Does Finley Hospital have an emergency room?

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

Where is Finley Hospital?

350 North Grandview Avenue, Dubuque, IA 52001, in Dubuque County, Iowa.

What is the phone number of Finley Hospital?

(563) 582-1881, as listed by Medicare (CMS).

What is the Medicare star rating of Finley Hospital?

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

Does Medicare reduce its payments to Finley Hospital for hospital-acquired conditions?

Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Finley Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.3806; 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).

Finley Hospital — Phone, Address, ER & Ratings

Quick answers

Does Finley Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Finley Hospital. In a medical emergency, call 911.
Where is Finley Hospital?: 350 North Grandview Avenue, Dubuque, IA 52001, in Dubuque County, Iowa.
What is the phone number of Finley Hospital?: (563) 582-1881, as listed by Medicare (CMS).
What is the Medicare star rating of Finley Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Finley Hospital for hospital-acquired conditions?: Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Finley Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.3806; 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][9][10][12][13][14]}

Heart care
Birth center
Cancer care (Wendt Regional Cancer Center)
Neurosurgery
Pain clinic
Rehabilitation
Sleep center
Behavioral health
Emergency care
Imaging
Primary care and pediatrics
Cardiology
Oncology
Pain medicine
Sleep medicine
Obstetrics
Neonatal intensive care
Palliative care
Radiology

Conditions treated^{[9][11][12][13][14]}

Back pain
Shingles
Compression fractures
Disc herniation
Neck pain
Fibromyalgia
Spinal stenosis
Knee pain
Shoulder pain
Chronic regional pain syndrome
Sciatica
Diabetic nerve pain
Sleep apnea
Insomnia
Narcolepsy
Snoring
Restless sleep
Anxiety
Depression
Thought disorders
Dementia with behavioral disturbance
Coronary artery disease
Peripheral arterial disease
Heart failure
COPD
Parkinson's disease
Cancer

Treatments^{[4][9][10][12]}

Cardiac catheterization
Shockwave intravascular lithotripsy
Heart scan (cardiac CT calcium scoring)
Stress test
Echocardiogram
Electrocardiogram
CT scan
MRI
Mammography
PET/CT
Nuclear medicine
Ultrasound
Sleep study
Home sleep test
C-section

Procedures^[7][14]

Basivertebral nerve ablation
Diagnostic discography
Epidural steroid injections
Facet and joint injections
Intrathecal drug delivery system refills
Kyphoplasty
Lumbar sympathetic blocks
Minimally invasive lumbar decompression (MILD)
Neurolytic blocks
Peripheral nerve blocks
Radiofrequency neurotomy
Spinal cord stimulation
Stellate ganglion blocks
Trigger point injections
Vasectomy
Cataract surgery
Hysterectomy
Colonoscopy
Orthopedic surgery (knee, hip, shoulder)
Endoscopy
Ear, nose and throat surgery
Mastectomy or lumpectomy
Laparoscopy
Appendectomy
Bowel or hernia repair
Gallbladder surgery
Pancreatic surgery
Trauma surgery
Surgical oncology
Aneurysm repair
Tumor removal
Splenectomy

Programs and centers^{[4][9][10][11][12][13][14]}

Babka Surgery Center
Acute Rehabilitation Unit
Wound Healing and Hyperbaric Center
Kehl Diabetes Center
Older adult inpatient behavioral health unit
Adult intensive outpatient program
Cardiac rehabilitation
Pulmonary rehabilitation
Pacemaker clinic
Cardiac outpatient center
Palliative care with Hospice of Dubuque
Family Birthing Suites
Level II neonatal intensive care unit (NICU)
Wendt Regional Cancer Center
Sleep center
Pain clinic

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

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Visitors welcome daily 6:00 a.m. to 9:00 p.m.; up to two visitors at a time^[8]
Parking	ER patients and visitors can park in the lot in front of the ER, entering from Grandview Avenue^[4]

Recognition^[4][12]

ACC NCDR Chest Pain-MI Registry Silver Achievement Award (2026)
Iowa Pediatric Emergency Assessment and Care Recognition (renewed 2026)
Accredited by the American Academy of Sleep Medicine (sleep center)

Doctors and clinicians (255)

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

Main specialties

And 231 more: the button below opens the full list.

Other emergency rooms nearby

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

MercyOne Dubuque Medical Center3.9 mi · Dubuque, IA · Acute Care Hospital
Southwest Health Center17 mi · Platteville, WI · Critical Access Hospital
Midwest Medical Center19 mi · Galena, IL · Critical Access Hospital
Grant Regional Health Center20 mi · Lancaster, WI · Critical Access Hospital
MercyOne Dyersville Medical Center23 mi · Dyersville, IA · Critical Access Hospital

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

Other hospitals near Dubuque

Guttenberg Municipal Hospital26 mi · Guttenberg, IA · Critical Access Hospital

All hospitals in Dubuque · Hospitals in Dubuque 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

Stonehill Care Center1.7 mi · Dubuque, IA · 5 of 5 stars
Sunnycrest Manor2.1 mi · Dubuque, IA · 4 of 5 stars
Dubuque Specialty Care2.5 mi · Dubuque, IA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Dubuque4.3 mi · Dubuque, IA · 5 of 5 stars
Grant County Hospice20 mi · Lancaster, WI

All hospice providers in the state →

Home health agencies

UnityPoint at Home0.0 mi · Dubuque, IA · 3.5 of 5 stars
Universal Pediatrics4.3 mi · Dubuque, IA
Open Arms Home Health Care, L L C8.2 mi · Dubuque, IA

All home health agencies in the state →

Dialysis facilities

Tri- State Dialysis - Dubuque0.0 mi · Dubuque, IA · 3 of 5 stars
FKC Dubuque Dialysis4.3 mi · Dubuque, IA
Tri State Dialysis17 mi · Platteville, WI · 3 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.

Dubuque Endoscopy Center0.0 mi · Dubuque, IA
Tri-State Surgery Center, LLC4.3 mi · Dubuque, IA
Upper Mississippi Surgery Center8.6 mi · Hazel Green, WI

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

Hills & Dales Clinic1.9 mi · Dubuque, IA · Community health center
Crescent Community Health Center3.0 mi · Dubuque, IA · Community health center
Crescent Community Health Center Pharmacy3.0 mi · Dubuque, IA · Community health center

Clinics and urgent care

Southwest Health Kieler Clinic5.2 mi · Kieler, WI · Rural health clinic
Potosi-Tennyson Medical Clinic10 mi · Potosi, WI · Rural health clinic
Southwest Health Cuba City Clinic12 mi · Cuba City, WI · Rural health clinic

Pharmacies

Crescent Community Health Center Pharmacy0.0 mi · Dubuque, IA · Community/retail pharmacy
Hartig Drug Co Corp0.0 mi · Dubuque, IA · Community/retail pharmacy
Hartig Drug Co Corp0.0 mi · Dubuque, IA · Community/retail pharmacy

Assisted living nearby

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

Assisi Village Assisted Living0.0 mi · Dubuque, IA
Eagle Pointe Place4.3 mi · Dubuque, IA
Oak Park Place4.3 mi · Dubuque, IA
Sunset Park Place Company LLC4.3 mi · Dubuque, IA

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 Finley 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Restfulness of Environment	4 of 5 stars
Care Coordination	4 of 5 stars
Symptoms After Stay	3 of 5 stars
Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	71%National average: 71%
Nurses “always” communicated well	82%National average: 80%
Doctors “always” communicated well	79%National average: 80%
“Always” got help as soon as they wanted	69%National average: 64%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	67%National average: 73%
Completed surveys	487Response rate: 29%

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.

Catheter-associated urinary tract infections (CAUTI)	0.639No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.499No different from the national benchmark
Not reported to Medicare	Central line bloodstream infections (CLABSI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

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 attack patients	11.7%
Deaths within 30 days: heart failure patients	12.8%
Deaths within 30 days: pneumonia patients	17.3%
Deaths within 30 days: COPD patients	11%
Deaths within 30 days: stroke patients	12.7%
Serious complications (patient safety indicator PSI-90)	1.11No different from the national rate
Complications after hip or knee replacement	5.7%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

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)	17.4%
Readmitted within 30 days: heart attack	14.6%
Readmitted within 30 days: heart failure	24.6%
Readmitted within 30 days: pneumonia	18.9%
Readmitted within 30 days: COPD	20.1%
Readmitted within 30 days: hip or knee replacement	7.3%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery

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)	120 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	52%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 Finley 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 2026	YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score	0.3806Lower 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 attack	0.9348Fewer readmissions than expected
Heart failure	0.9870Fewer readmissions than expected
Pneumonia	1.0373More readmissions than expected
COPD (chronic lung disease)	1.0014More readmissions than expected
Hip or knee replacement	1.0064More readmissions than expected
No result published	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 Score	38.25 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	16.00 out of 100
Person and community engagement (patient survey)	41.00 out of 100
Safety (infections and sepsis care)	36.00 out of 100
Efficiency and cost reduction (Medicare spending)	60.00 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, ratio	0.90Below 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 Dubuque Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Finley 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 86 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$237	$189.60	$74.50 – $218.04
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates Aetna — HMO: $150.11 Aetna — Medicare Advantage: $74.50 Aetna — PPO: $150.11 Amerivantage — Medicare Advantage: $78.23 BC Illinois Community — PPO: $188.36 Cigna/Midlands — Commercial: $153.98 Dean Health Plan — HMO: $218.04 Health Partners Open Network — Commercial: $127.02 Humana — Medicare Advantage: $78.23 Medical Associates Health Plan — HMO: $130.38
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN	Not listed in the file	Not listed in the file	$279.06
New patient office visit (about 30–44 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $279.06 BC Illinois Community — PPO: $279.06
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OFFICE O/P NEW LOW 30 MIN	Not listed in the file	Not listed in the file	$170.94 – $188.36
New patient office visit (about 30–44 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $170.94 BC Illinois Community — PPO: $188.36
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$362	$289.60	$121.61 – $333.04
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates Aetna — HMO: $254.67 Aetna — Medicare Advantage: $121.61 Aetna — PPO: $254.67 Amerivantage — Medicare Advantage: $127.69 BC Illinois Community — PPO: $283.30 Cigna/Midlands — Commercial: $251.15 Dean Health Plan — HMO: $333.04 Health Partners Open Network — Commercial: $214.84 Humana — Medicare Advantage: $127.69 Medical Associates Health Plan — HMO: $212.82
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$444.52
New patient office visit (about 45–59 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $444.52 BC Illinois Community — PPO: $444.52
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OFFICE O/P NEW MOD 45 MIN	Not listed in the file	Not listed in the file	$257.10 – $283.30
New patient office visit (about 45–59 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $257.10 BC Illinois Community — PPO: $283.30
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$459	$367.20	$165.20 – $422.28
New patient office visit (about 60–74 minutes): 10 of 20 insurance plan rates Aetna — HMO: $331.06 Aetna — Medicare Advantage: $165.20 Aetna — PPO: $331.06 Amerivantage — Medicare Advantage: $173.46 BC Illinois Community — Blue Choice: $189.36 BC Illinois Community — PPO: $225.43 Cigna/Midlands — Commercial: $341.28 Dean Health Plan — HMO: $422.28 Health Partners Open Network — Commercial: $279.38 Humana — Medicare Advantage: $173.46
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN	Not listed in the file	Not listed in the file	$603.47
New patient office visit (about 60–74 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $603.47 BC Illinois Community — PPO: $603.47
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OFFICE O/P NEW HI 60 MIN	Not listed in the file	Not listed in the file	$186.84
New patient office visit (about 60–74 minutes): rates for 1 insurance plan BC Illinois Community — PPO: $186.84
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$201	$160.80	$60.36 – $184.92
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — HMO: $99.17 Aetna — Medicare Advantage: $60.36 Aetna — PPO: $99.17 Amerivantage — Medicare Advantage: $63.38 BC Illinois Community — PPO: $152.67 Cigna/Midlands — Commercial: $124.66 Dean Health Plan — HMO: $184.92 Health Partners Open Network — Commercial: $83.62 Humana — Medicare Advantage: $63.38 Medical Associates Health Plan — HMO: $105.63
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$218.65
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $218.65 BC Illinois Community — PPO: $218.65
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OFFICE O/P EST LOW 20 MIN	Not listed in the file	Not listed in the file	$138.55 – $152.67
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $138.55 BC Illinois Community — PPO: $152.67
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$240	$192	$88.83 – $220.80
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates Aetna — HMO: $152.79 Aetna — Medicare Advantage: $88.83 Aetna — PPO: $152.79 Amerivantage — Medicare Advantage: $93.27 BC Illinois Community — PPO: $215.71 Cigna/Midlands — Commercial: $184.05 Dean Health Plan — HMO: $220.80 Health Partners Open Network — Commercial: $129.20 Humana — Medicare Advantage: $93.27 Medical Associates Health Plan — HMO: $155.45
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	Not listed in the file	Not listed in the file	$322.19
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $322.19 BC Illinois Community — PPO: $322.19
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: OFFICE O/P EST MOD 30 MIN	Not listed in the file	Not listed in the file	$195.76 – $215.71
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans BC Illinois Community — Blue Choice: $195.76 BC Illinois Community — PPO: $215.71
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$274	$219.20	$124.50 – $252.08
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — HMO: $191.66 Aetna — PPO: $191.66 Cigna/Midlands — Commercial: $171.80 Dean Health Plan — HMO: $252.08 Health Partners Open Network — Commercial: $166.22 United Healthcare — HMO: $216.83 United Healthcare — PPO: $216.83 Wellmark Blue Cross and Blue Shield — HMO: $124.50 Wellmark Blue Cross and Blue Shield — PPO: $124.50 Wellmark UPH Self-Funded — Commercial: $124.50
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$262.64
Office consultation with a specialist (moderate): rates for 2 insurance plans BC Illinois Community — Blue Choice: $262.64 BC Illinois Community — PPO: $262.64
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$411	$328.80	$188.80 – $378.12
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — HMO: $302.92 Aetna — PPO: $302.92 Cigna/Midlands — Commercial: $261.58 Dean Health Plan — HMO: $378.12 Health Partners Open Network — Commercial: $262.53 United Healthcare — HMO: $348.60 United Healthcare — PPO: $348.60 Wellmark Blue Cross and Blue Shield — HMO: $188.80 Wellmark Blue Cross and Blue Shield — PPO: $188.80 Wellmark UPH Self-Funded — Commercial: $188.80
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$401.31
Office consultation with a specialist (moderate to high): rates for 2 insurance plans BC Illinois Community — Blue Choice: $401.31 BC Illinois Community — PPO: $401.31
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PREVENTIVE VISIT,NEW,18-39	$294	$235.20	$136.77 – $270.48
Preventive checkup, new patient, age 18–39: 10 of 12 insurance plan rates Aetna — HMO: $164.83 Aetna — PPO: $164.83 BC Illinois Community — Blue Choice: $155.30 BC Illinois Community — PPO: $184.88 Cigna/Midlands — Commercial: $186.60 Dean Health Plan — HMO: $270.48 Health Partners Open Network — Commercial: $136.77 United Healthcare — HMO: $222.47 United Healthcare — PPO: $222.47 Wellmark Blue Cross and Blue Shield — HMO: $160.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$360.80
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans BC Illinois Community — Blue Choice: $360.80 BC Illinois Community — PPO: $360.80
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$135.93
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan BC Illinois Community — PPO: $135.93
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PREVENTIVE VISIT,NEW,40-64	$341	$272.80	$166.18 – $313.72
Preventive checkup, new patient, age 40–64: 10 of 12 insurance plan rates Aetna — HMO: $199.70 Aetna — PPO: $199.70 BC Illinois Community — Blue Choice: $179.43 BC Illinois Community — PPO: $213.61 Cigna/Midlands — Commercial: $226.37 Dean Health Plan — HMO: $313.72 Health Partners Open Network — Commercial: $166.18 United Healthcare — HMO: $270.05 United Healthcare — PPO: $270.05 Wellmark Blue Cross and Blue Shield — HMO: $194.10
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$436.77
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans BC Illinois Community — Blue Choice: $436.77 BC Illinois Community — PPO: $436.77
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$164.67
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan BC Illinois Community — PPO: $164.67
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 3 VISIT	$520.90	$416.72	$191.69 – $3,527.66
Emergency room visit (moderate): 10 of 22 insurance plan rates Aetna — HMO: $605.51 Aetna — Medicare Advantage: $270.38 Aetna — PPO: $639.67 Amerigroup — Managed Medicaid: $243.45 Amerivantage — Medicare Advantage: $278.33 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $275.04 Dean Health Plan — HMO: $416.72 Health Partners Open Network — Commercial: $505.62
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 3 INIT ASSESS	$55	$44	$20.24 – $3,527.66
Emergency room visit (moderate): 10 of 22 insurance plan rates Aetna — HMO: $605.51 Aetna — Medicare Advantage: $270.38 Aetna — PPO: $639.67 Amerigroup — Managed Medicaid: $243.45 Amerivantage — Medicare Advantage: $278.33 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $29.04 Dean Health Plan — HMO: $44 Health Partners Open Network — Commercial: $505.62
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$162	$129.60	$64.46 – $149.04
Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna — HMO: $120.63 Aetna — Medicare Advantage: $64.46 Aetna — PPO: $120.63 Amerivantage — Medicare Advantage: $67.68 BC Illinois Community — Blue Choice: $77.52 BC Illinois Community — PPO: $92.29 Cigna/Midlands — Commercial: $136.71 Dean Health Plan — HMO: $149.04 Health Partners Open Network — Commercial: $105.08 Humana — Medicare Advantage: $67.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 4 VISIT	$810.53	$648.43	$298.28 – $3,527.66
Emergency room visit (moderately high): 10 of 22 insurance plan rates Aetna — HMO: $931.20 Aetna — Medicare Advantage: $415.81 Aetna — PPO: $983.73 Amerigroup — Managed Medicaid: $374.39 Amerivantage — Medicare Advantage: $428.04 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $427.96 Dean Health Plan — HMO: $648.42 Health Partners Open Network — Commercial: $777.58
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 4 INIT ASSESS	$55	$44	$20.24 – $3,527.66
Emergency room visit (moderately high): 10 of 22 insurance plan rates Aetna — HMO: $931.20 Aetna — Medicare Advantage: $415.81 Aetna — PPO: $983.73 Amerigroup — Managed Medicaid: $374.39 Amerivantage — Medicare Advantage: $428.04 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $29.04 Dean Health Plan — HMO: $44 Health Partners Open Network — Commercial: $777.58
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$276	$220.80	$109.75 – $266.24
Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna — HMO: $230.52 Aetna — Medicare Advantage: $109.75 Aetna — PPO: $230.52 Amerivantage — Medicare Advantage: $115.24 BC Illinois Community — Blue Choice: $131.97 BC Illinois Community — PPO: $157.11 Cigna/Midlands — Commercial: $232.68 Dean Health Plan — HMO: $253.92 Health Partners Open Network — Commercial: $199.47 Humana — Medicare Advantage: $115.24
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 5 INIT ASSESS	$55	$44	$20.24 – $3,527.66
Emergency room visit (high): 10 of 22 insurance plan rates Aetna — HMO: $1,340.76 Aetna — Medicare Advantage: $598.68 Aetna — PPO: $1,416.39 Amerigroup — Managed Medicaid: $539.05 Amerivantage — Medicare Advantage: $616.29 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $29.04 Dean Health Plan — HMO: $44 Health Partners Open Network — Commercial: $1,119.57
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED LEVEL 5 VISIT	$1,163.81	$931.05	$428.28 – $3,527.66
Emergency room visit (high): 10 of 22 insurance plan rates Aetna — HMO: $1,340.76 Aetna — Medicare Advantage: $598.68 Aetna — PPO: $1,416.39 Amerigroup — Managed Medicaid: $539.05 Amerivantage — Medicare Advantage: $616.29 BC Illinois Community — Blue Choice: $3,072.30 BC Illinois Community — PPO: $3,527.66 Cigna/Midlands — Commercial: $614.49 Dean Health Plan — HMO: $931.05 Health Partners Open Network — Commercial: $1,119.57
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$399	$319.20	$159.07 – $386.61
Emergency room visit (high): 10 of 20 insurance plan rates Aetna — HMO: $341.78 Aetna — Medicare Advantage: $159.07 Aetna — PPO: $341.78 Amerivantage — Medicare Advantage: $167.02 BC Illinois Community — Blue Choice: $191.26 BC Illinois Community — PPO: $227.69 Cigna/Midlands — Commercial: $337.22 Dean Health Plan — HMO: $367.08 Health Partners Open Network — Commercial: $296.09 Humana — Medicare Advantage: $167.02

