Does Genesis Hospital have an emergency room?

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

Where is Genesis Hospital?

2951 Maple Avenue, Zanesville, OH 43701, in Muskingum County, Ohio.

What is the phone number of Genesis Hospital?

(740) 454-5000, as listed by Medicare (CMS).

What is the Medicare star rating of Genesis Hospital?

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

Genesis Hospital — Zanesville, OH

Quick answers

Does Genesis Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Genesis Hospital. In a medical emergency, call 911.
Where is Genesis Hospital?: 2951 Maple Avenue, Zanesville, OH 43701, in Muskingum County, Ohio.
What is the phone number of Genesis Hospital?: (740) 454-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Genesis Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Emergency Medicine
General Surgery
Maternity
Obstetrics & Gynecology Hospitalist
Pediatrics Hospitalist
Women's Care
Trauma Care

Treatments^[4]

Imaging services
Laboratory services

Programs and centers^[4][5][6][7]

Imaging Services
Laboratory
Trauma center
Emergency basic care program for minor conditions
Sexual assault and domestic violence support

Emergency care (hospital website)^{[4][5][6][7][8]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III-N
Stroke designation	Primary Stroke Certification

Visiting and practical information

Visiting	Emergency dept: limit visitors to two at a time; visitors stay in the room^[6]
Patient portal	MyChart

Recognition^[9]

IAC Vascular Accreditation

Doctors and clinicians (905)

905 doctors and other clinicians list Genesis 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 881 more: the button below opens the full list.

Other emergency rooms nearby

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

Coshocton Regional Medical Center22 mi · Coshocton, OH · Acute Care Hospital
Southeastern Ohio Regional Medical Center24 mi · Cambridge, OH · Acute Care Hospital
Licking Memorial Hospital24 mi · Newark, OH · Acute Care Hospital
Fairfield Medical Center35 mi · Lancaster, OH · Acute Care Hospital
Knox Community Hospital37 mi · Mount Vernon, OH · Acute Care Hospital

Other hospitals nearby

Select Specialty Hospital Southeast Ohio21 mi · Newark, OH · Long-Term Acute Care Hospital
Clearsky Rehabilitation Hospital of Lancaster LLC36 mi · Lancaster, OH · Inpatient Rehabilitation 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

The Oaks at Bethesda0.0 mi · Zanesville, OH · 5 of 5 stars
Continuing Healthcare at Willow Haven0.7 mi · Zanesville, OH · 2 of 5 stars
Adams Lane Healthcare and Rehabilitation Center1.2 mi · Zanesville, OH · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Buckeye Hospice and Palliative Care Services1.4 mi · Zanesville, OH · 2 of 5 stars
Genesis Hospice and Palliative Care1.4 mi · Zanesville, OH · 4 of 5 stars
Interim Healthcare Hospice of Coshocton1.4 mi · Zanesville, OH

All hospice providers in the state →

Home health agencies

American Nursing Care, Inc1.4 mi · Zanesville, OH · 4 of 5 stars
Genesis Home Care1.4 mi · Zanesville, OH
Interim Healthcare of Cambridge1.4 mi · Zanesville, OH · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Zanesville Dialysis1.4 mi · Zanesville, OH · 3 of 5 stars
Kidney Care Centers of Zanesville1.4 mi · Zanesville, OH · 2 of 5 stars
Kidney Care Centers of Coshocton, Ohio21 mi · Coshocton, OH · 1 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.

Alternacare Inc1.4 mi · Zanesville, OH
Insight Surgery and Laser Center, LLC1.4 mi · Zanesville, OH
Northpointe Surgical Suites LLC1.4 mi · Zanesville, 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

Muskingum Valley Health Centers - ZCS1.2 mi · Zanesville, OH · Community health center
Muskingum Valley Health Centers1.6 mi · Zanesville, OH · Community health center
Muskingum Valley Health Centers3.6 mi · Zanesville, OH · Community health center

Clinics and urgent care

Country Drive Inn Medical Practice11 mi · Mount Perry, OH · Rural health clinic
Perry County Family Practice Inc20 mi · New Lexington, OH · Rural health clinic
Primary Care New Lexington20 mi · New Lexington, OH · Rural health clinic

Pharmacies

Careequip, LLC1.4 mi · Zanesville, OH · Community/retail pharmacy
Coler Drug Brighton, Ltd1.4 mi · Zanesville, OH · Community/retail pharmacy
Coler Drug Zanesville Ltd1.4 mi · Zanesville, OH · Community/retail pharmacy

Assisted living nearby

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

Clay Gardens Place1.4 mi · Zanesville, OH
Continuing Healthcare at Sterling Suites1.4 mi · Zanesville, OH
Helen Purcell Home1.4 mi · Zanesville, OH
Primrose Retirement Communities1.4 mi · Zanesville, 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 Genesis Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	70%National average: 72%
Would definitely recommend the hospital	71%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	59%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	57%National average: 60%
Completed surveys	1,810Response rate: 28%

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)	0.223No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.148Better than the national benchmark
Surgical site infections after colon surgery	0.7No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.259No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.71Better than 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	9.4%
Deaths within 30 days: heart failure patients	11.4%
Deaths within 30 days: pneumonia patients	14.1%
Deaths within 30 days: COPD patients	8.4%
Deaths within 30 days: stroke patients	15.7%
Deaths within 30 days: coronary bypass surgery (CABG)	2.5%
Serious complications (patient safety indicator PSI-90)	1.12No different from the national rate
Complications after hip or knee replacement	4.9%

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	13.2%
Readmitted within 30 days: heart failure	19.2%
Readmitted within 30 days: pneumonia	15.8%
Readmitted within 30 days: COPD	18.4%
Readmitted within 30 days: coronary bypass surgery	10.8%
Readmitted within 30 days: hip or knee replacement	5.5%

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)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	210 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	64%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 77 common services exactly as Genesis 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 →

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl III	$390.16	$234.10	$9.34 – $804.73
New patient office visit (about 30–44 minutes): 10 of 140 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $145.08 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS HOME PREFERRED: $138.82 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $9.34 CAMBRIDGE BEHAVIORAL HOSPITAL [10011219] — HB CAMBRIDGE BEHAVIORAL HEALTH: $138.82
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl III	$352.78	$211.67	$70.77 – $299.86
New patient office visit (about 30–44 minutes): 10 of 89 insurance plan rates AETNA [10011] — HB AETNA: $222.25 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB AETNA: $222.25 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $145.08 ASSURANT HEALTH [100198] — HB AETNA: $222.25 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TH In the file: HC Outpatient Visit New Lvl III\|OB TX/SRVCS PRENATL/POSTPART	$1,372.94	$823.76	$9.34 – $804.73
New patient office visit (about 30–44 minutes): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $70.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $804.73 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $70.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $152.16 ANTHEM [10121] — HB ANTHEM BC/BS: $697.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $557.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $629.20 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $72.19 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $145.08 APWU [100197] — HB CIGNA / GREATWEST: $804.73
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl IV	$378.34	$227	$115.62 – $237.02
New patient office visit (about 45–59 minutes): 10 of 140 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $237.02 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS HOME PREFERRED: $138.82 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $115.62 CAMBRIDGE BEHAVIORAL HOSPITAL [10011219] — HB CAMBRIDGE BEHAVIORAL HEALTH: $138.82
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl IV	$378.34	$227	$115.62 – $321.59
New patient office visit (about 45–59 minutes): 10 of 89 insurance plan rates AETNA [10011] — HB AETNA: $238.35 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB AETNA: $238.35 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $237.02 ASSURANT HEALTH [100198] — HB AETNA: $238.35 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl V	$1,112.79	$667.67	$30.85 – $759.06
New patient office visit (about 60–74 minutes): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $209.19 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $759.06 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $209.19 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $209.19 ANTHEM [10121] — HB ANTHEM BC/BS: $657.89 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $526.31 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $593.49 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $209.19 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $324.88 APWU [100197] — HB CIGNA / GREATWEST: $759.06
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Outpatient Visit New Lvl V	$516.69	$310.01	$121.39 – $439.19
New patient office visit (about 60–74 minutes): 10 of 89 insurance plan rates AETNA [10011] — HB AETNA: $325.51 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB AETNA: $325.51 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $324.88 ASSURANT HEALTH [100198] — HB AETNA: $325.51 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC O/P Visit Est Lev III	$343.49	$206.09	$56.80 – $804.73
Established patient office visit (about 20–29 minutes): 10 of 140 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $116.44 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS HOME PREFERRED: $138.82 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $56.80 CAMBRIDGE BEHAVIORAL HOSPITAL [10011219] — HB CAMBRIDGE BEHAVIORAL HEALTH: $138.82
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC O/P Visit Est Lev III	$343.49	$206.09	$56.80 – $291.97
Established patient office visit (about 20–29 minutes): 10 of 89 insurance plan rates AETNA [10011] — HB AETNA: $216.40 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB AETNA: $216.40 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $116.44 ASSURANT HEALTH [100198] — HB AETNA: $216.40 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TH In the file: HC O/P Visit Est Lev III\|OB TX/SRVCS PRENATL/POSTPART	$1,765.19	$1,059.11	$56.80 – $804.73
Established patient office visit (about 20–29 minutes): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $56.80 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $804.73 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $56.80 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $122.12 ANTHEM [10121] — HB ANTHEM BC/BS: $697.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $557.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $629.20 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $57.94 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $116.44 APWU [100197] — HB CIGNA / GREATWEST: $804.73
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC O/P Visit Est Lev IV	$361.95	$217.17	$29.60 – $804.73
Established patient office visit (about 30–39 minutes): 10 of 140 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $171.36 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS HOME PREFERRED: $138.82 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $83.59 CAMBRIDGE BEHAVIORAL HOSPITAL [10011219] — HB CAMBRIDGE BEHAVIORAL HEALTH: $138.82
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC O/P Visit Est Lev IV	$361.95	$217.17	$83.59 – $307.66
Established patient office visit (about 30–39 minutes): 10 of 89 insurance plan rates AETNA [10011] — HB AETNA: $228.03 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB AETNA: $228.03 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $171.36 ASSURANT HEALTH [100198] — HB AETNA: $228.03 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TH In the file: HC O/P Visit Est Lev IV\|OB TX/SRVCS PRENATL/POSTPART	$1,511.21	$906.73	$29.60 – $804.73
Established patient office visit (about 30–39 minutes): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.59 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $804.73 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.59 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $179.72 ANTHEM [10121] — HB ANTHEM BC/BS: $697.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $557.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $629.20 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $85.26 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $171.36 APWU [100197] — HB CIGNA / GREATWEST: $804.73
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Screenings 40-64 Yrs	$56.45	$33.87	$25.97 – $47.98
Preventive checkup, new patient, age 40–64: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $35.56 ALLIED BENEFIT [100193] — HB AETNA: $35.56 ASSURANT HEALTH [100198] — HB AETNA: $35.56 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $33.59 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $33.59 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $33.59 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $35.56 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $32.73 COVENTRY HEALTH CARE [1001106] — HB AETNA: $35.56 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $33.59
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER Level III	$1,124.71	$674.83	$69.06 – $2,348
Emergency room visit (moderate): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $887 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $284.62 ALLIED BENEFIT [100193] — HB AETNA: $887 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $1,032.76 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $284.62 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $284.62 ANTHEM [10121] — HB ANTHEM BC/BS: $895.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $716.08 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $807.49 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $284.62
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ER Level III	$995	$597	$284.62 – $2,348
Emergency room visit (moderate): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $887 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $284.62 ALLIED BENEFIT [100193] — HB AETNA: $887 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $1,032.76 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $284.62 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $284.62 ANTHEM [10121] — HB ANTHEM BC/BS: $895.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $716.08 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $807.49 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $284.62
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER Level IV	$1,444.84	$866.90	$117.61 – $3,843
Emergency room visit (moderately high): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $1,574 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $435.06 ALLIED BENEFIT [100193] — HB AETNA: $1,574 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $1,578.65 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $435.06 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $435.06 ANTHEM [10121] — HB ANTHEM BC/BS: $1,368.24 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $1,094.59 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $1,234.31 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $435.06
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ER Level IV	$1,602	$961.20	$435.06 – $3,843
Emergency room visit (moderately high): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $1,574 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $435.06 ALLIED BENEFIT [100193] — HB AETNA: $1,574 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $1,578.65 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $435.06 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $435.06 ANTHEM [10121] — HB ANTHEM BC/BS: $1,368.24 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $1,094.59 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $1,234.31 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $435.06
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ER Level V	$2,664	$1,598.40	$1,200 – $3,843
Emergency room visit (high): 10 of 45 insurance plan rates AETNA [10011] — HB AETNA: $2,862 ALLIED BENEFIT [100193] — HB AETNA: $2,862 ASSURANT HEALTH [100198] — HB AETNA: $2,862 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $1,585.08 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $1,585.08 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $1,585.08 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $2,862 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $3,843 COVENTRY HEALTH CARE [1001106] — HB AETNA: $2,862 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $1,585.08

