Does Fisher-Titus Hospital have an emergency room?

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

Where is Fisher-Titus Hospital?

272 Benedict Avenue, Norwalk, OH 44857, in Huron County, Ohio.

What is the phone number of Fisher-Titus Hospital?

(419) 668-8101, as listed by Medicare (CMS).

What is the Medicare star rating of Fisher-Titus Hospital?

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

Fisher-Titus Hospital — Norwalk, OH

Quick answers

Does Fisher-Titus Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Fisher-Titus Hospital. In a medical emergency, call 911.
Where is Fisher-Titus Hospital?: 272 Benedict Avenue, Norwalk, OH 44857, in Huron County, Ohio.
What is the phone number of Fisher-Titus Hospital?: (419) 668-8101, as listed by Medicare (CMS).
What is the Medicare star rating of Fisher-Titus Hospital?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][5][7][8][9][11][12][13][14][16]}

Conditions treated^[8]

Treatments^[5][9]

Procedures^[5]

Endoscopy
Robotic-assisted surgery

Programs and centers^[4][7][8][9]

Same-Day Care
Cancer Care Center
Snyder White Heart and Vascular Center
Ralph and Alice Walcher Rehabilitation Center (inpatient and outpatient rehabilitation)

Emergency care (hospital website)^[4][5][15]

Emergency room	Yes

Visiting and practical information

Parking	Use Patient & Visitors Parking area C, then the Patient Pavilion main entrance^[10]

Doctors and clinicians (311)

311 doctors and other clinicians list Fisher-Titus 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 287 more: the button below opens the full list.

Other emergency rooms nearby

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

Mercy Health - Willard Hospital11 mi · Willard, OH · Critical Access Hospital
Bellevue Hospital15 mi · Bellevue, OH · Acute Care Hospital
Firelands Regional Medical Center16 mi · Sandusky, OH · Acute Care Hospital
Mercy Allen Hospital21 mi · Oberlin, OH · Critical Access Hospital
Mercy Regional Medical Center24 mi · Lorain, OH · Acute Care Hospital

Other hospitals nearby

OhioHealth Shelby Hospital24 mi · Shelby, OH · Critical Access Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Norwalk Memorial Home0.0 mi · Norwalk, OH · 5 of 5 stars
Carecore at Gaymont0.9 mi · Norwalk, OH · 2 of 5 stars
Twilight Gardens Nursing and Rehabilitation1.7 mi · Norwalk, OH · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Stein Hospice Services, Inc15 mi · Sandusky, OH · 4 of 5 stars
Mercy Health-New Life Hospice24 mi · Lorain, OH · 4 of 5 stars
Wellspring Hospice24 mi · Lorain, OH · 2 of 5 stars

All hospice providers in the state →

Home health agencies

Comfort Keepers1.5 mi · Norwalk, OH
Fisher Titus Home Health Center1.5 mi · Norwalk, OH
Cambridge Home Health Care15 mi · Sandusky, OH

All home health agencies in the state →

Dialysis facilities

FMC - Norwalk1.5 mi · Norwalk, OH · 3 of 5 stars
FMC - Willard11 mi · Willard, OH
Firelands Bellevue Dialysis Center13 mi · Bellevue, OH · 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.

Podiatric Surgicenter1.5 mi · Norwalk, OH
The Surgery Center of North Central Ohio LLC1.5 mi · Norwalk, OH
Erie Shores Surgery Center15 mi · Sandusky, OH

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

FHS Norwalk - 265 Benedict Ave0.1 mi · Norwalk, OH · Community health center
ECCHC Norwalk Health Center1.5 mi · Norwalk, OH · Community health center
FHS - BH @ Edison Elementary School4.6 mi · Milan, OH · Community health center

Clinics and urgent care

Samaritan Regional Health System14 mi · New London, OH · Urgent care center
North Coast Professional Company, LLC15 mi · Sandusky, OH · Urgent care center
Northern Ohio Medical Specialists, LLC15 mi · Sandusky, OH · Urgent care center

Pharmacies

Discount Drug Mart Inc1.5 mi · Norwalk, OH · Community/retail pharmacy
Fisher-Titus Medical Center1.5 mi · Norwalk, OH · Pharmacy
Ohio CVS Stores LLC1.5 mi · Norwalk, OH · Pharmacy

Assisted living nearby

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

Carriage House of Fisher-Titus1.5 mi · Norwalk, OH
Regent of Willard11 mi · Willard, OH
The Willows at Willard11 mi · Willard, OH
Orchard Grove13 mi · Bellevue, OH

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	65%National average: 72%
Would definitely recommend the hospital	62%National average: 71%
Nurses “always” communicated well	78%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	80%National average: 74%
Area around the room “always” quiet at night	55%National average: 60%
Completed surveys	593Response rate: 22%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.382No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 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	12.3%
Deaths within 30 days: heart failure patients	11.1%
Deaths within 30 days: pneumonia patients	13.4%
Deaths within 30 days: COPD patients	8.2%
Deaths within 30 days: stroke patients	16.5%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.92No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.4%
Readmitted within 30 days: heart failure	22.2%
Readmitted within 30 days: pneumonia	16.6%
Readmitted within 30 days: COPD	19.8%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	124 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)	73%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Ohio Best hospitals in Ohio

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Fisher-Titus Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT NEW INTER	$317	$285.30	$95.10 – $307.49
New patient office visit (about 30–44 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $275.79 Aetna — AetnaMedicare: $95.10 Anthem — AnthemBluePOS/PPO: $282.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $155.33 Anthem — AnthemTraditional: $288.47 Cigna — CignaCommercialHMO: $253.60 Cigna — CignaCommercialPPO: $253.60 ClaimsDoc — ClaimsDoc: $253.60 Emerald Health — Emerald Health: $307.49 First Health — First Health: $285.30
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPAT VISIT NEW LEV 3	$317	$285.30	$95.10 – $307.49
New patient office visit (about 30–44 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $275.79 Aetna — AetnaMedicare: $95.10 Anthem — AnthemBluePOS/PPO: $282.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $155.33 Anthem — AnthemTraditional: $288.47 Cigna — CignaCommercialHMO: $253.60 Cigna — CignaCommercialPPO: $253.60 ClaimsDoc — ClaimsDoc: $253.60 Emerald Health — Emerald Health: $307.49 First Health — First Health: $285.30
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT - NEW INTERMEDIATE	$317	$285.30	$95.10 – $307.49
New patient office visit (about 30–44 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $275.79 Aetna — AetnaMedicare: $95.10 Anthem — AnthemBluePOS/PPO: $282.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $155.33 Anthem — AnthemTraditional: $288.47 Cigna — CignaCommercialHMO: $253.60 Cigna — CignaCommercialPPO: $253.60 ClaimsDoc — ClaimsDoc: $253.60 Emerald Health — Emerald Health: $307.49 First Health — First Health: $285.30
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPAT VISIT NEW LEV 4	$361	$324.90	$108.30 – $350.17
New patient office visit (about 45–59 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $314.07 Aetna — AetnaMedicare: $108.30 Anthem — AnthemBluePOS/PPO: $321.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $176.89 Anthem — AnthemTraditional: $328.51 Cigna — CignaCommercialHMO: $288.80 Cigna — CignaCommercialPPO: $288.80 ClaimsDoc — ClaimsDoc: $288.80 Emerald Health — Emerald Health: $350.17 First Health — First Health: $324.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT NEW EXTEND	$361	$324.90	$108.30 – $350.17
New patient office visit (about 45–59 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $314.07 Aetna — AetnaMedicare: $108.30 Anthem — AnthemBluePOS/PPO: $321.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $176.89 Anthem — AnthemTraditional: $328.51 Cigna — CignaCommercialHMO: $288.80 Cigna — CignaCommercialPPO: $288.80 ClaimsDoc — ClaimsDoc: $288.80 Emerald Health — Emerald Health: $350.17 First Health — First Health: $324.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT - NEW EXTENDED	$361	$324.90	$108.30 – $350.17
New patient office visit (about 45–59 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $314.07 Aetna — AetnaMedicare: $108.30 Anthem — AnthemBluePOS/PPO: $321.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $176.89 Anthem — AnthemTraditional: $328.51 Cigna — CignaCommercialHMO: $288.80 Cigna — CignaCommercialPPO: $288.80 ClaimsDoc — ClaimsDoc: $288.80 Emerald Health — Emerald Health: $350.17 First Health — First Health: $324.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT NEW COMPLEX	$387	$348.30	$116.10 – $375.39
New patient office visit (about 60–74 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $336.69 Aetna — AetnaMedicare: $116.10 Anthem — AnthemBluePOS/PPO: $344.43 Anthem — AnthemPathwayHMO/HIC/Tiered: $189.63 Anthem — AnthemTraditional: $352.17 Cigna — CignaCommercialHMO: $309.60 Cigna — CignaCommercialPPO: $309.60 ClaimsDoc — ClaimsDoc: $309.60 Emerald Health — Emerald Health: $375.39 First Health — First Health: $348.30
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPAT VISIT NEW LEV 5	$387	$348.30	$116.10 – $375.39
New patient office visit (about 60–74 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $336.69 Aetna — AetnaMedicare: $116.10 Anthem — AnthemBluePOS/PPO: $344.43 Anthem — AnthemPathwayHMO/HIC/Tiered: $189.63 Anthem — AnthemTraditional: $352.17 Cigna — CignaCommercialHMO: $309.60 Cigna — CignaCommercialPPO: $309.60 ClaimsDoc — ClaimsDoc: $309.60 Emerald Health — Emerald Health: $375.39 First Health — First Health: $348.30
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT - NEW COMPLEX	$387	$348.30	$116.10 – $375.39
New patient office visit (about 60–74 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $336.69 Aetna — AetnaMedicare: $116.10 Anthem — AnthemBluePOS/PPO: $344.43 Anthem — AnthemPathwayHMO/HIC/Tiered: $189.63 Anthem — AnthemTraditional: $352.17 Cigna — CignaCommercialHMO: $309.60 Cigna — CignaCommercialPPO: $309.60 ClaimsDoc — ClaimsDoc: $309.60 Emerald Health — Emerald Health: $375.39 First Health — First Health: $348.30
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT EST INTER	$241	$216.90	$72.30 – $233.77
Established patient office visit (about 20–29 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $209.67 Aetna — AetnaMedicare: $72.30 Anthem — AnthemBluePOS/PPO: $214.49 Anthem — AnthemPathwayHMO/HIC/Tiered: $118.09 Anthem — AnthemTraditional: $219.31 Cigna — CignaCommercialHMO: $192.80 Cigna — CignaCommercialPPO: $192.80 ClaimsDoc — ClaimsDoc: $192.80 Emerald Health — Emerald Health: $233.77 First Health — First Health: $216.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPAT VISIT EST LEV 3	$241	$216.90	$72.30 – $233.77
Established patient office visit (about 20–29 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $209.67 Aetna — AetnaMedicare: $72.30 Anthem — AnthemBluePOS/PPO: $214.49 Anthem — AnthemPathwayHMO/HIC/Tiered: $118.09 Anthem — AnthemTraditional: $219.31 Cigna — CignaCommercialHMO: $192.80 Cigna — CignaCommercialPPO: $192.80 ClaimsDoc — ClaimsDoc: $192.80 Emerald Health — Emerald Health: $233.77 First Health — First Health: $216.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TREATMENT ROOM	$241	$216.90	$72.30 – $233.77
Established patient office visit (about 20–29 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $209.67 Aetna — AetnaMedicare: $72.30 Anthem — AnthemBluePOS/PPO: $214.49 Anthem — AnthemPathwayHMO/HIC/Tiered: $118.09 Anthem — AnthemTraditional: $219.31 Cigna — CignaCommercialHMO: $192.80 Cigna — CignaCommercialPPO: $192.80 ClaimsDoc — ClaimsDoc: $192.80 Emerald Health — Emerald Health: $233.77 First Health — First Health: $216.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT EST EXTEND	$286	$257.40	$85.80 – $277.42
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $248.82 Aetna — AetnaMedicare: $85.80 Anthem — AnthemBluePOS/PPO: $254.54 Anthem — AnthemPathwayHMO/HIC/Tiered: $140.14 Anthem — AnthemTraditional: $260.26 Cigna — CignaCommercialHMO: $228.80 Cigna — CignaCommercialPPO: $228.80 ClaimsDoc — ClaimsDoc: $228.80 Emerald Health — Emerald Health: $277.42 First Health — First Health: $257.40
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPAT VISIT EST LEV 4	$286	$257.40	$85.80 – $277.42
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $248.82 Aetna — AetnaMedicare: $85.80 Anthem — AnthemBluePOS/PPO: $254.54 Anthem — AnthemPathwayHMO/HIC/Tiered: $140.14 Anthem — AnthemTraditional: $260.26 Cigna — CignaCommercialHMO: $228.80 Cigna — CignaCommercialPPO: $228.80 ClaimsDoc — ClaimsDoc: $228.80 Emerald Health — Emerald Health: $277.42 First Health — First Health: $257.40
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP VISIT - EST EXTENDED	$286	$257.40	$85.80 – $277.42
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $248.82 Aetna — AetnaMedicare: $85.80 Anthem — AnthemBluePOS/PPO: $254.54 Anthem — AnthemPathwayHMO/HIC/Tiered: $140.14 Anthem — AnthemTraditional: $260.26 Cigna — CignaCommercialHMO: $228.80 Cigna — CignaCommercialPPO: $228.80 ClaimsDoc — ClaimsDoc: $228.80 Emerald Health — Emerald Health: $277.42 First Health — First Health: $257.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OP Consult New/Estab Pt Low 30 Min 99243	$248	$223.20	$74.40 – $240.56
Office consultation with a specialist (moderate): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $215.76 Aetna — AetnaMedicare: $74.40 Anthem — AnthemBluePOS/PPO: $220.72 Anthem — AnthemPathwayHMO/HIC/Tiered: $121.52 Anthem — AnthemTraditional: $225.68 Cigna — CignaCommercialHMO: $198.40 Cigna — CignaCommercialPPO: $198.40 ClaimsDoc — ClaimsDoc: $198.40 Emerald Health — Emerald Health: $240.56 First Health — First Health: $223.20
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Doctor (professional) fee In the file: OP Consult New/Estab Pt Low 30 Min 99243	$248	$223.20	$74.40 – $240.56
Office consultation with a specialist (moderate): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $215.76 Aetna — AetnaMedicare: $74.40 Anthem — AnthemBluePOS/PPO: $220.72 Anthem — AnthemPathwayHMO/HIC/Tiered: $187.61 Anthem — AnthemTraditional: $225.68 Cigna — CignaCommercialHMO: $198.40 Cigna — CignaCommercialPPO: $198.40 ClaimsDoc — ClaimsDoc: $198.40 Emerald Health — Emerald Health: $240.56 First Health — First Health: $223.20
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OP Consult New/Estab Pt Low 30 Min 99243	Not listed in the file	Not listed in the file	$47.76 – $133.05
Office consultation with a specialist (moderate): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $100.89 Aetna — AetnaMedicare: $83.16 Anthem — AnthemBluePOS/PPO: $95.63 Anthem — AnthemMedicare: $83.16 Anthem — AnthemPathwayHMO/HIC/Tiered: $95.63 Anthem — AnthemTraditional: $95.63 Buckeye — BuckeyeMedicare: $83.16 Caresource — CareSourceMedicare: $83.16 Cigna — CignaCommercial: $95.63 Clarity Health — ClarityHealth: $133.05
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OP Consult New/Estab Pt Moderate 40 Min 99244	$312	$280.80	$93.60 – $302.64
Office consultation with a specialist (moderate to high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $271.44 Aetna — AetnaMedicare: $93.60 Anthem — AnthemBluePOS/PPO: $277.68 Anthem — AnthemPathwayHMO/HIC/Tiered: $152.88 Anthem — AnthemTraditional: $283.92 Cigna — CignaCommercialHMO: $249.60 Cigna — CignaCommercialPPO: $249.60 ClaimsDoc — ClaimsDoc: $249.60 Emerald Health — Emerald Health: $302.64 First Health — First Health: $280.80
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Doctor (professional) fee In the file: OP Consult New/Estab Pt Moderate 40 Min 99244	$312	$280.80	$93.60 – $302.64
Office consultation with a specialist (moderate to high): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $271.44 Aetna — AetnaMedicare: $93.60 Anthem — AnthemBluePOS/PPO: $277.68 Anthem — AnthemPathwayHMO/HIC/Tiered: $236.03 Anthem — AnthemTraditional: $283.92 Cigna — CignaCommercialHMO: $249.60 Cigna — CignaCommercialPPO: $249.60 ClaimsDoc — ClaimsDoc: $249.60 Emerald Health — Emerald Health: $302.64 First Health — First Health: $280.80
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OP Consult New/Estab Pt Moderate 40 Min 99244	Not listed in the file	Not listed in the file	$76.31 – $201.52
Office consultation with a specialist (moderate to high): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $153.43 Aetna — AetnaMedicare: $125.95 Anthem — AnthemBluePOS/PPO: $144.84 Anthem — AnthemMedicare: $125.95 Anthem — AnthemPathwayHMO/HIC/Tiered: $144.84 Anthem — AnthemTraditional: $144.84 Buckeye — BuckeyeMedicare: $125.95 Caresource — CareSourceMedicare: $125.95 Cigna — CignaCommercial: $144.84 Clarity Health — ClarityHealth: $201.52
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99385 Initial Comp Preventive Med 18 to 39 years New	$166	$149.40	$49.80 – $161.02
Preventive checkup, new patient, age 18–39: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $144.42 Aetna — AetnaMedicare: $49.80 Anthem — AnthemBluePOS/PPO: $147.74 Anthem — AnthemPathwayHMO/HIC/Tiered: $81.34 Anthem — AnthemTraditional: $151.06 Cigna — CignaCommercialHMO: $132.80 Cigna — CignaCommercialPPO: $132.80 ClaimsDoc — ClaimsDoc: $132.80 Emerald Health — Emerald Health: $161.02 First Health — First Health: $149.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 99385 Initial Comp Preventive Med 18 to 39 years New	$166	$149.40	$49.80 – $161.02
Preventive checkup, new patient, age 18–39: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $144.42 Aetna — AetnaMedicare: $49.80 Anthem — AnthemBluePOS/PPO: $147.74 Anthem — AnthemPathwayHMO/HIC/Tiered: $125.58 Anthem — AnthemTraditional: $151.06 Cigna — CignaCommercialHMO: $132.80 Cigna — CignaCommercialPPO: $132.80 ClaimsDoc — ClaimsDoc: $132.80 Emerald Health — Emerald Health: $161.02 First Health — First Health: $149.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: 99385 Initial Comp Preventive Med 18 to 39 years New	Not listed in the file	Not listed in the file	$48.97 – $141.68
Preventive checkup, new patient, age 18–39: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $97.48 Aetna — AetnaMedicare: $88.55 Anthem — AnthemBluePOS/PPO: $101.83 Anthem — AnthemMedicare: $88.55 Anthem — AnthemPathwayHMO/HIC/Tiered: $101.83 Anthem — AnthemTraditional: $101.83 Buckeye — BuckeyeMedicare: $88.55 Caresource — CareSourceMedicare: $88.55 Cigna — CignaCommercial: $101.83 Clarity Health — ClarityHealth: $141.68
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99386 Initial Comp Preventive Med 40 to 64 years New	$196	$176.40	$58.80 – $190.12
Preventive checkup, new patient, age 40–64: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $170.52 Aetna — AetnaMedicare: $58.80 Anthem — AnthemBluePOS/PPO: $174.44 Anthem — AnthemPathwayHMO/HIC/Tiered: $96.04 Anthem — AnthemTraditional: $178.36 Cigna — CignaCommercialHMO: $156.80 Cigna — CignaCommercialPPO: $156.80 ClaimsDoc — ClaimsDoc: $156.80 Emerald Health — Emerald Health: $190.12 First Health — First Health: $176.40
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 99386 Initial Comp Preventive Med 40 to 64 years New	$196	$176.40	$58.80 – $190.12
Preventive checkup, new patient, age 40–64: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $170.52 Aetna — AetnaMedicare: $58.80 Anthem — AnthemBluePOS/PPO: $174.44 Anthem — AnthemPathwayHMO/HIC/Tiered: $148.27 Anthem — AnthemTraditional: $178.36 Cigna — CignaCommercialHMO: $156.80 Cigna — CignaCommercialPPO: $156.80 ClaimsDoc — ClaimsDoc: $156.80 Emerald Health — Emerald Health: $190.12 First Health — First Health: $176.40
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: 99386 Initial Comp Preventive Med 40 to 64 years New	Not listed in the file	Not listed in the file	$62.29 – $171.51
Preventive checkup, new patient, age 40–64: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $118.14 Aetna — AetnaMedicare: $107.20 Anthem — AnthemBluePOS/PPO: $123.27 Anthem — AnthemMedicare: $107.20 Anthem — AnthemPathwayHMO/HIC/Tiered: $123.27 Anthem — AnthemTraditional: $123.27 Buckeye — BuckeyeMedicare: $107.20 Caresource — CareSourceMedicare: $107.20 Cigna — CignaCommercial: $123.27 Clarity Health — ClarityHealth: $171.51
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit Level 3	$500	$450	$150 – $485
Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $435 Aetna — AetnaMedicare: $150 Anthem — AnthemBluePOS/PPO: $445 Anthem — AnthemPathwayHMO/HIC/Tiered: $245 Anthem — AnthemTraditional: $455 Cigna — CignaCommercialHMO: $400 Cigna — CignaCommercialPPO: $400 ClaimsDoc — ClaimsDoc: $400 Emerald Health — Emerald Health: $485 First Health — First Health: $450
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99283 - Level 3 - Lynx Visit Level	$500	$450	$150 – $485
Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $435 Aetna — AetnaMedicare: $150 Anthem — AnthemBluePOS/PPO: $445 Anthem — AnthemPathwayHMO/HIC/Tiered: $245 Anthem — AnthemTraditional: $455 Cigna — CignaCommercialHMO: $400 Cigna — CignaCommercialPPO: $400 ClaimsDoc — ClaimsDoc: $400 Emerald Health — Emerald Health: $485 First Health — First Health: $450
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Emergency Dept Visit 99283	$126	$113.40	$37.80 – $122.22
Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $109.62 Aetna — AetnaMedicare: $37.80 Anthem — AnthemBluePOS/PPO: $112.14 Anthem — AnthemPathwayHMO/HIC/Tiered: $61.74 Anthem — AnthemTraditional: $114.66 Cigna — CignaCommercialHMO: $100.80 Cigna — CignaCommercialPPO: $100.80 ClaimsDoc — ClaimsDoc: $100.80 Emerald Health — Emerald Health: $122.22 First Health — First Health: $113.40
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit Level 4	$800	$720	$240 – $776
Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $696 Aetna — AetnaMedicare: $240 Anthem — AnthemBluePOS/PPO: $712 Anthem — AnthemPathwayHMO/HIC/Tiered: $392 Anthem — AnthemTraditional: $728 Cigna — CignaCommercialHMO: $640 Cigna — CignaCommercialPPO: $640 ClaimsDoc — ClaimsDoc: $640 Emerald Health — Emerald Health: $776 First Health — First Health: $720
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284 - Level 4 - Lynx Visit Level	$800	$720	$240 – $776
Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $696 Aetna — AetnaMedicare: $240 Anthem — AnthemBluePOS/PPO: $712 Anthem — AnthemPathwayHMO/HIC/Tiered: $392 Anthem — AnthemTraditional: $728 Cigna — CignaCommercialHMO: $640 Cigna — CignaCommercialPPO: $640 ClaimsDoc — ClaimsDoc: $640 Emerald Health — Emerald Health: $776 First Health — First Health: $720
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Emergency Dept Visit 99284	$241	$216.90	$72.30 – $233.77
Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $209.67 Aetna — AetnaMedicare: $72.30 Anthem — AnthemBluePOS/PPO: $214.49 Anthem — AnthemPathwayHMO/HIC/Tiered: $118.09 Anthem — AnthemTraditional: $219.31 Cigna — CignaCommercialHMO: $192.80 Cigna — CignaCommercialPPO: $192.80 ClaimsDoc — ClaimsDoc: $192.80 Emerald Health — Emerald Health: $233.77 First Health — First Health: $216.90
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit Level 5	$4,680	$4,212	$1,404 – $4,539.60
Emergency room visit (high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $4,071.60 Aetna — AetnaMedicare: $1,404 Anthem — AnthemBluePOS/PPO: $4,165.20 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,293.20 Anthem — AnthemTraditional: $4,258.80 Cigna — CignaCommercialHMO: $3,744 Cigna — CignaCommercialPPO: $3,744 ClaimsDoc — ClaimsDoc: $3,744 Emerald Health — Emerald Health: $4,539.60 First Health — First Health: $4,212
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285 - Level 5 - Lynx Visit Level	$1,200	$1,080	$360 – $1,164
Emergency room visit (high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,044 Aetna — AetnaMedicare: $360 Anthem — AnthemBluePOS/PPO: $1,068 Anthem — AnthemPathwayHMO/HIC/Tiered: $588 Anthem — AnthemTraditional: $1,092 Cigna — CignaCommercialHMO: $960 Cigna — CignaCommercialPPO: $960 ClaimsDoc — ClaimsDoc: $960 Emerald Health — Emerald Health: $1,164 First Health — First Health: $1,080
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CATEGORY 1 TRAUMA ACTIVIATION w/o CC	$7,800	$7,020	$2,340 – $7,566
Emergency room visit (high): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $6,786 Aetna — AetnaMedicare: $2,340 Anthem — AnthemBluePOS/PPO: $6,942 Anthem — AnthemPathwayHMO/HIC/Tiered: $3,822 Anthem — AnthemTraditional: $7,098 Cigna — CignaCommercialHMO: $6,240 Cigna — CignaCommercialPPO: $6,240 ClaimsDoc — ClaimsDoc: $6,240 Emerald Health — Emerald Health: $7,566 First Health — First Health: $7,020

