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Acute Care Hospital

Goshen Hospital

Goshen, Indiana · Elkhart County · Emergency services listed

Summary

Goshen Hospital is an acute care hospital in Goshen, Indiana. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 73 services, specialties and programs. Medicare lists 391 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
73Services listed

Quick answers

Does Goshen Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Goshen Hospital. In a medical emergency, call 911.
Where is Goshen Hospital?
200 High Park Ave, Goshen, IN 46526, in Elkhart County, Indiana.
What is the phone number of Goshen Hospital?
(574) 364-1000, as listed by Medicare (CMS).
What is the Medicare star rating of Goshen Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][7]

Conditions treated[4][5][6][8][9]

  • Alcohol poisoning
  • Anaphylaxis
  • Appendicitis
  • Back and neck pain
  • Bites and stings
  • Blood clots
  • Brain aneurysm
  • Broken bones and fractures
  • Burns
  • Car accident injuries
  • Cardiac arrest
  • Chest pain
  • Concussion
  • Coughing blood
  • Delirium (confusion)
  • Drowning
  • Dysphagia (swallowing problems)
  • Electric shock

Treatments[4][7][8]

  • Award-winning treatment for heart attacks
  • Concussion treatment
  • Emergency care for appendicitis
  • Treating high temperature in children
  • Wound care
  • Cardiac ablation
  • Cardiac catheterization
  • Pacemaker
  • Smoking cessation

Procedures[7]

Programs and centers[7][9]

  • Cardiac rehabilitation program
  • Chest Pain Center with Primary PCI accreditation
  • Electrophysiology (EP) lab

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingMon-Fri 8am-8pm, Sat-Sun 8am-5pm; quiet time daily 2-4pm; visitor limits vary by unit[11]
Interpreters and languagesParkview Goshen Hospital offers interpreter services[10]

Recognition[7][12]

  • Accredited facility for echocardiography
  • College of American Pathologists (CAP) laboratory accreditation

Doctors and clinicians (391)

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

Main specialties

Doctors with a page on this site (391)

And 367 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Goshen 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 hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night4 of 5 stars
Rated the hospital 9 or 10 out of 1075%National average: 72%
Would definitely recommend the hospital75%National average: 71%
Nurses “always” communicated well81%National average: 80%
Doctors “always” communicated well81%National average: 80%
Staff “always” explained medicines before giving them58%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean68%National average: 74%
Area around the room “always” quiet at night63%National average: 60%
Completed surveys769Response rate: 23%

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)0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.685No different from the national benchmark
Surgical site infections after colon surgery0.296No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.985No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.263Better 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 patients13%
Deaths within 30 days: heart failure patients14.3%
Deaths within 30 days: pneumonia patients19.4%
Deaths within 30 days: COPD patients8.8%
Deaths within 30 days: stroke patients21%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.97No different from the national rate
Complications after hip or knee replacementToo few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.7%
Readmitted within 30 days: heart failure20.9%
Readmitted within 30 days: pneumonia17.6%
Readmitted within 30 days: COPD20.7%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementToo few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)158 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)63%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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 70 common services exactly as Goshen Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Ob eval new pt level 3 $350 $245 $85.40 – $277.20
New patient office visit (about 30–44 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Office/outpatient visit new $350 $245 $85.40 – $277.20
New patient office visit (about 30–44 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Op visit new pt level 3 $350 $245 $85.40 – $277.20
New patient office visit (about 30–44 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Ob eval new pt level 4 $449 $314.30 $109.56 – $355.61
New patient office visit (about 45–59 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Office/outpatient visit new $449 $314.30 $109.56 – $355.61
New patient office visit (about 45–59 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Op visit new pt level 4 $449 $314.30 $109.56 – $355.61
New patient office visit (about 45–59 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Ob eval new pt level 5 $662 $463.40 $161.53 – $524.30
New patient office visit (about 60–74 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Office/outpatient visit new $662 $463.40 $161.53 – $524.30
New patient office visit (about 60–74 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Op visit new pt level 5 $661 $462.70 $161.28 – $523.51
New patient office visit (about 60–74 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Ob eval est pt level 3 $278 $194.60 $67.83 – $220.18
Established patient office visit (about 20–29 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Office/outpatient visit est $278 $194.60 $67.83 – $220.18
Established patient office visit (about 20–29 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Op visit est pt level 3 $278 $194.60 $67.83 – $220.18
Established patient office visit (about 20–29 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Ob eval est pt level 4 $350 $245 $85.40 – $277.20
Established patient office visit (about 30–39 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Office/outpatient visit est $350 $245 $85.40 – $277.20
Established patient office visit (about 30–39 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Op visit est pt level 4 $350 $245 $85.40 – $277.20
Established patient office visit (about 30–39 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency dept visit $910 $637 $271 – $905.43
Emergency room visit (moderate): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $271
  • Aetna_Better_Health_of_IL — MCRAETIL: $271
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $271
  • Ambetter_MHS_Marketplace — MKTMHS: $390.45
  • Argent_Medicare — ARGMCR: $271
  • Atrio_Health_Plans — MCRATRIO: $271
  • Avmed_Medicare_Choice — MCRAVMED: $271
  • BC_ALLIED — BCALLIED: $905.43
  • BC_Anthem_Health_Plan_AHP — BCAHP: $905.43
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $905.43
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency room level iii $910 $637 $271 – $905.43
Emergency room visit (moderate): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $271
  • Aetna_Better_Health_of_IL — MCRAETIL: $271
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $271
  • Ambetter_MHS_Marketplace — MKTMHS: $390.45
  • Argent_Medicare — ARGMCR: $271
  • Atrio_Health_Plans — MCRATRIO: $271
  • Avmed_Medicare_Choice — MCRAVMED: $271
  • BC_ALLIED — BCALLIED: $905.43
  • BC_Anthem_Health_Plan_AHP — BCAHP: $905.43
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $905.43
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency dept visit $1,400 $980 $414.24 – $1,392.43
Emergency room visit (moderately high): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $414.24
  • Aetna_Better_Health_of_IL — MCRAETIL: $414.24
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $414.24
  • Ambetter_MHS_Marketplace — MKTMHS: $596.82
  • Argent_Medicare — ARGMCR: $414.24
  • Atrio_Health_Plans — MCRATRIO: $414.24
  • Avmed_Medicare_Choice — MCRAVMED: $414.24
  • BC_ALLIED — BCALLIED: $1,392.43
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,392.43
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $1,392.43
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency room level iv $1,400 $980 $414.24 – $1,392.43
Emergency room visit (moderately high): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $414.24
  • Aetna_Better_Health_of_IL — MCRAETIL: $414.24
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $414.24
  • Ambetter_MHS_Marketplace — MKTMHS: $596.82
  • Argent_Medicare — ARGMCR: $414.24
  • Atrio_Health_Plans — MCRATRIO: $414.24
  • Avmed_Medicare_Choice — MCRAVMED: $414.24
  • BC_ALLIED — BCALLIED: $1,392.43
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,392.43
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $1,392.43
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency dept visit $1,665 $1,165.50 $591.21 – $2,004.84
Emergency room visit (high): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $591.21
  • Aetna_Better_Health_of_IL — MCRAETIL: $591.21
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $591.21
  • Ambetter_MHS_Marketplace — MKTMHS: $851.80
  • Argent_Medicare — ARGMCR: $591.21
  • Atrio_Health_Plans — MCRATRIO: $591.21
  • Avmed_Medicare_Choice — MCRAVMED: $591.21
  • BC_ALLIED — BCALLIED: $2,004.84
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2,004.84
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2,004.84
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency room level v $1,665 $1,165.50 $591.21 – $2,004.84
Emergency room visit (high): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $591.21
  • Aetna_Better_Health_of_IL — MCRAETIL: $591.21
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $591.21
  • Ambetter_MHS_Marketplace — MKTMHS: $851.80
  • Argent_Medicare — ARGMCR: $591.21
  • Atrio_Health_Plans — MCRATRIO: $591.21
  • Avmed_Medicare_Choice — MCRAVMED: $591.21
  • BC_ALLIED — BCALLIED: $2,004.84
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2,004.84
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2,004.84