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Chem 8 (Basic Metabolic - Lik	$100.56	$60.34	$5.30 – $19.70
Basic metabolic panel (blood test): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $16.92 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.46 ANTHEM [10121] — HB ANTHEM BC/BS: $8.46 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.46 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $8.46 APWU [100197] — HB CIGNA / GREATWEST: $16.92
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Chem 8 Only	$35	$21	$8.01 – $29.75
Basic metabolic panel (blood test): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $22.05 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 ALLIED BENEFIT [100193] — HB AETNA: $22.05 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $16.92 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.46 ANTHEM [10121] — HB ANTHEM BC/BS: $8.46 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.46 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.63
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Chem 8	$12	$7.20	$2.75 – $16.92
Basic metabolic panel (blood test): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $7.56 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 ALLIED BENEFIT [100193] — HB AETNA: $7.56 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $16.92 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.46 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.46 ANTHEM [10121] — HB ANTHEM BC/BS: $8.46 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.46 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.63
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Metaboloc Panel (Comprehensiv	$470.43	$282.26	$6.62 – $24.60
Comprehensive metabolic panel (blood test): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $10.56 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $228.86 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $10.56 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $10.56 ANTHEM [10121] — HB ANTHEM BC/BS: $17.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $10.56 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $10.56 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $10.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $62.14 APWU [100197] — HB CIGNA / GREATWEST: $228.86
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prenatal Profile	$816.37	$489.82	$47.81 – $95.62
Obstetric blood test panel: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $47.81 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $95.62 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $47.81 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $47.81 ANTHEM [10121] — HB ANTHEM BC/BS: $47.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $47.81 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $47.81 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $48.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $47.81 APWU [100197] — HB CIGNA / GREATWEST: $95.62
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prenatal Profile	$709.46	$425.68	$47.81 – $603.04
Obstetric blood test panel: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $446.96 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $47.81 ALLIED BENEFIT [100193] — HB AETNA: $446.96 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $95.62 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $47.81 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $47.81 ANTHEM [10121] — HB ANTHEM BC/BS: $47.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $47.81 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $47.81 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $48.77
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholesterol Profile * (Measur	$162.99	$97.79	$8.39 – $31.19
Cholesterol panel (lipid panel): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $26.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13.39 ANTHEM [10121] — HB ANTHEM BC/BS: $6.02 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $13.39 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $13.39 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13.66 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13.39 APWU [100197] — HB CIGNA / GREATWEST: $26.78
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Lipid Profile Only	$35	$21	$8.01 – $29.75
Cholesterol panel (lipid panel): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $22.05 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 ALLIED BENEFIT [100193] — HB AETNA: $22.05 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $26.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13.39 ANTHEM [10121] — HB ANTHEM BC/BS: $13.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $13.39 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $13.39 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13.66
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel Send Out	$408.07	$244.84	$13.39 – $346.86
Cholesterol panel (lipid panel): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $257.08 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 ALLIED BENEFIT [100193] — HB AETNA: $257.08 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $26.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13.39 ANTHEM [10121] — HB ANTHEM BC/BS: $13.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $13.39 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $13.39 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13.66
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Renal Panel (Like a Chem 8 Pl	$115.78	$69.47	$5.44 – $20.21
Kidney function panel: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.68 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $17.36 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.68 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.68 ANTHEM [10121] — HB ANTHEM BC/BS: $8.68 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.68 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.68 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.85 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $8.68 APWU [100197] — HB CIGNA / GREATWEST: $17.36
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Liver Panel - Hepatic Functio	$125.62	$75.37	$5.12 – $19.03
Liver function panel: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.17 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $16.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.17 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.17 ANTHEM [10121] — HB ANTHEM BC/BS: $8.17 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.17 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.33 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $8.17 APWU [100197] — HB CIGNA / GREATWEST: $16.34
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Liver Panel	$35	$21	$8.01 – $29.75
Liver function panel: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $22.05 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.17 ALLIED BENEFIT [100193] — HB AETNA: $22.05 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $16.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $8.17 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $8.17 ANTHEM [10121] — HB ANTHEM BC/BS: $8.17 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $8.17 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $8.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Reflux Culture	$76.63	$45.98	$1.99 – $7.39
Urine test (automated, with microscope): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $6.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3.17 ANTHEM [10121] — HB ANTHEM BC/BS: $3.90 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.17 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3.23 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3.17 APWU [100197] — HB CIGNA / GREATWEST: $6.34
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis	$138.33	$83	$1.99 – $7.39
Urine test (automated, with microscope): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $5.47 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 ALLIED BENEFIT [100193] — HB AETNA: $5.47 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $6.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3.17 ANTHEM [10121] — HB ANTHEM BC/BS: $3.17 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.17 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3.23
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 1P In the file: HC Urinalysis Reflux Culture\|PQRI MEDICAL REASON	$1,740	$1,044	$3.17 – $26.61
Urine test (automated, with microscope): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $6.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.17 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3.17 ANTHEM [10121] — HB ANTHEM BC/BS: $3.17 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.17 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3.23 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3.17 APWU [100197] — HB CIGNA / GREATWEST: $6.34
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urine Dip Stick	$1,034.89	$620.93	$2.18 – $8.10
Urine test (manual, without microscope): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $138.82 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $138.82 ANTHEM [10121] — HB ANTHEM BC/BS: $3.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.48 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $138.82 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urine Dip POC	$39.97	$23.98	$3.48 – $33.97
Urine test (manual, without microscope): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $25.18 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.48 ALLIED BENEFIT [100193] — HB AETNA: $25.18 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $6.96 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.48 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3.48 ANTHEM [10121] — HB ANTHEM BC/BS: $3.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.48 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3.55
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urine Dip POC Ketones	$10.10	$6.06	$2.31 – $8.59
Urine test (manual, without microscope): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $6.36 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.48 ALLIED BENEFIT [100193] — HB AETNA: $6.36 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $6.96 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3.48 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3.48 ANTHEM [10121] — HB ANTHEM BC/BS: $3.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3.48 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3.55
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Ph, Urine	$62.52	$37.51	$1.41 – $5.24
Urine test (automated, without microscope): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2.25 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4.50 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2.25 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2.25 ANTHEM [10121] — HB ANTHEM BC/BS: $2.25 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2.30 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2.25 APWU [100197] — HB CIGNA / GREATWEST: $4.50
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Specific Gravity, Urine	$15.45	$9.27	$1.41 – $5.24
Urine test (automated, without microscope): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $3.89 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2.25 ALLIED BENEFIT [100193] — HB AETNA: $3.89 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4.50 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2.25 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2.25 ANTHEM [10121] — HB ANTHEM BC/BS: $2.25 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2.30
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Psa Total,Screening	$186.96	$112.18	$11.53 – $42.83
PSA (prostate specific antigen) blood test: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $19.31 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $36.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $19.31 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $19.31 ANTHEM [10121] — HB ANTHEM BC/BS: $19.31 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $19.31 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $19.31 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $19.70 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $18.39 APWU [100197] — HB CIGNA / GREATWEST: $36.78
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$40.27	$24.16	$9.21 – $36.78
PSA (prostate specific antigen) blood test: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $25.37 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $18.39 ALLIED BENEFIT [100193] — HB AETNA: $25.37 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $36.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $18.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $18.39 ANTHEM [10121] — HB ANTHEM BC/BS: $18.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $18.39 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $18.39 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $18.76
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Assay of Psa Total	$58.06	$34.84	$13.28 – $49.35
PSA (prostate specific antigen) blood test: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $36.58 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $18.39 ALLIED BENEFIT [100193] — HB AETNA: $36.58 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $36.78 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $18.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $18.39 ANTHEM [10121] — HB ANTHEM BC/BS: $18.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $18.39 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $18.39 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $18.76
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Tsh	$197.30	$118.38	$10.53 – $39.13
Thyroid stimulating hormone (TSH) test: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $16.80 ANTHEM [10121] — HB ANTHEM BC/BS: $17.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $16.80 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $16.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $17.14 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $15.08 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $16.80 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Tsh Only	$35	$21	$8.01 – $33.60
Thyroid stimulating hormone (TSH) test: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $22.05 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 ALLIED BENEFIT [100193] — HB AETNA: $22.05 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $33.60 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $16.80 ANTHEM [10121] — HB ANTHEM BC/BS: $16.80 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $16.80 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $16.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $17.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Thyroid Cascade	$318.53	$191.12	$10.53 – $39.13
Thyroid stimulating hormone (TSH) test: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $29 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 ALLIED BENEFIT [100193] — HB AETNA: $29 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $33.60 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $16.80 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $16.80 ANTHEM [10121] — HB ANTHEM BC/BS: $16.80 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $16.80 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $16.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $17.14
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc With Auto Diff	$168.21	$100.93	$4.87 – $18.09
Complete blood count (CBC) with differential: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7.77 ANTHEM [10121] — HB ANTHEM BC/BS: $7.77 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $7.77 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $7.77 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7.93 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $19.38 AULTCARE [10019] — HB QUALITY CARE PARTNERS (QCP PLUS): $7.77 AULTRA [10026] — HB QUALITY CARE PARTNERS (QCP PLUS): $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Cbc Only	$35	$21	$7.77 – $29.75
Complete blood count (CBC) with differential: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $22.05 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 ALLIED BENEFIT [100193] — HB AETNA: $22.05 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $15.54 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7.77 ANTHEM [10121] — HB ANTHEM BC/BS: $7.77 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $7.77 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $7.77 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7.93
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Health Fair Cbc	$12	$7.20	$2.75 – $15.54
Complete blood count (CBC) with differential: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $7.56 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 ALLIED BENEFIT [100193] — HB AETNA: $7.56 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $15.54 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7.77 ANTHEM [10121] — HB ANTHEM BC/BS: $7.77 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $7.77 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $7.77 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7.93
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hemogram & Platelet Count	$164.43	$98.66	$4.05 – $15.06
Complete blood count (CBC), automated: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.94 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.47 ANTHEM [10121] — HB ANTHEM BC/BS: $6.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.47 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.47 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.60 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6.47 APWU [100197] — HB CIGNA / GREATWEST: $12.94
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc W/Manual Diff	$185.02	$111.01	$4.05 – $15.06
Complete blood count (CBC), automated: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $11.16 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 ALLIED BENEFIT [100193] — HB AETNA: $11.16 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.94 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.47 ANTHEM [10121] — HB ANTHEM BC/BS: $6.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.47 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.47 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.60
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Manual W/Diff	$185.02	$111.01	$6.47 – $157.27
Complete blood count (CBC), automated: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $116.56 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 ALLIED BENEFIT [100193] — HB AETNA: $116.56 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.94 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.47 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.47 ANTHEM [10121] — HB ANTHEM BC/BS: $6.47 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.47 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.47 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Protime	$135.33	$81.20	$2.69 – $10
Blood clotting time test (prothrombin time, PT): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $4.29 ANTHEM [10121] — HB ANTHEM BC/BS: $4.29 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $4.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $4.29 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $4.38 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $4.29 APWU [100197] — HB CIGNA / GREATWEST: $8.58
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mixing Studies, Prothrombin Time	$117.80	$70.68	$4.29 – $100.13
Blood clotting time test (prothrombin time, PT): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $74.21 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 ALLIED BENEFIT [100193] — HB AETNA: $74.21 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $4.29 ANTHEM [10121] — HB ANTHEM BC/BS: $4.29 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $4.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $4.29 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $4.38
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POC Protime	$103.98	$62.39	$4.29 – $88.38
Blood clotting time test (prothrombin time, PT): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $65.51 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 ALLIED BENEFIT [100193] — HB AETNA: $65.51 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4.29 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $4.29 ANTHEM [10121] — HB ANTHEM BC/BS: $4.29 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $4.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $4.29 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $4.38
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Aptt	$480.83	$288.50	$3.77 – $13.99
Blood clotting test (partial thromboplastin time, PTT): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.01 ANTHEM [10121] — HB ANTHEM BC/BS: $6.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.13 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6.01 APWU [100197] — HB CIGNA / GREATWEST: $12.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Aptt 1 Hr	$117.80	$70.68	$6.01 – $100.13
Blood clotting test (partial thromboplastin time, PTT): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $74.21 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 ALLIED BENEFIT [100193] — HB AETNA: $74.21 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.01 ANTHEM [10121] — HB ANTHEM BC/BS: $6.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.13
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mixing Studies, Aptt	$117.80	$70.68	$6.01 – $100.13
Blood clotting test (partial thromboplastin time, PTT): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $74.21 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 ALLIED BENEFIT [100193] — HB AETNA: $74.21 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6.01 ANTHEM [10121] — HB ANTHEM BC/BS: $6.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6.13

