Does Falls Community Hospital and Clinic have an emergency room?

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

Where is Falls Community Hospital and Clinic?

322 Coleman Street, Marlin, TX 76661, in Falls County, Texas.

What is the phone number of Falls Community Hospital and Clinic?

(254) 803-3561, as listed by Medicare (CMS).

What is the Medicare star rating of Falls Community Hospital and Clinic?

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

Falls Community Hospital and Clinic

Quick answers

Does Falls Community Hospital and Clinic have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Falls Community Hospital and Clinic. In a medical emergency, call 911.
Where is Falls Community Hospital and Clinic?: 322 Coleman Street, Marlin, TX 76661, in Falls County, Texas.
What is the phone number of Falls Community Hospital and Clinic?: (254) 803-3561, as listed by Medicare (CMS).
What is the Medicare star rating of Falls Community Hospital and Clinic?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][5][7]

Procedures^[4][5]

Radiology
Laboratory

Programs and centers^[4][5][6]

Radiology
Laboratory
Rural health clinics
Specialty clinic
Falls County Indigent program
Sliding fee scale discount program
Financial assistance policy

Emergency care (hospital website)^[4][5]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Interpreters and languages	English and Spanish, and certain other languages, available on request for financial assistance documents^[6]
Patient portal	MyCareCorner

Recognition^[4]

Rural Emergency Hospital (REH)

Doctors and clinicians (22)

22 doctors and other clinicians list Falls Community Hospital and Clinic 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

Other emergency rooms nearby

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

Ascension Providence23 mi · Waco, TX · Acute Care Hospital
Baylor Scott & White Medical Center Hillcrest26 mi · Waco, TX · Acute Care Hospital
Limestone Medical Center26 mi · Groesbeck, TX · Critical Access Hospital
Temple VA Medical Center (VA Central Texas Healthcare System)31 mi · Temple, TX · Federal/VA Acute Care Hospital
Baylor Scott & White Medical Center - Temple32 mi · Temple, TX · Acute Care Hospital

Other hospitals nearby

Encompass Health Rehabilitation Hospital of Waco15 mi · Robinson, TX · Inpatient Rehabilitation Hospital
Oceans Behavioral Hospital of Waco20 mi · Waco, TX · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Golden Years Nursing and Rehabilitation Center0.1 mi · Marlin, TX · 5 of 5 stars
Bremond Nursing and Rehabilitation Center16 mi · Bremond, TX · 2 of 5 stars
Heritage House Nursing and Rehabilitation17 mi · Rosebud, TX · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Alamo Hospice of Waco24 mi · Waco, TX
Compassus - Central Texas24 mi · Waco, TX
Gentiva24 mi · Waco, TX

All hospice providers in the state →

Home health agencies

Texas Quality Home Health3.2 mi · Marlin, TX · 5 of 5 stars
Ascension at Home24 mi · Waco, TX · 3 of 5 stars
Bluebonnet Health Services of Waco24 mi · Waco, TX

All home health agencies in the state →

Dialysis facilities

Falls County Kidney Center3.2 mi · Marlin, TX · 3 of 5 stars
Fresenius Medical Care Bellmead25 mi · Bellmead, TX · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Fish Pond Surgery Center LLC24 mi · Waco, TX

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Waco Family Medicine - Tom Oliver S. 18th20 mi · Waco, TX · Community health center
Waco Family Medicine - Cesar Chavez22 mi · Waco, TX · Community health center
Waco Family Medicine - Imperial Drive22 mi · Waco, TX · Community health center

Clinics and urgent care

Falls Community Hosptial and Clinic3.2 mi · Marlin, TX · Rural health clinic
Fchc-Rosebud Medical Clinic16 mi · Rosebud, TX · Rural health clinic
Kosse Community Health Clinic a Limestone Medical Center Clinic17 mi · Kosse, TX · Rural health clinic

Pharmacies

Sanitarium Drug Co3.2 mi · Marlin, TX · Community/retail pharmacy
Wal-Mart Stores Texas LLC3.2 mi · Marlin, TX · Community/retail pharmacy

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Not reported to Medicare

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

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

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

Return visits to the hospital (readmissions)

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

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

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

Emergency room times and sepsis care

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

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

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 50 common services exactly as Falls Community Hospital and Clinic 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 →

