.79 BCBS-TX — Commercial\|Blue Advantage HMO: $12.29 BCBS-TX — Commercial\|Blue Premier: $17 BCBS-TX — Commercial\|HMO: $17 BCBS-TX — Commercial\|PPO: $17 Brookshire Brothers — Commercial\|All Plans: $19.41
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: CBC (HEMOGRAM ONLY)	$282.54	$42.39	$70.64 – $282.54
Complete blood count (CBC), automated: rates for 6 insurance plans Aetna — Commercial\|All Plans: $70.64 Galaxy — Commercial\|All Plans: $254.29 Humana — Commercial\|All Plans: $197.78 Multiplan — Commercial\|All Plans: $197.78 PHCS — Commercial\|All Plans: $226.04 United — Commercial\|Exchange: $282.54
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ED PROTIME INR	$248	$37.20	$3.60 – $223.20
Blood clotting time test (prothrombin time, PT): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $62 AETNA — Medicare\|All Plans: $4.29 Angelina County — Commercial\|All Plans: $11.71 BCBS — Medicaid\|All Plans: $6.17 BCBS — Medicare\|All Plans: $4.50 BCBS-TX — Commercial\|Blue Advantage HMO: $8.15 BCBS-TX — Commercial\|Blue Premier: $14.16 BCBS-TX — Commercial\|HMO: $15.02 BCBS-TX — Commercial\|PPO: $17.33 Brookshire Brothers — Commercial\|All Plans: $12.87
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: EL PT PROTIME	$23	$3.45	$3.60 – $20.70
Blood clotting time test (prothrombin time, PT): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $5.75 AETNA — Medicare\|All Plans: $4.29 Angelina County — Commercial\|All Plans: $11.71 BCBS — Medicaid\|All Plans: $6.17 BCBS — Medicare\|All Plans: $4.50 BCBS-TX — Commercial\|Blue Advantage HMO: $8.15 BCBS-TX — Commercial\|Blue Premier: $14.16 BCBS-TX — Commercial\|HMO: $15.02 BCBS-TX — Commercial\|PPO: $17.33 Brookshire Brothers — Commercial\|All Plans: $12.87
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME PT INR	$247.86	$37.18	$3.60 – $223.08
Blood clotting time test (prothrombin time, PT): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $61.97 AETNA — Medicare\|All Plans: $4.29 Angelina County — Commercial\|All Plans: $11.71 BCBS — Medicaid\|All Plans: $6.17 BCBS — Medicare\|All Plans: $4.50 BCBS-TX — Commercial\|Blue Advantage HMO: $8.15 BCBS-TX — Commercial\|Blue Premier: $14.16 BCBS-TX — Commercial\|HMO: $15.02 BCBS-TX — Commercial\|PPO: $17.33 Brookshire Brothers — Commercial\|All Plans: $12.87
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: EL PTT	$23	$3.45	$4.14 – $25.41
Blood clotting test (partial thromboplastin time, PTT): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $5.75 AETNA — Medicare\|All Plans: $6.01 Angelina County — Commercial\|All Plans: $16.41 BCBS — Medicaid\|All Plans: $8.64 BCBS — Medicare\|All Plans: $6.31 BCBS-TX — Commercial\|Blue Advantage HMO: $11.42 BCBS-TX — Commercial\|Blue Premier: $19.83 BCBS-TX — Commercial\|HMO: $21.04 BCBS-TX — Commercial\|PPO: $23 Brookshire Brothers — Commercial\|All Plans: $18.03
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT PARTIAL THROMBOPLASTIN TM	$365	$54.75	$5.05 – $328.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 39 insurance plan rates Aetna — Commercial\|All Plans: $91.25 AETNA — Medicare\|All Plans: $6.01 Angelina County — Commercial\|All Plans: $16.41 BCBS — Medicaid\|All Plans: $8.64 BCBS — Medicare\|All Plans: $6.31 BCBS-TX — Commercial\|Blue Advantage HMO: $11.42 BCBS-TX — Commercial\|Blue Premier: $19.83 BCBS-TX — Commercial\|HMO: $21.04 BCBS-TX — Commercial\|PPO: $24.28 Brookshire Brothers — Commercial\|All Plans: $18.03
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: EL PTT	$23	$3.45	$5.75 – $23
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans Aetna — Commercial\|All Plans: $5.75 Galaxy — Commercial\|All Plans: $20.70 Humana — Commercial\|All Plans: $16.10 Multiplan — Commercial\|All Plans: $16.10 PHCS — Commercial\|All Plans: $18.40 United — Commercial\|Exchange: $23

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) In the file: CT BRAIN (CODE TPA) W/O CON	$5,436	$815.40	$96.94 – $5,653.44
CT scan of the head or brain, without contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $1,359 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $128.89 BCBS-TX — Commercial\|Blue Premier: $353.05 BCBS-TX — Commercial\|HMO: $370.98 BCBS-TX — Commercial\|PPO: $447.20 Brookshire Brothers — Commercial\|All Plans: $290.82
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: CT BRAIN (CODE TPA) W/O CON	$5,436	$815.40	$1,359 – $5,436
CT scan of the head or brain, without contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,359 Galaxy — Commercial\|All Plans: $4,892.40 Humana — Commercial\|All Plans: $3,805.20 Multiplan — Commercial\|All Plans: $3,805.20 PHCS — Commercial\|All Plans: $4,348.80 United — Commercial\|Exchange: $5,436
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN WO/W CONT	$14,515	$2,177.25	$339.11 – $15,095.60
MRI of the brain, before and after contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $3,628.75 AETNA — Medicare\|All Plans: $339.11 Angelina County — Commercial\|All Plans: $925.77 BCBS — Medicaid\|All Plans: $484.77 BCBS — Medicare\|All Plans: $354.45 BCBS-TX — Commercial\|Blue Advantage HMO: $439.13 BCBS-TX — Commercial\|Blue Premier: $1,202.83 BCBS-TX — Commercial\|HMO: $1,263.92 BCBS-TX — Commercial\|PPO: $1,523.58 Brookshire Brothers — Commercial\|All Plans: $1,017.33
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: MRI BRAIN WO/W CONT	$14,515	$2,177.25	$3,628.75 – $14,515
MRI of the brain, before and after contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $3,628.75 Galaxy — Commercial\|All Plans: $13,063.50 Humana — Commercial\|All Plans: $10,160.50 Multiplan — Commercial\|All Plans: $10,160.50 PHCS — Commercial\|All Plans: $11,612 United — Commercial\|Exchange: $14,515
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST PA /LATERAL 2 VIEWS	$1,333	$199.95	$80.13 – $1,386.32
