Does Columbus Community Hospital have an emergency room?

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

Where is Columbus Community Hospital?

110 Shult Dr, Columbus, TX 78934, in Colorado County, Texas.

What is the phone number of Columbus Community Hospital?

(979) 732-2371, as listed by Medicare (CMS).

What is the Medicare star rating of Columbus Community Hospital?

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

Columbus Community Hospital — Columbus, TX

Quick answers

Does Columbus Community Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Columbus Community Hospital. In a medical emergency, call 911.
Where is Columbus Community Hospital?: 110 Shult Dr, Columbus, TX 78934, in Colorado County, Texas.
What is the phone number of Columbus Community Hospital?: (979) 732-2371, as listed by Medicare (CMS).
What is the Medicare star rating of Columbus Community Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5][10][16]

Conditions treated^{[10][12][15][16]}

Asthma
Chronic obstructive pulmonary disease (COPD)
Sleep apnea
Lung cancer
Emphysema
Pulmonary hypertension
Cystic fibrosis
Sarcoidosis
Tuberculosis
Breast cancer (early detection)
Cataracts
Glaucoma

Treatments^{[10][12][13][14][15]}

3D mammography
Open MRI
CT scans
Nuclear medicine studies
Ultrasound
Bone density scans
Echocardiograms
Fluoroscopic imaging
Sleep study
CPAP therapy
Laboratory services
Blood bank transfusion
Physical therapy
Occupational therapy
Lymphedema treatment
Pain management

Procedures^[10][18]

General surgery
Orthopedic surgery
Gynecological surgery
Endoscopy (colonoscopy, EGD)
Cesarean section
Cataract surgery
Glaucoma surgery
Laparoscopic hysterectomy
Endometrial ablation
Colposcopy
Electronic fetal monitoring

Programs and centers^[7]

Financial assistance program

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

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

Visiting and practical information

Visiting	Medical/surgical unit: visitors limited to 2 per patient, 30 minutes per visit; children must be accompanied by an adult^[9]
Patient portal	Patient Portal

Recognition^[11][18]

Texas Level II Maternal Care Facility designation (runs through Jan. 1, 2028)

Doctors and clinicians (247)

247 doctors and other clinicians list Columbus Community 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 223 more: the button below opens the full list.

Other emergency rooms nearby

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

Rice Medical Center14 mi · Eagle Lake, TX · Critical Access Hospital
Mid Coast Medical Center - Bellville24 mi · Bellville, TX · Acute Care Hospital
Lavaca Medical Center29 mi · Hallettsville, TX · Critical Access Hospital
Baylor Scott & White Hospital Brenham32 mi · Brenham, TX · Acute Care Hospital
El Campo Memorial Hospital36 mi · El Campo, TX · Acute Care Hospital

Other hospitals nearby

Ascension Seton Smithville42 mi · Smithville, TX · Critical Access Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Trucare Living Centers-Columbus1.1 mi · Columbus, TX · 5 of 5 stars
Columbus Oaks Healthcare Community1.5 mi · Columbus, TX · 2 of 5 stars
Arbor Hills Rehabilitation and Healthcare Center14 mi · Eagle Lake, TX · 4 of 5 stars

All nursing homes in the state →

Home health agencies

1st Texas Home Health22 mi · Sealy, TX · 3 of 5 stars
Regency Home Health of Schulenburg24 mi · Schulenburg, TX · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Sealy Dialysis22 mi · Sealy, TX · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Stridecare ASC Sugar Land, LLC11 mi · Sugar Land, TX

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Tejas Health Care Medical Center25 mi · La Grange, TX · Community health center
Tejas Health Care25 mi · La Grange, TX · Community health center

Clinics and urgent care

Columbus Medical Clinic1.7 mi · Columbus, TX · Rural health clinic
Four Oaks Medical Clinic1.7 mi · Columbus, TX · Rural health clinic
Rice Medical Associates18 mi · Eagle Lake, TX · Rural health clinic

Pharmacies

Columbus Pharmacy LLC1.7 mi · Columbus, TX · Community/retail pharmacy
Wal-Mart Stores Texas LLC1.7 mi · Columbus, TX · Community/retail pharmacy

Assisted living nearby

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

Columbus Oaks Healthcare Community1.7 mi · Columbus, TX
The Homestead Assisted Living12 mi · Weimar, TX

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	67%National average: 72%
Would definitely recommend the hospital	72%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	80%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	60%National average: 60%
Completed surveys	119Response rate: 22%

