Does Clay County Hospital have an emergency room?

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

Where is Clay County Hospital?

911 Stacy Burk Dr, Flora, IL 62839, in Clay County, Illinois.

What is the phone number of Clay County Hospital?

(618) 662-2131, as listed by Medicare (CMS).

What is the Medicare star rating of Clay County Hospital?

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

Clay County Hospital — Phone, Address, ER & Ratings

Quick answers

Does Clay County Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Clay County Hospital. In a medical emergency, call 911.
Where is Clay County Hospital?: 911 Stacy Burk Dr, Flora, IL 62839, in Clay County, Illinois.
What is the phone number of Clay County Hospital?: (618) 662-2131, as listed by Medicare (CMS).
What is the Medicare star rating of Clay County Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas^[5][7]

Behavioral Health
Cardiopulmonary
Pediatrics
Rehabilitation
Surgery
Occupational Health
Emergency
Diagnostic Imaging
Laboratory
Pharmacy

Treatments^[5][9]

Outpatient infusion
Prediabetes and diabetes education
Blood and blood product transfusion
Therapeutic phlebotomy
Intravenous hydration
Intravenous therapy (antibiotics, antibodies, specialty medications)
Wound care
PICC line maintenance and declotting
Port a cath maintenance
Intramuscular and subcutaneous injections
Bladder scan
Drain removal
Chemotherapy pump removal

Procedures^[9]

PICC line insertion coordination

Programs and centers^[5][7][9]

Swing Bed Program
Senior Renewal
Outpatient Infusion Clinic
Prediabetes and diabetes education
Telemedicine with Cardinal Glennon for pediatric emergencies

Emergency care (hospital website)^[5][6][7]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Visiting is encouraged between 7 a.m. and 9 p.m^[6]
Parking	Parking in lots at the main entrance and the ER entrance^[6]
Patient portal	SSM MyChart Portal

Recognition^[8]

The Joint Commission accreditation

Doctors and clinicians (138)

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

Main specialties

And 114 more: the button below opens the full list.

Other emergency rooms nearby

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

Fairfield Memorial Hospital 121 mi · Fairfield, IL · Critical Access Hospital
Carle Richland Memorial Hospital22 mi · Olney, IL · Critical Access Hospital
Salem Township Hospital26 mi · Salem, IL · Critical Access Hospital
St Anthonys Memorial Hospital31 mi · Effingham, IL · Acute Care Hospital
Deaconess Illinois Crossroads36 mi · Mount Vernon, IL · Acute Care Hospital

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

Other hospitals near Flora

SSM Health St Mary's Hospital -Centralia36 mi · Centralia, IL · Acute Care Hospital

Hospitals in Clay County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Axiom Gardens of Flora0.4 mi · Flora, IL · 1 of 5 stars
Axiom Healthcare of Flora0.9 mi · Flora, IL · 4 of 5 stars
Cisne Rehabilitation and Health Care Center11 mi · Cisne, IL · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Clay County Health Department1.8 mi · Flora, IL

All hospice providers in the state →

Home health agencies

Clay Home Health Services1.8 mi · Flora, IL · 2.5 of 5 stars
SSM Health at Home Health-Illinois20 mi · Mount Vernon, IL · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Wayne County Dialysis23 mi · Fairfield, IL · 2 of 5 stars

All dialysis facilities 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

Clay Medical Center1.0 mi · Flora, IL · Community health center
Fairfield Community Health Center21 mi · Fairfield, IL · Community health center
SIHF Healthcare - Olney22 mi · Olney, IL · Community health center

Clinics and urgent care

CCH Medical Clinic1.8 mi · Flora, IL · Rural health clinic
Springfield Clinic Flora Rural Health1.8 mi · Flora, IL · Rural health clinic
Clay City Medical Clinic7.1 mi · Clay City, IL · Rural health clinic

Pharmacies

Clay County Hospital1.8 mi · Flora, IL · Pharmacy
County of Clay1.8 mi · Flora, IL · Community/retail pharmacy
Walmart Inc.1.8 mi · Flora, IL · Community/retail pharmacy

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Rated the hospital 9 or 10 out of 10	87%National average: 72%
Would definitely recommend the hospital	75%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	90%National average: 80%
“Always” got help as soon as they wanted	82%National average: 64%
Staff “always” explained medicines before giving them	73%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	82%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	70Response rate: 40%

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

Complications and deaths

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

Deaths within 30 days: heart failure patients	11.9%
Deaths within 30 days: pneumonia patients	16.9%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to report	Deaths within 30 days: heart attack patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.1%
Readmitted within 30 days: pneumonia	16.3%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart failure; Readmitted within 30 days: COPD

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	93 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Too few cases to report	Sepsis patients who got all the recommended early care (SEP-1)

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

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Illinois Best hospitals in Illinois

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Clay County Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 82 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 3	$254	$254	$68.58 – $241.30
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $200.66 Aetna — Medicare Advantage: $68.58 Aetna Better Health — Dual Medicare/Medicaid MMAI: $68.58 Ambetter — All Ambetter ACA Exchange Plans: $68.58 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $180.09 Blue Cross Blue Shield of Illinois — PPO: $186.44 Cigna — All Commercial/HMO/PPO: $203.20 HealthLink — HMO/Open Access/POS: $165.10 HealthLink — PPO: $203.20 Medica(WellFirst) — All Commercial/HMO/PPO: $157.48
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 3	$254	$254	$157.48 – $241.30
New patient office visit (about 30–44 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $203.20 HealthLink — HMO/Open Access/POS: $165.10 HealthLink — PPO: $203.20 Medica(WellFirst) — All Commercial/HMO/PPO: $157.48 UnitedHealthcare — HMO/PPO: $203.20 USA MCO — Commercial PPO: $241.30
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	Not listed in the file	Not listed in the file	$73.38 – $116.84
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $73.38 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $116.84 Blue Cross Blue Shield of Illinois — PPO: $116.84 UnitedHealthcare — HMO/PPO: $101.67
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 4	$390	$390	$105.30 – $370.50
New patient office visit (about 45–59 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $308.10 Aetna — Medicare Advantage: $105.30 Aetna Better Health — Dual Medicare/Medicaid MMAI: $105.30 Ambetter — All Ambetter ACA Exchange Plans: $105.30 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $276.51 Blue Cross Blue Shield of Illinois — PPO: $286.26 Cigna — All Commercial/HMO/PPO: $312 HealthLink — HMO/Open Access/POS: $253.50 HealthLink — PPO: $312 Medica(WellFirst) — All Commercial/HMO/PPO: $241.80
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 4	$390	$390	$241.80 – $370.50
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $312 HealthLink — HMO/Open Access/POS: $253.50 HealthLink — PPO: $312 Medica(WellFirst) — All Commercial/HMO/PPO: $241.80 UnitedHealthcare — HMO/PPO: $312 USA MCO — Commercial PPO: $370.50
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$119.50 – $175.72
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $119.50 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $175.72 Blue Cross Blue Shield of Illinois — PPO: $175.72 UnitedHealthcare — HMO/PPO: $144.97
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 5	$495	$495	$133.65 – $470.25
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $391.05 Aetna — Medicare Advantage: $133.65 Aetna Better Health — Dual Medicare/Medicaid MMAI: $133.65 Ambetter — All Ambetter ACA Exchange Plans: $133.65 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $350.96 Blue Cross Blue Shield of Illinois — PPO: $363.33 Cigna — All Commercial/HMO/PPO: $396 HealthLink — HMO/Open Access/POS: $321.75 HealthLink — PPO: $396 Medica(WellFirst) — All Commercial/HMO/PPO: $306.90
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 5	$495	$495	$306.90 – $470.25
New patient office visit (about 60–74 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $396 HealthLink — HMO/Open Access/POS: $321.75 HealthLink — PPO: $396 Medica(WellFirst) — All Commercial/HMO/PPO: $306.90 UnitedHealthcare — HMO/PPO: $396 USA MCO — Commercial PPO: $470.25
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	Not listed in the file	Not listed in the file	$164.36 – $232.67
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $164.36 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $232.67 Blue Cross Blue Shield of Illinois — PPO: $232.67 UnitedHealthcare — HMO/PPO: $185.25
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 3	$157	$157	$42.39 – $149.15
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $124.03 Aetna — Medicare Advantage: $42.39 Aetna Better Health — Dual Medicare/Medicaid MMAI: $42.39 Ambetter — All Ambetter ACA Exchange Plans: $42.39 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $111.31 Blue Cross Blue Shield of Illinois — PPO: $115.24 Cigna — All Commercial/HMO/PPO: $125.60 HealthLink — HMO/Open Access/POS: $102.05 HealthLink — PPO: $125.60 Medica(WellFirst) — All Commercial/HMO/PPO: $97.34
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 3	$157	$157	$97.34 – $149.15
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $125.60 HealthLink — HMO/Open Access/POS: $102.05 HealthLink — PPO: $125.60 Medica(WellFirst) — All Commercial/HMO/PPO: $97.34 UnitedHealthcare — HMO/PPO: $125.60 USA MCO — Commercial PPO: $149.15
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$55.69 – $94.81
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $58.18 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $94.81 Blue Cross Blue Shield of Illinois — PPO: $94.81 UnitedHealthcare — HMO/PPO: $55.69
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 4	$243	$243	$65.61 – $230.85
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $191.97 Aetna — Medicare Advantage: $65.61 Aetna Better Health — Dual Medicare/Medicaid MMAI: $65.61 Ambetter — All Ambetter ACA Exchange Plans: $65.61 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $172.29 Blue Cross Blue Shield of Illinois — PPO: $178.36 Cigna — All Commercial/HMO/PPO: $194.40 HealthLink — HMO/Open Access/POS: $157.95 HealthLink — PPO: $194.40 Medica(WellFirst) — All Commercial/HMO/PPO: $150.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 4	$243	$243	$150.66 – $230.85
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $194.40 HealthLink — HMO/Open Access/POS: $157.95 HealthLink — PPO: $194.40 Medica(WellFirst) — All Commercial/HMO/PPO: $150.66 UnitedHealthcare — HMO/PPO: $194.40 USA MCO — Commercial PPO: $230.85
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN	Not listed in the file	Not listed in the file	$85.77 – $133.87
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $85.77 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $133.87 Blue Cross Blue Shield of Illinois — PPO: $133.87 UnitedHealthcare — HMO/PPO: $87.04
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OUTPATIENT CONSULT LOW	$383	$383	$51.30 – $363.85
Office consultation with a specialist (moderate): 10 of 13 insurance plan rates Aetna — All Commercial/HMO/PPO: $109.48 Aetna Better Health — HealthChoice/Illinois Medicaid: $51.30 Ambetter — All Ambetter ACA Exchange Plans: $114.90 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $51.30 Cigna — All Commercial/HMO/PPO: $306.40 HealthLink — HMO/Open Access/POS: $248.95 HealthLink — PPO: $306.40 Medica(WellFirst) — All Commercial/HMO/PPO: $229.80 Medica(WellFirst) — Medicare Advantage: $229.80 Meridian — HealthChoice/Medicaid/Youthcare: $51.30
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$182.39
Office consultation with a specialist (moderate to high): rates for 1 insurance plan UnitedHealthcare — HMO/PPO: $182.39
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 18-39	$277	$277	$74.79 – $263.15
Preventive checkup, new patient, age 18–39: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $218.83 Aetna — Medicare Advantage: $74.79 Aetna Better Health — Dual Medicare/Medicaid MMAI: $74.79 Ambetter — All Ambetter ACA Exchange Plans: $74.79 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $196.39 Blue Cross Blue Shield of Illinois — PPO: $203.32 Cigna — All Commercial/HMO/PPO: $221.60 HealthLink — HMO/Open Access/POS: $180.05 HealthLink — PPO: $221.60 Medica(WellFirst) — All Commercial/HMO/PPO: $171.74
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 18-39	$277	$277	$171.74 – $263.15
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $221.60 HealthLink — HMO/Open Access/POS: $180.05 HealthLink — PPO: $221.60 Medica(WellFirst) — All Commercial/HMO/PPO: $171.74 UnitedHealthcare — HMO/PPO: $221.60 USA MCO — Commercial PPO: $263.15
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$126.04 – $185.06
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $185.06 Blue Cross Blue Shield of Illinois — PPO: $185.06 UnitedHealthcare — HMO/PPO: $126.04
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 40-64	$286	$286	$77.22 – $271.70
Preventive checkup, new patient, age 40–64: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $225.94 Aetna — Medicare Advantage: $77.22 Aetna Better Health — Dual Medicare/Medicaid MMAI: $77.22 Ambetter — All Ambetter ACA Exchange Plans: $77.22 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $202.77 Blue Cross Blue Shield of Illinois — PPO: $209.92 Cigna — All Commercial/HMO/PPO: $228.80 HealthLink — HMO/Open Access/POS: $185.90 HealthLink — PPO: $228.80 Medica(WellFirst) — All Commercial/HMO/PPO: $177.32
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 40-64	$286	$286	$177.32 – $271.70
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $228.80 HealthLink — HMO/Open Access/POS: $185.90 HealthLink — PPO: $228.80 Medica(WellFirst) — All Commercial/HMO/PPO: $177.32 UnitedHealthcare — HMO/PPO: $228.80 USA MCO — Commercial PPO: $271.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$148.33 – $213.58
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $213.58 Blue Cross Blue Shield of Illinois — PPO: $213.58 UnitedHealthcare — HMO/PPO: $148.33
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL III	$852	$852	$230.04 – $809.40
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $673.08 Aetna — Medicare Advantage: $230.04 Aetna Better Health — Dual Medicare/Medicaid MMAI: $230.04 Ambetter — All Ambetter ACA Exchange Plans: $230.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $604.07 Blue Cross Blue Shield of Illinois — PPO: $625.37 Cigna — All Commercial/HMO/PPO: $681.60 HealthLink — HMO/Open Access/POS: $553.80 HealthLink — PPO: $681.60 Medica(WellFirst) — All Commercial/HMO/PPO: $528.24
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL III	$852	$852	$528.24 – $809.40
Emergency room visit (moderate): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $681.60 HealthLink — HMO/Open Access/POS: $553.80 HealthLink — PPO: $681.60 Medica(WellFirst) — All Commercial/HMO/PPO: $528.24 UnitedHealthcare — HMO/PPO: $681.60 USA MCO — Commercial PPO: $809.40
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT LOW MDM	Not listed in the file	Not listed in the file	$67.67 – $94.60
Emergency room visit (moderate): rates for 4 insurance plans Aetna — Medicare Advantage: $72.42 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $94.60 Blue Cross Blue Shield of Illinois — PPO: $94.60 UnitedHealthcare — HMO/PPO: $67.67
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL IV	$1,308	$1,308	$353.16 – $1,242.60
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $1,033.32 Aetna — Medicare Advantage: $353.16 Aetna Better Health — Dual Medicare/Medicaid MMAI: $353.16 Ambetter — All Ambetter ACA Exchange Plans: $353.16 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $927.37 Blue Cross Blue Shield of Illinois — PPO: $960.07 Cigna — All Commercial/HMO/PPO: $1,046.40 HealthLink — HMO/Open Access/POS: $850.20 HealthLink — PPO: $1,046.40 Medica(WellFirst) — All Commercial/HMO/PPO: $810.96
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL IV	$1,308	$1,308	$810.96 – $1,242.60
Emergency room visit (moderately high): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $1,046.40 HealthLink — HMO/Open Access/POS: $850.20 HealthLink — PPO: $1,046.40 Medica(WellFirst) — All Commercial/HMO/PPO: $810.96 UnitedHealthcare — HMO/PPO: $1,046.40 USA MCO — Commercial PPO: $1,242.60
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT MOD MDM	Not listed in the file	Not listed in the file	$105.63 – $161.79
Emergency room visit (moderately high): rates for 4 insurance plans Aetna — Medicare Advantage: $123.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $161.79 Blue Cross Blue Shield of Illinois — PPO: $161.79 UnitedHealthcare — HMO/PPO: $105.63
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL V	$1,701	$1,701	$459.27 – $1,615.95
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $1,343.79 Aetna — Medicare Advantage: $459.27 Aetna Better Health — Dual Medicare/Medicaid MMAI: $459.27 Ambetter — All Ambetter ACA Exchange Plans: $459.27 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,206.01 Blue Cross Blue Shield of Illinois — PPO: $1,248.53 Cigna — All Commercial/HMO/PPO: $1,360.80 HealthLink — HMO/Open Access/POS: $1,105.65 HealthLink — PPO: $1,360.80 Medica(WellFirst) — All Commercial/HMO/PPO: $1,054.62
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL V	$1,701	$1,701	$1,054.62 – $1,615.95
Emergency room visit (high): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $1,360.80 HealthLink — HMO/Open Access/POS: $1,105.65 HealthLink — PPO: $1,360.80 Medica(WellFirst) — All Commercial/HMO/PPO: $1,054.62 UnitedHealthcare — HMO/PPO: $1,360.80 USA MCO — Commercial PPO: $1,615.95
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT HI MDM	Not listed in the file	Not listed in the file	$164.74 – $234.89
Emergency room visit (high): rates for 4 insurance plans Aetna — Medicare Advantage: $178.48 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $234.89 Blue Cross Blue Shield of Illinois — PPO: $234.89 UnitedHealthcare — HMO/PPO: $164.74