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Ebmp $24 $16.80 $8.46 – $29
Basic metabolic panel (blood test): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $29
  • BC_ALLIED — BCALLIED: $8.46
  • BC_Anthem_Health_Plan_AHP — BCAHP: $8.46
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $8.46
  • BCBS — JAIL: $8.46
  • BCBS_Highmark — BCHIGHMARK: $8.46
  • Blue_Cross_Blue_Shield — BC: $8.46
  • Blue_Cross_Blue_Shield — BC2: $8.46
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $29
  • Optum — UHCOPTUM: $29
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Metabolic panel total ca $24 $16.80 $8.46 – $29
Basic metabolic panel (blood test): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $29
  • BC_ALLIED — BCALLIED: $8.46
  • BC_Anthem_Health_Plan_AHP — BCAHP: $8.46
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $8.46
  • BCBS — JAIL: $8.46
  • BCBS_Highmark — BCHIGHMARK: $8.46
  • Blue_Cross_Blue_Shield — BC: $8.46
  • Blue_Cross_Blue_Shield — BC2: $8.46
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $29
  • Optum — UHCOPTUM: $29
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehen metabolic panel $243 $170.10 $10.56 – $36.23
Comprehensive metabolic panel (blood test): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $36.23
  • BC_ALLIED — BCALLIED: $10.56
  • BC_Anthem_Health_Plan_AHP — BCAHP: $10.56
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $10.56
  • BCBS — JAIL: $10.56
  • BCBS_Highmark — BCHIGHMARK: $10.56
  • Blue_Cross_Blue_Shield — BC: $10.56
  • Blue_Cross_Blue_Shield — BC2: $10.56
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $36.23
  • Optum — UHCOPTUM: $36.23
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Gfgh - cmp $243 $170.10 $10.56 – $36.23
Comprehensive metabolic panel (blood test): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $36.23
  • BC_ALLIED — BCALLIED: $10.56
  • BC_Anthem_Health_Plan_AHP — BCAHP: $10.56
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $10.56
  • BCBS — JAIL: $10.56
  • BCBS_Highmark — BCHIGHMARK: $10.56
  • Blue_Cross_Blue_Shield — BC: $10.56
  • Blue_Cross_Blue_Shield — BC2: $10.56
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $36.23
  • Optum — UHCOPTUM: $36.23
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Gfgh - lipid $128 $89.60 $13.01 – $45.93
Cholesterol panel (lipid panel): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $13.01
  • Aetna_Better_Health_of_IL — MCRAETIL: $13.01
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $13.01
  • All_Savers — UHCALL: $45.93
  • Ambetter_MHS_Marketplace — MKTMHS: $18.75
  • Argent_Medicare — ARGMCR: $13.01
  • Atrio_Health_Plans — MCRATRIO: $13.01
  • Avmed_Medicare_Choice — MCRAVMED: $13.01
  • BC_ALLIED — BCALLIED: $13.39
  • BC_Anthem_Health_Plan_AHP — BCAHP: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel $128 $89.60 $13.01 – $45.93
Cholesterol panel (lipid panel): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $13.01
  • Aetna_Better_Health_of_IL — MCRAETIL: $13.01
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $13.01
  • All_Savers — UHCALL: $45.93
  • Ambetter_MHS_Marketplace — MKTMHS: $18.75
  • Argent_Medicare — ARGMCR: $13.01
  • Atrio_Health_Plans — MCRATRIO: $13.01
  • Avmed_Medicare_Choice — MCRAVMED: $13.01
  • BC_ALLIED — BCALLIED: $13.39
  • BC_Anthem_Health_Plan_AHP — BCAHP: $13.39
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel $25 $17.50 $8.68 – $29.78
Kidney function panel: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $29.78
  • BC_ALLIED — BCALLIED: $8.68
  • BC_Anthem_Health_Plan_AHP — BCAHP: $8.68
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $8.68
  • BCBS — JAIL: $8.68
  • BCBS_Highmark — BCHIGHMARK: $8.68
  • Blue_Cross_Blue_Shield — BC: $8.68
  • Blue_Cross_Blue_Shield — BC2: $8.68
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $29.78
  • Optum — UHCOPTUM: $29.78
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel $23 $16.10 $8.17 – $28.03
Liver function panel: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $28.03
  • BC_ALLIED — BCALLIED: $8.17
  • BC_Anthem_Health_Plan_AHP — BCAHP: $8.17
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $8.17
  • BCBS — JAIL: $8.17
  • BCBS_Highmark — BCHIGHMARK: $8.17
  • Blue_Cross_Blue_Shield — BC: $8.17
  • Blue_Cross_Blue_Shield — BC2: $8.17
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $28.03
  • Optum — UHCOPTUM: $28.03
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Q urinalysis $7.13 $4.99 $3.17 – $10.88
Urine test (automated, with microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $10.88
  • BC_ALLIED — BCALLIED: $3.17
  • BC_Anthem_Health_Plan_AHP — BCAHP: $3.17
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $3.17
  • BCBS — JAIL: $3.17
  • BCBS_Highmark — BCHIGHMARK: $3.17
  • Blue_Cross_Blue_Shield — BC: $3.17
  • Blue_Cross_Blue_Shield — BC2: $3.17
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $10.88
  • Optum — UHCOPTUM: $10.88
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis auto w/scope $7.13 $4.99 $3.17 – $10.88
Urine test (automated, with microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $10.88
  • BC_ALLIED — BCALLIED: $3.17
  • BC_Anthem_Health_Plan_AHP — BCAHP: $3.17
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $3.17
  • BCBS — JAIL: $3.17
  • BCBS_Highmark — BCHIGHMARK: $3.17
  • Blue_Cross_Blue_Shield — BC: $3.17
  • Blue_Cross_Blue_Shield — BC2: $3.17
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $10.88
  • Optum — UHCOPTUM: $10.88
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urinalysis nonauto w/o scope $57 $39.90 $3.48 – $8.75
Urine test (manual, without microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $8.75
  • BC_ALLIED — BCALLIED: $3.48
  • BC_Anthem_Health_Plan_AHP — BCAHP: $3.48
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $3.48
  • BCBS — JAIL: $3.48
  • BCBS_Highmark — BCHIGHMARK: $3.48
  • Blue_Cross_Blue_Shield — BC: $3.48
  • Blue_Cross_Blue_Shield — BC2: $3.48
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $8.75
  • Optum — UHCOPTUM: $8.75
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urine dipstick $57 $39.90 $3.48 – $8.75
Urine test (manual, without microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $8.75
  • BC_ALLIED — BCALLIED: $3.48
  • BC_Anthem_Health_Plan_AHP — BCAHP: $3.48
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $3.48
  • BCBS — JAIL: $3.48
  • BCBS_Highmark — BCHIGHMARK: $3.48
  • Blue_Cross_Blue_Shield — BC: $3.48
  • Blue_Cross_Blue_Shield — BC2: $3.48
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $8.75
  • Optum — UHCOPTUM: $8.75
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Glucose qualitative urine $16 $11.20 $2.25 – $7.70
Urine test (automated, without microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $7.70
  • BC_ALLIED — BCALLIED: $2.25
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2.25
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2.25
  • BCBS — JAIL: $2.25
  • BCBS_Highmark — BCHIGHMARK: $2.25
  • Blue_Cross_Blue_Shield — BC: $2.25
  • Blue_Cross_Blue_Shield — BC2: $2.25
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $7.70
  • Optum — UHCOPTUM: $7.70
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Urinalysis auto w/o scope $16 $11.20 $2.25 – $7.70
Urine test (automated, without microscope): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $7.70
  • BC_ALLIED — BCALLIED: $2.25
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2.25
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2.25
  • BCBS — JAIL: $2.25
  • BCBS_Highmark — BCHIGHMARK: $2.25
  • Blue_Cross_Blue_Shield — BC: $2.25
  • Blue_Cross_Blue_Shield — BC2: $2.25
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $7.70
  • Optum — UHCOPTUM: $7.70
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Assay of psa total $130 $91 $18.39 – $63.08
PSA (prostate specific antigen) blood test: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $63.08
  • BC_ALLIED — BCALLIED: $18.39
  • BC_Anthem_Health_Plan_AHP — BCAHP: $18.39
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $18.39
  • BCBS — JAIL: $18.39
  • BCBS_Highmark — BCHIGHMARK: $18.39
  • Blue_Cross_Blue_Shield — BC: $18.39
  • Blue_Cross_Blue_Shield — BC2: $18.39
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $63.08
  • Optum — UHCOPTUM: $63.08
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Gfgh - psa $130 $91 $18.39 – $63.08
PSA (prostate specific antigen) blood test: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $63.08
  • BC_ALLIED — BCALLIED: $18.39
  • BC_Anthem_Health_Plan_AHP — BCAHP: $18.39
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $18.39
  • BCBS — JAIL: $18.39
  • BCBS_Highmark — BCHIGHMARK: $18.39
  • Blue_Cross_Blue_Shield — BC: $18.39
  • Blue_Cross_Blue_Shield — BC2: $18.39
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $63.08
  • Optum — UHCOPTUM: $63.08
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Assay thyroid stim hormone $134 $93.80 $16.80 – $57.63
Thyroid stimulating hormone (TSH) test: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $57.63
  • BC_ALLIED — BCALLIED: $16.80
  • BC_Anthem_Health_Plan_AHP — BCAHP: $16.80
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $16.80
  • BCBS — JAIL: $16.80
  • BCBS_Highmark — BCHIGHMARK: $16.80
  • Blue_Cross_Blue_Shield — BC: $16.80
  • Blue_Cross_Blue_Shield — BC2: $16.80
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $57.63
  • Optum — UHCOPTUM: $57.63
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Gfgh - tsh $134 $93.80 $16.80 – $57.63
Thyroid stimulating hormone (TSH) test: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $57.63
  • BC_ALLIED — BCALLIED: $16.80
  • BC_Anthem_Health_Plan_AHP — BCAHP: $16.80
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $16.80
  • BCBS — JAIL: $16.80
  • BCBS_Highmark — BCHIGHMARK: $16.80
  • Blue_Cross_Blue_Shield — BC: $16.80
  • Blue_Cross_Blue_Shield — BC2: $16.80
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $57.63
  • Optum — UHCOPTUM: $57.63
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Complete cbc w/auto diff wbc $72 $50.40 $7.77 – $26.65
Complete blood count (CBC) with differential: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $26.65
  • BC_ALLIED — BCALLIED: $7.77
  • BC_Anthem_Health_Plan_AHP — BCAHP: $7.77
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $7.77
  • BCBS — JAIL: $7.77
  • BCBS_Highmark — BCHIGHMARK: $7.77
  • Blue_Cross_Blue_Shield — BC: $7.77
  • Blue_Cross_Blue_Shield — BC2: $7.77
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $26.65
  • Optum — UHCOPTUM: $26.65
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Ghgh - cbc $72 $50.40 $7.77 – $26.65
Complete blood count (CBC) with differential: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $26.65
  • BC_ALLIED — BCALLIED: $7.77
  • BC_Anthem_Health_Plan_AHP — BCAHP: $7.77
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $7.77
  • BCBS — JAIL: $7.77
  • BCBS_Highmark — BCHIGHMARK: $7.77
  • Blue_Cross_Blue_Shield — BC: $7.77
  • Blue_Cross_Blue_Shield — BC2: $7.77
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $26.65
  • Optum — UHCOPTUM: $26.65
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Automated hemogram $17 $11.90 $6.47 – $22.18
Complete blood count (CBC), automated: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $22.18
  • BC_ALLIED — BCALLIED: $6.47
  • BC_Anthem_Health_Plan_AHP — BCAHP: $6.47
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $6.47
  • BCBS — JAIL: $6.47
  • BCBS_Highmark — BCHIGHMARK: $6.47
  • Blue_Cross_Blue_Shield — BC: $6.47
  • Blue_Cross_Blue_Shield — BC2: $6.47
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $22.18
  • Optum — UHCOPTUM: $22.18
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Complete cbc automated $17 $11.90 $6.47 – $22.18
Complete blood count (CBC), automated: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $22.18
  • BC_ALLIED — BCALLIED: $6.47
  • BC_Anthem_Health_Plan_AHP — BCAHP: $6.47
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $6.47
  • BCBS — JAIL: $6.47
  • BCBS_Highmark — BCHIGHMARK: $6.47
  • Blue_Cross_Blue_Shield — BC: $6.47
  • Blue_Cross_Blue_Shield — BC2: $6.47
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $22.18
  • Optum — UHCOPTUM: $22.18
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin time $12 $8.40 $4.29 – $13.48
Blood clotting time test (prothrombin time, PT): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $13.48
  • BC_ALLIED — BCALLIED: $4.29
  • BC_Anthem_Health_Plan_AHP — BCAHP: $4.29
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $4.29
  • BCBS — JAIL: $4.29
  • BCBS_Highmark — BCHIGHMARK: $4.29
  • Blue_Cross_Blue_Shield — BC: $4.29
  • Blue_Cross_Blue_Shield — BC2: $4.29
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $13.48
  • Optum — UHCOPTUM: $13.48
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Antiphospholipid syndrome $215 $150.50 $6.01 – $20.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $20.60
  • BC_ALLIED — BCALLIED: $6.01
  • BC_Anthem_Health_Plan_AHP — BCAHP: $6.01
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $6.01
  • BCBS — JAIL: $6.01
  • BCBS_Highmark — BCHIGHMARK: $6.01
  • Blue_Cross_Blue_Shield — BC: $6.01
  • Blue_Cross_Blue_Shield — BC2: $6.01
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $20.60
  • Optum — UHCOPTUM: $20.60
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Thromboplastin time partial $215 $150.50 $6.01 – $20.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $20.60
  • BC_ALLIED — BCALLIED: $6.01
  • BC_Anthem_Health_Plan_AHP — BCAHP: $6.01
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $6.01
  • BCBS — JAIL: $6.01
  • BCBS_Highmark — BCHIGHMARK: $6.01
  • Blue_Cross_Blue_Shield — BC: $6.01
  • Blue_Cross_Blue_Shield — BC2: $6.01
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $20.60
  • Optum — UHCOPTUM: $20.60

