Does Community Hospital of Bremen Inc have an emergency room?

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

Where is Community Hospital of Bremen Inc?

1020 High Rd, Bremen, IN 46506, in Marshall County, Indiana.

What is the phone number of Community Hospital of Bremen Inc?

(574) 546-2211, as listed by Medicare (CMS).

What is the Medicare star rating of Community Hospital of Bremen Inc?

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

Community Hospital of Bremen Inc — Bremen, IN

Quick answers

Does Community Hospital of Bremen Inc have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Community Hospital of Bremen Inc. In a medical emergency, call 911.
Where is Community Hospital of Bremen Inc?: 1020 High Rd, Bremen, IN 46506, in Marshall County, Indiana.
What is the phone number of Community Hospital of Bremen Inc?: (574) 546-2211, as listed by Medicare (CMS).
What is the Medicare star rating of Community Hospital of Bremen Inc?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4]

Emergency Department
General surgery
Obstetrics
Radiology
Occupational health

Treatments^[4][6]

Procedures^[4]

Programs and centers^[6][9]

Sleep lab
Occupational health
Bremen Obstetrics

Emergency care (hospital website)^[4][6]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Visiting is open 24/7; one visitor may stay overnight; isolation may limit visits^[4]
Parking	Outpatient therapy parking lot is the first entrance on the left from High Road, near the ER entrance^[7]

Doctors and clinicians (202)

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

Main specialties

Doctors with a page on this site (202)

Abigail M. Battjes, DOFamily Practice
Abrar Sayeed, MDInternal Medicine
Abul W. Basher, MDCardiovascular Disease (Cardiology)
Ahmed Abdelhalim, MDInternal Medicine
Alejandro M. Mikelonis, PAPhysician Assistant
Aleksandar Alavanja, MDDiagnostic Radiology
Alexander Tawadros, MDDiagnostic Radiology
Algis J. Baliunas, MDEmergency Medicine
Allison Lamont, MDDiagnostic Radiology
Alphonse H. Harding, MDDiagnostic Radiology
Alyssa L. Ingle, NPNurse Practitioner
Amanda L. Springer, MDFamily Practice
Amanda M. Huff, CNACertified Registered Nurse Anesthetist (CRNA)
Amber L. Lichtenbarger, MDFamily Practice
Amy Williams, NPNurse Practitioner
Anish H. Nayee, MDUrology
Arif Goreja, MDNephrology
Asad Kizilbash, MDInternal Medicine
Ashley A. Saia, NPNurse Practitioner
Asma Iftikhar, MDInternal Medicine
Bethany Metz, NPNurse Practitioner
Blair S. Macphail, MDCardiovascular Disease (Cardiology)
Brendan T. Durr, DOCardiovascular Disease (Cardiology)
Brian FreemanEmergency Medicine

And 178 more: the button below opens the full list.

Other emergency rooms nearby

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

Michiana Behavioral Health Center11 mi · Plymouth, IN · Psychiatric Hospital
Saint Joseph Regional Medical Center - Plymouth12 mi · Plymouth, IN · Acute Care Hospital
Saint Joseph Regional Medical Center16 mi · Mishawaka, IN · Acute Care Hospital
Memorial Hospital of South Bend16 mi · South Bend, IN · Acute Care Hospital
Goshen Hospital19 mi · Goshen, IN · Acute Care Hospital

Other hospitals nearby

Doctors Neuropsychiatric Hospital1.0 mi · Bremen, IN · Psychiatric Hospital
Medical Behavioral Hospital - Mishawaka15 mi · Mishawaka, IN · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Signature Healthcare of Bremen1.4 mi · Bremen, IN · 2 of 5 stars
The Waters of Wakarusa Skilled Nursing Facility9.0 mi · Wakarusa, IN · 1 of 5 stars
Pilgrim Manor11 mi · Plymouth, IN · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Ascent Hospice LLC16 mi · South Bend, IN
Goshen Home Care and Hospice16 mi · Goshen, IN · 5 of 5 stars
Caring Cove Hospice LLC16 mi · Mishawaka, IN

All hospice providers in the state →

Home health agencies

Concept Therapy Home Health, LLC15 mi · South Bend, IN
Saint Joseph VNA Home Care16 mi · South Bend, IN
Goshen Home Care & Hospice16 mi · Goshen, IN

All home health agencies in the state →

Dialysis facilities

FMC - Nephrology - Marshall County11 mi · Plymouth, IN · 3 of 5 stars
DaVita Irish at Home12 mi · South Bend, IN · 2 of 5 stars
FMC - Nephrology - Elkhart14 mi · Elkhart, IN · 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.

The South Bend Clinic & Surgicenter16 mi · South Bend, IN
Goshen Health Surgery Center LLC16 mi · Goshen, IN
Azura Surgery Center Michiana Vascular16 mi · Mishawaka, IN

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

Bowen Health- Bremen0.8 mi · Bremen, IN · Community health center
Bowen Center Marshall12 mi · Plymouth, IN · Community health center
HealthLinc Mishawaka14 mi · Mishawaka, IN · Community health center

Clinics and urgent care

Franciscan Physician Network11 mi · Mishawaka, IN · Urgent care center
American Current Care P.A .16 mi · Goshen, IN · Urgent care center
Goshen Health System, Inc16 mi · Goshen, IN · Urgent care center

Pharmacies

Hook-Superx LLC0.8 mi · Bremen, IN · Pharmacy
Seifert Healthcare LLC7.6 mi · Wakarusa, IN · Community/retail pharmacy
Hook-Superx LLC8.2 mi · Nappanee, IN · Pharmacy

Assisted living nearby

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

Community Development Corporation of Mishawaka, in11 mi · Mishawaka, IN
Hellenic Senior Living of Mishawaka11 mi · Mishawaka, IN
Primrose of Mishawaka11 mi · Mishawaka, IN
Grand Emerald Place12 mi · South Bend, IN

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 Community Hospital of Bremen Inc 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	82%National average: 72%
Would definitely recommend the hospital	79%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	80%National average: 80%
Staff “always” explained medicines before giving them	64%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	75%National average: 74%
Area around the room “always” quiet at night	68%National average: 60%
Completed surveys	130Response rate: 31%

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	Too few cases to report
Deaths within 30 days: pneumonia patients	17.8%
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)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Too few cases to report
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	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	99 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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 Indiana Best hospitals in Indiana

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 62 common services exactly as Community Hospital of Bremen Inc 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)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Level 3 (Intermediate) (6-8)	$826	$536.90	$256.06 – $1,073.80
Emergency room visit (moderate): 10 of 29 insurance plan rates Aetna — Commercial: $624.46 Aetna — Medicare Advantage: $256.06 All Savers — Commercial: $677.32 Allied Benefit — Commercial: $624.46 Anthem — Commercial PPO: $452.65 Anthem — Commercial Trad: $497.17 Anthem — Exchange: $256.06 Anthem — Medicare Advantage: $256.06 Anthem — Pathway Essentials: $330.40 Anthem — Workers Compensation: $256.06
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Level 3 (Intermediate) (6-8)	$826	$536.90	$413 – $1,073.80
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — Commercial: $624.46 Allied Benefit — Commercial: $624.46 Anthem — Commercial PPO: $439.18 Anthem — Commercial Trad: $497.50 Caresource — IN Medicaid HIP: $1,073.80 CHA — Commercial: $636.02 CHA — Employer Group 4: $578.20 Cigna Prof Benefit — Commercial: $677.32 Cigna Sagamore — Commercial: $574.07 Cigna Sagamore — PPO: $574.07
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Level 4 (Extended) (9-13)	$1,291	$839.15	$400.21 – $1,678.30
Emergency room visit (moderately high): 10 of 29 insurance plan rates Aetna — Commercial: $976 Aetna — Medicare Advantage: $400.21 All Savers — Commercial: $1,058.62 Allied Benefit — Commercial: $976 Anthem — Commercial PPO: $707.47 Anthem — Commercial Trad: $777.05 Anthem — Exchange: $400.21 Anthem — Medicare Advantage: $400.21 Anthem — Pathway Essentials: $516.40 Anthem — Workers Compensation: $400.21
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Level 4 (Extended) (9-13)	$1,291	$839.15	$645.50 – $1,678.30
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — Commercial: $976 Allied Benefit — Commercial: $976 Anthem — Commercial PPO: $686.42 Anthem — Commercial Trad: $777.57 Caresource — IN Medicaid HIP: $1,678.30 CHA — Commercial: $994.07 CHA — Employer Group 4: $903.70 Cigna Prof Benefit — Commercial: $1,058.62 Cigna Sagamore — Commercial: $897.24 Cigna Sagamore — PPO: $897.24
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Level 5 (Comprehensive) (>/=14)	$1,925	$1,251.25	$596.75 – $2,502.50
Emergency room visit (high): 10 of 29 insurance plan rates Aetna — Commercial: $1,455.30 Aetna — Medicare Advantage: $596.75 All Savers — Commercial: $1,578.50 Allied Benefit — Commercial: $1,455.30 Anthem — Commercial PPO: $1,054.90 Anthem — Commercial Trad: $1,158.66 Anthem — Exchange: $596.75 Anthem — Medicare Advantage: $596.75 Anthem — Pathway Essentials: $770 Anthem — Workers Compensation: $596.75
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Level 5 (Comprehensive) (>/=14)	$1,925	$1,251.25	$962.50 – $2,502.50
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — Commercial: $1,455.30 Allied Benefit — Commercial: $1,455.30 Anthem — Commercial PPO: $1,023.52 Anthem — Commercial Trad: $1,159.43 Caresource — IN Medicaid HIP: $2,502.50 CHA — Commercial: $1,482.25 CHA — Employer Group 4: $1,347.50 Cigna Prof Benefit — Commercial: $1,578.50 Cigna Sagamore — Commercial: $1,337.88 Cigna Sagamore — PPO: $1,337.88