Chest X-ray, 2 views: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $333.25 AETNA — Medicare\|All Plans: $80.13 Angelina County — Commercial\|All Plans: $218.75 BCBS — Medicaid\|All Plans: $114.54 BCBS — Medicare\|All Plans: $87.39 BCBS-TX — Commercial\|Blue Advantage HMO: $150.04 BCBS-TX — Commercial\|Blue Premier: $206.71 BCBS-TX — Commercial\|HMO: $214.69 BCBS-TX — Commercial\|PPO: $238.63 Brookshire Brothers — Commercial\|All Plans: $240.39
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: XR CHEST PA /LATERAL 2 VIEWS	$1,333	$199.95	$333.25 – $1,333
Chest X-ray, 2 views: rates for 6 insurance plans Aetna — Commercial\|All Plans: $333.25 Galaxy — Commercial\|All Plans: $1,199.70 Humana — Commercial\|All Plans: $933.10 Multiplan — Commercial\|All Plans: $933.10 PHCS — Commercial\|All Plans: $1,066.40 United — Commercial\|Exchange: $1,333
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-S SPINE MIN 4 V	$3,433	$514.95	$96.94 – $3,570.32
X-ray of the lower spine, at least 4 views: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $858.25 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $210.71 BCBS-TX — Commercial\|Blue Premier: $290.29 BCBS-TX — Commercial\|HMO: $301.50 BCBS-TX — Commercial\|PPO: $335.12 Brookshire Brothers — Commercial\|All Plans: $290.82
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: XR L-S SPINE MIN 4 V	$3,433	$514.95	$858.25 – $3,433
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans Aetna — Commercial\|All Plans: $858.25 Galaxy — Commercial\|All Plans: $3,089.70 Humana — Commercial\|All Plans: $2,403.10 Multiplan — Commercial\|All Plans: $2,403.10 PHCS — Commercial\|All Plans: $2,746.40 United — Commercial\|Exchange: $3,433
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LSPINE W/O CONTRAST	$7,847.88	$1,177.19	$216.07 – $8,161.80
MRI of the lower back (lumbar spine), without contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $1,961.97 AETNA — Medicare\|All Plans: $216.07 Angelina County — Commercial\|All Plans: $589.87 BCBS — Medicaid\|All Plans: $308.88 BCBS — Medicare\|All Plans: $239.90 BCBS-TX — Commercial\|Blue Advantage HMO: $268 BCBS-TX — Commercial\|Blue Premier: $734.08 BCBS-TX — Commercial\|HMO: $771.36 BCBS-TX — Commercial\|PPO: $929.83 Brookshire Brothers — Commercial\|All Plans: $648.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: MRI LSPINE W/O CONTRAST	$7,847.88	$1,177.19	$1,961.97 – $7,847.88
MRI of the lower back (lumbar spine), without contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,961.97 Galaxy — Commercial\|All Plans: $7,063.10 Humana — Commercial\|All Plans: $5,493.52 Multiplan — Commercial\|All Plans: $5,493.52 PHCS — Commercial\|All Plans: $6,278.31 United — Commercial\|Exchange: $7,847.88
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$9,882	$1,482.30	$162.01 – $10,277.28
CT scan of the pelvis, with contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $2,470.50 AETNA — Medicare\|All Plans: $162.01 Angelina County — Commercial\|All Plans: $442.29 BCBS — Medicaid\|All Plans: $231.61 BCBS — Medicare\|All Plans: $176.68 BCBS-TX — Commercial\|Blue Advantage HMO: $209.55 BCBS-TX — Commercial\|Blue Premier: $573.99 BCBS-TX — Commercial\|HMO: $603.15 BCBS-TX — Commercial\|PPO: $727.06 Brookshire Brothers — Commercial\|All Plans: $486.03
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: CT PELVIS W/CONTRAST	$9,882	$1,482.30	$2,470.50 – $9,882
CT scan of the pelvis, with contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $2,470.50 Galaxy — Commercial\|All Plans: $8,893.80 Humana — Commercial\|All Plans: $6,917.40 Multiplan — Commercial\|All Plans: $6,917.40 PHCS — Commercial\|All Plans: $7,905.60 United — Commercial\|Exchange: $9,882
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI KNEE WO CONTRAST	$10,712	$1,606.80	$216.07 – $11,140.48
MRI of a leg joint (such as the knee), without contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $2,678 AETNA — Medicare\|All Plans: $216.07 Angelina County — Commercial\|All Plans: $589.87 BCBS — Medicaid\|All Plans: $308.88 BCBS — Medicare\|All Plans: $239.90 BCBS-TX — Commercial\|Blue Advantage HMO: $268 BCBS-TX — Commercial\|Blue Premier: $734.08 BCBS-TX — Commercial\|HMO: $771.36 BCBS-TX — Commercial\|PPO: $929.83 Brookshire Brothers — Commercial\|All Plans: $648.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: MRI KNEE WO CONTRAST	$10,712	$1,606.80	$2,678 – $10,712
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $2,678 Galaxy — Commercial\|All Plans: $9,640.80 Humana — Commercial\|All Plans: $7,498.40 Multiplan — Commercial\|All Plans: $7,498.40 PHCS — Commercial\|All Plans: $8,569.60 United — Commercial\|Exchange: $10,712
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN/PELVIS W/CONTRAST	$13,616	$2,042.40	$339.11 – $14,160.64
CT scan of the abdomen and pelvis, with contrast: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $3,404 AETNA — Medicare\|All Plans: $339.11 Angelina County — Commercial\|All Plans: $925.77 BCBS — Medicaid\|All Plans: $484.77 BCBS — Medicare\|All Plans: $354.45 BCBS-TX — Commercial\|Blue Advantage HMO: $439.13 BCBS-TX — Commercial\|Blue Premier: $1,202.83 BCBS-TX — Commercial\|HMO: $1,263.92 BCBS-TX — Commercial\|PPO: $1,523.58 Brookshire Brothers — Commercial\|All Plans: $1,017.33
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: CT ABDOMEN/PELVIS W/CONTRAST	$13,616	$2,042.40	$3,404 – $13,616
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $3,404 Galaxy — Commercial\|All Plans: $12,254.40 Humana — Commercial\|All Plans: $9,531.20 Multiplan — Commercial\|All Plans: $9,531.20 PHCS — Commercial\|All Plans: $10,892.80 United — Commercial\|Exchange: $13,616
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$3,470	$520.50	$96.94 – $3,608.80