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	11.2%
Deaths within 30 days: pneumonia patients	16.6%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.97No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.6%
Readmitted within 30 days: pneumonia	16.8%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	180 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	48%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as Columbus Community 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: ""ER OBS SUB LEVELIII-NEW PT""	$90	$67.50	$34.20 – $205.32
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $205.32 Blue Cross HMO — HMO: $205.32 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: ""ER OBS SUB LEVELIII-NEW PT""	$90	$67.50	$54 – $81
New patient office visit (about 30–44 minutes): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: ""ESTABLISHED PATIENT VISIT""	$76	$57	$28.88 – $137.54
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $137.54 Blue Cross HMO — HMO: $137.54 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: ""ESTABLISHED PATIENT VISIT""	$76	$57	$45.60 – $68.40
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: ""Established Patient Visit""	$114	$85.50	$43.32 – $212.03
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $212.03 Blue Cross HMO — HMO: $212.03 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: ""Established Patient Visit""	$114	$85.50	$68.40 – $102.60
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: ""Office or Outpatient Consult Low 30 Min""	$250	$187.50	$95 – $257.87
Office consultation with a specialist (moderate): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $257.87 Blue Cross HMO — HMO: $257.87 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) In the file: ""Office or Outpatient Consult Low 30 Min""	$250	$187.50	$150 – $225
Office consultation with a specialist (moderate): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: ""Office or Outpatient Consultation Moderate""	$275	$206.25	$104.50 – $414.49
Office consultation with a specialist (moderate to high): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $414.49 Blue Cross HMO — HMO: $414.49 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) In the file: ""Office or Outpatient Consultation Moderate""	$275	$206.25	$165 – $247.50
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ""ED Evaluation Facility Component, Extended (99283)""	$958	$718.50	$200.22 – $862.20
Emergency room visit (moderate): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $854 Blue Cross HMO — HMO: $854 United Healthcare - Medicare Advantage — Medicare Advantage: $278.89 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ""ER SERVICES""	$185	$138.75	$70.30 – $854
Emergency room visit (moderate): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $854 Blue Cross HMO — HMO: $854 United Healthcare - Medicare Advantage — Medicare Advantage: $278.89 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ""PB-ER MEDIUM Assistant""	$168	$126	$63.84 – $854
Emergency room visit (moderate): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $854 Blue Cross HMO — HMO: $854 United Healthcare - Medicare Advantage — Medicare Advantage: $278.89 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 292.25% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ""ED Evaluation Facility Component, Detailed (99284)""	$1,528	$1,146	$319.35 – $2,000
Emergency room visit (moderately high): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,000 Blue Cross HMO — HMO: $2,000 United Healthcare - Medicare Advantage — Medicare Advantage: $426.30 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 446.73% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 446.73% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 446.73% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: ""ED Evaluation Facility Component, Detailed (99284)""	$1,528	$1,146	$916.80 – $1,375.20
Emergency room visit (moderately high): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ""PB-EMERGENCY DEPT VISIT Assistant""	$412	$309	$156.56 – $2,280
Emergency room visit (high): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,280 Blue Cross HMO — HMO: $2,280 United Healthcare - Medicare Advantage — Medicare Advantage: $608.43 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ""ER SERVICES""	$497	$372.75	$188.86 – $2,280
Emergency room visit (high): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,280 Blue Cross HMO — HMO: $2,280 United Healthcare - Medicare Advantage — Medicare Advantage: $608.43 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ""PB-Emergency Dept Visit""	$515	$386.25	$195.70 – $2,280
Emergency room visit (high): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,280 Blue Cross HMO — HMO: $2,280 United Healthcare - Medicare Advantage — Medicare Advantage: $608.43 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 637.58% (a percentage in the contract, not a dollar amount)

