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Acute Care Hospital

Doctors Hospital

Also listed as: Baptist Health Doctors Hospital

Coral Gables, Florida · Miami-Dade County · Emergency services listed

Doctors Hospital is an acute care hospital at 5000 University Dr, Coral Gables, FL 33146. Phone: (786) 308-3000. It has an emergency department. Medicare overall rating: 5 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Doctors Hospital is an acute care hospital in Coral Gables, Florida. Medicare data lists emergency services. CMS overall star rating: 5 of 5 stars. Its official website lists 23 services, specialties and programs. Medicare lists 742 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(786) 308‑3000 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
5 of 5 stars5 of 5 stars · Medicare rating
742Doctors and clinicians
23Services listed

Quick answers

Does Doctors Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Doctors Hospital. In a medical emergency, call 911.
Where is Doctors Hospital?
5000 University Dr, Coral Gables, FL 33146, in Miami-Dade County, Florida.
What is the phone number of Doctors Hospital?
(786) 308-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Doctors Hospital?
5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Doctors Hospital for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Doctors Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.6183; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4]

Treatments[4]

  • Minimally invasive and robotic-assisted surgery
  • Outpatient diagnostic imaging
  • Laboratory services
  • Non-surgical treatments

Procedures[4]

  • Minimally invasive and robotic-assisted surgery

Programs and centers[4]

  • Miami HEAT Sports Medicine Center
  • High-acuity intensive care unit

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingVisiting hours 7 a.m. to 9 p.m.; after 9 p.m. visitors enter through the Emergency Room[4]
ParkingGarage with patient and family parking; complimentary valet at the main entrance; EV charging[4]

Recognition[4]

  • Magnet Recognition for Nursing Excellence

Doctors and clinicians (742)

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

Main specialties

Doctors with a page on this site (742)

And 718 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Coral Gables

All hospitals in Coral Gables · Hospitals in Miami-Dade County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment3 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1072%National average: 72%
Would definitely recommend the hospital75%National average: 71%
Nurses “always” communicated well77%National average: 80%
Doctors “always” communicated well81%National average: 80%
“Always” got help as soon as they wanted61%National average: 64%
Staff “always” explained medicines before giving them61%National average: 62%
Were given information about recovery at home87%National average: 86%
Room and bathroom “always” clean76%National average: 73%
Completed surveys595Response rate: 25%

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

MRSA bloodstream infections0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.489No different from the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart failure patients7.5%
Deaths within 30 days: pneumonia patients9.6%
Deaths within 30 days: COPD patients7.8%
Deaths within 30 days: stroke patients8.9%
Serious complications (patient safety indicator PSI-90)0.96No different from the national rate
Complications after hip or knee replacement4%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)
Too few cases to reportDeaths within 30 days: heart attack patients

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)16.1%
Readmitted within 30 days: heart failure20.9%
Readmitted within 30 days: pneumonia16.6%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: hip or knee replacement6.7%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)154 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)79%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Doctors Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.6183Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart failure1.0397More readmissions than expected
Pneumonia1.0257More readmissions than expected
COPD (chronic lung disease)1.0281More readmissions than expected
Hip or knee replacement0.8962Fewer readmissions than expected
No result publishedHeart attack; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score51.50 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)65.00 out of 100
Person and community engagement (patient survey)37.00 out of 100
Safety (infections and sepsis care)84.00 out of 100
Efficiency and cost reduction (Medicare spending)20.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio0.97Below the national median hospital (1.00): Medicare spent less

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

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 Coral GablesBest hospitals in Florida

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 53 common services exactly as Doctors Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Show the prices of 53 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ER level 3 $1,814 $1,179.10 $285.06 – $1,814
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $852.58
  • AETNA — AETNA HMO EXCHANGE: $689.32
  • AETNA — AETNA MEDICARE: $319.27
  • AETNA — AETNA PPO: $1,451.20
  • AETNA — AETNA TIER 2: $852.58
  • AFFORDABLE — AFFORDABLE PPO: $1,541.90
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $816.30
  • AVMED — AVMED ENTRUST: $647.60
  • AVMED — AVMED HMO: $754.62
  • AVMED — AVMED INDIVIDUAL: $736.48
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 76 In the file: ER level 3 $1,814 $1,179.10 $285.06 – $1,814
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $852.58
  • AETNA — AETNA HMO EXCHANGE: $689.32
  • AETNA — AETNA MEDICARE: $319.27
  • AETNA — AETNA PPO: $1,451.20
  • AETNA — AETNA TIER 2: $852.58
  • AFFORDABLE — AFFORDABLE PPO: $1,541.90
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $816.30
  • AVMED — AVMED ENTRUST: $647.60
  • AVMED — AVMED HMO: $754.62
  • AVMED — AVMED INDIVIDUAL: $736.48
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 25 In the file: ER level 3 $1,814 $1,179.10 $285.06 – $1,814
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $852.58
  • AETNA — AETNA HMO EXCHANGE: $689.32
  • AETNA — AETNA MEDICARE: $319.27
  • AETNA — AETNA PPO: $1,451.20
  • AETNA — AETNA TIER 2: $852.58
  • AFFORDABLE — AFFORDABLE PPO: $1,541.90
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $816.30
  • AVMED — AVMED ENTRUST: $647.60
  • AVMED — AVMED HMO: $754.62
  • AVMED — AVMED INDIVIDUAL: $736.48
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ER level 4 $2,444 $1,588.60 $427.70 – $2,444
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,148.68
  • AETNA — AETNA HMO EXCHANGE: $928.72
  • AETNA — AETNA MEDICARE: $488.03
  • AETNA — AETNA PPO: $1,955.20
  • AETNA — AETNA TIER 2: $1,148.68
  • AFFORDABLE — AFFORDABLE PPO: $2,077.40
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,099.80
  • AVMED — AVMED ENTRUST: $872.51
  • AVMED — AVMED HMO: $1,016.70
  • AVMED — AVMED INDIVIDUAL: $992.26
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier ER In the file: ER level 4 $2,444 $1,588.60 $427.70 – $2,444
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,148.68
  • AETNA — AETNA HMO EXCHANGE: $928.72
  • AETNA — AETNA MEDICARE: $488.03
  • AETNA — AETNA PPO: $1,955.20
  • AETNA — AETNA TIER 2: $1,148.68
  • AFFORDABLE — AFFORDABLE PPO: $2,077.40
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,099.80
  • AVMED — AVMED ENTRUST: $872.51
  • AVMED — AVMED HMO: $1,016.70
  • AVMED — AVMED INDIVIDUAL: $992.26
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier 27 In the file: ER level 4 $2,444 $1,588.60 $427.70 – $2,444
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,148.68
  • AETNA — AETNA HMO EXCHANGE: $928.72
  • AETNA — AETNA MEDICARE: $488.03
  • AETNA — AETNA PPO: $1,955.20
  • AETNA — AETNA TIER 2: $1,148.68
  • AFFORDABLE — AFFORDABLE PPO: $2,077.40
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,099.80
  • AVMED — AVMED ENTRUST: $872.51
  • AVMED — AVMED HMO: $1,016.70
  • AVMED — AVMED INDIVIDUAL: $992.26
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ER level 5 $2,912 $1,892.80 $509.60 – $2,912
Emergency room visit (high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,368.64
  • AETNA — AETNA HMO EXCHANGE: $1,106.56
  • AETNA — AETNA MEDICARE: $696.53
  • AETNA — AETNA PPO: $2,329.60
  • AETNA — AETNA TIER 2: $1,368.64
  • AFFORDABLE — AFFORDABLE PPO: $2,475.20
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,310.40
  • AVMED — AVMED ENTRUST: $1,039.58
  • AVMED — AVMED HMO: $1,211.39
  • AVMED — AVMED INDIVIDUAL: $1,182.27
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier ER In the file: ER level 5 $2,912 $1,892.80 $509.60 – $2,912
Emergency room visit (high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,368.64
  • AETNA — AETNA HMO EXCHANGE: $1,106.56
  • AETNA — AETNA MEDICARE: $696.53
  • AETNA — AETNA PPO: $2,329.60
  • AETNA — AETNA TIER 2: $1,368.64
  • AFFORDABLE — AFFORDABLE PPO: $2,475.20
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,310.40
  • AVMED — AVMED ENTRUST: $1,039.58
  • AVMED — AVMED HMO: $1,211.39
  • AVMED — AVMED INDIVIDUAL: $1,182.27
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier 25 In the file: ER level 5 $2,912 $1,892.80 $509.60 – $2,912
Emergency room visit (high): 10 of 45 insurance plan rates
  • AETNA — AETNA HMO: $1,368.64
  • AETNA — AETNA HMO EXCHANGE: $1,106.56
  • AETNA — AETNA MEDICARE: $696.53
  • AETNA — AETNA PPO: $2,329.60
  • AETNA — AETNA TIER 2: $1,368.64
  • AFFORDABLE — AFFORDABLE PPO: $2,475.20
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,310.40
  • AVMED — AVMED ENTRUST: $1,039.58
  • AVMED — AVMED HMO: $1,211.39
  • AVMED — AVMED INDIVIDUAL: $1,182.27