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG BASIC METABOLIC PANEL (CA TOTAL)	$240	$240	$64.80 – $228
Basic metabolic panel (blood test): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $189.60 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Dual Medicare/Medicaid MMAI: $64.80 Ambetter — All Ambetter ACA Exchange Plans: $64.80 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $170.16 Blue Cross Blue Shield of Illinois — PPO: $176.16 Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG BASIC METABOLIC PANEL (CA TOTAL)	$240	$240	$148.80 – $228
Basic metabolic panel (blood test): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80 UnitedHealthcare — HMO/PPO: $192 USA MCO — Commercial PPO: $228
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: BASIC METABOLIC PNL TOTAL CA	Not listed in the file	Not listed in the file	$3.15 – $8.46
Basic metabolic panel (blood test): rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $8.46 Blue Cross Blue Shield of Illinois — PPO: $8.46 UnitedHealthcare — HMO/PPO: $3.15
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG COMPREHENSIVE METABOLIC PANEL	$349	$349	$94.23 – $331.55
Comprehensive metabolic panel (blood test): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $275.71 Aetna — Medicare Advantage: $94.23 Aetna Better Health — Dual Medicare/Medicaid MMAI: $94.23 Ambetter — All Ambetter ACA Exchange Plans: $94.23 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $247.44 Blue Cross Blue Shield of Illinois — PPO: $256.17 Cigna — All Commercial/HMO/PPO: $279.20 HealthLink — HMO/Open Access/POS: $226.85 HealthLink — PPO: $279.20 Medica(WellFirst) — All Commercial/HMO/PPO: $216.38
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG COMPREHENSIVE METABOLIC PANEL	$349	$349	$216.38 – $331.55
Comprehensive metabolic panel (blood test): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $279.20 HealthLink — HMO/Open Access/POS: $226.85 HealthLink — PPO: $279.20 Medica(WellFirst) — All Commercial/HMO/PPO: $216.38 UnitedHealthcare — HMO/PPO: $279.20 USA MCO — Commercial PPO: $331.55
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$3.15 – $10.56
Comprehensive metabolic panel (blood test): rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $10.56 Blue Cross Blue Shield of Illinois — PPO: $10.56 UnitedHealthcare — HMO/PPO: $3.15
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$21 – $36.81
Obstetric blood test panel: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $36.81 Blue Cross Blue Shield of Illinois — PPO: $36.81 UnitedHealthcare — HMO/PPO: $21
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$3.50
Obstetric blood test panel: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3.50 Blue Cross Blue Shield of Illinois — PPO: $3.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE	$240	$240	$64.80 – $228
Cholesterol panel (lipid panel): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $189.60 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Dual Medicare/Medicaid MMAI: $64.80 Ambetter — All Ambetter ACA Exchange Plans: $64.80 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $170.16 Blue Cross Blue Shield of Illinois — PPO: $176.16 Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE I	$58	$58	$15.66 – $55.10
Cholesterol panel (lipid panel): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $45.82 Aetna — Medicare Advantage: $15.66 Aetna Better Health — Dual Medicare/Medicaid MMAI: $15.66 Ambetter — All Ambetter ACA Exchange Plans: $15.66 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $41.12 Blue Cross Blue Shield of Illinois — PPO: $42.57 Cigna — All Commercial/HMO/PPO: $46.40 HealthLink — HMO/Open Access/POS: $37.70 HealthLink — PPO: $46.40 Medica(WellFirst) — All Commercial/HMO/PPO: $35.96
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE	$240	$240	$148.80 – $228
Cholesterol panel (lipid panel): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80 UnitedHealthcare — HMO/PPO: $192 USA MCO — Commercial PPO: $228
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG RENAL FUNCTION PANEL	$260	$260	$70.20 – $247
Kidney function panel: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $205.40 Aetna — Medicare Advantage: $70.20 Aetna Better Health — Dual Medicare/Medicaid MMAI: $70.20 Ambetter — All Ambetter ACA Exchange Plans: $70.20 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $184.34 Blue Cross Blue Shield of Illinois — PPO: $190.84 Cigna — All Commercial/HMO/PPO: $208 HealthLink — HMO/Open Access/POS: $169 HealthLink — PPO: $208 Medica(WellFirst) — All Commercial/HMO/PPO: $161.20
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG RENAL FUNCTION PANEL	$260	$260	$161.20 – $247
Kidney function panel: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $208 HealthLink — HMO/Open Access/POS: $169 HealthLink — PPO: $208 Medica(WellFirst) — All Commercial/HMO/PPO: $161.20 UnitedHealthcare — HMO/PPO: $208 USA MCO — Commercial PPO: $247
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$3.15 – $8.68
Kidney function panel: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $8.68 Blue Cross Blue Shield of Illinois — PPO: $8.68 UnitedHealthcare — HMO/PPO: $3.15
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG HEPATIC FUNCTION PANEL	$230	$230	$62.10 – $218.50
Liver function panel: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $181.70 Aetna — Medicare Advantage: $62.10 Aetna Better Health — Dual Medicare/Medicaid MMAI: $62.10 Ambetter — All Ambetter ACA Exchange Plans: $62.10 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $163.07 Blue Cross Blue Shield of Illinois — PPO: $168.82 Cigna — All Commercial/HMO/PPO: $184 HealthLink — HMO/Open Access/POS: $149.50 HealthLink — PPO: $184 Medica(WellFirst) — All Commercial/HMO/PPO: $142.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG HEPATIC FUNCTION PANEL I	$84	$84	$22.68 – $79.80
Liver function panel: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $66.36 Aetna — Medicare Advantage: $22.68 Aetna Better Health — Dual Medicare/Medicaid MMAI: $22.68 Ambetter — All Ambetter ACA Exchange Plans: $22.68 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $59.56 Blue Cross Blue Shield of Illinois — PPO: $61.66 Cigna — All Commercial/HMO/PPO: $67.20 HealthLink — HMO/Open Access/POS: $54.60 HealthLink — PPO: $67.20 Medica(WellFirst) — All Commercial/HMO/PPO: $52.08
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG HEPATIC FUNCTION PANEL	$230	$230	$142.60 – $218.50
Liver function panel: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $184 HealthLink — HMO/Open Access/POS: $149.50 HealthLink — PPO: $184 Medica(WellFirst) — All Commercial/HMO/PPO: $142.60 UnitedHealthcare — HMO/PPO: $184 USA MCO — Commercial PPO: $218.50
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC	$113	$113	$30.51 – $107.35
Urine test (automated, with microscope): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $89.27 Aetna — Medicare Advantage: $30.51 Aetna Better Health — Dual Medicare/Medicaid MMAI: $30.51 Ambetter — All Ambetter ACA Exchange Plans: $30.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $80.12 Blue Cross Blue Shield of Illinois — PPO: $82.94 Cigna — All Commercial/HMO/PPO: $90.40 HealthLink — HMO/Open Access/POS: $73.45 HealthLink — PPO: $90.40 Medica(WellFirst) — All Commercial/HMO/PPO: $70.06
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC	$113	$113	$70.06 – $107.35
Urine test (automated, with microscope): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $90.40 HealthLink — HMO/Open Access/POS: $73.45 HealthLink — PPO: $90.40 Medica(WellFirst) — All Commercial/HMO/PPO: $70.06 UnitedHealthcare — HMO/PPO: $90.40 USA MCO — Commercial PPO: $107.35
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$3.15 – $3.17
Urine test (automated, with microscope): rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3.17 Blue Cross Blue Shield of Illinois — PPO: $3.17 UnitedHealthcare — HMO/PPO: $3.15
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS NON AUTO POCT PBB BILL	$26	$26	$7.02 – $24.70
Urine test (manual, without microscope): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $20.54 Aetna — Medicare Advantage: $7.02 Aetna Better Health — Dual Medicare/Medicaid MMAI: $7.02 Ambetter — All Ambetter ACA Exchange Plans: $7.02 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $18.43 Blue Cross Blue Shield of Illinois — PPO: $19.08 Cigna — All Commercial/HMO/PPO: $20.80 HealthLink — HMO/Open Access/POS: $16.90 HealthLink — PPO: $20.80 Medica(WellFirst) — All Commercial/HMO/PPO: $16.12
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS POCT (IP) BEAKER	$26	$26	$7.02 – $24.70
Urine test (manual, without microscope): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $20.54 Aetna — Medicare Advantage: $7.02 Aetna Better Health — Dual Medicare/Medicaid MMAI: $7.02 Ambetter — All Ambetter ACA Exchange Plans: $7.02 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $18.43 Blue Cross Blue Shield of Illinois — PPO: $19.08 Cigna — All Commercial/HMO/PPO: $20.80 HealthLink — HMO/Open Access/POS: $16.90 HealthLink — PPO: $20.80 Medica(WellFirst) — All Commercial/HMO/PPO: $16.12
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS NON AUTO POCT PBB BILL	$26	$26	$16.12 – $24.70
Urine test (manual, without microscope): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $20.80 HealthLink — HMO/Open Access/POS: $16.90 HealthLink — PPO: $20.80 Medica(WellFirst) — All Commercial/HMO/PPO: $16.12 UnitedHealthcare — HMO/PPO: $20.80 USA MCO — Commercial PPO: $24.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PH URINE AUTO	$100	$100	$27 – $95
Urine test (automated, without microscope): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $79 Aetna — Medicare Advantage: $27 Aetna Better Health — Dual Medicare/Medicaid MMAI: $27 Ambetter — All Ambetter ACA Exchange Plans: $27 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $70.90 Blue Cross Blue Shield of Illinois — PPO: $73.40 Cigna — All Commercial/HMO/PPO: $80 HealthLink — HMO/Open Access/POS: $65 HealthLink — PPO: $80 Medica(WellFirst) — All Commercial/HMO/PPO: $62
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG SPECIFIC GRAVITY URINE AUTO	$25	$25	$6.75 – $23.75
Urine test (automated, without microscope): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $19.75 Aetna — Medicare Advantage: $6.75 Aetna Better Health — Dual Medicare/Medicaid MMAI: $6.75 Ambetter — All Ambetter ACA Exchange Plans: $6.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $17.73 Blue Cross Blue Shield of Illinois — PPO: $18.35 Cigna — All Commercial/HMO/PPO: $20 HealthLink — HMO/Open Access/POS: $16.25 HealthLink — PPO: $20 Medica(WellFirst) — All Commercial/HMO/PPO: $15.50
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PH URINE AUTO	$100	$100	$62 – $95
Urine test (automated, without microscope): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $80 HealthLink — HMO/Open Access/POS: $65 HealthLink — PPO: $80 Medica(WellFirst) — All Commercial/HMO/PPO: $62 UnitedHealthcare — HMO/PPO: $80 USA MCO — Commercial PPO: $95
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$238	$238	$64.26 – $226.10
PSA (prostate specific antigen) blood test: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $188.02 Aetna — Medicare Advantage: $64.26 Aetna Better Health — Dual Medicare/Medicaid MMAI: $64.26 Ambetter — All Ambetter ACA Exchange Plans: $64.26 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $168.74 Blue Cross Blue Shield of Illinois — PPO: $174.69 Cigna — All Commercial/HMO/PPO: $190.40 HealthLink — HMO/Open Access/POS: $154.70 HealthLink — PPO: $190.40 Medica(WellFirst) — All Commercial/HMO/PPO: $147.56
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PSA TOTAL	$131	$131	$35.37 – $124.45
PSA (prostate specific antigen) blood test: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $103.49 Aetna — Medicare Advantage: $35.37 Aetna Better Health — Dual Medicare/Medicaid MMAI: $35.37 Ambetter — All Ambetter ACA Exchange Plans: $35.37 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $92.88 Blue Cross Blue Shield of Illinois — PPO: $96.15 Cigna — All Commercial/HMO/PPO: $104.80 HealthLink — HMO/Open Access/POS: $85.15 HealthLink — PPO: $104.80 Medica(WellFirst) — All Commercial/HMO/PPO: $81.22
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$238	$238	$147.56 – $226.10
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $190.40 HealthLink — HMO/Open Access/POS: $154.70 HealthLink — PPO: $190.40 Medica(WellFirst) — All Commercial/HMO/PPO: $147.56 UnitedHealthcare — HMO/PPO: $190.40 USA MCO — Commercial PPO: $226.10
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG TSH	$228	$228	$61.56 – $216.60
Thyroid stimulating hormone (TSH) test: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $180.12 Aetna — Medicare Advantage: $61.56 Aetna Better Health — Dual Medicare/Medicaid MMAI: $61.56 Ambetter — All Ambetter ACA Exchange Plans: $61.56 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $161.65 Blue Cross Blue Shield of Illinois — PPO: $167.35 Cigna — All Commercial/HMO/PPO: $182.40 HealthLink — HMO/Open Access/POS: $148.20 HealthLink — PPO: $182.40 Medica(WellFirst) — All Commercial/HMO/PPO: $141.36
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG TSH	$228	$228	$141.36 – $216.60
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $182.40 HealthLink — HMO/Open Access/POS: $148.20 HealthLink — PPO: $182.40 Medica(WellFirst) — All Commercial/HMO/PPO: $141.36 UnitedHealthcare — HMO/PPO: $182.40 USA MCO — Commercial PPO: $216.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$9.45 – $16.80
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $16.80 Blue Cross Blue Shield of Illinois — PPO: $16.80 UnitedHealthcare — HMO/PPO: $9.45
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG CBC W AUTO DIFFERENTIAL	$156	$156	$42.12 – $148.20
Complete blood count (CBC) with differential: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $123.24 Aetna — Medicare Advantage: $42.12 Aetna Better Health — Dual Medicare/Medicaid MMAI: $42.12 Ambetter — All Ambetter ACA Exchange Plans: $42.12 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $110.60 Blue Cross Blue Shield of Illinois — PPO: $114.50 Cigna — All Commercial/HMO/PPO: $124.80 HealthLink — HMO/Open Access/POS: $101.40 HealthLink — PPO: $124.80 Medica(WellFirst) — All Commercial/HMO/PPO: $96.72
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG CBC W AUTO DIFFERENTIAL I	$84	$84	$22.68 – $79.80
Complete blood count (CBC) with differential: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $66.36 Aetna — Medicare Advantage: $22.68 Aetna Better Health — Dual Medicare/Medicaid MMAI: $22.68 Ambetter — All Ambetter ACA Exchange Plans: $22.68 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $59.56 Blue Cross Blue Shield of Illinois — PPO: $61.66 Cigna — All Commercial/HMO/PPO: $67.20 HealthLink — HMO/Open Access/POS: $54.60 HealthLink — PPO: $67.20 Medica(WellFirst) — All Commercial/HMO/PPO: $52.08
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG CBC W AUTO DIFFERENTIAL	$156	$156	$96.72 – $148.20
Complete blood count (CBC) with differential: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $124.80 HealthLink — HMO/Open Access/POS: $101.40 HealthLink — PPO: $124.80 Medica(WellFirst) — All Commercial/HMO/PPO: $96.72 UnitedHealthcare — HMO/PPO: $124.80 USA MCO — Commercial PPO: $148.20
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC AUTOMATED	Not listed in the file	Not listed in the file	$2.10 – $6.47
Complete blood count (CBC), automated: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $6.47 Blue Cross Blue Shield of Illinois — PPO: $6.47 UnitedHealthcare — HMO/PPO: $2.10
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: COMPLETE CBC AUTOMATED	Not listed in the file	Not listed in the file	$3.50
Complete blood count (CBC), automated: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3.50 Blue Cross Blue Shield of Illinois — PPO: $3.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PT-INR	$84	$84	$22.68 – $79.80
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $66.36 Aetna — Medicare Advantage: $22.68 Aetna Better Health — Dual Medicare/Medicaid MMAI: $22.68 Ambetter — All Ambetter ACA Exchange Plans: $22.68 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $59.56 Blue Cross Blue Shield of Illinois — PPO: $61.66 Cigna — All Commercial/HMO/PPO: $67.20 HealthLink — HMO/Open Access/POS: $54.60 HealthLink — PPO: $67.20 Medica(WellFirst) — All Commercial/HMO/PPO: $52.08
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PT INHIBITOR SCREEN	$151	$151	$40.77 – $143.45
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $119.29 Aetna — Medicare Advantage: $40.77 Aetna Better Health — Dual Medicare/Medicaid MMAI: $40.77 Ambetter — All Ambetter ACA Exchange Plans: $40.77 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.06 Blue Cross Blue Shield of Illinois — PPO: $110.83 Cigna — All Commercial/HMO/PPO: $120.80 HealthLink — HMO/Open Access/POS: $98.15 HealthLink — PPO: $120.80 Medica(WellFirst) — All Commercial/HMO/PPO: $93.62
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PT II	$130	$130	$35.10 – $123.50
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $102.70 Aetna — Medicare Advantage: $35.10 Aetna Better Health — Dual Medicare/Medicaid MMAI: $35.10 Ambetter — All Ambetter ACA Exchange Plans: $35.10 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $92.17 Blue Cross Blue Shield of Illinois — PPO: $95.42 Cigna — All Commercial/HMO/PPO: $104 HealthLink — HMO/Open Access/POS: $84.50 HealthLink — PPO: $104 Medica(WellFirst) — All Commercial/HMO/PPO: $80.60
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PTT	$152	$152	$41.04 – $144.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $120.08 Aetna — Medicare Advantage: $41.04 Aetna Better Health — Dual Medicare/Medicaid MMAI: $41.04 Ambetter — All Ambetter ACA Exchange Plans: $41.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.77 Blue Cross Blue Shield of Illinois — PPO: $111.57 Cigna — All Commercial/HMO/PPO: $121.60 HealthLink — HMO/Open Access/POS: $98.80 HealthLink — PPO: $121.60 Medica(WellFirst) — All Commercial/HMO/PPO: $94.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG APTT III	$283	$283	$76.41 – $268.85
Blood clotting test (partial thromboplastin time, PTT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $223.57 Aetna — Medicare Advantage: $76.41 Aetna Better Health — Dual Medicare/Medicaid MMAI: $76.41 Ambetter — All Ambetter ACA Exchange Plans: $76.41 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $200.65 Blue Cross Blue Shield of Illinois — PPO: $207.72 Cigna — All Commercial/HMO/PPO: $226.40 HealthLink — HMO/Open Access/POS: $183.95 HealthLink — PPO: $226.40 Medica(WellFirst) — All Commercial/HMO/PPO: $175.46
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PTT INHIBITOR I	$151	$151	$40.77 – $143.45
Blood clotting test (partial thromboplastin time, PTT): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $119.29 Aetna — Medicare Advantage: $40.77 Aetna Better Health — Dual Medicare/Medicaid MMAI: $40.77 Ambetter — All Ambetter ACA Exchange Plans: $40.77 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.06 Blue Cross Blue Shield of Illinois — PPO: $110.83 Cigna — All Commercial/HMO/PPO: $120.80 HealthLink — HMO/Open Access/POS: $98.15 HealthLink — PPO: $120.80 Medica(WellFirst) — All Commercial/HMO/PPO: $93.62