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: ""BASIC METABOLIC PROFILE""	$172	$129	$22.42 – $154.80
Basic metabolic panel (blood test): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $22.42 Blue Cross HMO — HMO: $22.42 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: ""BASIC METABOLIC PROFILE""	$172	$129	$103.20 – $154.80
Basic metabolic panel (blood test): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: ""COMPREHENSIVE METABOLIC/LAB""	$204	$153	$27.98 – $183.60
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $27.98 Blue Cross HMO — HMO: $27.98 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: ""COMPREHENSIVE METABOLIC/LAB""	$204	$153	$122.40 – $183.60
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: ""PRENATAL PROFILE II/LAB""	$276	$207	$104.88 – $248.40
Obstetric blood test panel: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $126.70 Blue Cross HMO — HMO: $126.70 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: ""PRENATAL PROFILE II/LAB""	$276	$207	$165.60 – $248.40
Obstetric blood test panel: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: ""Cardio IQ Lipid Panel / lab""	$186	$139.50	$35.48 – $167.40
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $35.48 Blue Cross HMO — HMO: $35.48 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: ""LIPID PROFILE (CORONARY RISK) LAB""	$137	$102.75	$35.48 – $123.30
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $35.48 Blue Cross HMO — HMO: $35.48 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: ""Cardio IQ Lipid Panel / lab""	$186	$139.50	$111.60 – $167.40
Cholesterol panel (lipid panel): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: ""RENAL PROFILE""	$185	$138.75	$23 – $166.50
Kidney function panel: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $23 Blue Cross HMO — HMO: $23 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: ""RENAL PROFILE""	$185	$138.75	$111 – $166.50
Kidney function panel: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: ""LIVER PANEL/LAB""	$160	$120	$21.65 – $144
Liver function panel: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $21.65 Blue Cross HMO — HMO: $21.65 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: ""LIVER PANEL/LAB""	$160	$120	$96 – $144
Liver function panel: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: ""Urinalysis No Culture Reflex""	$50	$37.50	$8.40 – $45
Urine test (automated, with microscope): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $8.40 Blue Cross HMO — HMO: $8.40 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: ""Urinalysis with Culture Reflex if indicated- Lab""	$50	$37.50	$8.40 – $45
Urine test (automated, with microscope): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $8.40 Blue Cross HMO — HMO: $8.40 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: ""Urinalysis No Culture Reflex""	$50	$37.50	$30 – $45
Urine test (automated, with microscope): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: ""DIPSTICK-URINE/LAB""	$21	$15.75	$5.96 – $18.90
Urine test (automated, without microscope): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $5.96 Blue Cross HMO — HMO: $5.96 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: ""DIPSTICK-URINE/LAB""	$21	$15.75	$12.60 – $18.90
Urine test (automated, without microscope): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: ""PSA, TOTAL/LAB""	$115	$86.25	$43.70 – $103.50
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $48.73 Blue Cross HMO — HMO: $48.73 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: ""PSA, TOTAL (REF) /LAB""	$82	$61.50	$31.16 – $73.80
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $48.73 Blue Cross HMO — HMO: $48.73 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: ""PSA Post Prostatectomy /Lab""	$142	$106.50	$48.73 – $127.80
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $48.73 Blue Cross HMO — HMO: $48.73 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ""TSH/LAB""	$107	$80.25	$40.66 – $96.30
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $44.52 Blue Cross HMO — HMO: $44.52 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ""TSH with Reflex""	$107	$80.25	$40.66 – $96.30
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $44.52 Blue Cross HMO — HMO: $44.52 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ""TSH 3rd Generation/Lab""	$122	$91.50	$44.52 – $109.80
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $44.52 Blue Cross HMO — HMO: $44.52 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: ""CBC-AUTO DIFFERENTIAL/LAB""	$73	$54.75	$20.59 – $65.70
Complete blood count (CBC) with differential: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $20.59 Blue Cross HMO — HMO: $20.59 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: ""CBC-AUTO DIFFERENTIAL/LAB""	$73	$54.75	$43.80 – $65.70
Complete blood count (CBC) with differential: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: ""HEMOGRAM, NO DIFF/LAB""	$72	$54	$17.15 – $64.80
Complete blood count (CBC), automated: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $17.15 Blue Cross HMO — HMO: $17.15 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: ""HEMOGRAM, NO DIFF/LAB""	$72	$54	$43.20 – $64.80
Complete blood count (CBC), automated: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ""PROTHROMBIN TIME""	$62	$46.50	$11.37 – $55.80
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $11.37 Blue Cross HMO — HMO: $11.37 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ""LUPUS ANTICOAGULANT #1""	$125	$93.75	$11.37 – $112.50