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: Basic Metabolic Panel	$151	$135.90	$45.30 – $146.47
Basic metabolic panel (blood test): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $131.37 Aetna — AetnaMedicare: $45.30 Anthem — AnthemBluePOS/PPO: $134.39 Anthem — AnthemPathwayHMO/HIC/Tiered: $73.99 Anthem — AnthemTraditional: $137.41 Cigna — CignaCommercialHMO: $120.80 Cigna — CignaCommercialPPO: $120.80 ClaimsDoc — ClaimsDoc: $120.80 Emerald Health — Emerald Health: $146.47 First Health — First Health: $135.90
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel	$151	$135.90	$45.30 – $146.47
Basic metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $131.37 Aetna — AetnaMedicare: $45.30 Anthem — AnthemBluePOS/PPO: $134.39 Anthem — AnthemPathwayHMO/HIC/Tiered: $114.23 Anthem — AnthemTraditional: $137.41 Cigna — CignaCommercialHMO: $120.80 Cigna — CignaCommercialPPO: $120.80 ClaimsDoc — ClaimsDoc: $120.80 Emerald Health — Emerald Health: $146.47 First Health — First Health: $135.90
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$12.12 – $12.48
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — AetnaMedicare: $8.46 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $3.47 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $8.46 Anthem — AnthemPathwayHMO/HIC/Tiered: $3.47 Anthem — AnthemTraditional: $3.47 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $8.46 Caresource — CaresourceMedicaid: $12.12
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$169	$152.10	$50.70 – $163.93
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $147.03 Aetna — AetnaMedicare: $50.70 Anthem — AnthemBluePOS/PPO: $150.41 Anthem — AnthemPathwayHMO/HIC/Tiered: $82.81 Anthem — AnthemTraditional: $153.79 Cigna — CignaCommercialHMO: $135.20 Cigna — CignaCommercialPPO: $135.20 ClaimsDoc — ClaimsDoc: $135.20 Emerald Health — Emerald Health: $163.93 First Health — First Health: $152.10
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$169	$152.10	$50.70 – $163.93
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $147.03 Aetna — AetnaMedicare: $50.70 Anthem — AnthemBluePOS/PPO: $150.41 Anthem — AnthemPathwayHMO/HIC/Tiered: $127.85 Anthem — AnthemTraditional: $153.79 Cigna — CignaCommercialHMO: $135.20 Cigna — CignaCommercialPPO: $135.20 ClaimsDoc — ClaimsDoc: $135.20 Emerald Health — Emerald Health: $163.93 First Health — First Health: $152.10
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$12.12 – $12.48
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — AetnaMedicare: $10.56 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $5.99 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $10.56 Anthem — AnthemPathwayHMO/HIC/Tiered: $5.99 Anthem — AnthemTraditional: $5 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $10.56 Caresource — CaresourceMedicaid: $12.12
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$12.12 – $12.48
Obstetric blood test panel: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $47.81 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $23.61 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $47.81 Anthem — AnthemPathwayHMO/HIC/Tiered: $23.61 Anthem — AnthemTraditional: $88.80 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $47.81 Caresource — CaresourceMedicaid: $12.12
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$47.81
Obstetric blood test panel: rates for 3 insurance plans Optum — VACCNOptum: $47.81 Perennial Advantage — Perennial Advantage: $47.81 Sidecar — SidecarCommercial: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$153	$137.70	$45.90 – $148.41
Cholesterol panel (lipid panel): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $133.11 Aetna — AetnaMedicare: $45.90 Anthem — AnthemBluePOS/PPO: $136.17 Anthem — AnthemPathwayHMO/HIC/Tiered: $74.97 Anthem — AnthemTraditional: $139.23 Cigna — CignaCommercialHMO: $122.40 Cigna — CignaCommercialPPO: $122.40 ClaimsDoc — ClaimsDoc: $122.40 Emerald Health — Emerald Health: $148.41 First Health — First Health: $137.70
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lipid Panel	$153	$137.70	$45.90 – $148.41
Cholesterol panel (lipid panel): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $133.11 Aetna — AetnaMedicare: $45.90 Anthem — AnthemBluePOS/PPO: $136.17 Anthem — AnthemPathwayHMO/HIC/Tiered: $115.74 Anthem — AnthemTraditional: $139.23 Cigna — CignaCommercialHMO: $122.40 Cigna — CignaCommercialPPO: $122.40 ClaimsDoc — ClaimsDoc: $122.40 Emerald Health — Emerald Health: $148.41 First Health — First Health: $137.70
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$12.12 – $12.48
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — AetnaMedicare: $13.39 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $6.02 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $13.39 Anthem — AnthemPathwayHMO/HIC/Tiered: $6.02 Anthem — AnthemTraditional: $6.02 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $13.39 Caresource — CaresourceMedicaid: $12.12
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$61	$54.90	$18.30 – $59.17
Kidney function panel: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $53.07 Aetna — AetnaMedicare: $18.30 Anthem — AnthemBluePOS/PPO: $54.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $29.89 Anthem — AnthemTraditional: $55.51 Cigna — CignaCommercialHMO: $48.80 Cigna — CignaCommercialPPO: $48.80 ClaimsDoc — ClaimsDoc: $48.80 Emerald Health — Emerald Health: $59.17 First Health — First Health: $54.90
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Function Panel	$61	$54.90	$18.30 – $59.17
Kidney function panel: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $53.07 Aetna — AetnaMedicare: $18.30 Anthem — AnthemBluePOS/PPO: $54.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $46.15 Anthem — AnthemTraditional: $55.51 Cigna — CignaCommercialHMO: $48.80 Cigna — CignaCommercialPPO: $48.80 ClaimsDoc — ClaimsDoc: $48.80 Emerald Health — Emerald Health: $59.17 First Health — First Health: $54.90
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$12.12 – $12.48
Kidney function panel: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $8.68 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $4.11 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $8.68 Anthem — AnthemPathwayHMO/HIC/Tiered: $4.11 Anthem — AnthemTraditional: $4.11 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $8.68 Caresource — CaresourceMedicaid: $12.12
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hep Func Panel	$130	$117	$39 – $126.10
Liver function panel: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $113.10 Aetna — AetnaMedicare: $39 Anthem — AnthemBluePOS/PPO: $115.70 Anthem — AnthemPathwayHMO/HIC/Tiered: $63.70 Anthem — AnthemTraditional: $118.30 Cigna — CignaCommercialHMO: $104 Cigna — CignaCommercialPPO: $104 ClaimsDoc — ClaimsDoc: $104 Emerald Health — Emerald Health: $126.10 First Health — First Health: $117
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hep Func Panel	$130	$117	$39 – $126.10
Liver function panel: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $113.10 Aetna — AetnaMedicare: $39 Anthem — AnthemBluePOS/PPO: $115.70 Anthem — AnthemPathwayHMO/HIC/Tiered: $98.34 Anthem — AnthemTraditional: $118.30 Cigna — CignaCommercialHMO: $104 Cigna — CignaCommercialPPO: $104 ClaimsDoc — ClaimsDoc: $104 Emerald Health — Emerald Health: $126.10 First Health — First Health: $117
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$12.12 – $12.48
Liver function panel: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $8.17 AmeriHealth — AmeriHealthMedicaid: $12.48 Anthem — AnthemBluePOS/PPO: $4.04 Anthem — AnthemMedicaid: $12.12 Anthem — AnthemMedicare: $8.17 Anthem — AnthemPathwayHMO/HIC/Tiered: $4.04 Anthem — AnthemTraditional: $2.99 Buckeye — BuckeyeMedicaid: $12.48 Buckeye — BuckeyeMedicare: $8.17 Caresource — CaresourceMedicaid: $12.12
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine Urinalysis	$40	$36	$12 – $38.80
Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $34.80 Aetna — AetnaMedicare: $12 Anthem — AnthemBluePOS/PPO: $35.60 Anthem — AnthemPathwayHMO/HIC/Tiered: $19.60 Anthem — AnthemTraditional: $36.40 Cigna — CignaCommercialHMO: $32 Cigna — CignaCommercialPPO: $32 ClaimsDoc — ClaimsDoc: $32 Emerald Health — Emerald Health: $38.80 First Health — First Health: $36
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .UA With Cult Reflex	$40	$36	$12 – $38.80
Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $34.80 Aetna — AetnaMedicare: $12 Anthem — AnthemBluePOS/PPO: $35.60 Anthem — AnthemPathwayHMO/HIC/Tiered: $19.60 Anthem — AnthemTraditional: $36.40 Cigna — CignaCommercialHMO: $32 Cigna — CignaCommercialPPO: $32 ClaimsDoc — ClaimsDoc: $32 Emerald Health — Emerald Health: $38.80 First Health — First Health: $36
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .Urinalysis w/Micro, Automated	$40	$36	$12 – $38.80
Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $34.80 Aetna — AetnaMedicare: $12 Anthem — AnthemBluePOS/PPO: $35.60 Anthem — AnthemPathwayHMO/HIC/Tiered: $19.60 Anthem — AnthemTraditional: $36.40 Cigna — CignaCommercialHMO: $32 Cigna — CignaCommercialPPO: $32 ClaimsDoc — ClaimsDoc: $32 Emerald Health — Emerald Health: $38.80 First Health — First Health: $36
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Urnls Dip Stick Non-Auto w/o Micrscpy POC 81002	$9	$8.10	$2.70 – $8.73
Urine test (manual, without microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $7.83 Aetna — AetnaMedicare: $2.70 Anthem — AnthemBluePOS/PPO: $8.01 Anthem — AnthemPathwayHMO/HIC/Tiered: $4.41 Anthem — AnthemTraditional: $8.19 Cigna — CignaCommercialHMO: $7.20 Cigna — CignaCommercialPPO: $7.20 ClaimsDoc — ClaimsDoc: $7.20 Emerald Health — Emerald Health: $8.73 First Health — First Health: $8.10
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Urnls Dip Stick Non-Auto w/o Micrscpy POC 81002	$9	$8.10	$2.70 – $8.73
Urine test (manual, without microscope): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $7.83 Aetna — AetnaMedicare: $2.70 Anthem — AnthemBluePOS/PPO: $8.01 Anthem — AnthemPathwayHMO/HIC/Tiered: $6.81 Anthem — AnthemTraditional: $8.19 Cigna — CignaCommercialHMO: $7.20 Cigna — CignaCommercialPPO: $7.20 ClaimsDoc — ClaimsDoc: $7.20 Emerald Health — Emerald Health: $8.73 First Health — First Health: $8.10
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$3.93 – $4.05
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — AetnaMedicare: $3.48 AmeriHealth — AmeriHealthMedicaid: $4.05 Anthem — AnthemBluePOS/PPO: $2.77 Anthem — AnthemMedicaid: $3.93 Anthem — AnthemMedicare: $3.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $2.77 Anthem — AnthemTraditional: $2.77 Buckeye — BuckeyeMedicaid: $4.05 Buckeye — BuckeyeMedicare: $3.48 Caresource — CaresourceMedicaid: $3.93
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: pH Urine	$19	$17.10	$5.70 – $18.43
Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $16.53 Aetna — AetnaMedicare: $5.70 Anthem — AnthemBluePOS/PPO: $16.91 Anthem — AnthemPathwayHMO/HIC/Tiered: $9.31 Anthem — AnthemTraditional: $17.29 Cigna — CignaCommercialHMO: $15.20 Cigna — CignaCommercialPPO: $15.20 ClaimsDoc — ClaimsDoc: $15.20 Emerald Health — Emerald Health: $18.43 First Health — First Health: $17.10
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Dipstick	$19	$17.10	$5.70 – $18.43
Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $16.53 Aetna — AetnaMedicare: $5.70 Anthem — AnthemBluePOS/PPO: $16.91 Anthem — AnthemPathwayHMO/HIC/Tiered: $9.31 Anthem — AnthemTraditional: $17.29 Cigna — CignaCommercialHMO: $15.20 Cigna — CignaCommercialPPO: $15.20 ClaimsDoc — ClaimsDoc: $15.20 Emerald Health — Emerald Health: $18.43 First Health — First Health: $17.10
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Specific Gravity Urine Automated	$19	$17.10	$5.70 – $18.43
Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $16.53 Aetna — AetnaMedicare: $5.70 Anthem — AnthemBluePOS/PPO: $16.91 Anthem — AnthemPathwayHMO/HIC/Tiered: $9.31 Anthem — AnthemTraditional: $17.29 Cigna — CignaCommercialHMO: $15.20 Cigna — CignaCommercialPPO: $15.20 ClaimsDoc — ClaimsDoc: $15.20 Emerald Health — Emerald Health: $18.43 First Health — First Health: $17.10
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA Total	$128	$115.20	$38.40 – $124.16
PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $111.36 Aetna — AetnaMedicare: $38.40 Anthem — AnthemBluePOS/PPO: $113.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $62.72 Anthem — AnthemTraditional: $116.48 Cigna — CignaCommercialHMO: $102.40 Cigna — CignaCommercialPPO: $102.40 ClaimsDoc — ClaimsDoc: $102.40 Emerald Health — Emerald Health: $124.16 First Health — First Health: $115.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate Specific Antigen Free	$128	$115.20	$38.40 – $124.16
PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $111.36 Aetna — AetnaMedicare: $38.40 Anthem — AnthemBluePOS/PPO: $113.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $62.72 Anthem — AnthemTraditional: $116.48 Cigna — CignaCommercialHMO: $102.40 Cigna — CignaCommercialPPO: $102.40 ClaimsDoc — ClaimsDoc: $102.40 Emerald Health — Emerald Health: $124.16 First Health — First Health: $115.20
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA Total	$128	$115.20	$38.40 – $124.16
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $111.36 Aetna — AetnaMedicare: $38.40 Anthem — AnthemBluePOS/PPO: $113.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $96.83 Anthem — AnthemTraditional: $116.48 Cigna — CignaCommercialHMO: $102.40 Cigna — CignaCommercialPPO: $102.40 ClaimsDoc — ClaimsDoc: $102.40 Emerald Health — Emerald Health: $124.16 First Health — First Health: $115.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid Stimulating Hormone	$117	$105.30	$35.10 – $113.49
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $101.79 Aetna — AetnaMedicare: $35.10 Anthem — AnthemBluePOS/PPO: $104.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $57.33 Anthem — AnthemTraditional: $106.47 Cigna — CignaCommercialHMO: $93.60 Cigna — CignaCommercialPPO: $93.60 ClaimsDoc — ClaimsDoc: $93.60 Emerald Health — Emerald Health: $113.49 First Health — First Health: $105.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH With T4fr Reflex	$117	$105.30	$35.10 – $113.49
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $101.79 Aetna — AetnaMedicare: $35.10 Anthem — AnthemBluePOS/PPO: $104.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $57.33 Anthem — AnthemTraditional: $106.47 Cigna — CignaCommercialHMO: $93.60 Cigna — CignaCommercialPPO: $93.60 ClaimsDoc — ClaimsDoc: $93.60 Emerald Health — Emerald Health: $113.49 First Health — First Health: $105.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thryoid Stimulating Hormone	$117	$105.30	$35.10 – $113.49
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $101.79 Aetna — AetnaMedicare: $35.10 Anthem — AnthemBluePOS/PPO: $104.13 Anthem — AnthemPathwayHMO/HIC/Tiered: $57.33 Anthem — AnthemTraditional: $106.47 Cigna — CignaCommercialHMO: $93.60 Cigna — CignaCommercialPPO: $93.60 ClaimsDoc — ClaimsDoc: $93.60 Emerald Health — Emerald Health: $113.49 First Health — First Health: $105.30
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC w/ Auto Diff	$82	$73.80	$24.60 – $79.54
Complete blood count (CBC) with differential: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $71.34 Aetna — AetnaMedicare: $24.60 Anthem — AnthemBluePOS/PPO: $72.98 Anthem — AnthemPathwayHMO/HIC/Tiered: $40.18 Anthem — AnthemTraditional: $74.62 Cigna — CignaCommercialHMO: $65.60 Cigna — CignaCommercialPPO: $65.60 ClaimsDoc — ClaimsDoc: $65.60 Emerald Health — Emerald Health: $79.54 First Health — First Health: $73.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC w/ Auto Diff	$82	$73.80	$24.60 – $79.54
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $71.34 Aetna — AetnaMedicare: $24.60 Anthem — AnthemBluePOS/PPO: $72.98 Anthem — AnthemPathwayHMO/HIC/Tiered: $62.03 Anthem — AnthemTraditional: $74.62 Cigna — CignaCommercialHMO: $65.60 Cigna — CignaCommercialPPO: $65.60 ClaimsDoc — ClaimsDoc: $65.60 Emerald Health — Emerald Health: $79.54 First Health — First Health: $73.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$5.23 – $5.39
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $7.77 AmeriHealth — AmeriHealthMedicaid: $5.39 Anthem — AnthemBluePOS/PPO: $3.68 Anthem — AnthemMedicaid: $5.23 Anthem — AnthemMedicare: $7.77 Anthem — AnthemPathwayHMO/HIC/Tiered: $3.68 Anthem — AnthemTraditional: $3.68 Buckeye — BuckeyeMedicaid: $5.39 Buckeye — BuckeyeMedicare: $7.77 Caresource — CaresourceMedicaid: $5.23
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete Blood Count w/ Indices	$55	$49.50	$16.50 – $53.35
Complete blood count (CBC), automated: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $47.85 Aetna — AetnaMedicare: $16.50 Anthem — AnthemBluePOS/PPO: $48.95 Anthem — AnthemPathwayHMO/HIC/Tiered: $26.95 Anthem — AnthemTraditional: $50.05 Cigna — CignaCommercialHMO: $44 Cigna — CignaCommercialPPO: $44 ClaimsDoc — ClaimsDoc: $44 Emerald Health — Emerald Health: $53.35 First Health — First Health: $49.50
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Complete Blood Count w/ Indices	$55	$49.50	$16.50 – $53.35
Complete blood count (CBC), automated: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $47.85 Aetna — AetnaMedicare: $16.50 Anthem — AnthemBluePOS/PPO: $48.95 Anthem — AnthemPathwayHMO/HIC/Tiered: $41.61 Anthem — AnthemTraditional: $50.05 Cigna — CignaCommercialHMO: $44 Cigna — CignaCommercialPPO: $44 ClaimsDoc — ClaimsDoc: $44 Emerald Health — Emerald Health: $53.35 First Health — First Health: $49.50
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$5.23 – $5.39
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $6.47 AmeriHealth — AmeriHealthMedicaid: $5.39 Anthem — AnthemBluePOS/PPO: $3.06 Anthem — AnthemMedicaid: $5.23 Anthem — AnthemMedicare: $6.47 Anthem — AnthemPathwayHMO/HIC/Tiered: $3.06 Anthem — AnthemTraditional: $3.06 Buckeye — BuckeyeMedicaid: $5.39 Buckeye — BuckeyeMedicare: $6.47 Caresource — CaresourceMedicaid: $5.23
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$32	$28.80	$9.60 – $31.04
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $27.84 Aetna — AetnaMedicare: $9.60 Anthem — AnthemBluePOS/PPO: $28.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $15.68 Anthem — AnthemTraditional: $29.12 Cigna — CignaCommercialHMO: $25.60 Cigna — CignaCommercialPPO: $25.60 ClaimsDoc — ClaimsDoc: $25.60 Emerald Health — Emerald Health: $31.04 First Health — First Health: $28.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRO TIME	$32	$28.80	$9.60 – $31.04
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $27.84 Aetna — AetnaMedicare: $9.60 Anthem — AnthemBluePOS/PPO: $28.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $15.68 Anthem — AnthemTraditional: $29.12 Cigna — CignaCommercialHMO: $25.60 Cigna — CignaCommercialPPO: $25.60 ClaimsDoc — ClaimsDoc: $25.60 Emerald Health — Emerald Health: $31.04 First Health — First Health: $28.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prothrombin and INR POC 85610	$12	$10.80	$3.60 – $11.64
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $10.44 Aetna — AetnaMedicare: $3.60 Anthem — AnthemBluePOS/PPO: $10.68 Anthem — AnthemPathwayHMO/HIC/Tiered: $5.88 Anthem — AnthemTraditional: $10.92 Cigna — CignaCommercialHMO: $9.60 Cigna — CignaCommercialPPO: $9.60 ClaimsDoc — ClaimsDoc: $9.60 Emerald Health — Emerald Health: $11.64 First Health — First Health: $10.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Partial Thromboplastin Time	$44	$39.60	$13.20 – $42.68
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $38.28 Aetna — AetnaMedicare: $13.20 Anthem — AnthemBluePOS/PPO: $39.16 Anthem — AnthemPathwayHMO/HIC/Tiered: $21.56 Anthem — AnthemTraditional: $40.04 Cigna — CignaCommercialHMO: $35.20 Cigna — CignaCommercialPPO: $35.20 ClaimsDoc — ClaimsDoc: $35.20 Emerald Health — Emerald Health: $42.68 First Health — First Health: $39.60
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 85730 Add On	$47	$42.30	$14.10 – $45.59
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $40.89 Aetna — AetnaMedicare: $14.10 Anthem — AnthemBluePOS/PPO: $41.83 Anthem — AnthemPathwayHMO/HIC/Tiered: $23.03 Anthem — AnthemTraditional: $42.77 Cigna — CignaCommercialHMO: $37.60 Cigna — CignaCommercialPPO: $37.60 ClaimsDoc — ClaimsDoc: $37.60 Emerald Health — Emerald Health: $45.59 First Health — First Health: $42.30
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Partial Thromboplastin Time	$44	$39.60	$13.20 – $42.68
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $38.28 Aetna — AetnaMedicare: $13.20 Anthem — AnthemBluePOS/PPO: $39.16 Anthem — AnthemPathwayHMO/HIC/Tiered: $33.29 Anthem — AnthemTraditional: $40.04 Cigna — CignaCommercialHMO: $35.20 Cigna — CignaCommercialPPO: $35.20 ClaimsDoc — ClaimsDoc: $35.20 Emerald Health — Emerald Health: $42.68 First Health — First Health: $39.60