$ 5 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: RHC OV NP LOW MDM 30-44 MINS	$273	$218.40	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $348.66
New patient office visit (about 30–44 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $218.40 Blue Cross — PPO: $348.66 Cigna — HMO/PPO/POS: $54.60 Humana Medicare Advantage — Medicare Advantage: $80.95 Scott and White — HMO/PPO/POS: $80.95 United Health Commercial — HMO/PPO/POS: $191.10 United Healthcare Medicare Advantage — Medicare Advantage: $80.95
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: PF OFF/OP V NP LOW MDM 30-44 MINS	$202	$161.60	$40.40 – $348.66
New patient office visit (about 30–44 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $161.60 Blue Cross — PPO: $348.66 Cigna — HMO/PPO/POS: $40.40 Humana Medicare Advantage — Medicare Advantage: $80.95 Scott and White — HMO/PPO/POS: $80.95 United Health Commercial — HMO/PPO/POS: $141.40 United Healthcare Medicare Advantage — Medicare Advantage: $80.95
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: CHIRO OV NP LOW MDM 30-44 MINS	$303	$242.40	$80.95 – $348.66
New patient office visit (about 30–44 minutes): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $242.40 Blue Cross — PPO: $348.66 Humana Medicare Advantage — Medicare Advantage: $80.95 Scott and White — HMO/PPO/POS: $80.95 United Health Commercial — HMO/PPO/POS: $212.10 United Healthcare Medicare Advantage — Medicare Advantage: $80.95
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: RHC OV NP MOD MDM 45-59 MINS	$405	$324	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $590.31
New patient office visit (about 45–59 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $324 Blue Cross — PPO: $590.31 Cigna — HMO/PPO/POS: $81 Humana Medicare Advantage — Medicare Advantage: $131.51 Scott and White — HMO/PPO/POS: $131.51 United Health Commercial — HMO/PPO/POS: $283.50 United Healthcare Medicare Advantage — Medicare Advantage: $131.51
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: PF OFF/OP V NP MOD MDM 45-59 MINS	$325	$260	$65 – $590.31
New patient office visit (about 45–59 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $260 Blue Cross — PPO: $590.31 Cigna — HMO/PPO/POS: $65 Humana Medicare Advantage — Medicare Advantage: $131.51 Scott and White — HMO/PPO/POS: $131.51 United Health Commercial — HMO/PPO/POS: $227.50 United Healthcare Medicare Advantage — Medicare Advantage: $131.51
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: CHIRO OV NP MOD MDM 45-59 MINS	$333	$266.40	$131.51 – $590.31
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $266.40 Blue Cross — PPO: $590.31 Humana Medicare Advantage — Medicare Advantage: $131.51 Scott and White — HMO/PPO/POS: $131.51 United Health Commercial — HMO/PPO/POS: $233.10 United Healthcare Medicare Advantage — Medicare Advantage: $131.51
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: RHC OV NP HIGH MDM 60-74 MINS	$535	$428	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $770.36
New patient office visit (about 60–74 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $428 Blue Cross — PPO: $770.36 Cigna — HMO/PPO/POS: $107 Humana Medicare Advantage — Medicare Advantage: $178.48 Scott and White — HMO/PPO/POS: $178.48 United Health Commercial — HMO/PPO/POS: $374.50 United Healthcare Medicare Advantage — Medicare Advantage: $178.48
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PF OFF/OP V NP HIGH MDM 60-74 MINS	$441	$352.80	$88.20 – $770.36
New patient office visit (about 60–74 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $352.80 Blue Cross — PPO: $770.36 Cigna — HMO/PPO/POS: $88.20 Humana Medicare Advantage — Medicare Advantage: $178.48 Scott and White — HMO/PPO/POS: $178.48 United Health Commercial — HMO/PPO/POS: $308.70 United Healthcare Medicare Advantage — Medicare Advantage: $178.48
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: CL OV NP HIGH MDM 60-74 MINS	$252	$201.60	$120.96 – $770.36
New patient office visit (about 60–74 minutes): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $201.60 Blue Cross — PPO: $770.36 Humana Medicare Advantage — Medicare Advantage: $178.48 Scott and White — HMO/PPO/POS: $178.48 United Health Commercial — HMO/PPO/POS: $176.40 United Healthcare Medicare Advantage — Medicare Advantage: $178.48
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: RHC OV EP LOW MDM 20-29 MINS	$250	$200	$23.94 – $233.55
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $200 Blue Cross — PPO: $233.55 Cigna — HMO/PPO/POS: $50 Humana Medicare Advantage — Medicare Advantage: $65.19 Scott and White — HMO/PPO/POS: $65.19 United Health Commercial — HMO/PPO/POS: $175 United Healthcare Medicare Advantage — Medicare Advantage: $65.19
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP V EP LOW MDM 20-29 MINS	$303	$242.40	$23.94 – $242.40
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $242.40 Blue Cross — PPO: $50 Cigna — HMO/PPO/POS: $60.60 Humana Medicare Advantage — Medicare Advantage: $65.19 Scott and White — HMO/PPO/POS: $65.19 United Health Commercial — HMO/PPO/POS: $212.10 United Healthcare Medicare Advantage — Medicare Advantage: $65.19
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PF OFF/OP V EP LOW MDM 20-29 MINS	$161	$128.80	$23.94 – $233.55
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $128.80 Blue Cross — PPO: $233.55 Cigna — HMO/PPO/POS: $32.20 Humana Medicare Advantage — Medicare Advantage: $65.19 Scott and White — HMO/PPO/POS: $65.19 United Health Commercial — HMO/PPO/POS: $112.70 United Healthcare Medicare Advantage — Medicare Advantage: $65.19
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: RHC OV EP MOD MDM 30-39 MINS	$311	$248.80	$47.68 – $360.05
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $248.80 Blue Cross — PPO: $360.05 Cigna — HMO/PPO/POS: $62.20 Humana Medicare Advantage — Medicare Advantage: $95.97 Scott and White — HMO/PPO/POS: $95.97 United Health Commercial — HMO/PPO/POS: $217.70 United Healthcare Medicare Advantage — Medicare Advantage: $95.97
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: PF OFF/OP V EP MOD MDM 30-39 MINS	$238	$190.40	$47.60 – $360.05
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $190.40 Blue Cross — PPO: $360.05 Cigna — HMO/PPO/POS: $47.60 Humana Medicare Advantage — Medicare Advantage: $95.97 Scott and White — HMO/PPO/POS: $95.97 United Health Commercial — HMO/PPO/POS: $166.60 United Healthcare Medicare Advantage — Medicare Advantage: $95.97