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL TOTAL CA	$85.70	$68.56	$8.46 – $68.56
Basic metabolic panel (blood test): 10 of 20 insurance plan rates Aetna — HMO: $8.46 Aetna — Medicare Advantage: $8.63 Aetna — PPO: $8.46 Amerivantage — Medicare Advantage: $8.88 BC Illinois Community — Blue Choice: $25.13 BC Illinois Community — PPO: $25.13 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $16.64 Humana — Medicare Advantage: $8.88
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$27	$21.60	$5.08 – $24.84
Basic metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — HMO: $16.08 Aetna — PPO: $16.08 BC Illinois Community — Blue Choice: $7.11 BC Illinois Community — PPO: $8.46 Cigna/Midlands — Commercial: $11 Dean Health Plan — HMO: $24.84 Health Partners Open Network — Commercial: $13.16 United Healthcare — HMO: $5.08 United Healthcare — PPO: $5.08 Wellmark Blue Cross and Blue Shield — HMO: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL TOTAL CA	$85.70	$68.56	$45.25 – $68.56
Basic metabolic panel (blood test): rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$85.70	$68.56	$10.56 – $68.56
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates Aetna — HMO: $10.56 Aetna — Medicare Advantage: $10.77 Aetna — PPO: $10.56 Amerivantage — Medicare Advantage: $11.09 BC Illinois Community — Blue Choice: $31.36 BC Illinois Community — PPO: $31.36 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $20.76 Humana — Medicare Advantage: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG METABOLIC PANEL,COMPREHENSIVE	$34	$27.20	$6.34 – $31.28
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — HMO: $20.12 Aetna — PPO: $20.12 BC Illinois Community — PPO: $13.20 Cigna/Midlands — Commercial: $13.73 Dean Health Plan — HMO: $31.28 Health Partners Open Network — Commercial: $16.43 United Healthcare — HMO: $6.34 United Healthcare — PPO: $6.34 Wellmark Blue Cross and Blue Shield — HMO: $10.56 Wellmark Blue Cross and Blue Shield — PPO: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$85.70	$68.56	$45.25 – $68.56
Comprehensive metabolic panel (blood test): rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$85.70	$68.56	$31.54 – $109.33
Obstetric blood test panel: 10 of 20 insurance plan rates Aetna — HMO: $47.81 Aetna — Medicare Advantage: $48.77 Aetna — PPO: $47.81 Amerivantage — Medicare Advantage: $50.20 BC Illinois Community — Blue Choice: $109.33 BC Illinois Community — PPO: $109.33 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $94.02 Humana — Medicare Advantage: $50.20
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG OBSTETRIC PANEL	$120	$96	$28.69 – $110.40
Obstetric blood test panel: 10 of 12 insurance plan rates Aetna — HMO: $75.06 Aetna — PPO: $75.06 BC Illinois Community — Blue Choice: $30.92 BC Illinois Community — PPO: $36.81 Cigna/Midlands — Commercial: $62.15 Dean Health Plan — HMO: $110.40 Health Partners Open Network — Commercial: $74.37 United Healthcare — HMO: $28.69 United Healthcare — PPO: $28.69 Wellmark Blue Cross and Blue Shield — HMO: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$85.70	$68.56	$45.25 – $68.56
Obstetric blood test panel: rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$85.70	$68.56	$13.39 – $68.56
Cholesterol panel (lipid panel): 10 of 20 insurance plan rates Aetna — HMO: $13.39 Aetna — Medicare Advantage: $13.66 Aetna — PPO: $13.39 Amerivantage — Medicare Advantage: $14.06 BC Illinois Community — Blue Choice: $39.77 BC Illinois Community — PPO: $39.77 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $26.32 Humana — Medicare Advantage: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG LIPID PANEL	$42	$33.60	$8.03 – $38.64
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates Aetna — HMO: $25.47 Aetna — PPO: $25.47 BC Illinois Community — PPO: $16.74 Cigna/Midlands — Commercial: $17.41 Dean Health Plan — HMO: $38.64 Health Partners Open Network — Commercial: $20.82 United Healthcare — HMO: $8.03 United Healthcare — PPO: $8.03 Wellmark Blue Cross and Blue Shield — HMO: $13.39 Wellmark Blue Cross and Blue Shield — PPO: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$85.70	$68.56	$45.25 – $68.56
Cholesterol panel (lipid panel): rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$85.70	$68.56	$8.68 – $68.56
Kidney function panel: 10 of 20 insurance plan rates Aetna — HMO: $8.68 Aetna — Medicare Advantage: $8.85 Aetna — PPO: $8.68 Amerivantage — Medicare Advantage: $9.11 BC Illinois Community — Blue Choice: $25.78 BC Illinois Community — PPO: $25.78 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $17.06 Humana — Medicare Advantage: $9.11
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG RENAL FUNCTION PANEL	$28	$22.40	$5.21 – $25.76
Kidney function panel: 10 of 12 insurance plan rates Aetna — HMO: $16.77 Aetna — PPO: $16.77 BC Illinois Community — Blue Choice: $7.29 BC Illinois Community — PPO: $8.68 Cigna/Midlands — Commercial: $11.28 Dean Health Plan — HMO: $25.76 Health Partners Open Network — Commercial: $13.51 United Healthcare — HMO: $5.21 United Healthcare — PPO: $5.21 Wellmark Blue Cross and Blue Shield — HMO: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$85.70	$68.56	$45.25 – $68.56
Kidney function panel: rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$85.70	$68.56	$8.17 – $68.56
Liver function panel: 10 of 20 insurance plan rates Aetna — HMO: $8.17 Aetna — Medicare Advantage: $8.33 Aetna — PPO: $8.17 Amerivantage — Medicare Advantage: $8.58 BC Illinois Community — Blue Choice: $18.68 BC Illinois Community — PPO: $18.68 Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56 Health Partners Open Network — Commercial: $16.06 Humana — Medicare Advantage: $8.58
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG HEPATIC FUNCTION PANEL	$26	$20.80	$4.90 – $23.92
Liver function panel: 10 of 12 insurance plan rates Aetna — HMO: $15.43 Aetna — PPO: $15.43 BC Illinois Community — Blue Choice: $5.28 BC Illinois Community — PPO: $6.29 Cigna/Midlands — Commercial: $10.62 Dean Health Plan — HMO: $23.92 Health Partners Open Network — Commercial: $12.71 United Healthcare — HMO: $4.90 United Healthcare — PPO: $4.90 Wellmark Blue Cross and Blue Shield — HMO: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$85.70	$68.56	$45.25 – $68.56
Liver function panel: rates for 2 insurance plans Cigna/Midlands — Commercial: $45.25 Dean Health Plan — HMO: $68.56
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AUTOM URINE DIP W MICRO	$32.14	$25.72	$3.17 – $25.71
Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna — HMO: $3.17 Aetna — Medicare Advantage: $3.23 Aetna — PPO: $3.17 Amerivantage — Medicare Advantage: $3.33 BC Illinois Community — Blue Choice: $9.41 BC Illinois Community — PPO: $9.41 Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71 Health Partners Open Network — Commercial: $6.24 Humana — Medicare Advantage: $3.33
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS, AUTO, W/SCOPE	$10	$8	$3.17 – $9.20
Urine test (automated, with microscope): 10 of 11 insurance plan rates Aetna — HMO: $6.04 Aetna — PPO: $6.04 BC Illinois Community — PPO: $3.17 Cigna/Midlands — Commercial: $4.12 Dean Health Plan — HMO: $9.20 Health Partners Open Network — Commercial: $4.93 United Healthcare — HMO: $3.17 United Healthcare — PPO: $3.17 Wellmark Blue Cross and Blue Shield — HMO: $3.17 Wellmark Blue Cross and Blue Shield — PPO: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC AUTOM URINE DIP W MICRO	$32.14	$25.72	$16.97 – $25.71
Urine test (automated, with microscope): rates for 2 insurance plans Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC N-AUTOM URINALYS WO MICRO	$32.14	$25.72	$3.48 – $25.71
Urine test (manual, without microscope): 10 of 20 insurance plan rates Aetna — HMO: $3.48 Aetna — Medicare Advantage: $3.55 Aetna — PPO: $3.48 Amerivantage — Medicare Advantage: $3.65 BC Illinois Community — Blue Choice: $9.83 BC Illinois Community — PPO: $9.83 Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71 Health Partners Open Network — Commercial: $6.84 Humana — Medicare Advantage: $3.65
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS NONAUTO W/O SCOPE	$9	$7.20	$3.48 – $8.28
Urine test (manual, without microscope): 10 of 11 insurance plan rates Aetna — HMO: $4.70 Aetna — PPO: $4.70 BC Illinois Community — PPO: $3.48 Cigna/Midlands — Commercial: $4.52 Dean Health Plan — HMO: $8.28 Health Partners Open Network — Commercial: $4.88 United Healthcare — HMO: $3.48 United Healthcare — PPO: $3.48 Wellmark Blue Cross and Blue Shield — HMO: $3.48 Wellmark Blue Cross and Blue Shield — PPO: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC N-AUTOM URINALYS WO MICRO	$32.14	$25.72	$16.97 – $25.71
Urine test (manual, without microscope): rates for 2 insurance plans Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AUTOM URINALYSIS WO MICRO	$32.14	$25.72	$2.25 – $25.71
Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna — HMO: $2.25 Aetna — Medicare Advantage: $2.30 Aetna — PPO: $2.25 Amerivantage — Medicare Advantage: $2.36 BC Illinois Community — Blue Choice: $6.68 BC Illinois Community — PPO: $6.68 Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71 Health Partners Open Network — Commercial: $4.42 Humana — Medicare Advantage: $2.36
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG URINALYSIS, AUTO, W/O SCOPE	$8	$6.40	$2.25 – $7.36
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — HMO: $4.03 Aetna — PPO: $4.03 BC Illinois Community — PPO: $2.25 Cigna/Midlands — Commercial: $2.93 Dean Health Plan — HMO: $7.36 Health Partners Open Network — Commercial: $3.49 United Healthcare — HMO: $2.25 United Healthcare — PPO: $2.25 Wellmark Blue Cross and Blue Shield — HMO: $2.25 Wellmark Blue Cross and Blue Shield — PPO: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC AUTOM URINALYSIS WO MICRO	$32.14	$25.72	$16.97 – $25.71
Urine test (automated, without microscope): rates for 2 insurance plans Cigna/Midlands — Commercial: $16.97 Dean Health Plan — HMO: $25.71
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA; TOTAL	$80.35	$64.28	$18.39 – $64.28
PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna — HMO: $18.39 Aetna — Medicare Advantage: $18.76 Aetna — PPO: $18.39 Amerivantage — Medicare Advantage: $19.31 BC Illinois Community — Blue Choice: $42.06 BC Illinois Community — PPO: $42.06 Cigna/Midlands — Commercial: $42.42 Dean Health Plan — HMO: $64.28 Health Partners Open Network — Commercial: $36.17 Humana — Medicare Advantage: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG PROSTATE SPECIFIC ANTIGEN,TOTAL	$58	$46.40	$11.03 – $53.36
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — HMO: $34.84 Aetna — PPO: $34.84 BC Illinois Community — Blue Choice: $11.89 BC Illinois Community — PPO: $14.16 Cigna/Midlands — Commercial: $23.91 Dean Health Plan — HMO: $53.36 Health Partners Open Network — Commercial: $28.62 United Healthcare — HMO: $11.03 United Healthcare — PPO: $11.03 Wellmark Blue Cross and Blue Shield — HMO: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSA; TOTAL	$80.35	$64.28	$42.42 – $64.28
PSA (prostate specific antigen) blood test: rates for 2 insurance plans Cigna/Midlands — Commercial: $42.42 Dean Health Plan — HMO: $64.28
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE	$68.75	$55	$16.80 – $55
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates Aetna — HMO: $16.80 Aetna — Medicare Advantage: $17.14 Aetna — PPO: $16.80 Amerivantage — Medicare Advantage: $17.64 BC Illinois Community — Blue Choice: $49.90 BC Illinois Community — PPO: $49.90 Cigna/Midlands — Commercial: $36.30 Dean Health Plan — HMO: $55 Health Partners Open Network — Commercial: $33.03 Humana — Medicare Advantage: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG ASSAY THYROID STIM HORMONE	$53	$42.40	$10.08 – $48.76
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Aetna — HMO: $32.16 Aetna — PPO: $32.16 BC Illinois Community — PPO: $21 Cigna/Midlands — Commercial: $21.84 Dean Health Plan — HMO: $48.76 Health Partners Open Network — Commercial: $26.14 United Healthcare — HMO: $10.08 United Healthcare — PPO: $10.08 Wellmark Blue Cross and Blue Shield — HMO: $16.80 Wellmark Blue Cross and Blue Shield — PPO: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE	$68.75	$55	$36.30 – $55
Thyroid stimulating hormone (TSH) test: rates for 2 insurance plans Cigna/Midlands — Commercial: $36.30 Dean Health Plan — HMO: $55
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPL CBC W PLT W AUTOM DIFF	$41.96	$33.57	$7.77 – $33.57
Complete blood count (CBC) with differential: 10 of 20 insurance plan rates Aetna — HMO: $7.77 Aetna — Medicare Advantage: $7.93 Aetna — PPO: $7.77 Amerivantage — Medicare Advantage: $8.16 BC Illinois Community — Blue Choice: $23.08 BC Illinois Community — PPO: $23.08 Cigna/Midlands — Commercial: $22.15 Dean Health Plan — HMO: $33.57 Health Partners Open Network — Commercial: $15.27 Humana — Medicare Advantage: $8.16
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG COMPLETE CBC & AUTO DIFF WBC	$25	$20	$4.66 – $23
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — HMO: $14.75 Aetna — PPO: $14.75 BC Illinois Community — Blue Choice: $6.53 BC Illinois Community — PPO: $7.77 Cigna/Midlands — Commercial: $10.10 Dean Health Plan — HMO: $23 Health Partners Open Network — Commercial: $12.08 United Healthcare — HMO: $4.66 United Healthcare — PPO: $4.66 Wellmark Blue Cross and Blue Shield — HMO: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPL CBC W PLT W AUTOM DIFF	$41.96	$33.57	$22.15 – $33.57
Complete blood count (CBC) with differential: rates for 2 insurance plans Cigna/Midlands — Commercial: $22.15 Dean Health Plan — HMO: $33.57
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPL AUTOM CBC W PLT	$41.96	$33.57	$6.47 – $33.57
Complete blood count (CBC), automated: 10 of 20 insurance plan rates Aetna — HMO: $6.47 Aetna — Medicare Advantage: $6.60 Aetna — PPO: $6.47 Amerivantage — Medicare Advantage: $6.79 BC Illinois Community — Blue Choice: $19.22 BC Illinois Community — PPO: $19.22 Cigna/Midlands — Commercial: $22.15 Dean Health Plan — HMO: $33.57 Health Partners Open Network — Commercial: $12.72 Humana — Medicare Advantage: $6.79
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG COMPLETE CBC	$21	$16.80	$3.88 – $19.32
Complete blood count (CBC), automated: 10 of 12 insurance plan rates Aetna — HMO: $12.74 Aetna — PPO: $12.74 BC Illinois Community — Blue Choice: $5.43 BC Illinois Community — PPO: $6.47 Cigna/Midlands — Commercial: $8.41 Dean Health Plan — HMO: $19.32 Health Partners Open Network — Commercial: $10.06 United Healthcare — HMO: $3.88 United Healthcare — PPO: $3.88 Wellmark Blue Cross and Blue Shield — HMO: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPL AUTOM CBC W PLT	$41.96	$33.57	$22.15 – $33.57
Complete blood count (CBC), automated: rates for 2 insurance plans Cigna/Midlands — Commercial: $22.15 Dean Health Plan — HMO: $33.57
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$41.06	$32.85	$4.29 – $32.85
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna — HMO: $4.29 Aetna — Medicare Advantage: $4.38 Aetna — PPO: $4.29 Amerivantage — Medicare Advantage: $4.50 BC Illinois Community — Blue Choice: $12.74 BC Illinois Community — PPO: $12.74 Cigna/Midlands — Commercial: $21.68 Dean Health Plan — HMO: $32.85 Health Partners Open Network — Commercial: $8.43 Humana — Medicare Advantage: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG PROTHROMBIN TIME	$13	$10.40	$3.60 – $11.96
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — HMO: $6.71 Aetna — PPO: $6.71 BC Illinois Community — Blue Choice: $3.60 BC Illinois Community — PPO: $4.29 Cigna/Midlands — Commercial: $5.58 Dean Health Plan — HMO: $11.96 Health Partners Open Network — Commercial: $6.13 United Healthcare — HMO: $4.29 United Healthcare — PPO: $4.29 Wellmark Blue Cross and Blue Shield — HMO: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$41.06	$32.85	$21.68 – $32.85
Blood clotting time test (prothrombin time, PT): rates for 2 insurance plans Cigna/Midlands — Commercial: $21.68 Dean Health Plan — HMO: $32.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PTT; PLASMA OR WHOLE BLOOD	$41.06	$32.85	$6.01 – $32.85
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna — HMO: $6.01 Aetna — Medicare Advantage: $6.13 Aetna — PPO: $6.01 Amerivantage — Medicare Advantage: $6.31 BC Illinois Community — Blue Choice: $17.85 BC Illinois Community — PPO: $17.85 Cigna/Midlands — Commercial: $21.68 Dean Health Plan — HMO: $32.85 Health Partners Open Network — Commercial: $11.82 Humana — Medicare Advantage: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG THROMBOPLAS TIME PARTIAL	$19	$15.20	$3.61 – $17.48
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates Aetna — HMO: $10.06 Aetna — PPO: $10.06 BC Illinois Community — Blue Choice: $5.05 BC Illinois Community — PPO: $6.01 Cigna/Midlands — Commercial: $7.81 Dean Health Plan — HMO: $17.48 Health Partners Open Network — Commercial: $9.35 United Healthcare — HMO: $3.61 United Healthcare — PPO: $3.61 Wellmark Blue Cross and Blue Shield — HMO: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PTT; PLASMA OR WHOLE BLOOD	$41.06	$32.85	$21.68 – $32.85
Blood clotting test (partial thromboplastin time, PTT): rates for 2 insurance plans Cigna/Midlands — Commercial: $21.68 Dean Health Plan — HMO: $32.85