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head or Brain w/o Contrast	$1,500	$1,350	$450 – $1,455
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,305 Aetna — AetnaMedicare: $450 Anthem — AnthemBluePOS/PPO: $1,335 Anthem — AnthemPathwayHMO/HIC/Tiered: $735 Anthem — AnthemTraditional: $1,365 Cigna — CignaCommercialHMO: $1,200 Cigna — CignaCommercialPPO: $1,200 ClaimsDoc — ClaimsDoc: $1,200 Emerald Health — Emerald Health: $1,455 First Health — First Health: $1,350
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Head or Brain w/o Contrast	$1,500	$1,350	$450 – $1,455
CT scan of the head or brain, without contrast: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,305 Aetna — AetnaMedicare: $450 Anthem — AnthemBluePOS/PPO: $1,335 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,134.75 Anthem — AnthemTraditional: $1,365 Cigna — CignaCommercialHMO: $1,200 Cigna — CignaCommercialPPO: $1,200 ClaimsDoc — ClaimsDoc: $1,200 Emerald Health — Emerald Health: $1,455 First Health — First Health: $1,350
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$242.56 – $249.84
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $99.75 AmeriHealth — AmeriHealthMedicaid: $249.84 Anthem — AnthemBluePOS/PPO: $2,132 Anthem — AnthemMedicaid: $242.56 Anthem — AnthemMedicare: $99.75 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,161 Buckeye — BuckeyeMedicaid: $249.84 Buckeye — BuckeyeMedicare: $99.75 Caresource — CaresourceMedicaid: $242.56 Caresource — CareSourceMedicare: $99.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain w/ + w/o Contrast	$3,445	$3,100.50	$1,033.50 – $3,341.65
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $2,997.15 Aetna — AetnaMedicare: $1,033.50 Anthem — AnthemBluePOS/PPO: $3,066.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,688.05 Anthem — AnthemTraditional: $3,134.95 Cigna — CignaCommercialHMO: $2,756 Cigna — CignaCommercialPPO: $2,756 ClaimsDoc — ClaimsDoc: $2,756 Emerald Health — Emerald Health: $3,341.65 First Health — First Health: $3,100.50
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Brain w/ + w/o Contrast	$3,445	$3,100.50	$1,033.50 – $3,341.65
MRI of the brain, before and after contrast: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $2,997.15 Aetna — AetnaMedicare: $1,033.50 Anthem — AnthemBluePOS/PPO: $3,066.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,606.14 Anthem — AnthemTraditional: $3,134.95 Cigna — CignaCommercialHMO: $2,756 Cigna — CignaCommercialPPO: $2,756 ClaimsDoc — ClaimsDoc: $2,756 Emerald Health — Emerald Health: $3,341.65 First Health — First Health: $3,100.50
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$237.84 – $244.98
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $335 AmeriHealth — AmeriHealthMedicaid: $244.98 Anthem — AnthemBluePOS/PPO: $2,529 Anthem — AnthemMedicaid: $237.84 Anthem — AnthemMedicare: $335 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,378 Buckeye — BuckeyeMedicaid: $244.98 Buckeye — BuckeyeMedicare: $335 Caresource — CaresourceMedicaid: $237.84 Caresource — CareSourceMedicare: $335
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest 2 Views	$235	$211.50	$70.50 – $227.95
Chest X-ray, 2 views: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $204.45 Aetna — AetnaMedicare: $70.50 Anthem — AnthemBluePOS/PPO: $209.15 Anthem — AnthemPathwayHMO/HIC/Tiered: $115.15 Anthem — AnthemTraditional: $213.85 Cigna — CignaCommercialHMO: $188 Cigna — CignaCommercialPPO: $188 ClaimsDoc — ClaimsDoc: $188 Emerald Health — Emerald Health: $227.95 First Health — First Health: $211.50
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR Chest 2 Views	$235	$211.50	$70.50 – $227.95
Chest X-ray, 2 views: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $204.45 Aetna — AetnaMedicare: $70.50 Anthem — AnthemBluePOS/PPO: $209.15 Anthem — AnthemPathwayHMO/HIC/Tiered: $177.78 Anthem — AnthemTraditional: $213.85 Cigna — CignaCommercialHMO: $188 Cigna — CignaCommercialPPO: $188 ClaimsDoc — ClaimsDoc: $188 Emerald Health — Emerald Health: $227.95 First Health — First Health: $211.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$34.98 – $36.03
Chest X-ray, 2 views: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $82.59 AmeriHealth — AmeriHealthMedicaid: $36.03 Anthem — AnthemMedicaid: $34.98 Anthem — AnthemMedicare: $82.59 Buckeye — BuckeyeMedicaid: $36.03 Buckeye — BuckeyeMedicare: $82.59 Caresource — CaresourceMedicaid: $34.98 Caresource — CareSourceMedicare: $82.59 Medical Mutual of Ohio — MMOMedicare: $82.59 Molina — MolinaMedicaid: $36.03
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Spine Lumbosacral Minimum 4 Views	$445	$400.50	$133.50 – $431.65
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $387.15 Aetna — AetnaMedicare: $133.50 Anthem — AnthemBluePOS/PPO: $396.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $218.05 Anthem — AnthemTraditional: $404.95 Cigna — CignaCommercialHMO: $356 Cigna — CignaCommercialPPO: $356 ClaimsDoc — ClaimsDoc: $356 Emerald Health — Emerald Health: $431.65 First Health — First Health: $400.50
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR Spine Lumbosacral Minimum 4 Views	$445	$400.50	$133.50 – $431.65
X-ray of the lower spine, at least 4 views: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $387.15 Aetna — AetnaMedicare: $133.50 Anthem — AnthemBluePOS/PPO: $396.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $336.64 Anthem — AnthemTraditional: $404.95 Cigna — CignaCommercialHMO: $356 Cigna — CignaCommercialPPO: $356 ClaimsDoc — ClaimsDoc: $356 Emerald Health — Emerald Health: $431.65 First Health — First Health: $400.50
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$34.98 – $36.03
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $99.75 AmeriHealth — AmeriHealthMedicaid: $36.03 Anthem — AnthemMedicaid: $34.98 Anthem — AnthemMedicare: $99.75 Buckeye — BuckeyeMedicaid: $36.03 Buckeye — BuckeyeMedicare: $99.75 Caresource — CaresourceMedicaid: $34.98 Caresource — CareSourceMedicare: $99.75 Medical Mutual of Ohio — MMOMedicare: $99.75 Molina — MolinaMedicaid: $36.03
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$2,930	$2,637	$879 – $2,842.10
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $2,549.10 Aetna — AetnaMedicare: $879 Anthem — AnthemBluePOS/PPO: $2,607.70 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,435.70 Anthem — AnthemTraditional: $2,666.30 Cigna — CignaCommercialHMO: $2,344 Cigna — CignaCommercialPPO: $2,344 ClaimsDoc — ClaimsDoc: $2,344 Emerald Health — Emerald Health: $2,842.10 First Health — First Health: $2,637
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$2,930	$2,637	$879 – $2,842.10
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $2,549.10 Aetna — AetnaMedicare: $879 Anthem — AnthemBluePOS/PPO: $2,607.70 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,216.54 Anthem — AnthemTraditional: $2,666.30 Cigna — CignaCommercialHMO: $2,344 Cigna — CignaCommercialPPO: $2,344 ClaimsDoc — ClaimsDoc: $2,344 Emerald Health — Emerald Health: $2,842.10 First Health — First Health: $2,637
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$157.39 – $162.11
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $226.74 AmeriHealth — AmeriHealthMedicaid: $162.11 Anthem — AnthemBluePOS/PPO: $2,529 Anthem — AnthemMedicaid: $157.39 Anthem — AnthemMedicare: $226.74 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,378 Buckeye — BuckeyeMedicaid: $162.11 Buckeye — BuckeyeMedicare: $226.74 Caresource — CaresourceMedicaid: $157.39 Caresource — CareSourceMedicare: $226.74
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis w/ Contrast	$1,460	$1,314	$438 – $1,416.20
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,270.20 Aetna — AetnaMedicare: $438 Anthem — AnthemBluePOS/PPO: $1,299.40 Anthem — AnthemPathwayHMO/HIC/Tiered: $715.40 Anthem — AnthemTraditional: $1,328.60 Cigna — CignaCommercialHMO: $1,168 Cigna — CignaCommercialPPO: $1,168 ClaimsDoc — ClaimsDoc: $1,168 Emerald Health — Emerald Health: $1,416.20 First Health — First Health: $1,314
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Pelvis w/ Contrast	$1,460	$1,314	$438 – $1,416.20
CT scan of the pelvis, with contrast: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,270.20 Aetna — AetnaMedicare: $438 Anthem — AnthemBluePOS/PPO: $1,299.40 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,104.49 Anthem — AnthemTraditional: $1,328.60 Cigna — CignaCommercialHMO: $1,168 Cigna — CignaCommercialPPO: $1,168 ClaimsDoc — ClaimsDoc: $1,168 Emerald Health — Emerald Health: $1,416.20 First Health — First Health: $1,314
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$242.56 – $249.84
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $166.98 AmeriHealth — AmeriHealthMedicaid: $249.84 Anthem — AnthemBluePOS/PPO: $2,132 Anthem — AnthemMedicaid: $242.56 Anthem — AnthemMedicare: $166.98 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,161 Buckeye — BuckeyeMedicaid: $249.84 Buckeye — BuckeyeMedicare: $166.98 Caresource — CaresourceMedicaid: $242.56 Caresource — CareSourceMedicare: $166.98
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$157.39 – $162.11
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $226.74 AmeriHealth — AmeriHealthMedicaid: $162.11 Anthem — AnthemBluePOS/PPO: $2,529 Anthem — AnthemMedicaid: $157.39 Anthem — AnthemMedicare: $226.74 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,378 Buckeye — BuckeyeMedicaid: $162.11 Buckeye — BuckeyeMedicare: $226.74 Caresource — CaresourceMedicaid: $157.39 Caresource — CareSourceMedicare: $226.74
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI Ankle w/o Contrast Left	$2,505	$2,254.50	$751.50 – $2,429.85
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $2,179.35 Aetna — AetnaMedicare: $751.50 Anthem — AnthemBluePOS/PPO: $2,229.45 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,227.45 Anthem — AnthemTraditional: $2,279.55 Cigna — CignaCommercialHMO: $2,004 Cigna — CignaCommercialPPO: $2,004 ClaimsDoc — ClaimsDoc: $2,004 Emerald Health — Emerald Health: $2,429.85 First Health — First Health: $2,254.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MRI Ankle w/o Contrast Right	$2,505	$2,254.50	$751.50 – $2,429.85
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $2,179.35 Aetna — AetnaMedicare: $751.50 Anthem — AnthemBluePOS/PPO: $2,229.45 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,227.45 Anthem — AnthemTraditional: $2,279.55 Cigna — CignaCommercialHMO: $2,004 Cigna — CignaCommercialPPO: $2,004 ClaimsDoc — ClaimsDoc: $2,004 Emerald Health — Emerald Health: $2,429.85 First Health — First Health: $2,254.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abdomen/Pelvis w/contrast enterograph	$3,628	$3,265.20	$1,088.40 – $3,519.16
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $3,156.36 Aetna — AetnaMedicare: $1,088.40 Anthem — AnthemBluePOS/PPO: $3,228.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,777.72 Anthem — AnthemTraditional: $3,301.48 Cigna — CignaCommercialHMO: $2,902.40 Cigna — CignaCommercialPPO: $2,902.40 ClaimsDoc — ClaimsDoc: $2,902.40 Emerald Health — Emerald Health: $3,519.16 First Health — First Health: $3,265.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abdomen/Pelvis w/ Contrast	$3,628	$3,265.20	$1,088.40 – $3,519.16
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $3,156.36 Aetna — AetnaMedicare: $1,088.40 Anthem — AnthemBluePOS/PPO: $3,228.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,777.72 Anthem — AnthemTraditional: $3,301.48 Cigna — CignaCommercialHMO: $2,902.40 Cigna — CignaCommercialPPO: $2,902.40 ClaimsDoc — ClaimsDoc: $2,902.40 Emerald Health — Emerald Health: $3,519.16 First Health — First Health: $3,265.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Abdomen/Pelvis w/contrast enterograph	$3,628	$3,265.20	$1,088.40 – $3,519.16
CT scan of the abdomen and pelvis, with contrast: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $3,156.36 Aetna — AetnaMedicare: $1,088.40 Anthem — AnthemBluePOS/PPO: $3,228.92 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,744.58 Anthem — AnthemTraditional: $3,301.48 Cigna — CignaCommercialHMO: $2,902.40 Cigna — CignaCommercialPPO: $2,902.40 ClaimsDoc — ClaimsDoc: $2,902.40 Emerald Health — Emerald Health: $3,519.16 First Health — First Health: $3,265.20
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,100	$990	$330 – $1,067
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $957 Aetna — AetnaMedicare: $330 Anthem — AnthemBluePOS/PPO: $979 Anthem — AnthemPathwayHMO/HIC/Tiered: $539 Anthem — AnthemTraditional: $1,001 Cigna — CignaCommercialHMO: $880 Cigna — CignaCommercialPPO: $880 ClaimsDoc — ClaimsDoc: $880 Emerald Health — Emerald Health: $1,067 First Health — First Health: $990
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,100	$990	$330 – $1,067
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $957 Aetna — AetnaMedicare: $330 Anthem — AnthemBluePOS/PPO: $979 Anthem — AnthemPathwayHMO/HIC/Tiered: $832.15 Anthem — AnthemTraditional: $1,001 Cigna — CignaCommercialHMO: $880 Cigna — CignaCommercialPPO: $880 ClaimsDoc — ClaimsDoc: $880 Emerald Health — Emerald Health: $1,067 First Health — First Health: $990
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$92.57 – $95.35
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — AetnaMedicare: $99.75 AmeriHealth — AmeriHealthMedicaid: $95.35 Anthem — AnthemMedicaid: $92.57 Anthem — AnthemMedicare: $99.75 Buckeye — BuckeyeMedicaid: $95.35 Buckeye — BuckeyeMedicare: $99.75 Caresource — CaresourceMedicaid: $92.57 Caresource — CareSourceMedicare: $99.75 Medical Mutual of Ohio — MMOMedicare: $99.75 Molina — MolinaMedicaid: $95.35
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Pregnancy After 1st Trimester	$770	$693	$231 – $746.90
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $669.90 Aetna — AetnaMedicare: $231 Anthem — AnthemBluePOS/PPO: $685.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $377.30 Anthem — AnthemTraditional: $700.70 Cigna — CignaCommercialHMO: $616 Cigna — CignaCommercialPPO: $616 ClaimsDoc — ClaimsDoc: $616 Emerald Health — Emerald Health: $746.90 First Health — First Health: $693
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US Pregnancy After 1st Trimester	$214	$192.60	$64.20 – $207.58
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $186.18 Aetna — AetnaMedicare: $64.20 Anthem — AnthemBluePOS/PPO: $190.46 Anthem — AnthemPathwayHMO/HIC/Tiered: $104.86 Anthem — AnthemTraditional: $194.74 Cigna — CignaCommercialHMO: $171.20 Cigna — CignaCommercialPPO: $171.20 ClaimsDoc — ClaimsDoc: $171.20 Emerald Health — Emerald Health: $207.58 First Health — First Health: $192.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Pregnancy After 1st Trimester	$770	$693	$231 – $746.90
Pregnancy ultrasound (after the first trimester): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $669.90 Aetna — AetnaMedicare: $231 Anthem — AnthemBluePOS/PPO: $685.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $582.50 Anthem — AnthemTraditional: $700.70 Cigna — CignaCommercialHMO: $616 Cigna — CignaCommercialPPO: $616 ClaimsDoc — ClaimsDoc: $616 Emerald Health — Emerald Health: $746.90 First Health — First Health: $693
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginl Non-OB	$770	$693	$231 – $746.90
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $669.90 Aetna — AetnaMedicare: $231 Anthem — AnthemBluePOS/PPO: $685.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $377.30 Anthem — AnthemTraditional: $700.70 Cigna — CignaCommercialHMO: $616 Cigna — CignaCommercialPPO: $616 ClaimsDoc — ClaimsDoc: $616 Emerald Health — Emerald Health: $746.90 First Health — First Health: $693
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US Transvaginl Non-OB	$207	$186.30	$62.10 – $200.79
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $180.09 Aetna — AetnaMedicare: $62.10 Anthem — AnthemBluePOS/PPO: $184.23 Anthem — AnthemPathwayHMO/HIC/Tiered: $101.43 Anthem — AnthemTraditional: $188.37 Cigna — CignaCommercialHMO: $165.60 Cigna — CignaCommercialPPO: $165.60 ClaimsDoc — ClaimsDoc: $165.60 Emerald Health — Emerald Health: $200.79 First Health — First Health: $186.30
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Transvaginl Non-OB	$770	$693	$231 – $746.90
Transvaginal ultrasound: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $669.90 Aetna — AetnaMedicare: $231 Anthem — AnthemBluePOS/PPO: $685.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $582.50 Anthem — AnthemTraditional: $700.70 Cigna — CignaCommercialHMO: $616 Cigna — CignaCommercialPPO: $616 ClaimsDoc — ClaimsDoc: $616 Emerald Health — Emerald Health: $746.90 First Health — First Health: $693
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Diag w/CAD if perf and 3D LT	$260	$234	$78 – $252.20
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $226.20 Aetna — AetnaMedicare: $78 Anthem — AnthemBluePOS/PPO: $231.40 Anthem — AnthemPathwayHMO/HIC/Tiered: $127.40 Anthem — AnthemTraditional: $236.60 Cigna — CignaCommercialHMO: $208 Cigna — CignaCommercialPPO: $208 ClaimsDoc — ClaimsDoc: $208 Emerald Health — Emerald Health: $252.20 First Health — First Health: $234
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Diag w/CAD if perf and 3D RT	$260	$234	$78 – $252.20
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $226.20 Aetna — AetnaMedicare: $78 Anthem — AnthemBluePOS/PPO: $231.40 Anthem — AnthemPathwayHMO/HIC/Tiered: $127.40 Anthem — AnthemTraditional: $236.60 Cigna — CignaCommercialHMO: $208 Cigna — CignaCommercialPPO: $208 ClaimsDoc — ClaimsDoc: $208 Emerald Health — Emerald Health: $252.20 First Health — First Health: $234
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Contrast Enhanced Left	$364	$327.60	$109.20 – $353.08
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $316.68 Aetna — AetnaMedicare: $109.20 Anthem — AnthemBluePOS/PPO: $323.96 Anthem — AnthemPathwayHMO/HIC/Tiered: $178.36 Anthem — AnthemTraditional: $331.24 Cigna — CignaCommercialHMO: $291.20 Cigna — CignaCommercialPPO: $291.20 ClaimsDoc — ClaimsDoc: $291.20 Emerald Health — Emerald Health: $353.08 First Health — First Health: $327.60
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Diag w/CAD if performed bilat	$310	$279	$93 – $300.70
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $269.70 Aetna — AetnaMedicare: $93 Anthem — AnthemBluePOS/PPO: $275.90 Anthem — AnthemPathwayHMO/HIC/Tiered: $151.90 Anthem — AnthemTraditional: $282.10 Cigna — CignaCommercialHMO: $248 Cigna — CignaCommercialPPO: $248 ClaimsDoc — ClaimsDoc: $248 Emerald Health — Emerald Health: $300.70 First Health — First Health: $279
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Diag w/CAD if perf and 3D Bil	$310	$279	$93 – $300.70
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $269.70 Aetna — AetnaMedicare: $93 Anthem — AnthemBluePOS/PPO: $275.90 Anthem — AnthemPathwayHMO/HIC/Tiered: $151.90 Anthem — AnthemTraditional: $282.10 Cigna — CignaCommercialHMO: $248 Cigna — CignaCommercialPPO: $248 ClaimsDoc — ClaimsDoc: $248 Emerald Health — Emerald Health: $300.70 First Health — First Health: $279
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Diag w/CAD if perf and 3D Bilat	$310	$279	$93 – $300.70
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $269.70 Aetna — AetnaMedicare: $93 Anthem — AnthemBluePOS/PPO: $275.90 Anthem — AnthemPathwayHMO/HIC/Tiered: $151.90 Anthem — AnthemTraditional: $282.10 Cigna — CignaCommercialHMO: $248 Cigna — CignaCommercialPPO: $248 ClaimsDoc — ClaimsDoc: $248 Emerald Health — Emerald Health: $300.70 First Health — First Health: $279
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Screen w/CAD if performed bilat	$238	$214.20	$71.40 – $230.86
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $207.06 Aetna — AetnaMedicare: $71.40 Anthem — AnthemBluePOS/PPO: $211.82 Anthem — AnthemPathwayHMO/HIC/Tiered: $116.62 Anthem — AnthemTraditional: $216.58 Cigna — CignaCommercialHMO: $190.40 Cigna — CignaCommercialPPO: $190.40 ClaimsDoc — ClaimsDoc: $190.40 Emerald Health — Emerald Health: $230.86 First Health — First Health: $214.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Mamm Screen w/CAD if perf and 3D Bil	$238	$214.20	$71.40 – $230.86
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $207.06 Aetna — AetnaMedicare: $71.40 Anthem — AnthemBluePOS/PPO: $211.82 Anthem — AnthemPathwayHMO/HIC/Tiered: $116.62 Anthem — AnthemTraditional: $216.58 Cigna — CignaCommercialHMO: $190.40 Cigna — CignaCommercialPPO: $190.40 ClaimsDoc — ClaimsDoc: $190.40 Emerald Health — Emerald Health: $230.86 First Health — First Health: $214.20
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA Mamm Screen w/CAD if performed bilat	$238	$214.20	$71.40 – $230.86
Screening mammogram, both breasts: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $207.06 Aetna — AetnaMedicare: $71.40 Anthem — AnthemBluePOS/PPO: $211.82 Anthem — AnthemPathwayHMO/HIC/Tiered: $180.05 Anthem — AnthemTraditional: $216.58 Cigna — CignaCommercialHMO: $190.40 Cigna — CignaCommercialPPO: $190.40 ClaimsDoc — ClaimsDoc: $190.40 Emerald Health — Emerald Health: $230.86 First Health — First Health: $214.20