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Basic metabolic panel (BMP) $675 $438.75 $4.59 – $675
Basic metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $344.25
  • AETNA — AETNA HMO EXCHANGE: $256.50
  • AETNA — AETNA MEDICARE: $9.48
  • AETNA — AETNA PPO: $540
  • AETNA — AETNA TIER 2: $344.25
  • AFFORDABLE — AFFORDABLE PPO: $573.75
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $303.75
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier 59 In the file: Basic metabolic panel (BMP) $675 $438.75 $4.59 – $675
Basic metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $344.25
  • AETNA — AETNA HMO EXCHANGE: $256.50
  • AETNA — AETNA MEDICARE: $9.48
  • AETNA — AETNA PPO: $540
  • AETNA — AETNA TIER 2: $344.25
  • AFFORDABLE — AFFORDABLE PPO: $573.75
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $303.75
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier PN In the file: Basic metabolic panel (BMP) $675 $438.75 $4.59 – $675
Basic metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $344.25
  • AETNA — AETNA HMO EXCHANGE: $256.50
  • AETNA — AETNA MEDICARE: $9.48
  • AETNA — AETNA PPO: $540
  • AETNA — AETNA TIER 2: $344.25
  • AFFORDABLE — AFFORDABLE PPO: $573.75
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $303.75
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehensive metabolic panel $1,178 $765.70 $4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $600.78
  • AETNA — AETNA HMO EXCHANGE: $447.64
  • AETNA — AETNA MEDICARE: $11.83
  • AETNA — AETNA PPO: $942.40
  • AETNA — AETNA TIER 2: $600.78
  • AFFORDABLE — AFFORDABLE PPO: $1,001.30
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $530.10
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier PN In the file: Comprehensive metabolic panel $1,178 $765.70 $4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $600.78
  • AETNA — AETNA HMO EXCHANGE: $447.64
  • AETNA — AETNA MEDICARE: $11.83
  • AETNA — AETNA PPO: $942.40
  • AETNA — AETNA TIER 2: $600.78
  • AFFORDABLE — AFFORDABLE PPO: $1,001.30
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $530.10
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier AY In the file: Comprehensive metabolic panel $1,178 $765.70 $4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $600.78
  • AETNA — AETNA HMO EXCHANGE: $447.64
  • AETNA — AETNA MEDICARE: $11.83
  • AETNA — AETNA PPO: $942.40
  • AETNA — AETNA TIER 2: $600.78
  • AFFORDABLE — AFFORDABLE PPO: $1,001.30
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $530.10
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel $252 $163.80 $4.59 – $252
Cholesterol panel (lipid panel): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $128.52
  • AETNA — AETNA HMO EXCHANGE: $95.76
  • AETNA — AETNA MEDICARE: $15
  • AETNA — AETNA PPO: $201.60
  • AETNA — AETNA TIER 2: $128.52
  • AFFORDABLE — AFFORDABLE PPO: $214.20
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $113.40
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: NMR-lipid panel $59 $38.35 $4.59 – $59
Cholesterol panel (lipid panel): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $30.09
  • AETNA — AETNA HMO EXCHANGE: $22.42
  • AETNA — AETNA MEDICARE: $15
  • AETNA — AETNA PPO: $47.20
  • AETNA — AETNA TIER 2: $30.09
  • AFFORDABLE — AFFORDABLE PPO: $50.15
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $26.55
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · modifier PN In the file: NMR-lipid panel $59 $38.35 $4.59 – $59
Cholesterol panel (lipid panel): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $30.09
  • AETNA — AETNA HMO EXCHANGE: $22.42
  • AETNA — AETNA MEDICARE: $15
  • AETNA — AETNA PPO: $47.20
  • AETNA — AETNA TIER 2: $30.09
  • AFFORDABLE — AFFORDABLE PPO: $50.15
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $26.55
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel $841 $546.65 $4.59 – $841
Kidney function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $428.91
  • AETNA — AETNA HMO EXCHANGE: $319.58
  • AETNA — AETNA MEDICARE: $9.72
  • AETNA — AETNA PPO: $672.80
  • AETNA — AETNA TIER 2: $428.91
  • AFFORDABLE — AFFORDABLE PPO: $714.85
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $378.45
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier ER In the file: Renal function panel $841 $546.65 $4.59 – $841
Kidney function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $428.91
  • AETNA — AETNA HMO EXCHANGE: $319.58
  • AETNA — AETNA MEDICARE: $9.72
  • AETNA — AETNA PPO: $672.80
  • AETNA — AETNA TIER 2: $428.91
  • AFFORDABLE — AFFORDABLE PPO: $714.85
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $378.45
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier AY In the file: Renal function panel $841 $546.65 $4.59 – $841
Kidney function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $428.91
  • AETNA — AETNA HMO EXCHANGE: $319.58
  • AETNA — AETNA MEDICARE: $9.72
  • AETNA — AETNA PPO: $672.80
  • AETNA — AETNA TIER 2: $428.91
  • AFFORDABLE — AFFORDABLE PPO: $714.85
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $378.45
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel $590 $383.50 $4.59 – $590
Liver function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $300.90
  • AETNA — AETNA HMO EXCHANGE: $224.20
  • AETNA — AETNA MEDICARE: $9.15
  • AETNA — AETNA PPO: $472
  • AETNA — AETNA TIER 2: $300.90
  • AFFORDABLE — AFFORDABLE PPO: $501.50
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $265.50
Liver function panel CPT 80076 · Inpatient or outpatient · modifier PN In the file: Hepatic function panel $590 $383.50 $4.59 – $590
Liver function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $300.90
  • AETNA — AETNA HMO EXCHANGE: $224.20
  • AETNA — AETNA MEDICARE: $9.15
  • AETNA — AETNA PPO: $472
  • AETNA — AETNA TIER 2: $300.90
  • AFFORDABLE — AFFORDABLE PPO: $501.50
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $265.50
Liver function panel CPT 80076 · Inpatient or outpatient · modifier Q1 In the file: Hepatic function panel $590 $383.50 $4.59 – $590
Liver function panel: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4.96
  • AETNA — AETNA HMO: $300.90
  • AETNA — AETNA HMO EXCHANGE: $224.20
  • AETNA — AETNA MEDICARE: $9.15
  • AETNA — AETNA PPO: $472
  • AETNA — AETNA TIER 2: $300.90
  • AFFORDABLE — AFFORDABLE PPO: $501.50
  • AMERIGROUP — AMERIGROUP: $4.59
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $265.50
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URO UA Complete $251 $163.15 $1.49 – $251
Urine test (automated, with microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $128.01
  • AETNA — AETNA HMO EXCHANGE: $95.38
  • AETNA — AETNA MEDICARE: $3.55
  • AETNA — AETNA PPO: $200.80
  • AETNA — AETNA TIER 2: $128.01
  • AFFORDABLE — AFFORDABLE PPO: $213.35
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $112.95
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis (with micro) $251 $163.15 $1.49 – $251
Urine test (automated, with microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $128.01
  • AETNA — AETNA HMO EXCHANGE: $95.38
  • AETNA — AETNA MEDICARE: $3.55
  • AETNA — AETNA PPO: $200.80
  • AETNA — AETNA TIER 2: $128.01
  • AFFORDABLE — AFFORDABLE PPO: $213.35
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $112.95
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier PN In the file: Urinalysis (with micro) $251 $163.15 $1.49 – $251
Urine test (automated, with microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $128.01
  • AETNA — AETNA HMO EXCHANGE: $95.38
  • AETNA — AETNA MEDICARE: $3.55
  • AETNA — AETNA PPO: $200.80
  • AETNA — AETNA TIER 2: $128.01
  • AFFORDABLE — AFFORDABLE PPO: $213.35
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $112.95
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Specific gravity-urine $136 $88.40 $1.49 – $136
Urine test (automated, without microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $69.36
  • AETNA — AETNA HMO EXCHANGE: $51.68
  • AETNA — AETNA MEDICARE: $2.52
  • AETNA — AETNA PPO: $108.80
  • AETNA — AETNA TIER 2: $69.36
  • AFFORDABLE — AFFORDABLE PPO: $115.60
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $61.20
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS AUTO W/O SCOPE $88 $57.20 $1.49 – $88
Urine test (automated, without microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $44.88
  • AETNA — AETNA HMO EXCHANGE: $33.44
  • AETNA — AETNA MEDICARE: $2.52
  • AETNA — AETNA PPO: $70.40
  • AETNA — AETNA TIER 2: $44.88
  • AFFORDABLE — AFFORDABLE PPO: $74.80
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $39.60
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier 59 In the file: Specific gravity-urine $136 $88.40 $1.49 – $136
Urine test (automated, without microscope): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1.61
  • AETNA — AETNA HMO: $69.36
  • AETNA — AETNA HMO EXCHANGE: $51.68
  • AETNA — AETNA MEDICARE: $2.52
  • AETNA — AETNA PPO: $108.80
  • AETNA — AETNA TIER 2: $69.36