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $11.37 Blue Cross HMO — HMO: $11.37 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ""Protime - Lab""	$62	$46.50	$11.37 – $55.80
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $11.37 Blue Cross HMO — HMO: $11.37 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: ""P.T.T./LAB""	$73	$54.75	$15.93 – $65.70
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15.93 Blue Cross HMO — HMO: $15.93 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: ""PTT-LA Screen""	$125	$93.75	$15.93 – $112.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15.93 Blue Cross HMO — HMO: $15.93 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: ""MIXING STUDY - PTT-LA""	$70	$52.50	$15.93 – $63
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15.93 Blue Cross HMO — HMO: $15.93 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: ""CT Head WO Contrast""	$1,329	$996.75	$106.81 – $1,196.10
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $515 Blue Cross - PPO/Traditional — PPO: $336.24 Blue Cross HMO — HMO: $302.62 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 United Healthcare Commercial — PPO/HMO: $600 Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: ""CT Head WO Contrast""	$1,329	$996.75	$797.40 – $1,196.10
CT scan of the head or brain, without contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: ""MRI Brain WWO Contrast""	$2,300	$1,725	$356.43 – $2,070
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $650 Blue Cross - PPO/Traditional — PPO: $1,145.55 Blue Cross HMO — HMO: $1,031 United Healthcare - Medicare Advantage — Medicare Advantage: $356.43 United Healthcare Commercial — PPO/HMO: $750 Aetna Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: ""MRI IAC Pituitary WWO Contrast""	$2,300	$1,725	$356.43 – $2,070
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $650 Blue Cross - PPO/Traditional — PPO: $1,145.55 Blue Cross HMO — HMO: $1,031 United Healthcare - Medicare Advantage — Medicare Advantage: $356.43 United Healthcare Commercial — PPO/HMO: $750 Aetna Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: ""MRI Brain WWO Contrast""	$2,300	$1,725	$1,380 – $2,070
MRI of the brain, before and after contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: ""Xray Chest 2v""	$275	$206.25	$88.91 – $247.50
Chest X-ray, 2 views: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $239.43 Blue Cross HMO — HMO: $143.66 United Healthcare - Medicare Advantage — Medicare Advantage: $88.91 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 93.17% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 93.17% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 93.17% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: ""Xray Chest 2v""	$275	$206.25	$165 – $247.50
Chest X-ray, 2 views: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: ""Xray Spine Lumbar 5 views""	$375	$281.25	$106.81 – $337.50
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $336.24 Blue Cross HMO — HMO: $201.74 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: ""Xray Spine Lumbar 5 views""	$375	$281.25	$225 – $337.50
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: ""MRI Lumbar Spine WO Contrast""	$2,000	$1,500	$243.77 – $1,800
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $650 Blue Cross - PPO/Traditional — PPO: $699.12 Blue Cross HMO — HMO: $629.21 United Healthcare - Medicare Advantage — Medicare Advantage: $243.77 United Healthcare Commercial — PPO/HMO: $750 Aetna Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: ""MRI Lumbar Spine WO Contrast""	$2,000	$1,500	$1,200 – $1,800
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: ""CT Pelvis W Contrast""	$1,833	$1,374.75	$179.20 – $1,649.70
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $515 Blue Cross - PPO/Traditional — PPO: $546.66 Blue Cross HMO — HMO: $491.99 United Healthcare - Medicare Advantage — Medicare Advantage: $179.20 United Healthcare Commercial — PPO/HMO: $600 Aetna Medicare Advantage — Medicare Advantage: 187.79% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 187.79% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: ""CT Pelvis W Contrast""	$1,833	$1,374.75	$1,099.80 – $1,649.70
CT scan of the pelvis, with contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: ""MRI Lower Extremity Joint WO Contrast Left""	$2,100	$1,575	$243.77 – $1,890
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $650 Blue Cross - PPO/Traditional — PPO: $699.12 Blue Cross HMO — HMO: $629.21 United Healthcare - Medicare Advantage — Medicare Advantage: $243.77 United Healthcare Commercial — PPO/HMO: $750 Aetna Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: ""MRI Lower Extremity Joint WO Contrast Right""	$2,100	$1,575	$243.77 – $1,890
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $650 Blue Cross - PPO/Traditional — PPO: $699.12 Blue Cross HMO — HMO: $629.21 United Healthcare - Medicare Advantage — Medicare Advantage: $243.77 United Healthcare Commercial — PPO/HMO: $750 Aetna Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 255.45% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: ""MRI Lower Extremity Joint WO Contrast Left""	$2,100	$1,575	$1,260 – $1,890
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: ""CT Abd/Pelvis W Contrast""	$3,262	$2,446.50	$356.43 – $2,935.80
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates Aetna Commercial — PPO/HMO: $515 Blue Cross - PPO/Traditional — PPO: $1,145.55 Blue Cross HMO — HMO: $1,031 United Healthcare - Medicare Advantage — Medicare Advantage: $356.43 United Healthcare Commercial — PPO/HMO: $600 Aetna Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 373.51% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: ""CT Abd/Pelvis W Contrast""	$3,262	$2,446.50	$1,957.20 – $2,935.80