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 80048 METABOLIC PANEL TOTAL CA	$9	$5.85	$2.79 – $11.70
Basic metabolic panel (blood test): 10 of 29 insurance plan rates Aetna — Commercial: $6.80 Aetna — Medicare Advantage: $2.79 All Savers — Commercial: $7.38 Allied Benefit — Commercial: $6.80 Anthem — Commercial PPO: $4.93 Anthem — Commercial Trad: $5.42 Anthem — Exchange: $2.79 Anthem — Medicare Advantage: $2.79 Anthem — Pathway Essentials: $3.60 Anthem — Workers Compensation: $2.79
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 80048 METABOLIC PANEL TOTAL CA	$9	$5.85	$4.50 – $11.70
Basic metabolic panel (blood test): 10 of 16 insurance plan rates Aetna — Commercial: $6.80 Allied Benefit — Commercial: $6.80 Anthem — Commercial PPO: $4.79 Anthem — Commercial Trad: $5.42 Caresource — IN Medicaid HIP: $11.70 CHA — Commercial: $6.93 CHA — Employer Group 4: $6.30 Cigna Prof Benefit — Commercial: $7.38 Cigna Sagamore — Commercial: $6.26 Cigna Sagamore — PPO: $6.26
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$8.46
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $8.46 Anthem — Exchange: $8.46 Anthem — IN Medicaid HCC: $8.46 Anthem — IN Medicaid HIP: $8.46 Anthem — Medicare Advantage: $8.46 Anthem — Workers Compensation: $8.46 Caresource — Exchange: $13.54 Caresource — IN Medicaid HIP: $8.46 Humana — Medicare Advantage: $8.54 Humana — Pathways for Aging: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic PanelComprehensive	$15	$9.75	$4.65 – $19.50
Comprehensive metabolic panel (blood test): 10 of 29 insurance plan rates Aetna — Commercial: $11.34 Aetna — Medicare Advantage: $4.65 All Savers — Commercial: $12.30 Allied Benefit — Commercial: $11.34 Anthem — Commercial PPO: $8.22 Anthem — Commercial Trad: $9.03 Anthem — Exchange: $4.65 Anthem — Medicare Advantage: $4.65 Anthem — Pathway Essentials: $6 Anthem — Workers Compensation: $4.65
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Metabolic PanelComprehensive	$15	$9.75	$7.50 – $19.50
Comprehensive metabolic panel (blood test): 10 of 16 insurance plan rates Aetna — Commercial: $11.34 Allied Benefit — Commercial: $11.34 Anthem — Commercial PPO: $7.98 Anthem — Commercial Trad: $9.03 Caresource — IN Medicaid HIP: $19.50 CHA — Commercial: $11.55 CHA — Employer Group 4: $10.50 Cigna Prof Benefit — Commercial: $12.30 Cigna Sagamore — Commercial: $10.42 Cigna Sagamore — PPO: $10.42
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$10.56
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $10.56 Anthem — Exchange: $10.56 Anthem — IN Medicaid HCC: $10.56 Anthem — IN Medicaid HIP: $10.56 Anthem — Medicare Advantage: $10.56 Anthem — Workers Compensation: $10.56 Caresource — Exchange: $16.90 Caresource — IN Medicaid HIP: $10.56 Humana — Medicare Advantage: $10.67 Humana — Pathways for Aging: $10.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$47.81
Obstetric blood test panel: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $47.81 Anthem — Exchange: $47.81 Anthem — IN Medicaid HCC: $47.81 Anthem — IN Medicaid HIP: $47.81 Anthem — Medicare Advantage: $47.81 Anthem — Workers Compensation: $47.81 Caresource — Exchange: $76.50 Caresource — IN Medicaid HIP: $47.81 Humana — Medicare Advantage: $48.29 Humana — Pathways for Aging: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel with LDL Cholesterol Direct Measurement, if Indicated	$19	$12.35	$5.89 – $24.70
Cholesterol panel (lipid panel): 10 of 29 insurance plan rates Aetna — Commercial: $14.36 Aetna — Medicare Advantage: $5.89 All Savers — Commercial: $15.58 Allied Benefit — Commercial: $14.36 Anthem — Commercial PPO: $10.41 Anthem — Commercial Trad: $11.44 Anthem — Exchange: $5.89 Anthem — Medicare Advantage: $5.89 Anthem — Pathway Essentials: $7.60 Anthem — Workers Compensation: $5.89
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lipid Panel with LDL Cholesterol Direct Measurement, if Indicated	$19	$12.35	$9.50 – $24.70
Cholesterol panel (lipid panel): 10 of 16 insurance plan rates Aetna — Commercial: $14.36 Allied Benefit — Commercial: $14.36 Anthem — Commercial PPO: $10.10 Anthem — Commercial Trad: $11.44 Caresource — IN Medicaid HIP: $24.70 CHA — Commercial: $14.63 CHA — Employer Group 4: $13.30 Cigna Prof Benefit — Commercial: $15.58 Cigna Sagamore — Commercial: $13.20 Cigna Sagamore — PPO: $13.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$13.39
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $13.39 Anthem — Exchange: $13.39 Anthem — IN Medicaid HCC: $13.39 Anthem — IN Medicaid HIP: $13.39 Anthem — Medicare Advantage: $13.39 Anthem — Workers Compensation: $13.39 Caresource — Exchange: $21.42 Caresource — IN Medicaid HIP: $13.39 Humana — Medicare Advantage: $13.52 Humana — Pathways for Aging: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal	$16	$10.40	$4.96 – $20.80
Kidney function panel: 10 of 29 insurance plan rates Aetna — Commercial: $12.10 Aetna — Medicare Advantage: $4.96 All Savers — Commercial: $13.12 Allied Benefit — Commercial: $12.10 Anthem — Commercial PPO: $8.77 Anthem — Commercial Trad: $9.63 Anthem — Exchange: $4.96 Anthem — Medicare Advantage: $4.96 Anthem — Pathway Essentials: $6.40 Anthem — Workers Compensation: $4.96
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal	$16	$10.40	$8 – $20.80
Kidney function panel: 10 of 16 insurance plan rates Aetna — Commercial: $12.10 Allied Benefit — Commercial: $12.10 Anthem — Commercial PPO: $8.51 Anthem — Commercial Trad: $9.64 Caresource — IN Medicaid HIP: $20.80 CHA — Commercial: $12.32 CHA — Employer Group 4: $11.20 Cigna Prof Benefit — Commercial: $13.12 Cigna Sagamore — Commercial: $11.12 Cigna Sagamore — PPO: $11.12
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$8.68
Kidney function panel: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $8.68 Anthem — Exchange: $8.68 Anthem — IN Medicaid HCC: $8.68 Anthem — IN Medicaid HIP: $8.68 Anthem — Medicare Advantage: $8.68 Anthem — Workers Compensation: $8.68 Caresource — Exchange: $13.89 Caresource — IN Medicaid HIP: $8.68 Humana — Medicare Advantage: $8.77 Humana — Pathways for Aging: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$11	$7.15	$3.41 – $14.30
Liver function panel: 10 of 29 insurance plan rates Aetna — Commercial: $8.32 Aetna — Medicare Advantage: $3.41 All Savers — Commercial: $9.02 Allied Benefit — Commercial: $8.32 Anthem — Commercial PPO: $6.03 Anthem — Commercial Trad: $6.62 Anthem — Exchange: $3.41 Anthem — Medicare Advantage: $3.41 Anthem — Pathway Essentials: $4.40 Anthem — Workers Compensation: $3.41
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$11	$7.15	$5.50 – $14.30
Liver function panel: 10 of 16 insurance plan rates Aetna — Commercial: $8.32 Allied Benefit — Commercial: $8.32 Anthem — Commercial PPO: $5.85 Anthem — Commercial Trad: $6.63 Caresource — IN Medicaid HIP: $14.30 CHA — Commercial: $8.47 CHA — Employer Group 4: $7.70 Cigna Prof Benefit — Commercial: $9.02 Cigna Sagamore — Commercial: $7.64 Cigna Sagamore — PPO: $7.64
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$8.17
Liver function panel: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $8.17 Anthem — Exchange: $8.17 Anthem — IN Medicaid HCC: $8.17 Anthem — IN Medicaid HIP: $8.17 Anthem — Medicare Advantage: $8.17 Anthem — Workers Compensation: $8.17 Caresource — Exchange: $13.07 Caresource — IN Medicaid HIP: $8.17 Humana — Medicare Advantage: $8.25 Humana — Pathways for Aging: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA Scrn w/Micro + Cult if Ind	$4	$2.60	$1.24 – $5.20
Urine test (automated, with microscope): 10 of 29 insurance plan rates Aetna — Commercial: $3.02 Aetna — Medicare Advantage: $1.24 All Savers — Commercial: $3.28 Allied Benefit — Commercial: $3.02 Anthem — Commercial PPO: $2.19 Anthem — Commercial Trad: $2.41 Anthem — Exchange: $1.24 Anthem — Medicare Advantage: $1.24 Anthem — Pathway Essentials: $1.60 Anthem — Workers Compensation: $1.24
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UA Scrn w/Micro + Cult if Ind	$4	$2.60	$2 – $5.20
Urine test (automated, with microscope): 10 of 16 insurance plan rates Aetna — Commercial: $3.02 Allied Benefit — Commercial: $3.02 Anthem — Commercial PPO: $2.13 Anthem — Commercial Trad: $2.41 Caresource — IN Medicaid HIP: $5.20 CHA — Commercial: $3.08 CHA — Employer Group 4: $2.80 Cigna Prof Benefit — Commercial: $3.28 Cigna Sagamore — Commercial: $2.78 Cigna Sagamore — PPO: $2.78
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$3.17
Urine test (automated, with microscope): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $3.17 Anthem — Exchange: $3.17 Anthem — IN Medicaid HCC: $3.17 Anthem — IN Medicaid HIP: $3.17 Anthem — Medicare Advantage: $3.17 Anthem — Workers Compensation: $3.17 Caresource — Exchange: $5.07 Caresource — IN Medicaid HIP: $3.17 Humana — Medicare Advantage: $3.20 Humana — Pathways for Aging: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE DIB STICK	$183	$118.95	$56.73 – $237.90
Urine test (manual, without microscope): 10 of 29 insurance plan rates Aetna — Commercial: $138.35 Aetna — Medicare Advantage: $56.73 All Savers — Commercial: $150.06 Allied Benefit — Commercial: $138.35 Anthem — Commercial PPO: $100.28 Anthem — Commercial Trad: $110.15 Anthem — Exchange: $56.73 Anthem — Medicare Advantage: $56.73 Anthem — Pathway Essentials: $73.20 Anthem — Workers Compensation: $56.73
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE DIB STICK	$183	$118.95	$91.50 – $237.90
Urine test (manual, without microscope): 10 of 16 insurance plan rates Aetna — Commercial: $138.35 Allied Benefit — Commercial: $138.35 Anthem — Commercial PPO: $97.30 Anthem — Commercial Trad: $110.22 Caresource — IN Medicaid HIP: $237.90 CHA — Commercial: $140.91 CHA — Employer Group 4: $128.10 Cigna Prof Benefit — Commercial: $150.06 Cigna Sagamore — Commercial: $127.18 Cigna Sagamore — PPO: $127.18
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$3.48
Urine test (manual, without microscope): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $3.48 Anthem — Exchange: $3.48 Anthem — IN Medicaid HCC: $3.48 Anthem — IN Medicaid HIP: $3.48 Anthem — Medicare Advantage: $3.48 Anthem — Workers Compensation: $3.48 Caresource — Exchange: $5.57 Caresource — IN Medicaid HIP: $3.48 Humana — Medicare Advantage: $3.51 Humana — Pathways for Aging: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA Macro	$4	$2.60	$1.24 – $5.20