  • AFFORDABLE — AFFORDABLE PPO: $115.60
  • AMERIGROUP — AMERIGROUP: $1.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $61.20
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: ARU Prostate Specific Ag $37 $24.05 $6.12 – $37
PSA (prostate specific antigen) blood test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $6.61
  • AETNA — AETNA HMO: $18.87
  • AETNA — AETNA HMO EXCHANGE: $14.06
  • AETNA — AETNA MEDICARE: $20.60
  • AETNA — AETNA PPO: $29.60
  • AETNA — AETNA TIER 2: $18.87
  • AFFORDABLE — AFFORDABLE PPO: $31.45
  • AMERIGROUP — AMERIGROUP: $6.12
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $16.65
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: ARU PSA total $34 $22.10 $5.95 – $34
PSA (prostate specific antigen) blood test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $6.61
  • AETNA — AETNA HMO: $17.34
  • AETNA — AETNA HMO EXCHANGE: $12.92
  • AETNA — AETNA MEDICARE: $20.60
  • AETNA — AETNA PPO: $27.20
  • AETNA — AETNA TIER 2: $17.34
  • AFFORDABLE — AFFORDABLE PPO: $28.90
  • AMERIGROUP — AMERIGROUP: $6.12
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $15.30
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA Free & Total $482 $313.30 $6.12 – $482
PSA (prostate specific antigen) blood test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61
  • AETNA — AETNA BETTER HEALTH MEDICAID: $6.61
  • AETNA — AETNA HMO: $245.82
  • AETNA — AETNA HMO EXCHANGE: $183.16
  • AETNA — AETNA MEDICARE: $20.60
  • AETNA — AETNA PPO: $385.60
  • AETNA — AETNA TIER 2: $245.82
  • AFFORDABLE — AFFORDABLE PPO: $409.70
  • AMERIGROUP — AMERIGROUP: $6.12
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $216.90
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: ARU TSH 3rd Generation $32 $20.80 $5.60 – $32
Thyroid stimulating hormone (TSH) test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26
  • AETNA — AETNA BETTER HEALTH MEDICAID: $7.26
  • AETNA — AETNA HMO: $16.32
  • AETNA — AETNA HMO EXCHANGE: $12.16
  • AETNA — AETNA MEDICARE: $18.82
  • AETNA — AETNA PPO: $25.60
  • AETNA — AETNA TIER 2: $16.32
  • AFFORDABLE — AFFORDABLE PPO: $27.20
  • AMERIGROUP — AMERIGROUP: $6.72
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $14.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: ASSAY THYROID STIM HORMONE $255 $165.75 $6.72 – $255
Thyroid stimulating hormone (TSH) test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26
  • AETNA — AETNA BETTER HEALTH MEDICAID: $7.26
  • AETNA — AETNA HMO: $130.05
  • AETNA — AETNA HMO EXCHANGE: $96.90
  • AETNA — AETNA MEDICARE: $18.82
  • AETNA — AETNA PPO: $204
  • AETNA — AETNA TIER 2: $130.05
  • AFFORDABLE — AFFORDABLE PPO: $216.75
  • AMERIGROUP — AMERIGROUP: $6.72
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $114.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 59 In the file: ASSAY THYROID STIM HORMONE $255 $165.75 $6.72 – $255
Thyroid stimulating hormone (TSH) test: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26
  • AETNA — AETNA BETTER HEALTH MEDICAID: $7.26
  • AETNA — AETNA HMO: $130.05
  • AETNA — AETNA HMO EXCHANGE: $96.90
  • AETNA — AETNA MEDICARE: $18.82
  • AETNA — AETNA PPO: $204
  • AETNA — AETNA TIER 2: $130.05
  • AFFORDABLE — AFFORDABLE PPO: $216.75
  • AMERIGROUP — AMERIGROUP: $6.72
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $114.75
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: COMPLETE CBC W/AUTO DIFF WBC $389 $252.85 $3.02 – $389
Complete blood count (CBC) with differential: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $198.39
  • AETNA — AETNA HMO EXCHANGE: $147.82
  • AETNA — AETNA MEDICARE: $8.70
  • AETNA — AETNA PPO: $311.20
  • AETNA — AETNA TIER 2: $198.39
  • AFFORDABLE — AFFORDABLE PPO: $330.65
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $175.05
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier AY In the file: COMPLETE CBC W/AUTO DIFF WBC $389 $252.85 $3.02 – $389
Complete blood count (CBC) with differential: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $198.39
  • AETNA — AETNA HMO EXCHANGE: $147.82
  • AETNA — AETNA MEDICARE: $8.70
  • AETNA — AETNA PPO: $311.20
  • AETNA — AETNA TIER 2: $198.39
  • AFFORDABLE — AFFORDABLE PPO: $330.65
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $175.05
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier PN In the file: COMPLETE CBC W/AUTO DIFF WBC $389 $252.85 $3.02 – $389
Complete blood count (CBC) with differential: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $198.39
  • AETNA — AETNA HMO EXCHANGE: $147.82
  • AETNA — AETNA MEDICARE: $8.70
  • AETNA — AETNA PPO: $311.20
  • AETNA — AETNA TIER 2: $198.39
  • AFFORDABLE — AFFORDABLE PPO: $330.65
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $175.05
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: COMPLETE CBC AUTOMATED $247 $160.55 $3.02 – $247
Complete blood count (CBC), automated: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $125.97
  • AETNA — AETNA HMO EXCHANGE: $93.86
  • AETNA — AETNA MEDICARE: $7.25
  • AETNA — AETNA PPO: $197.60
  • AETNA — AETNA TIER 2: $125.97
  • AFFORDABLE — AFFORDABLE PPO: $209.95
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.15
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier Q1 In the file: COMPLETE CBC AUTOMATED $247 $160.55 $3.02 – $247
Complete blood count (CBC), automated: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $125.97
  • AETNA — AETNA HMO EXCHANGE: $93.86
  • AETNA — AETNA MEDICARE: $7.25
  • AETNA — AETNA PPO: $197.60
  • AETNA — AETNA TIER 2: $125.97
  • AFFORDABLE — AFFORDABLE PPO: $209.95
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.15
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier AY In the file: COMPLETE CBC AUTOMATED $247 $160.55 $3.02 – $247
Complete blood count (CBC), automated: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27
  • AETNA — AETNA BETTER HEALTH MEDICAID: $3.27
  • AETNA — AETNA HMO: $125.97
  • AETNA — AETNA HMO EXCHANGE: $93.86
  • AETNA — AETNA MEDICARE: $7.25
  • AETNA — AETNA PPO: $197.60
  • AETNA — AETNA TIER 2: $125.97
  • AFFORDABLE — AFFORDABLE PPO: $209.95
  • AMERIGROUP — AMERIGROUP: $3.02
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.15
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT-INR (prothrombin time) $201 $130.65 $2.24 – $201
Blood clotting time test (prothrombin time, PT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $102.51
  • AETNA — AETNA HMO EXCHANGE: $76.38
  • AETNA — AETNA MEDICARE: $4.80
  • AETNA — AETNA PPO: $160.80
  • AETNA — AETNA TIER 2: $102.51
  • AFFORDABLE — AFFORDABLE PPO: $170.85
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $90.45
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HCA mixing studies-PT $32 $20.80 $2.24 – $32
Blood clotting time test (prothrombin time, PT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $16.32
  • AETNA — AETNA HMO EXCHANGE: $12.16
  • AETNA — AETNA MEDICARE: $4.80
  • AETNA — AETNA PPO: $25.60
  • AETNA — AETNA TIER 2: $16.32
  • AFFORDABLE — AFFORDABLE PPO: $27.20
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $14.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: ARU PT-INR (PROTHROMBIN TIME) $25 $16.25 $2.24 – $25
Blood clotting time test (prothrombin time, PT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $12.75
  • AETNA — AETNA HMO EXCHANGE: $9.50
  • AETNA — AETNA MEDICARE: $4.80
  • AETNA — AETNA PPO: $20
  • AETNA — AETNA TIER 2: $12.75
  • AFFORDABLE — AFFORDABLE PPO: $21.25
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $11.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: ARU Rflx PTT ratio, treated (C) $87 $56.55 $2.24 – $87
Blood clotting test (partial thromboplastin time, PTT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $44.37
  • AETNA — AETNA HMO EXCHANGE: $33.06
  • AETNA — AETNA MEDICARE: $6.73
  • AETNA — AETNA PPO: $69.60
  • AETNA — AETNA TIER 2: $44.37
  • AFFORDABLE — AFFORDABLE PPO: $73.95
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $39.15
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT (partial thromb time) $244 $158.60 $2.24 – $244
Blood clotting test (partial thromboplastin time, PTT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $124.44
  • AETNA — AETNA HMO EXCHANGE: $92.72
  • AETNA — AETNA MEDICARE: $6.73
  • AETNA — AETNA PPO: $195.20
  • AETNA — AETNA TIER 2: $124.44
  • AFFORDABLE — AFFORDABLE PPO: $207.40
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $109.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: ARU PTT-LA Ratio $25 $16.25 $2.24 – $25
Blood clotting test (partial thromboplastin time, PTT): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42
  • AETNA — AETNA BETTER HEALTH MEDICAID: $2.42
  • AETNA — AETNA HMO: $12.75
  • AETNA — AETNA HMO EXCHANGE: $9.50
  • AETNA — AETNA MEDICARE: $6.73
  • AETNA — AETNA PPO: $20
  • AETNA — AETNA TIER 2: $12.75
  • AFFORDABLE — AFFORDABLE PPO: $21.25
  • AMERIGROUP — AMERIGROUP: $2.24
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $11.25