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head W/O Contrast	$999.10	$599.46	$61.63 – $342.81
CT scan of the head or brain, without contrast: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head W/O Contrast	$999.10	$599.46	$109.01 – $849.24
CT scan of the head or brain, without contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Brain W W/O Contrast	$4,038.39	$2,423.03	$194.40 – $1,143.97
MRI of the brain, before and after contrast: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $521.49 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $363.76 ANTHEM [10121] — HB ANTHEM BC/BS: $1,143.97 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $915.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $1,031.99 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $363.76 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $363.76 APWU [100197] — HB CIGNA / GREATWEST: $521.49
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W W/O Contrast	$3,996.40	$2,397.84	$363.76 – $3,396.94
MRI of the brain, before and after contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $521.49 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $363.76 ANTHEM [10121] — HB ANTHEM BC/BS: $1,143.97 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $915.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $1,031.99 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $363.76 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $363.76 APWU [100197] — HB CIGNA / GREATWEST: $521.49
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Chest X-Ray 2 Views	$542.14	$325.28	$21.18 – $285.36
Chest X-ray, 2 views: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $130.09 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $90.74 ANTHEM [10121] — HB ANTHEM BC/BS: $285.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $228.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $257.43 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $90.74 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $90.74 APWU [100197] — HB CIGNA / GREATWEST: $130.09
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Chest X-Ray 2 Views	$328.73	$197.24	$82.71 – $285.36
Chest X-ray, 2 views: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $207.10 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 ALLIED BENEFIT [100193] — HB AETNA: $207.10 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $130.09 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $90.74 ANTHEM [10121] — HB ANTHEM BC/BS: $285.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $228.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $257.43 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $90.74
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Oehs Chest X-Ray Two View	$64	$38.40	$22.02 – $285.36
Chest X-ray, 2 views: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $40.32 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 ALLIED BENEFIT [100193] — HB AETNA: $40.32 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $130.09 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $90.74 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $90.74 ANTHEM [10121] — HB ANTHEM BC/BS: $285.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $228.29 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $257.43 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $90.74
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Lumbar Spine-Min 4 Views	$404	$242.40	$37.42 – $342.81
X-ray of the lower spine, at least 4 views: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lumbar Spine-Min 4 Views	$404	$242.40	$109.01 – $343.40
X-ray of the lower spine, at least 4 views: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $254.52 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB AETNA: $254.52 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$3,996.40	$2,397.84	$113.15 – $782.38
MRI of the lower back (lumbar spine), without contrast: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $248.78 APWU [100197] — HB CIGNA / GREATWEST: $356.66
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$3,996.40	$2,397.84	$235.27 – $3,396.94
MRI of the lower back (lumbar spine), without contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $248.78 APWU [100197] — HB CIGNA / GREATWEST: $356.66
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: HC MRI Lumbar Spine W/O Contrast\|REDUCED SERVICES	$3,996.40	$2,397.84	$235.27 – $3,396.94
MRI of the lower back (lumbar spine), without contrast: 10 of 80 insurance plan rates AETNA [10011] — HB AETNA: $1,258.87 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB AETNA: $1,258.87 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Pelvis With Contrast	$1,096.72	$658.03	$158.20 – $575.15
CT scan of the pelvis, with contrast: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $182.88 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $262.19 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $182.88 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $182.88 ANTHEM [10121] — HB ANTHEM BC/BS: $575.15 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $460.12 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $518.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $182.88 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $182.88 APWU [100197] — HB CIGNA / GREATWEST: $262.19
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis With Contrast	$1,041.03	$624.62	$182.54 – $884.88
CT scan of the pelvis, with contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $182.88 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $262.19 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $182.88 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $182.88 ANTHEM [10121] — HB ANTHEM BC/BS: $575.15 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $460.12 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $518.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $182.88 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $182.88 APWU [100197] — HB CIGNA / GREATWEST: $262.19
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Low Ext Joint W/O Cont	$1,998.20	$1,198.92	$130.01 – $782.38
MRI of a leg joint (such as the knee), without contrast: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $248.78 APWU [100197] — HB CIGNA / GREATWEST: $356.66
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Low Ext Joint W/O Cont-Limited Study	$1,998.20	$1,198.92	$235.27 – $1,698.47
MRI of a leg joint (such as the knee), without contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $248.78 APWU [100197] — HB CIGNA / GREATWEST: $356.66
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Low Ext Joint W/O Cont	$1,998.20	$1,198.92	$235.27 – $1,698.47
MRI of a leg joint (such as the knee), without contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $356.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $248.78 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $248.78 ANTHEM [10121] — HB ANTHEM BC/BS: $782.38 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $625.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $705.80 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $248.78 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $248.78 APWU [100197] — HB CIGNA / GREATWEST: $356.66
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abd-Pelvis W/Contrast	$2,997.30	$1,798.38	$363.76 – $2,547.71
CT scan of the abdomen and pelvis, with contrast: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $521.49 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $363.76 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $363.76 ANTHEM [10121] — HB ANTHEM BC/BS: $1,143.97 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $915.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $1,031.99 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $363.76 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $363.76 APWU [100197] — HB CIGNA / GREATWEST: $521.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abd-Pelvis W/Contrast	$5,037.16	$3,022.30	$198.66
CT scan of the abdomen and pelvis, with contrast: 10 of 82 insurance plan rates BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $198.66 GENERIC WORKERS' COMP [10051] — HB OHIO BWC: $198.66 MCO 3 HAB [100522] — HB OHIO BWC: $198.66 MCO ADVOCARE [100525] — HB OHIO BWC: $198.66 MCO AULTCOMP [100526] — HB OHIO BWC: $198.66 MCO CAREWORKS OF OHIO [100122] — HB OHIO BWC: $198.66 MCO COMP MANAGEMENT HEALTH [100123] — HB OHIO BWC: $198.66 MCO COMP ONE [100527] — HB OHIO BWC: $198.66 MCO CONDUENT [100545] — HB OHIO BWC: $198.66 MCO CORVEL GROUP [100124] — HB OHIO BWC: $198.66
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Abdominal Scan	$577.64	$346.58	$70.55 – $342.81
Ultrasound of the abdomen, complete: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdominal Scan	$577.64	$346.58	$109.01 – $490.99
Ultrasound of the abdomen, complete: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: HC US Abdominal Scan\|RIGHT SIDE	$577.64	$346.58	$70.55 – $342.81
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 COVENTRY HEALTH CARE MEDICARE ADVANTAGE [111102] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 DEPARTMENT OF VETERANS AFFAIRS [100702] — HB VA CCN OPTUM: $109.01 HUMANA MEDICARE ADVANTAGE [111003] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 MEDICAL MUTUAL MEDICARE ADVANTAGE [111013] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 MEDICARE [10021] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 MEDICARE ACCIDENT INSURANCE [10022] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 MEDICARE ALTERNATE PAYOR [99910021] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Fet Scan W/ Tv > 14 Wee	$2,179.94	$1,307.96	$81.59 – $342.81
Pregnancy ultrasound (after the first trimester): 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Fet Scan W/ Tv > 14 Wee	$577.64	$346.58	$109.01 – $490.99
Pregnancy ultrasound (after the first trimester): 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US-Transvaginal Imaging	$1,155.28	$693.17	$78.21 – $342.81
Transvaginal ultrasound: 10 of 146 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US-Transvaginal Imaging	$577.64	$346.58	$109.01 – $490.99
Transvaginal ultrasound: 10 of 95 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $156.27 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $109.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $342.81 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $274.25 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $309.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $109.01 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $109.01 APWU [100197] — HB CIGNA / GREATWEST: $156.27
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Unilat Includes Cad When Performed	$2,116.34	$1,269.80	$79.10 – $158.20
Diagnostic mammogram, one breast: 10 of 163 insurance plan rates AETNA [10011] — HB AETNA: $102.83 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 ALLIED BENEFIT [100193] — HB AETNA: $102.83 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $158.20 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $79.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $79.10 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $79.10 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $80.68
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Dx Mammo Unilat Includes Cad When Performed	$652.37	$391.42	$79.10 – $554.51
Diagnostic mammogram, one breast: 10 of 112 insurance plan rates AETNA [10011] — HB AETNA: $102.83 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 ALLIED BENEFIT [100193] — HB AETNA: $102.83 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $158.20 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $79.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $79.10 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $79.10 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $80.68
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: HC Dx Mammo Unilat Includes Cad When Performed\|LEFT SIDE	$1,134.76	$680.86	$79.10 – $158.20
Diagnostic mammogram, one breast: 10 of 163 insurance plan rates AETNA [10011] — HB AETNA: $102.83 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 ALLIED BENEFIT [100193] — HB AETNA: $102.83 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $158.20 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $79.10 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $79.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $79.10 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $79.10 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $80.68
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Bilat Includes Cad When Performed	$2,517.58	$1,510.55	$101.51 – $203.02
Diagnostic mammogram, both breasts: 10 of 163 insurance plan rates AETNA [10011] — HB AETNA: $131.96 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $101.51 ALLIED BENEFIT [100193] — HB AETNA: $131.96 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $203.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $101.51 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $101.51 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $101.51 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $101.51 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $103.54
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Dx Mammo Bilat Includes Cad When Performed	$879.91	$527.95	$101.51 – $747.92
Diagnostic mammogram, both breasts: 10 of 112 insurance plan rates AETNA [10011] — HB AETNA: $131.96 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $101.51 ALLIED BENEFIT [100193] — HB AETNA: $131.96 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $203.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $101.51 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $101.51 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $101.51 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $101.51 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $103.54
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Screen Mammo Bilat( 2 View Ea Breast) Incl Cad When Perfoemed	$2,503.83	$1,502.30	$41.85 – $167.40
Screening mammogram, both breasts: 10 of 163 insurance plan rates AETNA [10011] — HB AETNA: $108.81 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 ALLIED BENEFIT [100193] — HB AETNA: $108.81 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $167.40 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $109.01 ANTHEM [10121] — HB ANTHEM BC/BS: $83.70 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $83.70 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $83.70 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $85.37
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Screen Mammo Bilat( 2 View Ea Breast) Incl Cad When Perfoemed	$879.91	$527.95	$41.85 – $747.92
Screening mammogram, both breasts: 10 of 112 insurance plan rates AETNA [10011] — HB AETNA: $108.81 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 ALLIED BENEFIT [100193] — HB AETNA: $108.81 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $167.40 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $83.70 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $83.70 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $83.70 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $85.37
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Unilat Mammo Screen W/Cad if Performed	$879.91	$527.95	$41.85 – $747.92
Screening mammogram, both breasts: 10 of 112 insurance plan rates AETNA [10011] — HB AETNA: $108.81 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 ALLIED BENEFIT [100193] — HB AETNA: $108.81 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $167.40 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $83.70 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $150 ANTHEM [10121] — HB ANTHEM BC/BS: $83.70 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $83.70 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $83.70 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $85.37