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 · Inpatient or outpatient · Doctor (professional) fee In the file: HP CT BRAIN W/O CONTRAST	$316	$316	$38.60 – $300.20
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $134.62 Aetna — Medicare Advantage: $100.99 Aetna Better Health — Dual Medicare/Medicaid MMAI: $100.99 Aetna Better Health — HealthChoice/Illinois Medicaid: $38.60 Ambetter — All Ambetter ACA Exchange Plans: $100.99 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $242.56 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $38.60 Blue Cross Blue Shield of Illinois — PPO: $242.56 Cigna — All Commercial/HMO/PPO: $252.80 HealthLink — HMO/Open Access/POS: $205.40
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD NON CONTRAST	$2,420	$2,420	$653.40 – $2,299
CT scan of the head or brain, without contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $1,911.80 Aetna — Medicare Advantage: $653.40 Aetna Better Health — Dual Medicare/Medicaid MMAI: $653.40 Ambetter — All Ambetter ACA Exchange Plans: $653.40 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,715.78 Blue Cross Blue Shield of Illinois — PPO: $1,776.28 Cigna — All Commercial/HMO/PPO: $1,936 HealthLink — HMO/Open Access/POS: $1,573 HealthLink — PPO: $1,936 Medica(WellFirst) — All Commercial/HMO/PPO: $1,500.40
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD NON CONTRAST	$2,420	$2,420	$1,500.40 – $2,299
CT scan of the head or brain, without contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $1,936 HealthLink — HMO/Open Access/POS: $1,573 HealthLink — PPO: $1,936 Medica(WellFirst) — All Commercial/HMO/PPO: $1,500.40 UnitedHealthcare — HMO/PPO: $1,936 USA MCO — Commercial PPO: $2,299
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MRI BRAIN W/WO CONTRAST	$356	$356	$89 – $1,136.29
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $471.18 Aetna — Medicare Advantage: $299.35 Aetna Better Health — Dual Medicare/Medicaid MMAI: $299.35 Ambetter — All Ambetter ACA Exchange Plans: $299.35 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $913.21 Blue Cross Blue Shield of Illinois — PPO: $913.21 Cigna — All Commercial/HMO/PPO: $284.80 HealthLink — HMO/Open Access/POS: $231.40 HealthLink — PPO: $284.80 Medica(WellFirst) — All Commercial/HMO/PPO: $374.19
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH & WITHOUT CONTRAST	$5,256	$5,256	$1,419.12 – $4,993.20
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $4,152.24 Aetna — Medicare Advantage: $1,419.12 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,419.12 Ambetter — All Ambetter ACA Exchange Plans: $1,419.12 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,726.50 Blue Cross Blue Shield of Illinois — PPO: $3,857.90 Cigna — All Commercial/HMO/PPO: $4,204.80 HealthLink — HMO/Open Access/POS: $3,416.40 HealthLink — PPO: $4,204.80 Medica(WellFirst) — All Commercial/HMO/PPO: $3,258.72
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH & WITHOUT CONTRAST	$5,256	$5,256	$3,258.72 – $4,993.20
MRI of the brain, before and after contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $4,204.80 HealthLink — HMO/Open Access/POS: $3,416.40 HealthLink — PPO: $4,204.80 Medica(WellFirst) — All Commercial/HMO/PPO: $3,258.72 UnitedHealthcare — HMO/PPO: $4,204.80 USA MCO — Commercial PPO: $4,993.20
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: HP XRAY CHEST 2 VIEWS	$92	$92	$7.03 – $87.40
Chest X-ray, 2 views: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $34.31 Aetna — Medicare Advantage: $31.23 Aetna Better Health — Dual Medicare/Medicaid MMAI: $31.23 Aetna Better Health — HealthChoice/Illinois Medicaid: $7.03 Ambetter — All Ambetter ACA Exchange Plans: $31.23 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $75.24 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $7.03 Blue Cross Blue Shield of Illinois — PPO: $75.24 Cigna — All Commercial/HMO/PPO: $73.60 HealthLink — HMO/Open Access/POS: $59.80
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XRAY CHEST 2 VIEWS	$432	$432	$116.64 – $410.40
Chest X-ray, 2 views: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $341.28 Aetna — Medicare Advantage: $116.64 Aetna Better Health — Dual Medicare/Medicaid MMAI: $116.64 Ambetter — All Ambetter ACA Exchange Plans: $116.64 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $306.29 Blue Cross Blue Shield of Illinois — PPO: $317.09 Cigna — All Commercial/HMO/PPO: $345.60 HealthLink — HMO/Open Access/POS: $280.80 HealthLink — PPO: $345.60 Medica(WellFirst) — All Commercial/HMO/PPO: $267.84
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC XRAY CHEST 2 VIEWS	$432	$432	$267.84 – $410.40
Chest X-ray, 2 views: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $345.60 HealthLink — HMO/Open Access/POS: $280.80 HealthLink — PPO: $345.60 Medica(WellFirst) — All Commercial/HMO/PPO: $267.84 UnitedHealthcare — HMO/PPO: $345.60 USA MCO — Commercial PPO: $410.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: HP LUMBAR SPINE W/OBLIQU	$92	$92	$37.90 – $105.66
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $51.92 Aetna — Medicare Advantage: $50.17 Aetna Better Health — Dual Medicare/Medicaid MMAI: $50.17 Aetna Better Health — HealthChoice/Illinois Medicaid: $37.90 Ambetter — All Ambetter ACA Exchange Plans: $50.17 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $105.66 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $37.90 Blue Cross Blue Shield of Illinois — PPO: $105.66 Cigna — All Commercial/HMO/PPO: $73.60 HealthLink — HMO/Open Access/POS: $59.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LUMBAR SPINE 4+ VW	$548	$548	$147.96 – $520.60
X-ray of the lower spine, at least 4 views: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $432.92 Aetna — Medicare Advantage: $147.96 Aetna Better Health — Dual Medicare/Medicaid MMAI: $147.96 Ambetter — All Ambetter ACA Exchange Plans: $147.96 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $388.53 Blue Cross Blue Shield of Illinois — PPO: $402.23 Cigna — All Commercial/HMO/PPO: $438.40 HealthLink — HMO/Open Access/POS: $356.20 HealthLink — PPO: $438.40 Medica(WellFirst) — All Commercial/HMO/PPO: $339.76
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LUMBAR SPINE 4+ VW	$548	$548	$339.76 – $520.60
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $438.40 HealthLink — HMO/Open Access/POS: $356.20 HealthLink — PPO: $438.40 Medica(WellFirst) — All Commercial/HMO/PPO: $339.76 UnitedHealthcare — HMO/PPO: $438.40 USA MCO — Commercial PPO: $520.60
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MRI LUMBAR SPINE WO CONTRAST	$356	$356	$67.91 – $584.86
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $282.52 Aetna — Medicare Advantage: $181.40 Aetna Better Health — Dual Medicare/Medicaid MMAI: $181.40 Aetna Better Health — HealthChoice/Illinois Medicaid: $67.91 Ambetter — All Ambetter ACA Exchange Plans: $181.40 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $398.36 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $67.91 Blue Cross Blue Shield of Illinois — PPO: $398.36 Cigna — All Commercial/HMO/PPO: $284.80 HealthLink — HMO/Open Access/POS: $231.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR NON CONTRAST	$4,181	$4,181	$1,128.87 – $3,971.95
MRI of the lower back (lumbar spine), without contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $3,302.99 Aetna — Medicare Advantage: $1,128.87 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,128.87 Ambetter — All Ambetter ACA Exchange Plans: $1,128.87 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,964.33 Blue Cross Blue Shield of Illinois — PPO: $3,068.85 Cigna — All Commercial/HMO/PPO: $3,344.80 HealthLink — HMO/Open Access/POS: $2,717.65 HealthLink — PPO: $3,344.80 Medica(WellFirst) — All Commercial/HMO/PPO: $2,592.22
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR NON CONTRAST	$4,181	$4,181	$2,592.22 – $3,971.95
MRI of the lower back (lumbar spine), without contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $3,344.80 HealthLink — HMO/Open Access/POS: $2,717.65 HealthLink — PPO: $3,344.80 Medica(WellFirst) — All Commercial/HMO/PPO: $2,592.22 UnitedHealthcare — HMO/PPO: $3,344.80 USA MCO — Commercial PPO: $3,971.95
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: HP CT PELVIS W CONTRAST	$316	$316	$75.29 – $467.23
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $281.92 Aetna — Medicare Advantage: $211.38 Aetna Better Health — Dual Medicare/Medicaid MMAI: $211.38 Aetna Better Health — HealthChoice/Illinois Medicaid: $75.29 Ambetter — All Ambetter ACA Exchange Plans: $211.38 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $467.23 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $75.29 Blue Cross Blue Shield of Illinois — PPO: $467.23 Cigna — All Commercial/HMO/PPO: $252.80 HealthLink — HMO/Open Access/POS: $205.40
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH IV CONTRAST	$3,077	$3,077	$830.79 – $2,923.15
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $2,430.83 Aetna — Medicare Advantage: $830.79 Aetna Better Health — Dual Medicare/Medicaid MMAI: $830.79 Ambetter — All Ambetter ACA Exchange Plans: $830.79 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,181.59 Blue Cross Blue Shield of Illinois — PPO: $2,258.52 Cigna — All Commercial/HMO/PPO: $2,461.60 HealthLink — HMO/Open Access/POS: $2,000.05 HealthLink — PPO: $2,461.60 Medica(WellFirst) — All Commercial/HMO/PPO: $1,907.74
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH IV CONTRAST	$3,077	$3,077	$1,907.74 – $2,923.15
CT scan of the pelvis, with contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $2,461.60 HealthLink — HMO/Open Access/POS: $2,000.05 HealthLink — PPO: $2,461.60 Medica(WellFirst) — All Commercial/HMO/PPO: $1,907.74 UnitedHealthcare — HMO/PPO: $2,461.60 USA MCO — Commercial PPO: $2,923.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MRI LOWER EXTREMITY JOINT WO CONTRAST	$356	$356	$89 – $518.54
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $297.85 Aetna — Medicare Advantage: $192.42 Aetna Better Health — Dual Medicare/Medicaid MMAI: $192.42 Ambetter — All Ambetter ACA Exchange Plans: $192.42 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $459.92 Blue Cross Blue Shield of Illinois — PPO: $459.92 Cigna — All Commercial/HMO/PPO: $284.80 HealthLink — HMO/Open Access/POS: $231.40 HealthLink — PPO: $284.80 Medica(WellFirst) — All Commercial/HMO/PPO: $240.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,747	$3,747	$1,011.69 – $3,559.65
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $2,960.13 Aetna — Medicare Advantage: $1,011.69 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,011.69 Ambetter — All Ambetter ACA Exchange Plans: $1,011.69 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,656.62 Blue Cross Blue Shield of Illinois — PPO: $2,750.30 Cigna — All Commercial/HMO/PPO: $2,997.60 HealthLink — HMO/Open Access/POS: $2,435.55 HealthLink — PPO: $2,997.60 Medica(WellFirst) — All Commercial/HMO/PPO: $2,323.14
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,747	$3,747	$2,323.14 – $3,559.65
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $2,997.60 HealthLink — HMO/Open Access/POS: $2,435.55 HealthLink — PPO: $2,997.60 Medica(WellFirst) — All Commercial/HMO/PPO: $2,323.14 UnitedHealthcare — HMO/PPO: $2,997.60 USA MCO — Commercial PPO: $3,559.65
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: HP CT ABD PEL W/CONTRAST	$316	$316	$57.95 – $681.03