Ultrasound of the abdomen, complete: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $867.50 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $210.71 BCBS-TX — Commercial\|Blue Premier: $290.29 BCBS-TX — Commercial\|HMO: $301.50 BCBS-TX — Commercial\|PPO: $335.12 Brookshire Brothers — Commercial\|All Plans: $290.82
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: US ABDOMEN COMPLETE	$3,470	$520.50	$867.50 – $3,470
Ultrasound of the abdomen, complete: rates for 6 insurance plans Aetna — Commercial\|All Plans: $867.50 Galaxy — Commercial\|All Plans: $3,123 Humana — Commercial\|All Plans: $2,429 Multiplan — Commercial\|All Plans: $2,429 PHCS — Commercial\|All Plans: $2,776 United — Commercial\|Exchange: $3,470
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB COMP > 14 WKS (TA)	$3,745	$561.75	$96.94 – $3,894.80
Pregnancy ultrasound (after the first trimester): 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $936.25 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $172.10 BCBS-TX — Commercial\|Blue Premier: $237.09 BCBS-TX — Commercial\|HMO: $246.24 BCBS-TX — Commercial\|PPO: $273.70 Brookshire Brothers — Commercial\|All Plans: $290.82
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: US OB COMP > 14 WKS (TA)	$3,745	$561.75	$936.25 – $3,745
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans Aetna — Commercial\|All Plans: $936.25 Galaxy — Commercial\|All Plans: $3,370.50 Humana — Commercial\|All Plans: $2,621.50 Multiplan — Commercial\|All Plans: $2,621.50 PHCS — Commercial\|All Plans: $2,996 United — Commercial\|Exchange: $3,745
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US INTRAVAGINAL PELV	$2,078	$311.70	$96.94 – $2,161.12
Transvaginal ultrasound: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $519.50 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $166 BCBS-TX — Commercial\|Blue Premier: $228.70 BCBS-TX — Commercial\|HMO: $237.53 BCBS-TX — Commercial\|PPO: $264.02 Brookshire Brothers — Commercial\|All Plans: $290.82
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US INTRAVAGINAL PELVIS NON-OB	$2,036	$305.40	$96.94 – $2,117.44
Transvaginal ultrasound: 10 of 37 insurance plan rates Aetna — Commercial\|All Plans: $509 AETNA — Medicare\|All Plans: $96.94 Angelina County — Commercial\|All Plans: $264.65 BCBS — Medicaid\|All Plans: $138.59 BCBS — Medicare\|All Plans: $105.54 BCBS-TX — Commercial\|Blue Advantage HMO: $166 BCBS-TX — Commercial\|Blue Premier: $228.70 BCBS-TX — Commercial\|HMO: $237.53 BCBS-TX — Commercial\|PPO: $264.02 Brookshire Brothers — Commercial\|All Plans: $290.82
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: US INTRAVAGINAL PELV	$2,078	$311.70	$519.50 – $2,078
Transvaginal ultrasound: rates for 6 insurance plans Aetna — Commercial\|All Plans: $519.50 Galaxy — Commercial\|All Plans: $1,870.20 Humana — Commercial\|All Plans: $1,454.60 Multiplan — Commercial\|All Plans: $1,454.60 PHCS — Commercial\|All Plans: $1,662.40 United — Commercial\|Exchange: $2,078
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MM MAMMO DIAG DIR DIGITAL-UNIL	$669	$100.35	$120.42 – $695.76
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $167.25 BCBS-TX — Commercial\|Blue Advantage HMO: $176.83 BCBS-TX — Commercial\|Blue Premier: $243.62 BCBS-TX — Commercial\|HMO: $253.02 BCBS-TX — Commercial\|PPO: $281.24 Cigna — Commercial\|All Plans: $391.65 Entrust — Commercial\|All Plans: $695.76 Galaxy — Commercial\|All Plans: $602.10 Humana — Commercial\|All Plans: $468.30 Multiplan — Commercial\|All Plans: $468.30
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: ZZ BCCCP MAMMO DIAG DIR DIG-UNI	$669	$100.35	$120.42 – $695.76
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $167.25 BCBS-TX — Commercial\|Blue Advantage HMO: $176.83 BCBS-TX — Commercial\|Blue Premier: $243.62 BCBS-TX — Commercial\|HMO: $253.02 BCBS-TX — Commercial\|PPO: $281.24 Cigna — Commercial\|All Plans: $391.65 Entrust — Commercial\|All Plans: $695.76 Galaxy — Commercial\|All Plans: $602.10 Humana — Commercial\|All Plans: $468.30 Multiplan — Commercial\|All Plans: $468.30
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: MM MAMMO DIAG DIR DIGITAL-UNIL	$669	$100.35	$167.25 – $669
Diagnostic mammogram, one breast: rates for 6 insurance plans Aetna — Commercial\|All Plans: $167.25 Galaxy — Commercial\|All Plans: $602.10 Humana — Commercial\|All Plans: $468.30 Multiplan — Commercial\|All Plans: $468.30 PHCS — Commercial\|All Plans: $535.20 United — Commercial\|Exchange: $669
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MM MAMMO SCRN DIAG DIR DIGITAL-BILAT	$1,014	$152.10	$182.52 – $1,054.56
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $253.50 BCBS-TX — Commercial\|Blue Advantage HMO: $226.30 BCBS-TX — Commercial\|Blue Premier: $311.76 BCBS-TX — Commercial\|HMO: $323.80 BCBS-TX — Commercial\|PPO: $359.91 Cigna — Commercial\|All Plans: $499.34 Entrust — Commercial\|All Plans: $1,054.56 Galaxy — Commercial\|All Plans: $912.60 Humana — Commercial\|All Plans: $709.80 Multiplan — Commercial\|All Plans: $709.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: ZZ BCCCP MAMMO DIAG DIR DIG-BIL	$1,014	$152.10	$182.52 – $1,054.56
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $253.50 BCBS-TX — Commercial\|Blue Advantage HMO: $226.30 BCBS-TX — Commercial\|Blue Premier: $311.76 BCBS-TX — Commercial\|HMO: $323.80 BCBS-TX — Commercial\|PPO: $359.91 Cigna — Commercial\|All Plans: $499.34 Entrust — Commercial\|All Plans: $1,054.56 Galaxy — Commercial\|All Plans: $912.60 Humana — Commercial\|All Plans: $709.80 Multiplan — Commercial\|All Plans: $709.80
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: MM MAMMO SCRN DIAG DIR DIGITAL-BILAT	$1,014	$152.10	$253.50 – $1,014
Diagnostic mammogram, both breasts: rates for 6 insurance plans Aetna — Commercial\|All Plans: $253.50 Galaxy — Commercial\|All Plans: $912.60 Humana — Commercial\|All Plans: $709.80 Multiplan — Commercial\|All Plans: $709.80 PHCS — Commercial\|All Plans: $811.20 United — Commercial\|Exchange: $1,014