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O DYE $4,699 $3,054.35 $109.17 – $4,699
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $2,396.49
  • AETNA — AETNA HMO EXCHANGE: $1,785.62
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $3,759.20
  • AETNA — AETNA TIER 2: $2,396.49
  • AFFORDABLE — AFFORDABLE PPO: $3,994.15
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,114.55
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier Q1 In the file: CT HEAD/BRAIN W/O DYE $4,699 $3,054.35 $109.17 – $4,699
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $2,396.49
  • AETNA — AETNA HMO EXCHANGE: $1,785.62
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $3,759.20
  • AETNA — AETNA TIER 2: $2,396.49
  • AFFORDABLE — AFFORDABLE PPO: $3,994.15
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,114.55
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier 59 In the file: CT HEAD/BRAIN W/O DYE $4,699 $3,054.35 $109.17 – $4,699
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $2,396.49
  • AETNA — AETNA HMO EXCHANGE: $1,785.62
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $3,759.20
  • AETNA — AETNA TIER 2: $2,396.49
  • AFFORDABLE — AFFORDABLE PPO: $3,994.15
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,114.55
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye $7,569 $4,919.85 $247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55
  • AETNA — AETNA BETTER HEALTH MEDICAID: $267.55
  • AETNA — AETNA HMO: $3,860.19
  • AETNA — AETNA HMO EXCHANGE: $2,876.22
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $6,055.20
  • AETNA — AETNA TIER 2: $3,860.19
  • AFFORDABLE — AFFORDABLE PPO: $6,433.65
  • AMERIGROUP — AMERIGROUP: $247.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $3,406.05
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier 59 In the file: Mri brain stem w/o & w/dye $7,569 $4,919.85 $247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55
  • AETNA — AETNA BETTER HEALTH MEDICAID: $267.55
  • AETNA — AETNA HMO: $3,860.19
  • AETNA — AETNA HMO EXCHANGE: $2,876.22
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $6,055.20
  • AETNA — AETNA TIER 2: $3,860.19
  • AFFORDABLE — AFFORDABLE PPO: $6,433.65
  • AMERIGROUP — AMERIGROUP: $247.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $3,406.05
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier ER In the file: Mri brain stem w/o & w/dye $7,569 $4,919.85 $247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55
  • AETNA — AETNA BETTER HEALTH MEDICAID: $267.55
  • AETNA — AETNA HMO: $3,860.19
  • AETNA — AETNA HMO EXCHANGE: $2,876.22
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $6,055.20
  • AETNA — AETNA TIER 2: $3,860.19
  • AFFORDABLE — AFFORDABLE PPO: $6,433.65
  • AMERIGROUP — AMERIGROUP: $247.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $3,406.05
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest XR 2 views $765 $497.25 $34.17 – $765
Chest X-ray, 2 views: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90
  • AETNA — AETNA BETTER HEALTH MEDICAID: $36.90
  • AETNA — AETNA HMO: $390.15
  • AETNA — AETNA HMO EXCHANGE: $290.70
  • AETNA — AETNA MEDICARE: $101.78
  • AETNA — AETNA PPO: $612
  • AETNA — AETNA TIER 2: $390.15
  • AFFORDABLE — AFFORDABLE PPO: $650.25
  • AMERIGROUP — AMERIGROUP: $34.17
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $344.25
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier 59 In the file: Chest XR 2 views $765 $497.25 $34.17 – $765
Chest X-ray, 2 views: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90
  • AETNA — AETNA BETTER HEALTH MEDICAID: $36.90
  • AETNA — AETNA HMO: $390.15
  • AETNA — AETNA HMO EXCHANGE: $290.70
  • AETNA — AETNA MEDICARE: $101.78
  • AETNA — AETNA PPO: $612
  • AETNA — AETNA TIER 2: $390.15
  • AFFORDABLE — AFFORDABLE PPO: $650.25
  • AMERIGROUP — AMERIGROUP: $34.17
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $344.25
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier ER In the file: Chest XR 2 views $765 $497.25 $34.17 – $765
Chest X-ray, 2 views: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90
  • AETNA — AETNA BETTER HEALTH MEDICAID: $36.90
  • AETNA — AETNA HMO: $390.15
  • AETNA — AETNA HMO EXCHANGE: $290.70
  • AETNA — AETNA MEDICARE: $101.78
  • AETNA — AETNA PPO: $612
  • AETNA — AETNA TIER 2: $390.15
  • AFFORDABLE — AFFORDABLE PPO: $650.25
  • AMERIGROUP — AMERIGROUP: $34.17
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $344.25
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Lumbar spine mini 4 view xr $1,723 $1,119.95 $34.17 – $1,723
X-ray of the lower spine, at least 4 views: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90
  • AETNA — AETNA BETTER HEALTH MEDICAID: $36.90
  • AETNA — AETNA HMO: $878.73
  • AETNA — AETNA HMO EXCHANGE: $654.74
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,378.40
  • AETNA — AETNA TIER 2: $878.73
  • AFFORDABLE — AFFORDABLE PPO: $1,464.55
  • AMERIGROUP — AMERIGROUP: $34.17
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $775.35
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O DYE $5,808 $3,775.20 $147.32 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10
  • AETNA — AETNA BETTER HEALTH MEDICAID: $159.10
  • AETNA — AETNA HMO: $2,962.08
  • AETNA — AETNA HMO EXCHANGE: $2,207.04
  • AETNA — AETNA MEDICARE: $279.07
  • AETNA — AETNA PPO: $4,646.40
  • AETNA — AETNA TIER 2: $2,962.08
  • AFFORDABLE — AFFORDABLE PPO: $4,936.80
  • AMERIGROUP — AMERIGROUP: $147.32
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,613.60
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier ER In the file: MRI LUMBAR SPINE W/O DYE $5,808 $3,775.20 $147.32 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10
  • AETNA — AETNA BETTER HEALTH MEDICAID: $159.10
  • AETNA — AETNA HMO: $2,962.08
  • AETNA — AETNA HMO EXCHANGE: $2,207.04
  • AETNA — AETNA MEDICARE: $279.07
  • AETNA — AETNA PPO: $4,646.40
  • AETNA — AETNA TIER 2: $2,962.08
  • AFFORDABLE — AFFORDABLE PPO: $4,936.80
  • AMERIGROUP — AMERIGROUP: $147.32
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,613.60
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier KX In the file: MRI LUMBAR SPINE W/O DYE $5,808 $3,775.20 $147.32 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10
  • AETNA — AETNA BETTER HEALTH MEDICAID: $159.10
  • AETNA — AETNA HMO: $2,962.08
  • AETNA — AETNA HMO EXCHANGE: $2,207.04
  • AETNA — AETNA MEDICARE: $279.07
  • AETNA — AETNA PPO: $4,646.40
  • AETNA — AETNA TIER 2: $2,962.08
  • AFFORDABLE — AFFORDABLE PPO: $4,936.80
  • AMERIGROUP — AMERIGROUP: $147.32
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,613.60