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD OR BRAIN WO CONTRAST	$1,201.44	$961.16	$93.50 – $961.15
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates Aetna — HMO: $232.56 Aetna — Medicare Advantage: $103.84 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $93.50 Amerivantage — Medicare Advantage: $106.89 BC Illinois Community — Blue Choice: $300.27 BC Illinois Community — PPO: $300.27 Cigna/Midlands — Commercial: $634.36 Dean Health Plan — HMO: $961.15 Health Partners Open Network — Commercial: $194.19
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: PR CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL	$337	$269.60	$97.63 – $317.66
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — HMO: $270.75 Aetna — Medicare Advantage: $97.63 Aetna — PPO: $317.66 Amerivantage — Medicare Advantage: $102.51 BC Illinois Community — Blue Choice: $204.41 BC Illinois Community — PPO: $243.34 Cigna/Midlands — Commercial: $208.17 Dean Health Plan — HMO: $310.04 Health Partners Open Network — Commercial: $226.12 Humana — Medicare Advantage: $102.51
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD OR BRAIN WO CONTRAST	$1,201.44	$961.16	$634.36 – $961.15
CT scan of the head or brain, without contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $634.36 Dean Health Plan — HMO: $961.15
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W WO CONTRAST	$3,170.13	$2,536.11	$314 – $2,536.10
MRI of the brain, before and after contrast: 10 of 22 insurance plan rates Aetna — HMO: $780.99 Aetna — Medicare Advantage: $348.73 Aetna — PPO: $825.05 Amerigroup — Managed Medicaid: $314 Amerivantage — Medicare Advantage: $358.99 BC Illinois Community — Blue Choice: $1,995.25 BC Illinois Community — PPO: $1,995.25 Cigna/Midlands — Commercial: $1,673.83 Dean Health Plan — HMO: $2,536.10 Health Partners Open Network — Commercial: $652.15
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI BRAIN COMBO	$1,182	$945.60	$290.84 – $1,220.99
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — HMO: $1,033.36 Aetna — Medicare Advantage: $290.84 Aetna — PPO: $1,220.99 Amerivantage — Medicare Advantage: $305.38 BC Illinois Community — Blue Choice: $793.96 BC Illinois Community — PPO: $945.19 Cigna/Midlands — Commercial: $625.51 Dean Health Plan — HMO: $1,087.44 Health Partners Open Network — Commercial: $865.17 Humana — Medicare Advantage: $305.38
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN W WO CONTRAST	$3,170.13	$2,536.11	$1,673.83 – $2,536.10
MRI of the brain, before and after contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $1,673.83 Dean Health Plan — HMO: $2,536.10
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC X-RAY EXAM CHEST 2 VIEWS	$244.38	$195.51	$61.86 – $203.40
Chest X-ray, 2 views: 10 of 22 insurance plan rates Aetna — HMO: $192.54 Aetna — Medicare Advantage: $85.98 Aetna — PPO: $203.40 Amerigroup — Managed Medicaid: $77.41 Amerivantage — Medicare Advantage: $88.51 BC Illinois Community — Blue Choice: $101.40 BC Illinois Community — PPO: $101.40 Cigna/Midlands — Commercial: $129.03 Dean Health Plan — HMO: $195.50 Health Partners Open Network — Commercial: $160.78
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$77	$61.60	$30.15 – $75.26
Chest X-ray, 2 views: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $30.15 Amerivantage — Medicare Advantage: $31.66 BC Illinois Community — Blue Choice: $63.22 BC Illinois Community — PPO: $75.26 Cigna/Midlands — Commercial: $64.09 Dean Health Plan — HMO: $70.84 Health Partners Open Network — Commercial: $61.21 Humana — Medicare Advantage: $31.66 Medical Associates Health Plan — HMO: $45.23 Meridian — MMAI (Medicare-Medicaid): $31.66
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC X-RAY EXAM CHEST 2 VIEWS	$244.38	$195.51	$129.03 – $195.50
Chest X-ray, 2 views: rates for 2 insurance plans Cigna/Midlands — Commercial: $129.03 Dean Health Plan — HMO: $195.50
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LUMBOSACR SPINE MIN 4 VIEWS	$448.99	$359.20	$93.50 – $359.19
X-ray of the lower spine, at least 4 views: 10 of 22 insurance plan rates Aetna — HMO: $232.56 Aetna — Medicare Advantage: $103.84 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $93.50 Amerivantage — Medicare Advantage: $106.89 BC Illinois Community — Blue Choice: $223.91 BC Illinois Community — PPO: $223.91 Cigna/Midlands — Commercial: $237.07 Dean Health Plan — HMO: $359.19 Health Partners Open Network — Commercial: $194.19
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG X-RAY LUMBAR SPINE 4 VW	$169	$135.20	$46.51 – $155.48
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — HMO: $123.30 Aetna — Medicare Advantage: $46.51 Aetna — PPO: $144.76 Amerivantage — Medicare Advantage: $48.84 BC Illinois Community — Blue Choice: $88.49 BC Illinois Community — PPO: $105.34 Cigna/Midlands — Commercial: $98.87 Dean Health Plan — HMO: $155.48 Health Partners Open Network — Commercial: $104.17 Humana — Medicare Advantage: $48.84
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LUMBOSACR SPINE MIN 4 VIEWS	$448.99	$359.20	$237.07 – $359.19
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Cigna/Midlands — Commercial: $237.07 Dean Health Plan — HMO: $359.19
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST	$2,183.30	$1,746.64	$212.53 – $1,746.64
MRI of the lower back (lumbar spine), without contrast: 10 of 22 insurance plan rates Aetna — HMO: $528.61 Aetna — Medicare Advantage: $236.04 Aetna — PPO: $558.42 Amerigroup — Managed Medicaid: $212.53 Amerivantage — Medicare Advantage: $242.98 BC Illinois Community — Blue Choice: $922.13 BC Illinois Community — PPO: $922.13 Cigna/Midlands — Commercial: $1,152.78 Dean Health Plan — HMO: $1,746.64 Health Partners Open Network — Commercial: $441.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI, LUMBAR SPINE	$650	$520	$174.72 – $710.34
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — HMO: $601.77 Aetna — Medicare Advantage: $174.72 Aetna — PPO: $710.34 Amerivantage — Medicare Advantage: $183.46 BC Illinois Community — Blue Choice: $331.76 BC Illinois Community — PPO: $394.95 Cigna/Midlands — Commercial: $376.13 Dean Health Plan — HMO: $598 Health Partners Open Network — Commercial: $506.36 Humana — Medicare Advantage: $183.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST	$2,183.30	$1,746.64	$1,152.78 – $1,746.64
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $1,152.78 Dean Health Plan — HMO: $1,746.64
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$2,181.24	$1,745	$156.52 – $1,744.99
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates Aetna — HMO: $389.30 Aetna — Medicare Advantage: $173.83 Aetna — PPO: $411.26 Amerigroup — Managed Medicaid: $156.52 Amerivantage — Medicare Advantage: $178.95 BC Illinois Community — Blue Choice: $1,057.53 BC Illinois Community — PPO: $1,057.53 Cigna/Midlands — Commercial: $1,151.69 Dean Health Plan — HMO: $1,744.99 Health Partners Open Network — Commercial: $325.07
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: PR CT SCAN OF PELVIS CONTRAST	$671	$536.80	$206.01 – $625.91
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — HMO: $530.75 Aetna — Medicare Advantage: $206.01 Aetna — PPO: $625.91 Amerivantage — Medicare Advantage: $216.31 BC Illinois Community — Blue Choice: $437.20 BC Illinois Community — PPO: $520.48 Cigna/Midlands — Commercial: $442.64 Dean Health Plan — HMO: $617.32 Health Partners Open Network — Commercial: $494.75 Humana — Medicare Advantage: $216.31
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$2,181.24	$1,745	$1,151.69 – $1,744.99
CT scan of the pelvis, with contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $1,151.69 Dean Health Plan — HMO: $1,744.99
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOW EXTR ANY JOINT WO CONTRAST	$2,049.39	$1,639.52	$212.53 – $1,639.51
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — HMO: $528.61 Aetna — Medicare Advantage: $236.04 Aetna — PPO: $558.42 Amerigroup — Managed Medicaid: $212.53 Amerivantage — Medicare Advantage: $242.98 BC Illinois Community — Blue Choice: $1,048.14 BC Illinois Community — PPO: $1,048.14 Cigna/Midlands — Commercial: $1,082.08 Dean Health Plan — HMO: $1,639.51 Health Partners Open Network — Commercial: $441.40
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: PR MRI LOWER EXTREM JT, W/O CONTRAST	$690	$552	$185.28 – $763.97
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — HMO: $646.01 Aetna — Medicare Advantage: $185.28 Aetna — PPO: $763.97 Amerivantage — Medicare Advantage: $194.54 BC Illinois Community — Blue Choice: $349.84 BC Illinois Community — PPO: $416.48 Cigna/Midlands — Commercial: $397.64 Dean Health Plan — HMO: $634.80 Health Partners Open Network — Commercial: $540.86 Humana — Medicare Advantage: $194.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOW EXTR ANY JOINT WO CONTRAST	$2,049.39	$1,639.52	$1,082.08 – $1,639.51
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $1,082.08 Dean Health Plan — HMO: $1,639.51
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,143.99	$2,515.20	$314 – $2,515.19
CT scan of the abdomen and pelvis, with contrast: 10 of 22 insurance plan rates Aetna — HMO: $780.99 Aetna — Medicare Advantage: $348.73 Aetna — PPO: $825.05 Amerigroup — Managed Medicaid: $314 Amerivantage — Medicare Advantage: $358.99 BC Illinois Community — Blue Choice: $1,321.53 BC Illinois Community — PPO: $1,321.53 Cigna/Midlands — Commercial: $1,660.03 Dean Health Plan — HMO: $2,515.19 Health Partners Open Network — Commercial: $652.15
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG CT SCAN,ABDOMENT AND PELVIS,W CONTRAST	$781	$624.80	$274.75 – $861.80
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — HMO: $731.78 Aetna — Medicare Advantage: $274.75 Aetna — PPO: $861.80 Amerivantage — Medicare Advantage: $288.49 BC Illinois Community — Blue Choice: $580.99 BC Illinois Community — PPO: $691.66 Cigna/Midlands — Commercial: $593.82 Dean Health Plan — HMO: $718.52 Health Partners Open Network — Commercial: $650.23 Humana — Medicare Advantage: $288.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,143.99	$2,515.20	$1,660.03 – $2,515.19
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans Cigna/Midlands — Commercial: $1,660.03 Dean Health Plan — HMO: $2,515.19
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$1,295.79	$1,036.64	$93.50 – $1,036.63
Ultrasound of the abdomen, complete: 10 of 22 insurance plan rates Aetna — HMO: $232.56 Aetna — Medicare Advantage: $103.84 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $93.50 Amerivantage — Medicare Advantage: $106.89 BC Illinois Community — Blue Choice: $451.83 BC Illinois Community — PPO: $451.83 Cigna/Midlands — Commercial: $684.18 Dean Health Plan — HMO: $1,036.63 Health Partners Open Network — Commercial: $194.19
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE	$304	$243.20	$103.58 – $320.34
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — HMO: $273.43 Aetna — Medicare Advantage: $103.58 Aetna — PPO: $320.34 Amerivantage — Medicare Advantage: $108.76 BC Illinois Community — Blue Choice: $218.45 BC Illinois Community — PPO: $260.06 Cigna/Midlands — Commercial: $222.08 Dean Health Plan — HMO: $279.68 Health Partners Open Network — Commercial: $236 Humana — Medicare Advantage: $108.76
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$1,295.79	$1,036.64	$684.18 – $1,036.63
Ultrasound of the abdomen, complete: rates for 2 insurance plans Cigna/Midlands — Commercial: $684.18 Dean Health Plan — HMO: $1,036.63
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB COMPLETE SNGL FETUS	$774.07	$619.26	$93.50 – $619.26
Pregnancy ultrasound (after the first trimester): 10 of 22 insurance plan rates Aetna — HMO: $232.56 Aetna — Medicare Advantage: $103.84 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $93.50 Amerivantage — Medicare Advantage: $106.89 BC Illinois Community — Blue Choice: $459.46 BC Illinois Community — PPO: $459.46 Cigna/Midlands — Commercial: $408.71 Dean Health Plan — HMO: $619.26 Health Partners Open Network — Commercial: $194.19
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: US, OB >/= 14 WKS, SNGL FETUS	$338	$270.40	$120.62 – $372.60
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — HMO: $317.66 Aetna — Medicare Advantage: $120.62 Aetna — PPO: $372.60 Amerivantage — Medicare Advantage: $126.65 BC Illinois Community — Blue Choice: $254.70 BC Illinois Community — PPO: $303.22 Cigna/Midlands — Commercial: $259.56 Dean Health Plan — HMO: $310.96 Health Partners Open Network — Commercial: $269.77 Humana — Medicare Advantage: $126.65
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB COMPLETE SNGL FETUS	$774.07	$619.26	$408.71 – $619.26
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Cigna/Midlands — Commercial: $408.71 Dean Health Plan — HMO: $619.26
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US NON OB TRANSVAG	$764.96	$611.97	$93.50 – $611.97
Transvaginal ultrasound: 10 of 22 insurance plan rates Aetna — HMO: $232.56 Aetna — Medicare Advantage: $103.84 Aetna — PPO: $245.68 Amerigroup — Managed Medicaid: $93.50 Amerivantage — Medicare Advantage: $106.89 BC Illinois Community — Blue Choice: $386.72 BC Illinois Community — PPO: $386.72 Cigna/Midlands — Commercial: $403.90 Dean Health Plan — HMO: $611.97 Health Partners Open Network — Commercial: $194.19
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ECHOGRAPHY,TRANSVAGINAL	$297	$237.60	$105.45 – $320.34
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — HMO: $274.77 Aetna — Medicare Advantage: $105.45 Aetna — PPO: $320.34 Amerivantage — Medicare Advantage: $110.72 BC Illinois Community — Blue Choice: $222.89 BC Illinois Community — PPO: $265.35 Cigna/Midlands — Commercial: $227.30 Dean Health Plan — HMO: $273.24 Health Partners Open Network — Commercial: $228.80 Humana — Medicare Advantage: $110.72
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US NON OB TRANSVAG	$764.96	$611.97	$403.90 – $611.97
Transvaginal ultrasound: rates for 2 insurance plans Cigna/Midlands — Commercial: $403.90 Dean Health Plan — HMO: $611.97
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNIL	$364.87	$291.90	$78.92 – $386.72
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — HMO: $182.44 Aetna — Medicare Advantage: $78.92 Aetna — PPO: $182.44 Amerivantage — Medicare Advantage: $81.24 BC Illinois Community — Blue Choice: $386.72 BC Illinois Community — PPO: $386.72 Cigna/Midlands — Commercial: $192.65 Dean Health Plan — HMO: $291.90 Health Partners Open Network — Commercial: $117.47 Humana — Medicare Advantage: $81.24
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$283	$226.40	$77.38 – $279.19
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — HMO: $77.38 Aetna — Medicare Advantage: $112.73 Aetna — PPO: $77.38 Amerivantage — Medicare Advantage: $118.37 BC Illinois Community — Blue Choice: $234.52 BC Illinois Community — PPO: $279.19 Cigna/Midlands — Commercial: $239.34 Dean Health Plan — HMO: $260.36 Health Partners Open Network — Commercial: $259.38 Humana — Medicare Advantage: $118.37
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNIL	$364.87	$291.90	$192.65 – $291.90
Diagnostic mammogram, one breast: rates for 2 insurance plans Cigna/Midlands — Commercial: $192.65 Dean Health Plan — HMO: $291.90
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BILAT	$416.01	$332.81	$100.61 – $492.66
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — HMO: $208.01 Aetna — Medicare Advantage: $100.61 Aetna — PPO: $208.01 Amerivantage — Medicare Advantage: $103.57 BC Illinois Community — Blue Choice: $492.66 BC Illinois Community — PPO: $492.66 Cigna/Midlands — Commercial: $219.65 Dean Health Plan — HMO: $332.81 Health Partners Open Network — Commercial: $149.75 Humana — Medicare Advantage: $103.57
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$357	$285.60	$98.64 – $353.52
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — HMO: $98.64 Aetna — Medicare Advantage: $142.21 Aetna — PPO: $98.64 Amerivantage — Medicare Advantage: $149.32 BC Illinois Community — Blue Choice: $296.96 BC Illinois Community — PPO: $353.52 Cigna/Midlands — Commercial: $302.63 Dean Health Plan — HMO: $328.44 Health Partners Open Network — Commercial: $328.22 Humana — Medicare Advantage: $149.32
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BILAT	$416.01	$332.81	$219.65 – $332.81
Diagnostic mammogram, both breasts: rates for 2 insurance plans Cigna/Midlands — Commercial: $219.65 Dean Health Plan — HMO: $332.81
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCR MAMMO INCL CAD UNIL	$398.52	$318.82	$83.29 – $408.79
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — HMO: $199.26 Aetna — Medicare Advantage: $83.29 Aetna — PPO: $199.26 Amerivantage — Medicare Advantage: $85.74 BC Illinois Community — Blue Choice: $408.79 BC Illinois Community — PPO: $408.79 Cigna/Midlands — Commercial: $210.42 Dean Health Plan — HMO: $318.82 Health Partners Open Network — Commercial: $123.75 Humana — Medicare Advantage: $85.74
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$289	$231.20	$81.66 – $284.63
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — HMO: $81.66 Aetna — Medicare Advantage: $115.10 Aetna — PPO: $81.66 Amerivantage — Medicare Advantage: $120.86 BC Illinois Community — Blue Choice: $239.09 BC Illinois Community — PPO: $284.63 Cigna/Midlands — Commercial: $244.06 Dean Health Plan — HMO: $265.88 Health Partners Open Network — Commercial: $264.13 Humana — Medicare Advantage: $120.86
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCR MAMMO INCL CAD BILAT	$398.52	$318.82	$83.29 – $408.79
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — HMO: $199.26 Aetna — Medicare Advantage: $83.29 Aetna — PPO: $199.26 Amerivantage — Medicare Advantage: $85.74 BC Illinois Community — Blue Choice: $408.79 BC Illinois Community — PPO: $408.79 Cigna/Midlands — Commercial: $210.42 Dean Health Plan — HMO: $318.82 Health Partners Open Network — Commercial: $123.75 Humana — Medicare Advantage: $85.74