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECG 12 Lead Adult	$42	$37.80	$12.60 – $40.74
Electrocardiogram (ECG/EKG) with reading: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $36.54 Aetna — AetnaMedicare: $12.60 Anthem — AnthemBluePOS/PPO: $37.38 Anthem — AnthemPathwayHMO/HIC/Tiered: $20.58 Anthem — AnthemTraditional: $38.22 Cigna — CignaCommercialHMO: $33.60 Cigna — CignaCommercialPPO: $33.60 ClaimsDoc — ClaimsDoc: $33.60 Emerald Health — Emerald Health: $40.74 First Health — First Health: $37.80
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECG Pedatric POC 93000 (Non Interfaced)	$42	$37.80	$12.60 – $40.74
Electrocardiogram (ECG/EKG) with reading: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $36.54 Aetna — AetnaMedicare: $12.60 Anthem — AnthemBluePOS/PPO: $37.38 Anthem — AnthemPathwayHMO/HIC/Tiered: $20.58 Anthem — AnthemTraditional: $38.22 Cigna — CignaCommercialHMO: $33.60 Cigna — CignaCommercialPPO: $33.60 ClaimsDoc — ClaimsDoc: $33.60 Emerald Health — Emerald Health: $40.74 First Health — First Health: $37.80
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECG 12 Lead Acquisition	$42	$37.80	$12.60 – $40.74
Electrocardiogram (ECG/EKG) with reading: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $36.54 Aetna — AetnaMedicare: $12.60 Anthem — AnthemBluePOS/PPO: $37.38 Anthem — AnthemPathwayHMO/HIC/Tiered: $20.58 Anthem — AnthemTraditional: $38.22 Cigna — CignaCommercialHMO: $33.60 Cigna — CignaCommercialPPO: $33.60 ClaimsDoc — ClaimsDoc: $33.60 Emerald Health — Emerald Health: $40.74 First Health — First Health: $37.80
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LHC WITH VENTRICLE	$4,300	$3,870	$1,290 – $4,171
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $3,741 Aetna — AetnaMedicare: $1,290 Anthem — AnthemBluePOS/PPO: $3,827 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,107 Anthem — AnthemTraditional: $3,913 Cigna — CignaCommercialHMO: $3,440 Cigna — CignaCommercialPPO: $3,440 ClaimsDoc — ClaimsDoc: $3,440 Emerald Health — Emerald Health: $4,171 First Health — First Health: $3,870
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 93452 LHC +/- LL vgram	$623	$560.70	$186.90 – $604.31
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $542.01 Aetna — AetnaMedicare: $186.90 Anthem — AnthemBluePOS/PPO: $554.47 Anthem — AnthemPathwayHMO/HIC/Tiered: $305.27 Anthem — AnthemTraditional: $566.93 Cigna — CignaCommercialHMO: $498.40 Cigna — CignaCommercialPPO: $498.40 ClaimsDoc — ClaimsDoc: $498.40 Emerald Health — Emerald Health: $604.31 First Health — First Health: $560.70
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LHC WITH VENTRICLE	$4,300	$3,870	$1,290 – $4,171
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $3,741 Aetna — AetnaMedicare: $1,290 Anthem — AnthemBluePOS/PPO: $3,827 Anthem — AnthemPathwayHMO/HIC/Tiered: $3,252.95 Anthem — AnthemTraditional: $3,913 Cigna — CignaCommercialHMO: $3,440 Cigna — CignaCommercialPPO: $3,440 ClaimsDoc — ClaimsDoc: $3,440 Emerald Health — Emerald Health: $4,171 First Health — First Health: $3,870
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	$961.05 – $989.88
Heart rhythm study (electrophysiology evaluation): 10 of 21 insurance plan rates Aetna — AetnaMedicare: $7,117.79 AmeriHealth — AmeriHealthMedicaid: $989.88 Anthem — AnthemMedicaid: $961.05 Anthem — AnthemMedicare: $7,117.79 Buckeye — BuckeyeMedicaid: $989.88 Buckeye — BuckeyeMedicare: $7,117.79 Caresource — CaresourceMedicaid: $961.05 Caresource — CareSourceMedicare: $7,117.79 Medical Mutual of Ohio — MMOMedicare: $7,117.79 Molina — MolinaMedicaid: $989.88
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$354.86 – $365.96
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Optum — VACCNOptum: $354.86 Perennial Advantage — Perennial Advantage: $354.86 Sidecar — SidecarCommercial: $365.96
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier TC In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$321.19
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Optum — VACCNOptum: $321.19 Perennial Advantage — Perennial Advantage: $321.19 Sidecar — SidecarCommercial: $321.19
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	$7,467.77 – $7,691.80
Heart rhythm study with ablation for atrial fibrillation: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $23,011.79 AmeriHealth — AmeriHealthMedicaid: $7,691.80 Anthem — AnthemMedicaid: $7,467.77 Anthem — AnthemMedicare: $23,011.79 Buckeye — BuckeyeMedicaid: $7,691.80 Buckeye — BuckeyeMedicare: $23,011.79 Caresource — CaresourceMedicaid: $7,467.77 Caresource — CareSourceMedicare: $23,011.79 Medical Mutual of Ohio — MMOMedicare: $23,011.79 Molina — MolinaMedicaid: $7,691.80
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$880.82 – $905.78
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans Optum — VACCNOptum: $880.82 Perennial Advantage — Perennial Advantage: $880.82 Sidecar — SidecarCommercial: $905.78
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnograpy	$5,890	$5,301	$1,767 – $5,713.30
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $5,124.30 Aetna — AetnaMedicare: $1,767 Anthem — AnthemBluePOS/PPO: $5,242.10 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,886.10 Anthem — AnthemTraditional: $5,359.90 Cigna — CignaCommercialHMO: $4,712 Cigna — CignaCommercialPPO: $4,712 ClaimsDoc — ClaimsDoc: $4,712 Emerald Health — Emerald Health: $5,713.30 First Health — First Health: $5,301
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Polysomnograpy	$5,890	$5,301	$1,767 – $5,713.30
Sleep study (overnight, in a sleep lab): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $5,124.30 Aetna — AetnaMedicare: $1,767 Anthem — AnthemBluePOS/PPO: $5,242.10 Anthem — AnthemPathwayHMO/HIC/Tiered: $4,455.78 Anthem — AnthemTraditional: $5,359.90 Cigna — CignaCommercialHMO: $4,712 Cigna — CignaCommercialPPO: $4,712 ClaimsDoc — ClaimsDoc: $4,712 Emerald Health — Emerald Health: $5,713.30 First Health — First Health: $5,301
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$434.07 – $447.09
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates Aetna — AetnaMedicare: $954.33 AmeriHealth — AmeriHealthMedicaid: $447.09 Anthem — AnthemMedicaid: $434.07 Anthem — AnthemMedicare: $954.33 Buckeye — BuckeyeMedicaid: $447.09 Buckeye — BuckeyeMedicare: $954.33 Caresource — CaresourceMedicaid: $434.07 Caresource — CareSourceMedicare: $954.33 Medical Mutual of Ohio — MMOMedicare: $954.33 Molina — MolinaMedicaid: $447.09