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head w/o cont $1,769 $1,238.30 $219.67 – $1,001
CT scan of the head or brain, without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $219.67
  • Aetna_Better_Health_of_IL — MCRAETIL: $219.67
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $219.67
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $316.50
  • Argent_Medicare — ARGMCR: $219.67
  • Atrio_Health_Plans — MCRATRIO: $219.67
  • Avmed_Medicare_Choice — MCRAVMED: $219.67
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head/brain w/o dye $1,769 $1,238.30 $219.67 – $1,001
CT scan of the head or brain, without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $219.67
  • Aetna_Better_Health_of_IL — MCRAETIL: $219.67
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $219.67
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $316.50
  • Argent_Medicare — ARGMCR: $219.67
  • Atrio_Health_Plans — MCRATRIO: $219.67
  • Avmed_Medicare_Choice — MCRAVMED: $219.67
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mr iac w/wo contrast $1,373 $961.10 $842.54 – $1,253
MRI of the brain, before and after contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $842.54
  • Aetna_Better_Health_of_IL — MCRAETIL: $842.54
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $842.54
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $1,213.91
  • Argent_Medicare — ARGMCR: $842.54
  • Atrio_Health_Plans — MCRATRIO: $842.54
  • Avmed_Medicare_Choice — MCRAVMED: $842.54
  • BC_ALLIED — BCALLIED: $1,167.82
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,167.82
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye $1,373 $961.10 $842.54 – $1,253
MRI of the brain, before and after contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $842.54
  • Aetna_Better_Health_of_IL — MCRAETIL: $842.54
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $842.54
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $1,213.91
  • Argent_Medicare — ARGMCR: $842.54
  • Atrio_Health_Plans — MCRATRIO: $842.54
  • Avmed_Medicare_Choice — MCRAVMED: $842.54
  • BC_ALLIED — BCALLIED: $1,167.82
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,167.82
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest pa & lateral $366 $256.20 $221 – $1,181.49
Chest X-ray, 2 views: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $820.04
  • Aetna_Better_Health_of_IL — MCRAETIL: $820.04
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $820.04
  • All_Savers — UHCALL: $221
  • Ambetter_MHS_Marketplace — MKTMHS: $1,181.49
  • Argent_Medicare — ARGMCR: $820.04
  • Atrio_Health_Plans — MCRATRIO: $820.04
  • Avmed_Medicare_Choice — MCRAVMED: $820.04
  • BC_ALLIED — BCALLIED: $287.92
  • BC_Anthem_Health_Plan_AHP — BCAHP: $287.92
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-ray exam chest 2 views $366 $256.20 $221 – $1,181.49
Chest X-ray, 2 views: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $820.04
  • Aetna_Better_Health_of_IL — MCRAETIL: $820.04
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $820.04
  • All_Savers — UHCALL: $221
  • Ambetter_MHS_Marketplace — MKTMHS: $1,181.49
  • Argent_Medicare — ARGMCR: $820.04
  • Atrio_Health_Plans — MCRATRIO: $820.04
  • Avmed_Medicare_Choice — MCRAVMED: $820.04
  • BC_ALLIED — BCALLIED: $287.92
  • BC_Anthem_Health_Plan_AHP — BCAHP: $287.92
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Spine lumbar min 4v $682 $477.40 $103.79 – $347.73
X-ray of the lower spine, at least 4 views: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • All_Savers — UHCALL: $221
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-ray exam l-2 spine 4/>vws $682 $477.40 $103.79 – $347.73
X-ray of the lower spine, at least 4 views: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • All_Savers — UHCALL: $221
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar spine w/o dye $1,373 $961.10 $522.63 – $1,253
MRI of the lower back (lumbar spine), without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $522.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $522.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $522.63
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $752.99
  • Argent_Medicare — ARGMCR: $522.63
  • Atrio_Health_Plans — MCRATRIO: $522.63
  • Avmed_Medicare_Choice — MCRAVMED: $522.63
  • BC_ALLIED — BCALLIED: $790.42
  • BC_Anthem_Health_Plan_AHP — BCAHP: $790.42
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri spine lumbar w/o cont $1,373 $961.10 $522.63 – $1,253
MRI of the lower back (lumbar spine), without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $522.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $522.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $522.63
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $752.99
  • Argent_Medicare — ARGMCR: $522.63
  • Atrio_Health_Plans — MCRATRIO: $522.63
  • Avmed_Medicare_Choice — MCRAVMED: $522.63
  • BC_ALLIED — BCALLIED: $790.42
  • BC_Anthem_Health_Plan_AHP — BCAHP: $790.42
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w cont $2,237 $1,565.90 $426.48 – $1,001
CT scan of the pelvis, with contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $426.48
  • Aetna_Better_Health_of_IL — MCRAETIL: $426.48
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $426.48
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $614.46
  • Argent_Medicare — ARGMCR: $426.48
  • Atrio_Health_Plans — MCRATRIO: $426.48
  • Avmed_Medicare_Choice — MCRAVMED: $426.48
  • BC_ALLIED — BCALLIED: $582.13
  • BC_Anthem_Health_Plan_AHP — BCAHP: $582.13
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/dye $2,237 $1,565.90 $426.48 – $1,001
CT scan of the pelvis, with contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $426.48
  • Aetna_Better_Health_of_IL — MCRAETIL: $426.48
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $426.48
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $614.46
  • Argent_Medicare — ARGMCR: $426.48
  • Atrio_Health_Plans — MCRATRIO: $426.48
  • Avmed_Medicare_Choice — MCRAVMED: $426.48
  • BC_ALLIED — BCALLIED: $582.13
  • BC_Anthem_Health_Plan_AHP — BCAHP: $582.13
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Mri jnt of lwr extre w/o dye $2,060 $1,442 $522.63 – $1,253
MRI of a leg joint (such as the knee), without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $522.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $522.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $522.63
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $752.99
  • Argent_Medicare — ARGMCR: $522.63
  • Atrio_Health_Plans — MCRATRIO: $522.63
  • Avmed_Medicare_Choice — MCRAVMED: $522.63
  • BC_ALLIED — BCALLIED: $790.42
  • BC_Anthem_Health_Plan_AHP — BCAHP: $790.42
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier 50 In the file: Mri low ext jt wo cont bilat $2,060 $1,442 $502.64 – $1,879.50
MRI of a leg joint (such as the knee), without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $522.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $522.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $522.63
  • All_Savers — UHCALL: $1,879.50
  • Ambetter_MHS_Marketplace — MKTMHS: $752.99
  • Argent_Medicare — ARGMCR: $522.63
  • Atrio_Health_Plans — MCRATRIO: $522.63
  • Avmed_Medicare_Choice — MCRAVMED: $522.63
  • BC_Federal_Employee — BCFEDEE: $522.63
  • BC_MCR_Advantage_PPO — MCRADV: $522.63
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: Mri low ext jt w/o cont lt $1,373 $961.10 $335.01 – $1,253
MRI of a leg joint (such as the knee), without contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $522.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $522.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $522.63
  • All_Savers — UHCALL: $1,253
  • Ambetter_MHS_Marketplace — MKTMHS: $752.99
  • Argent_Medicare — ARGMCR: $522.63
  • Atrio_Health_Plans — MCRATRIO: $522.63
  • Avmed_Medicare_Choice — MCRAVMED: $522.63
  • BC_Federal_Employee — BCFEDEE: $522.63
  • BC_MCR_Advantage_PPO — MCRADV: $522.63
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd & pelv w/contrast $3,996 $2,797.20 $426.48 – $1,167.82
CT scan of the abdomen and pelvis, with contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $426.48
  • Aetna_Better_Health_of_IL — MCRAETIL: $426.48
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $426.48
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $614.46
  • Argent_Medicare — ARGMCR: $426.48
  • Atrio_Health_Plans — MCRATRIO: $426.48
  • Avmed_Medicare_Choice — MCRAVMED: $426.48
  • BC_ALLIED — BCALLIED: $1,167.82
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,167.82
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd/pelvis w cont $3,996 $2,797.20 $426.48 – $1,167.82
CT scan of the abdomen and pelvis, with contrast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $426.48
  • Aetna_Better_Health_of_IL — MCRAETIL: $426.48
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $426.48
  • All_Savers — UHCALL: $1,001
  • Ambetter_MHS_Marketplace — MKTMHS: $614.46
  • Argent_Medicare — ARGMCR: $426.48
  • Atrio_Health_Plans — MCRATRIO: $426.48
  • Avmed_Medicare_Choice — MCRAVMED: $426.48
  • BC_ALLIED — BCALLIED: $1,167.82
  • BC_Anthem_Health_Plan_AHP — BCAHP: $1,167.82
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us abdomen complete $1,324 $926.80 $292.06 – $420.80
Ultrasound of the abdomen, complete: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $292.06
  • Aetna_Better_Health_of_IL — MCRAETIL: $292.06
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $292.06
  • All_Savers — UHCALL: $373
  • Ambetter_MHS_Marketplace — MKTMHS: $420.80
  • Argent_Medicare — ARGMCR: $292.06
  • Atrio_Health_Plans — MCRATRIO: $292.06
  • Avmed_Medicare_Choice — MCRAVMED: $292.06
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us exam abdom complete $1,324 $926.80 $292.06 – $420.80
Ultrasound of the abdomen, complete: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $292.06
  • Aetna_Better_Health_of_IL — MCRAETIL: $292.06
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $292.06
  • All_Savers — UHCALL: $373
  • Ambetter_MHS_Marketplace — MKTMHS: $420.80
  • Argent_Medicare — ARGMCR: $292.06
  • Atrio_Health_Plans — MCRATRIO: $292.06
  • Avmed_Medicare_Choice — MCRAVMED: $292.06
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier 52 In the file: Us abdomen complete icu $1,324 $926.80 $292.06 – $1,048.61
Ultrasound of the abdomen, complete: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $292.06
  • Aetna_Better_Health_of_IL — MCRAETIL: $292.06
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $292.06
  • Ambetter_MHS_Marketplace — MKTMHS: $420.80
  • Argent_Medicare — ARGMCR: $292.06
  • Atrio_Health_Plans — MCRATRIO: $292.06
  • Avmed_Medicare_Choice — MCRAVMED: $292.06