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $386.68 Aetna — Medicare Advantage: $282.12 Aetna Better Health — Dual Medicare/Medicaid MMAI: $282.12 Aetna Better Health — HealthChoice/Illinois Medicaid: $57.95 Ambetter — All Ambetter ACA Exchange Plans: $282.12 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $681.03 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $57.95 Blue Cross Blue Shield of Illinois — PPO: $681.03 Cigna — All Commercial/HMO/PPO: $252.80 HealthLink — HMO/Open Access/POS: $205.40
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS W CONTRAST	$6,701	$6,701	$1,809.27 – $6,365.95
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $5,293.79 Aetna — Medicare Advantage: $1,809.27 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,809.27 Ambetter — All Ambetter ACA Exchange Plans: $1,809.27 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $4,751.01 Blue Cross Blue Shield of Illinois — PPO: $4,918.53 Cigna — All Commercial/HMO/PPO: $5,360.80 HealthLink — HMO/Open Access/POS: $4,355.65 HealthLink — PPO: $5,360.80 Medica(WellFirst) — All Commercial/HMO/PPO: $4,154.62
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS W CONTRAST	$6,701	$6,701	$4,154.62 – $6,365.95
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $5,360.80 HealthLink — HMO/Open Access/POS: $4,355.65 HealthLink — PPO: $5,360.80 Medica(WellFirst) — All Commercial/HMO/PPO: $4,154.62 UnitedHealthcare — HMO/PPO: $5,360.80 USA MCO — Commercial PPO: $6,365.95
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: HP US ABDOMEN COMPLETE	$208	$208	$26.56 – $257.82
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $119.10 Aetna — Medicare Advantage: $107.89 Aetna Better Health — Dual Medicare/Medicaid MMAI: $107.89 Aetna Better Health — HealthChoice/Illinois Medicaid: $26.56 Ambetter — All Ambetter ACA Exchange Plans: $107.89 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $257.82 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $26.56 Blue Cross Blue Shield of Illinois — PPO: $257.82 Cigna — All Commercial/HMO/PPO: $166.40 HealthLink — HMO/Open Access/POS: $135.20
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOMEN COMPLETE	$1,711	$1,711	$461.97 – $1,625.45
Ultrasound of the abdomen, complete: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $1,351.69 Aetna — Medicare Advantage: $461.97 Aetna Better Health — Dual Medicare/Medicaid MMAI: $461.97 Ambetter — All Ambetter ACA Exchange Plans: $461.97 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,213.10 Blue Cross Blue Shield of Illinois — PPO: $1,255.87 Cigna — All Commercial/HMO/PPO: $1,368.80 HealthLink — HMO/Open Access/POS: $1,112.15 HealthLink — PPO: $1,368.80 Medica(WellFirst) — All Commercial/HMO/PPO: $1,060.82
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOMEN COMPLETE	$1,711	$1,711	$1,060.82 – $1,625.45
Ultrasound of the abdomen, complete: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $1,368.80 HealthLink — HMO/Open Access/POS: $1,112.15 HealthLink — PPO: $1,368.80 Medica(WellFirst) — All Commercial/HMO/PPO: $1,060.82 UnitedHealthcare — HMO/PPO: $1,368.80 USA MCO — Commercial PPO: $1,625.45
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: HP US PREG UTERUS >14 WKS	$208	$208	$87.72 – $299.53
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $138.62 Aetna — Medicare Advantage: $128.45 Aetna Better Health — Dual Medicare/Medicaid MMAI: $128.45 Aetna Better Health — HealthChoice/Illinois Medicaid: $87.72 Ambetter — All Ambetter ACA Exchange Plans: $128.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $299.53 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $87.72 Blue Cross Blue Shield of Illinois — PPO: $299.53 Cigna — All Commercial/HMO/PPO: $166.40 HealthLink — HMO/Open Access/POS: $135.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB 14+ WKS SINGLE GEST	$1,359	$1,359	$366.93 – $1,291.05
Pregnancy ultrasound (after the first trimester): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $1,073.61 Aetna — Medicare Advantage: $366.93 Aetna Better Health — Dual Medicare/Medicaid MMAI: $366.93 Ambetter — All Ambetter ACA Exchange Plans: $366.93 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $963.53 Blue Cross Blue Shield of Illinois — PPO: $997.51 Cigna — All Commercial/HMO/PPO: $1,087.20 HealthLink — HMO/Open Access/POS: $883.35 HealthLink — PPO: $1,087.20 Medica(WellFirst) — All Commercial/HMO/PPO: $842.58
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB 14+ WKS SINGLE GEST	$1,359	$1,359	$842.58 – $1,291.05
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $1,087.20 HealthLink — HMO/Open Access/POS: $883.35 HealthLink — PPO: $1,087.20 Medica(WellFirst) — All Commercial/HMO/PPO: $842.58 UnitedHealthcare — HMO/PPO: $1,087.20 USA MCO — Commercial PPO: $1,291.05
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: HP US TRANSVAGINAL NON OB	$208	$208	$76.76 – $261.67
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $122.02 Aetna — Medicare Advantage: $110.59 Aetna Better Health — Dual Medicare/Medicaid MMAI: $110.59 Aetna Better Health — HealthChoice/Illinois Medicaid: $76.76 Ambetter — All Ambetter ACA Exchange Plans: $110.59 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $261.67 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $76.76 Blue Cross Blue Shield of Illinois — PPO: $261.67 Cigna — All Commercial/HMO/PPO: $166.40 HealthLink — HMO/Open Access/POS: $135.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON OB	$1,167	$1,167	$315.09 – $1,108.65
Transvaginal ultrasound: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $921.93 Aetna — Medicare Advantage: $315.09 Aetna Better Health — Dual Medicare/Medicaid MMAI: $315.09 Ambetter — All Ambetter ACA Exchange Plans: $315.09 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $827.40 Blue Cross Blue Shield of Illinois — PPO: $856.58 Cigna — All Commercial/HMO/PPO: $933.60 HealthLink — HMO/Open Access/POS: $758.55 HealthLink — PPO: $933.60 Medica(WellFirst) — All Commercial/HMO/PPO: $723.54
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON OB	$1,167	$1,167	$723.54 – $1,108.65
Transvaginal ultrasound: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $933.60 HealthLink — HMO/Open Access/POS: $758.55 HealthLink — PPO: $933.60 Medica(WellFirst) — All Commercial/HMO/PPO: $723.54 UnitedHealthcare — HMO/PPO: $933.60 USA MCO — Commercial PPO: $1,108.65
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: HP DX MAMMO INCL CAD UNI	$92	$92	$23 – $280.22
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $127.36 Aetna — Medicare Advantage: $116.73 Aetna Better Health — Dual Medicare/Medicaid MMAI: $116.73 Ambetter — All Ambetter ACA Exchange Plans: $116.73 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $280.22 Blue Cross Blue Shield of Illinois — PPO: $280.22 Cigna — All Commercial/HMO/PPO: $73.60 HealthLink — HMO/Open Access/POS: $59.80 HealthLink — PPO: $73.60 Medica(WellFirst) — All Commercial/HMO/PPO: $145.91
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM DX UNILATERAL INCLUDES CAD/AI	$393	$393	$106.11 – $373.35
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $310.47 Aetna — Medicare Advantage: $106.11 Aetna Better Health — Dual Medicare/Medicaid MMAI: $106.11 Ambetter — All Ambetter ACA Exchange Plans: $106.11 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $278.64 Blue Cross Blue Shield of Illinois — PPO: $288.46 Cigna — All Commercial/HMO/PPO: $314.40 HealthLink — HMO/Open Access/POS: $255.45 HealthLink — PPO: $314.40 Medica(WellFirst) — All Commercial/HMO/PPO: $243.66
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMM DX UNILATERAL INCLUDES CAD/AI	$393	$393	$243.66 – $373.35
Diagnostic mammogram, one breast: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $314.40 HealthLink — HMO/Open Access/POS: $255.45 HealthLink — PPO: $314.40 Medica(WellFirst) — All Commercial/HMO/PPO: $243.66 UnitedHealthcare — HMO/PPO: $314.40 USA MCO — Commercial PPO: $373.35
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MAMM DX BILATERAL INCLUDES CAD	$224	$224	$56 – $352.34
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $160.31 Aetna — Medicare Advantage: $147.91 Aetna Better Health — Dual Medicare/Medicaid MMAI: $147.91 Ambetter — All Ambetter ACA Exchange Plans: $147.91 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $352.34 Blue Cross Blue Shield of Illinois — PPO: $352.34 Cigna — All Commercial/HMO/PPO: $179.20 HealthLink — HMO/Open Access/POS: $145.60 HealthLink — PPO: $179.20 Medica(WellFirst) — All Commercial/HMO/PPO: $184.89
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM DX BILATERAL INCLUDES CAD/AI	$590	$590	$159.30 – $560.50
Diagnostic mammogram, both breasts: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $466.10 Aetna — Medicare Advantage: $159.30 Aetna Better Health — Dual Medicare/Medicaid MMAI: $159.30 Ambetter — All Ambetter ACA Exchange Plans: $159.30 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $418.31 Blue Cross Blue Shield of Illinois — PPO: $433.06 Cigna — All Commercial/HMO/PPO: $472 HealthLink — HMO/Open Access/POS: $383.50 HealthLink — PPO: $472 Medica(WellFirst) — All Commercial/HMO/PPO: $365.80
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMM DX BILATERAL INCLUDES CAD/AI	$590	$590	$365.80 – $560.50
Diagnostic mammogram, both breasts: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $472 HealthLink — HMO/Open Access/POS: $383.50 HealthLink — PPO: $472 Medica(WellFirst) — All Commercial/HMO/PPO: $365.80 UnitedHealthcare — HMO/PPO: $472 USA MCO — Commercial PPO: $560.50
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: HP SCR MAMMO BI INCL CAD	$174	$174	$43.50 – $285.28
Screening mammogram, both breasts: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $130.16 Aetna — Medicare Advantage: $118.51 Aetna Better Health — Dual Medicare/Medicaid MMAI: $118.51 Ambetter — All Ambetter ACA Exchange Plans: $118.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $285.28 Blue Cross Blue Shield of Illinois — PPO: $285.28 Cigna — All Commercial/HMO/PPO: $139.20 HealthLink — HMO/Open Access/POS: $113.10 HealthLink — PPO: $139.20 Medica(WellFirst) — All Commercial/HMO/PPO: $148.14
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MAMM SCREEN UNILAT INCLUDES CAD	$87	$87	$21.75 – $285.28
Screening mammogram, both breasts: 10 of 17 insurance plan rates Aetna — All Commercial/HMO/PPO: $130.16 Aetna — Medicare Advantage: $118.51 Aetna Better Health — Dual Medicare/Medicaid MMAI: $118.51 Ambetter — All Ambetter ACA Exchange Plans: $118.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $285.28 Blue Cross Blue Shield of Illinois — PPO: $285.28 Cigna — All Commercial/HMO/PPO: $69.60 HealthLink — HMO/Open Access/POS: $56.55 HealthLink — PPO: $69.60 Medica(WellFirst) — All Commercial/HMO/PPO: $148.14
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM SCREEN BILAT INCLUDES CAD/AI	$501	$501	$135.27 – $475.95
Screening mammogram, both breasts: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $395.79 Aetna — Medicare Advantage: $135.27 Aetna Better Health — Dual Medicare/Medicaid MMAI: $135.27 Ambetter — All Ambetter ACA Exchange Plans: $135.27 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $355.21 Blue Cross Blue Shield of Illinois — PPO: $367.73 Cigna — All Commercial/HMO/PPO: $400.80 HealthLink — HMO/Open Access/POS: $325.65 HealthLink — PPO: $400.80 Medica(WellFirst) — All Commercial/HMO/PPO: $310.62