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: CL OV EP MOD MDM 30-39 MINS	$252	$201.60	$47.68 – $360.05
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $201.60 Blue Cross — PPO: $360.05 Humana Medicare Advantage — Medicare Advantage: $95.97 Scott and White — HMO/PPO/POS: $95.97 United Health Commercial — HMO/PPO/POS: $176.40 United Healthcare Medicare Advantage — Medicare Advantage: $95.97
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: PF OV/CONSULT NEW/EST LOW MDM =/>30 MINS	$178	$142.40	$35.60 – $437.90
Office consultation with a specialist (moderate): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $142.40 Blue Cross — PPO: $437.90 Cigna — HMO/PPO/POS: $35.60 Humana Medicare Advantage — Medicare Advantage: $91.96 Scott and White — HMO/PPO/POS: $91.96 United Health Commercial — HMO/PPO/POS: $124.60 United Healthcare Medicare Advantage — Medicare Advantage: $91.96
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: CL OV CONSULT LOW MDM 30 MINS OR>	$252	$201.60	$91.96 – $437.90
Office consultation with a specialist (moderate): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $201.60 Blue Cross — PPO: $437.90 Humana Medicare Advantage — Medicare Advantage: $91.96 Scott and White — HMO/PPO/POS: $91.96 United Health Commercial — HMO/PPO/POS: $176.40 United Healthcare Medicare Advantage — Medicare Advantage: $91.96
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: PF OV/CONSULT NEW/EST MOD MDM =/>40 MINS	$272	$217.60	$54.40 – $703.85
Office consultation with a specialist (moderate to high): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $217.60 Blue Cross — PPO: $703.85 Cigna — HMO/PPO/POS: $54.40 Humana Medicare Advantage — Medicare Advantage: $147.24 Scott and White — HMO/PPO/POS: $147.24 United Health Commercial — HMO/PPO/POS: $190.40 United Healthcare Medicare Advantage — Medicare Advantage: $147.24
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: CHIRO OV/CONSULT NP/EP MOD MDM =>40M	$270	$216	$129.60 – $703.85
Office consultation with a specialist (moderate to high): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $216 Blue Cross — PPO: $703.85 Humana Medicare Advantage — Medicare Advantage: $147.24 Scott and White — HMO/PPO/POS: $147.24 United Health Commercial — HMO/PPO/POS: $189 United Healthcare Medicare Advantage — Medicare Advantage: $147.24
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: CL OFFICE CONSULT MOD MDM 40MIN OR >	$303	$242.40	$145.44 – $703.85
Office consultation with a specialist (moderate to high): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $242.40 Blue Cross — PPO: $703.85 Humana Medicare Advantage — Medicare Advantage: $147.24 Scott and White — HMO/PPO/POS: $147.24 United Health Commercial — HMO/PPO/POS: $212.10 United Healthcare Medicare Advantage — Medicare Advantage: $147.24
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: RHC INITL COMP PREV MED 18-39YRS	$325	$260	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $447.62
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $260 Blue Cross — PPO: $447.62 Cigna — HMO/PPO/POS: $65 Humana Medicare Advantage — Medicare Advantage: $94.34 Scott and White — HMO/PPO/POS: $94.34 United Health Commercial — HMO/PPO/POS: $227.50 United Healthcare Medicare Advantage — Medicare Advantage: $94.34
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: RHC INITL COMP PREV MED 40-64 YR	$340	$272	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $544.91
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $272 Blue Cross — PPO: $544.91 Cigna — HMO/PPO/POS: $68 Humana Medicare Advantage — Medicare Advantage: $114.42 Scott and White — HMO/PPO/POS: $114.42 United Health Commercial — HMO/PPO/POS: $238 United Healthcare Medicare Advantage — Medicare Advantage: $114.42
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: PF ED VISIT LVL 3	$176	$140.80	$84.48 – $1,005.03
Emergency room visit (moderate): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $140.80 Blue Cross — PPO: $1,005.03 Cigna — HMO/PPO/POS: $140.80 Humana Medicare Advantage — Medicare Advantage: $245.03 Scott and White — HMO/PPO/POS: $245.03 United Health Commercial — HMO/PPO/POS: $123.20 United Healthcare Medicare Advantage — Medicare Advantage: $245.03
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT LVL 3	$2,160	$1,728	$245.03 – $1,728
Emergency room visit (moderate): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $1,728 Blue Cross — PPO: $1,005.03 Cigna — HMO/PPO/POS: $1,728 Humana Medicare Advantage — Medicare Advantage: $245.03 Scott and White — HMO/PPO/POS: $245.03 United Health Commercial — HMO/PPO/POS: $1,512 United Healthcare Medicare Advantage — Medicare Advantage: $245.03
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT LVL 4	$706	$564.80	$186.38 – $1,583.06
Emergency room visit (moderately high): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $564.80 Blue Cross — PPO: $1,583.06 Cigna — HMO/PPO/POS: $564.80 Humana Medicare Advantage — Medicare Advantage: $381.61 Scott and White — HMO/PPO/POS: $381.61 United Health Commercial — HMO/PPO/POS: $494.20 United Healthcare Medicare Advantage — Medicare Advantage: $381.61
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: PF ED VISIT LVL 4	$296	$236.80	$142.08 – $1,583.06
Emergency room visit (moderately high): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $236.80 Blue Cross — PPO: $1,583.06 Cigna — HMO/PPO/POS: $236.80 Humana Medicare Advantage — Medicare Advantage: $381.61 Scott and White — HMO/PPO/POS: $381.61 United Health Commercial — HMO/PPO/POS: $207.20 United Healthcare Medicare Advantage — Medicare Advantage: $381.61
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT LVL 5	$3,862	$3,089.60	$548.11 – $3,089.60
Emergency room visit (high): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $3,089.60 Blue Cross — PPO: $2,270.30 Cigna — HMO/PPO/POS: $3,089.60 Humana Medicare Advantage — Medicare Advantage: $548.11 Scott and White — HMO/PPO/POS: $548.11 United Health Commercial — HMO/PPO/POS: $2,703.40 United Healthcare Medicare Advantage — Medicare Advantage: $548.11
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: PF ED VISIT LVL 5	$430	$344	$206.40 – $2,270.30
Emergency room visit (high): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $344 Blue Cross — PPO: $2,270.30 Cigna — HMO/PPO/POS: $344 Humana Medicare Advantage — Medicare Advantage: $548.11 Scott and White — HMO/PPO/POS: $548.11 United Health Commercial — HMO/PPO/POS: $301 United Healthcare Medicare Advantage — Medicare Advantage: $548.11