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lhc/Inj. for Lv When Performe	$13,896.09	$8,337.65	$2,529.09 – $11,811.68
Left heart catheterization (diagnostic): 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $8,754.54 ALLIED BENEFIT [100193] — HB AETNA: $8,754.54 ASSURANT HEALTH [100198] — HB AETNA: $8,754.54 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $8,268.17 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $8,268.17 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $8,268.17 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $8,754.54 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $8,056.95 COVENTRY HEALTH CARE [1001106] — HB AETNA: $8,754.54 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $8,268.17
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comp Ep Eval W/O a Induction	$16,892.94	$10,135.76	$3,074.52 – $14,359
Heart rhythm study (electrophysiology evaluation): 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $10,642.55 ALLIED BENEFIT [100193] — HB AETNA: $10,642.55 ASSURANT HEALTH [100198] — HB AETNA: $10,642.55 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $10,051.30 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $10,051.30 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $10,051.30 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $10,642.55 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $9,794.53 COVENTRY HEALTH CARE [1001106] — HB AETNA: $10,642.55 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $10,051.30
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Eps W P.V.I for Afib Icl Transep	$124,785.44	$74,871.26	$801.02 – $98,887.85
Heart rhythm study with ablation for atrial fibrillation: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $98,887.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $27,252.91 ANTHEM [10121] — HB ANTHEM BC/BS: $85,707.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $68,565.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $77,317.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $27,252.91 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $27,252.91 APWU [100197] — HB CIGNA / GREATWEST: $98,887.85
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Eps W P.V.I for Afib Icl Transep	$77,557.39	$46,534.43	$14,115.44 – $98,887.85
Heart rhythm study with ablation for atrial fibrillation: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $48,861.16 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 ALLIED BENEFIT [100193] — HB AETNA: $48,861.16 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $98,887.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $27,252.91 ANTHEM [10121] — HB ANTHEM BC/BS: $85,707.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $68,565.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $77,317.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $27,252.91
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: HC Eps W P.V.I for Afib Icl Transep\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION OF ANES	$86,749	$52,049.40	$801.02 – $98,887.85
Heart rhythm study with ablation for atrial fibrillation: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $98,887.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $27,252.91 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $27,252.91 ANTHEM [10121] — HB ANTHEM BC/BS: $85,707.48 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $68,565.98 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $77,317.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $27,252.91 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $27,252.91 APWU [100197] — HB CIGNA / GREATWEST: $98,887.85
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Psg Only (Has No Cpap)	$4,640.63	$2,784.38	$254.46 – $3,248.88
Sleep study (overnight, in a sleep lab): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,248.88 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $895.37 ANTHEM [10121] — HB ANTHEM BC/BS: $2,815.85 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,252.68 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,540.21 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $895.37 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $895.37 APWU [100197] — HB CIGNA / GREATWEST: $3,248.88
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psg Only (Has No Cpap)	$4,640.63	$2,784.38	$793.55 – $3,944.54
Sleep study (overnight, in a sleep lab): 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $2,923.60 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 ALLIED BENEFIT [100193] — HB AETNA: $2,923.60 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,248.88 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $895.37 ANTHEM [10121] — HB ANTHEM BC/BS: $2,815.85 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,252.68 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,540.21 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $895.37
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: HC Psg Only (Has No Cpap)\|REDUCED SERVICES	$4,640.63	$2,784.38	$254.46 – $3,248.88
Sleep study (overnight, in a sleep lab): 10 of 131 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,248.88 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $895.37 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $895.37 ANTHEM [10121] — HB ANTHEM BC/BS: $2,815.85 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,252.68 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,540.21 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $895.37 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $895.37 APWU [100197] — HB CIGNA / GREATWEST: $3,248.88