  • BC_Federal_Employee — BCFEDEE: $292.06
  • BC_MCR_Advantage_PPO — MCRADV: $292.06
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $292.06
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Ob us >= 14 wks sngl fetus $873 $611.10 $103.79 – $691.42
Pregnancy ultrasound (after the first trimester): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $347.73
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Us preg uter>1st tri single $873 $611.10 $103.79 – $691.42
Pregnancy ultrasound (after the first trimester): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $347.73
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal us non-ob $788 $551.60 $103.79 – $373
Transvaginal ultrasound: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • All_Savers — UHCALL: $373
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Us pelvis (nonob) transvaginal $788 $551.60 $103.79 – $373
Transvaginal ultrasound: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $103.79
  • Aetna_Better_Health_of_IL — MCRAETIL: $103.79
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $103.79
  • All_Savers — UHCALL: $373
  • Ambetter_MHS_Marketplace — MKTMHS: $149.53
  • Argent_Medicare — ARGMCR: $103.79
  • Atrio_Health_Plans — MCRATRIO: $103.79
  • Avmed_Medicare_Choice — MCRAVMED: $103.79
  • BC_ALLIED — BCALLIED: $347.73
  • BC_Anthem_Health_Plan_AHP — BCAHP: $347.73
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Dx mammo incl cad uni $478 $334.60 $112.63 – $250
Diagnostic mammogram, one breast: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $112.63
  • Aetna_Better_Health_of_IL — MCRAETIL: $112.63
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $112.63
  • All_Savers — UHCALL: $250
  • Ambetter_MHS_Marketplace — MKTMHS: $162.27
  • Argent_Medicare — ARGMCR: $112.63
  • Atrio_Health_Plans — MCRATRIO: $112.63
  • Avmed_Medicare_Choice — MCRAVMED: $112.63
  • BC_Federal_Employee — BCFEDEE: $112.63
  • BC_MCR_Advantage_PPO — MCRADV: $112.63
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier LT In the file: Diag mammo left tomosynthesis $478 $334.60 $116.63 – $250
Diagnostic mammogram, one breast: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $250
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $250
  • Optum — UHCOPTUM: $250
  • Oxford_Health — UHCOXFOR: $250
  • UHC_Student_Resources — UHCSTU: $250
  • UHC_Surest — UHCSUREST: $250
  • UHCLIC — UHCUHCLI: $250
  • UHSS — UHCSHARE: $250
  • UMR — UHCUMR: $250
  • UMR — UHCUMR2: $250
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier RT In the file: Diag mammo right tomosynthesis $478 $334.60 $116.63 – $250
Diagnostic mammogram, one breast: 10 of 207 insurance plan rates
  • All_Savers — UHCALL: $250
  • Golden_Rule_Insurance_2nd — UHCGOLDE: $250
  • Optum — UHCOPTUM: $250
  • Oxford_Health — UHCOXFOR: $250
  • UHC_Student_Resources — UHCSTU: $250
  • UHC_Surest — UHCSUREST: $250
  • UHCLIC — UHCUHCLI: $250
  • UHSS — UHCSHARE: $250
  • UMR — UHCUMR: $250
  • UMR — UHCUMR2: $250
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Dx mammo incl cad bi $550 $385 $134.20 – $250
Diagnostic mammogram, both breasts: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $142.59
  • Aetna_Better_Health_of_IL — MCRAETIL: $142.59
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $142.59
  • All_Savers — UHCALL: $250
  • Ambetter_MHS_Marketplace — MKTMHS: $205.44
  • Argent_Medicare — ARGMCR: $142.59
  • Atrio_Health_Plans — MCRATRIO: $142.59
  • Avmed_Medicare_Choice — MCRAVMED: $142.59
  • BC_Federal_Employee — BCFEDEE: $142.59
  • BC_MCR_Advantage_PPO — MCRADV: $142.59
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier PO In the file: Diag mammo bil tomosynthesis $550 $385 $134.20 – $435.60
Diagnostic mammogram, both breasts: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Scr mammo bi incl cad $393 $275.10 $95.89 – $250
Screening mammogram, both breasts: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $114.77
  • Aetna_Better_Health_of_IL — MCRAETIL: $114.77
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $114.77
  • All_Savers — UHCALL: $250
  • Ambetter_MHS_Marketplace — MKTMHS: $165.35
  • Argent_Medicare — ARGMCR: $114.77
  • Atrio_Health_Plans — MCRATRIO: $114.77
  • Avmed_Medicare_Choice — MCRAVMED: $114.77
  • BC_Federal_Employee — BCFEDEE: $114.77
  • BC_MCR_Advantage_PPO — MCRADV: $114.77
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52 In the file: Scrn mammo mod tomosynthesis $393 $275.10 $95.89 – $311.26
Screening mammogram, both breasts: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier PO In the file: Bil screen mammo tomosynthesis $393 $275.10 $95.89 – $311.26
Screening mammogram, both breasts: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Left heart cath w lv inj $13,647 $9,552.90 $3,218.42 – $10,808.42
Left heart catheterization (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,218.42
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,218.42
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,218.42
  • Ambetter_MHS_Marketplace — MKTMHS: $4,637.01
  • Argent_Medicare — ARGMCR: $3,218.42
  • Atrio_Health_Plans — MCRATRIO: $3,218.42
  • Avmed_Medicare_Choice — MCRAVMED: $3,218.42
  • BC_ALLIED — BCALLIED: $10,517.66
  • BC_Anthem_Health_Plan_AHP — BCAHP: $10,517.66
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $10,517.66
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Left hrt cath w/ventrclgrphy $13,647 $9,552.90 $3,218.42 – $10,808.42
Left heart catheterization (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,218.42
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,218.42
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,218.42
  • Ambetter_MHS_Marketplace — MKTMHS: $4,637.01
  • Argent_Medicare — ARGMCR: $3,218.42
  • Atrio_Health_Plans — MCRATRIO: $3,218.42
  • Avmed_Medicare_Choice — MCRAVMED: $3,218.42
  • BC_ALLIED — BCALLIED: $10,517.66
  • BC_Anthem_Health_Plan_AHP — BCAHP: $10,517.66
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $10,517.66
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: Electrophysiology evaluation $16,430 $11,501 $7,743.09 – $24,813.09
Heart rhythm study (electrophysiology evaluation): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $7,743.09
  • Aetna_Better_Health_of_IL — MCRAETIL: $7,743.09
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $7,743.09
  • Ambetter_MHS_Marketplace — MKTMHS: $11,156.04
  • Argent_Medicare — ARGMCR: $7,743.09
  • Atrio_Health_Plans — MCRATRIO: $7,743.09
  • Avmed_Medicare_Choice — MCRAVMED: $7,743.09
  • BC_ALLIED — BCALLIED: $24,813.09
  • BC_Anthem_Health_Plan_AHP — BCAHP: $24,813.09
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $24,813.09
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: Ep comprehen eval w/o induct $16,430 $11,501 $7,743.09 – $24,813.09
Heart rhythm study (electrophysiology evaluation): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $7,743.09
  • Aetna_Better_Health_of_IL — MCRAETIL: $7,743.09
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $7,743.09
  • Ambetter_MHS_Marketplace — MKTMHS: $11,156.04
  • Argent_Medicare — ARGMCR: $7,743.09
  • Atrio_Health_Plans — MCRATRIO: $7,743.09
  • Avmed_Medicare_Choice — MCRAVMED: $7,743.09
  • BC_ALLIED — BCALLIED: $24,813.09
  • BC_Anthem_Health_Plan_AHP — BCAHP: $24,813.09
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $24,813.09
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: Ep comp w transsep pun/abla af $74,371 $52,059.70 $25,948.27 – $80,220.62
Heart rhythm study with ablation for atrial fibrillation: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $25,948.27
  • Aetna_Better_Health_of_IL — MCRAETIL: $25,948.27
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $25,948.27
  • Ambetter_MHS_Marketplace — MKTMHS: $37,385.59
  • Argent_Medicare — ARGMCR: $25,948.27
  • Atrio_Health_Plans — MCRATRIO: $25,948.27
  • Avmed_Medicare_Choice — MCRAVMED: $25,948.27
  • BC_ALLIED — BCALLIED: $80,220.62
  • BC_Anthem_Health_Plan_AHP — BCAHP: $80,220.62
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $80,220.62
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: Tx atrial fib pulm vein isol $74,371 $52,059.70 $25,948.27 – $80,220.62
Heart rhythm study with ablation for atrial fibrillation: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $25,948.27
  • Aetna_Better_Health_of_IL — MCRAETIL: $25,948.27
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $25,948.27
  • Ambetter_MHS_Marketplace — MKTMHS: $37,385.59
  • Argent_Medicare — ARGMCR: $25,948.27
  • Atrio_Health_Plans — MCRATRIO: $25,948.27
  • Avmed_Medicare_Choice — MCRAVMED: $25,948.27
  • BC_ALLIED — BCALLIED: $80,220.62
  • BC_Anthem_Health_Plan_AHP — BCAHP: $80,220.62
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $80,220.62
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: Polysom 6/> yrs 4/> param $5,222 $3,655.40 $852.51 – $4,135.82
Sleep study (overnight, in a sleep lab): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $852.51
  • Aetna_Better_Health_of_IL — MCRAETIL: $852.51
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $852.51
  • Ambetter_MHS_Marketplace — MKTMHS: $1,228.28
  • Argent_Medicare — ARGMCR: $852.51
  • Atrio_Health_Plans — MCRATRIO: $852.51
  • Avmed_Medicare_Choice — MCRAVMED: $852.51
  • BC_ALLIED — BCALLIED: $3,326.87
  • BC_Anthem_Health_Plan_AHP — BCAHP: $3,326.87
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $3,326.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier 52 In the file: Psg 4 or more parm < 6hr $5,222 $3,655.40 $852.51 – $4,135.82
Sleep study (overnight, in a sleep lab): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $852.51
  • Aetna_Better_Health_of_IL — MCRAETIL: $852.51
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $852.51
  • Ambetter_MHS_Marketplace — MKTMHS: $1,228.28
  • Argent_Medicare — ARGMCR: $852.51
  • Atrio_Health_Plans — MCRATRIO: $852.51
  • Avmed_Medicare_Choice — MCRAVMED: $852.51
  • BC_Federal_Employee — BCFEDEE: $852.51
  • BC_MCR_Advantage_PPO — MCRADV: $852.51
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $852.51
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier PO In the file: Psg apnea screen 16 chan $5,222 $3,655.40 $852.51 – $4,135.82
Sleep study (overnight, in a sleep lab): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $852.51
  • Aetna_Better_Health_of_IL — MCRAETIL: $852.51
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $852.51
  • Ambetter_MHS_Marketplace — MKTMHS: $1,228.28
  • Argent_Medicare — ARGMCR: $852.51
  • Atrio_Health_Plans — MCRATRIO: $852.51
  • Avmed_Medicare_Choice — MCRAVMED: $852.51
  • BC_Federal_Employee — BCFEDEE: $852.51
  • BC_MCR_Advantage_PPO — MCRADV: $852.51
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $852.51