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL	$316.05	$252.84	$8.46 – $252.84
Basic metabolic panel (blood test): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $252.84 Blue Cross — PPO: $33.84 Cigna — HMO/PPO/POS: $63.21 Humana Medicare Advantage — Medicare Advantage: $8.46 Scott and White — HMO/PPO/POS: $8.46 United Health Commercial — HMO/PPO/POS: $221.24 United Healthcare Medicare Advantage — Medicare Advantage: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: ISTAT CHEM 8	$316.05	$252.84	$8.46 – $252.84
Basic metabolic panel (blood test): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $252.84 Blue Cross — PPO: $33.84 Cigna — HMO/PPO/POS: $63.21 Humana Medicare Advantage — Medicare Advantage: $8.46 Scott and White — HMO/PPO/POS: $8.46 United Health Commercial — HMO/PPO/POS: $221.24 United Healthcare Medicare Advantage — Medicare Advantage: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL	$359.86	$287.89	$10.56 – $287.89
Comprehensive metabolic panel (blood test): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $287.89 Blue Cross — PPO: $42.24 Cigna — HMO/PPO/POS: $71.97 Humana Medicare Advantage — Medicare Advantage: $10.56 Scott and White — HMO/PPO/POS: $10.56 United Health Commercial — HMO/PPO/POS: $251.90 United Healthcare Medicare Advantage — Medicare Advantage: $10.56
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$293.25	$234.60	$13.39 – $234.60
Cholesterol panel (lipid panel): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $234.60 Blue Cross — PPO: $53.56 Cigna — HMO/PPO/POS: $58.65 Humana Medicare Advantage — Medicare Advantage: $13.39 Scott and White — HMO/PPO/POS: $13.39 United Health Commercial — HMO/PPO/POS: $205.28 United Healthcare Medicare Advantage — Medicare Advantage: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$439.86	$351.89	$8.68 – $351.89
Kidney function panel: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $351.89 Blue Cross — PPO: $34.72 Cigna — HMO/PPO/POS: $87.97 Humana Medicare Advantage — Medicare Advantage: $8.68 Scott and White — HMO/PPO/POS: $8.68 United Health Commercial — HMO/PPO/POS: $307.90 United Healthcare Medicare Advantage — Medicare Advantage: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$376.05	$300.84	$8.17 – $300.84
Liver function panel: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $300.84 Blue Cross — PPO: $32.68 Cigna — HMO/PPO/POS: $75.21 Humana Medicare Advantage — Medicare Advantage: $8.17 Scott and White — HMO/PPO/POS: $8.17 United Health Commercial — HMO/PPO/POS: $263.24 United Healthcare Medicare Advantage — Medicare Advantage: $8.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: BRHC LAB URINE DIP	$52.99	$42.39	$3.48 – $42.39
Urine test (manual, without microscope): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $42.39 Blue Cross — PPO: $13.92 Cigna — HMO/PPO/POS: $10.60 Humana Medicare Advantage — Medicare Advantage: $3.48 Scott and White — HMO/PPO/POS: $3.48 United Health Commercial — HMO/PPO/POS: $37.09 United Healthcare Medicare Advantage — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · modifier QW In the file: URINE DIP STICK W/O MICRO	$34	$27.20	$3.48 – $27.20
Urine test (manual, without microscope): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $27.20 Blue Cross — PPO: $13.92 Cigna — HMO/PPO/POS: $6.80 Humana Medicare Advantage — Medicare Advantage: $3.48 Scott and White — HMO/PPO/POS: $3.48 United Health Commercial — HMO/PPO/POS: $23.80 United Healthcare Medicare Advantage — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · modifier QW In the file: CLINIC URINE DIPSTICK	$34	$27.20	$3.48 – $27.20
Urine test (manual, without microscope): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $27.20 Blue Cross — PPO: $13.92 Cigna — HMO/PPO/POS: $6.80 Humana Medicare Advantage — Medicare Advantage: $3.48 Scott and White — HMO/PPO/POS: $3.48 United Health Commercial — HMO/PPO/POS: $23.80 United Healthcare Medicare Advantage — Medicare Advantage: $3.48
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA TOTAL	$290	$232	$18.39 – $232
PSA (prostate specific antigen) blood test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $232 Blue Cross — PPO: $73.56 Cigna — HMO/PPO/POS: $58 Humana Medicare Advantage — Medicare Advantage: $18.39 Scott and White — HMO/PPO/POS: $18.39 United Health Commercial — HMO/PPO/POS: $203 United Healthcare Medicare Advantage — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA, TOTAL	$290	$232	$18.39 – $232