Urine test (automated, without microscope): 10 of 29 insurance plan rates Aetna — Commercial: $3.02 Aetna — Medicare Advantage: $1.24 All Savers — Commercial: $3.28 Allied Benefit — Commercial: $3.02 Anthem — Commercial PPO: $2.19 Anthem — Commercial Trad: $2.41 Anthem — Exchange: $1.24 Anthem — Medicare Advantage: $1.24 Anthem — Pathway Essentials: $1.60 Anthem — Workers Compensation: $1.24
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UA Macro	$4	$2.60	$2 – $5.20
Urine test (automated, without microscope): 10 of 16 insurance plan rates Aetna — Commercial: $3.02 Allied Benefit — Commercial: $3.02 Anthem — Commercial PPO: $2.13 Anthem — Commercial Trad: $2.41 Caresource — IN Medicaid HIP: $5.20 CHA — Commercial: $3.08 CHA — Employer Group 4: $2.80 Cigna Prof Benefit — Commercial: $3.28 Cigna Sagamore — Commercial: $2.78 Cigna Sagamore — PPO: $2.78
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$2.25
Urine test (automated, without microscope): 10 of 18 insurance plan rates Aetna — Medicare Advantage: $2.25 Anthem — Exchange: $2.25 Anthem — IN Medicaid HCC: $2.25 Anthem — IN Medicaid HIP: $2.25 Anthem — Medicare Advantage: $2.25 Anthem — Workers Compensation: $2.25 Caresource — Exchange: $3.60 Caresource — IN Medicaid HIP: $2.25 Humana — Medicare Advantage: $2.27 Humana — Pathways for Aging: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate-specific Antigen (PSA), Free:Total Ratio Reflex	$13	$8.45	$4.03 – $16.90
PSA (prostate specific antigen) blood test: 10 of 29 insurance plan rates Aetna — Commercial: $9.83 Aetna — Medicare Advantage: $4.03 All Savers — Commercial: $10.66 Allied Benefit — Commercial: $9.83 Anthem — Commercial PPO: $7.12 Anthem — Commercial Trad: $7.82 Anthem — Exchange: $4.03 Anthem — Medicare Advantage: $4.03 Anthem — Pathway Essentials: $5.20 Anthem — Workers Compensation: $4.03
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA Prostate Specific Antigen Total Diagnostic	$26	$16.90	$8.06 – $33.80
PSA (prostate specific antigen) blood test: 10 of 29 insurance plan rates Aetna — Commercial: $19.66 Aetna — Medicare Advantage: $8.06 All Savers — Commercial: $21.32 Allied Benefit — Commercial: $19.66 Anthem — Commercial PPO: $14.25 Anthem — Commercial Trad: $15.65 Anthem — Exchange: $8.06 Anthem — Medicare Advantage: $8.06 Anthem — Pathway Essentials: $10.40 Anthem — Workers Compensation: $8.06
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Prostate-specific Antigen (PSA), Free:Total Ratio Reflex	$13	$8.45	$6.50 – $16.90
PSA (prostate specific antigen) blood test: 10 of 16 insurance plan rates Aetna — Commercial: $9.83 Allied Benefit — Commercial: $9.83 Anthem — Commercial PPO: $6.91 Anthem — Commercial Trad: $7.83 Caresource — IN Medicaid HIP: $16.90 CHA — Commercial: $10.01 CHA — Employer Group 4: $9.10 Cigna Prof Benefit — Commercial: $10.66 Cigna Sagamore — Commercial: $9.04 Cigna Sagamore — PPO: $9.04
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4	$24	$15.60	$7.44 – $31.20
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates Aetna — Commercial: $18.14 Aetna — Medicare Advantage: $7.44 All Savers — Commercial: $19.68 Allied Benefit — Commercial: $18.14 Anthem — Commercial PPO: $13.15 Anthem — Commercial Trad: $14.45 Anthem — Exchange: $7.44 Anthem — Medicare Advantage: $7.44 Anthem — Pathway Essentials: $9.60 Anthem — Workers Compensation: $7.44
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid Cascade Profile	$58	$37.70	$17.98 – $75.40
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates Aetna — Commercial: $43.85 Aetna — Medicare Advantage: $17.98 All Savers — Commercial: $47.56 Allied Benefit — Commercial: $43.85 Anthem — Commercial PPO: $31.78 Anthem — Commercial Trad: $34.91 Anthem — Exchange: $17.98 Anthem — Medicare Advantage: $17.98 Anthem — Pathway Essentials: $23.20 Anthem — Workers Compensation: $17.98
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4	$24	$15.60	$12 – $31.20
Thyroid stimulating hormone (TSH) test: 10 of 16 insurance plan rates Aetna — Commercial: $18.14 Allied Benefit — Commercial: $18.14 Anthem — Commercial PPO: $12.76 Anthem — Commercial Trad: $14.46 Caresource — IN Medicaid HIP: $31.20 CHA — Commercial: $18.48 CHA — Employer Group 4: $16.80 Cigna Prof Benefit — Commercial: $19.68 Cigna Sagamore — Commercial: $16.68 Cigna Sagamore — PPO: $16.68
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC wDiff	$11	$7.15	$3.41 – $14.30
Complete blood count (CBC) with differential: 10 of 29 insurance plan rates Aetna — Commercial: $8.32 Aetna — Medicare Advantage: $3.41 All Savers — Commercial: $9.02 Allied Benefit — Commercial: $8.32 Anthem — Commercial PPO: $6.03 Anthem — Commercial Trad: $6.62 Anthem — Exchange: $3.41 Anthem — Medicare Advantage: $3.41 Anthem — Pathway Essentials: $4.40 Anthem — Workers Compensation: $3.41
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC wDiff	$11	$7.15	$5.50 – $14.30
Complete blood count (CBC) with differential: 10 of 16 insurance plan rates Aetna — Commercial: $8.32 Allied Benefit — Commercial: $8.32 Anthem — Commercial PPO: $5.85 Anthem — Commercial Trad: $6.63 Caresource — IN Medicaid HIP: $14.30 CHA — Commercial: $8.47 CHA — Employer Group 4: $7.70 Cigna Prof Benefit — Commercial: $9.02 Cigna Sagamore — Commercial: $7.64 Cigna Sagamore — PPO: $7.64
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$7.77
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $7.77 Anthem — Exchange: $7.77 Anthem — IN Medicaid HCC: $7.77 Anthem — IN Medicaid HIP: $7.77 Anthem — Medicare Advantage: $7.77 Anthem — Workers Compensation: $7.77 Caresource — Exchange: $12.43 Caresource — IN Medicaid HIP: $7.77 Humana — Medicare Advantage: $7.85 Humana — Pathways for Aging: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC	$9	$5.85	$2.79 – $11.70
Complete blood count (CBC), automated: 10 of 29 insurance plan rates Aetna — Commercial: $6.80 Aetna — Medicare Advantage: $2.79 All Savers — Commercial: $7.38 Allied Benefit — Commercial: $6.80 Anthem — Commercial PPO: $4.93 Anthem — Commercial Trad: $5.42 Anthem — Exchange: $2.79 Anthem — Medicare Advantage: $2.79 Anthem — Pathway Essentials: $3.60 Anthem — Workers Compensation: $2.79
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC	$9	$5.85	$4.50 – $11.70
Complete blood count (CBC), automated: 10 of 16 insurance plan rates Aetna — Commercial: $6.80 Allied Benefit — Commercial: $6.80 Anthem — Commercial PPO: $4.79 Anthem — Commercial Trad: $5.42 Caresource — IN Medicaid HIP: $11.70 CHA — Commercial: $6.93 CHA — Employer Group 4: $6.30 Cigna Prof Benefit — Commercial: $7.38 Cigna Sagamore — Commercial: $6.26 Cigna Sagamore — PPO: $6.26
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$6.47
Complete blood count (CBC), automated: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $6.47 Anthem — Exchange: $6.47 Anthem — IN Medicaid HCC: $6.47 Anthem — IN Medicaid HIP: $6.47 Anthem — Medicare Advantage: $6.47 Anthem — Workers Compensation: $6.47 Caresource — Exchange: $10.35 Caresource — IN Medicaid HIP: $6.47 Humana — Medicare Advantage: $6.53 Humana — Pathways for Aging: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Prothrombin Time w/ INR	$6	$3.90	$1.86 – $7.80
Blood clotting time test (prothrombin time, PT): 10 of 29 insurance plan rates Aetna — Commercial: $4.54 Aetna — Medicare Advantage: $1.86 All Savers — Commercial: $4.92 Allied Benefit — Commercial: $4.54 Anthem — Commercial PPO: $3.29 Anthem — Commercial Trad: $3.61 Anthem — Exchange: $1.86 Anthem — Medicare Advantage: $1.86 Anthem — Pathway Essentials: $2.40 Anthem — Workers Compensation: $1.86
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Prothrombin Time with Mixing Studies if Indicated	$14	$9.10	$4.34 – $18.20
Blood clotting time test (prothrombin time, PT): 10 of 29 insurance plan rates Aetna — Commercial: $10.58 Aetna — Medicare Advantage: $4.34 All Savers — Commercial: $11.48 Allied Benefit — Commercial: $10.58 Anthem — Commercial PPO: $7.67 Anthem — Commercial Trad: $8.43 Anthem — Exchange: $4.34 Anthem — Medicare Advantage: $4.34 Anthem — Pathway Essentials: $5.60 Anthem — Workers Compensation: $4.34
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Prothrombin Time w/ INR	$6	$3.90	$3 – $7.80
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates Aetna — Commercial: $4.54 Allied Benefit — Commercial: $4.54 Anthem — Commercial PPO: $3.19 Anthem — Commercial Trad: $3.61 Caresource — IN Medicaid HIP: $7.80 CHA — Commercial: $4.62 CHA — Employer Group 4: $4.20 Cigna Prof Benefit — Commercial: $4.92 Cigna Sagamore — Commercial: $4.17 Cigna Sagamore — PPO: $4.17
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 85730 THROMBOPLASTIN TIME PARTIAL	$12	$7.80	$3.72 – $15.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 29 insurance plan rates Aetna — Commercial: $9.07 Aetna — Medicare Advantage: $3.72 All Savers — Commercial: $9.84 Allied Benefit — Commercial: $9.07 Anthem — Commercial PPO: $6.58 Anthem — Commercial Trad: $7.22 Anthem — Exchange: $3.72 Anthem — Medicare Advantage: $3.72 Anthem — Pathway Essentials: $4.80 Anthem — Workers Compensation: $3.72
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Factor VIII Inhibitor Profile Comprehensive	$14	$9.10	$4.34 – $18.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 29 insurance plan rates Aetna — Commercial: $10.58 Aetna — Medicare Advantage: $4.34 All Savers — Commercial: $11.48 Allied Benefit — Commercial: $10.58 Anthem — Commercial PPO: $7.67 Anthem — Commercial Trad: $8.43 Anthem — Exchange: $4.34 Anthem — Medicare Advantage: $4.34 Anthem — Pathway Essentials: $5.60 Anthem — Workers Compensation: $4.34
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 85730 THROMBOPLASTIN TIME PARTIAL	$12	$7.80	$6 – $15.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 16 insurance plan rates Aetna — Commercial: $9.07 Allied Benefit — Commercial: $9.07 Anthem — Commercial PPO: $6.38 Anthem — Commercial Trad: $7.23 Caresource — IN Medicaid HIP: $15.60 CHA — Commercial: $9.24 CHA — Employer Group 4: $8.40 Cigna Prof Benefit — Commercial: $9.84 Cigna Sagamore — Commercial: $8.34 Cigna Sagamore — PPO: $8.34