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.96 – $31.28
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Aetna — Medicare Advantage: $14.96 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $31.28 Blue Cross Blue Shield of Illinois — PPO: $31.28 UnitedHealthcare — HMO/PPO: $28.06
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$832.18 – $1,728.79
Left heart catheterization (diagnostic): rates for 4 insurance plans Aetna — Medicare Advantage: $832.18 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,728.79 Blue Cross Blue Shield of Illinois — PPO: $1,728.79 UnitedHealthcare — HMO/PPO: $982.54
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$242.24 – $504.86
Left heart catheterization (diagnostic): rates for 3 insurance plans Aetna — Medicare Advantage: $242.24 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $504.86 Blue Cross Blue Shield of Illinois — PPO: $504.86
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$589.94 – $1,223.92
Left heart catheterization (diagnostic): rates for 3 insurance plans Aetna — Medicare Advantage: $589.94 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,223.92 Blue Cross Blue Shield of Illinois — PPO: $1,223.92
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$697.66 – $1,397.20
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans Aetna — Medicare Advantage: $697.66 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,397.20 Blue Cross Blue Shield of Illinois — PPO: $1,397.20 UnitedHealthcare — HMO/PPO: $747.24
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$391.94 – $815.79
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Aetna — Medicare Advantage: $391.94 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $815.79 Blue Cross Blue Shield of Illinois — PPO: $815.79
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$305.72 – $571.31
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Aetna — Medicare Advantage: $305.72 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $571.31 Blue Cross Blue Shield of Illinois — PPO: $571.31
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$869.52 – $2,040.01
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans Aetna — Medicare Advantage: $869.52 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,040.01 Blue Cross Blue Shield of Illinois — PPO: $2,040.01 UnitedHealthcare — HMO/PPO: $1,350
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOMN 4 OR MORE >=6YRS	$5,445	$5,445	$1,470.15 – $5,172.75
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $4,301.55 Aetna — Medicare Advantage: $1,470.15 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,470.15 Ambetter — All Ambetter ACA Exchange Plans: $1,470.15 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,860.51 Blue Cross Blue Shield of Illinois — PPO: $3,996.63 Cigna — All Commercial/HMO/PPO: $4,356 HealthLink — HMO/Open Access/POS: $3,539.25 HealthLink — PPO: $4,356 Medica(WellFirst) — All Commercial/HMO/PPO: $3,375.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOMN 4 OR MORE LESS THAN 6 HRS	$4,818	$4,818	$1,300.86 – $4,577.10
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $3,806.22 Aetna — Medicare Advantage: $1,300.86 Aetna Better Health — Dual Medicare/Medicaid MMAI: $1,300.86 Ambetter — All Ambetter ACA Exchange Plans: $1,300.86 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,415.96 Blue Cross Blue Shield of Illinois — PPO: $3,536.41 Cigna — All Commercial/HMO/PPO: $3,854.40 HealthLink — HMO/Open Access/POS: $3,131.70 HealthLink — PPO: $3,854.40 Medica(WellFirst) — All Commercial/HMO/PPO: $2,987.16
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC POLYSOMN 4 OR MORE >=6YRS	$5,445	$5,445	$3,375.90 – $5,172.75
Sleep study (overnight, in a sleep lab): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $4,356 HealthLink — HMO/Open Access/POS: $3,539.25 HealthLink — PPO: $4,356 Medica(WellFirst) — All Commercial/HMO/PPO: $3,375.90 UnitedHealthcare — HMO/PPO: $4,356 USA MCO — Commercial PPO: $5,172.75