PSA (prostate specific antigen) blood test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $232 Blue Cross — PPO: $73.56 Cigna — HMO/PPO/POS: $58 Humana Medicare Advantage — Medicare Advantage: $18.39 Scott and White — HMO/PPO/POS: $18.39 United Health Commercial — HMO/PPO/POS: $203 United Healthcare Medicare Advantage — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA TOTAL (DIAGNOSTIC)	$290	$232	$18.39 – $232
PSA (prostate specific antigen) blood test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $232 Blue Cross — PPO: $73.56 Cigna — HMO/PPO/POS: $58 Humana Medicare Advantage — Medicare Advantage: $18.39 Scott and White — HMO/PPO/POS: $18.39 United Health Commercial — HMO/PPO/POS: $203 United Healthcare Medicare Advantage — Medicare Advantage: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: THYROID STIMULATING HORMONE	$214.14	$171.31	$16.80 – $171.31
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $171.31 Blue Cross — PPO: $67.20 Cigna — HMO/PPO/POS: $42.83 Humana Medicare Advantage — Medicare Advantage: $16.80 Scott and White — HMO/PPO/POS: $16.80 United Health Commercial — HMO/PPO/POS: $149.90 United Healthcare Medicare Advantage — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH 3	$319	$255.20	$16.80 – $255.20
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $255.20 Blue Cross — PPO: $67.20 Cigna — HMO/PPO/POS: $63.80 Humana Medicare Advantage — Medicare Advantage: $16.80 Scott and White — HMO/PPO/POS: $16.80 United Health Commercial — HMO/PPO/POS: $223.30 United Healthcare Medicare Advantage — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: THYROID CASCADE REFLEX	$25	$20	$5 – $67.20
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $20 Blue Cross — PPO: $67.20 Cigna — HMO/PPO/POS: $5 Humana Medicare Advantage — Medicare Advantage: $16.80 Scott and White — HMO/PPO/POS: $16.80 United Health Commercial — HMO/PPO/POS: $17.50 United Healthcare Medicare Advantage — Medicare Advantage: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC HEMOGRAM W/PART AUTO DIF	$186.30	$149.04	$7.77 – $149.04
Complete blood count (CBC) with differential: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $149.04 Blue Cross — PPO: $31.08 Cigna — HMO/PPO/POS: $37.26 Humana Medicare Advantage — Medicare Advantage: $7.77 Scott and White — HMO/PPO/POS: $7.77 United Health Commercial — HMO/PPO/POS: $130.41 United Healthcare Medicare Advantage — Medicare Advantage: $7.77
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PT- PROTHROMBIN TIME	$125	$100	$4.29 – $100
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $100 Blue Cross — PPO: $17.16 Cigna — HMO/PPO/POS: $25 Humana Medicare Advantage — Medicare Advantage: $4.29 Scott and White — HMO/PPO/POS: $4.29 United Health Commercial — HMO/PPO/POS: $87.50 United Healthcare Medicare Advantage — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PT (PROTIME)	$128	$102.40	$4.29 – $102.40
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $102.40 Blue Cross — PPO: $17.16 Cigna — HMO/PPO/POS: $25.60 Humana Medicare Advantage — Medicare Advantage: $4.29 Scott and White — HMO/PPO/POS: $4.29 United Health Commercial — HMO/PPO/POS: $89.60 United Healthcare Medicare Advantage — Medicare Advantage: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT- PROTHROMBIN TIME PARTIAL	$161	$128.80	$6.01 – $128.80
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $128.80 Blue Cross — PPO: $24.04 Cigna — HMO/PPO/POS: $32.20 Humana Medicare Advantage — Medicare Advantage: $6.01 Scott and White — HMO/PPO/POS: $6.01 United Health Commercial — HMO/PPO/POS: $112.70 United Healthcare Medicare Advantage — Medicare Advantage: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT BRAIN W/O CONTRAST	$2,611	$2,088.80	$106.88 – $2,088.80
CT scan of the head or brain, without contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,088.80 Blue Cross — PPO: $532.38 Cigna — HMO/PPO/POS: $400 Humana Medicare Advantage — Medicare Advantage: $106.88 Scott and White — HMO/PPO/POS: $106.88 United Health Commercial — HMO/PPO/POS: $1,827.70 United Healthcare Medicare Advantage — Medicare Advantage: $106.88
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W/WO	$5,796.84	$4,637.47	$368.43 – $4,637.47