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MM MAMMO SCRN DIR DIGITAL	$789	$118.35	$142.02 – $820.56
Screening mammogram, both breasts: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $197.25 BCBS-TX — Commercial\|Blue Advantage HMO: $187 BCBS-TX — Commercial\|Blue Premier: $257.63 BCBS-TX — Commercial\|HMO: $267.57 BCBS-TX — Commercial\|PPO: $297.42 Cigna — Commercial\|All Plans: $412.61 Entrust — Commercial\|All Plans: $820.56 Galaxy — Commercial\|All Plans: $710.10 Humana — Commercial\|All Plans: $552.30 Multiplan — Commercial\|All Plans: $552.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: ZZ BCCCP MAMMO SCREEN DIR DIGITAL	$789	$118.35	$142.02 – $820.56
Screening mammogram, both breasts: 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $197.25 BCBS-TX — Commercial\|Blue Advantage HMO: $187 BCBS-TX — Commercial\|Blue Premier: $257.63 BCBS-TX — Commercial\|HMO: $267.57 BCBS-TX — Commercial\|PPO: $297.42 Cigna — Commercial\|All Plans: $412.61 Entrust — Commercial\|All Plans: $820.56 Galaxy — Commercial\|All Plans: $710.10 Humana — Commercial\|All Plans: $552.30 Multiplan — Commercial\|All Plans: $552.30
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: MM MAMMO SCRN DIR DIGITAL	$789	$118.35	$197.25 – $789
Screening mammogram, both breasts: rates for 6 insurance plans Aetna — Commercial\|All Plans: $197.25 Galaxy — Commercial\|All Plans: $710.10 Humana — Commercial\|All Plans: $552.30 Multiplan — Commercial\|All Plans: $552.30 PHCS — Commercial\|All Plans: $631.20 United — Commercial\|Exchange: $789

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: LHC W/LV ONLY	$40,417	$6,062.55	$100 – $65,111.79
Left heart catheterization (diagnostic): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $10,104.25 AETNA — Medicare\|All Plans: $2,873.37 Angelina County — Commercial\|All Plans: $7,844.30 BCBS — Medicare\|All Plans: $3,192.23 BCBS-TX — Commercial\|Blue Advantage HMO: $3,220.44 BCBS-TX — Commercial\|Blue Premier: $8,293.35 BCBS-TX — Commercial\|HMO: $9,148.34 BCBS-TX — Commercial\|PPO: $10,373.82 Brookshire Brothers — Commercial\|All Plans: $8,620.11 Cigna — Commercial\|All Plans: $100
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: LHC W/LV ONLY	$40,417	$6,062.55	$10,104.25 – $40,417
Left heart catheterization (diagnostic): rates for 6 insurance plans Aetna — Commercial\|All Plans: $10,104.25 Galaxy — Commercial\|All Plans: $36,375.30 Humana — Commercial\|All Plans: $28,291.90 Multiplan — Commercial\|All Plans: $28,291.90 PHCS — Commercial\|All Plans: $32,333.60 United — Commercial\|Exchange: $40,417
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: COMP WP EVAL WO INDUCT ARRHYTHMIA	$17,036	$2,555.40	$100 – $27,445
Heart rhythm study (electrophysiology evaluation): 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $4,259 AETNA — Medicare\|All Plans: $6,585.36 Angelina County — Commercial\|All Plans: $17,978.03 BCBS — Medicare\|All Plans: $7,531.04 BCBS-TX — Commercial\|Blue Advantage HMO: $14,361.13 BCBS-TX — Commercial\|Blue Premier: $12,595.42 BCBS-TX — Commercial\|HMO: $14,419.99 BCBS-TX — Commercial\|PPO: $15,655.99 Brookshire Brothers — Commercial\|All Plans: $19,756.08 Cigna — Commercial\|All Plans: $100
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: COMP WP EVAL WO INDUCT ARRHYTHMIA	$17,036	$2,555.40	$4,259 – $17,036
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans Aetna — Commercial\|All Plans: $4,259 Galaxy — Commercial\|All Plans: $15,332.40 Humana — Commercial\|All Plans: $11,925.20 Multiplan — Commercial\|All Plans: $11,925.20 PHCS — Commercial\|All Plans: $13,628.80 United — Commercial\|Exchange: $17,036
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: EP & ABLATE AGENIC TX AFIB PV	$52,723	$7,908.45	$100 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $84,936.76
Heart rhythm study with ablation for atrial fibrillation: 10 of 27 insurance plan rates Aetna — Commercial\|All Plans: $13,180.75 AETNA — Medicare\|All Plans: $20,942.86 Angelina County — Commercial\|All Plans: $57,174.01 BCBS — Medicare\|All Plans: $24,347.84 BCBS-TX — Commercial\|Blue Advantage HMO: $13,487.28 BCBS-TX — Commercial\|Blue Premier: $30,039.85 BCBS-TX — Commercial\|HMO: $30,652.91 BCBS-TX — Commercial\|PPO: $33,718.20 Brookshire Brothers — Commercial\|All Plans: $62,828.58 Cigna — Commercial\|All Plans: $100 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) In the file: EP & ABLATE AGENIC TX AFIB PV	$52,723	$7,908.45	$13,180.75 – $52,723
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans Aetna — Commercial\|All Plans: $13,180.75 Galaxy — Commercial\|All Plans: $47,450.70 Humana — Commercial\|All Plans: $36,906.10 Multiplan — Commercial\|All Plans: $36,906.10 PHCS — Commercial\|All Plans: $42,178.40 United — Commercial\|Exchange: $52,723
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: 8 HOUR SLEEP STUDY WO CPAP	$7,483.34	$1,122.51	$100 – $7,782.68
Sleep study (overnight, in a sleep lab): 10 of 25 insurance plan rates Aetna — Commercial\|All Plans: $1,870.84 AETNA — Medicare\|All Plans: $921.94 Angelina County — Commercial\|All Plans: $2,516.90 BCBS — Medicare\|All Plans: $1,009.74 BCBS-TX — Commercial\|Blue Advantage HMO: $1,222.29 BCBS-TX — Commercial\|Blue Premier: $1,072.01 BCBS-TX — Commercial\|HMO: $1,227.30 BCBS-TX — Commercial\|PPO: $1,332.50 Brookshire Brothers — Commercial\|All Plans: $2,765.82 Cigna — Commercial\|All Plans: $100
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: 8 HOUR SLEEP STUDY WO CPAP	$7,483.34	$1,122.51	$1,870.84 – $7,483.34
Sleep study (overnight, in a sleep lab): rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,870.84 Galaxy — Commercial\|All Plans: $6,735.01 Humana — Commercial\|All Plans: $5,238.34 Multiplan — Commercial\|All Plans: $5,238.34 PHCS — Commercial\|All Plans: $5,986.68 United — Commercial\|Exchange: $7,483.34