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ELECTROCARDIOGRAM, COMPLETE	$47	$37.60	$12.88 – $43.24
Electrocardiogram (ECG/EKG) with reading: 10 of 20 insurance plan rates Aetna — HMO: $36.18 Aetna — Medicare Advantage: $12.88 Aetna — PPO: $42.87 Amerivantage — Medicare Advantage: $13.52 BC Illinois Community — Blue Choice: $26.28 BC Illinois Community — PPO: $31.28 Cigna/Midlands — Commercial: $33.90 Dean Health Plan — HMO: $43.24 Health Partners Open Network — Commercial: $33.44 Humana — Medicare Advantage: $13.52
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$26.34 – $90.91
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans BC Illinois Community — Blue Choice: $90.91 BC Illinois Community — PPO: $90.91 Medical Associates Health Plan — HMO: $26.34
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$2,434	$1,947.20	$757.63 – $2,403.26
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — HMO: $1,939.38 Aetna — Medicare Advantage: $757.63 Aetna — PPO: $2,360.24 Amerivantage — Medicare Advantage: $795.51 BC Illinois Community — Blue Choice: $1,491.68 BC Illinois Community — PPO: $1,775.81 Cigna/Midlands — Commercial: $2,059.75 Dean Health Plan — HMO: $2,239.28 Health Partners Open Network — Commercial: $1,717.50 Humana — Medicare Advantage: $795.51
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$2,827.97 – $11,411.40
Left heart catheterization (diagnostic): 10 of 16 insurance plan rates Aetna — HMO: $7,033.85 Aetna — Medicare Advantage: $3,140.78 Aetna — PPO: $7,430.63 Amerigroup — Managed Medicaid: $2,827.97 Amerivantage — Medicare Advantage: $3,233.16 BC Illinois Community — Blue Choice: $10,246.12 BC Illinois Community — PPO: $11,411.40 Health Partners Open Network — Commercial: $5,873.44 Humana — Medicare Advantage: $3,233.16 Iowa Total Care — Managed Medicaid: $2,827.97
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I (TC)	$1,787	$1,429.60	$553.73 – $1,764.45
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — HMO: $1,372.45 Aetna — Medicare Advantage: $553.73 Aetna — PPO: $1,670 Amerivantage — Medicare Advantage: $581.42 BC Illinois Community — Blue Choice: $1,491.68 BC Illinois Community — PPO: $1,273.11 Cigna/Midlands — Commercial: $1,523.86 Dean Health Plan — HMO: $1,644.04 Health Partners Open Network — Commercial: $1,205.35 Humana — Medicare Advantage: $581.42
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$2,181	$1,744.80	$787.77 – $2,152.57
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates Aetna — HMO: $1,565.45 Aetna — Medicare Advantage: $787.77 Aetna — PPO: $1,904.56 Amerivantage — Medicare Advantage: $827.16 BC Illinois Community — Blue Choice: $1,167.08 BC Illinois Community — PPO: $1,389.38 Cigna/Midlands — Commercial: $871.21 Dean Health Plan — HMO: $2,006.52 Health Partners Open Network — Commercial: $1,360.27 Humana — Medicare Advantage: $827.16
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$1,750.34 – $17,530.19
Heart rhythm study (electrophysiology evaluation): 10 of 16 insurance plan rates Aetna — HMO: $16,594.11 Aetna — Medicare Advantage: $7,409.68 Aetna — PPO: $17,530.19 Amerigroup — Managed Medicaid: $6,671.68 Amerivantage — Medicare Advantage: $7,627.61 BC Illinois Community — Blue Choice: $1,750.34 BC Illinois Community — PPO: $1,750.34 Health Partners Open Network — Commercial: $13,856.51 Humana — Medicare Advantage: $7,627.61 Iowa Total Care — Managed Medicaid: $6,671.68
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION (TC)	$1,114	$891.20	$316.69 – $1,167.08
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates Aetna — HMO: $647.37 Aetna — Medicare Advantage: $316.69 Aetna — PPO: $788.08 Amerivantage — Medicare Advantage: $332.52 BC Illinois Community — Blue Choice: $1,167.08 BC Illinois Community — PPO: $568.11 Cigna/Midlands — Commercial: $871.21 Dean Health Plan — HMO: $1,024.88 Health Partners Open Network — Commercial: $565.75 Humana — Medicare Advantage: $332.52
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$3,444	$2,755.20	$810.28 – $3,443.33
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates Aetna — HMO: $2,537.16 Aetna — Medicare Advantage: $810.28 Aetna — PPO: $3,088.01 Amerivantage — Medicare Advantage: $850.79 BC Illinois Community — Blue Choice: $1,704.06 BC Illinois Community — PPO: $2,028.64 Cigna/Midlands — Commercial: $2,127.97 Dean Health Plan — HMO: $3,168.48 Health Partners Open Network — Commercial: $2,233.18 Humana — Medicare Advantage: $850.79
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$5,664.47 – $56,675.01
Heart rhythm study with ablation for atrial fibrillation: 10 of 16 insurance plan rates Aetna — HMO: $53,648.67 Aetna — Medicare Advantage: $23,955.47 Aetna — PPO: $56,675.01 Amerigroup — Managed Medicaid: $21,569.52 Amerivantage — Medicare Advantage: $24,660.04 BC Illinois Community — Blue Choice: $5,664.47 BC Illinois Community — PPO: $5,664.47 Health Partners Open Network — Commercial: $44,798.02 Humana — Medicare Advantage: $24,660.04 Iowa Total Care — Managed Medicaid: $21,569.52
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSS W 4/> PARAM W TECH 6+ YRS	$2,431.30	$1,945.04	$894.52 – $2,360.79
Sleep study (overnight, in a sleep lab): 10 of 22 insurance plan rates Aetna — HMO: $1,044.46 Aetna — Medicare Advantage: $993.47 Aetna — PPO: $1,244.74 Amerigroup — Managed Medicaid: $894.52 Amerivantage — Medicare Advantage: $1,022.69 BC Illinois Community — Blue Choice: $2,360.79 BC Illinois Community — PPO: $2,360.79 Cigna/Midlands — Commercial: $1,283.73 Dean Health Plan — HMO: $1,945.04 Health Partners Open Network — Commercial: $1,857.84
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$1,746	$1,396.80	$559 – $1,606.32
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — HMO: $1,330.90 Aetna — Medicare Advantage: $559 Aetna — PPO: $1,586.90 Amerivantage — Medicare Advantage: $586.95 BC Illinois Community — Blue Choice: $1,124.16 BC Illinois Community — PPO: $1,338.29 Cigna/Midlands — Commercial: $1,464.27 Dean Health Plan — HMO: $1,606.32 Health Partners Open Network — Commercial: $1,214.60 Humana — Medicare Advantage: $586.95
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSS W 4/> PARAM W TECH 6+ YRS	$2,431.30	$1,945.04	$1,283.73 – $1,945.04
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Cigna/Midlands — Commercial: $1,283.73 Dean Health Plan — HMO: $1,945.04