MRI of the brain, before and after contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $4,637.47 Blue Cross — PPO: $1,813.79 Cigna — HMO/PPO/POS: $800 Humana Medicare Advantage — Medicare Advantage: $368.43 Scott and White — HMO/PPO/POS: $368.43 United Health Commercial — HMO/PPO/POS: $4,057.79 United Healthcare Medicare Advantage — Medicare Advantage: $368.43
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST 2 VIEWS	$260	$208	$52 – $359.15
Chest X-ray, 2 views: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $208 Blue Cross — PPO: $359.15 Cigna — HMO/PPO/POS: $52 Humana Medicare Advantage — Medicare Advantage: $86.88 Scott and White — HMO/PPO/POS: $86.88 United Health Commercial — HMO/PPO/POS: $182 United Healthcare Medicare Advantage — Medicare Advantage: $86.88
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier 26 In the file: PF CHEST XRAY 2 VW INTERP	$26	$20.80	$5.20 – $359.15
Chest X-ray, 2 views: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $20.80 Blue Cross — PPO: $359.15 Cigna — HMO/PPO/POS: $5.20 Humana Medicare Advantage — Medicare Advantage: $86.88 Scott and White — HMO/PPO/POS: $86.88 United Health Commercial — HMO/PPO/POS: $18.20 United Healthcare Medicare Advantage — Medicare Advantage: $86.88
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: SPINE LUMBAR 4 VIEWS	$750	$600	$106.88 – $600
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $600 Blue Cross — PPO: $504.36 Cigna — HMO/PPO/POS: $150 Humana Medicare Advantage — Medicare Advantage: $106.88 Scott and White — HMO/PPO/POS: $106.88 United Health Commercial — HMO/PPO/POS: $525 United Healthcare Medicare Advantage — Medicare Advantage: $106.88
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LUMBAR W/O	$4,135.66	$3,308.53	$233.52 – $3,308.53
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $3,308.53 Blue Cross — PPO: $1,106.94 Cigna — HMO/PPO/POS: $800 Humana Medicare Advantage — Medicare Advantage: $233.52 Scott and White — HMO/PPO/POS: $233.52 United Health Commercial — HMO/PPO/POS: $2,894.96 United Healthcare Medicare Advantage — Medicare Advantage: $233.52
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS WITH CONTRAST	$3,029	$2,423.20	$180.34 – $2,423.20
CT scan of the pelvis, with contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,423.20 Blue Cross — PPO: $865.55 Cigna — HMO/PPO/POS: $400 Humana Medicare Advantage — Medicare Advantage: $180.34 Scott and White — HMO/PPO/POS: $180.34 United Health Commercial — HMO/PPO/POS: $2,120.30 United Healthcare Medicare Advantage — Medicare Advantage: $180.34
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI LOWER EXT JT W/O LT	$4,063	$3,250.40	$233.52 – $3,250.40
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $3,250.40 Blue Cross — PPO: $1,106.94 Cigna — HMO/PPO/POS: $800 Humana Medicare Advantage — Medicare Advantage: $233.52 Scott and White — HMO/PPO/POS: $233.52 United Health Commercial — HMO/PPO/POS: $2,844.10 United Healthcare Medicare Advantage — Medicare Advantage: $233.52
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LOWER EXT JT W/O RT	$4,063	$3,250.40	$233.52 – $3,250.40
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $3,250.40 Blue Cross — PPO: $1,106.94 Cigna — HMO/PPO/POS: $800 Humana Medicare Advantage — Medicare Advantage: $233.52 Scott and White — HMO/PPO/POS: $233.52 United Health Commercial — HMO/PPO/POS: $2,844.10 United Healthcare Medicare Advantage — Medicare Advantage: $233.52
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN AND PELVIS W CONTRAST	$5,955	$4,764	$368.43 – $4,764
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $4,764 Blue Cross — PPO: $1,813.79 Cigna — HMO/PPO/POS: $400 Humana Medicare Advantage — Medicare Advantage: $368.43 Scott and White — HMO/PPO/POS: $368.43 United Health Commercial — HMO/PPO/POS: $4,168.50 United Healthcare Medicare Advantage — Medicare Advantage: $368.43
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$1,295.64	$1,036.51	$106.88 – $1,036.51
Ultrasound of the abdomen, complete: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $1,036.51 Blue Cross — PPO: $504.36 Cigna — HMO/PPO/POS: $259.13 Humana Medicare Advantage — Medicare Advantage: $106.88 Scott and White — HMO/PPO/POS: $106.88 United Health Commercial — HMO/PPO/POS: $906.95 United Healthcare Medicare Advantage — Medicare Advantage: $106.88