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Therapeutic exercises $155 $108.50 $27.10 – $122.76
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $27.10
  • Aetna_Better_Health_of_IL — MCRAETIL: $27.10
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $27.10
  • Ambetter_MHS_Marketplace — MKTMHS: $39.05
  • Argent_Medicare — ARGMCR: $27.10
  • Atrio_Health_Plans — MCRATRIO: $27.10
  • Avmed_Medicare_Choice — MCRAVMED: $27.10
  • BC_Federal_Employee — BCFEDEE: $27.10
  • BC_MCR_Advantage_PPO — MCRADV: $27.10
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $27.10
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: Ther ex ea 15 min $155 $108.50 $37.82 – $122.76
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP In the file: Ther-ex ea 15 min $155 $108.50 $37.82 – $122.76
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Pt eval low complex 20 min $311 $217.70 $75.88 – $246.31
Physical therapy evaluation (low complexity): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $91.66
  • Aetna_Better_Health_of_IL — MCRAETIL: $91.66
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $91.66
  • Ambetter_MHS_Marketplace — MKTMHS: $132.06
  • Argent_Medicare — ARGMCR: $91.66
  • Atrio_Health_Plans — MCRATRIO: $91.66
  • Avmed_Medicare_Choice — MCRAVMED: $91.66
  • BC_Federal_Employee — BCFEDEE: $91.66
  • BC_MCR_Advantage_PPO — MCRADV: $91.66
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $91.66
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: Pt eval - low complexity $311 $217.70 $75.88 – $246.31
Physical therapy evaluation (low complexity): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Pt eval mod complex 30 min $383 $268.10 $91.66 – $303.34
Physical therapy evaluation (moderate complexity): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $91.66
  • Aetna_Better_Health_of_IL — MCRAETIL: $91.66
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $91.66
  • Ambetter_MHS_Marketplace — MKTMHS: $132.06
  • Argent_Medicare — ARGMCR: $91.66
  • Atrio_Health_Plans — MCRATRIO: $91.66
  • Avmed_Medicare_Choice — MCRAVMED: $91.66
  • BC_Federal_Employee — BCFEDEE: $91.66
  • BC_MCR_Advantage_PPO — MCRADV: $91.66
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $91.66
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: Pt eval - mod complexity $383 $268.10 $93.45 – $303.34
Physical therapy evaluation (moderate complexity): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Pt eval high complex 45 min $456 $319.20 $91.66 – $361.15
Physical therapy evaluation (high complexity): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $91.66
  • Aetna_Better_Health_of_IL — MCRAETIL: $91.66
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $91.66
  • Ambetter_MHS_Marketplace — MKTMHS: $132.06
  • Argent_Medicare — ARGMCR: $91.66
  • Atrio_Health_Plans — MCRATRIO: $91.66
  • Avmed_Medicare_Choice — MCRAVMED: $91.66
  • BC_Federal_Employee — BCFEDEE: $91.66
  • BC_MCR_Advantage_PPO — MCRADV: $91.66
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $91.66
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: Pt eval - high complexity $456 $319.20 $111.26 – $361.15
Physical therapy evaluation (high complexity): 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: Exc cyst fibroadenoma breast $10,888 $7,621.60 $2,656.67 – $8,623.30
Removal of breast growth (open surgery): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,887.03
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,887.03
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,887.03
  • Ambetter_MHS_Marketplace — MKTMHS: $5,600.34
  • Argent_Medicare — ARGMCR: $3,887.03
  • Atrio_Health_Plans — MCRATRIO: $3,887.03
  • Avmed_Medicare_Choice — MCRAVMED: $3,887.03
  • BC_Federal_Employee — BCFEDEE: $3,887.03
  • BC_MCR_Advantage_PPO — MCRADV: $3,887.03
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,887.03
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: Removal of breast lesion $46,303.69 $32,412.58 $3,887.03 – $36,672.52
Removal of breast growth (open surgery): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,887.03
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,887.03
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,887.03
  • Ambetter_MHS_Marketplace — MKTMHS: $5,600.34
  • Argent_Medicare — ARGMCR: $3,887.03
  • Atrio_Health_Plans — MCRATRIO: $3,887.03
  • Avmed_Medicare_Choice — MCRAVMED: $3,887.03
  • BC_Federal_Employee — BCFEDEE: $3,887.03
  • BC_MCR_Advantage_PPO — MCRADV: $3,887.03
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,887.03
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of breast lesion $11,007.32 $7,705.12 $2,685.79 – $8,717.80
Removal of breast growth (open surgery): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,887.03
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,887.03
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,887.03
  • Ambetter_MHS_Marketplace — MKTMHS: $5,600.34
  • Argent_Medicare — ARGMCR: $3,887.03
  • Atrio_Health_Plans — MCRATRIO: $3,887.03
  • Avmed_Medicare_Choice — MCRAVMED: $3,887.03
  • BC_Federal_Employee — BCFEDEE: $3,887.03
  • BC_MCR_Advantage_PPO — MCRADV: $3,887.03
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,887.03
Total hip replacement CPT 27130 · Inpatient (hospital stay) In the file: Total hip arthroplasty $67,739.76 $47,417.83 $12,745.56 – $53,649.89
Total hip replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty $59,782.25 $41,847.58 $12,745.56 – $47,347.54
Total hip replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier LT In the file: Total hip arthroplasty $59,782.25 $41,847.58 $12,745.56 – $47,347.54
Total hip replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Total knee replacement CPT 27447 · Inpatient (hospital stay) In the file: Total knee arthroplasty $70,388.39 $49,271.87 $12,745.56 – $55,747.60
Total knee replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total knee arthroplasty $60,157.38 $42,110.17 $12,745.56 – $47,644.64
Total knee replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier LT In the file: Total knee arthroplasty $58,820.57 $41,174.40 $12,745.56 – $46,585.89
Total knee replacement: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $12,745.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $12,745.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $12,745.56
  • Ambetter_MHS_Marketplace — MKTMHS: $18,363.46
  • Argent_Medicare — ARGMCR: $12,745.56
  • Atrio_Health_Plans — MCRATRIO: $12,745.56
  • Avmed_Medicare_Choice — MCRAVMED: $12,745.56
  • BC_Federal_Employee — BCFEDEE: $12,745.56
  • BC_MCR_Advantage_PPO — MCRADV: $12,745.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $12,745.56
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: Shoulder arthroscopy/surgery $40,918.28 $28,642.80 $9,984.06 – $32,407.28
Shoulder arthroscopy: shaving of shoulder bone: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier LT In the file: Shoulder arthroscopy/surgery $35,908.57 $25,136 $8,761.69 – $28,439.59
Shoulder arthroscopy: shaving of shoulder bone: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier RT In the file: Shoulder arthroscopy/surgery $40,918.28 $28,642.80 $9,984.06 – $32,407.28
Shoulder arthroscopy: shaving of shoulder bone: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) In the file: Knee arthroscopy/surgery $52,764.75 $36,935.33 $3,248.27 – $41,789.68
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,248.27
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,248.27
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,248.27
  • Ambetter_MHS_Marketplace — MKTMHS: $4,680.02
  • Argent_Medicare — ARGMCR: $3,248.27
  • Atrio_Health_Plans — MCRATRIO: $3,248.27
  • Avmed_Medicare_Choice — MCRAVMED: $3,248.27
  • BC_Federal_Employee — BCFEDEE: $3,248.27
  • BC_MCR_Advantage_PPO — MCRADV: $3,248.27
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,248.27
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Knee arthroscopy/surgery $38,283.91 $26,798.74 $3,248.27 – $30,320.86
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,248.27
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,248.27
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,248.27
  • Ambetter_MHS_Marketplace — MKTMHS: $4,680.02
  • Argent_Medicare — ARGMCR: $3,248.27
  • Atrio_Health_Plans — MCRATRIO: $3,248.27
  • Avmed_Medicare_Choice — MCRAVMED: $3,248.27
  • BC_Federal_Employee — BCFEDEE: $3,248.27
  • BC_MCR_Advantage_PPO — MCRADV: $3,248.27
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,248.27
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier LT In the file: Knee arthroscopy/surgery $27,375.39 $19,162.77 $3,248.27 – $21,681.31
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,248.27
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,248.27
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,248.27
  • Ambetter_MHS_Marketplace — MKTMHS: $4,680.02
  • Argent_Medicare — ARGMCR: $3,248.27
  • Atrio_Health_Plans — MCRATRIO: $3,248.27
  • Avmed_Medicare_Choice — MCRAVMED: $3,248.27