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THERAP EXERCISE ROM EA 15M	$123.89	$99.12	$27.95 – $99.11
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna — HMO: $61.95 Aetna — Medicare Advantage: $27.95 Aetna — PPO: $61.95 Amerivantage — Medicare Advantage: $28.77 BC Illinois Community — Blue Choice: $89.58 BC Illinois Community — PPO: $89.58 Cigna/Midlands — Commercial: $65.41 Dean Health Plan — HMO: $99.11 Health Partners Open Network — Commercial: $39 Humana — Medicare Advantage: $28.77
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Doctor (professional) fee In the file: PR THERAPEUTIC EXERCISES	$69	$55.20	$26.94 – $63.48
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna — HMO: $26.94 Aetna — Medicare Advantage: $27.40 Aetna — PPO: $26.94 Amerivantage — Medicare Advantage: $28.77 BC Illinois Community — Blue Choice: $28.42 BC Illinois Community — PPO: $33.83 Cigna/Midlands — Commercial: $45.28 Dean Health Plan — HMO: $63.48 Health Partners Open Network — Commercial: $40.67 Humana — Medicare Advantage: $28.77
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THERAP EXERCISE ROM EA 15M	$123.89	$99.12	$65.41 – $99.11
Physical therapy: therapeutic exercise (each 15 minutes): rates for 2 insurance plans Cigna/Midlands — Commercial: $65.41 Dean Health Plan — HMO: $99.11
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$234	$187.20	$82.70 – $215.28
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates Aetna — HMO: $91.63 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $91.63 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $97.29 BC Illinois Community — PPO: $115.82 Cigna/Midlands — Commercial: $154.74 Dean Health Plan — HMO: $215.28 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX	$265.98	$212.79	$80 – $212.78
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates Aetna — HMO: $132.99 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $132.99 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $202.38 BC Illinois Community — PPO: $202.38 Cigna/Midlands — Commercial: $140.44 Dean Health Plan — HMO: $212.78 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX	$265.98	$212.79	$140.44 – $212.78
Physical therapy evaluation (low complexity): rates for 2 insurance plans Cigna/Midlands — Commercial: $140.44 Dean Health Plan — HMO: $212.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX	$278.49	$222.80	$80 – $224.83
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates Aetna — HMO: $139.25 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $139.25 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $224.83 BC Illinois Community — PPO: $224.83 Cigna/Midlands — Commercial: $147.04 Dean Health Plan — HMO: $222.79 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$234	$187.20	$82.70 – $215.28
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates Aetna — HMO: $91.63 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $91.63 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $97.29 BC Illinois Community — PPO: $115.82 Cigna/Midlands — Commercial: $154.74 Dean Health Plan — HMO: $215.28 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX	$278.49	$222.80	$147.04 – $222.79
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans Cigna/Midlands — Commercial: $147.04 Dean Health Plan — HMO: $222.79
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX	$289.85	$231.88	$80 – $247.28
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates Aetna — HMO: $144.93 Aetna — Medicare Advantage: $95.09 Aetna — PPO: $144.93 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $247.28 BC Illinois Community — PPO: $247.28 Cigna/Midlands — Commercial: $153.04 Dean Health Plan — HMO: $231.88 Health Partners Open Network — Commercial: $132.71 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$234	$187.20	$82.70 – $215.28
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates Aetna — HMO: $91.63 Aetna — Medicare Advantage: $93.23 Aetna — PPO: $91.63 Amerivantage — Medicare Advantage: $97.89 BC Illinois Community — Blue Choice: $97.29 BC Illinois Community — PPO: $115.82 Cigna/Midlands — Commercial: $154.74 Dean Health Plan — HMO: $215.28 Health Partners Open Network — Commercial: $136.91 Humana — Medicare Advantage: $97.89
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX	$289.85	$231.88	$153.04 – $231.88
Physical therapy evaluation (high complexity): rates for 2 insurance plans Cigna/Midlands — Commercial: $153.04 Dean Health Plan — HMO: $231.88
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$210	$168	$67.55 – $193.20
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna — HMO: $103.19 Aetna — Medicare Advantage: $67.55 Aetna — PPO: $107.22 Amerivantage — Medicare Advantage: $70.93 BC Illinois Community — Blue Choice: $96.07 BC Illinois Community — PPO: $114.37 Cigna/Midlands — Commercial: $170.59 Dean Health Plan — HMO: $193.20 Health Partners Open Network — Commercial: $93.19 Humana — Medicare Advantage: $70.93
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$141.27 – $371.19
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates Aetna — HMO: $351.37 Aetna — Medicare Advantage: $156.89 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $141.27 Amerivantage — Medicare Advantage: $161.51 BC Illinois Community — Blue Choice: $286.19 BC Illinois Community — PPO: $286.19 Health Partners Open Network — Commercial: $293.40 Humana — Medicare Advantage: $161.51 Iowa Total Care — Managed Medicaid: $141.27
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN (38-52 MIN)	$276.20	$220.96	$101.64 – $377.64
Psychotherapy, 45 minutes: 10 of 22 insurance plan rates Aetna — HMO: $351.37 Aetna — Medicare Advantage: $156.89 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $141.27 Amerivantage — Medicare Advantage: $161.51 BC Illinois Community — Blue Choice: $377.64 BC Illinois Community — PPO: $377.64 Cigna/Midlands — Commercial: $145.83 Dean Health Plan — HMO: $220.96 Health Partners Open Network — Commercial: $293.40
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$262	$209.60	$89.14 – $241.04
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna — HMO: $136.70 Aetna — Medicare Advantage: $89.14 Aetna — PPO: $142.07 Amerivantage — Medicare Advantage: $93.60 BC Illinois Community — Blue Choice: $126.81 BC Illinois Community — PPO: $150.96 Cigna/Midlands — Commercial: $225.73 Dean Health Plan — HMO: $241.04 Health Partners Open Network — Commercial: $128.07 Humana — Medicare Advantage: $93.60
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN (38-52 MIN)	$276.20	$220.96	$145.83 – $220.96
Psychotherapy, 45 minutes: rates for 2 insurance plans Cigna/Midlands — Commercial: $145.83 Dean Health Plan — HMO: $220.96
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN (>53 MIN)	$339.86	$271.89	$125.07 – $555.89
Psychotherapy, 60 minutes: 10 of 22 insurance plan rates Aetna — HMO: $351.37 Aetna — Medicare Advantage: $156.89 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $141.27 Amerivantage — Medicare Advantage: $161.51 BC Illinois Community — Blue Choice: $555.89 BC Illinois Community — PPO: $555.89 Cigna/Midlands — Commercial: $179.45 Dean Health Plan — HMO: $271.89 Health Partners Open Network — Commercial: $293.40
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$392	$313.60	$131.89 – $360.64
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates Aetna — HMO: $206.40 Aetna — Medicare Advantage: $131.89 Aetna — PPO: $214.44 Amerivantage — Medicare Advantage: $138.48 BC Illinois Community — Blue Choice: $185.93 BC Illinois Community — PPO: $221.35 Cigna/Midlands — Commercial: $333.11 Dean Health Plan — HMO: $360.64 Health Partners Open Network — Commercial: $193.26 Humana — Medicare Advantage: $138.48
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN (>53 MIN)	$339.86	$271.89	$179.45 – $271.89
Psychotherapy, 60 minutes: rates for 2 insurance plans Cigna/Midlands — Commercial: $179.45 Dean Health Plan — HMO: $271.89
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$288	$230.40	$96.29 – $264.96
Family psychotherapy, without the patient: 10 of 20 insurance plan rates Aetna — HMO: $166.18 Aetna — Medicare Advantage: $96.29 Aetna — PPO: $172.89 Amerivantage — Medicare Advantage: $101.10 BC Illinois Community — Blue Choice: $164.01 BC Illinois Community — PPO: $195.25 Cigna/Midlands — Commercial: $242.84 Dean Health Plan — HMO: $264.96 Health Partners Open Network — Commercial: $147.33 Humana — Medicare Advantage: $101.10
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$141.27 – $371.19
Family psychotherapy, without the patient: 10 of 16 insurance plan rates Aetna — HMO: $351.37 Aetna — Medicare Advantage: $156.89 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $141.27 Amerivantage — Medicare Advantage: $161.51 BC Illinois Community — Blue Choice: $360.44 BC Illinois Community — PPO: $360.44 Health Partners Open Network — Commercial: $293.40 Humana — Medicare Advantage: $161.51 Iowa Total Care — Managed Medicaid: $141.27
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY THERAPY W PT 50 MIN	$328.50	$262.80	$120.89 – $471.43
Family psychotherapy, with the patient: 10 of 22 insurance plan rates Aetna — HMO: $351.37 Aetna — Medicare Advantage: $156.89 Aetna — PPO: $371.19 Amerigroup — Managed Medicaid: $141.27 Amerivantage — Medicare Advantage: $161.51 BC Illinois Community — Blue Choice: $471.43 BC Illinois Community — PPO: $471.43 Cigna/Midlands — Commercial: $173.45 Dean Health Plan — HMO: $262.80 Health Partners Open Network — Commercial: $293.40
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$299	$239.20	$100.44 – $275.08
Family psychotherapy, with the patient: 10 of 20 insurance plan rates Aetna — HMO: $172.89 Aetna — Medicare Advantage: $100.44 Aetna — PPO: $179.60 Amerivantage — Medicare Advantage: $105.46 BC Illinois Community — Blue Choice: $169.81 BC Illinois Community — PPO: $202.15 Cigna/Midlands — Commercial: $253.76 Dean Health Plan — HMO: $275.08 Health Partners Open Network — Commercial: $159.54 Humana — Medicare Advantage: $105.46
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY THERAPY W PT 50 MIN	$328.50	$262.80	$173.45 – $262.80
Family psychotherapy, with the patient: rates for 2 insurance plans Cigna/Midlands — Commercial: $173.45 Dean Health Plan — HMO: $262.80
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP THERAPY NOT MULTI-FAMILY	$142.09	$113.68	$52.29 – $213.70
Group psychotherapy: 10 of 22 insurance plan rates Aetna — HMO: $202.29 Aetna — Medicare Advantage: $90.33 Aetna — PPO: $213.70 Amerigroup — Managed Medicaid: $81.33 Amerivantage — Medicare Advantage: $92.98 BC Illinois Community — Blue Choice: $100.06 BC Illinois Community — PPO: $100.06 Cigna/Midlands — Commercial: $75.02 Dean Health Plan — HMO: $113.67 Health Partners Open Network — Commercial: $168.92
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: PR GROUP PSYCHOTHERAPY	$78	$62.40	$23.68 – $71.76
Group psychotherapy: 10 of 20 insurance plan rates Aetna — HMO: $41.55 Aetna — Medicare Advantage: $23.68 Aetna — PPO: $42.87 Amerivantage — Medicare Advantage: $24.86 BC Illinois Community — Blue Choice: $47.33 BC Illinois Community — PPO: $56.34 Cigna/Midlands — Commercial: $59.77 Dean Health Plan — HMO: $71.76 Health Partners Open Network — Commercial: $34.87 Humana — Medicare Advantage: $24.86
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC GROUP THERAPY NOT MULTI-FAMILY	$142.09	$113.68	$75.02 – $113.67
Group psychotherapy: rates for 2 insurance plans Cigna/Midlands — Commercial: $75.02 Dean Health Plan — HMO: $113.67