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: Therapeutic exercises	Not listed in the file	Not listed in the file	$52.41 – $53.99
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna — AetnaMedicare: $27.56 AmeriHealth — AmeriHealthMedicaid: $53.99 Anthem — AnthemMedicaid: $52.41 Anthem — AnthemMedicare: $27.56 Buckeye — BuckeyeMedicaid: $53.99 Buckeye — BuckeyeMedicare: $27.56 Caresource — CaresourceMedicaid: $52.41 Caresource — CareSourceMedicare: $27.56 Medical Mutual of Ohio — MMOMedicare: $27.56 Molina — MolinaMedicaid: $53.99
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$27.56 – $28.06
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans Optum — VACCNOptum: $27.56 Perennial Advantage — Perennial Advantage: $27.56 Sidecar — SidecarCommercial: $28.06
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: OT Therapeutic Exercise Charges	$120	$108	$36 – $116.40
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $104.40 Aetna — AetnaMedicare: $36 Anthem — AnthemBluePOS/PPO: $106.80 Anthem — AnthemPathwayHMO/HIC/Tiered: $58.80 Anthem — AnthemTraditional: $109.20 Cigna — CignaCommercialHMO: $96 Cigna — CignaCommercialPPO: $96 ClaimsDoc — ClaimsDoc: $96 Emerald Health — Emerald Health: $116.40 First Health — First Health: $108
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$57.41 – $59.13
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates Aetna — AetnaMedicare: $93.88 AmeriHealth — AmeriHealthMedicaid: $59.13 Anthem — AnthemMedicaid: $57.41 Anthem — AnthemMedicare: $93.88 Buckeye — BuckeyeMedicaid: $59.13 Buckeye — BuckeyeMedicare: $93.88 Caresource — CaresourceMedicaid: $57.41 Caresource — CareSourceMedicare: $93.88 Medical Mutual of Ohio — MMOMedicare: $93.88 Molina — MolinaMedicaid: $59.13
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$93.88 – $96
Physical therapy evaluation (low complexity): rates for 3 insurance plans Optum — VACCNOptum: $93.88 Perennial Advantage — Perennial Advantage: $93.88 Sidecar — SidecarCommercial: $96
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Low	$268	$241.20	$80.40 – $259.96
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $233.16 Aetna — AetnaMedicare: $80.40 Anthem — AnthemBluePOS/PPO: $238.52 Anthem — AnthemPathwayHMO/HIC/Tiered: $131.32 Anthem — AnthemTraditional: $243.88 Cigna — CignaCommercialHMO: $214.40 Cigna — CignaCommercialPPO: $214.40 ClaimsDoc — ClaimsDoc: $214.40 Emerald Health — Emerald Health: $259.96 First Health — First Health: $241.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$57.41 – $59.13
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates Aetna — AetnaMedicare: $93.88 AmeriHealth — AmeriHealthMedicaid: $59.13 Anthem — AnthemMedicaid: $57.41 Anthem — AnthemMedicare: $93.88 Buckeye — BuckeyeMedicaid: $59.13 Buckeye — BuckeyeMedicare: $93.88 Caresource — CaresourceMedicaid: $57.41 Caresource — CareSourceMedicare: $93.88 Medical Mutual of Ohio — MMOMedicare: $93.88 Molina — MolinaMedicaid: $59.13
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$93.88 – $96
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans Optum — VACCNOptum: $93.88 Perennial Advantage — Perennial Advantage: $93.88 Sidecar — SidecarCommercial: $96
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Moderate	$283	$254.70	$84.90 – $274.51
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $246.21 Aetna — AetnaMedicare: $84.90 Anthem — AnthemBluePOS/PPO: $251.87 Anthem — AnthemPathwayHMO/HIC/Tiered: $138.67 Anthem — AnthemTraditional: $257.53 Cigna — CignaCommercialHMO: $226.40 Cigna — CignaCommercialPPO: $226.40 ClaimsDoc — ClaimsDoc: $226.40 Emerald Health — Emerald Health: $274.51 First Health — First Health: $254.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$57.41 – $59.13
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates Aetna — AetnaMedicare: $93.88 AmeriHealth — AmeriHealthMedicaid: $59.13 Anthem — AnthemMedicaid: $57.41 Anthem — AnthemMedicare: $93.88 Buckeye — BuckeyeMedicaid: $59.13 Buckeye — BuckeyeMedicare: $93.88 Caresource — CaresourceMedicaid: $57.41 Caresource — CareSourceMedicare: $93.88 Medical Mutual of Ohio — MMOMedicare: $93.88 Molina — MolinaMedicaid: $59.13
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$93.88 – $96
Physical therapy evaluation (high complexity): rates for 3 insurance plans Optum — VACCNOptum: $93.88 Perennial Advantage — Perennial Advantage: $93.88 Sidecar — SidecarCommercial: $96
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation High	$325	$292.50	$97.50 – $315.25
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $282.75 Aetna — AetnaMedicare: $97.50 Anthem — AnthemBluePOS/PPO: $289.25 Anthem — AnthemPathwayHMO/HIC/Tiered: $159.25 Anthem — AnthemTraditional: $295.75 Cigna — CignaCommercialHMO: $260 Cigna — CignaCommercialPPO: $260 ClaimsDoc — ClaimsDoc: $260 Emerald Health — Emerald Health: $315.25 First Health — First Health: $292.50
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psychotherapy, 30 Mins 90832	$138	$124.20	$41.40 – $133.86
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $120.06 Aetna — AetnaMedicare: $41.40 Anthem — AnthemBluePOS/PPO: $122.82 Anthem — AnthemPathwayHMO/HIC/Tiered: $67.62 Anthem — AnthemTraditional: $125.58 Cigna — CignaCommercialHMO: $110.40 Cigna — CignaCommercialPPO: $110.40 ClaimsDoc — ClaimsDoc: $110.40 Emerald Health — Emerald Health: $133.86 First Health — First Health: $124.20
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TELEHEALTH Psychotherapy, 30 Mins 90832	$131	$117.90	$39.30 – $127.07
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $113.97 Aetna — AetnaMedicare: $39.30 Anthem — AnthemBluePOS/PPO: $116.59 Anthem — AnthemPathwayHMO/HIC/Tiered: $64.19 Anthem — AnthemTraditional: $119.21 Cigna — CignaCommercialHMO: $104.80 Cigna — CignaCommercialPPO: $104.80 ClaimsDoc — ClaimsDoc: $104.80 Emerald Health — Emerald Health: $127.07 First Health — First Health: $117.90
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Psychotherapy, 30 Mins 90832	$138	$124.20	$41.40 – $133.86
Psychotherapy, 30 minutes: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $120.06 Aetna — AetnaMedicare: $41.40 Anthem — AnthemBluePOS/PPO: $122.82 Anthem — AnthemPathwayHMO/HIC/Tiered: $104.40 Anthem — AnthemTraditional: $125.58 Cigna — CignaCommercialHMO: $110.40 Cigna — CignaCommercialPPO: $110.40 ClaimsDoc — ClaimsDoc: $110.40 Emerald Health — Emerald Health: $133.86 First Health — First Health: $124.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psychotherapy, 45 Mins 90834	$184	$165.60	$55.20 – $178.48
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $160.08 Aetna — AetnaMedicare: $55.20 Anthem — AnthemBluePOS/PPO: $163.76 Anthem — AnthemPathwayHMO/HIC/Tiered: $90.16 Anthem — AnthemTraditional: $167.44 Cigna — CignaCommercialHMO: $147.20 Cigna — CignaCommercialPPO: $147.20 ClaimsDoc — ClaimsDoc: $147.20 Emerald Health — Emerald Health: $178.48 First Health — First Health: $165.60
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TELEHEALTH Psychotherapy, 45 Mins 90834	$173	$155.70	$51.90 – $167.81
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $150.51 Aetna — AetnaMedicare: $51.90 Anthem — AnthemBluePOS/PPO: $153.97 Anthem — AnthemPathwayHMO/HIC/Tiered: $84.77 Anthem — AnthemTraditional: $157.43 Cigna — CignaCommercialHMO: $138.40 Cigna — CignaCommercialPPO: $138.40 ClaimsDoc — ClaimsDoc: $138.40 Emerald Health — Emerald Health: $167.81 First Health — First Health: $155.70
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Psychotherapy, 45 Mins 90834	$184	$165.60	$55.20 – $178.48
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $160.08 Aetna — AetnaMedicare: $55.20 Anthem — AnthemBluePOS/PPO: $163.76 Anthem — AnthemPathwayHMO/HIC/Tiered: $139.20 Anthem — AnthemTraditional: $167.44 Cigna — CignaCommercialHMO: $147.20 Cigna — CignaCommercialPPO: $147.20 ClaimsDoc — ClaimsDoc: $147.20 Emerald Health — Emerald Health: $178.48 First Health — First Health: $165.60
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psychotherapy, 60 Mins 90837	$275	$247.50	$82.50 – $266.75
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $239.25 Aetna — AetnaMedicare: $82.50 Anthem — AnthemBluePOS/PPO: $244.75 Anthem — AnthemPathwayHMO/HIC/Tiered: $134.75 Anthem — AnthemTraditional: $250.25 Cigna — CignaCommercialHMO: $220 Cigna — CignaCommercialPPO: $220 ClaimsDoc — ClaimsDoc: $220 Emerald Health — Emerald Health: $266.75 First Health — First Health: $247.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TELEHEALTH Psychotherapy, 60 Mins 90837	$260	$234	$78 – $252.20
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $226.20 Aetna — AetnaMedicare: $78 Anthem — AnthemBluePOS/PPO: $231.40 Anthem — AnthemPathwayHMO/HIC/Tiered: $127.40 Anthem — AnthemTraditional: $236.60 Cigna — CignaCommercialHMO: $208 Cigna — CignaCommercialPPO: $208 ClaimsDoc — ClaimsDoc: $208 Emerald Health — Emerald Health: $252.20 First Health — First Health: $234
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Psychotherapy, 60 Mins 90837	$275	$247.50	$82.50 – $266.75
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $239.25 Aetna — AetnaMedicare: $82.50 Anthem — AnthemBluePOS/PPO: $244.75 Anthem — AnthemPathwayHMO/HIC/Tiered: $208.04 Anthem — AnthemTraditional: $250.25 Cigna — CignaCommercialHMO: $220 Cigna — CignaCommercialPPO: $220 ClaimsDoc — ClaimsDoc: $220 Emerald Health — Emerald Health: $266.75 First Health — First Health: $247.50
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family, Couples Psychotherapy W/O Patient 90846	$221	$198.90	$66.30 – $214.37
Family psychotherapy, without the patient: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $192.27 Aetna — AetnaMedicare: $66.30 Anthem — AnthemBluePOS/PPO: $196.69 Anthem — AnthemPathwayHMO/HIC/Tiered: $108.29 Anthem — AnthemTraditional: $201.11 Cigna — CignaCommercialHMO: $176.80 Cigna — CignaCommercialPPO: $176.80 ClaimsDoc — ClaimsDoc: $176.80 Emerald Health — Emerald Health: $214.37 First Health — First Health: $198.90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Telehealth Family, Couples Psychotherapy W/O Patient 90846	$221	$198.90	$66.30 – $214.37
Family psychotherapy, without the patient: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $192.27 Aetna — AetnaMedicare: $66.30 Anthem — AnthemBluePOS/PPO: $196.69 Anthem — AnthemPathwayHMO/HIC/Tiered: $108.29 Anthem — AnthemTraditional: $201.11 Cigna — CignaCommercialHMO: $176.80 Cigna — CignaCommercialPPO: $176.80 ClaimsDoc — ClaimsDoc: $176.80 Emerald Health — Emerald Health: $214.37 First Health — First Health: $198.90
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Family, Couples Psychotherapy W/O Patient 90846	$221	$198.90	$66.30 – $214.37
Family psychotherapy, without the patient: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $192.27 Aetna — AetnaMedicare: $66.30 Anthem — AnthemBluePOS/PPO: $196.69 Anthem — AnthemPathwayHMO/HIC/Tiered: $167.19 Anthem — AnthemTraditional: $201.11 Cigna — CignaCommercialHMO: $176.80 Cigna — CignaCommercialPPO: $176.80 ClaimsDoc — ClaimsDoc: $176.80 Emerald Health — Emerald Health: $214.37 First Health — First Health: $198.90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family, Couples Psychotherapy With Patient 90847	$231	$207.90	$69.30 – $224.07
Family psychotherapy, with the patient: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $200.97 Aetna — AetnaMedicare: $69.30 Anthem — AnthemBluePOS/PPO: $205.59 Anthem — AnthemPathwayHMO/HIC/Tiered: $113.19 Anthem — AnthemTraditional: $210.21 Cigna — CignaCommercialHMO: $184.80 Cigna — CignaCommercialPPO: $184.80 ClaimsDoc — ClaimsDoc: $184.80 Emerald Health — Emerald Health: $224.07 First Health — First Health: $207.90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Telehealth Family, Couples Psychotherapy With Patient 90847	$231	$207.90	$69.30 – $224.07
Family psychotherapy, with the patient: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $200.97 Aetna — AetnaMedicare: $69.30 Anthem — AnthemBluePOS/PPO: $205.59 Anthem — AnthemPathwayHMO/HIC/Tiered: $113.19 Anthem — AnthemTraditional: $210.21 Cigna — CignaCommercialHMO: $184.80 Cigna — CignaCommercialPPO: $184.80 ClaimsDoc — ClaimsDoc: $184.80 Emerald Health — Emerald Health: $224.07 First Health — First Health: $207.90
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Family, Couples Psychotherapy With Patient 90847	$231	$207.90	$69.30 – $224.07
Family psychotherapy, with the patient: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $200.97 Aetna — AetnaMedicare: $69.30 Anthem — AnthemBluePOS/PPO: $205.59 Anthem — AnthemPathwayHMO/HIC/Tiered: $174.75 Anthem — AnthemTraditional: $210.21 Cigna — CignaCommercialHMO: $184.80 Cigna — CignaCommercialPPO: $184.80 ClaimsDoc — ClaimsDoc: $184.80 Emerald Health — Emerald Health: $224.07 First Health — First Health: $207.90
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Group Therapy 90853	$55	$49.50	$16.50 – $53.35
Group psychotherapy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $47.85 Aetna — AetnaMedicare: $16.50 Anthem — AnthemBluePOS/PPO: $48.95 Anthem — AnthemPathwayHMO/HIC/Tiered: $26.95 Anthem — AnthemTraditional: $50.05 Cigna — CignaCommercialHMO: $44 Cigna — CignaCommercialPPO: $44 ClaimsDoc — ClaimsDoc: $44 Emerald Health — Emerald Health: $53.35 First Health — First Health: $49.50
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Group Therapy 90853	$55	$49.50	$16.50 – $53.35
Group psychotherapy: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $47.85 Aetna — AetnaMedicare: $16.50 Anthem — AnthemBluePOS/PPO: $48.95 Anthem — AnthemPathwayHMO/HIC/Tiered: $41.61 Anthem — AnthemTraditional: $50.05 Cigna — CignaCommercialHMO: $44 Cigna — CignaCommercialPPO: $44 ClaimsDoc — ClaimsDoc: $44 Emerald Health — Emerald Health: $53.35 First Health — First Health: $49.50
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: Group Therapy 90853	Not listed in the file	Not listed in the file	$18.04
Group psychotherapy: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $31.59 Aetna — AetnaMedicare: $24.05 Anthem — AnthemBluePOS/PPO: $27.66 Anthem — AnthemMedicare: $24.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $27.66 Anthem — AnthemTraditional: $27.66 Buckeye — BuckeyeMedicare: $24.05 Caresource — CareSourceMedicare: $24.05 Cigna — CignaCommercial: $33.67 Clarity Health — ClarityHealth: $33.67