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM (EKG) COMPLETE	$209	$167.20	$13.89 – $167.20
Electrocardiogram (ECG/EKG) with reading: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $167.20 Blue Cross — PPO: $69.20 Cigna — HMO/PPO/POS: $41.80 Humana Medicare Advantage — Medicare Advantage: $13.89 Scott and White — HMO/PPO/POS: $13.89 United Health Commercial — HMO/PPO/POS: $146.30 United Healthcare Medicare Advantage — Medicare Advantage: $13.89
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY, 4 OR MORE	$5,716.81	$4,573.45	$934.38 – $4,573.45
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $4,573.45 Blue Cross — PPO: $2,254.23 Cigna — HMO/PPO/POS: $1,143.36 Humana Medicare Advantage — Medicare Advantage: $934.38 Scott and White — HMO/PPO/POS: $934.38 United Health Commercial — HMO/PPO/POS: $4,001.77 United Healthcare Medicare Advantage — Medicare Advantage: $934.38

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: PT THER EX 15 MIN	$123	$98.40	$24.60 – $141.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $98.40 Blue Cross — PPO: $141.08 Cigna — HMO/PPO/POS: $24.60 Humana Medicare Advantage — Medicare Advantage: $29.20 Scott and White — HMO/PPO/POS: $29.20 United Health Commercial — HMO/PPO/POS: $86.10 United Healthcare Medicare Advantage — Medicare Advantage: $29.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: OT OCC THER EXERCISE 15 MIN	$123	$98.40	$24.60 – $141.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $98.40 Blue Cross — PPO: $141.08 Cigna — HMO/PPO/POS: $24.60 Humana Medicare Advantage — Medicare Advantage: $29.20 Scott and White — HMO/PPO/POS: $50 United Health Commercial — HMO/PPO/POS: $86.10 United Healthcare Medicare Advantage — Medicare Advantage: $29.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier AT In the file: CHIRO THERAPEUTIC EXERCISE EA 15 MIN	$59	$47.20	$29.20 – $141.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Aetna Commercial — HMO/PPO/POS: $47.20 Blue Cross — PPO: $141.08 Humana Medicare Advantage — Medicare Advantage: $29.20 Scott and White — HMO/PPO/POS: $29.20 United Health Commercial — HMO/PPO/POS: $41.30 United Healthcare Medicare Advantage — Medicare Advantage: $29.20
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: PT PHYSICAL THERAPY EVAL LOW COMP 20 MIN	$359	$287.20	$71.80 – $389.21
Physical therapy evaluation (low complexity): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $287.20 Blue Cross — PPO: $389.21 Cigna — HMO/PPO/POS: $71.80 Humana Medicare Advantage — Medicare Advantage: $99.32 Scott and White — HMO/PPO/POS: $75 United Health Commercial — HMO/PPO/POS: $251.30 United Healthcare Medicare Advantage — Medicare Advantage: $99.32
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: PT PHYSICAL THERAPY EVAL MOD COMP 30 MIN	$395	$316	$75 – $389.21
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $316 Blue Cross — PPO: $389.21 Cigna — HMO/PPO/POS: $79 Humana Medicare Advantage — Medicare Advantage: $99.32 Scott and White — HMO/PPO/POS: $75 United Health Commercial — HMO/PPO/POS: $276.50 United Healthcare Medicare Advantage — Medicare Advantage: $99.32
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: PT PHYSICAL THRPY EVAL HIGH COMP 45 MIN	$435	$348	$75 – $389.21
Physical therapy evaluation (high complexity): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $348 Blue Cross — PPO: $389.21 Cigna — HMO/PPO/POS: $87 Humana Medicare Advantage — Medicare Advantage: $99.32 Scott and White — HMO/PPO/POS: $75 United Health Commercial — HMO/PPO/POS: $304.50 United Healthcare Medicare Advantage — Medicare Advantage: $99.32
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: INDIVID THERAPY 20-30 MIN DXEX	$200	$160	$150
Psychotherapy, 30 minutes: rates for 4 insurance plans Aetna Commercial — HMO/PPO/POS: $160 Blue Cross — PPO: $150 Cigna — HMO/PPO/POS: $40 United Health Commercial — HMO/PPO/POS: $140
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYCH IP INSIGHT 20-30MIN	$200	$160	$150
Psychotherapy, 30 minutes: rates for 4 insurance plans Aetna Commercial — HMO/PPO/POS: $160 Blue Cross — PPO: $150 Cigna — HMO/PPO/POS: $40 United Health Commercial — HMO/PPO/POS: $140
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: INDIVID THERAPY 45-50 MIN DXEX	$306	$244.80	$229.50
Psychotherapy, 45 minutes: rates for 4 insurance plans Aetna Commercial — HMO/PPO/POS: $244.80 Blue Cross — PPO: $229.50 Cigna — HMO/PPO/POS: $61.20 United Health Commercial — HMO/PPO/POS: $214.20
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYCH INSIT IND 75-80 MIN	$364	$291.20	$273
Psychotherapy, 60 minutes: rates for 4 insurance plans Aetna Commercial — HMO/PPO/POS: $291.20 Blue Cross — PPO: $273 Cigna — HMO/PPO/POS: $72.80 United Health Commercial — HMO/PPO/POS: $254.80
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAMILY PSYCH W/O PT	$288	$230.40	$57.60 – $230.40
Family psychotherapy, without the patient: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $230.40 Blue Cross — PPO: $216 Cigna — HMO/PPO/POS: $57.60 Humana Medicare Advantage — Medicare Advantage: $145.70 Scott and White — HMO/PPO/POS: $145.70 United Health Commercial — HMO/PPO/POS: $201.60 United Healthcare Medicare Advantage — Medicare Advantage: $145.70
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · modifier AQ In the file: FAMILY PSYCHOTHERAPY W/PATIENT	$313	$250.40	$62.60 – $250.40
Family psychotherapy, with the patient: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $250.40 Blue Cross — PPO: $234.75 Cigna — HMO/PPO/POS: $62.60 Humana Medicare Advantage — Medicare Advantage: $145.70 Scott and White — HMO/PPO/POS: $145.70 United Health Commercial — HMO/PPO/POS: $219.10 United Healthcare Medicare Advantage — Medicare Advantage: $145.70
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY	$177	$141.60	$35.40 – $141.60
Group psychotherapy: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $141.60 Blue Cross — PPO: $132.75 Cigna — HMO/PPO/POS: $35.40 Humana Medicare Advantage — Medicare Advantage: $75.85 Scott and White — HMO/PPO/POS: $75.85 United Health Commercial — HMO/PPO/POS: $123.90 United Healthcare Medicare Advantage — Medicare Advantage: $75.85