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) In the file: ACUTE THERAPEUTIC EXERCISES 15M	$286	$42.90	$51.48 – $297.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $71.50 BCBS-TX — Commercial\|Blue Advantage HMO: $76.49 BCBS-TX — Commercial\|Blue Premier: $67.09 BCBS-TX — Commercial\|HMO: $76.81 BCBS-TX — Commercial\|PPO: $83.39 Cigna — Commercial\|All Plans: $100 Entrust — Commercial\|All Plans: $297.44 Galaxy — Commercial\|All Plans: $257.40 Humana — Commercial\|All Plans: $200.20 Multiplan — Commercial\|All Plans: $200.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: WMRC THERAPEUTIC EXER 15 MIN	$286	$42.90	$51.48 – $297.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $71.50 BCBS-TX — Commercial\|Blue Advantage HMO: $76.49 BCBS-TX — Commercial\|Blue Premier: $67.09 BCBS-TX — Commercial\|HMO: $76.81 BCBS-TX — Commercial\|PPO: $83.39 Cigna — Commercial\|All Plans: $100 Entrust — Commercial\|All Plans: $297.44 Galaxy — Commercial\|All Plans: $257.40 Humana — Commercial\|All Plans: $200.20 Multiplan — Commercial\|All Plans: $200.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) In the file: ACUTE THERAPEUTIC EXERCISES 15M	$286	$42.90	$71.50 – $286
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Aetna — Commercial\|All Plans: $71.50 Galaxy — Commercial\|All Plans: $257.40 Humana — Commercial\|All Plans: $200.20 Multiplan — Commercial\|All Plans: $200.20 PHCS — Commercial\|All Plans: $228.80 United — Commercial\|Exchange: $286
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: OP PT INITIAL EVAL LOW COMPLEXITY	$669	$100.35	$100 – $695.76
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $167.25 BCBS-TX — Commercial\|Blue Advantage HMO: $211.04 BCBS-TX — Commercial\|Blue Premier: $185.09 BCBS-TX — Commercial\|HMO: $211.90 BCBS-TX — Commercial\|PPO: $230.06 Cigna — Commercial\|All Plans: $100 Entrust — Commercial\|All Plans: $695.76 Galaxy — Commercial\|All Plans: $602.10 Humana — Commercial\|All Plans: $468.30 Multiplan — Commercial\|All Plans: $468.30
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) In the file: OP PT INITIAL EVAL LOW COMPLEXITY	$669	$100.35	$167.25 – $669
Physical therapy evaluation (low complexity): rates for 6 insurance plans Aetna — Commercial\|All Plans: $167.25 Galaxy — Commercial\|All Plans: $602.10 Humana — Commercial\|All Plans: $468.30 Multiplan — Commercial\|All Plans: $468.30 PHCS — Commercial\|All Plans: $535.20 United — Commercial\|Exchange: $669
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: OP PT EVAL MODERATE COMPLEXITY	$892	$133.80	$100 – $927.68
Physical therapy evaluation (moderate complexity): 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $223 BCBS-TX — Commercial\|Blue Advantage HMO: $211.04 BCBS-TX — Commercial\|Blue Premier: $185.09 BCBS-TX — Commercial\|HMO: $211.90 BCBS-TX — Commercial\|PPO: $230.06 Cigna — Commercial\|All Plans: $100 Entrust — Commercial\|All Plans: $927.68 Galaxy — Commercial\|All Plans: $802.80 Humana — Commercial\|All Plans: $624.40 Multiplan — Commercial\|All Plans: $624.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) In the file: OP PT EVAL MODERATE COMPLEXITY	$892	$133.80	$223 – $892
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Aetna — Commercial\|All Plans: $223 Galaxy — Commercial\|All Plans: $802.80 Humana — Commercial\|All Plans: $624.40 Multiplan — Commercial\|All Plans: $624.40 PHCS — Commercial\|All Plans: $713.60 United — Commercial\|Exchange: $892
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: OP PT EVAL HIGH COMPLEXITY	$1,115	$167.25	$100 – $1,159.60
Physical therapy evaluation (high complexity): 10 of 13 insurance plan rates Aetna — Commercial\|All Plans: $278.75 BCBS-TX — Commercial\|Blue Advantage HMO: $211.04 BCBS-TX — Commercial\|Blue Premier: $185.09 BCBS-TX — Commercial\|HMO: $211.90 BCBS-TX — Commercial\|PPO: $230.06 Cigna — Commercial\|All Plans: $100 Entrust — Commercial\|All Plans: $1,159.60 Galaxy — Commercial\|All Plans: $1,003.50 Humana — Commercial\|All Plans: $780.50 Multiplan — Commercial\|All Plans: $780.50
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: OP PT EVAL HIGH COMPLEXITY	$1,115	$167.25	$278.75 – $1,115
Physical therapy evaluation (high complexity): rates for 6 insurance plans Aetna — Commercial\|All Plans: $278.75 Galaxy — Commercial\|All Plans: $1,003.50 Humana — Commercial\|All Plans: $780.50 Multiplan — Commercial\|All Plans: $780.50 PHCS — Commercial\|All Plans: $892 United — Commercial\|Exchange: $1,115

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$963.66 – $10,083.45
Removal of breast growth (open surgery): 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $3,361.15 Angelina County — Commercial\|All Plans: $9,175.94 BCBS — Medicaid\|All Plans: $1,011.84 BCBS — Medicare\|All Plans: $3,800.49 BCBS-TX — Commercial\|Blue Advantage HMO: $1,999.50 BCBS-TX — Commercial\|Blue Premier: $4,453.44 BCBS-TX — Commercial\|HMO: $4,544.33 BCBS-TX — Commercial\|PPO: $4,998.76 Brookshire Brothers — Commercial\|All Plans: $10,083.45 Cigna — Commercial\|All Plans: $3,623
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$3,326 – $34,816.05
Total hip replacement: 10 of 23 insurance plan rates AETNA — Medicare\|All Plans: $11,605.35 Angelina County — Commercial\|All Plans: $31,682.61 BCBS — Medicare\|All Plans: $12,770.08 BCBS-TX — Commercial\|Blue Advantage HMO: $7,854.47 BCBS-TX — Commercial\|Blue Premier: $17,494.04 BCBS-TX — Commercial\|HMO: $17,851.07 BCBS-TX — Commercial\|PPO: $19,636.17 Brookshire Brothers — Commercial\|All Plans: $34,816.05 Cigna — Commercial\|All Plans: $3,326 CIGNA HEALTHSPRING — Medicare\|All Other Plans: $12,185.62
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$3,326 – $34,816.05