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/DYE $5,201 $3,380.65 $183.17 – $5,201
CT scan of the pelvis, with contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $2,652.51
  • AETNA — AETNA HMO EXCHANGE: $1,976.38
  • AETNA — AETNA MEDICARE: $205.15
  • AETNA — AETNA PPO: $4,160.80
  • AETNA — AETNA TIER 2: $2,652.51
  • AFFORDABLE — AFFORDABLE PPO: $4,420.85
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,340.45
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier ER In the file: CT PELVIS W/DYE $5,201 $3,380.65 $183.17 – $5,201
CT scan of the pelvis, with contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $2,652.51
  • AETNA — AETNA HMO EXCHANGE: $1,976.38
  • AETNA — AETNA MEDICARE: $205.15
  • AETNA — AETNA PPO: $4,160.80
  • AETNA — AETNA TIER 2: $2,652.51
  • AFFORDABLE — AFFORDABLE PPO: $4,420.85
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,340.45
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI JNT OF LWR EXTRE W/O DYE $5,526 $3,591.90 $147.32 – $5,526
MRI of a leg joint (such as the knee), without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10
  • AETNA — AETNA BETTER HEALTH MEDICAID: $159.10
  • AETNA — AETNA HMO: $2,818.26
  • AETNA — AETNA HMO EXCHANGE: $2,099.88
  • AETNA — AETNA MEDICARE: $279.07
  • AETNA — AETNA PPO: $4,420.80
  • AETNA — AETNA TIER 2: $2,818.26
  • AFFORDABLE — AFFORDABLE PPO: $4,697.10
  • AMERIGROUP — AMERIGROUP: $147.32
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,486.70
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier KX In the file: MRI JNT OF LWR EXTRE W/O DYE $5,526 $3,591.90 $147.32 – $5,526
MRI of a leg joint (such as the knee), without contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10
  • AETNA — AETNA BETTER HEALTH MEDICAID: $159.10
  • AETNA — AETNA HMO: $2,818.26
  • AETNA — AETNA HMO EXCHANGE: $2,099.88
  • AETNA — AETNA MEDICARE: $279.07
  • AETNA — AETNA PPO: $4,420.80
  • AETNA — AETNA TIER 2: $2,818.26
  • AFFORDABLE — AFFORDABLE PPO: $4,697.10
  • AMERIGROUP — AMERIGROUP: $147.32
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,486.70
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Abd pelvis CT scans w con $9,176 $5,964.40 $197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $4,679.76
  • AETNA — AETNA HMO EXCHANGE: $3,486.88
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $7,340.80
  • AETNA — AETNA TIER 2: $4,679.76
  • AFFORDABLE — AFFORDABLE PPO: $7,799.60
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $4,129.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier 59 In the file: Abd pelvis CT scans w con $9,176 $5,964.40 $197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $4,679.76
  • AETNA — AETNA HMO EXCHANGE: $3,486.88
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $7,340.80
  • AETNA — AETNA TIER 2: $4,679.76
  • AFFORDABLE — AFFORDABLE PPO: $7,799.60
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $4,129.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier XE In the file: Abd pelvis CT scans w con $9,176 $5,964.40 $197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86
  • AETNA — AETNA BETTER HEALTH MEDICAID: $212.86
  • AETNA — AETNA HMO: $4,679.76
  • AETNA — AETNA HMO EXCHANGE: $3,486.88
  • AETNA — AETNA MEDICARE: $408.04
  • AETNA — AETNA PPO: $7,340.80
  • AETNA — AETNA TIER 2: $4,679.76
  • AFFORDABLE — AFFORDABLE PPO: $7,799.60
  • AMERIGROUP — AMERIGROUP: $197.10
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $4,129.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Abdominal complete US $2,276 $1,479.40 $101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62
  • AETNA — AETNA BETTER HEALTH MEDICAID: $109.62
  • AETNA — AETNA HMO: $1,160.76
  • AETNA — AETNA HMO EXCHANGE: $864.88
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,820.80
  • AETNA — AETNA TIER 2: $1,160.76
  • AFFORDABLE — AFFORDABLE PPO: $1,934.60
  • AMERIGROUP — AMERIGROUP: $101.50
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,024.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier 59 In the file: Abdominal complete US $2,276 $1,479.40 $101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62
  • AETNA — AETNA BETTER HEALTH MEDICAID: $109.62
  • AETNA — AETNA HMO: $1,160.76
  • AETNA — AETNA HMO EXCHANGE: $864.88
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,820.80
  • AETNA — AETNA TIER 2: $1,160.76
  • AFFORDABLE — AFFORDABLE PPO: $1,934.60
  • AMERIGROUP — AMERIGROUP: $101.50
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,024.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier ER In the file: Abdominal complete US $2,276 $1,479.40 $101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62
  • AETNA — AETNA BETTER HEALTH MEDICAID: $109.62
  • AETNA — AETNA HMO: $1,160.76
  • AETNA — AETNA HMO EXCHANGE: $864.88
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,820.80
  • AETNA — AETNA TIER 2: $1,160.76
  • AFFORDABLE — AFFORDABLE PPO: $1,934.60
  • AMERIGROUP — AMERIGROUP: $101.50
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,024.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB 2nd 3rd tri complete US $1,259 $818.35 $61.43 – $1,259
Pregnancy ultrasound (after the first trimester): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $66.34
  • AETNA — AETNA BETTER HEALTH MEDICAID: $66.34
  • AETNA — AETNA HMO: $642.09
  • AETNA — AETNA HMO EXCHANGE: $478.42
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,007.20
  • AETNA — AETNA TIER 2: $642.09
  • AFFORDABLE — AFFORDABLE PPO: $1,070.15
  • AMERIGROUP — AMERIGROUP: $61.43
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $566.55
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal US $1,354 $880.10 $66.99 – $1,354
Transvaginal ultrasound: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $72.35
  • AETNA — AETNA BETTER HEALTH MEDICAID: $72.35
  • AETNA — AETNA HMO: $690.54
  • AETNA — AETNA HMO EXCHANGE: $514.52
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,083.20
  • AETNA — AETNA TIER 2: $690.54
  • AFFORDABLE — AFFORDABLE PPO: $1,150.90
  • AMERIGROUP — AMERIGROUP: $66.99
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $609.30
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier ER In the file: Transvaginal US $1,354 $880.10 $66.99 – $1,354
Transvaginal ultrasound: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $72.35
  • AETNA — AETNA BETTER HEALTH MEDICAID: $72.35
  • AETNA — AETNA HMO: $690.54
  • AETNA — AETNA HMO EXCHANGE: $514.52
  • AETNA — AETNA MEDICARE: $122.28
  • AETNA — AETNA PPO: $1,083.20
  • AETNA — AETNA TIER 2: $690.54
  • AFFORDABLE — AFFORDABLE PPO: $1,150.90
  • AMERIGROUP — AMERIGROUP: $66.99
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $609.30