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Therapeutic Ex per 15 Min	$1,828.11	$1,096.87	$28.01 – $56.02
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $56.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $28.01 ANTHEM [10121] — HB ANTHEM BC/BS: $28.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $28.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $28.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $28.57 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $28.01 APWU [100197] — HB CIGNA / GREATWEST: $56.02
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Wh Pt Therapeutic Ex per 15 Min	$282.35	$169.41	$28.01 – $240
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $177.88 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 ALLIED BENEFIT [100193] — HB AETNA: $177.88 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $128 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $28.01 ANTHEM [10121] — HB ANTHEM BC/BS: $28.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $28.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $28.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $28.57
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Wh Ot Therapeutic Ex per 15 Min	$282.35	$169.41	$28.01 – $240
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $177.88 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 ALLIED BENEFIT [100193] — HB AETNA: $177.88 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $56.02 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $28.01 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $28.01 ANTHEM [10121] — HB ANTHEM BC/BS: $28.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $28.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $28.01 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $28.57
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Eval Low Complexity	$3,402.35	$2,041.41	$94.33 – $183.94
Physical therapy evaluation (low complexity): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $128 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $94.33 APWU [100197] — HB CIGNA / GREATWEST: $128
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Rsc Pt Eval Low Complexity	$296.50	$177.90	$85.96 – $252.03
Physical therapy evaluation (low complexity): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $186.80 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB AETNA: $186.80 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $128 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Eval Low Complexity	$296.50	$177.90	$85.96 – $252.03
Physical therapy evaluation (low complexity): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $186.80 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB AETNA: $186.80 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $128 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Eval Moderate Complexity	$47,779.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$28,667.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$94.33 – $48,572.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Physical therapy evaluation (moderate complexity): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $94.33 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Eval Moderate Complexity	$338.84	$203.30	$94.33 – $288.01
Physical therapy evaluation (moderate complexity): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $213.47 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB AETNA: $213.47 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $188.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Eval High Complexity	$945.92	$567.55	$94.33 – $188.66
Physical therapy evaluation (high complexity): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $188.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $94.33 APWU [100197] — HB CIGNA / GREATWEST: $188.66
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Eval High Complexity	$381.22	$228.73	$94.33 – $324.04
Physical therapy evaluation (high complexity): 10 of 159 insurance plan rates AETNA [10011] — HB AETNA: $240.17 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 ALLIED BENEFIT [100193] — HB AETNA: $240.17 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $188.66 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $94.33 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $94.33 ANTHEM [10121] — HB ANTHEM BC/BS: $94.33 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $94.33 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $94.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $96.22
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam 16-37 Min Lisw/Lsw	$1,066.16	$639.70	$69.44 – $582.02
Psychotherapy, 30 minutes: 10 of 115 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 ANTHEM [10121] — HB ANTHEM BC/BS: $582.02 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $69.44 COVENTRY HEALTH CARE MEDICARE ADVANTAGE [111102] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 GENERIC WORKERS' COMP [10051] — HB OHIO BWC: $69.44 GENESIS MEDICAL BENEFITS ALTERNATE [99910012801] — HB Genesis Employee Health Plan: $185.07 HUMANA MEDICARE ADVANTAGE [111003] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 MCO 3 HAB [100522] — HB OHIO BWC: $69.44 MCO ADVOCARE [100525] — HB OHIO BWC: $69.44
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam 16-37 Min Lisw/Lsw	$531.42	$318.85	$244.45 – $451.71
Psychotherapy, 30 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $334.79 ALLIED BENEFIT [100193] — HB AETNA: $334.79 ASSURANT HEALTH [100198] — HB AETNA: $334.79 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $316.19 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $316.19 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $316.19 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $334.79 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $308.12 COVENTRY HEALTH CARE [1001106] — HB AETNA: $334.79 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $316.19
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Diagnostic Art Psych Htp 16-37 Mins	$531.42	$318.85	$244.45 – $451.71
Psychotherapy, 30 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $334.79 ALLIED BENEFIT [100193] — HB AETNA: $334.79 ASSURANT HEALTH [100198] — HB AETNA: $334.79 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $316.19 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $316.19 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $316.19 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $334.79 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $308.12 COVENTRY HEALTH CARE [1001106] — HB AETNA: $334.79 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $316.19
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam 38-52 Min Lisw/Lsw	$1,048.74	$629.24	$91.82 – $582.02
Psychotherapy, 45 minutes: 10 of 115 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 ANTHEM [10121] — HB ANTHEM BC/BS: $582.02 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $91.82 COVENTRY HEALTH CARE MEDICARE ADVANTAGE [111102] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 GENERIC WORKERS' COMP [10051] — HB OHIO BWC: $91.82 GENESIS MEDICAL BENEFITS ALTERNATE [99910012801] — HB Genesis Employee Health Plan: $185.07 HUMANA MEDICARE ADVANTAGE [111003] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $185.07 MCO 3 HAB [100522] — HB OHIO BWC: $91.82 MCO ADVOCARE [100525] — HB OHIO BWC: $91.82
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam 38-52 Min Lisw/Lsw	$534.74	$320.84	$245.98 – $454.53
Psychotherapy, 45 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $336.89 ALLIED BENEFIT [100193] — HB AETNA: $336.89 ASSURANT HEALTH [100198] — HB AETNA: $336.89 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $318.17 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $318.17 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $318.17 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $336.89 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $310.04 COVENTRY HEALTH CARE [1001106] — HB AETNA: $336.89 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $318.17
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam 38-52 Min Lpcc/Lpc	$534.74	$320.84	$245.98 – $454.53
Psychotherapy, 45 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $336.89 ALLIED BENEFIT [100193] — HB AETNA: $336.89 ASSURANT HEALTH [100198] — HB AETNA: $336.89 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $318.17 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $318.17 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $318.17 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $336.89 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $310.04 COVENTRY HEALTH CARE [1001106] — HB AETNA: $336.89 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $318.17
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam > 53 Mins Lisw/Lsw	$1,028	$616.80	$135.22 – $671.52
Psychotherapy, 60 minutes: 10 of 111 insurance plan rates ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $671.52 ANTHEM [10121] — HB ANTHEM BC/BS: $582.02 APWU [100197] — HB CIGNA / GREATWEST: $671.52 AULTCARE [10019] — HB CIGNA / GREATWEST: $671.52 BAC [1001100] — HB CIGNA / GREATWEST: $671.52 BOILERMAKER [1001101] — HB CIGNA / GREATWEST: $671.52 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $135.22 CIGNA [10013] — HB CIGNA / GREATWEST: $671.52 CIGNA [100140] — HB CIGNA / GREATWEST: $671.52 CONNECTICUT GENERAL LIFE INS [10011214] — HB CIGNA / GREATWEST: $671.52
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam > 53 Mins Lisw/Lsw	$514	$308.40	$236.44 – $436.90
Psychotherapy, 60 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $323.82 ALLIED BENEFIT [100193] — HB AETNA: $323.82 ASSURANT HEALTH [100198] — HB AETNA: $323.82 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $305.83 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $305.83 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $305.83 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $323.82 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $298.02 COVENTRY HEALTH CARE [1001106] — HB AETNA: $323.82 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $305.83
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt 1:1 or W Fam > 53 Mins Lpcc/Lpc	$514	$308.40	$236.44 – $436.90
Psychotherapy, 60 minutes: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $323.82 ALLIED BENEFIT [100193] — HB AETNA: $323.82 ASSURANT HEALTH [100198] — HB AETNA: $323.82 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $305.83 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $305.83 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $305.83 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $323.82 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $298.02 COVENTRY HEALTH CARE [1001106] — HB AETNA: $323.82 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $305.83
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Family Therapy WO Pt 6269	$545.43	$327.26	$250.90 – $463.62
Family psychotherapy, without the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $343.62 ALLIED BENEFIT [100193] — HB AETNA: $343.62 ASSURANT HEALTH [100198] — HB AETNA: $343.62 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $324.53 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $324.53 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $324.53 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $343.62 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $316.24 COVENTRY HEALTH CARE [1001106] — HB AETNA: $343.62 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $324.53
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Family Therapy WO Pt 50 Min Lisw/Lsw	$545.43	$327.26	$250.90 – $463.62
Family psychotherapy, without the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $343.62 ALLIED BENEFIT [100193] — HB AETNA: $343.62 ASSURANT HEALTH [100198] — HB AETNA: $343.62 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $324.53 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $324.53 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $324.53 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $343.62 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $316.24 COVENTRY HEALTH CARE [1001106] — HB AETNA: $343.62 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $324.53
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Family Therapy WO Pt 50 Min Lpcc/Lpc	$545.43	$327.26	$250.90 – $463.62
Family psychotherapy, without the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $343.62 ALLIED BENEFIT [100193] — HB AETNA: $343.62 ASSURANT HEALTH [100198] — HB AETNA: $343.62 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $324.53 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $324.53 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $324.53 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $343.62 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $316.24 COVENTRY HEALTH CARE [1001106] — HB AETNA: $343.62 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $324.53
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Family Therapy W Pt 6269	$420.49	$252.29	$193.43 – $357.42
Family psychotherapy, with the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $264.91 ALLIED BENEFIT [100193] — HB AETNA: $264.91 ASSURANT HEALTH [100198] — HB AETNA: $264.91 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $250.19 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $250.19 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $250.19 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $264.91 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $243.80 COVENTRY HEALTH CARE [1001106] — HB AETNA: $264.91 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $250.19
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Fam & Pt 50 Min Lisw/Lsw	$420.49	$252.29	$193.43 – $357.42
Family psychotherapy, with the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $264.91 ALLIED BENEFIT [100193] — HB AETNA: $264.91 ASSURANT HEALTH [100198] — HB AETNA: $264.91 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $250.19 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $250.19 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $250.19 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $264.91 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $243.80 COVENTRY HEALTH CARE [1001106] — HB AETNA: $264.91 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $250.19
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Fam & Pt 50 Min Lpcc/Lpc	$420.49	$252.29	$193.43 – $357.42
Family psychotherapy, with the patient: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $264.91 ALLIED BENEFIT [100193] — HB AETNA: $264.91 ASSURANT HEALTH [100198] — HB AETNA: $264.91 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $250.19 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $250.19 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $250.19 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $264.91 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $243.80 COVENTRY HEALTH CARE [1001106] — HB AETNA: $264.91 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $250.19
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Grouped Therapy	$2,633.31	$1,579.99	$73.08 – $105.92
Group psychotherapy: 10 of 112 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $105.92 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $105.92 BWC PENDING ENABLECOMP [100544] — HB OHIO BWC: $73.08 COVENTRY HEALTH CARE MEDICARE ADVANTAGE [111102] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $105.92 GENERIC WORKERS' COMP [10051] — HB OHIO BWC: $73.08 HUMANA MEDICARE ADVANTAGE [111003] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $105.92 MCO 3 HAB [100522] — HB OHIO BWC: $73.08 MCO ADVOCARE [100525] — HB OHIO BWC: $73.08 MCO AULTCOMP [100526] — HB OHIO BWC: $73.08 MCO CAREWORKS OF OHIO [100122] — HB OHIO BWC: $73.08
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Three Hour Group Therapy	$718.18	$430.91	$330.36 – $610.45
Group psychotherapy: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $452.45 ALLIED BENEFIT [100193] — HB AETNA: $452.45 ASSURANT HEALTH [100198] — HB AETNA: $452.45 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $427.32 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $427.32 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $427.32 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $452.45 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $416.40 COVENTRY HEALTH CARE [1001106] — HB AETNA: $452.45 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $427.32
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Two Hour Group Therapy	$478.79	$287.27	$220.24 – $406.97
Group psychotherapy: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $301.64 ALLIED BENEFIT [100193] — HB AETNA: $301.64 ASSURANT HEALTH [100198] — HB AETNA: $301.64 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $284.88 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $284.88 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $284.88 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $301.64 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $277.60 COVENTRY HEALTH CARE [1001106] — HB AETNA: $301.64 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $284.88