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: ""US Abdomen,Complete""	$750	$562.50	$106.81 – $675
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $336.24 Blue Cross HMO — HMO: $201.74 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: ""US Abdomen,Complete""	$750	$562.50	$450 – $675
Ultrasound of the abdomen, complete: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: ""US OB,After 1St Trimester""	$450	$337.50	$106.81 – $405
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $274.62 Blue Cross HMO — HMO: $164.77 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: ""ULTRASOUND/ECHO EXAM/PREG.""	$172	$129	$65.36 – $274.62
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $274.62 Blue Cross HMO — HMO: $164.77 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: ""US OB,After 1St Trimester""	$450	$337.50	$270 – $405
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: ""US Transvaginal,Non-Obstetric""	$450	$337.50	$106.81 – $405
Transvaginal ultrasound: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $264.90 Blue Cross HMO — HMO: $158.94 United Healthcare - Medicare Advantage — Medicare Advantage: $106.81 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 111.93% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: ""US Transvaginal,Non-Obstetric""	$450	$337.50	$270 – $405
Transvaginal ultrasound: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: ""Mammogram Unilateral Left""	$320	$240	$121.60 – $288
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $282.18 Blue Cross HMO — HMO: $169.31 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: ""Mammogram Unilateral - Right""	$320	$240	$121.60 – $288
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $282.18 Blue Cross HMO — HMO: $169.31 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: ""Mammogram Unilateral Left""	$320	$240	$192 – $288
Diagnostic mammogram, one breast: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: ""Mammography Digital Diagnostic with CAD- Bilateral""	$400	$300	$100 – $361.11
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates Blue Cross - PPO/Traditional — PPO: $361.11 Blue Cross HMO — HMO: $216.67 United Healthcare - Medicare Advantage — Medicare Advantage: $100 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: ""Mammography Digital Diagnostic with CAD- Bilateral""	$400	$300	$240 – $360
Diagnostic mammogram, both breasts: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: ""Mammogram Screening with CAD, Digital""	$375	$281.25	$100 – $337.50
Screening mammogram, both breasts: 10 of 12 insurance plan rates Blue Cross - PPO/Traditional — PPO: $298.41 Blue Cross HMO — HMO: $179.05 United Healthcare - Medicare Advantage — Medicare Advantage: $100 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: ""Mammogram Screening with CAD, Digital""	$375	$281.25	$225 – $337.50
Screening mammogram, both breasts: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: ""SLEEP STUDY (POLYSOMNOGRAPHY)""	$1,557	$1,167.75	$591.66 – $1,401.30
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,327.49 Blue Cross HMO — HMO: $1,327.49 United Healthcare - Medicare Advantage — Medicare Advantage: $877.34 Aetna Medicare Advantage — Medicare Advantage: 919.37% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 919.37% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 919.37% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: ""SLEEP STUDY (POLYSOMNOGRAPHY)""	$1,557	$1,167.75	$934.20 – $1,401.30
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: ""OT Therapeutic Exercises""	$50	$37.50	$19 – $125
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $83.08 Blue Cross HMO — HMO: $83.08 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: ""THERAPEUTIC EXERCISE/ST""	$45	$33.75	$17.10 – $125
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $83.08 Blue Cross HMO — HMO: $83.08 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: ""OT Therapeutic Exercises with Manual Therapy""	$50	$37.50	$19 – $125
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $83.08 Blue Cross HMO — HMO: $83.08 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: ""PT Eval Low Complexity-97161""	$250	$187.50	$95 – $229.20
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $229.20 Blue Cross HMO — HMO: $229.20 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: ""PT Physical Therapy Visit Cash Payment 15 min""	$25	$18.75	$9.50 – $229.20
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $229.20 Blue Cross HMO — HMO: $229.20 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) In the file: ""PT Eval Low Complexity-97161""	$250	$187.50	$150 – $225
Physical therapy evaluation (low complexity): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: ""PT Eval Moderate Complexity-97162""	$250	$187.50	$95 – $229.20
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $229.20 Blue Cross HMO — HMO: $229.20 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) In the file: ""PT Eval Moderate Complexity-97162""	$250	$187.50	$150 – $225
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: ""PT Eval High Complexity-97163""	$250	$187.50	$95 – $229.20
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $229.20 Blue Cross HMO — HMO: $229.20 United Healthcare Commercial — PPO/HMO: $125 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: ""PT Eval High Complexity-97163""	$250	$187.50	$150 – $225