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN PT	$210	$210	$56.70 – $199.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $165.90 Aetna — Medicare Advantage: $56.70 Aetna Better Health — Dual Medicare/Medicaid MMAI: $56.70 Ambetter — All Ambetter ACA Exchange Plans: $56.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $148.89 Blue Cross Blue Shield of Illinois — PPO: $154.14 Cigna — All Commercial/HMO/PPO: $168 HealthLink — HMO/Open Access/POS: $136.50 HealthLink — PPO: $168 Medica(WellFirst) — All Commercial/HMO/PPO: $130.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN OT	$210	$210	$56.70 – $199.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $165.90 Aetna — Medicare Advantage: $56.70 Aetna Better Health — Dual Medicare/Medicaid MMAI: $56.70 Ambetter — All Ambetter ACA Exchange Plans: $56.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $148.89 Blue Cross Blue Shield of Illinois — PPO: $154.14 Cigna — All Commercial/HMO/PPO: $168 HealthLink — HMO/Open Access/POS: $136.50 HealthLink — PPO: $168 Medica(WellFirst) — All Commercial/HMO/PPO: $130.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN PT	$210	$210	$130.20 – $199.50
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $168 HealthLink — HMO/Open Access/POS: $136.50 HealthLink — PPO: $168 Medica(WellFirst) — All Commercial/HMO/PPO: $130.20 UnitedHealthcare — HMO/PPO: $168 USA MCO — Commercial PPO: $199.50
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEXITY 1 RVU	$240	$240	$64.80 – $228
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $189.60 Aetna — Medicare Advantage: $64.80 Aetna Better Health — Dual Medicare/Medicaid MMAI: $64.80 Ambetter — All Ambetter ACA Exchange Plans: $64.80 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $170.16 Blue Cross Blue Shield of Illinois — PPO: $176.16 Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEXITY 1 RVU	$240	$240	$148.80 – $228
Physical therapy evaluation (low complexity): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $192 HealthLink — HMO/Open Access/POS: $156 HealthLink — PPO: $192 Medica(WellFirst) — All Commercial/HMO/PPO: $148.80 UnitedHealthcare — HMO/PPO: $192 USA MCO — Commercial PPO: $228
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$92.27 – $103.82
Physical therapy evaluation (low complexity): rates for 4 insurance plans Aetna — Medicare Advantage: $94.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $103.82 Blue Cross Blue Shield of Illinois — PPO: $103.82 UnitedHealthcare — HMO/PPO: $92.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEXITY 2 RVU	$336	$336	$90.72 – $319.20
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $265.44 Aetna — Medicare Advantage: $90.72 Aetna Better Health — Dual Medicare/Medicaid MMAI: $90.72 Ambetter — All Ambetter ACA Exchange Plans: $90.72 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $238.22 Blue Cross Blue Shield of Illinois — PPO: $246.62 Cigna — All Commercial/HMO/PPO: $268.80 HealthLink — HMO/Open Access/POS: $218.40 HealthLink — PPO: $268.80 Medica(WellFirst) — All Commercial/HMO/PPO: $208.32
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEXITY 2 RVU	$336	$336	$208.32 – $319.20
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $268.80 HealthLink — HMO/Open Access/POS: $218.40 HealthLink — PPO: $268.80 Medica(WellFirst) — All Commercial/HMO/PPO: $208.32 UnitedHealthcare — HMO/PPO: $268.80 USA MCO — Commercial PPO: $319.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$92.27 – $103.82
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans Aetna — Medicare Advantage: $94.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $103.82 Blue Cross Blue Shield of Illinois — PPO: $103.82 UnitedHealthcare — HMO/PPO: $92.27
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEXITY 3 RVU	$457	$457	$123.39 – $434.15
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $361.03 Aetna — Medicare Advantage: $123.39 Aetna Better Health — Dual Medicare/Medicaid MMAI: $123.39 Ambetter — All Ambetter ACA Exchange Plans: $123.39 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $324.01 Blue Cross Blue Shield of Illinois — PPO: $335.44 Cigna — All Commercial/HMO/PPO: $365.60 HealthLink — HMO/Open Access/POS: $297.05 HealthLink — PPO: $365.60 Medica(WellFirst) — All Commercial/HMO/PPO: $283.34
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEXITY 3 RVU	$457	$457	$283.34 – $434.15
Physical therapy evaluation (high complexity): rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $365.60 HealthLink — HMO/Open Access/POS: $297.05 HealthLink — PPO: $365.60 Medica(WellFirst) — All Commercial/HMO/PPO: $283.34 UnitedHealthcare — HMO/PPO: $365.60 USA MCO — Commercial PPO: $434.15
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$92.27 – $103.82
Physical therapy evaluation (high complexity): rates for 4 insurance plans Aetna — Medicare Advantage: $94.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $103.82 Blue Cross Blue Shield of Illinois — PPO: $103.82 UnitedHealthcare — HMO/PPO: $92.27
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: HP PSYCHOTHERAPY W PT 30 MIN	$274	$274	$46.98 – $260.30
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $79.38 Aetna — Medicare Advantage: $69.28 Aetna Better Health — Dual Medicare/Medicaid MMAI: $69.28 Aetna Better Health — HealthChoice/Illinois Medicaid: $46.98 Ambetter — All Ambetter ACA Exchange Plans: $69.28 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $116.68 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $46.98 Blue Cross Blue Shield of Illinois — PPO: $116.68 Cigna — All Commercial/HMO/PPO: $219.20 HealthLink — HMO/Open Access/POS: $178.10
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OP PSYCHOTHERAPY W PT 30 MIN	$274	$274	$73.98 – $260.30
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $216.46 Aetna — Medicare Advantage: $73.98 Aetna Better Health — Dual Medicare/Medicaid MMAI: $73.98 Ambetter — All Ambetter ACA Exchange Plans: $73.98 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $194.27 Blue Cross Blue Shield of Illinois — PPO: $201.12 Cigna — All Commercial/HMO/PPO: $219.20 HealthLink — HMO/Open Access/POS: $178.10 HealthLink — PPO: $219.20 Medica(WellFirst) — All Commercial/HMO/PPO: $169.88
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY W PT 30 MIN	$274	$274	$73.98 – $260.30
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $216.46 Aetna — Medicare Advantage: $73.98 Aetna Better Health — Dual Medicare/Medicaid MMAI: $73.98 Ambetter — All Ambetter ACA Exchange Plans: $73.98 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $194.27 Blue Cross Blue Shield of Illinois — PPO: $201.12 Cigna — All Commercial/HMO/PPO: $219.20 HealthLink — HMO/Open Access/POS: $178.10 HealthLink — PPO: $219.20 Medica(WellFirst) — All Commercial/HMO/PPO: $169.88
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OP PSYCHOTHERAPY W PT 45 MIN	$371	$371	$100.17 – $352.45
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $293.09 Aetna — Medicare Advantage: $100.17 Aetna Better Health — Dual Medicare/Medicaid MMAI: $100.17 Ambetter — All Ambetter ACA Exchange Plans: $100.17 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $263.04 Blue Cross Blue Shield of Illinois — PPO: $272.31 Cigna — All Commercial/HMO/PPO: $296.80 HealthLink — HMO/Open Access/POS: $241.15 HealthLink — PPO: $296.80 Medica(WellFirst) — All Commercial/HMO/PPO: $230.02
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY W PT 45 MIN	$371	$371	$100.17 – $352.45
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $293.09 Aetna — Medicare Advantage: $100.17 Aetna Better Health — Dual Medicare/Medicaid MMAI: $100.17 Ambetter — All Ambetter ACA Exchange Plans: $100.17 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $263.04 Blue Cross Blue Shield of Illinois — PPO: $272.31 Cigna — All Commercial/HMO/PPO: $296.80 HealthLink — HMO/Open Access/POS: $241.15 HealthLink — PPO: $296.80 Medica(WellFirst) — All Commercial/HMO/PPO: $230.02
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OP PSYCHOTHERAPY W PT 45 MIN	$371	$371	$230.02 – $352.45
Psychotherapy, 45 minutes: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $296.80 HealthLink — HMO/Open Access/POS: $241.15 HealthLink — PPO: $296.80 Medica(WellFirst) — All Commercial/HMO/PPO: $230.02 UnitedHealthcare — HMO/PPO: $296.80 USA MCO — Commercial PPO: $352.45
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OP PSYCHOTHERAPY W PT 60 MIN	$437	$437	$117.99 – $415.15
Psychotherapy, 60 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $345.23 Aetna — Medicare Advantage: $117.99 Aetna Better Health — Dual Medicare/Medicaid MMAI: $117.99 Ambetter — All Ambetter ACA Exchange Plans: $117.99 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $309.83 Blue Cross Blue Shield of Illinois — PPO: $320.76 Cigna — All Commercial/HMO/PPO: $349.60 HealthLink — HMO/Open Access/POS: $284.05 HealthLink — PPO: $349.60 Medica(WellFirst) — All Commercial/HMO/PPO: $270.94
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY W PT 60 MIN	$437	$437	$117.99 – $415.15
Psychotherapy, 60 minutes: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $345.23 Aetna — Medicare Advantage: $117.99 Aetna Better Health — Dual Medicare/Medicaid MMAI: $117.99 Ambetter — All Ambetter ACA Exchange Plans: $117.99 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $309.83 Blue Cross Blue Shield of Illinois — PPO: $320.76 Cigna — All Commercial/HMO/PPO: $349.60 HealthLink — HMO/Open Access/POS: $284.05 HealthLink — PPO: $349.60 Medica(WellFirst) — All Commercial/HMO/PPO: $270.94
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OP PSYCHOTHERAPY W PT 60 MIN	$437	$437	$270.94 – $415.15
Psychotherapy, 60 minutes: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $349.60 HealthLink — HMO/Open Access/POS: $284.05 HealthLink — PPO: $349.60 Medica(WellFirst) — All Commercial/HMO/PPO: $270.94 UnitedHealthcare — HMO/PPO: $349.60 USA MCO — Commercial PPO: $415.15
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$99.18 – $199.20
Family psychotherapy, without the patient: rates for 4 insurance plans Aetna — Medicare Advantage: $99.18 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $199.20 Blue Cross Blue Shield of Illinois — PPO: $199.20 UnitedHealthcare — HMO/PPO: $103.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W PT 50 MIN	$376	$376	$101.52 – $357.20
Family psychotherapy, with the patient: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $297.04 Aetna — Medicare Advantage: $101.52 Aetna Better Health — Dual Medicare/Medicaid MMAI: $101.52 Ambetter — All Ambetter ACA Exchange Plans: $101.52 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $266.58 Blue Cross Blue Shield of Illinois — PPO: $275.98 Cigna — All Commercial/HMO/PPO: $300.80 HealthLink — HMO/Open Access/POS: $244.40 HealthLink — PPO: $300.80 Medica(WellFirst) — All Commercial/HMO/PPO: $233.12
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W PT 50 MIN	$376	$376	$233.12 – $357.20
Family psychotherapy, with the patient: rates for 6 insurance plans Cigna — All Commercial/HMO/PPO: $300.80 HealthLink — HMO/Open Access/POS: $244.40 HealthLink — PPO: $300.80 Medica(WellFirst) — All Commercial/HMO/PPO: $233.12 UnitedHealthcare — HMO/PPO: $300.80 USA MCO — Commercial PPO: $357.20
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$102.67 – $206.27
Family psychotherapy, with the patient: rates for 4 insurance plans Aetna — Medicare Advantage: $102.67 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $206.27 Blue Cross Blue Shield of Illinois — PPO: $206.27 UnitedHealthcare — HMO/PPO: $126.32
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: HP GROUP PSYCHOTHERAPY	$498	$498	$24.43 – $473.10
Group psychotherapy: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $28 Aetna — Medicare Advantage: $24.43 Aetna Better Health — Dual Medicare/Medicaid MMAI: $24.43 Aetna Better Health — HealthChoice/Illinois Medicaid: $33.70 Ambetter — All Ambetter ACA Exchange Plans: $24.43 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $57.47 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $33.70 Blue Cross Blue Shield of Illinois — PPO: $57.47 Cigna — All Commercial/HMO/PPO: $398.40 HealthLink — HMO/Open Access/POS: $323.70
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC IOP GROUP PSYCHOTHERAPY SESSION	$498	$498	$134.46 – $473.10
Group psychotherapy: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $393.42 Aetna — Medicare Advantage: $134.46 Aetna Better Health — Dual Medicare/Medicaid MMAI: $134.46 Ambetter — All Ambetter ACA Exchange Plans: $134.46 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $353.08 Blue Cross Blue Shield of Illinois — PPO: $365.53 Cigna — All Commercial/HMO/PPO: $398.40 HealthLink — HMO/Open Access/POS: $323.70 HealthLink — PPO: $398.40 Medica(WellFirst) — All Commercial/HMO/PPO: $308.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OP GROUP PSYCHOTHERAPY SESSION	$498	$498	$134.46 – $473.10
Group psychotherapy: 10 of 16 insurance plan rates Aetna — All Commercial/HMO/PPO: $393.42 Aetna — Medicare Advantage: $134.46 Aetna Better Health — Dual Medicare/Medicaid MMAI: $134.46 Ambetter — All Ambetter ACA Exchange Plans: $134.46 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $353.08 Blue Cross Blue Shield of Illinois — PPO: $365.53 Cigna — All Commercial/HMO/PPO: $398.40 HealthLink — HMO/Open Access/POS: $323.70 HealthLink — PPO: $398.40 Medica(WellFirst) — All Commercial/HMO/PPO: $308.76