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 19120 Excision cyst/fibroadenoma, benign/malig breast tumor(s), duct/nipple/areolar lesion(s), M/F	$1,061	$954.90	$318.30 – $1,029.17
Removal of breast growth (open surgery): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $923.07 Aetna — AetnaMedicare: $318.30 Anthem — AnthemBluePOS/PPO: $944.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $519.89 Anthem — AnthemTraditional: $965.51 Cigna — CignaCommercialHMO: $848.80 Cigna — CignaCommercialPPO: $848.80 ClaimsDoc — ClaimsDoc: $848.80 Emerald Health — Emerald Health: $1,029.17 First Health — First Health: $954.90
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 19120 Excision cyst/fibroadenoma, benign/malig breast tumor(s), duct/nipple/areolar lesion(s), M/F	$1,061	$954.90	$318.30 – $1,029.17
Removal of breast growth (open surgery): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $923.07 Aetna — AetnaMedicare: $318.30 Anthem — AnthemBluePOS/PPO: $944.29 Anthem — AnthemPathwayHMO/HIC/Tiered: $802.65 Anthem — AnthemTraditional: $965.51 Cigna — CignaCommercialHMO: $848.80 Cigna — CignaCommercialPPO: $848.80 ClaimsDoc — ClaimsDoc: $848.80 Emerald Health — Emerald Health: $1,029.17 First Health — First Health: $954.90
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: 19120 Excision cyst/fibroadenoma, benign/malig breast tumor(s), duct/nipple/areolar lesion(s), M/F	Not listed in the file	Not listed in the file	$215.08 – $598.22
Removal of breast growth (open surgery): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $572.02 Aetna — AetnaMedicare: $398.81 Anthem — AnthemBluePOS/PPO: $458.63 Anthem — AnthemMedicare: $398.81 Anthem — AnthemPathwayHMO/HIC/Tiered: $458.63 Anthem — AnthemTraditional: $458.63 Buckeye — BuckeyeMedicare: $398.81 Caresource — CareSourceMedicare: $398.81 Cigna — CignaCommercial: $558.34 Clarity Health — ClarityHealth: $558.34
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	$4,855.69 – $5,001.36
Total hip replacement: 10 of 23 insurance plan rates Aetna — AetnaMedicare: $12,069.33 AmeriHealth — AmeriHealthMedicaid: $5,001.36 Anthem — AnthemBluePOS/PPO: $45,218 Anthem — AnthemMedicaid: $4,855.69 Anthem — AnthemMedicare: $12,069.33 Anthem — AnthemPathwayHMO/HIC/Tiered: $24,633 Buckeye — BuckeyeMedicaid: $5,001.36 Buckeye — BuckeyeMedicare: $12,069.33 Caresource — CaresourceMedicaid: $4,855.69 Caresource — CareSourceMedicare: $12,069.33
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,829.03 – $1,868.82
Total hip replacement: rates for 3 insurance plans Optum — VACCNOptum: $1,829.03 Perennial Advantage — Perennial Advantage: $1,829.03 Sidecar — SidecarCommercial: $1,868.82
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$841.35 – $859.66
Total hip replacement: rates for 3 insurance plans Optum — VACCNOptum: $841.35 Perennial Advantage — Perennial Advantage: $841.35 Sidecar — SidecarCommercial: $859.66
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	$4,855.69 – $5,001.36
Total knee replacement: 10 of 23 insurance plan rates Aetna — AetnaMedicare: $12,069.33 AmeriHealth — AmeriHealthMedicaid: $5,001.36 Anthem — AnthemBluePOS/PPO: $45,697 Anthem — AnthemMedicaid: $4,855.69 Anthem — AnthemMedicare: $12,069.33 Anthem — AnthemPathwayHMO/HIC/Tiered: $24,894 Buckeye — BuckeyeMedicaid: $5,001.36 Buckeye — BuckeyeMedicare: $12,069.33 Caresource — CaresourceMedicaid: $4,855.69 Caresource — CareSourceMedicare: $12,069.33
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$840.30 – $858.35
Total knee replacement: rates for 3 insurance plans Optum — VACCNOptum: $840.30 Perennial Advantage — Perennial Advantage: $840.30 Sidecar — SidecarCommercial: $858.35
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$1,826.75 – $1,865.97
Total knee replacement: rates for 3 insurance plans Optum — VACCNOptum: $1,826.75 Perennial Advantage — Perennial Advantage: $1,826.75 Sidecar — SidecarCommercial: $1,865.97
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$1,128.24 – $1,162.09
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans AmeriHealth — AmeriHealthMedicaid: $1,162.09 Anthem — AnthemMedicaid: $1,128.24 Buckeye — BuckeyeMedicaid: $1,162.09 Caresource — CaresourceMedicaid: $1,128.24 Molina — MolinaMedicaid: $1,162.09 United Healthcare — UnitedMedicaid: $1,162.09
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 80\|81\|82 In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$26.04 – $26.54
Shoulder arthroscopy: shaving of shoulder bone: rates for 3 insurance plans Optum — VACCNOptum: $26.04 Perennial Advantage — Perennial Advantage: $26.04 Sidecar — SidecarCommercial: $26.54
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$244.08 – $248.85
Shoulder arthroscopy: shaving of shoulder bone: rates for 3 insurance plans Optum — VACCNOptum: $244.08 Perennial Advantage — Perennial Advantage: $244.08 Sidecar — SidecarCommercial: $248.85
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$1,128.24 – $1,162.09
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates Aetna — AetnaMedicare: $3,043.51 AmeriHealth — AmeriHealthMedicaid: $1,162.09 Anthem — AnthemBluePOS/PPO: $23,051 Anthem — AnthemMedicaid: $1,128.24 Anthem — AnthemMedicare: $3,043.51 Anthem — AnthemPathwayHMO/HIC/Tiered: $12,557 Buckeye — BuckeyeMedicaid: $1,162.09 Buckeye — BuckeyeMedicare: $3,043.51 Caresource — CaresourceMedicaid: $1,128.24 Caresource — CareSourceMedicare: $3,043.51
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$774.11 – $790.31
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Optum — VACCNOptum: $774.11 Perennial Advantage — Perennial Advantage: $774.11 Sidecar — SidecarCommercial: $790.31
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$356.09 – $363.54
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Optum — VACCNOptum: $356.09 Perennial Advantage — Perennial Advantage: $356.09 Sidecar — SidecarCommercial: $363.54
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	$883.73 – $910.24
Removal of tonsils and adenoids (under age 12): 10 of 21 insurance plan rates Aetna — AetnaMedicare: $5,549.01 AmeriHealth — AmeriHealthMedicaid: $910.24 Anthem — AnthemMedicaid: $883.73 Anthem — AnthemMedicare: $5,549.01 Buckeye — BuckeyeMedicaid: $910.24 Buckeye — BuckeyeMedicare: $5,549.01 Caresource — CaresourceMedicaid: $883.73 Caresource — CareSourceMedicare: $5,549.01 Medical Mutual of Ohio — MMOMedicare: $5,549.01 Molina — MolinaMedicaid: $910.24
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$223.98 – $229.51
Removal of tonsils and adenoids (under age 12): rates for 3 insurance plans Optum — VACCNOptum: $223.98 Perennial Advantage — Perennial Advantage: $223.98 Sidecar — SidecarCommercial: $229.51
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 43235 EGD Diagnostic, flexible, transoral including collection of specimen(s) 43235	$320	$288	$96 – $310.40
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $278.40 Aetna — AetnaMedicare: $96 Anthem — AnthemBluePOS/PPO: $284.80 Anthem — AnthemPathwayHMO/HIC/Tiered: $156.80 Anthem — AnthemTraditional: $291.20 Cigna — CignaCommercialHMO: $256 Cigna — CignaCommercialPPO: $256 ClaimsDoc — ClaimsDoc: $256 Emerald Health — Emerald Health: $310.40 First Health — First Health: $288
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 43235 EGD Diagnostic, flexible, transoral including collection of specimen(s) 43235	$320	$288	$96 – $310.40
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $278.40 Aetna — AetnaMedicare: $96 Anthem — AnthemBluePOS/PPO: $284.80 Anthem — AnthemPathwayHMO/HIC/Tiered: $242.08 Anthem — AnthemTraditional: $291.20 Cigna — CignaCommercialHMO: $256 Cigna — CignaCommercialPPO: $256 ClaimsDoc — ClaimsDoc: $256 Emerald Health — Emerald Health: $310.40 First Health — First Health: $288
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: 43235 EGD Diagnostic, flexible, transoral including collection of specimen(s) 43235	Not listed in the file	Not listed in the file	$97.44
Upper GI endoscopy (diagnostic): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $186.69 Aetna — AetnaMedicare: $114.64 Anthem — AnthemBluePOS/PPO: $131.84 Anthem — AnthemMedicare: $114.64 Anthem — AnthemPathwayHMO/HIC/Tiered: $131.84 Anthem — AnthemTraditional: $131.84 Buckeye — BuckeyeMedicare: $114.64 Caresource — CareSourceMedicare: $114.64 Cigna — CignaCommercial: $160.49 Clarity Health — ClarityHealth: $160.49
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 43239 EGD w/ biopsy, single or multiple 43239	$362	$325.80	$108.60 – $351.14
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $314.94 Aetna — AetnaMedicare: $108.60 Anthem — AnthemBluePOS/PPO: $322.18 Anthem — AnthemPathwayHMO/HIC/Tiered: $177.38 Anthem — AnthemTraditional: $329.42 Cigna — CignaCommercialHMO: $289.60 Cigna — CignaCommercialPPO: $289.60 ClaimsDoc — ClaimsDoc: $289.60 Emerald Health — Emerald Health: $351.14 First Health — First Health: $325.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 43239 EGD w/ biopsy, single or multiple 43239	$362	$325.80	$108.60 – $351.14
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $314.94 Aetna — AetnaMedicare: $108.60 Anthem — AnthemBluePOS/PPO: $322.18 Anthem — AnthemPathwayHMO/HIC/Tiered: $273.85 Anthem — AnthemTraditional: $329.42 Cigna — CignaCommercialHMO: $289.60 Cigna — CignaCommercialPPO: $289.60 ClaimsDoc — ClaimsDoc: $289.60 Emerald Health — Emerald Health: $351.14 First Health — First Health: $325.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: 43239 EGD w/ biopsy, single or multiple 43239	Not listed in the file	Not listed in the file	$109.52
Upper GI endoscopy with biopsy: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $211.04 Aetna — AetnaMedicare: $128.84 Anthem — AnthemBluePOS/PPO: $148.17 Anthem — AnthemMedicare: $128.84 Anthem — AnthemPathwayHMO/HIC/Tiered: $148.17 Anthem — AnthemTraditional: $148.17 Buckeye — BuckeyeMedicare: $128.84 Caresource — CareSourceMedicare: $128.84 Cigna — CignaCommercial: $180.38 Clarity Health — ClarityHealth: $180.38
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 45378 COLONOSCOPY (inc collection of specimens by brushing/washing when performed) 45378	$485	$436.50	$145.50 – $470.45
Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $421.95 Aetna — AetnaMedicare: $145.50 Anthem — AnthemBluePOS/PPO: $431.65 Anthem — AnthemPathwayHMO/HIC/Tiered: $237.65 Anthem — AnthemTraditional: $441.35 Cigna — CignaCommercialHMO: $388 Cigna — CignaCommercialPPO: $388 ClaimsDoc — ClaimsDoc: $388 Emerald Health — Emerald Health: $470.45 First Health — First Health: $436.50
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 45378 - 52 Looping 45378 - 52	$485	$436.50	$145.50 – $470.45
Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $421.95 Aetna — AetnaMedicare: $145.50 Anthem — AnthemBluePOS/PPO: $431.65 Anthem — AnthemPathwayHMO/HIC/Tiered: $237.65 Anthem — AnthemTraditional: $441.35 Cigna — CignaCommercialHMO: $388 Cigna — CignaCommercialPPO: $388 ClaimsDoc — ClaimsDoc: $388 Emerald Health — Emerald Health: $470.45 First Health — First Health: $436.50
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 45378 COLONOSCOPY (inc collection of specimens by brushing/washing when performed) 45378	$485	$436.50	$145.50 – $470.45
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $421.95 Aetna — AetnaMedicare: $145.50 Anthem — AnthemBluePOS/PPO: $431.65 Anthem — AnthemPathwayHMO/HIC/Tiered: $366.90 Anthem — AnthemTraditional: $441.35 Cigna — CignaCommercialHMO: $388 Cigna — CignaCommercialPPO: $388 ClaimsDoc — ClaimsDoc: $388 Emerald Health — Emerald Health: $470.45 First Health — First Health: $436.50
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 45380 Colonoscopy w/ biopsy, single or multiple 45380	$525	$472.50	$157.50 – $509.25
Colonoscopy with biopsy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $456.75 Aetna — AetnaMedicare: $157.50 Anthem — AnthemBluePOS/PPO: $467.25 Anthem — AnthemPathwayHMO/HIC/Tiered: $257.25 Anthem — AnthemTraditional: $477.75 Cigna — CignaCommercialHMO: $420 Cigna — CignaCommercialPPO: $420 ClaimsDoc — ClaimsDoc: $420 Emerald Health — Emerald Health: $509.25 First Health — First Health: $472.50
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 45380 Colonoscopy w/ biopsy, single or multiple 45380	$525	$472.50	$157.50 – $509.25
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $456.75 Aetna — AetnaMedicare: $157.50 Anthem — AnthemBluePOS/PPO: $467.25 Anthem — AnthemPathwayHMO/HIC/Tiered: $397.16 Anthem — AnthemTraditional: $477.75 Cigna — CignaCommercialHMO: $420 Cigna — CignaCommercialPPO: $420 ClaimsDoc — ClaimsDoc: $420 Emerald Health — Emerald Health: $509.25 First Health — First Health: $472.50
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: 45380 Colonoscopy w/ biopsy, single or multiple 45380	Not listed in the file	Not listed in the file	$159.58
Colonoscopy with biopsy: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $305.28 Aetna — AetnaMedicare: $187.73 Anthem — AnthemBluePOS/PPO: $215.89 Anthem — AnthemMedicare: $187.73 Anthem — AnthemPathwayHMO/HIC/Tiered: $215.89 Anthem — AnthemTraditional: $215.89 Buckeye — BuckeyeMedicare: $187.73 Caresource — CareSourceMedicare: $187.73 Cigna — CignaCommercial: $262.82 Clarity Health — ClarityHealth: $262.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 45385 Colonoscopy w/ removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45385	$668	$601.20	$200.40 – $647.96
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $581.16 Aetna — AetnaMedicare: $200.40 Anthem — AnthemBluePOS/PPO: $594.52 Anthem — AnthemPathwayHMO/HIC/Tiered: $327.32 Anthem — AnthemTraditional: $607.88 Cigna — CignaCommercialHMO: $534.40 Cigna — CignaCommercialPPO: $534.40 ClaimsDoc — ClaimsDoc: $534.40 Emerald Health — Emerald Health: $647.96 First Health — First Health: $601.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 45385 Colonoscopy w/ removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45385	$668	$601.20	$200.40 – $647.96
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $581.16 Aetna — AetnaMedicare: $200.40 Anthem — AnthemBluePOS/PPO: $594.52 Anthem — AnthemPathwayHMO/HIC/Tiered: $505.34 Anthem — AnthemTraditional: $607.88 Cigna — CignaCommercialHMO: $534.40 Cigna — CignaCommercialPPO: $534.40 ClaimsDoc — ClaimsDoc: $534.40 Emerald Health — Emerald Health: $647.96 First Health — First Health: $601.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: 45385 Colonoscopy w/ removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45385	Not listed in the file	Not listed in the file	$201.17
Colonoscopy with removal of polyps (snare): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $386.58 Aetna — AetnaMedicare: $236.67 Anthem — AnthemBluePOS/PPO: $272.17 Anthem — AnthemMedicare: $236.67 Anthem — AnthemPathwayHMO/HIC/Tiered: $272.17 Anthem — AnthemTraditional: $272.17 Buckeye — BuckeyeMedicare: $236.67 Caresource — CareSourceMedicare: $236.67 Cigna — CignaCommercial: $331.34 Clarity Health — ClarityHealth: $331.34
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	$548.41 – $564.86
Ultrasound of the lower bowel by endoscope: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $1,106 AmeriHealth — AmeriHealthMedicaid: $564.86 Anthem — AnthemMedicaid: $548.41 Anthem — AnthemMedicare: $1,106 Buckeye — BuckeyeMedicaid: $564.86 Buckeye — BuckeyeMedicare: $1,106 Caresource — CaresourceMedicaid: $548.41 Caresource — CareSourceMedicare: $1,106 Medical Mutual of Ohio — MMOMedicare: $1,106 Molina — MolinaMedicaid: $564.86
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$239.74 – $246.11
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans Optum — VACCNOptum: $239.74 Perennial Advantage — Perennial Advantage: $239.74 Sidecar — SidecarCommercial: $246.11
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	$194	$174.60	$58.20 – $188.18
Screening colonoscopy (not high risk): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $168.78 Aetna — AetnaMedicare: $58.20 Anthem — AnthemBluePOS/PPO: $172.66 Anthem — AnthemPathwayHMO/HIC/Tiered: $95.06 Anthem — AnthemTraditional: $176.54 Cigna — CignaCommercialHMO: $155.20 Cigna — CignaCommercialPPO: $155.20 ClaimsDoc — ClaimsDoc: $155.20 Emerald Health — Emerald Health: $188.18 First Health — First Health: $174.60
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	$194	$174.60	$58.20 – $188.18
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $168.78 Aetna — AetnaMedicare: $58.20 Anthem — AnthemBluePOS/PPO: $172.66 Anthem — AnthemPathwayHMO/HIC/Tiered: $146.76 Anthem — AnthemTraditional: $176.54 Cigna — CignaCommercialHMO: $155.20 Cigna — CignaCommercialPPO: $155.20 ClaimsDoc — ClaimsDoc: $155.20 Emerald Health — Emerald Health: $188.18 First Health — First Health: $174.60
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Not listed in the file	Not listed in the file	$146.96
Screening colonoscopy (not high risk): 10 of 35 insurance plan rates Aetna — AetnaCommercial: $203.24 Aetna — AetnaMedicare: $172.90 Anthem — AnthemBluePOS/PPO: $198.83 Anthem — AnthemMedicare: $172.90 Anthem — AnthemPathwayHMO/HIC/Tiered: $198.83 Anthem — AnthemTraditional: $198.83 Buckeye — BuckeyeMedicare: $172.90 Caresource — CareSourceMedicare: $172.90 Clarity Health — ClarityHealth: $242.06 Coresource — CoreSource: $175.21
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 47562 Laparoscopy, surgical; cholecystectomy	$1,706	$1,535.40	$511.80 – $1,654.82
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,484.22 Aetna — AetnaMedicare: $511.80 Anthem — AnthemBluePOS/PPO: $1,518.34 Anthem — AnthemPathwayHMO/HIC/Tiered: $835.94 Anthem — AnthemTraditional: $1,552.46 Cigna — CignaCommercialHMO: $1,364.80 Cigna — CignaCommercialPPO: $1,364.80 ClaimsDoc — ClaimsDoc: $1,364.80 Emerald Health — Emerald Health: $1,654.82 First Health — First Health: $1,535.40
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 47562 Laparoscopy, surgical; cholecystectomy	$1,706	$1,535.40	$511.80 – $1,654.82
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,484.22 Aetna — AetnaMedicare: $511.80 Anthem — AnthemBluePOS/PPO: $1,518.34 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,290.59 Anthem — AnthemTraditional: $1,552.46 Cigna — CignaCommercialHMO: $1,364.80 Cigna — CignaCommercialPPO: $1,364.80 ClaimsDoc — ClaimsDoc: $1,364.80 Emerald Health — Emerald Health: $1,654.82 First Health — First Health: $1,535.40
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: 47562 Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$515.68 – $1,027.62
Gallbladder removal by laparoscope: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $1,027.62 Aetna — AetnaMedicare: $631.60 Anthem — AnthemBluePOS/PPO: $726.34 Anthem — AnthemMedicare: $631.60 Anthem — AnthemPathwayHMO/HIC/Tiered: $726.34 Anthem — AnthemTraditional: $726.34 Buckeye — BuckeyeMedicare: $631.60 Caresource — CareSourceMedicare: $631.60 Cigna — CignaCommercial: $884.24 Clarity Health — ClarityHealth: $884.24
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 49505 Repair initial inguinal hernia, age 5 years or over; reducible	$1,345	$1,210.50	$403.50 – $1,304.65
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,170.15 Aetna — AetnaMedicare: $403.50 Anthem — AnthemBluePOS/PPO: $1,197.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $659.05 Anthem — AnthemTraditional: $1,223.95 Cigna — CignaCommercialHMO: $1,076 Cigna — CignaCommercialPPO: $1,076 ClaimsDoc — ClaimsDoc: $1,076 Emerald Health — Emerald Health: $1,304.65 First Health — First Health: $1,210.50
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 49505 Repair initial inguinal hernia, age 5 years or over; reducible	$1,345	$1,210.50	$403.50 – $1,304.65
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,170.15 Aetna — AetnaMedicare: $403.50 Anthem — AnthemBluePOS/PPO: $1,197.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,017.49 Anthem — AnthemTraditional: $1,223.95 Cigna — CignaCommercialHMO: $1,076 Cigna — CignaCommercialPPO: $1,076 ClaimsDoc — ClaimsDoc: $1,076 Emerald Health — Emerald Health: $1,304.65 First Health — First Health: $1,210.50
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: 49505 Repair initial inguinal hernia, age 5 years or over; reducible	Not listed in the file	Not listed in the file	$313.69 – $813.87
Groin (inguinal) hernia repair, age 5 or older: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $813.87 Aetna — AetnaMedicare: $500.48 Anthem — AnthemBluePOS/PPO: $575.56 Anthem — AnthemMedicare: $500.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $575.56 Anthem — AnthemTraditional: $575.56 Buckeye — BuckeyeMedicare: $500.48 Caresource — CareSourceMedicare: $500.48 Cigna — CignaCommercial: $700.68 Clarity Health — ClarityHealth: $700.68
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Prostate Biopsy	$7,562	$6,805.80	$2,268.60 – $7,335.14
Prostate biopsy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $6,578.94 Aetna — AetnaMedicare: $2,268.60 Anthem — AnthemBluePOS/PPO: $6,730.18 Anthem — AnthemPathwayHMO/HIC/Tiered: $3,705.38 Anthem — AnthemTraditional: $6,881.42 Cigna — CignaCommercialHMO: $6,049.60 Cigna — CignaCommercialPPO: $6,049.60 ClaimsDoc — ClaimsDoc: $6,049.60 Emerald Health — Emerald Health: $7,335.14 First Health — First Health: $6,805.80
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRUS WITH BIOPSY OF PROSTATE	$7,562	$6,805.80	$2,268.60 – $7,335.14
Prostate biopsy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $6,578.94 Aetna — AetnaMedicare: $2,268.60 Anthem — AnthemBluePOS/PPO: $6,730.18 Anthem — AnthemPathwayHMO/HIC/Tiered: $3,705.38 Anthem — AnthemTraditional: $6,881.42 Cigna — CignaCommercialHMO: $6,049.60 Cigna — CignaCommercialPPO: $6,049.60 ClaimsDoc — ClaimsDoc: $6,049.60 Emerald Health — Emerald Health: $7,335.14 First Health — First Health: $6,805.80
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URONAV MRI FUSION SYSTEM	$7,060.55	$6,354.49	$2,118.16 – $6,848.73
Prostate biopsy: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $6,142.68 Aetna — AetnaMedicare: $2,118.16 Anthem — AnthemBluePOS/PPO: $6,283.89 Anthem — AnthemPathwayHMO/HIC/Tiered: $3,459.67 Anthem — AnthemTraditional: $6,425.10 Cigna — CignaCommercialHMO: $5,648.44 Cigna — CignaCommercialPPO: $5,648.44 ClaimsDoc — ClaimsDoc: $5,648.44 Emerald Health — Emerald Health: $6,848.73 First Health — First Health: $6,354.50
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 55866 Laparoscopy, surgical prostatectomy, retropubic radical incl nerve sparing, robotic assist	$3,750	$3,375	$1,125 – $3,637.50
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates Aetna — AetnaCommercial: $3,262.50 Aetna — AetnaMedicare: $1,125 Anthem — AnthemBluePOS/PPO: $3,337.50 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,837.50 Anthem — AnthemTraditional: $3,412.50 Cigna — CignaCommercialHMO: $3,000 Cigna — CignaCommercialPPO: $3,000 ClaimsDoc — ClaimsDoc: $3,000 Emerald Health — Emerald Health: $3,637.50 First Health — First Health: $3,375
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Doctor (professional) fee In the file: 55866 Laparoscopy, surgical prostatectomy, retropubic radical incl nerve sparing, robotic assist	$3,750	$3,375	$1,125 – $3,637.50
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates Aetna — AetnaCommercial: $3,262.50 Aetna — AetnaMedicare: $1,125 Anthem — AnthemBluePOS/PPO: $3,337.50 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,836.88 Anthem — AnthemTraditional: $3,412.50 Cigna — CignaCommercialHMO: $3,000 Cigna — CignaCommercialPPO: $3,000 ClaimsDoc — ClaimsDoc: $3,000 Emerald Health — Emerald Health: $3,637.50 First Health — First Health: $3,375
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: 55866 Laparoscopy, surgical prostatectomy, retropubic radical incl nerve sparing, robotic assist	Not listed in the file	Not listed in the file	$959.85
Prostate removal by laparoscope (radical prostatectomy): 10 of 39 insurance plan rates Aetna — AetnaCommercial: $1,910.10 Aetna — AetnaMedicare: $1,129.24 Anthem — AnthemBluePOS/PPO: $1,298.62 Anthem — AnthemMedicare: $1,129.24 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,298.62 Anthem — AnthemTraditional: $1,298.62 Buckeye — BuckeyeMedicare: $1,129.24 Caresource — CareSourceMedicare: $1,129.24 Cigna — CignaCommercial: $1,580.93 Clarity Health — ClarityHealth: $1,580.93
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Hysteroscopy, surgical; with endometrial bx and/or polypectomy w/w/o D&C 58558	$595	$535.50	$178.50 – $577.15
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $517.65 Aetna — AetnaMedicare: $178.50 Anthem — AnthemBluePOS/PPO: $529.55 Anthem — AnthemPathwayHMO/HIC/Tiered: $291.55 Anthem — AnthemTraditional: $541.45 Cigna — CignaCommercialHMO: $476 Cigna — CignaCommercialPPO: $476 ClaimsDoc — ClaimsDoc: $476 Emerald Health — Emerald Health: $577.15 First Health — First Health: $535.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Hysteroscopy, surgical; with endometrial bx and/or polypectomy w/w/o D&C 58558	$595	$535.50	$178.50 – $577.15
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $517.65 Aetna — AetnaMedicare: $178.50 Anthem — AnthemBluePOS/PPO: $529.55 Anthem — AnthemPathwayHMO/HIC/Tiered: $450.12 Anthem — AnthemTraditional: $541.45 Cigna — CignaCommercialHMO: $476 Cigna — CignaCommercialPPO: $476 ClaimsDoc — ClaimsDoc: $476 Emerald Health — Emerald Health: $577.15 First Health — First Health: $535.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: Hysteroscopy, surgical; with endometrial bx and/or polypectomy w/w/o D&C 58558	Not listed in the file	Not listed in the file	$117.66 – $363.11
Hysteroscopy with biopsy of the uterus lining: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $363.11 Aetna — AetnaMedicare: $219.31 Anthem — AnthemBluePOS/PPO: $252.21 Anthem — AnthemMedicare: $219.31 Anthem — AnthemPathwayHMO/HIC/Tiered: $252.21 Anthem — AnthemTraditional: $252.21 Buckeye — BuckeyeMedicare: $219.31 Caresource — CareSourceMedicare: $219.31 Cigna — CignaCommercial: $307.04 Clarity Health — ClarityHealth: $307.04
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECT SPINE L/C (CD)	$1,732	$1,558.80	$519.60 – $1,680.04
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,506.84 Aetna — AetnaMedicare: $519.60 Anthem — AnthemBluePOS/PPO: $1,541.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $848.68 Anthem — AnthemTraditional: $1,576.12 Cigna — CignaCommercialHMO: $1,385.60 Cigna — CignaCommercialPPO: $1,385.60 ClaimsDoc — ClaimsDoc: $1,385.60 Emerald Health — Emerald Health: $1,680.04 First Health — First Health: $1,558.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJECT SPINE L/C (CD)	$1,732	$1,558.80	$519.60 – $1,680.04
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,506.84 Aetna — AetnaMedicare: $519.60 Anthem — AnthemBluePOS/PPO: $1,541.48 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,310.26 Anthem — AnthemTraditional: $1,576.12 Cigna — CignaCommercialHMO: $1,385.60 Cigna — CignaCommercialPPO: $1,385.60 ClaimsDoc — ClaimsDoc: $1,385.60 Emerald Health — Emerald Health: $1,680.04 First Health — First Health: $1,558.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$348.39 – $358.84
Spinal injection, lower back (epidural), with imaging guidance: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $649.60 AmeriHealth — AmeriHealthMedicaid: $358.84 Anthem — AnthemMedicaid: $348.39 Anthem — AnthemMedicare: $649.60 Buckeye — BuckeyeMedicaid: $358.84 Buckeye — BuckeyeMedicare: $649.60 Caresource — CaresourceMedicaid: $348.39 Caresource — CareSourceMedicare: $649.60 Medical Mutual of Ohio — MMOMedicare: $649.60 Molina — MolinaMedicaid: $358.84
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FORAMEN EPIDURAL INJ L/S	$2,226	$2,003.40	$667.80 – $2,159.22
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $1,936.62 Aetna — AetnaMedicare: $667.80 Anthem — AnthemBluePOS/PPO: $1,981.14 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,090.74 Anthem — AnthemTraditional: $2,025.66 Cigna — CignaCommercialHMO: $1,780.80 Cigna — CignaCommercialPPO: $1,780.80 ClaimsDoc — ClaimsDoc: $1,780.80 Emerald Health — Emerald Health: $2,159.22 First Health — First Health: $2,003.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: FORAMEN EPIDURAL INJ L/S	$2,226	$2,003.40	$667.80 – $2,159.22
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $1,936.62 Aetna — AetnaMedicare: $667.80 Anthem — AnthemBluePOS/PPO: $1,981.14 Anthem — AnthemPathwayHMO/HIC/Tiered: $1,683.97 Anthem — AnthemTraditional: $2,025.66 Cigna — CignaCommercialHMO: $1,780.80 Cigna — CignaCommercialPPO: $1,780.80 ClaimsDoc — ClaimsDoc: $1,780.80 Emerald Health — Emerald Health: $2,159.22 First Health — First Health: $2,003.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx aa&/strd tfrm epi l/s 1	Not listed in the file	Not listed in the file	$348.39 – $358.84
Nerve root injection, lower back, with imaging guidance: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $835.11 AmeriHealth — AmeriHealthMedicaid: $358.84 Anthem — AnthemMedicaid: $348.39 Anthem — AnthemMedicare: $835.11 Buckeye — BuckeyeMedicaid: $358.84 Buckeye — BuckeyeMedicare: $835.11 Caresource — CaresourceMedicaid: $348.39 Caresource — CareSourceMedicare: $835.11 Medical Mutual of Ohio — MMOMedicare: $835.11 Molina — MolinaMedicaid: $358.84
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	$671.60 – $691.74
Carpal tunnel release: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $1,831.74 AmeriHealth — AmeriHealthMedicaid: $691.74 Anthem — AnthemMedicaid: $671.60 Anthem — AnthemMedicare: $1,831.74 Buckeye — BuckeyeMedicaid: $691.74 Buckeye — BuckeyeMedicare: $1,831.74 Caresource — CaresourceMedicaid: $671.60 Caresource — CareSourceMedicare: $1,831.74 Medical Mutual of Ohio — MMOMedicare: $1,831.74 Molina — MolinaMedicaid: $691.74
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$321.11 – $327.74
Carpal tunnel release: rates for 3 insurance plans Optum — VACCNOptum: $321.11 Perennial Advantage — Perennial Advantage: $321.11 Sidecar — SidecarCommercial: $327.74
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$633.77 – $646.86
Carpal tunnel release: rates for 3 insurance plans Optum — VACCNOptum: $633.77 Perennial Advantage — Perennial Advantage: $633.77 Sidecar — SidecarCommercial: $646.86
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	$196.13 – $202.01
Laser treatment of clouding after cataract surgery: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $514.60 AmeriHealth — AmeriHealthMedicaid: $202.01 Anthem — AnthemMedicaid: $196.13 Anthem — AnthemMedicare: $514.60 Buckeye — BuckeyeMedicaid: $202.01 Buckeye — BuckeyeMedicare: $514.60 Caresource — CaresourceMedicaid: $196.13 Caresource — CareSourceMedicare: $514.60 Medical Mutual of Ohio — MMOMedicare: $514.60 Molina — MolinaMedicaid: $202.01
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$424.67 – $439.31
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans Optum — VACCNOptum: $424.67 Perennial Advantage — Perennial Advantage: $424.67 Sidecar — SidecarCommercial: $439.31
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$198.18 – $205.01
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans Optum — VACCNOptum: $198.18 Perennial Advantage — Perennial Advantage: $198.18 Sidecar — SidecarCommercial: $205.01
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	$813.22 – $837.61
Cataract removal with lens implant: 10 of 21 insurance plan rates Aetna — AetnaMedicare: $2,139.37 AmeriHealth — AmeriHealthMedicaid: $837.61 Anthem — AnthemMedicaid: $813.22 Anthem — AnthemMedicare: $2,139.37 Buckeye — BuckeyeMedicaid: $837.61 Buckeye — BuckeyeMedicare: $2,139.37 Caresource — CaresourceMedicaid: $813.22 Caresource — CareSourceMedicare: $2,139.37 Medical Mutual of Ohio — MMOMedicare: $2,139.37 Molina — MolinaMedicaid: $837.61
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$747.96 – $770.18
Cataract removal with lens implant: rates for 3 insurance plans Optum — VACCNOptum: $747.96 Perennial Advantage — Perennial Advantage: $747.96 Sidecar — SidecarCommercial: $770.18
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$349.05 – $359.42
Cataract removal with lens implant: rates for 3 insurance plans Optum — VACCNOptum: $349.05 Perennial Advantage — Perennial Advantage: $349.05 Sidecar — SidecarCommercial: $359.42