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Lt heart cath wwo vgram $20,797 $13,518.05 $1,521.09 – $20,797
Left heart catheterization (diagnostic): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1,642.78
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1,642.78
  • AETNA — AETNA HMO: $10,606.47
  • AETNA — AETNA HMO EXCHANGE: $7,902.86
  • AETNA — AETNA MEDICARE: $3,791.74
  • AETNA — AETNA PPO: $16,637.60
  • AETNA — AETNA TIER 2: $10,606.47
  • AFFORDABLE — AFFORDABLE PPO: $17,677.45
  • AMERIGROUP — AMERIGROUP: $1,521.09
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $9,358.65
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier XU In the file: Lt heart cath wwo vgram $20,797 $13,518.05 $1,521.09 – $20,797
Left heart catheterization (diagnostic): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1,642.78
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1,642.78
  • AETNA — AETNA HMO: $10,606.47
  • AETNA — AETNA HMO EXCHANGE: $7,902.86
  • AETNA — AETNA MEDICARE: $3,791.74
  • AETNA — AETNA PPO: $16,637.60
  • AETNA — AETNA TIER 2: $10,606.47
  • AFFORDABLE — AFFORDABLE PPO: $17,677.45
  • AMERIGROUP — AMERIGROUP: $1,521.09
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $9,358.65
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: EP wo induct/attempted arrhy $18,835 $12,242.75 $3,296.13 – $18,835
Heart rhythm study (electrophysiology evaluation): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4,525.08
  • AETNA — AETNA BETTER HEALTH MEDICAID: $4,525.08
  • AETNA — AETNA HMO: $9,605.85
  • AETNA — AETNA HMO EXCHANGE: $7,157.30
  • AETNA — AETNA MEDICARE: $9,122.43
  • AETNA — AETNA PPO: $15,068
  • AETNA — AETNA TIER 2: $9,605.85
  • AFFORDABLE — AFFORDABLE PPO: $16,009.75
  • AMERIGROUP — AMERIGROUP: $4,189.88
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $8,475.75
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: Comp EP evl & pv isltn -af abl $45,794 $29,766.10 $8,013.95 – $45,794
Heart rhythm study with ablation for atrial fibrillation: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $11,289.78
  • AETNA — AETNA BETTER HEALTH MEDICAID: $11,289.78
  • AETNA — AETNA HMO: $23,354.94
  • AETNA — AETNA HMO EXCHANGE: $17,401.72
  • AETNA — AETNA MEDICARE: $30,570.64
  • AETNA — AETNA PPO: $36,635.20
  • AETNA — AETNA TIER 2: $23,354.94
  • AFFORDABLE — AFFORDABLE PPO: $38,924.90
  • AMERIGROUP — AMERIGROUP: $10,453.50
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $20,607.30
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: Polysom 6/> yrs 4/> param $6,505 $4,228.25 $471.38 – $6,505
Sleep study (overnight, in a sleep lab): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $509.09
  • AETNA — AETNA BETTER HEALTH MEDICAID: $509.09
  • AETNA — AETNA HMO: $3,317.55
  • AETNA — AETNA HMO EXCHANGE: $2,471.90
  • AETNA — AETNA MEDICARE: $1,004.38
  • AETNA — AETNA PPO: $5,204
  • AETNA — AETNA TIER 2: $3,317.55
  • AFFORDABLE — AFFORDABLE PPO: $5,529.25
  • AMERIGROUP — AMERIGROUP: $471.38
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,927.25
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier TC In the file: Polysom 6/> yrs 4/> param $6,505 $4,228.25 $471.38 – $6,505
Sleep study (overnight, in a sleep lab): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $509.09
  • AETNA — AETNA BETTER HEALTH MEDICAID: $509.09
  • AETNA — AETNA HMO: $3,317.55
  • AETNA — AETNA HMO EXCHANGE: $2,471.90
  • AETNA — AETNA MEDICARE: $1,004.38
  • AETNA — AETNA PPO: $5,204
  • AETNA — AETNA TIER 2: $3,317.55
  • AFFORDABLE — AFFORDABLE PPO: $5,529.25
  • AMERIGROUP — AMERIGROUP: $471.38
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,927.25