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Brain W-O Contrast AIS	$1,373	$892.45	$425.63 – $1,784.90
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,037.99 Aetna — Medicare Advantage: $425.63 All Savers — Commercial: $1,125.86 Allied Benefit — Commercial: $1,037.99 Anthem — Commercial PPO: $752.40 Anthem — Commercial Trad: $826.41 Anthem — Exchange: $425.63 Anthem — Medicare Advantage: $425.63 Anthem — Pathway Essentials: $549.20 Anthem — Workers Compensation: $425.63
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Brain W-O Contrast AIS	$1,373	$892.45	$686.50 – $1,784.90
CT scan of the head or brain, without contrast: 10 of 16 insurance plan rates Aetna — Commercial: $1,037.99 Allied Benefit — Commercial: $1,037.99 Anthem — Commercial PPO: $730.02 Anthem — Commercial Trad: $826.96 Caresource — IN Medicaid HIP: $1,784.90 CHA — Commercial: $1,057.21 CHA — Employer Group 4: $961.10 Cigna Prof Benefit — Commercial: $1,125.86 Cigna Sagamore — Commercial: $954.23 Cigna Sagamore — PPO: $954.23
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$220.90
CT scan of the head or brain, without contrast: rates for 10 insurance plans Anthem — Exchange: $220.90 Anthem — IN Medicaid HCC: $220.90 Anthem — IN Medicaid HIP: $220.90 Caresource — IN Medicaid HIP: $220.90 Humana — Pathways for Aging: $220.90 MdWise — IN Medicaid HHW: $220.90 MdWise — IN Medicaid HIP: $220.90 MHS — IN Medicaid HHW: $220.90 MHS — IN Medicaid HIP: $220.90 UHC — Pathways for Aging: $220.90
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR Brain W W-O Contrast	$2,541	$1,651.65	$787.71 – $3,303.30
MRI of the brain, before and after contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,921 Aetna — Medicare Advantage: $787.71 All Savers — Commercial: $2,083.62 Allied Benefit — Commercial: $1,921 Anthem — Commercial PPO: $1,392.47 Anthem — Commercial Trad: $1,529.43 Anthem — Exchange: $787.71 Anthem — Medicare Advantage: $787.71 Anthem — Pathway Essentials: $1,016.40 Anthem — Workers Compensation: $787.71
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR Brain W W-O Contrast	$2,541	$1,651.65	$1,270.50 – $3,303.30
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — Commercial: $1,921 Allied Benefit — Commercial: $1,921 Anthem — Commercial PPO: $1,351.05 Anthem — Commercial Trad: $1,530.44 Caresource — IN Medicaid HIP: $3,303.30 CHA — Commercial: $1,956.57 CHA — Employer Group 4: $1,778.70 Cigna Prof Benefit — Commercial: $2,083.62 Cigna Sagamore — Commercial: $1,766 Cigna Sagamore — PPO: $1,766
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$756.13
MRI of the brain, before and after contrast: rates for 10 insurance plans Anthem — Exchange: $756.13 Anthem — IN Medicaid HCC: $756.13 Anthem — IN Medicaid HIP: $756.13 Caresource — IN Medicaid HIP: $756.13 Humana — Pathways for Aging: $756.13 MdWise — IN Medicaid HHW: $756.13 MdWise — IN Medicaid HIP: $756.13 MHS — IN Medicaid HHW: $756.13 MHS — IN Medicaid HIP: $756.13 UHC — Pathways for Aging: $756.13
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX CHEST INSPIRATION & EXPIRATION ONLY	$302	$196.30	$93.62 – $392.60
Chest X-ray, 2 views: 10 of 29 insurance plan rates Aetna — Commercial: $228.31 Aetna — Medicare Advantage: $93.62 All Savers — Commercial: $247.64 Allied Benefit — Commercial: $228.31 Anthem — Commercial PPO: $165.50 Anthem — Commercial Trad: $181.77 Anthem — Exchange: $93.62 Anthem — Medicare Advantage: $93.62 Anthem — Pathway Essentials: $120.80 Anthem — Workers Compensation: $93.62
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX CHEST INSPIRATION & EXPIRATION ONLY	$302	$196.30	$151 – $392.60
Chest X-ray, 2 views: 10 of 16 insurance plan rates Aetna — Commercial: $228.31 Allied Benefit — Commercial: $228.31 Anthem — Commercial PPO: $160.57 Anthem — Commercial Trad: $181.89 Caresource — IN Medicaid HIP: $392.60 CHA — Commercial: $232.54 CHA — Employer Group 4: $211.40 Cigna Prof Benefit — Commercial: $247.64 Cigna Sagamore — Commercial: $209.89 Cigna Sagamore — PPO: $209.89
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$242.27
Chest X-ray, 2 views: rates for 10 insurance plans Anthem — Exchange: $242.27 Anthem — IN Medicaid HCC: $242.27 Anthem — IN Medicaid HIP: $242.27 Caresource — IN Medicaid HIP: $242.27 Humana — Pathways for Aging: $242.27 MdWise — IN Medicaid HHW: $242.27 MdWise — IN Medicaid HIP: $242.27 MHS — IN Medicaid HHW: $242.27 MHS — IN Medicaid HIP: $242.27 UHC — Pathways for Aging: $242.27
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX Spine Lumbar 4 Views	$519	$337.35	$160.89 – $674.70
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates Aetna — Commercial: $392.36 Aetna — Medicare Advantage: $160.89 All Savers — Commercial: $425.58 Allied Benefit — Commercial: $392.36 Anthem — Commercial PPO: $284.41 Anthem — Commercial Trad: $312.39 Anthem — Exchange: $160.89 Anthem — Medicare Advantage: $160.89 Anthem — Pathway Essentials: $207.60 Anthem — Workers Compensation: $160.89
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX Spine Lumbar 4 Views	$519	$337.35	$259.50 – $674.70
X-ray of the lower spine, at least 4 views: 10 of 16 insurance plan rates Aetna — Commercial: $392.36 Allied Benefit — Commercial: $392.36 Anthem — Commercial PPO: $275.95 Anthem — Commercial Trad: $312.59 Caresource — IN Medicaid HIP: $674.70 CHA — Commercial: $399.63 CHA — Employer Group 4: $363.30 Cigna Prof Benefit — Commercial: $425.58 Cigna Sagamore — Commercial: $360.70 Cigna Sagamore — PPO: $360.70
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$91.46
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Anthem — Exchange: $91.46 Anthem — IN Medicaid HCC: $91.46 Anthem — IN Medicaid HIP: $91.46 Caresource — IN Medicaid HIP: $91.46 Humana — Pathways for Aging: $91.46 MdWise — IN Medicaid HHW: $91.46 MdWise — IN Medicaid HIP: $91.46 MHS — IN Medicaid HHW: $91.46 MHS — IN Medicaid HIP: $91.46 UHC — Pathways for Aging: $91.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR Lumbar Spine W-O Contrast	$2,032	$1,320.80	$629.92 – $2,641.60
MRI of the lower back (lumbar spine), without contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,536.19 Aetna — Medicare Advantage: $629.92 All Savers — Commercial: $1,666.24 Allied Benefit — Commercial: $1,536.19 Anthem — Commercial PPO: $1,113.54 Anthem — Commercial Trad: $1,223.06 Anthem — Exchange: $629.92 Anthem — Medicare Advantage: $629.92 Anthem — Pathway Essentials: $812.80 Anthem — Workers Compensation: $629.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR Lumbar Spine W-O Contrast	$2,032	$1,320.80	$1,016 – $2,641.60
MRI of the lower back (lumbar spine), without contrast: 10 of 16 insurance plan rates Aetna — Commercial: $1,536.19 Allied Benefit — Commercial: $1,536.19 Anthem — Commercial PPO: $1,080.41 Anthem — Commercial Trad: $1,223.87 Caresource — IN Medicaid HIP: $2,641.60 CHA — Commercial: $1,564.64 CHA — Employer Group 4: $1,422.40 Cigna Prof Benefit — Commercial: $1,666.24 Cigna Sagamore — Commercial: $1,412.24 Cigna Sagamore — PPO: $1,412.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$457.59
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Anthem — Exchange: $457.59 Anthem — IN Medicaid HCC: $457.59 Anthem — IN Medicaid HIP: $457.59 Caresource — IN Medicaid HIP: $457.59 Humana — Pathways for Aging: $457.59 MdWise — IN Medicaid HHW: $457.59 MdWise — IN Medicaid HIP: $457.59 MHS — IN Medicaid HHW: $457.59 MHS — IN Medicaid HIP: $457.59 UHC — Pathways for Aging: $457.59
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W-Contrast	$1,527	$992.55	$473.37 – $1,985.10
CT scan of the pelvis, with contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,154.41 Aetna — Medicare Advantage: $473.37 All Savers — Commercial: $1,252.14 Allied Benefit — Commercial: $1,154.41 Anthem — Commercial PPO: $836.80 Anthem — Commercial Trad: $919.10 Anthem — Exchange: $473.37 Anthem — Medicare Advantage: $473.37 Anthem — Pathway Essentials: $610.80 Anthem — Workers Compensation: $473.37
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Pelvis W-Contrast	$1,527	$992.55	$763.50 – $1,985.10
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates Aetna — Commercial: $1,154.41 Allied Benefit — Commercial: $1,154.41 Anthem — Commercial PPO: $811.91 Anthem — Commercial Trad: $919.71 Caresource — IN Medicaid HIP: $1,985.10 CHA — Commercial: $1,175.79 CHA — Employer Group 4: $1,068.90 Cigna Prof Benefit — Commercial: $1,252.14 Cigna Sagamore — Commercial: $1,061.26 Cigna Sagamore — PPO: $1,061.26
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$480.79
CT scan of the pelvis, with contrast: rates for 10 insurance plans Anthem — Exchange: $480.79 Anthem — IN Medicaid HCC: $480.79 Anthem — IN Medicaid HIP: $480.79 Caresource — IN Medicaid HIP: $480.79 Humana — Pathways for Aging: $480.79 MdWise — IN Medicaid HHW: $480.79 MdWise — IN Medicaid HIP: $480.79 MHS — IN Medicaid HHW: $480.79 MHS — IN Medicaid HIP: $480.79 UHC — Pathways for Aging: $480.79
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$504.93
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Anthem — Exchange: $504.93 Anthem — IN Medicaid HCC: $504.93 Anthem — IN Medicaid HIP: $504.93 Caresource — IN Medicaid HIP: $504.93 Humana — Pathways for Aging: $504.93 MdWise — IN Medicaid HHW: $504.93 MdWise — IN Medicaid HIP: $504.93 MHS — IN Medicaid HHW: $504.93 MHS — IN Medicaid HIP: $504.93 UHC — Pathways for Aging: $504.93
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MR Lower Ext Joint W-O Contrast RT	$2,032	$1,320.80	$629.92 – $2,641.60
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,536.19 Aetna — Medicare Advantage: $629.92 All Savers — Commercial: $1,666.24 Allied Benefit — Commercial: $1,536.19 Anthem — Commercial PPO: $1,113.54 Anthem — Commercial Trad: $1,223.06 Anthem — Exchange: $629.92 Anthem — Medicare Advantage: $629.92 Anthem — Pathway Essentials: $812.80 Anthem — Workers Compensation: $629.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MR Lower Ext Joint W-O Contrast LT	$2,032	$1,320.80	$629.92 – $2,641.60
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna — Commercial: $1,536.19 Aetna — Medicare Advantage: $629.92 All Savers — Commercial: $1,666.24 Allied Benefit — Commercial: $1,536.19 Anthem — Commercial PPO: $1,113.54 Anthem — Commercial Trad: $1,223.06 Anthem — Exchange: $629.92 Anthem — Medicare Advantage: $629.92 Anthem — Pathway Essentials: $812.80 Anthem — Workers Compensation: $629.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abdomen and Pelvis W-Contrast	$3,979.57	$2,586.72	$1,233.67 – $5,173.44