Physical therapy evaluation (high complexity): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: ""OR/BREAST BIOPSY""	$7,245	$5,433.75	$2,753.10 – $6,520.50
Removal of breast growth (open surgery): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,938.42 Blue Cross HMO — HMO: $4,301.96 United Healthcare - Medicare Advantage — Medicare Advantage: $4,000.24 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 4,191.9% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 4,191.9% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 4,191.9% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: ""OR/BREAST BIOPSY""	$7,245	$5,433.75	$4,347 – $6,520.50
Removal of breast growth (open surgery): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: ""PB-THR""	$2,487	$1,865.25	$945.06 – $16,899.01
Total hip replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: ""OR/Arthroplasty Hip""	$27,300	$20,475	$10,374 – $24,570
Total hip replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: ""PB-THR Assistant""	$1,990	$1,492.50	$756.20 – $16,899.01
Total hip replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: ""PB-TKR""	$2,485	$1,863.75	$944.30 – $16,899.01
Total knee replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: ""OR/Total Knee arthroplasty""	$25,200	$18,900	$9,576 – $22,680
Total knee replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: ""PB-TKR Assistant""	$1,988	$1,491	$755.44 – $16,899.01
Total knee replacement: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $15,470.92 Blue Cross HMO — HMO: $16,899.01 United Healthcare - Medicare Advantage — Medicare Advantage: $13,116.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 13,745.21% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: ""OR/DECOMPRESSION SUBACROMIAL SPACE/ARTHO""	$1,112	$834	$422.56 – $1,000.80
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) United Healthcare Commercial — PPO/HMO: 78% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) In the file: ""OR/DECOMPRESSION SUBACROMIAL SPACE/ARTHO""	$1,112	$834	$667.20 – $1,000.80
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ""PB-SCOPE MED OR LAT""	$1,322	$991.50	$502.36 – $3,887.18
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,558.69 Blue Cross HMO — HMO: $3,887.18 United Healthcare - Medicare Advantage — Medicare Advantage: $3,342.87 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ""PB-SCOPE MED OR LAT Assistant""	$1,058	$793.50	$402.04 – $3,887.18
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,558.69 Blue Cross HMO — HMO: $3,887.18 United Healthcare - Medicare Advantage — Medicare Advantage: $3,342.87 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ""OR/ARTHOSCOPY/KNEE WITH MEN. LATERAL""	$3,150	$2,362.50	$1,197 – $3,887.18
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,558.69 Blue Cross HMO — HMO: $3,887.18 United Healthcare - Medicare Advantage — Medicare Advantage: $3,342.87 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,503.03% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: ""Tonsillectomy & Adenoidectomy, Under Age 12""	$900	$675	$342 – $6,887.75
Removal of tonsils and adenoids (under age 12): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $6,305.69 Blue Cross HMO — HMO: $6,887.75 United Healthcare - Medicare Advantage — Medicare Advantage: $6,048.05 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: ""Or/T&A""	$1,164	$873	$442.32 – $6,887.75
Removal of tonsils and adenoids (under age 12): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $6,305.69 Blue Cross HMO — HMO: $6,887.75 United Healthcare - Medicare Advantage — Medicare Advantage: $6,048.05 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 6,337.82% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) In the file: ""Tonsillectomy & Adenoidectomy, Under Age 12""	$900	$675	$540 – $810
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: ""OR/EGD ONLY""	$1,155	$866.25	$438.90 – $1,116.01
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,021.70 Blue Cross HMO — HMO: $1,116.01 United Healthcare - Medicare Advantage — Medicare Advantage: $926.63 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: ""OR/EGD ONLY""	$1,155	$866.25	$693 – $1,039.50
Upper GI endoscopy (diagnostic): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: ""OR/EGD ONLY W/BIOPSY""	$1,100	$825	$418 – $1,116.01
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,021.70 Blue Cross HMO — HMO: $1,116.01 United Healthcare - Medicare Advantage — Medicare Advantage: $926.63 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 971.03% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: ""OR/EGD ONLY W/BIOPSY""	$1,100	$825	$660 – $990
Upper GI endoscopy with biopsy: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: ""Colonoscopy, flexible; diagnositc""	$1,172	$879	$445.36 – $1,084.71
Colonoscopy (diagnostic): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $993.04 Blue Cross HMO — HMO: $1,084.71 United Healthcare - Medicare Advantage — Medicare Advantage: $950.10 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: ""OR/COLONSCOPY ONLY""	$1,155	$866.25	$438.90 – $1,084.71
Colonoscopy (diagnostic): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $993.04 Blue Cross HMO — HMO: $1,084.71 United Healthcare - Medicare Advantage — Medicare Advantage: $950.10 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: ""Colonoscopy, flexible; diagnositc""	$1,172	$879	$703.20 – $1,054.80
Colonoscopy (diagnostic): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: ""OR/COLONSCOPY ONLY W/BIOPSY""	$1,155	$866.25	$438.90 – $1,425.99