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EXCISE BREAST LESION OPEN >=1	$1,747	$1,747	$292.39 – $1,659.65
Removal of breast growth (open surgery): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $431.72 Aetna — Medicare Advantage: $420.59 Aetna Better Health — Dual Medicare/Medicaid MMAI: $420.59 Aetna Better Health — HealthChoice/Illinois Medicaid: $292.39 Ambetter — All Ambetter ACA Exchange Plans: $420.59 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $903.69 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $292.39 Blue Cross Blue Shield of Illinois — PPO: $903.69 Cigna — All Commercial/HMO/PPO: $1,397.60 HealthLink — HMO/Open Access/POS: $1,135.55
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$744.11
Removal of breast growth (open surgery): rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $744.11 Blue Cross Blue Shield of Illinois — PPO: $744.11
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,204.38 – $2,654.91
Total hip replacement: rates for 4 insurance plans Aetna — Medicare Advantage: $1,204.38 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,654.91 Blue Cross Blue Shield of Illinois — PPO: $2,654.91 UnitedHealthcare — HMO/PPO: $1,494.79
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,201.29 – $2,651.49
Total knee replacement: rates for 4 insurance plans Aetna — Medicare Advantage: $1,201.29 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,651.49 Blue Cross Blue Shield of Illinois — PPO: $2,651.49 UnitedHealthcare — HMO/PPO: $1,607.63
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$155.89 – $727.67
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans Aetna — Medicare Advantage: $155.89 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $355.63 Blue Cross Blue Shield of Illinois — PPO: $355.63 UnitedHealthcare — HMO/PPO: $727.67
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$521.14 – $1,052.56
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans Aetna — Medicare Advantage: $521.14 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,052.56 Blue Cross Blue Shield of Illinois — PPO: $1,052.56 UnitedHealthcare — HMO/PPO: $645.61
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$262.92 – $509.25
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans Aetna — Medicare Advantage: $262.92 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $509.25 Blue Cross Blue Shield of Illinois — PPO: $509.25 UnitedHealthcare — HMO/PPO: $338.79
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EGD FLEX TRANSORAL DX	$2,293	$2,293	$112.08 – $2,178.35
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $142.01 Aetna — Medicare Advantage: $112.08 Aetna Better Health — Dual Medicare/Medicaid MMAI: $112.08 Aetna Better Health — HealthChoice/Illinois Medicaid: $118.42 Ambetter — All Ambetter ACA Exchange Plans: $112.08 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $486.91 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $118.42 Blue Cross Blue Shield of Illinois — PPO: $486.91 Cigna — All Commercial/HMO/PPO: $1,834.40 HealthLink — HMO/Open Access/POS: $1,490.45
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$218.80
Upper GI endoscopy (diagnostic): rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $218.80 Blue Cross Blue Shield of Illinois — PPO: $218.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EGD FLEX TRANSORAL W BX SNGL OR MULT	$2,809	$2,809	$125.46 – $2,668.55
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $160.21 Aetna — Medicare Advantage: $125.46 Aetna Better Health — Dual Medicare/Medicaid MMAI: $125.46 Aetna Better Health — HealthChoice/Illinois Medicaid: $133.93 Ambetter — All Ambetter ACA Exchange Plans: $125.46 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $618.01 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $133.93 Blue Cross Blue Shield of Illinois — PPO: $618.01 Cigna — All Commercial/HMO/PPO: $2,247.20 HealthLink — HMO/Open Access/POS: $1,825.85
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$242.44
Upper GI endoscopy with biopsy: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $242.44 Blue Cross Blue Shield of Illinois — PPO: $242.44
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX DIAGNOSTIC	$3,276	$3,276	$168.48 – $3,112.20
Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $214.61 Aetna — Medicare Advantage: $168.48 Aetna Better Health — Dual Medicare/Medicaid MMAI: $168.48 Aetna Better Health — HealthChoice/Illinois Medicaid: $178.60 Ambetter — All Ambetter ACA Exchange Plans: $168.48 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $673.89 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $178.60 Blue Cross Blue Shield of Illinois — PPO: $673.89 Cigna — All Commercial/HMO/PPO: $2,620.80 HealthLink — HMO/Open Access/POS: $2,129.40
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$84.50 – $107.30
Colonoscopy (diagnostic): rates for 9 insurance plans Aetna — All Commercial/HMO/PPO: $107.30 Aetna — Medicare Advantage: $84.50 Aetna Better Health — Dual Medicare/Medicaid MMAI: $84.50 Ambetter — All Ambetter ACA Exchange Plans: $84.50 Medica(WellFirst) — All Commercial/HMO/PPO: $105.63 Medica(WellFirst) — Medicare Advantage: $84.50 Meridian — Dual Medicare/Medicaid MMAI: $84.50 UnitedHealthcare — VA/Community Care: $84.50 WellCare — Medicare Advantage: $84.50
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$380.09
Colonoscopy (diagnostic): rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $380.09 Blue Cross Blue Shield of Illinois — PPO: $380.09
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX WITH BIOPSY	$3,890	$3,890	$181.44 – $3,695.50
Colonoscopy with biopsy: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $233.04 Aetna — Medicare Advantage: $181.44 Aetna Better Health — Dual Medicare/Medicaid MMAI: $181.44 Aetna Better Health — HealthChoice/Illinois Medicaid: $193.80 Ambetter — All Ambetter ACA Exchange Plans: $181.44 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $848.82 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $193.80 Blue Cross Blue Shield of Illinois — PPO: $848.82 Cigna — All Commercial/HMO/PPO: $3,112 HealthLink — HMO/Open Access/POS: $2,528.50
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$414.44
Colonoscopy with biopsy: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $414.44 Blue Cross Blue Shield of Illinois — PPO: $414.44
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX W REMV LES SNARE	$4,107	$4,107	$228.04 – $3,901.65
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $294.90 Aetna — Medicare Advantage: $228.04 Aetna Better Health — Dual Medicare/Medicaid MMAI: $228.04 Aetna Better Health — HealthChoice/Illinois Medicaid: $245.44 Ambetter — All Ambetter ACA Exchange Plans: $228.04 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $898.45 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $245.44 Blue Cross Blue Shield of Illinois — PPO: $898.45 Cigna — All Commercial/HMO/PPO: $3,285.60 HealthLink — HMO/Open Access/POS: $2,669.55
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$521.69
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $521.69 Blue Cross Blue Shield of Illinois — PPO: $521.69
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$230.22 – $451.10
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans Aetna — Medicare Advantage: $230.22 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $451.10 Blue Cross Blue Shield of Illinois — PPO: $451.10 UnitedHealthcare — HMO/PPO: $307.48
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLON CA SCRN NOT HI RSK IND	$575	$575	$169 – $709.04
Screening colonoscopy (not high risk): 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $219.52 Aetna — Medicare Advantage: $169 Aetna Better Health — Dual Medicare/Medicaid MMAI: $169 Aetna Better Health — HealthChoice/Illinois Medicaid: $179.05 Ambetter — All Ambetter ACA Exchange Plans: $169 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $709.04 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $179.05 Blue Cross Blue Shield of Illinois — PPO: $709.04 Cigna — All Commercial/HMO/PPO: $460 HealthLink — HMO/Open Access/POS: $373.75
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$84.50 – $110.02
Screening colonoscopy (not high risk): rates for 9 insurance plans Aetna — All Commercial/HMO/PPO: $110.02 Aetna — Medicare Advantage: $84.50 Aetna Better Health — Dual Medicare/Medicaid MMAI: $84.50 Ambetter — All Ambetter ACA Exchange Plans: $84.50 Medica(WellFirst) — All Commercial/HMO/PPO: $105.63 Medica(WellFirst) — Medicare Advantage: $84.50 Meridian — Dual Medicare/Medicaid MMAI: $84.50 UnitedHealthcare — VA/Community Care: $84.50 WellCare — Medicare Advantage: $84.50
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$400.35
Screening colonoscopy (not high risk): rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $400.35 Blue Cross Blue Shield of Illinois — PPO: $400.35
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: HP LAPAROSCOPIC CHOLECYSTECTOMY	$6,224	$6,224	$647.90 – $5,912.80
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $792.64 Aetna — Medicare Advantage: $664.60 Aetna Better Health — Dual Medicare/Medicaid MMAI: $664.60 Aetna Better Health — HealthChoice/Illinois Medicaid: $647.90 Ambetter — All Ambetter ACA Exchange Plans: $664.60 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,213.20 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $647.90 Blue Cross Blue Shield of Illinois — PPO: $1,213.20 Cigna — All Commercial/HMO/PPO: $4,979.20 HealthLink — HMO/Open Access/POS: $4,045.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: HP RPR HERNIA ING INIT REDUCIBLE >=5YRS	$5,351	$5,351	$387.05 – $5,083.45
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — All Commercial/HMO/PPO: $627.94 Aetna — Medicare Advantage: $530.89 Aetna Better Health — Dual Medicare/Medicaid MMAI: $530.89 Aetna Better Health — HealthChoice/Illinois Medicaid: $387.05 Ambetter — All Ambetter ACA Exchange Plans: $530.89 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $949.73 Blue Cross Blue Shield of Illinois — HealthChoice/Illinois Medicaid: $387.05 Blue Cross Blue Shield of Illinois — PPO: $949.73 Cigna — All Commercial/HMO/PPO: $4,280.80 HealthLink — HMO/Open Access/POS: $3,478.15
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Professional Services	Not listed in the file	Not listed in the file	$204.04 – $406.53
Prostate biopsy: rates for 3 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $406.53 Blue Cross Blue Shield of Illinois — PPO: $406.53 UnitedHealthcare — HMO/PPO: $204.04
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: Professional Services	Not listed in the file	Not listed in the file	$227.35
Prostate biopsy: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $227.35 Blue Cross Blue Shield of Illinois — PPO: $227.35
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$1,112.81 – $2,466.02
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans Aetna — Medicare Advantage: $1,112.81 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,466.02 Blue Cross Blue Shield of Illinois — PPO: $2,466.02 UnitedHealthcare — HMO/PPO: $1,794.72
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$214.09 – $2,424.56
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans Aetna — Medicare Advantage: $214.09 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,424.56 Blue Cross Blue Shield of Illinois — PPO: $2,424.56 UnitedHealthcare — HMO/PPO: $302.60
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$490.64
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $490.64 Blue Cross Blue Shield of Illinois — PPO: $490.64
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$90.23 – $445.19
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans Aetna — Medicare Advantage: $90.23 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $445.19 Blue Cross Blue Shield of Illinois — PPO: $445.19 UnitedHealthcare — HMO/PPO: $273.28
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$182.29
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $182.29 Blue Cross Blue Shield of Illinois — PPO: $182.29
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$99.94 – $416.06
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans Aetna — Medicare Advantage: $99.94 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $416.06 Blue Cross Blue Shield of Illinois — PPO: $416.06 UnitedHealthcare — HMO/PPO: $381.34
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$197.74
Nerve root injection, lower back, with imaging guidance: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $197.74 Blue Cross Blue Shield of Illinois — PPO: $197.74
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$421.96 – $829.81
Carpal tunnel release: rates for 4 insurance plans Aetna — Medicare Advantage: $421.96 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $829.81 Blue Cross Blue Shield of Illinois — PPO: $829.81 UnitedHealthcare — HMO/PPO: $435.79
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$816.83
Carpal tunnel release: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $816.83 Blue Cross Blue Shield of Illinois — PPO: $816.83
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$249.02 – $557.31
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans Aetna — Medicare Advantage: $266.38 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $557.31 Blue Cross Blue Shield of Illinois — PPO: $557.31 UnitedHealthcare — HMO/PPO: $249.02
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$522.30
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans Blue Cross Blue Shield of Illinois — Blue Choice PPO: $522.30 Blue Cross Blue Shield of Illinois — PPO: $522.30
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$454.91 – $1,054.66
Cataract removal with lens implant: rates for 4 insurance plans Aetna — Medicare Advantage: $454.91 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,054.66 Blue Cross Blue Shield of Illinois — PPO: $1,054.66 UnitedHealthcare — HMO/PPO: $737.56