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates Aetna — Commercial: $3,008.55 Aetna — Medicare Advantage: $1,233.67 All Savers — Commercial: $3,263.25 Allied Benefit — Commercial: $3,008.55 Anthem — Commercial PPO: $2,180.80 Anthem — Commercial Trad: $2,395.30 Anthem — Exchange: $1,233.67 Anthem — Medicare Advantage: $1,233.67 Anthem — Pathway Essentials: $1,591.83 Anthem — Workers Compensation: $1,233.67
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Abdomen and Pelvis W-Contrast	$3,979.57	$2,586.72	$1,989.78 – $5,173.44
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — Commercial: $3,008.55 Allied Benefit — Commercial: $3,008.55 Anthem — Commercial PPO: $2,115.94 Anthem — Commercial Trad: $2,396.90 Caresource — IN Medicaid HIP: $5,173.44 CHA — Commercial: $3,064.27 CHA — Employer Group 4: $2,785.70 Cigna Prof Benefit — Commercial: $3,263.25 Cigna Sagamore — Commercial: $2,765.80 Cigna Sagamore — PPO: $2,765.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelvis w/contrast	Not listed in the file	Not listed in the file	$632.46
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Anthem — Exchange: $632.46 Anthem — IN Medicaid HCC: $632.46 Anthem — IN Medicaid HIP: $632.46 Caresource — IN Medicaid HIP: $632.46 Humana — Pathways for Aging: $632.46 MdWise — IN Medicaid HHW: $632.46 MdWise — IN Medicaid HIP: $632.46 MHS — IN Medicaid HHW: $632.46 MHS — IN Medicaid HIP: $632.46 UHC — Pathways for Aging: $632.46
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,026	$666.90	$318.06 – $1,333.80
Ultrasound of the abdomen, complete: 10 of 29 insurance plan rates Aetna — Commercial: $775.66 Aetna — Medicare Advantage: $318.06 All Savers — Commercial: $841.32 Allied Benefit — Commercial: $775.66 Anthem — Commercial PPO: $562.25 Anthem — Commercial Trad: $617.55 Anthem — Exchange: $318.06 Anthem — Medicare Advantage: $318.06 Anthem — Pathway Essentials: $410.40 Anthem — Workers Compensation: $318.06
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,026	$666.90	$513 – $1,333.80
Ultrasound of the abdomen, complete: 10 of 16 insurance plan rates Aetna — Commercial: $775.66 Allied Benefit — Commercial: $775.66 Anthem — Commercial PPO: $545.52 Anthem — Commercial Trad: $617.96 Caresource — IN Medicaid HIP: $1,333.80 CHA — Commercial: $790.02 CHA — Employer Group 4: $718.20 Cigna Prof Benefit — Commercial: $841.32 Cigna Sagamore — Commercial: $713.07 Cigna Sagamore — PPO: $713.07
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$274.05
Ultrasound of the abdomen, complete: rates for 10 insurance plans Anthem — Exchange: $274.05 Anthem — IN Medicaid HCC: $274.05 Anthem — IN Medicaid HIP: $274.05 Caresource — IN Medicaid HIP: $274.05 Humana — Pathways for Aging: $274.05 MdWise — IN Medicaid HHW: $274.05 MdWise — IN Medicaid HIP: $274.05 MHS — IN Medicaid HHW: $274.05 MHS — IN Medicaid HIP: $274.05 UHC — Pathways for Aging: $274.05
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US OB Greater Than 14 Wks	$617	$401.05	$191.27 – $802.10
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates Aetna — Commercial: $466.45 Aetna — Medicare Advantage: $191.27 All Savers — Commercial: $505.94 Allied Benefit — Commercial: $466.45 Anthem — Commercial PPO: $338.12 Anthem — Commercial Trad: $371.37 Anthem — Exchange: $191.27 Anthem — Medicare Advantage: $191.27 Anthem — Pathway Essentials: $246.80 Anthem — Workers Compensation: $191.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US OB Greater Than 14 Wks	$617	$401.05	$308.50 – $802.10
Pregnancy ultrasound (after the first trimester): 10 of 16 insurance plan rates Aetna — Commercial: $466.45 Allied Benefit — Commercial: $466.45 Anthem — Commercial PPO: $328.06 Anthem — Commercial Trad: $371.62 Caresource — IN Medicaid HIP: $802.10 CHA — Commercial: $475.09 CHA — Employer Group 4: $431.90 Cigna Prof Benefit — Commercial: $505.94 Cigna Sagamore — Commercial: $428.82 Cigna Sagamore — PPO: $428.82
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$263.41
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Anthem — Exchange: $263.41 Anthem — IN Medicaid HCC: $263.41 Anthem — IN Medicaid HIP: $263.41 Caresource — IN Medicaid HIP: $263.41 Humana — Pathways for Aging: $263.41 MdWise — IN Medicaid HHW: $263.41 MdWise — IN Medicaid HIP: $263.41 MHS — IN Medicaid HHW: $263.41 MHS — IN Medicaid HIP: $263.41 UHC — Pathways for Aging: $263.41
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US--Transvaginal Non OB	$626	$406.90	$194.06 – $813.80
Transvaginal ultrasound: 10 of 29 insurance plan rates Aetna — Commercial: $473.26 Aetna — Medicare Advantage: $194.06 All Savers — Commercial: $513.32 Allied Benefit — Commercial: $473.26 Anthem — Commercial PPO: $343.05 Anthem — Commercial Trad: $376.79 Anthem — Exchange: $194.06 Anthem — Medicare Advantage: $194.06 Anthem — Pathway Essentials: $250.40 Anthem — Workers Compensation: $194.06
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US--Transvaginal Non OB	$626	$406.90	$313 – $813.80
Transvaginal ultrasound: 10 of 16 insurance plan rates Aetna — Commercial: $473.26 Allied Benefit — Commercial: $473.26 Anthem — Commercial PPO: $332.84 Anthem — Commercial Trad: $377.04 Caresource — IN Medicaid HIP: $813.80 CHA — Commercial: $482.02 CHA — Employer Group 4: $438.20 Cigna Prof Benefit — Commercial: $513.32 Cigna Sagamore — Commercial: $435.07 Cigna Sagamore — PPO: $435.07
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$249.91
Transvaginal ultrasound: rates for 10 insurance plans Anthem — Exchange: $249.91 Anthem — IN Medicaid HCC: $249.91 Anthem — IN Medicaid HIP: $249.91 Caresource — IN Medicaid HIP: $249.91 Humana — Pathways for Aging: $249.91 MdWise — IN Medicaid HHW: $249.91 MdWise — IN Medicaid HIP: $249.91 MHS — IN Medicaid HHW: $249.91 MHS — IN Medicaid HIP: $249.91 UHC — Pathways for Aging: $249.91
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$255.68
Diagnostic mammogram, one breast: rates for 10 insurance plans Anthem — Exchange: $255.68 Anthem — IN Medicaid HCC: $255.68 Anthem — IN Medicaid HIP: $255.68 Caresource — IN Medicaid HIP: $255.68 Humana — Pathways for Aging: $255.68 MdWise — IN Medicaid HHW: $255.68 MdWise — IN Medicaid HIP: $255.68 MHS — IN Medicaid HHW: $255.68 MHS — IN Medicaid HIP: $255.68 UHC — Pathways for Aging: $255.68
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MA Digital Diagnostic Mammo RT	$370	$240.50	$114.70 – $481
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — Commercial: $279.72 Aetna — Medicare Advantage: $114.70 All Savers — Commercial: $303.40 Allied Benefit — Commercial: $279.72 Anthem — Commercial PPO: $202.76 Anthem — Commercial Trad: $222.70 Anthem — Exchange: $114.70 Anthem — Medicare Advantage: $114.70 Anthem — Pathway Essentials: $148 Anthem — Workers Compensation: $114.70
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MA Digital Diagnostic Mammo LT	$370	$240.50	$114.70 – $481
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — Commercial: $279.72 Aetna — Medicare Advantage: $114.70 All Savers — Commercial: $303.40 Allied Benefit — Commercial: $279.72 Anthem — Commercial PPO: $202.76 Anthem — Commercial Trad: $222.70 Anthem — Exchange: $114.70 Anthem — Medicare Advantage: $114.70 Anthem — Pathway Essentials: $148 Anthem — Workers Compensation: $114.70
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Digital Diagnostic Mammo	$488	$317.20	$151.28 – $634.40
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates Aetna — Commercial: $368.93 Aetna — Medicare Advantage: $151.28 All Savers — Commercial: $400.16 Allied Benefit — Commercial: $368.93 Anthem — Commercial PPO: $267.42 Anthem — Commercial Trad: $293.73 Anthem — Exchange: $151.28 Anthem — Medicare Advantage: $151.28 Anthem — Pathway Essentials: $195.20 Anthem — Workers Compensation: $151.28
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA Digital Diagnostic Mammo	$488	$317.20	$244 – $634.40
Diagnostic mammogram, both breasts: 10 of 16 insurance plan rates Aetna — Commercial: $368.93 Allied Benefit — Commercial: $368.93 Anthem — Commercial PPO: $259.47 Anthem — Commercial Trad: $293.92 Caresource — IN Medicaid HIP: $634.40 CHA — Commercial: $375.76 CHA — Employer Group 4: $341.60 Cigna Prof Benefit — Commercial: $400.16 Cigna Sagamore — Commercial: $339.16 Cigna Sagamore — PPO: $339.16
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$327.17
Diagnostic mammogram, both breasts: rates for 10 insurance plans Anthem — Exchange: $327.17 Anthem — IN Medicaid HCC: $327.17 Anthem — IN Medicaid HIP: $327.17 Caresource — IN Medicaid HIP: $327.17 Humana — Pathways for Aging: $327.17 MdWise — IN Medicaid HHW: $327.17 MdWise — IN Medicaid HIP: $327.17 MHS — IN Medicaid HHW: $327.17 MHS — IN Medicaid HIP: $327.17 UHC — Pathways for Aging: $327.17
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Digital Screening Mammo	$290	$188.50	$89.90 – $377
Screening mammogram, both breasts: 10 of 29 insurance plan rates Aetna — Commercial: $219.24 Aetna — Medicare Advantage: $89.90 All Savers — Commercial: $237.80 Allied Benefit — Commercial: $219.24 Anthem — Commercial PPO: $158.92 Anthem — Commercial Trad: $174.55 Anthem — Exchange: $89.90 Anthem — Medicare Advantage: $89.90 Anthem — Pathway Essentials: $116 Anthem — Workers Compensation: $89.90
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA Digital Screening Mammo	$290	$188.50	$145 – $377
Screening mammogram, both breasts: 10 of 16 insurance plan rates Aetna — Commercial: $219.24 Allied Benefit — Commercial: $219.24 Anthem — Commercial PPO: $154.19 Anthem — Commercial Trad: $174.67 Caresource — IN Medicaid HIP: $377 CHA — Commercial: $223.30 CHA — Employer Group 4: $203 Cigna Prof Benefit — Commercial: $237.80 Cigna Sagamore — Commercial: $201.55 Cigna Sagamore — PPO: $201.55
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$270.19
Screening mammogram, both breasts: rates for 10 insurance plans Anthem — Exchange: $270.19 Anthem — IN Medicaid HCC: $270.19 Anthem — IN Medicaid HIP: $270.19 Caresource — IN Medicaid HIP: $270.19 Humana — Pathways for Aging: $270.19 MdWise — IN Medicaid HHW: $270.19 MdWise — IN Medicaid HIP: $270.19 MHS — IN Medicaid HHW: $270.19 MHS — IN Medicaid HIP: $270.19 UHC — Pathways for Aging: $270.19