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$10,848.63	$6,509.18	$395.68 – $14,813.33
Removal of breast growth (open surgery): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4,082.47 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $14,813.33 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4,082.47 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $4,082.47 ANTHEM [10121] — HB ANTHEM BC/BS: $12,838.92 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $10,271.14 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $11,582.16 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $4,082.47 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $4,082.47 APWU [100197] — HB CIGNA / GREATWEST: $14,813.33
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Excision ,Open, Breast Mass	$11,234.92	$6,740.95	$487.80 – $14,324.52
Removal of breast growth (open surgery): 10 of 48 insurance plan rates AETNA [10011] — HB AETNA: $7,078 ALLIED BENEFIT [100193] — HB AETNA: $7,078 ASSURANT HEALTH [100198] — HB AETNA: $7,078 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $6,684.78 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $6,684.78 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $6,684.78 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $7,078 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $6,514.01 COVENTRY HEALTH CARE [1001106] — HB AETNA: $7,078 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $6,684.78
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion\|BILATERAL PROCEDURE	$13,301.19	$7,980.71	$395.68 – $14,813.33
Removal of breast growth (open surgery): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4,082.47 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $14,813.33 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $4,082.47 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $4,082.47 ANTHEM [10121] — HB ANTHEM BC/BS: $12,232.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $10,271.14 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $11,582.16 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $4,082.47 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $4,082.47 APWU [100197] — HB CIGNA / GREATWEST: $14,813.33
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$41,577.92	$24,946.75	$1,134.94 – $48,572.85
Total hip replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft\|LEFT SIDE	$46,152.97	$27,691.78	$1,134.94 – $48,572.85
Total hip replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT\|74 In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft\|LEFT SIDE\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMI	$13,393.06	$8,035.84	$1,134.94 – $48,572.85
Total hip replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$47,152.69	$28,291.61	$1,132.39 – $48,572.85
Total knee replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments\|LEFT SIDE	$49,997.80	$29,998.68	$1,132.39 – $48,572.85
Total knee replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments\|RIGHT SIDE	$50,058.68	$30,035.21	$1,132.39 – $48,572.85
Total knee replacement: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $48,572.85 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $13,386.39 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $13,386.39 ANTHEM [10121] — HB ANTHEM BC/BS: $42,098.76 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,679.01 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,977.85 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $13,386.39 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $13,386.39 APWU [100197] — HB CIGNA / GREATWEST: $48,572.85
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$26,310.29	$15,786.17	$145.87 – $27,452.58
Shoulder arthroscopy: shaving of shoulder bone: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $27,452.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7,565.77 ANTHEM [10121] — HB ANTHEM BC/BS: $23,793.54 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $19,034.83 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $21,464.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7,565.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $7,565.77 APWU [100197] — HB CIGNA / GREATWEST: $27,452.58
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls\|LEFT SIDE	$36,889.08	$22,133.45	$145.87 – $27,452.58
Shoulder arthroscopy: shaving of shoulder bone: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $27,452.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7,565.77 ANTHEM [10121] — HB ANTHEM BC/BS: $23,793.54 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $19,034.83 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $21,464.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7,565.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $7,565.77 APWU [100197] — HB CIGNA / GREATWEST: $27,452.58
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls\|RIGHT SIDE	$33,566.76	$20,140.06	$145.87 – $27,452.58
Shoulder arthroscopy: shaving of shoulder bone: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $27,452.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $7,565.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $7,565.77 ANTHEM [10121] — HB ANTHEM BC/BS: $23,793.54 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $19,034.83 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $21,464.46 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $7,565.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $7,565.77 APWU [100197] — HB CIGNA / GREATWEST: $27,452.58
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$15,795.40	$9,477.24	$497.66 – $12,379.03
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12,379.03 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,411.59 ANTHEM [10121] — HB ANTHEM BC/BS: $10,729.08 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8,583.26 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $9,678.84 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,411.59 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,411.59 APWU [100197] — HB CIGNA / GREATWEST: $12,379.03
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg\|LEFT SIDE	$16,278.41	$9,767.05	$497.66 – $12,379.03
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12,379.03 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,411.59 ANTHEM [10121] — HB ANTHEM BC/BS: $10,729.08 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8,583.26 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $9,678.84 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,411.59 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,411.59 APWU [100197] — HB CIGNA / GREATWEST: $12,379.03
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg\|RIGHT SIDE	$15,567.37	$9,340.42	$497.66 – $12,379.03
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12,379.03 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,411.59 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,411.59 ANTHEM [10121] — HB ANTHEM BC/BS: $10,729.08 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8,583.26 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $9,678.84 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,411.59 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,411.59 APWU [100197] — HB CIGNA / GREATWEST: $12,379.03
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy & Adenoidectomy <Age 12	$13,996.42	$8,397.85	$253.24 – $22,396.62
Removal of tonsils and adenoids (under age 12): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,172.37 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,396.62 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,172.37 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,172.37 ANTHEM [10121] — HB ANTHEM BC/BS: $19,411.46 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,529.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,511.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,172.37 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,172.37 APWU [100197] — HB CIGNA / GREATWEST: $22,396.62
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: Tonsillectomy & Adenoidectomy <Age 12\|BILATERAL PROCEDURE	$13,292.08	$7,975.25	$253.24 – $22,396.62
Removal of tonsils and adenoids (under age 12): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,172.37 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,396.62 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,172.37 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,172.37 ANTHEM [10121] — HB ANTHEM BC/BS: $19,411.46 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,529.17 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,511.33 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,172.37 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,172.37 APWU [100197] — HB CIGNA / GREATWEST: $22,396.62
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$7,615.41	$4,569.25	$65.59 – $3,431.41
Upper GI endoscopy (diagnostic): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $945.68 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,431.41 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $945.68 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $945.68 ANTHEM [10121] — HB ANTHEM BC/BS: $2,974.05 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,379.24 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,682.93 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $945.68 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $945.68 APWU [100197] — HB CIGNA / GREATWEST: $3,431.41
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Esophagogastroduodenoscopy Transoral Diagnostic	$2,457.99	$1,474.79	$1,130.68 – $2,089.29
Upper GI endoscopy (diagnostic): 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $1,548.53 ALLIED BENEFIT [100193] — HB AETNA: $1,548.53 ASSURANT HEALTH [100198] — HB AETNA: $1,548.53 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $1,462.50 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $1,462.50 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $1,462.50 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $1,548.53 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $1,425.14 COVENTRY HEALTH CARE [1001106] — HB AETNA: $1,548.53 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $1,462.50
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: Esophagogastroduodenoscopy Transoral Diagnostic\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRA	$5,470.52	$3,282.31	$65.59 – $3,431.41
Upper GI endoscopy (diagnostic): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $945.68 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,431.41 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $945.68 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $945.68 ANTHEM [10121] — HB ANTHEM BC/BS: $2,974.05 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,379.24 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,682.93 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $945.68 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $945.68 APWU [100197] — HB CIGNA / GREATWEST: $3,431.41
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd Transoral Biopsy Single/Multiple	$8,963.54	$5,378.12	$65.59 – $7,259.83
Upper GI endoscopy with biopsy: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,000.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $7,259.83 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,000.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,000.77 ANTHEM [10121] — HB ANTHEM BC/BS: $6,292.20 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $5,033.76 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $5,676.27 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,000.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,000.77 APWU [100197] — HB CIGNA / GREATWEST: $7,259.83
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Egd Biopsy Single/Multiple	$5,859.87	$3,515.92	$2,764.69 – $4,980.89
Upper GI endoscopy with biopsy: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $3,691.72 ALLIED BENEFIT [100193] — HB AETNA: $3,691.72 ASSURANT HEALTH [100198] — HB AETNA: $3,691.72 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $3,486.62 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $3,486.62 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $3,486.62 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $3,691.72 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $3,397.55 COVENTRY HEALTH CARE [1001106] — HB AETNA: $3,691.72 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $3,486.62
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22 In the file: Egd Transoral Biopsy Single/Multiple\|UNUSUAL PROCEDURAL SERVICES	$20,383.89	$12,230.33	$65.59 – $7,259.83
Upper GI endoscopy with biopsy: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,000.77 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $7,259.83 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,000.77 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,000.77 ANTHEM [10121] — HB ANTHEM BC/BS: $6,292.20 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $5,033.76 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $5,676.27 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,000.77 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,000.77 APWU [100197] — HB CIGNA / GREATWEST: $7,259.83
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$5,980.05	$3,588.03	$80.84 – $3,518.34
Colonoscopy (diagnostic): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION	$8,442.87	$5,065.72	$80.84 – $3,518.34
Colonoscopy (diagnostic): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 78 In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd\|RETURN TO THE OPERATING ROOM FOR A RELATED PROCEDURE DURING THE POSTOPERATIVE PERIOD	$19,652.15	$11,791.29	$80.84 – $3,518.34
Colonoscopy (diagnostic): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy W/Biopsy Single/Multiple	$9,101.07	$5,460.64	$64.98 – $4,527.26
Colonoscopy with biopsy: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 1P In the file: Colonoscopy W/Biopsy Single/Multiple\|PQRI MEDICAL REASON	$7,991.11	$4,794.67	$64.98 – $4,527.26
Colonoscopy with biopsy: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22 In the file: Colonoscopy W/Biopsy Single/Multiple\|UNUSUAL PROCEDURAL SERVICES	$15,703.50	$9,422.10	$64.98 – $4,527.26
Colonoscopy with biopsy: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$9,380.16	$5,628.10	$65.59 – $4,527.26
Colonoscopy with removal of polyps (snare): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22 In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq\|UNUSUAL PROCEDURAL SERVICES	$14,722.11	$8,833.27	$65.59 – $4,527.26
Colonoscopy with removal of polyps (snare): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq\|REDUCED SERVICES	$7,436.26	$4,461.76	$65.59 – $4,527.26
Colonoscopy with removal of polyps (snare): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $4,527.26 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $1,247.69 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $1,247.69 ANTHEM [10121] — HB ANTHEM BC/BS: $3,923.84 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $3,139.07 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $3,539.75 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $1,247.69 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $1,247.69 APWU [100197] — HB CIGNA / GREATWEST: $4,527.26
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	$6,153.26	$3,691.96	$65.59 – $3,518.34
Screening colonoscopy (not high risk): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: Colon ca scrn not hi rsk ind\|REDUCED SERVICES	$16,363.97	$9,818.38	$65.59 – $3,518.34