Colonoscopy with biopsy: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,305.49 Blue Cross HMO — HMO: $1,425.99 United Healthcare - Medicare Advantage — Medicare Advantage: $1,222.56 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: ""Colonoscopy, Fiberoptic W/Biopsy""	$1,451	$1,088.25	$551.38 – $1,425.99
Colonoscopy with biopsy: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,305.49 Blue Cross HMO — HMO: $1,425.99 United Healthcare - Medicare Advantage — Medicare Advantage: $1,222.56 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: ""OR/COLONSCOPY ONLY W/BIOPSY""	$1,155	$866.25	$693 – $1,039.50
Colonoscopy with biopsy: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: ""OR/PROCTOSCOPY WITH BIOPSY""	$1,100	$825	$418 – $1,425.99
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,305.49 Blue Cross HMO — HMO: $1,425.99 United Healthcare - Medicare Advantage — Medicare Advantage: $1,222.56 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: ""Colonoscopy, Flexible; With Removal of Tumor(S), Polyp(S) Or Other Lesion(S) By Snare Technique""	$1,538	$1,153.50	$584.44 – $1,425.99
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,305.49 Blue Cross HMO — HMO: $1,425.99 United Healthcare - Medicare Advantage — Medicare Advantage: $1,222.56 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 1,281.13% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) In the file: ""OR/PROCTOSCOPY WITH BIOPSY""	$1,100	$825	$660 – $990
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: ""OR/COLONSCOPY WITH SCREENING""	$1,100	$825	$418 – $1,084.71
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $993.04 Blue Cross HMO — HMO: $1,084.71 United Healthcare - Medicare Advantage — Medicare Advantage: $950.10 Aetna Commercial — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 995.63% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: ""OR/COLONSCOPY WITH SCREENING""	$1,100	$825	$660 – $990
Screening colonoscopy (not high risk): rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: ""OR/LAPAROSCOPIC CHOLECYSTECTOMY""	$5,250	$3,937.50	$1,995 – $6,863.87
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $6,283.82 Blue Cross HMO — HMO: $6,863.87 United Healthcare - Medicare Advantage — Medicare Advantage: $6,176.47 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 6,472.39% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 6,472.39% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 6,472.39% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: ""OR/LAPAROSCOPIC CHOLECYSTECTOMY""	$5,250	$3,937.50	$3,150 – $4,725
Gallbladder removal by laparoscope: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: ""OR/REPAIR HERNIA WITH PLUG AND PATCH""	$6,720	$5,040	$2,553.60 – $6,048
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $4,042.14 Blue Cross HMO — HMO: $4,415.26 United Healthcare - Medicare Advantage — Medicare Advantage: $3,657.95 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,833.2% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,833.2% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,833.2% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: ""OR/REPAIR HERNIA WITH PLUG AND PATCH""	$6,720	$5,040	$4,032 – $6,048
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: ""BIOPSY OF PROSTATE""	$3,900	$2,925	$1,482 – $3,510
Prostate biopsy: 10 of 12 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,303.02 Blue Cross HMO — HMO: $2,515.60 United Healthcare - Medicare Advantage — Medicare Advantage: $2,048.51 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Inpatient (hospital stay) In the file: ""BIOPSY OF PROSTATE""	$3,900	$2,925	$2,340 – $3,510
Prostate biopsy: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: ""OR/HYSTEROSCOPIC D&C""	$4,200	$3,150	$1,596 – $3,780
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,247.53 Blue Cross HMO — HMO: $3,547.30 United Healthcare - Medicare Advantage — Medicare Advantage: $3,307.24 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: ""HYSTEROSCOPY W/BIOPSY""	$754	$565.50	$286.52 – $3,547.30
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,247.53 Blue Cross HMO — HMO: $3,547.30 United Healthcare - Medicare Advantage — Medicare Advantage: $3,307.24 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 3,465.69% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) In the file: ""OR/HYSTEROSCOPIC D&C""	$4,200	$3,150	$2,520 – $3,780
Hysteroscopy with biopsy of the uterus lining: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: ""OR/injection, lumbar or sacral with guidance""	$1,313	$984.75	$498.94 – $1,181.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $812.57 Blue Cross HMO — HMO: $887.57 United Healthcare - Medicare Advantage — Medicare Advantage: $721.17 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 755.72% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 755.72% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 755.72% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: ""OR/injection, lumbar or sacral with guidance""	$1,313	$984.75	$787.80 – $1,181.70
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: ""Injection, Foramen Epidural, lumbar or sacral w/guidance, single""	$1,733	$1,299.75	$658.54 – $1,559.70
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $1,055.67 Blue Cross HMO — HMO: $1,153.11 United Healthcare - Medicare Advantage — Medicare Advantage: $903.63 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 946.93% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 946.93% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 946.93% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: ""Injection, Foramen Epidural, lumbar or sacral w/guidance, single""	$1,733	$1,299.75	$1,039.80 – $1,559.70