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine ob care incl ante & postpartum care, vag delivery w/ or w/o episiotomy and/or forceps 59400	$5,400	$4,860	$1,620 – $5,238
Vaginal delivery, with care before and after: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $4,698 Aetna — AetnaMedicare: $1,620 Anthem — AnthemBluePOS/PPO: $4,806 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,646 Anthem — AnthemTraditional: $4,914 Cigna — CignaCommercialHMO: $4,320 Cigna — CignaCommercialPPO: $4,320 ClaimsDoc — ClaimsDoc: $4,320 Emerald Health — Emerald Health: $5,238 First Health — First Health: $4,860
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Routine ob care incl ante & postpartum care, vag delivery w/ or w/o episiotomy and/or forceps 59400	$5,400	$4,860	$1,620 – $5,238
Vaginal delivery, with care before and after: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $4,698 Aetna — AetnaMedicare: $1,620 Anthem — AnthemBluePOS/PPO: $4,806 Anthem — AnthemPathwayHMO/HIC/Tiered: $4,085.10 Anthem — AnthemTraditional: $4,914 Cigna — CignaCommercialHMO: $4,320 Cigna — CignaCommercialPPO: $4,320 ClaimsDoc — ClaimsDoc: $4,320 Emerald Health — Emerald Health: $5,238 First Health — First Health: $4,860
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: Routine ob care incl ante & postpartum care, vag delivery w/ or w/o episiotomy and/or forceps 59400	Not listed in the file	Not listed in the file	$2,062.85 – $3,438.08
Vaginal delivery, with care before and after: 10 of 39 insurance plan rates Aetna — AetnaCommercial: $2,579 Aetna — AetnaMedicare: $2,292.05 Anthem — AnthemBluePOS/PPO: $2,635.86 Anthem — AnthemMedicare: $2,292.05 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,635.86 Anthem — AnthemTraditional: $2,635.86 Buckeye — BuckeyeMedicare: $2,292.05 Caresource — CareSourceMedicare: $2,292.05 Cigna — CignaCommercial: $3,208.87 Clarity Health — ClarityHealth: $3,208.87
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine OB care including antepartum care, cesarean delivery and postpartum care 59510	$5,991	$5,391.90	$1,797.30 – $5,811.27
Cesarean delivery (C-section), with care before and after: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $5,212.17 Aetna — AetnaMedicare: $1,797.30 Anthem — AnthemBluePOS/PPO: $5,331.99 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,935.59 Anthem — AnthemTraditional: $5,451.81 Cigna — CignaCommercialHMO: $4,792.80 Cigna — CignaCommercialPPO: $4,792.80 ClaimsDoc — ClaimsDoc: $4,792.80 Emerald Health — Emerald Health: $5,811.27 First Health — First Health: $5,391.90
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetrical Delivery	$5,991	$5,391.90	$1,797.30 – $5,811.27
Cesarean delivery (C-section), with care before and after: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $5,212.17 Aetna — AetnaMedicare: $1,797.30 Anthem — AnthemBluePOS/PPO: $5,331.99 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,935.59 Anthem — AnthemTraditional: $5,451.81 Cigna — CignaCommercialHMO: $4,792.80 Cigna — CignaCommercialPPO: $4,792.80 ClaimsDoc — ClaimsDoc: $4,792.80 Emerald Health — Emerald Health: $5,811.27 First Health — First Health: $5,391.90
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Routine OB care including antepartum care, cesarean delivery and postpartum care 59510	$5,991	$5,391.90	$1,797.30 – $5,811.27
Cesarean delivery (C-section), with care before and after: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $5,212.17 Aetna — AetnaMedicare: $1,797.30 Anthem — AnthemBluePOS/PPO: $5,331.99 Anthem — AnthemPathwayHMO/HIC/Tiered: $4,532.19 Anthem — AnthemTraditional: $5,451.81 Cigna — CignaCommercialHMO: $4,792.80 Cigna — CignaCommercialPPO: $4,792.80 ClaimsDoc — ClaimsDoc: $4,792.80 Emerald Health — Emerald Health: $5,811.27 First Health — First Health: $5,391.90
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine OB ante & postpartum care VBAC 59610	$5,670	$5,103	$1,701 – $5,499.90
Vaginal delivery after a previous C-section, with care before and after: 10 of 20 insurance plan rates Aetna — AetnaCommercial: $4,932.90 Aetna — AetnaMedicare: $1,701 Anthem — AnthemBluePOS/PPO: $5,046.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,778.30 Anthem — AnthemTraditional: $5,159.70 Cigna — CignaCommercialHMO: $4,536 Cigna — CignaCommercialPPO: $4,536 ClaimsDoc — ClaimsDoc: $4,536 Emerald Health — Emerald Health: $5,499.90 First Health — First Health: $5,103
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Routine OB ante & postpartum care VBAC 59610	$5,670	$5,103	$1,701 – $5,499.90
Vaginal delivery after a previous C-section, with care before and after: 10 of 19 insurance plan rates Aetna — AetnaCommercial: $4,932.90 Aetna — AetnaMedicare: $1,701 Anthem — AnthemBluePOS/PPO: $5,046.30 Anthem — AnthemPathwayHMO/HIC/Tiered: $4,289.35 Anthem — AnthemTraditional: $5,159.70 Cigna — CignaCommercialHMO: $4,536 Cigna — CignaCommercialPPO: $4,536 ClaimsDoc — ClaimsDoc: $4,536 Emerald Health — Emerald Health: $5,499.90 First Health — First Health: $5,103
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: Routine OB ante & postpartum care VBAC 59610	Not listed in the file	Not listed in the file	$2,044.73
Vaginal delivery after a previous C-section, with care before and after: 10 of 38 insurance plan rates Aetna — AetnaCommercial: $2,708.80 Aetna — AetnaMedicare: $2,405.56 Anthem — AnthemBluePOS/PPO: $2,766.40 Anthem — AnthemMedicare: $2,405.56 Anthem — AnthemPathwayHMO/HIC/Tiered: $2,766.40 Anthem — AnthemTraditional: $2,766.40 Buckeye — BuckeyeMedicare: $2,405.56 Caresource — CareSourceMedicare: $2,405.56 Cigna — CignaCommercial: $3,367.79 Clarity Health — ClarityHealth: $3,367.79