  • BC_Federal_Employee — BCFEDEE: $3,248.27
  • BC_MCR_Advantage_PPO — MCRADV: $3,248.27
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,248.27
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: Remove tonsils and adenoids $19,341.18 $13,538.83 $4,719.25 – $15,318.21
Removal of tonsils and adenoids (under age 12): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $5,876.89
  • Aetna_Better_Health_of_IL — MCRAETIL: $5,876.89
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $5,876.89
  • Ambetter_MHS_Marketplace — MKTMHS: $8,467.27
  • Argent_Medicare — ARGMCR: $5,876.89
  • Atrio_Health_Plans — MCRATRIO: $5,876.89
  • Avmed_Medicare_Choice — MCRAVMED: $5,876.89
  • BC_Federal_Employee — BCFEDEE: $5,876.89
  • BC_MCR_Advantage_PPO — MCRADV: $5,876.89
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $5,876.89
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: Egd diagnostic brush wash $42,113.04 $29,479.13 $900.41 – $33,353.53
Upper GI endoscopy (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $900.41
  • Aetna_Better_Health_of_IL — MCRAETIL: $900.41
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $900.41
  • Ambetter_MHS_Marketplace — MKTMHS: $1,297.28
  • Argent_Medicare — ARGMCR: $900.41
  • Atrio_Health_Plans — MCRATRIO: $900.41
  • Avmed_Medicare_Choice — MCRAVMED: $900.41
  • BC_Federal_Employee — BCFEDEE: $900.41
  • BC_MCR_Advantage_PPO — MCRADV: $900.41
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $900.41
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Egd diagnostic brush wash $6,787.60 $4,751.32 $900.41 – $5,375.78
Upper GI endoscopy (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $900.41
  • Aetna_Better_Health_of_IL — MCRAETIL: $900.41
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $900.41
  • Ambetter_MHS_Marketplace — MKTMHS: $1,297.28
  • Argent_Medicare — ARGMCR: $900.41
  • Atrio_Health_Plans — MCRATRIO: $900.41
  • Avmed_Medicare_Choice — MCRAVMED: $900.41
  • BC_Federal_Employee — BCFEDEE: $900.41
  • BC_MCR_Advantage_PPO — MCRADV: $900.41
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $900.41
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: Egd biopsy single/multiple $42,541.06 $29,778.74 $900.41 – $33,692.52
Upper GI endoscopy with biopsy: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $900.41
  • Aetna_Better_Health_of_IL — MCRAETIL: $900.41
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $900.41
  • Ambetter_MHS_Marketplace — MKTMHS: $1,297.28
  • Argent_Medicare — ARGMCR: $900.41
  • Atrio_Health_Plans — MCRATRIO: $900.41
  • Avmed_Medicare_Choice — MCRAVMED: $900.41
  • BC_Federal_Employee — BCFEDEE: $900.41
  • BC_MCR_Advantage_PPO — MCRADV: $900.41
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $900.41
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple $8,810.59 $6,167.41 $900.41 – $6,977.99
Upper GI endoscopy with biopsy: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $900.41
  • Aetna_Better_Health_of_IL — MCRAETIL: $900.41
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $900.41
  • Ambetter_MHS_Marketplace — MKTMHS: $1,297.28
  • Argent_Medicare — ARGMCR: $900.41
  • Atrio_Health_Plans — MCRATRIO: $900.41
  • Avmed_Medicare_Choice — MCRAVMED: $900.41
  • BC_Federal_Employee — BCFEDEE: $900.41
  • BC_MCR_Advantage_PPO — MCRADV: $900.41
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $900.41
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: Diagnostic colonoscopy $49,391.14 $34,573.80 $923.21 – $39,117.78
Colonoscopy (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $923.21
  • Aetna_Better_Health_of_IL — MCRAETIL: $923.21
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $923.21
  • Ambetter_MHS_Marketplace — MKTMHS: $1,330.14
  • Argent_Medicare — ARGMCR: $923.21
  • Atrio_Health_Plans — MCRATRIO: $923.21
  • Avmed_Medicare_Choice — MCRAVMED: $923.21
  • BC_Federal_Employee — BCFEDEE: $923.21
  • BC_MCR_Advantage_PPO — MCRADV: $923.21
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $923.21
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic colonoscopy $7,158.90 $5,011.23 $923.21 – $5,669.85
Colonoscopy (diagnostic): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $923.21
  • Aetna_Better_Health_of_IL — MCRAETIL: $923.21
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $923.21
  • Ambetter_MHS_Marketplace — MKTMHS: $1,330.14
  • Argent_Medicare — ARGMCR: $923.21
  • Atrio_Health_Plans — MCRATRIO: $923.21
  • Avmed_Medicare_Choice — MCRAVMED: $923.21
  • BC_Federal_Employee — BCFEDEE: $923.21
  • BC_MCR_Advantage_PPO — MCRADV: $923.21
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $923.21
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: Colonoscopy and biopsy $46,642.41 $32,649.69 $1,187.96 – $36,940.79
Colonoscopy with biopsy: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,187.96
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,187.96
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,187.96
  • Ambetter_MHS_Marketplace — MKTMHS: $1,711.58
  • Argent_Medicare — ARGMCR: $1,187.96
  • Atrio_Health_Plans — MCRATRIO: $1,187.96
  • Avmed_Medicare_Choice — MCRAVMED: $1,187.96
  • BC_Federal_Employee — BCFEDEE: $1,187.96
  • BC_MCR_Advantage_PPO — MCRADV: $1,187.96
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,187.96
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy and biopsy $8,157.03 $5,709.92 $1,187.96 – $6,460.37
Colonoscopy with biopsy: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,187.96
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,187.96
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,187.96
  • Ambetter_MHS_Marketplace — MKTMHS: $1,711.58
  • Argent_Medicare — ARGMCR: $1,187.96
  • Atrio_Health_Plans — MCRATRIO: $1,187.96
  • Avmed_Medicare_Choice — MCRAVMED: $1,187.96
  • BC_Federal_Employee — BCFEDEE: $1,187.96
  • BC_MCR_Advantage_PPO — MCRADV: $1,187.96
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,187.96
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: Colonoscopy w/lesion removal $8,230.53 $5,761.37 $1,187.96 – $6,518.58
Colonoscopy with removal of polyps (snare): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,187.96
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,187.96
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,187.96
  • Ambetter_MHS_Marketplace — MKTMHS: $1,711.58
  • Argent_Medicare — ARGMCR: $1,187.96
  • Atrio_Health_Plans — MCRATRIO: $1,187.96
  • Avmed_Medicare_Choice — MCRAVMED: $1,187.96
  • BC_Federal_Employee — BCFEDEE: $1,187.96
  • BC_MCR_Advantage_PPO — MCRADV: $1,187.96
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,187.96
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) In the file: Colonoscopy w/endoscope us $49,391.14 $34,573.80 $1,187.96 – $39,117.78
Ultrasound of the lower bowel by endoscope: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,187.96
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,187.96
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,187.96
  • Ambetter_MHS_Marketplace — MKTMHS: $1,711.58
  • Argent_Medicare — ARGMCR: $1,187.96
  • Atrio_Health_Plans — MCRATRIO: $1,187.96
  • Avmed_Medicare_Choice — MCRAVMED: $1,187.96
  • BC_Federal_Employee — BCFEDEE: $1,187.96
  • BC_MCR_Advantage_PPO — MCRADV: $1,187.96
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,187.96
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy w/endoscope us $10,162.65 $7,113.86 $1,187.96 – $8,048.82
Ultrasound of the lower bowel by endoscope: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,187.96
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,187.96
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,187.96
  • Ambetter_MHS_Marketplace — MKTMHS: $1,711.58
  • Argent_Medicare — ARGMCR: $1,187.96
  • Atrio_Health_Plans — MCRATRIO: $1,187.96
  • Avmed_Medicare_Choice — MCRAVMED: $1,187.96
  • BC_Federal_Employee — BCFEDEE: $1,187.96
  • BC_MCR_Advantage_PPO — MCRADV: $1,187.96
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,187.96
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: Colon ca scrn not hi rsk ind $6,514.93 $4,560.45 $923.21 – $5,159.82
Screening colonoscopy (not high risk): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $923.21
  • Aetna_Better_Health_of_IL — MCRAETIL: $923.21
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $923.21
  • Ambetter_MHS_Marketplace — MKTMHS: $1,330.14
  • Argent_Medicare — ARGMCR: $923.21
  • Atrio_Health_Plans — MCRATRIO: $923.21
  • Avmed_Medicare_Choice — MCRAVMED: $923.21
  • BC_ALLIED — BCALLIED: $2,981.29
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2,981.29
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2,981.29
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: Laparoscopic cholecystectomy $55,334.02 $38,733.81 $6,001.68 – $43,824.54
Gallbladder removal by laparoscope: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $6,001.68
  • Aetna_Better_Health_of_IL — MCRAETIL: $6,001.68
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $6,001.68
  • Ambetter_MHS_Marketplace — MKTMHS: $8,647.06
  • Argent_Medicare — ARGMCR: $6,001.68