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$1,778.54 – $3,630.04
Vaginal delivery, with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,358.17 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,630.04 Blue Cross Blue Shield of Illinois — PPO: $3,630.04 UnitedHealthcare — HMO/PPO: $1,778.54
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,018.65 – $4,039.56
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,659.68 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $4,039.56 Blue Cross Blue Shield of Illinois — PPO: $4,039.56 UnitedHealthcare — HMO/PPO: $2,018.65
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$1,878.52 – $3,812.55
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,510.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,812.55 Blue Cross Blue Shield of Illinois — PPO: $3,812.55 UnitedHealthcare — HMO/PPO: $1,878.52

Source: Clay County Hospital’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on May 7, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	911 Stacy Burk Dr, Flora, IL 62839
County	Clay County
State	Illinois
Phone	(618) 662‑2131
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	3 of 5 stars
CMS Certification Number	141351
Name in Medicare records	CLAY COUNTY HOSPITAL
Profile level	Medicare data + hospital website
Official website	claycountyhospital.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

Providers & Departments — claycountyhospital.org
Visitor Information — claycountyhospital.org
Emergency | Clay County Hospital and Medical Clinics, Flora, IL — claycountyhospital.org
About Us | Clay County Hospital and Medical Clinics, Flora, IL — claycountyhospital.org
Outpatient Infusion Clinic | Clay County Hospital and Medical Clinics, Flora, IL — claycountyhospital.org

Clay County Hospital

Summary

Profile from official sources

At a glance