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REMOVAL OF BREAST LESION	$1,534	$1,227.20	$371.96 – $1,411.28
Removal of breast growth (open surgery): 10 of 20 insurance plan rates Aetna — HMO: $914.07 Aetna — Medicare Advantage: $371.96 Aetna — PPO: $1,113.77 Amerivantage — Medicare Advantage: $390.56 BC Illinois Community — Blue Choice: $753.32 BC Illinois Community — PPO: $896.81 Cigna/Midlands — Commercial: $989.48 Dean Health Plan — HMO: $1,411.28 Health Partners Open Network — Commercial: $753.98 Humana — Medicare Advantage: $390.56
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$1,791.74 – $8,846.48
Removal of breast growth (open surgery): 10 of 17 insurance plan rates Aetna — HMO: $8,374.10 Aetna — Medicare Advantage: $3,739.24 Aetna — PPO: $8,846.48 Amerigroup — Managed Medicaid: $3,366.82 Amerivantage — Medicare Advantage: $3,849.22 BC Illinois Community — Blue Choice: $1,791.74 BC Illinois Community — PPO: $1,791.74 Health Partners Open Network — Commercial: $6,992.59 Humana — Medicare Advantage: $3,849.22 Iowa Total Care — Managed Medicaid: $3,366.82
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REMOVAL OF BREAST LESION (BILAT)	$3,068	$2,454.40	$371.96 – $2,822.56
Removal of breast growth (open surgery): 10 of 20 insurance plan rates Aetna — HMO: $914.07 Aetna — Medicare Advantage: $371.96 Aetna — PPO: $1,113.77 Amerivantage — Medicare Advantage: $390.56 BC Illinois Community — Blue Choice: $753.32 BC Illinois Community — PPO: $896.81 Cigna/Midlands — Commercial: $989.48 Dean Health Plan — HMO: $2,822.56 Health Partners Open Network — Commercial: $753.98 Humana — Medicare Advantage: $390.56
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: PR TOTAL HIP ARTHROPLASTY	$4,172	$3,337.60	$1,146 – $4,171.24
Total hip replacement: 10 of 20 insurance plan rates Aetna — HMO: $3,026.37 Aetna — Medicare Advantage: $1,146 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,203.30 BC Illinois Community — Blue Choice: $2,384.61 BC Illinois Community — PPO: $2,838.82 Cigna/Midlands — Commercial: $3,048.88 Dean Health Plan — HMO: $3,838.24 Health Partners Open Network — Commercial: $2,586.94 Humana — Medicare Advantage: $1,203.30
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$6,393.46 – $29,725.18
Total hip replacement: 10 of 16 insurance plan rates Aetna — HMO: $28,137.92 Aetna — Medicare Advantage: $12,564.28 Aetna — PPO: $29,725.18 Amerigroup — Managed Medicaid: $11,312.88 Amerivantage — Medicare Advantage: $12,933.82 BC Illinois Community — Blue Choice: $6,393.46 BC Illinois Community — PPO: $6,393.46 Health Partners Open Network — Commercial: $23,495.88 Humana — Medicare Advantage: $12,933.82 Iowa Total Care — Managed Medicaid: $11,312.88
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR TOTAL HIP ARTHROPLASTY (BILAT)	$8,344	$6,675.20	$1,146 – $7,676.48
Total hip replacement: 10 of 20 insurance plan rates Aetna — HMO: $3,026.37 Aetna — Medicare Advantage: $1,146 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,203.30 BC Illinois Community — Blue Choice: $2,384.61 BC Illinois Community — PPO: $2,838.82 Cigna/Midlands — Commercial: $3,048.88 Dean Health Plan — HMO: $7,676.48 Health Partners Open Network — Commercial: $2,586.94 Humana — Medicare Advantage: $1,203.30
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: PR TOTAL KNEE ARTHROPLASTY	$4,168	$3,334.40	$1,144.67 – $4,167.04
Total knee replacement: 10 of 20 insurance plan rates Aetna — HMO: $3,026.37 Aetna — Medicare Advantage: $1,144.67 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,201.90 BC Illinois Community — Blue Choice: $2,380.68 BC Illinois Community — PPO: $2,834.14 Cigna/Midlands — Commercial: $3,044.93 Dean Health Plan — HMO: $3,834.56 Health Partners Open Network — Commercial: $2,631.60 Humana — Medicare Advantage: $1,201.90
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$6,542.02 – $29,725.18
Total knee replacement: 10 of 16 insurance plan rates Aetna — HMO: $28,137.92 Aetna — Medicare Advantage: $12,564.28 Aetna — PPO: $29,725.18 Amerigroup — Managed Medicaid: $11,312.88 Amerivantage — Medicare Advantage: $12,933.82 BC Illinois Community — Blue Choice: $6,542.02 BC Illinois Community — PPO: $6,542.02 Health Partners Open Network — Commercial: $23,495.88 Humana — Medicare Advantage: $12,933.82 Iowa Total Care — Managed Medicaid: $11,312.88
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR TOTAL KNEE ARTHROPLASTY (BILAT)	$8,336	$6,668.80	$1,144.67 – $7,669.12
Total knee replacement: 10 of 20 insurance plan rates Aetna — HMO: $3,026.37 Aetna — Medicare Advantage: $1,144.67 Aetna — PPO: $3,683.07 Amerivantage — Medicare Advantage: $1,201.90 BC Illinois Community — Blue Choice: $2,380.68 BC Illinois Community — PPO: $2,834.14 Cigna/Midlands — Commercial: $3,044.93 Dean Health Plan — HMO: $7,669.12 Health Partners Open Network — Commercial: $2,631.60 Humana — Medicare Advantage: $1,201.90
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: PR SHOULDER SCOPE BONE SHAVING	$663	$530.40	$151.83 – $609.96
Shoulder arthroscopy: shaving of shoulder bone: 10 of 20 insurance plan rates Aetna — HMO: $394.06 Aetna — Medicare Advantage: $151.83 Aetna — PPO: $479.84 Amerivantage — Medicare Advantage: $159.42 BC Illinois Community — Blue Choice: $318.43 BC Illinois Community — PPO: $379.08 Cigna/Midlands — Commercial: $403.73 Dean Health Plan — HMO: $609.96 Health Partners Open Network — Commercial: $329.08 Humana — Medicare Advantage: $159.42
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$857.17 – $3,613.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 3 insurance plans BC Illinois Community — Blue Choice: $857.17 BC Illinois Community — PPO: $857.17 Medical Associates Health Plan — HMO: $3,613.95
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR SHOULDER SCOPE BONE SHAVING (BILAT)	$1,326	$1,060.80	$151.83 – $1,219.92
Shoulder arthroscopy: shaving of shoulder bone: 10 of 20 insurance plan rates Aetna — HMO: $394.06 Aetna — Medicare Advantage: $151.83 Aetna — PPO: $479.84 Amerivantage — Medicare Advantage: $159.42 BC Illinois Community — Blue Choice: $318.43 BC Illinois Community — PPO: $379.08 Cigna/Midlands — Commercial: $403.73 Dean Health Plan — HMO: $1,219.92 Health Partners Open Network — Commercial: $329.08 Humana — Medicare Advantage: $159.42
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,662	$1,329.60	$490.70 – $1,661.93
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates Aetna — HMO: $1,204.90 Aetna — Medicare Advantage: $490.70 Aetna — PPO: $1,466.27 Amerivantage — Medicare Advantage: $515.24 BC Illinois Community — Blue Choice: $932.52 BC Illinois Community — PPO: $1,110.14 Cigna/Midlands — Commercial: $1,304.86 Dean Health Plan — HMO: $1,529.04 Health Partners Open Network — Commercial: $1,054.76 Humana — Medicare Advantage: $515.24
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$2,780.31 – $7,495.76
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Aetna — HMO: $7,095.50 Aetna — Medicare Advantage: $3,168.32 Aetna — PPO: $7,495.76 Amerigroup — Managed Medicaid: $2,852.76 Amerivantage — Medicare Advantage: $3,261.50 BC Illinois Community — Blue Choice: $2,780.31 BC Illinois Community — PPO: $2,780.31 Health Partners Open Network — Commercial: $5,924.93 Humana — Medicare Advantage: $3,261.50 Iowa Total Care — Managed Medicaid: $2,852.76
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG (BILAT)	$3,324	$2,659.20	$490.70 – $3,058.08
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates Aetna — HMO: $1,204.90 Aetna — Medicare Advantage: $490.70 Aetna — PPO: $1,466.27 Amerivantage — Medicare Advantage: $515.24 BC Illinois Community — Blue Choice: $932.52 BC Illinois Community — PPO: $1,110.14 Cigna/Midlands — Commercial: $1,304.86 Dean Health Plan — HMO: $3,058.08 Health Partners Open Network — Commercial: $1,054.76 Humana — Medicare Advantage: $515.24
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS/ADENOIDS,<12 Y/O	$894	$715.20	$265.42 – $893.91
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates Aetna — HMO: $648.68 Aetna — Medicare Advantage: $265.42 Aetna — PPO: $789.42 Amerivantage — Medicare Advantage: $278.69 BC Illinois Community — Blue Choice: $426.65 BC Illinois Community — PPO: $507.92 Cigna/Midlands — Commercial: $708.85 Dean Health Plan — HMO: $822.48 Health Partners Open Network — Commercial: $547.27 Humana — Medicare Advantage: $278.69
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$1,216.51 – $13,666.47
Removal of tonsils and adenoids (under age 12): 10 of 17 insurance plan rates Aetna — HMO: $12,936.71 Aetna — Medicare Advantage: $5,776.56 Aetna — PPO: $13,666.47 Amerigroup — Managed Medicaid: $5,201.22 Amerivantage — Medicare Advantage: $5,946.46 BC Illinois Community — Blue Choice: $1,216.51 BC Illinois Community — PPO: $1,216.51 Health Partners Open Network — Commercial: $10,802.48 Humana — Medicare Advantage: $5,946.46 Iowa Total Care — Managed Medicaid: $5,201.22
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$859	$687.20	$109.69 – $790.28
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — HMO: $294.87 Aetna — Medicare Advantage: $109.69 Aetna — PPO: $359.20 Amerivantage — Medicare Advantage: $115.17 BC Illinois Community — Blue Choice: $414.29 BC Illinois Community — PPO: $493.20 Cigna/Midlands — Commercial: $293.06 Dean Health Plan — HMO: $790.28 Health Partners Open Network — Commercial: $253.88 Humana — Medicare Advantage: $115.17
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$500.89 – $2,165.97
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — HMO: $2,050.31 Aetna — Medicare Advantage: $915.51 Aetna — PPO: $2,165.97 Amerigroup — Managed Medicaid: $824.33 Amerivantage — Medicare Advantage: $942.44 BC Illinois Community — Blue Choice: $500.89 BC Illinois Community — PPO: $500.89 Health Partners Open Network — Commercial: $1,712.06 Humana — Medicare Advantage: $942.44 Iowa Total Care — Managed Medicaid: $824.33
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$218.14
Upper GI endoscopy (diagnostic): rates for 1 insurance plan BC Illinois Community — PPO: $218.14
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$1,143	$914.40	$123.53 – $1,051.56
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates Aetna — HMO: $331.06 Aetna — Medicare Advantage: $123.53 Aetna — PPO: $403.43 Amerivantage — Medicare Advantage: $129.71 BC Illinois Community — Blue Choice: $632.96 BC Illinois Community — PPO: $753.52 Cigna/Midlands — Commercial: $330.99 Dean Health Plan — HMO: $1,051.56 Health Partners Open Network — Commercial: $289.14 Humana — Medicare Advantage: $129.71
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$564.42 – $2,165.97
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates Aetna — HMO: $2,050.31 Aetna — Medicare Advantage: $915.51 Aetna — PPO: $2,165.97 Amerigroup — Managed Medicaid: $824.33 Amerivantage — Medicare Advantage: $942.44 BC Illinois Community — Blue Choice: $564.42 BC Illinois Community — PPO: $564.42 Health Partners Open Network — Commercial: $1,712.06 Humana — Medicare Advantage: $942.44 Iowa Total Care — Managed Medicaid: $824.33
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$289.71
Upper GI endoscopy with biopsy: rates for 1 insurance plan BC Illinois Community — PPO: $289.71
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$1,017	$813.60	$164.67 – $935.64
Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — HMO: $478.47 Aetna — Medicare Advantage: $164.67 Aetna — PPO: $581.68 Amerivantage — Medicare Advantage: $172.90 BC Illinois Community — Blue Choice: $572.11 BC Illinois Community — PPO: $681.08 Cigna/Midlands — Commercial: $439.77 Dean Health Plan — HMO: $935.64 Health Partners Open Network — Commercial: $404.53 Humana — Medicare Advantage: $172.90
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$801.60 – $2,106.25
Colonoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — HMO: $1,993.78 Aetna — Medicare Advantage: $890.27 Aetna — PPO: $2,106.25 Amerigroup — Managed Medicaid: $801.60 Amerivantage — Medicare Advantage: $916.46 BC Illinois Community — Blue Choice: $993.29 BC Illinois Community — PPO: $993.29 Health Partners Open Network — Commercial: $1,664.86 Humana — Medicare Advantage: $916.46 Iowa Total Care — Managed Medicaid: $801.60
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$82.56 – $220.27
Colonoscopy (diagnostic): rates for 10 insurance plans Aetna — Medicare Advantage: $82.56 Amerivantage — Medicare Advantage: $86.69 Cigna/Midlands — Commercial: $220.27 Health Partners Open Network — Commercial: $167.21 Humana — Medicare Advantage: $86.69 Medical Associates Health Plan — HMO: $152.74 Meridian — MMAI (Medicare-Medicaid): $86.69 Molina — Medicare Advantage: $84.21 United Healthcare — Medicare Advantage: $86.69 Wellmark Blue Cross and Blue Shield — Medicare Advantage: $84.21
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$1,309	$1,047.20	$179.10 – $1,204.28
Colonoscopy with biopsy: 10 of 20 insurance plan rates Aetna — HMO: $572.30 Aetna — Medicare Advantage: $179.10 Aetna — PPO: $695.60 Amerivantage — Medicare Advantage: $188.06 BC Illinois Community — Blue Choice: $723.62 BC Illinois Community — PPO: $861.45 Cigna/Midlands — Commercial: $478.46 Dean Health Plan — HMO: $1,204.28 Health Partners Open Network — Commercial: $484.27 Humana — Medicare Advantage: $188.06
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$1,036.68 – $2,723.94
Colonoscopy with biopsy: 10 of 17 insurance plan rates Aetna — HMO: $2,578.49 Aetna — Medicare Advantage: $1,151.36 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $1,036.68 Amerivantage — Medicare Advantage: $1,185.22 BC Illinois Community — Blue Choice: $1,147.16 BC Illinois Community — PPO: $1,147.16 Health Partners Open Network — Commercial: $2,153.10 Humana — Medicare Advantage: $1,185.22 Iowa Total Care — Managed Medicaid: $1,036.68
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$412.30
Colonoscopy with biopsy: rates for 1 insurance plan BC Illinois Community — PPO: $412.30
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,371	$1,096.80	$226.39 – $1,261.32
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates Aetna — HMO: $678.17 Aetna — Medicare Advantage: $226.39 Aetna — PPO: $825.61 Amerivantage — Medicare Advantage: $237.71 BC Illinois Community — Blue Choice: $764.67 BC Illinois Community — PPO: $910.32 Cigna/Midlands — Commercial: $605.71 Dean Health Plan — HMO: $1,261.32 Health Partners Open Network — Commercial: $574.03 Humana — Medicare Advantage: $237.71
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$1,036.68 – $2,723.94
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates Aetna — HMO: $2,578.49 Aetna — Medicare Advantage: $1,151.36 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $1,036.68 Amerivantage — Medicare Advantage: $1,185.22 BC Illinois Community — Blue Choice: $1,449.66 BC Illinois Community — PPO: $1,449.66 Health Partners Open Network — Commercial: $2,153.10 Humana — Medicare Advantage: $1,185.22 Iowa Total Care — Managed Medicaid: $1,036.68
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$522.15
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan BC Illinois Community — PPO: $522.15
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$815	$652	$229.83 – $814.61
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates Aetna — HMO: $651.37 Aetna — Medicare Advantage: $229.83 Aetna — PPO: $792.09 Amerivantage — Medicare Advantage: $241.32 BC Illinois Community — Blue Choice: $379.29 BC Illinois Community — PPO: $451.53 Cigna/Midlands — Commercial: $614.96 Dean Health Plan — HMO: $749.80 Health Partners Open Network — Commercial: $552.59 Humana — Medicare Advantage: $241.32
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$1,036.68 – $2,723.94
Ultrasound of the lower bowel by endoscope: 10 of 16 insurance plan rates Aetna — HMO: $2,578.49 Aetna — Medicare Advantage: $1,151.36 Aetna — PPO: $2,723.94 Amerigroup — Managed Medicaid: $1,036.68 Amerivantage — Medicare Advantage: $1,185.22 BC Illinois Community — Blue Choice: $1,050.40 BC Illinois Community — PPO: $1,050.40 Health Partners Open Network — Commercial: $2,153.10 Humana — Medicare Advantage: $1,185.22 Iowa Total Care — Managed Medicaid: $1,036.68
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: PR COLON CA SCRN NOT HI RSK IND	$1,017	$813.60	$164.82 – $935.64
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — HMO: $446.33 Aetna — Medicare Advantage: $164.82 Aetna — PPO: $530.75 Amerivantage — Medicare Advantage: $173.06 BC Illinois Community — Blue Choice: $608.19 BC Illinois Community — PPO: $724.04 Cigna/Midlands — Commercial: $431.86 Dean Health Plan — HMO: $935.64 Health Partners Open Network — Commercial: $383.51 Humana — Medicare Advantage: $173.06
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$801.60 – $2,106.25
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates Aetna — HMO: $1,993.78 Aetna — Medicare Advantage: $890.27 Aetna — PPO: $2,106.25 Amerigroup — Managed Medicaid: $801.60 Amerivantage — Medicare Advantage: $916.46 BC Illinois Community — Blue Choice: $941.16 BC Illinois Community — PPO: $941.16 Health Partners Open Network — Commercial: $1,664.86 Humana — Medicare Advantage: $916.46 Iowa Total Care — Managed Medicaid: $801.60
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$82.56 – $216.50
Screening colonoscopy (not high risk): rates for 9 insurance plans Aetna — Medicare Advantage: $82.56 Amerivantage — Medicare Advantage: $86.69 Cigna/Midlands — Commercial: $216.50 Health Partners Open Network — Commercial: $112.46 Humana — Medicare Advantage: $86.69 Meridian — MMAI (Medicare-Medicaid): $86.69 Molina — Medicare Advantage: $84.21 United Healthcare — Medicare Advantage: $86.69 Wellmark Blue Cross and Blue Shield — Medicare Advantage: $84.21
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: PR LAP,CHOLECYSTECTOMY	$2,018	$1,614.40	$583.24 – $2,017.34
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — HMO: $1,467.60 Aetna — Medicare Advantage: $583.24 Aetna — PPO: $1,786.59 Amerivantage — Medicare Advantage: $612.40 BC Illinois Community — Blue Choice: $1,016.60 BC Illinois Community — PPO: $1,210.24 Cigna/Midlands — Commercial: $1,552.71 Dean Health Plan — HMO: $1,856.56 Health Partners Open Network — Commercial: $1,252.26 Humana — Medicare Advantage: $612.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$5,129.74 – $13,478.66
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates Aetna — HMO: $12,758.93 Aetna — Medicare Advantage: $5,697.18 Aetna — PPO: $13,478.66 Amerigroup — Managed Medicaid: $5,129.74 Amerivantage — Medicare Advantage: $5,864.74 BC Illinois Community — Blue Choice: $10,246.12 BC Illinois Community — PPO: $11,411.40 Health Partners Open Network — Commercial: $10,654.03 Humana — Medicare Advantage: $5,864.74 Iowa Total Care — Managed Medicaid: $5,129.74
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REPAIR ING HERNIA,5+Y/O,REDUCIBL	$1,597	$1,277.60	$463.79 – $1,596.17
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — HMO: $1,159.33 Aetna — Medicare Advantage: $463.79 Aetna — PPO: $1,411.33 Amerivantage — Medicare Advantage: $486.98 BC Illinois Community — Blue Choice: $797.02 BC Illinois Community — PPO: $948.83 Cigna/Midlands — Commercial: $1,233.87 Dean Health Plan — HMO: $1,469.24 Health Partners Open Network — Commercial: $962.18 Humana — Medicare Advantage: $486.98
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$3,102.85 – $11,411.40
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Aetna — HMO: $7,717.55 Aetna — Medicare Advantage: $3,446.08 Aetna — PPO: $8,152.90 Amerigroup — Managed Medicaid: $3,102.85 Amerivantage — Medicare Advantage: $3,547.44 BC Illinois Community — Blue Choice: $10,246.12 BC Illinois Community — PPO: $11,411.40 Health Partners Open Network — Commercial: $6,444.36 Humana — Medicare Advantage: $3,547.44 Iowa Total Care — Managed Medicaid: $3,102.85
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REPAIR ING HERNIA,5+Y/O,REDUCIBL (BILAT)	$3,194	$2,555.20	$463.79 – $2,938.48
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — HMO: $1,159.33 Aetna — Medicare Advantage: $463.79 Aetna — PPO: $1,411.33 Amerivantage — Medicare Advantage: $486.98 BC Illinois Community — Blue Choice: $797.02 BC Illinois Community — PPO: $948.83 Cigna/Midlands — Commercial: $1,233.87 Dean Health Plan — HMO: $2,938.48 Health Partners Open Network — Commercial: $962.18 Humana — Medicare Advantage: $486.98
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: PR BIOPSY OF PROSTATE,NEEDLE/PUNCH	$767	$613.60	$116.75 – $705.64
Prostate biopsy: 10 of 20 insurance plan rates Aetna — HMO: $309.61 Aetna — Medicare Advantage: $116.75 Aetna — PPO: $376.62 Amerivantage — Medicare Advantage: $122.59 BC Illinois Community — Blue Choice: $402.12 BC Illinois Community — PPO: $478.72 Cigna/Midlands — Commercial: $312.41 Dean Health Plan — HMO: $705.64 Health Partners Open Network — Commercial: $261.61 Humana — Medicare Advantage: $122.59
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Outpatient Services	Not listed in the file	Not listed in the file	$708.34 – $4,732.50
Prostate biopsy: rates for 9 insurance plans Aetna — Medicare Advantage: $2,000.34 Amerigroup — Managed Medicaid: $1,801.11 Amerivantage — Medicare Advantage: $2,059.18 Humana — Medicare Advantage: $2,059.18 Iowa Total Care — Managed Medicaid: $1,801.11 Meridian — MMAI (Medicare-Medicaid): $2,274.90 Molina — Medicare Advantage: $2,000.34 United Healthcare — Medicare Advantage: $2,059.18 Wellmark Blue Cross and Blue Shield — Medicare Advantage: $2,000.34
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Addendum B Codes	Not listed in the file	Not listed in the file	$708.34 – $4,732.50
Prostate biopsy: rates for 3 insurance plans Health Partners Open Network — Commercial: $3,740.74 United Healthcare — HMO: $4,318.98 United Healthcare — PPO: $4,318.98
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: PR LAP,PROSTATECTOMY,RADICAL,W/NERVE SPARE	$4,560	$3,648	$1,078.87 – $4,678.90
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates Aetna — HMO: $3,845.28 Aetna — Medicare Advantage: $1,078.87 Aetna — PPO: $4,678.90 Amerivantage — Medicare Advantage: $1,132.81 BC Illinois Community — Blue Choice: $2,423.34 BC Illinois Community — PPO: $2,884.93 Cigna/Midlands — Commercial: $2,875.94 Dean Health Plan — HMO: $4,195.20 Health Partners Open Network — Commercial: $3,287.65 Humana — Medicare Advantage: $1,132.81
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$6,529.19 – $24,052.21
Prostate removal by laparoscope (radical prostatectomy): 10 of 16 insurance plan rates Aetna — HMO: $22,767.87 Aetna — Medicare Advantage: $10,166.42 Aetna — PPO: $24,052.21 Amerigroup — Managed Medicaid: $9,153.85 Amerivantage — Medicare Advantage: $10,465.43 BC Illinois Community — Blue Choice: $6,529.19 BC Illinois Community — PPO: $6,529.19 Health Partners Open Network — Commercial: $19,011.75 Humana — Medicare Advantage: $10,465.43 Iowa Total Care — Managed Medicaid: $9,153.85
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: PR HYSTEROSCOPY,W/ENDO BX	$784	$627.20	$206.22 – $2,525.33
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna — HMO: $587.05 Aetna — Medicare Advantage: $206.22 Aetna — PPO: $714.35 Amerivantage — Medicare Advantage: $216.53 BC Illinois Community — Blue Choice: $2,121.28 BC Illinois Community — PPO: $2,525.33 Cigna/Midlands — Commercial: $551.60 Dean Health Plan — HMO: $721.28 Health Partners Open Network — Commercial: $498.47 Humana — Medicare Advantage: $216.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$2,795.53 – $11,411.40
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates Aetna — HMO: $6,953.17 Aetna — Medicare Advantage: $3,104.77 Aetna — PPO: $7,345.40 Amerigroup — Managed Medicaid: $2,795.53 Amerivantage — Medicare Advantage: $3,196.09 BC Illinois Community — Blue Choice: $10,246.12 BC Illinois Community — PPO: $11,411.40 Health Partners Open Network — Commercial: $5,806.08 Humana — Medicare Advantage: $3,196.09 Iowa Total Care — Managed Medicaid: $2,795.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee · modifier st In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$481.51
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan BC Illinois Community — PPO: $481.51
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ INTERLAM L/S W IMG	$1,512.89	$1,210.32	$452.84 – $1,599.88
Spinal injection, lower back (epidural), with imaging guidance: 10 of 22 insurance plan rates Aetna — HMO: $1,514.45 Aetna — Medicare Advantage: $676.24 Aetna — PPO: $1,599.88 Amerigroup — Managed Medicaid: $608.89 Amerivantage — Medicare Advantage: $696.13 BC Illinois Community — Blue Choice: $452.84 BC Illinois Community — PPO: $452.84 Cigna/Midlands — Commercial: $798.81 Dean Health Plan — HMO: $1,210.31 Health Partners Open Network — Commercial: $1,264.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$787	$629.60	$90.27 – $724.04
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates Aetna — Medicare Advantage: $90.27 Amerivantage — Medicare Advantage: $94.78 BC Illinois Community — Blue Choice: $400.04 BC Illinois Community — PPO: $476.24 Cigna/Midlands — Commercial: $240.96 Dean Health Plan — HMO: $724.04 Health Partners Open Network — Commercial: $179.07 Humana — Medicare Advantage: $94.78 Medical Associates Health Plan — HMO: $167 Meridian — MMAI (Medicare-Medicaid): $94.78
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJ INTERLAM L/S W IMG	$1,512.89	$1,210.32	$798.81 – $1,210.31
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans Cigna/Midlands — Commercial: $798.81 Dean Health Plan — HMO: $1,210.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ(S) FORAMEN EPID L/S SGL LEV BILAT	$4,157.90	$3,326.32	$504.69 – $3,326.32
Nerve root injection, lower back, with imaging guidance: 10 of 22 insurance plan rates Aetna — HMO: $1,946.94 Aetna — Medicare Advantage: $869.36 Aetna — PPO: $2,056.77 Amerigroup — Managed Medicaid: $782.77 Amerivantage — Medicare Advantage: $894.93 BC Illinois Community — Blue Choice: $504.69 BC Illinois Community — PPO: $504.69 Cigna/Midlands — Commercial: $2,195.37 Dean Health Plan — HMO: $3,326.32 Health Partners Open Network — Commercial: $1,625.74
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$2,078.95	$1,663.16	$765.05 – $8,778
Nerve root injection, lower back, with imaging guidance: 10 of 22 insurance plan rates Aetna — HMO: $1,946.94 Aetna — Medicare Advantage: $869.36 Aetna — PPO: $2,056.77 Amerigroup — Managed Medicaid: $782.77 Amerivantage — Medicare Advantage: $894.93 BC Illinois Community — Blue Choice: $7,680.75 BC Illinois Community — PPO: $8,778 Cigna/Midlands — Commercial: $1,097.69 Dean Health Plan — HMO: $1,663.16 Health Partners Open Network — Commercial: $1,625.74
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$728	$582.40	$101.33 – $669.76
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates Aetna — HMO: $250.62 Aetna — Medicare Advantage: $101.33 Aetna — PPO: $305.59 Amerivantage — Medicare Advantage: $106.40 BC Illinois Community — Blue Choice: $369.88 BC Illinois Community — PPO: $440.33 Cigna/Midlands — Commercial: $270.25 Dean Health Plan — HMO: $669.76 Health Partners Open Network — Commercial: $210.64 Humana — Medicare Advantage: $106.40
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG	$1,337	$1,069.60	$397.78 – $1,317.94
Carpal tunnel release: 10 of 20 insurance plan rates Aetna — HMO: $946.25 Aetna — Medicare Advantage: $397.78 Aetna — PPO: $1,151.29 Amerivantage — Medicare Advantage: $417.67 BC Illinois Community — Blue Choice: $727.63 BC Illinois Community — PPO: $866.23 Cigna/Midlands — Commercial: $1,056.77 Dean Health Plan — HMO: $1,230.04 Health Partners Open Network — Commercial: $792.94 Humana — Medicare Advantage: $417.67
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,716.94 – $4,511.34
Carpal tunnel release: 10 of 17 insurance plan rates Aetna — HMO: $4,270.44 Aetna — Medicare Advantage: $1,906.85 Aetna — PPO: $4,511.34 Amerigroup — Managed Medicaid: $1,716.94 Amerivantage — Medicare Advantage: $1,962.94 BC Illinois Community — Blue Choice: $1,988 BC Illinois Community — PPO: $1,988 Health Partners Open Network — Commercial: $3,565.93 Humana — Medicare Advantage: $1,962.94 Iowa Total Care — Managed Medicaid: $1,716.94
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG (BILAT)	$2,674	$2,139.20	$397.78 – $2,460.08
Carpal tunnel release: 10 of 20 insurance plan rates Aetna — HMO: $946.25 Aetna — Medicare Advantage: $397.78 Aetna — PPO: $1,151.29 Amerivantage — Medicare Advantage: $417.67 BC Illinois Community — Blue Choice: $727.63 BC Illinois Community — PPO: $866.23 Cigna/Midlands — Commercial: $1,056.77 Dean Health Plan — HMO: $2,460.08 Health Partners Open Network — Commercial: $792.94 Humana — Medicare Advantage: $417.67
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: PR DISCISSION,2ND CATARACT,LASER	$1,025	$820	$278.82 – $961.39
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates Aetna — HMO: $679.52 Aetna — Medicare Advantage: $278.82 Aetna — PPO: $826.95 Amerivantage — Medicare Advantage: $292.76 BC Illinois Community — Blue Choice: $468.21 BC Illinois Community — PPO: $557.39 Cigna/Midlands — Commercial: $751.91 Dean Health Plan — HMO: $943 Health Partners Open Network — Commercial: $565.32 Humana — Medicare Advantage: $292.76
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$481.95 – $1,460.62
Laser treatment of clouding after cataract surgery: 10 of 17 insurance plan rates Aetna — HMO: $1,199.72 Aetna — Medicare Advantage: $535.70 Aetna — PPO: $1,267.39 Amerigroup — Managed Medicaid: $482.35 Amerivantage — Medicare Advantage: $551.46 BC Illinois Community — Blue Choice: $1,460.62 BC Illinois Community — PPO: $1,460.62 Health Partners Open Network — Commercial: $1,001.80 Humana — Medicare Advantage: $551.46 Iowa Total Care — Managed Medicaid: $482.35
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR DISCISSION,2ND CATARACT,LASER (BILAT)	$2,050	$1,640	$278.82 – $1,886
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates Aetna — HMO: $679.52 Aetna — Medicare Advantage: $278.82 Aetna — PPO: $826.95 Amerivantage — Medicare Advantage: $292.76 BC Illinois Community — Blue Choice: $468.21 BC Illinois Community — PPO: $557.39 Cigna/Midlands — Commercial: $751.91 Dean Health Plan — HMO: $1,886 Health Partners Open Network — Commercial: $565.32 Humana — Medicare Advantage: $292.76
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$1,697	$1,357.60	$488.93 – $1,702.14
Cataract removal with lens implant: 10 of 20 insurance plan rates Aetna — HMO: $1,397.91 Aetna — Medicare Advantage: $488.93 Aetna — PPO: $1,702.14 Amerivantage — Medicare Advantage: $513.38 BC Illinois Community — Blue Choice: $885.91 BC Illinois Community — PPO: $1,054.65 Cigna/Midlands — Commercial: $1,312.39 Dean Health Plan — HMO: $1,561.24 Health Partners Open Network — Commercial: $1,221.90 Humana — Medicare Advantage: $513.38
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$2,005.28 – $5,268.99
Cataract removal with lens implant: 10 of 17 insurance plan rates Aetna — HMO: $4,987.63 Aetna — Medicare Advantage: $2,227.10 Aetna — PPO: $5,268.99 Amerigroup — Managed Medicaid: $2,005.28 Amerivantage — Medicare Advantage: $2,292.61 BC Illinois Community — Blue Choice: $2,648.74 BC Illinois Community — PPO: $2,648.74 Health Partners Open Network — Commercial: $4,164.80 Humana — Medicare Advantage: $2,292.61 Iowa Total Care — Managed Medicaid: $2,005.28
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee · modifier 50 In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP (BILAT)	$3,394	$2,715.20	$488.93 – $3,122.48
Cataract removal with lens implant: 10 of 20 insurance plan rates Aetna — HMO: $1,397.91 Aetna — Medicare Advantage: $488.93 Aetna — PPO: $1,702.14 Amerivantage — Medicare Advantage: $513.38 BC Illinois Community — Blue Choice: $885.91 BC Illinois Community — PPO: $1,054.65 Cigna/Midlands — Commercial: $1,312.39 Dean Health Plan — HMO: $3,122.48 Health Partners Open Network — Commercial: $1,221.90 Humana — Medicare Advantage: $513.38