Total knee replacement: 10 of 23 insurance plan rates AETNA — Medicare\|All Plans: $11,605.35 Angelina County — Commercial\|All Plans: $31,682.61 BCBS — Medicare\|All Plans: $12,770.08 BCBS-TX — Commercial\|Blue Advantage HMO: $7,854.47 BCBS-TX — Commercial\|Blue Premier: $17,494.04 BCBS-TX — Commercial\|HMO: $17,851.07 BCBS-TX — Commercial\|PPO: $19,636.17 Brookshire Brothers — Commercial\|All Plans: $34,816.05 Cigna — Commercial\|All Plans: $3,326 CIGNA HEALTHSPRING — Medicare\|All Other Plans: $12,185.62
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$3,623
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans Cigna — Commercial\|All Plans: $3,623 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Entrust — Commercial\|All Plans: 104% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 68% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$1,088.27 – $8,562.63
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $2,854.21 Angelina County — Commercial\|All Plans: $7,791.99 BCBS — Medicaid\|All Plans: $1,142.68 BCBS — Medicare\|All Plans: $3,220.21 BCBS-TX — Commercial\|Blue Advantage HMO: $1,806.72 BCBS-TX — Commercial\|Blue Premier: $4,024.05 BCBS-TX — Commercial\|HMO: $4,106.18 BCBS-TX — Commercial\|PPO: $4,516.79 Brookshire Brothers — Commercial\|All Plans: $8,562.63 Cigna — Commercial\|All Plans: $3,623
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$1,954.22 – $15,491.73
Removal of tonsils and adenoids (under age 12): 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $5,163.91 Angelina County — Commercial\|All Plans: $14,097.47 BCBS — Medicaid\|All Plans: $2,051.93 BCBS — Medicare\|All Plans: $5,871.18 BCBS-TX — Commercial\|Blue Advantage HMO: $3,201.35 BCBS-TX — Commercial\|Blue Premier: $7,130.28 BCBS-TX — Commercial\|HMO: $7,275.80 BCBS-TX — Commercial\|PPO: $8,003.37 Brookshire Brothers — Commercial\|All Plans: $15,491.73 Cigna — Commercial\|All Plans: $3,623
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH	$4,224	$633.60	$334.95 – $4,392.96
Upper GI endoscopy (diagnostic): 10 of 38 insurance plan rates Aetna — Commercial\|All Plans: $1,056 AETNA — Medicare\|All Plans: $799.33 Angelina County — Commercial\|All Plans: $2,182.17 BCBS — Medicaid\|All Plans: $351.70 BCBS — Medicare\|All Plans: $930.51 BCBS-TX — Commercial\|Blue Advantage HMO: $518.71 BCBS-TX — Commercial\|Blue Premier: $1,155.30 BCBS-TX — Commercial\|HMO: $1,178.88 BCBS-TX — Commercial\|PPO: $1,296.77 Brookshire Brothers — Commercial\|All Plans: $2,397.99
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: EGD DIAGNOSTIC BRUSH WASH	$4,224	$633.60	$1,056 – $4,224
Upper GI endoscopy (diagnostic): rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,056 Galaxy — Commercial\|All Plans: $3,801.60 Humana — Commercial\|All Plans: $2,956.80 Multiplan — Commercial\|All Plans: $2,956.80 PHCS — Commercial\|All Plans: $3,379.20 United — Commercial\|Exchange: $4,224
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$334.95 – $2,957
Upper GI endoscopy with biopsy: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $799.33 Angelina County — Commercial\|All Plans: $2,182.17 BCBS — Medicaid\|All Plans: $351.70 BCBS — Medicare\|All Plans: $930.51 BCBS-TX — Commercial\|Blue Advantage HMO: $518.71 BCBS-TX — Commercial\|Blue Premier: $1,155.30 BCBS-TX — Commercial\|HMO: $1,178.88 BCBS-TX — Commercial\|PPO: $1,296.77 Brookshire Brothers — Commercial\|All Plans: $2,397.99 Cigna — Commercial\|All Plans: $2,957
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$328.50 – $2,957
Colonoscopy (diagnostic): 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $805.92 Angelina County — Commercial\|All Plans: $2,200.16 BCBS — Medicaid\|All Plans: $344.93 BCBS — Medicare\|All Plans: $904.86 BCBS-TX — Commercial\|Blue Advantage HMO: $504.16 BCBS-TX — Commercial\|Blue Premier: $1,122.90 BCBS-TX — Commercial\|HMO: $1,145.82 BCBS-TX — Commercial\|PPO: $1,260.40 Brookshire Brothers — Commercial\|All Plans: $2,417.76 Cigna — Commercial\|All Plans: $2,957
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$429.26 – $3,121.71
Colonoscopy with biopsy: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $1,040.57 Angelina County — Commercial\|All Plans: $2,840.76 BCBS — Medicaid\|All Plans: $450.72 BCBS — Medicare\|All Plans: $1,170.21 BCBS-TX — Commercial\|Blue Advantage HMO: $662.79 BCBS-TX — Commercial\|Blue Premier: $1,476.20 BCBS-TX — Commercial\|HMO: $1,506.33 BCBS-TX — Commercial\|PPO: $1,656.96 Brookshire Brothers — Commercial\|All Plans: $3,121.71 Cigna — Commercial\|All Plans: $2,957
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$429.26 – $3,121.71
Colonoscopy with removal of polyps (snare): 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $1,040.57 Angelina County — Commercial\|All Plans: $2,840.76 BCBS — Medicaid\|All Plans: $450.72 BCBS — Medicare\|All Plans: $1,170.21 BCBS-TX — Commercial\|Blue Advantage HMO: $662.79 BCBS-TX — Commercial\|Blue Premier: $1,476.20 BCBS-TX — Commercial\|HMO: $1,506.33 BCBS-TX — Commercial\|PPO: $1,656.96 Brookshire Brothers — Commercial\|All Plans: $3,121.71 Cigna — Commercial\|All Plans: $2,957
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$429.26 – $3,121.71
Ultrasound of the lower bowel by endoscope: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $1,040.57 Angelina County — Commercial\|All Plans: $2,840.76 BCBS — Medicaid\|All Plans: $450.72 BCBS — Medicare\|All Plans: $1,170.21 BCBS-TX — Commercial\|Blue Advantage HMO: $662.79 BCBS-TX — Commercial\|Blue Premier: $1,476.20 BCBS-TX — Commercial\|HMO: $1,506.33 BCBS-TX — Commercial\|PPO: $1,656.96 Brookshire Brothers — Commercial\|All Plans: $3,121.71 Cigna — Commercial\|All Plans: $2,957
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$1,888.85 – $15,263.73