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$8,683.74
Left heart catheterization (diagnostic): rates for 10 insurance plans Anthem — Exchange: $8,683.74 Anthem — IN Medicaid HCC: $8,683.74 Anthem — IN Medicaid HIP: $8,683.74 Caresource — IN Medicaid HIP: $8,683.74 Humana — Pathways for Aging: $8,683.74 MdWise — IN Medicaid HHW: $8,683.74 MdWise — IN Medicaid HIP: $8,683.74 MHS — IN Medicaid HHW: $8,683.74 MHS — IN Medicaid HIP: $8,683.74 UHC — Pathways for Aging: $8,683.74
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$13,051.74
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans Anthem — Exchange: $13,051.74 Anthem — IN Medicaid HCC: $13,051.74 Anthem — IN Medicaid HIP: $13,051.74 Caresource — IN Medicaid HIP: $13,051.74 Humana — Pathways for Aging: $13,051.74 MdWise — IN Medicaid HHW: $13,051.74 MdWise — IN Medicaid HIP: $13,051.74 MHS — IN Medicaid HHW: $13,051.74 MHS — IN Medicaid HIP: $13,051.74 UHC — Pathways for Aging: $13,051.74
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$26,103.48
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans Anthem — Exchange: $26,103.48 Anthem — IN Medicaid HCC: $26,103.48 Anthem — IN Medicaid HIP: $26,103.48 Caresource — IN Medicaid HIP: $26,103.48 Humana — Pathways for Aging: $26,103.48 MdWise — IN Medicaid HHW: $26,103.48 MdWise — IN Medicaid HIP: $26,103.48 MHS — IN Medicaid HHW: $26,103.48 MHS — IN Medicaid HIP: $26,103.48 UHC — Pathways for Aging: $26,103.48
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC SLEEP STUDY	$4,545	$2,954.25	$1,408.95 – $5,908.50
Sleep study (overnight, in a sleep lab): 10 of 29 insurance plan rates Aetna — Commercial: $3,436.02 Aetna — Medicare Advantage: $1,408.95 All Savers — Commercial: $3,726.90 Allied Benefit — Commercial: $3,436.02 Anthem — Commercial PPO: $2,490.66 Anthem — Commercial Trad: $2,735.64 Anthem — Exchange: $1,408.95 Anthem — Medicare Advantage: $1,408.95 Anthem — Pathway Essentials: $1,818 Anthem — Workers Compensation: $1,408.95
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC SLEEP STUDY	$4,545	$2,954.25	$2,272.50 – $5,908.50
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates Aetna — Commercial: $3,436.02 Allied Benefit — Commercial: $3,436.02 Anthem — Commercial PPO: $2,416.58 Anthem — Commercial Trad: $2,737.45 Caresource — IN Medicaid HIP: $5,908.50 CHA — Commercial: $3,499.65 CHA — Employer Group 4: $3,181.50 Cigna Prof Benefit — Commercial: $3,726.90 Cigna Sagamore — Commercial: $3,158.77 Cigna Sagamore — PPO: $3,158.77
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$3,559.88
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Anthem — Exchange: $3,559.88 Anthem — IN Medicaid HCC: $3,559.88 Anthem — IN Medicaid HIP: $3,559.88 Caresource — IN Medicaid HIP: $3,559.88 Humana — Pathways for Aging: $3,559.88 MdWise — IN Medicaid HHW: $3,559.88 MdWise — IN Medicaid HIP: $3,559.88 MHS — IN Medicaid HHW: $3,559.88 MHS — IN Medicaid HIP: $3,559.88 UHC — Pathways for Aging: $3,559.88