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FULL ROUT OBSTE CARE,VAGINAL DELIV	$5,690	$4,552	$2,106.28 – $5,372.16
Vaginal delivery, with care before and after: 10 of 20 insurance plan rates Aetna — HMO: $3,818.48 Aetna — Medicare Advantage: $2,106.28 Aetna — PPO: $4,144.15 Amerivantage — Medicare Advantage: $2,211.59 BC Illinois Community — Blue Choice: $3,049.25 BC Illinois Community — PPO: $3,630.06 Cigna/Midlands — Commercial: $5,338.68 Dean Health Plan — HMO: $5,234.80 Health Partners Open Network — Commercial: $3,299.55 Humana — Medicare Advantage: $2,211.59
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$9,959.30
Vaginal delivery, with care before and after: rates for 2 insurance plans BC Illinois Community — Blue Choice: $9,959.30 BC Illinois Community — PPO: $9,959.30
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: PR FULL ROUT OBSTE CARE,CESAREAN DELIV	$5,924	$4,739.20	$2,322.97 – $5,923.56
Cesarean delivery (C-section), with care before and after: 10 of 20 insurance plan rates Aetna — HMO: $4,219.22 Aetna — Medicare Advantage: $2,322.97 Aetna — PPO: $4,577.08 Amerivantage — Medicare Advantage: $2,439.12 BC Illinois Community — Blue Choice: $3,393.26 BC Illinois Community — PPO: $4,039.60 Cigna/Midlands — Commercial: $5,892.65 Dean Health Plan — HMO: $5,450.08 Health Partners Open Network — Commercial: $3,666.23 Humana — Medicare Advantage: $2,439.12
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$10,758.41
Cesarean delivery (C-section), with care before and after: rates for 2 insurance plans BC Illinois Community — Blue Choice: $10,758.41 BC Illinois Community — PPO: $10,758.41
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: PR ROUT OB CARE,VAG DELIV,PREV C-SEC	$5,615	$4,492	$2,188.50 – $5,614.60
Vaginal delivery after a previous C-section, with care before and after: 10 of 20 insurance plan rates Aetna — HMO: $4,000.73 Aetna — Medicare Advantage: $2,188.50 Aetna — PPO: $4,341.19 Amerivantage — Medicare Advantage: $2,297.93 BC Illinois Community — Blue Choice: $3,201.68 BC Illinois Community — PPO: $3,811.52 Cigna/Midlands — Commercial: $5,551.23 Dean Health Plan — HMO: $5,165.80 Health Partners Open Network — Commercial: $3,460.25 Humana — Medicare Advantage: $2,297.93
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$12,892.29
Vaginal delivery after a previous C-section, with care before and after: rates for 2 insurance plans BC Illinois Community — Blue Choice: $12,892.29 BC Illinois Community — PPO: $12,892.29