Source: Fisher-Titus Hospital’s standard charges file (ft-data.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 29, 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	272 Benedict Avenue, Norwalk, OH 44857
County	Huron County
State	Ohio
Phone	(419) 668‑8101
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	360065
Name in Medicare records	FISHER-TITUS HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Fisher-Titus Medical Center
Official website	fishertitus.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Fisher-Titus Medical Center, Norwalk, OH — fishertitus.org
Medical Services in North Central Ohio | Fisher-Titus — fishertitus.org
About Our Healthcare System | Fisher-Titus — fishertitus.org
Cancer Care Center | Norwalk, OH | Fisher-Titus — fishertitus.org
Heart & Vascular Care Services in Norwalk | Fisher-Titus — fishertitus.org
Rehabilitation & Physical Therapy in Norwalk | Fisher-Titus — fishertitus.org
Our Cafeteria, Gift Shop & Coffee Shop | Fisher-Titus — fishertitus.org
Brent Burkey, MD | Hospital Medicine | Fisher Titus — fishertitus.org
Lawrence Anderle, DO | Hospital Medicine | Fisher-Titus — fishertitus.org
Charlene Breedlove, CNP | Hospital Medicine | Fisher-Titus — fishertitus.org
Patrick Breslin, DO | Hospital Medicine | Fisher-Titus — fishertitus.org
Grant Ferrell, PA | Emergency Medicine | Fisher Titus — fishertitus.org
Kristen Gennari, MD | Hospital Medicine | Fisher-Titus — fishertitus.org

Fisher-Titus Hospital

Summary

Profile from official sources

At a glance