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: THERAPEUTIC EXERCISES $248 $161.20 $21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47
  • AETNA — AETNA BETTER HEALTH MEDICAID: $23.47
  • AETNA — AETNA HMO: $126.48
  • AETNA — AETNA HMO EXCHANGE: $94.24
  • AETNA — AETNA MEDICARE: $33.75
  • AETNA — AETNA PPO: $198.40
  • AETNA — AETNA TIER 2: $126.48
  • AFFORDABLE — AFFORDABLE PPO: $210.80
  • AMERIGROUP — AMERIGROUP: $21.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PT thera proced ea 15 min $248 $161.20 $21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47
  • AETNA — AETNA BETTER HEALTH MEDICAID: $23.47
  • AETNA — AETNA HMO: $126.48
  • AETNA — AETNA HMO EXCHANGE: $94.24
  • AETNA — AETNA MEDICARE: $33.75
  • AETNA — AETNA PPO: $198.40
  • AETNA — AETNA TIER 2: $126.48
  • AFFORDABLE — AFFORDABLE PPO: $210.80
  • AMERIGROUP — AMERIGROUP: $21.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 97 In the file: THERAPEUTIC EXERCISES $248 $161.20 $21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47
  • AETNA — AETNA BETTER HEALTH MEDICAID: $23.47
  • AETNA — AETNA HMO: $126.48
  • AETNA — AETNA HMO EXCHANGE: $94.24
  • AETNA — AETNA MEDICARE: $33.75
  • AETNA — AETNA PPO: $198.40
  • AETNA — AETNA TIER 2: $126.48
  • AFFORDABLE — AFFORDABLE PPO: $210.80
  • AMERIGROUP — AMERIGROUP: $21.73
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $111.60
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT eval low complex $402 $261.30 $70.35 – $402
Physical therapy evaluation (low complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $205.02
  • AETNA — AETNA HMO EXCHANGE: $152.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $321.60
  • AETNA — AETNA TIER 2: $205.02
  • AFFORDABLE — AFFORDABLE PPO: $341.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $180.90
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier 59 In the file: PT eval low complex $402 $261.30 $70.35 – $402
Physical therapy evaluation (low complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $205.02
  • AETNA — AETNA HMO EXCHANGE: $152.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $321.60
  • AETNA — AETNA TIER 2: $205.02
  • AFFORDABLE — AFFORDABLE PPO: $341.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $180.90
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier 95 In the file: PT eval low complex $402 $261.30 $70.35 – $402
Physical therapy evaluation (low complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $205.02
  • AETNA — AETNA HMO EXCHANGE: $152.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $321.60
  • AETNA — AETNA TIER 2: $205.02
  • AFFORDABLE — AFFORDABLE PPO: $341.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $180.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT eval mod complex $602 $391.30 $100.27 – $602
Physical therapy evaluation (moderate complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $307.02
  • AETNA — AETNA HMO EXCHANGE: $228.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $481.60
  • AETNA — AETNA TIER 2: $307.02
  • AFFORDABLE — AFFORDABLE PPO: $511.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $270.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier 97 In the file: PT eval mod complex $602 $391.30 $100.27 – $602
Physical therapy evaluation (moderate complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $307.02
  • AETNA — AETNA HMO EXCHANGE: $228.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $481.60
  • AETNA — AETNA TIER 2: $307.02
  • AFFORDABLE — AFFORDABLE PPO: $511.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $270.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier PN In the file: PT eval mod complex $602 $391.30 $100.27 – $602
Physical therapy evaluation (moderate complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $307.02
  • AETNA — AETNA HMO EXCHANGE: $228.76
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $481.60
  • AETNA — AETNA TIER 2: $307.02
  • AFFORDABLE — AFFORDABLE PPO: $511.70
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $270.90
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT eval high complex $903 $586.95 $100.27 – $903
Physical therapy evaluation (high complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $460.53
  • AETNA — AETNA HMO EXCHANGE: $343.14
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $722.40
  • AETNA — AETNA TIER 2: $460.53
  • AFFORDABLE — AFFORDABLE PPO: $767.55
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $406.35
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: PT eval high complex $903 $586.95 $100.27 – $903
Physical therapy evaluation (high complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $460.53
  • AETNA — AETNA HMO EXCHANGE: $343.14
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $722.40
  • AETNA — AETNA TIER 2: $460.53
  • AFFORDABLE — AFFORDABLE PPO: $767.55
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $406.35
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier 97 In the file: PT eval high complex $903 $586.95 $100.27 – $903
Physical therapy evaluation (high complexity): 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67
  • AETNA — AETNA BETTER HEALTH MEDICAID: $154.67
  • AETNA — AETNA HMO: $460.53
  • AETNA — AETNA HMO EXCHANGE: $343.14
  • AETNA — AETNA MEDICARE: $112.30
  • AETNA — AETNA PPO: $722.40
  • AETNA — AETNA TIER 2: $460.53
  • AFFORDABLE — AFFORDABLE PPO: $767.55
  • AMERIGROUP — AMERIGROUP: $143.21
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $406.35