Screening colonoscopy (not high risk): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: Colon ca scrn not hi rsk ind\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION OF ANESTHESIA	$5,932.40	$3,559.44	$65.59 – $3,518.34
Screening colonoscopy (not high risk): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,518.34 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $969.63 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $969.63 ANTHEM [10121] — HB ANTHEM BC/BS: $3,049.39 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,439.52 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,750.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $969.63 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $969.63 APWU [100197] — HB CIGNA / GREATWEST: $3,518.34
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy Surg Cholecystectomy	$22,387.33	$13,432.40	$618.18 – $22,872.17
Gallbladder removal by laparoscope: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,872.17 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,303.43 ANTHEM [10121] — HB ANTHEM BC/BS: $19,823.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,858.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,883.16 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,303.43 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,303.43 APWU [100197] — HB CIGNA / GREATWEST: $22,872.17
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22 In the file: Laparoscopy Surg Cholecystectomy\|UNUSUAL PROCEDURAL SERVICES	$19,452.91	$11,671.75	$618.18 – $22,872.17
Gallbladder removal by laparoscope: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,872.17 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,303.43 ANTHEM [10121] — HB ANTHEM BC/BS: $19,823.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,858.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,883.16 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,303.43 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,303.43 APWU [100197] — HB CIGNA / GREATWEST: $22,872.17
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: Laparoscopy Surg Cholecystectomy\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION OF ANESTHE	$16,686.28	$10,011.77	$618.18 – $22,872.17
Gallbladder removal by laparoscope: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,872.17 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,303.43 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,303.43 ANTHEM [10121] — HB ANTHEM BC/BS: $19,823.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,858.90 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,883.16 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,303.43 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,303.43 APWU [100197] — HB CIGNA / GREATWEST: $22,872.17
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$14,796.45	$8,877.87	$495.34 – $22,968.14
Groin (inguinal) hernia repair, age 5 or older: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,733.14 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $13,545.81 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,733.14 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,733.14 ANTHEM [10121] — HB ANTHEM BC/BS: $11,740.34 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $9,392.27 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $10,591.12 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,733.14 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,733.14 APWU [100197] — HB CIGNA / GREATWEST: $13,545.81
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible\|BILATERAL PROCEDURE	$24,481.51	$14,688.91	$495.34 – $22,968.14
Groin (inguinal) hernia repair, age 5 or older: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,329.89 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $22,968.14 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $6,329.89 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $6,329.89 ANTHEM [10121] — HB ANTHEM BC/BS: $19,016.22 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $15,925.45 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $17,958.19 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $6,329.89 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $6,329.89 APWU [100197] — HB CIGNA / GREATWEST: $22,968.14
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible\|LEFT SIDE	$17,932.82	$10,759.69	$495.34 – $22,968.14
Groin (inguinal) hernia repair, age 5 or older: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,733.14 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $13,545.81 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,733.14 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,733.14 ANTHEM [10121] — HB ANTHEM BC/BS: $11,740.34 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $9,392.27 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $10,591.12 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,733.14 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,733.14 APWU [100197] — HB CIGNA / GREATWEST: $13,545.81
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate Needle Biopsy Any Approach	$7,645.63	$4,587.38	Not listed in the file
Prostate biopsy: 10 of 59 insurance plan rates AETNA [10011] — HB AETNA: 63% (a percentage in the contract, not a dollar amount) ALLIED BENEFIT [100193] — HB AETNA: 63% (a percentage in the contract, not a dollar amount) ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: 60% (a percentage in the contract, not a dollar amount) APWU [100197] — HB CIGNA / GREATWEST: 60% (a percentage in the contract, not a dollar amount) ASSURANT HEALTH [100198] — HB AETNA: 63% (a percentage in the contract, not a dollar amount) AULTCARE [10019] — HB CIGNA / GREATWEST: 60% (a percentage in the contract, not a dollar amount) BAC [1001100] — HB CIGNA / GREATWEST: 60% (a percentage in the contract, not a dollar amount) BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: 59.5% (a percentage in the contract, not a dollar amount) BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: 59.5% (a percentage in the contract, not a dollar amount) BOILERMAKER [1001101] — HB CIGNA / GREATWEST: 60% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$53,018.94	$31,811.36	$258.28 – $40,216.07
Prostate removal by laparoscope (radical prostatectomy): 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $11,083.31 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $40,216.07 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $11,083.31 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $11,083.31 ANTHEM [10121] — HB ANTHEM BC/BS: $34,855.83 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $27,884.67 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $31,443.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $11,083.31 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $11,083.31 APWU [100197] — HB CIGNA / GREATWEST: $40,216.07
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing\|BILATERAL PROCEDURE	$40,137.75	$24,082.65	$258.28 – $40,216.07
Prostate removal by laparoscope (radical prostatectomy): 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $11,083.31 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $40,216.07 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $11,083.31 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $11,083.31 ANTHEM [10121] — HB ANTHEM BC/BS: $34,855.83 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $27,884.67 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $31,443.90 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $11,083.31 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $11,083.31 APWU [100197] — HB CIGNA / GREATWEST: $40,216.07
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$12,915.56	$7,749.34	$65.59 – $12,247.08
Hysteroscopy with biopsy of the uterus lining: 10 of 163 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,375.22 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12,247.08 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,375.22 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,375.22 ANTHEM [10121] — HB ANTHEM BC/BS: $10,614.71 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8,491.77 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $9,575.67 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,375.22 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,375.22 APWU [100197] — HB CIGNA / GREATWEST: $12,247.08
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATIO	$14,346.20	$8,607.72	$65.59 – $12,247.08
Hysteroscopy with biopsy of the uterus lining: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,375.22 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $12,247.08 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $3,375.22 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $3,375.22 ANTHEM [10121] — HB ANTHEM BC/BS: $10,614.71 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $8,491.77 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $9,575.67 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $3,375.22 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $3,375.22 APWU [100197] — HB CIGNA / GREATWEST: $12,247.08
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Epidural Steroid Inj W/Img-Lumbar or Sacral	$2,095.67	$1,257.40	$87.51 – $2,670.58
Spinal injection, lower back (epidural), with imaging guidance: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $735.99 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $2,670.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $735.99 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $735.99 ANTHEM [10121] — HB ANTHEM BC/BS: $2,314.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $1,851.71 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,088.06 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $735.99 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $735.99 APWU [100197] — HB CIGNA / GREATWEST: $2,670.58
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Epidural Steroid Inj W/Img-Lumbar or Sacral	$2,021.92	$1,213.15	$648.78 – $2,670.58
Spinal injection, lower back (epidural), with imaging guidance: 10 of 108 insurance plan rates AETNA [10011] — HB AETNA: $1,273.81 AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $735.99 ALLIED BENEFIT [100193] — HB AETNA: $1,273.81 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $2,670.58 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $735.99 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $735.99 ANTHEM [10121] — HB ANTHEM BC/BS: $2,314.63 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $1,851.71 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,088.06 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $735.99
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$5,792.42	$3,475.45	$97.27 – $3,346.24
Nerve root injection, lower back, with imaging guidance: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $922.20 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $3,346.24 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $922.20 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $922.20 ANTHEM [10121] — HB ANTHEM BC/BS: $2,900.23 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $2,320.18 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $2,616.34 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $922.20 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $922.20 APWU [100197] — HB CIGNA / GREATWEST: $3,346.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Transform. Epi Inject L/S Incl Imaging	$3,026.83	$1,816.10	$1,428.06 – $2,572.81
Nerve root injection, lower back, with imaging guidance: 10 of 44 insurance plan rates AETNA [10011] — HB AETNA: $1,906.90 ALLIED BENEFIT [100193] — HB AETNA: $1,906.90 ASSURANT HEALTH [100198] — HB AETNA: $1,906.90 BAC [1001100] — HB MEDICAL MUTUAL OF OHIO: $1,800.96 BENEFIT SERVICES [100114] — HB MEDICAL MUTUAL OF OHIO: $1,800.96 CENTRAL STATES [100118] — HB MEDICAL MUTUAL OF OHIO: $1,800.96 CHESTERFIELD RESOURCES [1001166] — HB AETNA: $1,906.90 COMPASS ROSE HEALTH PLAN [10011209] — HB UNITED HEALTHCARE (UHC): $1,754.96 COVENTRY HEALTH CARE [1001106] — HB AETNA: $1,906.90 EBMC [100119] — HB MEDICAL MUTUAL OF OHIO: $1,800.96
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$28,198.44	$16,919.06	$405.62 – $7,387.79
Carpal tunnel release: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $7,387.79 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,036.03 ANTHEM [10121] — HB ANTHEM BC/BS: $6,403.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $5,122.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $5,776.32 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,036.03 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,036.03 APWU [100197] — HB CIGNA / GREATWEST: $7,387.79
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne\|BILATERAL PROCEDURE	$9,468.92	$5,681.35	$405.62 – $7,387.79
Carpal tunnel release: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $7,387.79 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,036.03 ANTHEM [10121] — HB ANTHEM BC/BS: $6,403.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $5,122.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $5,776.32 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,036.03 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,036.03 APWU [100197] — HB CIGNA / GREATWEST: $7,387.79
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne\|LEFT SIDE	$11,389.79	$6,833.87	$405.62 – $7,387.79
Carpal tunnel release: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $7,387.79 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,036.03 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,036.03 ANTHEM [10121] — HB ANTHEM BC/BS: $6,403.10 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $5,122.48 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $5,776.32 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,036.03 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,036.03 APWU [100197] — HB CIGNA / GREATWEST: $7,387.79
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$13,888.89	$8,333.33	$447.12 – $8,731.24
Cataract removal with lens implant: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8,731.24 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,406.28 ANTHEM [10121] — HB ANTHEM BC/BS: $7,567.49 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6,053.99 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6,826.73 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,406.28 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,406.28 APWU [100197] — HB CIGNA / GREATWEST: $8,731.24
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp\|LEFT SIDE	$12,432.56	$7,459.54	$447.12 – $8,731.24
Cataract removal with lens implant: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8,731.24 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,406.28 ANTHEM [10121] — HB ANTHEM BC/BS: $7,567.49 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6,053.99 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6,826.73 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,406.28 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,406.28 APWU [100197] — HB CIGNA / GREATWEST: $8,731.24
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp\|RIGHT SIDE	$13,927.76	$8,356.66	$447.12 – $8,731.24
Cataract removal with lens implant: 10 of 159 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $8,731.24 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $2,406.28 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $2,406.28 ANTHEM [10121] — HB ANTHEM BC/BS: $7,567.49 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $6,053.99 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $6,826.73 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $2,406.28 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $2,406.28 APWU [100197] — HB CIGNA / GREATWEST: $8,731.24