  • Atrio_Health_Plans — MCRATRIO: $6,001.68
  • Avmed_Medicare_Choice — MCRAVMED: $6,001.68
  • BC_Federal_Employee — BCFEDEE: $6,001.68
  • BC_MCR_Advantage_PPO — MCRADV: $6,001.68
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $6,001.68
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic cholecystectomy $28,119.09 $19,683.36 $6,001.68 – $22,270.32
Gallbladder removal by laparoscope: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $6,001.68
  • Aetna_Better_Health_of_IL — MCRAETIL: $6,001.68
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $6,001.68
  • Ambetter_MHS_Marketplace — MKTMHS: $8,647.06
  • Argent_Medicare — ARGMCR: $6,001.68
  • Atrio_Health_Plans — MCRATRIO: $6,001.68
  • Avmed_Medicare_Choice — MCRAVMED: $6,001.68
  • BC_Federal_Employee — BCFEDEE: $6,001.68
  • BC_MCR_Advantage_PPO — MCRADV: $6,001.68
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $6,001.68
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: Prp i/hern init reduc >5 yr $40,895.79 $28,627.05 $3,554.43 – $32,389.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,554.43
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,554.43
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,554.43
  • Ambetter_MHS_Marketplace — MKTMHS: $5,121.13
  • Argent_Medicare — ARGMCR: $3,554.43
  • Atrio_Health_Plans — MCRATRIO: $3,554.43
  • Avmed_Medicare_Choice — MCRAVMED: $3,554.43
  • BC_Federal_Employee — BCFEDEE: $3,554.43
  • BC_MCR_Advantage_PPO — MCRADV: $3,554.43
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,554.43
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Prp i/hern init reduc >5 yr $13,042.40 $9,129.68 $3,182.35 – $10,329.58
Groin (inguinal) hernia repair, age 5 or older: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,554.43
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,554.43
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,554.43
  • Ambetter_MHS_Marketplace — MKTMHS: $5,121.13
  • Argent_Medicare — ARGMCR: $3,554.43
  • Atrio_Health_Plans — MCRATRIO: $3,554.43
  • Avmed_Medicare_Choice — MCRAVMED: $3,554.43
  • BC_Federal_Employee — BCFEDEE: $3,554.43
  • BC_MCR_Advantage_PPO — MCRADV: $3,554.43
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,554.43
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier LT In the file: Prp i/hern init reduc >5 yr $13,017.34 $9,112.14 $3,176.23 – $10,309.73
Groin (inguinal) hernia repair, age 5 or older: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,554.43
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,554.43
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,554.43
  • Ambetter_MHS_Marketplace — MKTMHS: $5,121.13
  • Argent_Medicare — ARGMCR: $3,554.43
  • Atrio_Health_Plans — MCRATRIO: $3,554.43
  • Avmed_Medicare_Choice — MCRAVMED: $3,554.43
  • BC_Federal_Employee — BCFEDEE: $3,554.43
  • BC_MCR_Advantage_PPO — MCRADV: $3,554.43
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $3,554.43
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) In the file: Laparo radical prostatectomy $71,666.78 $50,166.75 $10,552.73 – $56,760.09
Prostate removal by laparoscope (radical prostatectomy): 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $10,552.73
  • Aetna_Better_Health_of_IL — MCRAETIL: $10,552.73
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $10,552.73
  • Ambetter_MHS_Marketplace — MKTMHS: $15,204.10
  • Argent_Medicare — ARGMCR: $10,552.73
  • Atrio_Health_Plans — MCRATRIO: $10,552.73
  • Avmed_Medicare_Choice — MCRAVMED: $10,552.73
  • BC_ALLIED — BCALLIED: $34,044.69
  • BC_Anthem_Health_Plan_AHP — BCAHP: $34,044.69
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $34,044.69
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: Hysteroscopy biopsy $18,330.25 $12,831.18 $3,213.65 – $14,517.56
Hysteroscopy with biopsy of the uterus lining: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $3,213.65
  • Aetna_Better_Health_of_IL — MCRAETIL: $3,213.65
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $3,213.65
  • Ambetter_MHS_Marketplace — MKTMHS: $4,630.14
  • Argent_Medicare — ARGMCR: $3,213.65
  • Atrio_Health_Plans — MCRATRIO: $3,213.65
  • Avmed_Medicare_Choice — MCRAVMED: $3,213.65
  • BC_ALLIED — BCALLIED: $10,397.06
  • BC_Anthem_Health_Plan_AHP — BCAHP: $10,397.06
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $10,397.06
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: Njx interlaminar lmbr/sac $3,396.81 $2,377.77 $700.76 – $2,690.27
Spinal injection, lower back (epidural), with imaging guidance: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $700.76
  • Aetna_Better_Health_of_IL — MCRAETIL: $700.76
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $700.76
  • Ambetter_MHS_Marketplace — MKTMHS: $1,009.64
  • Argent_Medicare — ARGMCR: $700.76
  • Atrio_Health_Plans — MCRATRIO: $700.76
  • Avmed_Medicare_Choice — MCRAVMED: $700.76
  • BC_ALLIED — BCALLIED: $2,264.54
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2,264.54
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2,264.54
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier LT In the file: Njx interlaminar lmbr/sac $3,625.71 $2,538 $700.76 – $2,871.56
Spinal injection, lower back (epidural), with imaging guidance: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $700.76
  • Aetna_Better_Health_of_IL — MCRAETIL: $700.76
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $700.76
  • Ambetter_MHS_Marketplace — MKTMHS: $1,009.64
  • Argent_Medicare — ARGMCR: $700.76
  • Atrio_Health_Plans — MCRATRIO: $700.76
  • Avmed_Medicare_Choice — MCRAVMED: $700.76
  • BC_Federal_Employee — BCFEDEE: $700.76
  • BC_MCR_Advantage_PPO — MCRADV: $700.76
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $700.76
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Inj foramen epidural l/s $8,028.08 $5,619.66 $878.06 – $6,358.24
Nerve root injection, lower back, with imaging guidance: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $878.06
  • Aetna_Better_Health_of_IL — MCRAETIL: $878.06
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $878.06
  • Ambetter_MHS_Marketplace — MKTMHS: $1,265.08
  • Argent_Medicare — ARGMCR: $878.06
  • Atrio_Health_Plans — MCRATRIO: $878.06
  • Avmed_Medicare_Choice — MCRAVMED: $878.06
  • BC_ALLIED — BCALLIED: $2,911.25
  • BC_Anthem_Health_Plan_AHP — BCAHP: $2,911.25
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $2,911.25
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50 In the file: Inj foramen epidural l/s $8,028.08 $5,619.66 $878.06 – $6,358.24
Nerve root injection, lower back, with imaging guidance: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $878.06
  • Aetna_Better_Health_of_IL — MCRAETIL: $878.06
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $878.06
  • Ambetter_MHS_Marketplace — MKTMHS: $1,265.08
  • Argent_Medicare — ARGMCR: $878.06
  • Atrio_Health_Plans — MCRATRIO: $878.06
  • Avmed_Medicare_Choice — MCRAVMED: $878.06
  • BC_Federal_Employee — BCFEDEE: $878.06
  • BC_MCR_Advantage_PPO — MCRADV: $878.06
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $878.06
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: Carpal tunnel surgery $19,765.47 $13,835.83 $1,938.56 – $15,654.25
Carpal tunnel release: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,938.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,938.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,938.56
  • Ambetter_MHS_Marketplace — MKTMHS: $2,793.03
  • Argent_Medicare — ARGMCR: $1,938.56
  • Atrio_Health_Plans — MCRATRIO: $1,938.56
  • Avmed_Medicare_Choice — MCRAVMED: $1,938.56
  • BC_ALLIED — BCALLIED: $6,385.56
  • BC_Anthem_Health_Plan_AHP — BCAHP: $6,385.56
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2: $6,385.56
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier LT In the file: Carpal tunnel surgery $12,613.65 $8,829.56 $1,938.56 – $9,990.01
Carpal tunnel release: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,938.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,938.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,938.56
  • Ambetter_MHS_Marketplace — MKTMHS: $2,793.03
  • Argent_Medicare — ARGMCR: $1,938.56
  • Atrio_Health_Plans — MCRATRIO: $1,938.56
  • Avmed_Medicare_Choice — MCRAVMED: $1,938.56
  • BC_Federal_Employee — BCFEDEE: $1,938.56
  • BC_MCR_Advantage_PPO — MCRADV: $1,938.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,938.56
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier RT In the file: Carpal tunnel surgery $12,120.40 $8,484.28 $1,938.56 – $9,599.36
Carpal tunnel release: 10 of 274 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS: $1,938.56
  • Aetna_Better_Health_of_IL — MCRAETIL: $1,938.56
  • Aetna_Better_Health_of_Ohio — MCRAETBE: $1,938.56
  • Ambetter_MHS_Marketplace — MKTMHS: $2,793.03
  • Argent_Medicare — ARGMCR: $1,938.56
  • Atrio_Health_Plans — MCRATRIO: $1,938.56
  • Avmed_Medicare_Choice — MCRAVMED: $1,938.56
  • BC_Federal_Employee — BCFEDEE: $1,938.56
  • BC_MCR_Advantage_PPO — MCRADV: $1,938.56
  • Blue_Cross_Medicare_HMO — BCMCRHMO: $1,938.56