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION Not listed in the file Not listed in the file $815.35 – $15,738
Removal of breast growth (open surgery): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 50 In the file: REMOVAL OF BREAST LESION Not listed in the file Not listed in the file $1,223.02 – $15,738
Removal of breast growth (open surgery): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $5,795.63 – $36,175.16
Total hip replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 50 In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $6,330.65 – $36,175.16
Total hip replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 22 In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $5,795.63 – $36,175.16
Total hip replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $4,441.06 – $25,377.48
Total knee replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 50 In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $4,441.06 – $25,377.48
Total knee replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 22 In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $4,441.06 – $25,377.48
Total knee replacement: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file Not listed in the file $366 – $10,975.33
Shoulder arthroscopy: shaving of shoulder bone: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file Not listed in the file $1,334.27 – $17,544.67
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 59 In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file Not listed in the file $1,334.27 – $17,544.67
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH Not listed in the file Not listed in the file $605.30 – $3,458.86
Upper GI endoscopy (diagnostic): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 74 In the file: EGD DIAGNOSTIC BRUSH WASH Not listed in the file Not listed in the file $605.30 – $3,458.86
Upper GI endoscopy (diagnostic): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE Not listed in the file Not listed in the file $617.47 – $3,790.26
Upper GI endoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier PT In the file: EGD BIOPSY SINGLE/MULTIPLE Not listed in the file Not listed in the file $617.47 – $3,790.26
Upper GI endoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 59 In the file: EGD BIOPSY SINGLE/MULTIPLE Not listed in the file Not listed in the file $617.47 – $3,790.26
Upper GI endoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $612.86 – $3,502.08
Colonoscopy (diagnostic): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 33 In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $612.86 – $3,502.08
Colonoscopy (diagnostic): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $612.86 – $3,502.08
Colonoscopy (diagnostic): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $613.58 – $3,998.84
Colonoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 74 In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $613.58 – $3,998.84
Colonoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $613.58 – $3,998.84
Colonoscopy with biopsy: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL Not listed in the file Not listed in the file $613.58 – $3,908.65
Colonoscopy with removal of polyps (snare): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 59 In the file: COLONOSCOPY W/LESION REMOVAL Not listed in the file Not listed in the file $613.58 – $3,908.65
Colonoscopy with removal of polyps (snare): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY W/LESION REMOVAL Not listed in the file Not listed in the file $613.58 – $3,908.65
Colonoscopy with removal of polyps (snare): 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLON CA SCRN NOT HI RSK IND Not listed in the file Not listed in the file $539 – $3,506.58
Screening colonoscopy (not high risk): 10 of 28 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 74 In the file: COLON CA SCRN NOT HI RSK IND Not listed in the file Not listed in the file $539 – $3,506.58
Screening colonoscopy (not high risk): 10 of 28 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file $2,234.72 – $21,654.43
Gallbladder removal by laparoscope: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier ER In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file $2,234.72 – $21,654.43
Gallbladder removal by laparoscope: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 59 In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file $2,234.72 – $21,654.43
Gallbladder removal by laparoscope: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR Not listed in the file Not listed in the file $2,250.18 – $22,934.13
Groin (inguinal) hernia repair, age 5 or older: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: PRP I/HERN INIT REDUC >5 YR Not listed in the file Not listed in the file $3,375.27 – $22,934.13
Groin (inguinal) hernia repair, age 5 or older: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: Prostate biopsy surgical $2,968 $1,929.20 $519.40 – $2,968
Prostate biopsy: 10 of 42 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1,138.85
  • AETNA — AETNA BETTER HEALTH MEDICAID: $1,138.85
  • AETNA — AETNA HMO: $1,513.68
  • AETNA — AETNA HMO EXCHANGE: $1,127.84
  • AETNA — AETNA PPO: $2,374.40
  • AETNA — AETNA TIER 2: $1,513.68
  • AFFORDABLE — AFFORDABLE PPO: $2,522.80
  • AMERIGROUP — AMERIGROUP: $1,054.49
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,335.60
  • AVMED — AVMED ENTRUST: $1,059.58
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY Not listed in the file Not listed in the file $1,457.27 – $21,258.36
Hysteroscopy with biopsy of the uterus lining: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 59 In the file: HYSTEROSCOPY BIOPSY Not listed in the file Not listed in the file $1,457.27 – $21,258.36
Hysteroscopy with biopsy of the uterus lining: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 74 In the file: HYSTEROSCOPY BIOPSY Not listed in the file Not listed in the file $1,457.27 – $21,258.36
Hysteroscopy with biopsy of the uterus lining: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: Lumbar sac epidural inj w gui $5,329 $3,463.85 $468.92 – $5,329
Spinal injection, lower back (epidural), with imaging guidance: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $506.43
  • AETNA — AETNA BETTER HEALTH MEDICAID: $506.43
  • AETNA — AETNA HMO: $2,717.79
  • AETNA — AETNA HMO EXCHANGE: $2,025.02
  • AETNA — AETNA MEDICARE: $825.59
  • AETNA — AETNA PPO: $4,263.20
  • AETNA — AETNA TIER 2: $2,717.79
  • AFFORDABLE — AFFORDABLE PPO: $4,529.65
  • AMERIGROUP — AMERIGROUP: $468.92
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,398.05
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier 59 In the file: Lumbar sac epidural inj w gui $5,329 $3,463.85 $468.92 – $5,329
Spinal injection, lower back (epidural), with imaging guidance: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $506.43
  • AETNA — AETNA BETTER HEALTH MEDICAID: $506.43
  • AETNA — AETNA HMO: $2,717.79
  • AETNA — AETNA HMO EXCHANGE: $2,025.02
  • AETNA — AETNA MEDICARE: $825.59
  • AETNA — AETNA PPO: $4,263.20
  • AETNA — AETNA TIER 2: $2,717.79
  • AFFORDABLE — AFFORDABLE PPO: $4,529.65
  • AMERIGROUP — AMERIGROUP: $468.92
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,398.05
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Transfor epi L-S sglv w gui $3,366 $2,187.90 $468.92 – $3,366
Nerve root injection, lower back, with imaging guidance: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $506.43
  • AETNA — AETNA BETTER HEALTH MEDICAID: $506.43
  • AETNA — AETNA HMO: $1,716.66
  • AETNA — AETNA HMO EXCHANGE: $1,279.08
  • AETNA — AETNA MEDICARE: $1,034.47
  • AETNA — AETNA PPO: $2,692.80
  • AETNA — AETNA TIER 2: $1,716.66
  • AFFORDABLE — AFFORDABLE PPO: $2,861.10
  • AMERIGROUP — AMERIGROUP: $468.92
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,514.70
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Transfor epi ls sg lv bil wgui $6,729 $4,373.85 $468.92 – $6,729
Nerve root injection, lower back, with imaging guidance: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $506.43
  • AETNA — AETNA BETTER HEALTH MEDICAID: $506.43
  • AETNA — AETNA HMO: $3,431.79
  • AETNA — AETNA HMO EXCHANGE: $2,557.02
  • AETNA — AETNA MEDICARE: $1,034.47
  • AETNA — AETNA PPO: $5,383.20
  • AETNA — AETNA TIER 2: $3,431.79
  • AFFORDABLE — AFFORDABLE PPO: $5,719.65
  • AMERIGROUP — AMERIGROUP: $468.92
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $3,028.05
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50 In the file: Transfor epi L-S sglv w gui $3,366 $2,187.90 $589.05 – $3,366
Nerve root injection, lower back, with imaging guidance: 10 of 55 insurance plan rates
  • AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $759.64
  • AETNA — AETNA BETTER HEALTH MEDICAID: $759.64
  • AETNA — AETNA HMO: $1,716.66
  • AETNA — AETNA HMO EXCHANGE: $1,279.08
  • AETNA — AETNA MEDICARE: $1,551.71
  • AETNA — AETNA PPO: $2,692.80
  • AETNA — AETNA TIER 2: $1,716.66
  • AFFORDABLE — AFFORDABLE PPO: $2,861.10
  • AMERIGROUP — AMERIGROUP: $703.37
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,514.70
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file $836.71 – $14,389.77
Carpal tunnel release: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 50 In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file $1,255.06 – $14,389.77
Carpal tunnel release: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 59 In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file $836.71 – $14,389.77
Carpal tunnel release: 10 of 30 insurance plan rates
  • AETNA — AETNA HMO: 51% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA HMO EXCHANGE: 38% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount)
  • AETNA — AETNA TIER 2: 51% (a percentage in the contract, not a dollar amount)
  • AFFORDABLE — AFFORDABLE PPO: 85% (a percentage in the contract, not a dollar amount)
  • AMERIHEALTH — AMERIHTH CARITAS NXT EX: 45% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED ENTRUST: 35.7% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED HMO: 41.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED INDIVIDUAL: 40.6% (a percentage in the contract, not a dollar amount)
  • AVMED — AVMED PPO: 49.5% (a percentage in the contract, not a dollar amount)

Source: Doctors Hospital’s standard charges file (baptisthealth.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 30, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address5000 University Dr, Coral Gables, FL 33146
CountyMiami-Dade County
StateFlorida
Phone(786) 308‑3000
Emergency servicesYes
OwnershipVoluntary non-profit - Other
Medicare overall rating5 of 5 stars
CMS Certification Number100296
Name in Medicare recordsDOCTORS HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteBaptist Health Doctors Hospital
Official websitebaptisthealth.net
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Doctors Hospital - Baptist Health South Florida — baptisthealth.net