Gallbladder removal by laparoscope: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $5,087.91 Angelina County — Commercial\|All Plans: $13,889.99 BCBS — Medicaid\|All Plans: $1,983.29 BCBS — Medicare\|All Plans: $5,790.49 BCBS-TX — Commercial\|Blue Advantage HMO: $3,190.25 BCBS-TX — Commercial\|Blue Premier: $7,105.55 BCBS-TX — Commercial\|HMO: $7,250.57 BCBS-TX — Commercial\|PPO: $7,975.62 Brookshire Brothers — Commercial\|All Plans: $15,263.73 Cigna — Commercial\|All Plans: $8,720
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$1,151.54 – $9,152.10
Groin (inguinal) hernia repair, age 5 or older: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $3,050.70 Angelina County — Commercial\|All Plans: $8,328.41 BCBS — Medicaid\|All Plans: $1,209.12 BCBS — Medicare\|All Plans: $3,502.53 BCBS-TX — Commercial\|Blue Advantage HMO: $2,052.16 BCBS-TX — Commercial\|Blue Premier: $4,570.73 BCBS-TX — Commercial\|HMO: $4,664.01 BCBS-TX — Commercial\|PPO: $5,130.41 Brookshire Brothers — Commercial\|All Plans: $9,152.10 Cigna — Commercial\|All Plans: $3,623
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: US NEEDLE BX PROSTAT	$6,206	$930.90	$652.80 – $6,454.24
Prostate biopsy: 10 of 38 insurance plan rates Aetna — Commercial\|All Plans: $1,551.50 AETNA — Medicare\|All Plans: $1,796.04 Angelina County — Commercial\|All Plans: $4,903.19 BCBS — Medicaid\|All Plans: $685.44 BCBS — Medicare\|All Plans: $2,033.10 BCBS-TX — Commercial\|Blue Advantage HMO: $1,169.22 BCBS-TX — Commercial\|Blue Premier: $2,604.18 BCBS-TX — Commercial\|HMO: $2,657.33 BCBS-TX — Commercial\|PPO: $2,923.06 Brookshire Brothers — Commercial\|All Plans: $5,388.12
Prostate biopsy CPT 55700 · Inpatient (hospital stay) In the file: US NEEDLE BX PROSTAT	$6,206	$930.90	$1,551.50 – $6,206
Prostate biopsy: rates for 6 insurance plans Aetna — Commercial\|All Plans: $1,551.50 Galaxy — Commercial\|All Plans: $5,585.40 Humana — Commercial\|All Plans: $4,344.20 Multiplan — Commercial\|All Plans: $4,344.20 PHCS — Commercial\|All Plans: $4,964.80 United — Commercial\|Exchange: $6,206
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$3,326 – $27,230.67
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates AETNA — Medicare\|All Plans: $9,076.89 Angelina County — Commercial\|All Plans: $24,779.91 BCBS — Medicare\|All Plans: $10,332.93 BCBS-TX — Commercial\|Blue Advantage HMO: $5,552.65 BCBS-TX — Commercial\|Blue Premier: $12,367.27 BCBS-TX — Commercial\|HMO: $12,619.67 BCBS-TX — Commercial\|PPO: $13,881.63 Brookshire Brothers — Commercial\|All Plans: $27,230.67 Cigna — Commercial\|All Plans: $3,326 CIGNA HEALTHSPRING — Medicare\|All Other Plans: $9,530.73
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$1,063.52 – $8,270.37
Hysteroscopy with biopsy of the uterus lining: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $2,756.79 Angelina County — Commercial\|All Plans: $7,526.04 BCBS — Medicaid\|All Plans: $1,116.70 BCBS — Medicare\|All Plans: $3,155.63 BCBS-TX — Commercial\|Blue Advantage HMO: $1,648.75 BCBS-TX — Commercial\|Blue Premier: $3,672.21 BCBS-TX — Commercial\|HMO: $3,747.15 BCBS-TX — Commercial\|PPO: $4,121.87 Brookshire Brothers — Commercial\|All Plans: $8,270.37 Cigna — Commercial\|All Plans: $3,623
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: INJECT SPINE LUMBAR/SACRAL	$2,915	$437.25	$262.86 – $3,031.60
Spinal injection, lower back (epidural), with imaging guidance: 10 of 38 insurance plan rates Aetna — Commercial\|All Plans: $728.75 AETNA — Medicare\|All Plans: $609.80 Angelina County — Commercial\|All Plans: $1,664.75 BCBS — Medicaid\|All Plans: $276 BCBS — Medicare\|All Plans: $687.31 BCBS-TX — Commercial\|Blue Advantage HMO: $412.53 BCBS-TX — Commercial\|Blue Premier: $918.82 BCBS-TX — Commercial\|HMO: $937.58 BCBS-TX — Commercial\|PPO: $1,031.33 Brookshire Brothers — Commercial\|All Plans: $1,829.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: SP ESI LUMBAR/SACRAL	$2,981	$447.15	$262.86 – $3,100.24
Spinal injection, lower back (epidural), with imaging guidance: 10 of 38 insurance plan rates Aetna — Commercial\|All Plans: $745.25 AETNA — Medicare\|All Plans: $609.80 Angelina County — Commercial\|All Plans: $1,664.75 BCBS — Medicaid\|All Plans: $276 BCBS — Medicare\|All Plans: $687.31 BCBS-TX — Commercial\|Blue Advantage HMO: $412.53 BCBS-TX — Commercial\|Blue Premier: $918.82 BCBS-TX — Commercial\|HMO: $937.58 BCBS-TX — Commercial\|PPO: $1,031.33 Brookshire Brothers — Commercial\|All Plans: $1,829.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: INJECT SPINE LUMBAR/SACRAL	$2,915	$437.25	$728.75 – $2,915
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans Aetna — Commercial\|All Plans: $728.75 Galaxy — Commercial\|All Plans: $2,623.50 Humana — Commercial\|All Plans: $2,040.50 Multiplan — Commercial\|All Plans: $2,040.50 PHCS — Commercial\|All Plans: $2,332 United — Commercial\|Exchange: $2,915
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: SP LUMB NERVE RT BLOCK W/FLURO SNGLE	$2,773	$415.95	$340.77 – $2,883.92
Nerve root injection, lower back, with imaging guidance: 10 of 38 insurance plan rates Aetna — Commercial\|All Plans: $693.25 AETNA — Medicare\|All Plans: $803.73 Angelina County — Commercial\|All Plans: $2,194.18 BCBS — Medicaid\|All Plans: $357.81 BCBS — Medicare\|All Plans: $883.60 BCBS-TX — Commercial\|Blue Advantage HMO: $535.95 BCBS-TX — Commercial\|Blue Premier: $1,193.71 BCBS-TX — Commercial\|HMO: $1,218.08 BCBS-TX — Commercial\|PPO: $1,339.88 Brookshire Brothers — Commercial\|All Plans: $2,411.19
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: SP LUMB NERVE RT BLOCK W/FLURO SNGLE	$2,773	$415.95	$693.25 – $2,773
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans Aetna — Commercial\|All Plans: $693.25 Galaxy — Commercial\|All Plans: $2,495.70 Humana — Commercial\|All Plans: $1,941.10 Multiplan — Commercial\|All Plans: $1,941.10 PHCS — Commercial\|All Plans: $2,218.40 United — Commercial\|Exchange: $2,773
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$659.94 – $5,107.62