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CQ,GP In the file: PTA Ther Exer 15MIN MHSB INPT StatU	$182	$118.30	$56.42 – $236.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 29 insurance plan rates Aetna — Commercial: $137.59 Aetna — Medicare Advantage: $56.42 All Savers — Commercial: $149.24 Allied Benefit — Commercial: $137.59 Anthem — Commercial PPO: $99.74 Anthem — Commercial Trad: $109.55 Anthem — Exchange: $56.42 Anthem — Medicare Advantage: $56.42 Anthem — Pathway Essentials: $72.80 Anthem — Workers Compensation: $56.42
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CO,GO In the file: OTA Therapeutic Exercise Units	$182	$118.30	$56.42 – $236.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 29 insurance plan rates Aetna — Commercial: $137.59 Aetna — Medicare Advantage: $56.42 All Savers — Commercial: $149.24 Allied Benefit — Commercial: $137.59 Anthem — Commercial PPO: $99.74 Anthem — Commercial Trad: $109.55 Anthem — Exchange: $56.42 Anthem — Medicare Advantage: $56.42 Anthem — Pathway Essentials: $72.80 Anthem — Workers Compensation: $56.42
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Therapeutic Exercise Units	$182	$118.30	$56.42 – $236.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 29 insurance plan rates Aetna — Commercial: $137.59 Aetna — Medicare Advantage: $56.42 All Savers — Commercial: $149.24 Allied Benefit — Commercial: $137.59 Anthem — Commercial PPO: $99.74 Anthem — Commercial Trad: $109.55 Anthem — Exchange: $56.42 Anthem — Medicare Advantage: $56.42 Anthem — Pathway Essentials: $72.80 Anthem — Workers Compensation: $56.42
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT 97161 THERAPY EVAL LOW15 MIN/1	$140	$91	$43.40 – $182
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna — Commercial: $105.84 Aetna — Medicare Advantage: $43.40 All Savers — Commercial: $114.80 Allied Benefit — Commercial: $105.84 Anthem — Commercial PPO: $76.72 Anthem — Commercial Trad: $84.27 Anthem — Exchange: $43.40 Anthem — Medicare Advantage: $43.40 Anthem — Pathway Essentials: $56 Anthem — Workers Compensation: $43.40
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Low	$140	$91	$43.40 – $182
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna — Commercial: $105.84 Aetna — Medicare Advantage: $43.40 All Savers — Commercial: $114.80 Allied Benefit — Commercial: $105.84 Anthem — Commercial PPO: $76.72 Anthem — Commercial Trad: $84.27 Anthem — Exchange: $43.40 Anthem — Medicare Advantage: $43.40 Anthem — Pathway Essentials: $56 Anthem — Workers Compensation: $43.40
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT 97161 THERAPY EVAL LOW15 MIN/1	$140	$91	$70 – $182
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates Aetna — Commercial: $105.84 Allied Benefit — Commercial: $105.84 Anthem — Commercial PPO: $74.44 Anthem — Commercial Trad: $84.32 Caresource — IN Medicaid HIP: $182 CHA — Commercial: $107.80 CHA — Employer Group 4: $98 Cigna Prof Benefit — Commercial: $114.80 Cigna Sagamore — Commercial: $97.30 Cigna Sagamore — PPO: $97.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT 97162 THERAPY EVAL MOD 30 MIN/1	$280	$182	$86.80 – $364
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna — Commercial: $211.68 Aetna — Medicare Advantage: $86.80 All Savers — Commercial: $229.60 Allied Benefit — Commercial: $211.68 Anthem — Commercial PPO: $153.44 Anthem — Commercial Trad: $168.53 Anthem — Exchange: $86.80 Anthem — Medicare Advantage: $86.80 Anthem — Pathway Essentials: $112 Anthem — Workers Compensation: $86.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Moderate	$280	$182	$86.80 – $364
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna — Commercial: $211.68 Aetna — Medicare Advantage: $86.80 All Savers — Commercial: $229.60 Allied Benefit — Commercial: $211.68 Anthem — Commercial PPO: $153.44 Anthem — Commercial Trad: $168.53 Anthem — Exchange: $86.80 Anthem — Medicare Advantage: $86.80 Anthem — Pathway Essentials: $112 Anthem — Workers Compensation: $86.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT 97162 THERAPY EVAL MOD 30 MIN/1	$280	$182	$140 – $364
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates Aetna — Commercial: $211.68 Allied Benefit — Commercial: $211.68 Anthem — Commercial PPO: $148.88 Anthem — Commercial Trad: $168.64 Caresource — IN Medicaid HIP: $364 CHA — Commercial: $215.60 CHA — Employer Group 4: $196 Cigna Prof Benefit — Commercial: $229.60 Cigna Sagamore — Commercial: $194.60 Cigna Sagamore — PPO: $194.60
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT PT EVAL HIGH COMPLEX 45 MIN	$396	$257.40	$122.76 – $514.80
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna — Commercial: $299.38 Aetna — Medicare Advantage: $122.76 All Savers — Commercial: $324.72 Allied Benefit — Commercial: $299.38 Anthem — Commercial PPO: $217.01 Anthem — Commercial Trad: $238.35 Anthem — Exchange: $122.76 Anthem — Medicare Advantage: $122.76 Anthem — Pathway Essentials: $158.40 Anthem — Workers Compensation: $122.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: High	$396	$257.40	$122.76 – $514.80
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna — Commercial: $299.38 Aetna — Medicare Advantage: $122.76 All Savers — Commercial: $324.72 Allied Benefit — Commercial: $299.38 Anthem — Commercial PPO: $217.01 Anthem — Commercial Trad: $238.35 Anthem — Exchange: $122.76 Anthem — Medicare Advantage: $122.76 Anthem — Pathway Essentials: $158.40 Anthem — Workers Compensation: $122.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT 97163 THERAPY EVAL COMPLEX 60 MIN	$553	$359.45	$171.43 – $718.90
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna — Commercial: $418.07 Aetna — Medicare Advantage: $171.43 All Savers — Commercial: $453.46 Allied Benefit — Commercial: $418.07 Anthem — Commercial PPO: $303.04 Anthem — Commercial Trad: $332.85 Anthem — Exchange: $171.43 Anthem — Medicare Advantage: $171.43 Anthem — Pathway Essentials: $221.20 Anthem — Workers Compensation: $171.43