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: ""OR/CARPAL TUNNEL RELEASE""	$3,780	$2,835	$1,436.40 – $3,402
Carpal tunnel release: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,235.16 Blue Cross HMO — HMO: $2,441.48 United Healthcare - Medicare Advantage — Medicare Advantage: $1,995.02 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: ""OR/ Neuro/ Right Media Nerve""	$3,780	$2,835	$1,436.40 – $3,402
Carpal tunnel release: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,235.16 Blue Cross HMO — HMO: $2,441.48 United Healthcare - Medicare Advantage — Medicare Advantage: $1,995.02 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: ""PB-CTR""	$1,281	$960.75	$486.78 – $2,441.48
Carpal tunnel release: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,235.16 Blue Cross HMO — HMO: $2,441.48 United Healthcare - Medicare Advantage — Medicare Advantage: $1,995.02 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 2,090.61% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: ""OR/SELECTIVE LASER CAPSULOTOMY YAG""	$1,020	$765	$387.60 – $918
Laser treatment of clouding after cataract surgery: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $659.01 Blue Cross HMO — HMO: $719.84 United Healthcare - Medicare Advantage — Medicare Advantage: $561.91 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 588.84% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 588.84% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 588.84% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) In the file: ""OR/SELECTIVE LASER CAPSULOTOMY YAG""	$1,020	$765	$612 – $918
Laser treatment of clouding after cataract surgery: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: ""OR/CATARACT REMOVAL/LENS INSERTION""	$1,290	$967.50	$490.20 – $2,871.04
Cataract removal with lens implant: 10 of 17 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,628.42 Blue Cross HMO — HMO: $2,871.04 United Healthcare - Medicare Advantage — Medicare Advantage: $2,357.81 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Aetna Medicare Advantage — Medicare Advantage: 2,470.77% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) BCBS Medicare Advantage — Medicare Advantage: 2,470.77% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Cigna Healthspring Medicare Advantage — Medicare Advantage: 2,470.77% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) In the file: ""OR/CATARACT REMOVAL/LENS INSERTION""	$1,290	$967.50	$774 – $1,161
Cataract removal with lens implant: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: ""Vaginal Delivery-Global Billing""	$3,568	$2,676	$1,355.84 – $3,211.20
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $2,831.19 Blue Cross HMO — HMO: $3,092.53 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: ""Vaginal Delivery-Global Billing""	$3,568	$2,676	$2,140.80 – $3,211.20
Vaginal delivery, with care before and after: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: ""Cesarean Delivery-Global Billing""	$3,691	$2,768.25	$1,402.58 – $3,428.76
Cesarean delivery (C-section), with care before and after: 10 of 11 insurance plan rates Blue Cross - PPO/Traditional — PPO: $3,139.01 Blue Cross HMO — HMO: $3,428.76 Aetna Commercial — PPO/HMO: 75% (a percentage in the contract, not a dollar amount) Affiliated Healthcare — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Cigna — PPO/HMO: 67.6% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount) Superior Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount) Texas Medicaid — Medicaid: 38% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: ""Cesarean Delivery-Global Billing""	$3,691	$2,768.25	$2,214.60 – $3,321.90
Cesarean delivery (C-section), with care before and after: rates for 5 insurance plans Blue Bell Creameries INC — PPO/HMO: 90% (a percentage in the contract, not a dollar amount) Blue Cross - PPO/Traditional — PPO: 60% (a percentage in the contract, not a dollar amount) Blue Cross HMO — HMO: 60% (a percentage in the contract, not a dollar amount) Great Southern Wood Preserving INC — PPO/HMO: 65% (a percentage in the contract, not a dollar amount) Multiplan — PPO/HMO: 85% (a percentage in the contract, not a dollar amount)

Source: Columbus Community Hospital’s standard charges file (columbusch.slicedhealth.io, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 25, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	110 Shult Dr, Columbus, TX 78934
County	Colorado County
State	Texas
Phone	(979) 732‑2371
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	450370
Name in Medicare records	COLUMBUS COMMUNITY HOSPITAL
Profile level	Medicare data + hospital website
Official website	columbusch.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Our Services — columbusch.com
Financial Services | Columbus Community Hospital — columbusch.com
Emergency Medicine | Columbus Community Hospital — columbusch.com
Inpatient Services | Columbus Community Hospital — columbusch.com
Surgical Services | Columbus Community Hospital — columbusch.com
Level II Maternal Facility | Columbus Community Hospital — columbusch.com
Imaging Services | Columbus Community Hospital — columbusch.com
Laboratory | Columbus Community Hospital — columbusch.com
Physical and Occupational Therapy | Columbus Community Hospital — columbusch.com
Sleep Medicine | Columbus Community Hospital — columbusch.com
Pulmonology | Columbus Community Hospital — columbusch.com
Ob/Gyn Services | Columbus Community Hospital — columbusch.com

Columbus Community Hospital

Summary

Profile from official sources

At a glance