Carpal tunnel release: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $1,702.54 Angelina County — Commercial\|All Plans: $4,647.93 BCBS — Medicaid\|All Plans: $692.94 BCBS — Medicare\|All Plans: $1,938.09 BCBS-TX — Commercial\|Blue Advantage HMO: $1,134.77 BCBS-TX — Commercial\|Blue Premier: $2,527.44 BCBS-TX — Commercial\|HMO: $2,579.03 BCBS-TX — Commercial\|PPO: $2,836.93 Brookshire Brothers — Commercial\|All Plans: $5,107.62 Cigna — Commercial\|All Plans: $2,957
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$208.33 – $2,957
Laser treatment of clouding after cataract surgery: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $512.56 Angelina County — Commercial\|All Plans: $1,399.29 BCBS — Medicaid\|All Plans: $218.75 BCBS — Medicare\|All Plans: $544.48 BCBS-TX — Commercial\|Blue Advantage HMO: $334.57 BCBS-TX — Commercial\|Blue Premier: $745.19 BCBS-TX — Commercial\|HMO: $760.40 BCBS-TX — Commercial\|PPO: $836.43 Brookshire Brothers — Commercial\|All Plans: $1,537.68 Cigna — Commercial\|All Plans: $2,957
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$849.94 – $8,247
Cataract removal with lens implant: 10 of 36 insurance plan rates AETNA — Medicare\|All Plans: $2,054.89 Angelina County — Commercial\|All Plans: $5,609.85 BCBS — Medicaid\|All Plans: $892.44 BCBS — Medicare\|All Plans: $2,263.58 BCBS-TX — Commercial\|Blue Advantage HMO: $1,334.43 BCBS-TX — Commercial\|Blue Premier: $2,972.13 BCBS-TX — Commercial\|HMO: $3,032.79 BCBS-TX — Commercial\|PPO: $3,336.07 Brookshire Brothers — Commercial\|All Plans: $6,164.67 Cigna — Commercial\|All Plans: $8,247

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) In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$1,437.37 – $3,593.44
Vaginal delivery, with care before and after: rates for 10 insurance plans BCBS-TX — Commercial\|Blue Advantage HMO: $1,437.37 BCBS-TX — Commercial\|Blue Premier: $3,201.42 BCBS-TX — Commercial\|HMO: $3,266.76 BCBS-TX — Commercial\|PPO: $3,593.44 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Entrust — Commercial\|All Plans: 104% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 68% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$1,593.65 – $3,984.12
Cesarean delivery (C-section), with care before and after: rates for 10 insurance plans BCBS-TX — Commercial\|Blue Advantage HMO: $1,593.65 BCBS-TX — Commercial\|Blue Premier: $3,549.49 BCBS-TX — Commercial\|HMO: $3,621.93 BCBS-TX — Commercial\|PPO: $3,984.12 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Entrust — Commercial\|All Plans: 104% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 68% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$1,508.26 – $3,770.65
Vaginal delivery after a previous C-section, with care before and after: rates for 10 insurance plans BCBS-TX — Commercial\|Blue Advantage HMO: $1,508.26 BCBS-TX — Commercial\|Blue Premier: $3,359.30 BCBS-TX — Commercial\|HMO: $3,427.86 BCBS-TX — Commercial\|PPO: $3,770.65 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Entrust — Commercial\|All Plans: 104% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 68% (a percentage in the contract, not a dollar amount)

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) 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	$65,627 – $108,478
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 8 insurance plans Cigna — Commercial\|All Plans: $108,478 United — Commercial\|All Other Plans: $65,627 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 80% (a percentage in the contract, not a dollar amount) United — Commercial\|Exchange: 100% (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) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$12,821 – $21,193
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans Cigna — Commercial\|All Plans: $21,193 United — Commercial\|All Other Plans: $12,821 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 80% (a percentage in the contract, not a dollar amount) United — Commercial\|Exchange: 100% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$16,098 – $26,610
Neck (cervical) spinal fusion, without complications: rates for 8 insurance plans Cigna — Commercial\|All Plans: $26,610 United — Commercial\|All Other Plans: $16,098 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 80% (a percentage in the contract, not a dollar amount) United — Commercial\|Exchange: 100% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$8,151 – $13,473
Uterus and ovary surgery (not for cancer), without complications: rates for 8 insurance plans Cigna — Commercial\|All Plans: $13,473 United — Commercial\|All Other Plans: $8,151 Aetna — Commercial\|All Plans: 25% (a percentage in the contract, not a dollar amount) Galaxy — Commercial\|All Plans: 90% (a percentage in the contract, not a dollar amount) Humana — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) Multiplan — Commercial\|All Plans: 70% (a percentage in the contract, not a dollar amount) PHCS — Commercial\|All Plans: 80% (a percentage in the contract, not a dollar amount) United — Commercial\|Exchange: 100% (a percentage in the contract, not a dollar amount)

Source: CHI St Lukes Health Memorial San Augustine’s standard charges file (commonspirit.org, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on February 28, 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	Rural Emergency Hospital
Address	511 Hospital St, San Augustine, TX 75972
County	San Augustine County
State	Texas
Phone	(936) 275‑3446
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	670783
Name in Medicare records	CHI ST LUKES HEALTH MEMORIAL SAN AUGUSTINE
Profile level	Medicare data + hospital website
Name on the hospital’s website	CommonSpirit - St. Luke's Hospital - San Augustine
Official website	commonspirit.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

CommonSpirit - St. Luke's Hospital - San Augustine — commonspirit.org