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$1,905.42
Removal of breast growth (open surgery): rates for 10 insurance plans Anthem — Exchange: $1,905.42 Anthem — IN Medicaid HCC: $1,905.42 Anthem — IN Medicaid HIP: $1,905.42 Caresource — IN Medicaid HIP: $1,905.42 Humana — Pathways for Aging: $1,905.42 MdWise — IN Medicaid HHW: $1,905.42 MdWise — IN Medicaid HIP: $1,905.42 MHS — IN Medicaid HHW: $1,905.42 MHS — IN Medicaid HIP: $1,905.42 UHC — Pathways for Aging: $1,905.42
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$26,103.48
Total hip replacement: rates for 10 insurance plans Anthem — Exchange: $26,103.48 Anthem — IN Medicaid HCC: $26,103.48 Anthem — IN Medicaid HIP: $26,103.48 Caresource — IN Medicaid HIP: $26,103.48 Humana — Pathways for Aging: $26,103.48 MdWise — IN Medicaid HHW: $26,103.48 MdWise — IN Medicaid HIP: $26,103.48 MHS — IN Medicaid HHW: $26,103.48 MHS — IN Medicaid HIP: $26,103.48 UHC — Pathways for Aging: $26,103.48
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$26,103.48
Total knee replacement: rates for 10 insurance plans Anthem — Exchange: $26,103.48 Anthem — IN Medicaid HCC: $26,103.48 Anthem — IN Medicaid HIP: $26,103.48 Caresource — IN Medicaid HIP: $26,103.48 Humana — Pathways for Aging: $26,103.48 MdWise — IN Medicaid HHW: $26,103.48 MdWise — IN Medicaid HIP: $26,103.48 MHS — IN Medicaid HHW: $26,103.48 MHS — IN Medicaid HIP: $26,103.48 UHC — Pathways for Aging: $26,103.48
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$1,905.42
Shoulder arthroscopy: shaving of shoulder bone: rates for 10 insurance plans Anthem — Exchange: $1,905.42 Anthem — IN Medicaid HCC: $1,905.42 Anthem — IN Medicaid HIP: $1,905.42 Caresource — IN Medicaid HIP: $1,905.42 Humana — Pathways for Aging: $1,905.42 MdWise — IN Medicaid HHW: $1,905.42 MdWise — IN Medicaid HIP: $1,905.42 MHS — IN Medicaid HHW: $1,905.42 MHS — IN Medicaid HIP: $1,905.42 UHC — Pathways for Aging: $1,905.42
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,273.62
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans Anthem — Exchange: $2,273.62 Anthem — IN Medicaid HCC: $2,273.62 Anthem — IN Medicaid HIP: $2,273.62 Caresource — IN Medicaid HIP: $2,273.62 Humana — Pathways for Aging: $2,273.62 MdWise — IN Medicaid HHW: $2,273.62 MdWise — IN Medicaid HIP: $2,273.62 MHS — IN Medicaid HHW: $2,273.62 MHS — IN Medicaid HIP: $2,273.62 UHC — Pathways for Aging: $2,273.62
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$3,121.64
Removal of tonsils and adenoids (under age 12): rates for 10 insurance plans Anthem — Exchange: $3,121.64 Anthem — IN Medicaid HCC: $3,121.64 Anthem — IN Medicaid HIP: $3,121.64 Caresource — IN Medicaid HIP: $3,121.64 Humana — Pathways for Aging: $3,121.64 MdWise — IN Medicaid HHW: $3,121.64 MdWise — IN Medicaid HIP: $3,121.64 MHS — IN Medicaid HHW: $3,121.64 MHS — IN Medicaid HIP: $3,121.64 UHC — Pathways for Aging: $3,121.64
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$2,273.62
Upper GI endoscopy (diagnostic): rates for 10 insurance plans Anthem — Exchange: $2,273.62 Anthem — IN Medicaid HCC: $2,273.62 Anthem — IN Medicaid HIP: $2,273.62 Caresource — IN Medicaid HIP: $2,273.62 Humana — Pathways for Aging: $2,273.62 MdWise — IN Medicaid HHW: $2,273.62 MdWise — IN Medicaid HIP: $2,273.62 MHS — IN Medicaid HHW: $2,273.62 MHS — IN Medicaid HIP: $2,273.62 UHC — Pathways for Aging: $2,273.62
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$2,273.62
Upper GI endoscopy with biopsy: rates for 10 insurance plans Anthem — Exchange: $2,273.62 Anthem — IN Medicaid HCC: $2,273.62 Anthem — IN Medicaid HIP: $2,273.62 Caresource — IN Medicaid HIP: $2,273.62 Humana — Pathways for Aging: $2,273.62 MdWise — IN Medicaid HHW: $2,273.62 MdWise — IN Medicaid HIP: $2,273.62 MHS — IN Medicaid HHW: $2,273.62 MHS — IN Medicaid HIP: $2,273.62 UHC — Pathways for Aging: $2,273.62
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$2,273.62
Colonoscopy (diagnostic): rates for 10 insurance plans Anthem — Exchange: $2,273.62 Anthem — IN Medicaid HCC: $2,273.62 Anthem — IN Medicaid HIP: $2,273.62 Caresource — IN Medicaid HIP: $2,273.62 Humana — Pathways for Aging: $2,273.62 MdWise — IN Medicaid HHW: $2,273.62 MdWise — IN Medicaid HIP: $2,273.62 MHS — IN Medicaid HHW: $2,273.62 MHS — IN Medicaid HIP: $2,273.62 UHC — Pathways for Aging: $2,273.62
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$3,121.64
Colonoscopy with biopsy: rates for 10 insurance plans Anthem — Exchange: $3,121.64 Anthem — IN Medicaid HCC: $3,121.64 Anthem — IN Medicaid HIP: $3,121.64 Caresource — IN Medicaid HIP: $3,121.64 Humana — Pathways for Aging: $3,121.64 MdWise — IN Medicaid HHW: $3,121.64 MdWise — IN Medicaid HIP: $3,121.64 MHS — IN Medicaid HHW: $3,121.64 MHS — IN Medicaid HIP: $3,121.64 UHC — Pathways for Aging: $3,121.64
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$3,121.64
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans Anthem — Exchange: $3,121.64 Anthem — IN Medicaid HCC: $3,121.64 Anthem — IN Medicaid HIP: $3,121.64 Caresource — IN Medicaid HIP: $3,121.64 Humana — Pathways for Aging: $3,121.64 MdWise — IN Medicaid HHW: $3,121.64 MdWise — IN Medicaid HIP: $3,121.64 MHS — IN Medicaid HHW: $3,121.64 MHS — IN Medicaid HIP: $3,121.64 UHC — Pathways for Aging: $3,121.64
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$3,121.64
Ultrasound of the lower bowel by endoscope: rates for 10 insurance plans Anthem — Exchange: $3,121.64 Anthem — IN Medicaid HCC: $3,121.64 Anthem — IN Medicaid HIP: $3,121.64 Caresource — IN Medicaid HIP: $3,121.64 Humana — Pathways for Aging: $3,121.64 MdWise — IN Medicaid HHW: $3,121.64 MdWise — IN Medicaid HIP: $3,121.64 MHS — IN Medicaid HHW: $3,121.64 MHS — IN Medicaid HIP: $3,121.64 UHC — Pathways for Aging: $3,121.64
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$4,211.34
Gallbladder removal by laparoscope: rates for 10 insurance plans Anthem — Exchange: $4,211.34 Anthem — IN Medicaid HCC: $4,211.34 Anthem — IN Medicaid HIP: $4,211.34 Caresource — IN Medicaid HIP: $4,211.34 Humana — Pathways for Aging: $4,211.34 MdWise — IN Medicaid HHW: $4,211.34 MdWise — IN Medicaid HIP: $4,211.34 MHS — IN Medicaid HHW: $4,211.34 MHS — IN Medicaid HIP: $4,211.34 UHC — Pathways for Aging: $4,211.34
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$2,273.62
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans Anthem — Exchange: $2,273.62 Anthem — IN Medicaid HCC: $2,273.62 Anthem — IN Medicaid HIP: $2,273.62 Caresource — IN Medicaid HIP: $2,273.62 Humana — Pathways for Aging: $2,273.62 MdWise — IN Medicaid HHW: $2,273.62 MdWise — IN Medicaid HIP: $2,273.62 MHS — IN Medicaid HHW: $2,273.62 MHS — IN Medicaid HIP: $2,273.62 UHC — Pathways for Aging: $2,273.62
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$1,728.79
Prostate biopsy: rates for 10 insurance plans Anthem — Exchange: $1,728.79 Anthem — IN Medicaid HCC: $1,728.79 Anthem — IN Medicaid HIP: $1,728.79 Caresource — IN Medicaid HIP: $1,728.79 Humana — Pathways for Aging: $1,728.79 MdWise — IN Medicaid HHW: $1,728.79 MdWise — IN Medicaid HIP: $1,728.79 MHS — IN Medicaid HHW: $1,728.79 MHS — IN Medicaid HIP: $1,728.79 UHC — Pathways for Aging: $1,728.79
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$26,103.48
Prostate removal by laparoscope (radical prostatectomy): rates for 10 insurance plans Anthem — Exchange: $26,103.48 Anthem — IN Medicaid HCC: $26,103.48 Anthem — IN Medicaid HIP: $26,103.48 Caresource — IN Medicaid HIP: $26,103.48 Humana — Pathways for Aging: $26,103.48 MdWise — IN Medicaid HHW: $26,103.48 MdWise — IN Medicaid HIP: $26,103.48 MHS — IN Medicaid HHW: $26,103.48 MHS — IN Medicaid HIP: $26,103.48 UHC — Pathways for Aging: $26,103.48
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$1,905.42
Hysteroscopy with biopsy of the uterus lining: rates for 10 insurance plans Anthem — Exchange: $1,905.42 Anthem — IN Medicaid HCC: $1,905.42 Anthem — IN Medicaid HIP: $1,905.42 Caresource — IN Medicaid HIP: $1,905.42 Humana — Pathways for Aging: $1,905.42 MdWise — IN Medicaid HHW: $1,905.42 MdWise — IN Medicaid HIP: $1,905.42 MHS — IN Medicaid HHW: $1,905.42 MHS — IN Medicaid HIP: $1,905.42 UHC — Pathways for Aging: $1,905.42
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$1,905.42
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Anthem — Exchange: $1,905.42 Anthem — IN Medicaid HCC: $1,905.42 Anthem — IN Medicaid HIP: $1,905.42 Caresource — IN Medicaid HIP: $1,905.42 Humana — Pathways for Aging: $1,905.42 MdWise — IN Medicaid HHW: $1,905.42 MdWise — IN Medicaid HIP: $1,905.42 MHS — IN Medicaid HHW: $1,905.42 MHS — IN Medicaid HIP: $1,905.42 UHC — Pathways for Aging: $1,905.42
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx aa&/strd tfrm epi l/s 1	Not listed in the file	Not listed in the file	$1,242.31
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans Anthem — Exchange: $1,242.31 Anthem — IN Medicaid HCC: $1,242.31 Anthem — IN Medicaid HIP: $1,242.31 Caresource — IN Medicaid HIP: $1,242.31 Humana — Pathways for Aging: $1,242.31 MdWise — IN Medicaid HHW: $1,242.31 MdWise — IN Medicaid HIP: $1,242.31 MHS — IN Medicaid HHW: $1,242.31 MHS — IN Medicaid HIP: $1,242.31 UHC — Pathways for Aging: $1,242.31
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$1,728.79
Carpal tunnel release: rates for 10 insurance plans Anthem — Exchange: $1,728.79 Anthem — IN Medicaid HCC: $1,728.79 Anthem — IN Medicaid HIP: $1,728.79 Caresource — IN Medicaid HIP: $1,728.79 Humana — Pathways for Aging: $1,728.79 MdWise — IN Medicaid HHW: $1,728.79 MdWise — IN Medicaid HIP: $1,728.79 MHS — IN Medicaid HHW: $1,728.79 MHS — IN Medicaid HIP: $1,728.79 UHC — Pathways for Aging: $1,728.79
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$1,728.79
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans Anthem — Exchange: $1,728.79 Anthem — IN Medicaid HCC: $1,728.79 Anthem — IN Medicaid HIP: $1,728.79 Caresource — IN Medicaid HIP: $1,728.79 Humana — Pathways for Aging: $1,728.79 MdWise — IN Medicaid HHW: $1,728.79 MdWise — IN Medicaid HIP: $1,728.79 MHS — IN Medicaid HHW: $1,728.79 MHS — IN Medicaid HIP: $1,728.79 UHC — Pathways for Aging: $1,728.79
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$4,315.74
Cataract removal with lens implant: rates for 10 insurance plans Anthem — Exchange: $4,315.74 Anthem — IN Medicaid HCC: $4,315.74 Anthem — IN Medicaid HIP: $4,315.74 Caresource — IN Medicaid HIP: $4,315.74 Humana — Pathways for Aging: $4,315.74 MdWise — IN Medicaid HHW: $4,315.74 MdWise — IN Medicaid HIP: $4,315.74 MHS — IN Medicaid HHW: $4,315.74 MHS — IN Medicaid HIP: $4,315.74 UHC — Pathways for Aging: $4,315.74

Source: Community Hospital of Bremen Inc’s standard charges file (beaconhealthsystem.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the price transparency link on the hospital’s website (beaconhealthsystem.org), because the hospital has no cms-hpt.txt file; both are required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	1020 High Rd, Bremen, IN 46506
County	Marshall County
State	Indiana
Phone	(574) 546‑2211
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	151300
Name in Medicare records	COMMUNITY HOSPITAL OF BREMEN INC
Profile level	Medicare data + hospital website
Name on the hospital’s website	Community Hospital of Bremen
Official website	locations.beaconhealthsystem.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Community Hospital of Bremen — locations.beaconhealthsystem.org
Community Hospital of Bremen Emergency - Beacon Health System Bremen, IN — locations.beaconhealthsystem.org
Community Hospital of Bremen Outpatient Physical Therapy and Occupational Therapy - Beacon Health System — locations.beaconhealthsystem.org
Bremen Obstetrics > Beacon Health System — beaconhealthsystem.org

Community Hospital of Bremen Inc

Summary

Profile from official sources

At a glance