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: UPPER GASTROINTES ENDOSCOPY	$2,682	$2,145.60	$825.51 – $3,536.64
Upper GI endoscopy (diagnostic): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,145.60 Blue Cross — PPO: $3,536.64 Cigna — HMO/PPO/POS: $2,145.60 Humana Medicare Advantage — Medicare Advantage: $825.51 Scott and White — HMO/PPO/POS: $825.51 United Health Commercial — HMO/PPO/POS: $1,877.40 United Healthcare Medicare Advantage — Medicare Advantage: $825.51
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: UPPER GASTROINTES ENDO W/BX	$2,840	$2,272	$825.51 – $3,536.64
Upper GI endoscopy with biopsy: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,272 Blue Cross — PPO: $3,536.64 Cigna — HMO/PPO/POS: $2,272 Humana Medicare Advantage — Medicare Advantage: $825.51 Scott and White — HMO/PPO/POS: $825.51 United Health Commercial — HMO/PPO/POS: $1,988 United Healthcare Medicare Advantage — Medicare Advantage: $825.51
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: COLONOSCOPY FLEX DIAG W/WO COL	$3,279.11	$2,623.29	$831.04 – $3,437.46
Colonoscopy (diagnostic): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,623.29 Blue Cross — PPO: $3,437.46 Cigna — HMO/PPO/POS: $2,623.29 Humana Medicare Advantage — Medicare Advantage: $831.04 Scott and White — HMO/PPO/POS: $831.04 United Health Commercial — HMO/PPO/POS: $2,295.38 United Healthcare Medicare Advantage — Medicare Advantage: $831.04
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONSCOPY W/BX	$3,437	$2,749.60	$1,082.91 – $4,518.99
Colonoscopy with biopsy: rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,749.60 Blue Cross — PPO: $4,518.99 Cigna — HMO/PPO/POS: $2,749.60 Humana Medicare Advantage — Medicare Advantage: $1,082.91 Scott and White — HMO/PPO/POS: $1,082.91 United Health Commercial — HMO/PPO/POS: $2,405.90 United Healthcare Medicare Advantage — Medicare Advantage: $1,082.91
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONSCOPY W/REM TUMOR/POLYPS	$3,506	$2,804.80	$1,082.91 – $4,518.99
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,804.80 Blue Cross — PPO: $4,518.99 Cigna — HMO/PPO/POS: $2,804.80 Humana Medicare Advantage — Medicare Advantage: $1,082.91 Scott and White — HMO/PPO/POS: $1,082.91 United Health Commercial — HMO/PPO/POS: $2,454.20 United Healthcare Medicare Advantage — Medicare Advantage: $1,082.91
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: SCREENING COLONOSCOPY NOT HIGH RISK PT	$3,238	$2,590.40	$647.60 – $3,437.46
Screening colonoscopy (not high risk): rates for 7 insurance plans Aetna Commercial — HMO/PPO/POS: $2,590.40 Blue Cross — PPO: $3,437.46 Cigna — HMO/PPO/POS: $647.60 Humana Medicare Advantage — Medicare Advantage: $831.04 Scott and White — HMO/PPO/POS: $831.04 United Health Commercial — HMO/PPO/POS: $2,266.60 United Healthcare Medicare Advantage — Medicare Advantage: $831.04

Source: Falls Community Hospital and Clinic’s standard charges file (fallshospital.slicedhealth.io, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on February 3, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Rural Emergency Hospital
Address	322 Coleman Street, Marlin, TX 76661
County	Falls County
State	Texas
Phone	(254) 803‑3561
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	670780
Name in Medicare records	FALLS COMMUNITY HOSPITAL AND CLINIC
Profile level	Medicare data + hospital website
Name on the hospital’s website	Falls Community Hospital & Clinic
Official website	fallshospital.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Falls Community Hospital & Clinic — fallshospital.com
Contact - Falls Community Hospital & Clinic — fallshospital.com
PATIENT INFORMATION – Falls Community Hospital & Clinic — fallshospital.com
About – Falls Community Hospital & Clinic — fallshospital.com