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$53,499.23 – $128,376.18
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 20 insurance plan rates Aetna — HMO: $91,781.96 Aetna — Medicare Advantage: $69,302.70 Aetna — PPO: $98,489.48 Amerigroup — Managed Medicaid: $75,419.39 Amerivantage — Medicare Advantage: $71,341.01 BC Illinois Community — Blue Choice: $53,499.23 BC Illinois Community — PPO: $67,057.19 Health Partners Open Network — Commercial: $112,387.06 Humana — Medicare Advantage: $71,341.01 Iowa Total Care — Managed Medicaid: $75,419.39
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$10,451.95 – $26,331.88
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates Aetna — HMO: $17,931.11 Aetna — Medicare Advantage: $13,709.08 Aetna — PPO: $19,241.53 Amerigroup — Managed Medicaid: $14,734.41 Amerivantage — Medicare Advantage: $14,112.28 BC Illinois Community — Blue Choice: $10,451.95 BC Illinois Community — PPO: $13,100.72 Health Partners Open Network — Commercial: $21,956.65 Humana — Medicare Advantage: $14,112.28 Iowa Total Care — Managed Medicaid: $14,734.41
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$13,123.28 – $32,664.31
Neck (cervical) spinal fusion, without complications: 10 of 20 insurance plan rates Aetna — HMO: $22,513.97 Aetna — Medicare Advantage: $17,158.98 Aetna — PPO: $24,159.32 Amerigroup — Managed Medicaid: $18,500.26 Amerivantage — Medicare Advantage: $17,663.66 BC Illinois Community — Blue Choice: $13,123.28 BC Illinois Community — PPO: $16,449.03 Health Partners Open Network — Commercial: $27,568.37 Humana — Medicare Advantage: $17,663.66 Iowa Total Care — Managed Medicaid: $18,500.26
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$6,644.79 – $17,306.93
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates Aetna — HMO: $11,399.64 Aetna — Medicare Advantage: $8,792.31 Aetna — PPO: $12,232.73 Amerigroup — Managed Medicaid: $9,367.35 Amerivantage — Medicare Advantage: $9,050.91 BC Illinois Community — Blue Choice: $6,644.79 BC Illinois Community — PPO: $8,328.74 Health Partners Open Network — Commercial: $13,958.86 Humana — Medicare Advantage: $9,050.91 Iowa Total Care — Managed Medicaid: $9,367.35

Source: Finley Hospital’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 28, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	350 North Grandview Avenue, Dubuque, IA 52001
County	Dubuque County
State	Iowa
Phone	(563) 582‑1881
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	160117
Name in Medicare records	FINLEY HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	UnityPoint Health - Finley Hospital
Official website	unitypoint.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

UnityPoint Health - Finley Hospital — unitypoint.org
UnityPoint Health - Finley Hospital Emergency Department — unitypoint.org
Babka Surgery Center - UnityPoint Health - Finley Hospital — unitypoint.org
Patients and Visitors - UnityPoint Health - Finley Hospital — unitypoint.org
Heart Care - UnityPoint Health - Finley Hospital — unitypoint.org
Birth Center - UnityPoint Health - Finley Hospital — unitypoint.org
Behavioral Health - UnityPoint Health - Finley Hospital — unitypoint.org
Sleep Center - UnityPoint Health - Finley Hospital — unitypoint.org
Palliative Care at UnityPoint Health - Finley Hospital — unitypoint.org
Pain Clinic - UnityPoint Health - Finley Hospital — unitypoint.org

Finley Hospital

Summary

Profile from official sources

At a glance