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	$347,031.11	$208,218.67	$66,173.87 – $210,789.99
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 157 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $69,507.76 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $205,438.80 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $69,507.76 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $69,507.76 ANTHEM [10121] — HB ANTHEM BC/BS: $210,789.99 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $168,635.91 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $190,735.25 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $70,897.92 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $69,507.76 APWU [100197] — HB CIGNA / GREATWEST: $205,438.80
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$66,268.39	$39,761.03	$5,410.34 – $41,562.01
Hip or knee replacement (major joint of the leg), without major complications: 10 of 157 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $14,152.07 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $40,506.90 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $14,152.07 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $14,152.07 ANTHEM [10121] — HB ANTHEM BC/BS: $41,562.01 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $33,250.38 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $37,607.76 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $14,435.11 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $14,152.07 APWU [100197] — HB CIGNA / GREATWEST: $40,506.90
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$77,681.70	$46,609.02	$16,453.94 – $52,602.69
Neck (cervical) spinal fusion, without complications: 10 of 157 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $17,763.56 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $51,267.30 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $17,763.56 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $17,763.56 ANTHEM [10121] — HB ANTHEM BC/BS: $52,602.69 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $42,083.13 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $47,598.03 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $18,118.83 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $17,763.56 APWU [100197] — HB CIGNA / GREATWEST: $51,267.30
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$44,690.49	$26,814.29	$7,581.75 – $26,733.36
Uterus and ovary surgery (not for cancer), without complications: 10 of 157 insurance plan rates AETNA MEDICARE ADVANTAGE [111009] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $9,301.53 ALLIED BENEFIT [100193] — HB CIGNA / GREATWEST: $26,054.70 ALLWELL MEDICARE BUCKEYE HEALTH PLAN [111105] — HB MEDICARE AND MEDICARE ADVANTAGE IP OP: $9,301.53 AMERICAN TRUST ADM [100196] — HB QUALITY CARE PARTNERS (QCP PLUS): $9,301.53 ANTHEM [10121] — HB ANTHEM BC/BS: $26,733.36 ANTHEM BCBS EXCHANGE HMO [10131] — HB ANTHEM PATHWAY HMO EXCHANGE: $21,387.19 ANTHEM BCBS EXCHANGE PPO [10141] — HB ANTHEM PATHWAY EXCHANGE PPO: $24,189.93 ANTHEM MEDICARE ADVANTAGE [10020] — HB Anthem MA: $9,487.56 ANTIDOTE HEALTHPLAN [111121] — HB ANTIDOTE QCP Marketplace: $9,301.53 APWU [100197] — HB CIGNA / GREATWEST: $26,054.70

Source: Genesis Hospital’s standard charges file (genesisgenericblob.blob.core.windows.net, CSV, CMS template 5.0.0; it can be a very large file), last updated by the hospital on March 27, 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	2951 Maple Avenue, Zanesville, OH 43701
County	Muskingum County
State	Ohio
Phone	(740) 454‑5000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	360039
Name in Medicare records	GENESIS HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(740) 454‑4000^[4]
Official website	genesishcs.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.

Genesis Hospital — genesishcs.org
Emergency & Trauma Services | Genesis Healthcare System — genesishcs.org
An Emergency Department Visit | Genesis Healthcare System — genesishcs.org
Trauma Center | Genesis Healthcare System — genesishcs.org
Genesis Emergency Department — genesishcs.org
Accreditations and Quality | Genesis Healthcare System — genesishcs.org

Genesis Hospital

Summary

Profile from official sources

At a glance