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: Obstetrical care $16,055.60 $11,238.92 $3,917.57 – $12,716.04
Vaginal delivery, with care before and after: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: Cesarean delivery $20,644.52 $14,451.16 $5,037.26 – $16,350.46
Cesarean delivery (C-section), with care before and after: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) In the file: Vbac delivery $16,053.51 $11,237.46 $3,917.06 – $12,714.38
Vaginal delivery after a previous C-section, with care before and after: 10 of 207 insurance plan rates
  • Aetna_Allied_Benefit_Systems — AETABS: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Allied_Benefit_Systems — AETABS_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_American_Continental_Ins — AETNAACI_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Consociate_Health — AETCONSHLT_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Coresource — AETNACOR_1: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE: 81% (a percentage in the contract, not a dollar amount)
  • Aetna_Gravie_Administrative — AETGRAVIE_1: 81% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with mcc $180,848.69 $126,594.08 $72,769.86 – $224,603.31
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 75 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS_1: $72,769.86
  • Aetna_Better_Health_of_IL — MCRAETIL_1: $72,769.86
  • Aetna_Better_Health_of_Ohio — MCRAETBE_1: $72,769.86
  • Ambetter_MHS_Marketplace — MKTMHS_1: $101,877.81
  • Argent_Medicare — ARGMCR_1: $72,769.86
  • Atrio_Health_Plans — MCRATRIO_1: $72,769.86
  • Avmed_Medicare_Choice — MCRAVMED_1: $72,769.86
  • BC_ALLIED — BCALLIED_1: $224,603.31
  • BC_Anthem_Health_Plan_AHP — BCAHP_1: $224,603.31
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2_1: $224,603.31
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major hip and knee joint replacement or reattachment of lower extremity without mcc $51,723.31 $36,206.32 $15,448.34 – $44,285.62
Hip or knee replacement (major joint of the leg), without major complications: 10 of 75 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS_1: $15,448.34
  • Aetna_Better_Health_of_IL — MCRAETIL_1: $15,448.34
  • Aetna_Better_Health_of_Ohio — MCRAETBE_1: $15,448.34
  • Ambetter_MHS_Marketplace — MKTMHS_1: $21,627.67
  • Argent_Medicare — ARGMCR_1: $15,448.34
  • Atrio_Health_Plans — MCRATRIO_1: $15,448.34
  • Avmed_Medicare_Choice — MCRAVMED_1: $15,448.34
  • BC_ALLIED — BCALLIED_1: $44,285.62
  • BC_Anthem_Health_Plan_AHP — BCAHP_1: $44,285.62
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2_1: $44,285.62
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: Uterine and adnexa procedures for non-malignancy without cc/mcc $37,189.43 $26,032.60 $10,425.52 – $28,485.23
Uterus and ovary surgery (not for cancer), without complications: 10 of 75 insurance plan rates
  • Advantage_Health_Solutions — MCRAHS_1: $10,425.52
  • Aetna_Better_Health_of_IL — MCRAETIL_1: $10,425.52
  • Aetna_Better_Health_of_Ohio — MCRAETBE_1: $10,425.52
  • Ambetter_MHS_Marketplace — MKTMHS_1: $14,595.73
  • Argent_Medicare — ARGMCR_1: $10,425.52
  • Atrio_Health_Plans — MCRATRIO_1: $10,425.52
  • Avmed_Medicare_Choice — MCRAVMED_1: $10,425.52
  • BC_ALLIED — BCALLIED_1: $28,485.23
  • BC_Anthem_Health_Plan_AHP — BCAHP_1: $28,485.23
  • BC_Anthem_Health_Plan_AHP_2nd — BCAHP2_1: $28,485.23

Source: Goshen Hospital’s standard charges file (goshenhealth.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on August 14, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address200 High Park Ave, Goshen, IN 46526
CountyElkhart County
StateIndiana
Phone(574) 364‑1000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number150026
Name in Medicare recordsGOSHEN HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteParkview Goshen Hospital (formerly Goshen Hospital)
Official websitegoshenhealth.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Expert Emergency Care, Close to Home — goshenhealth.com
  2. Stroke | Parkview Goshen Hospital — goshenhealth.com
  3. Head Injury Symptoms | Parkview Goshen Hospital — goshenhealth.com
  4. Heart Health | Parkvew Goshen Hospital — goshenhealth.com
  5. Care for Heart Attacks | Parkview Goshen Hospital — goshenhealth.com
  6. Heart Disease Care and Treatment Plans | Parkview Goshen Hospital — goshenhealth.com
  7. Your Personal Health & Financial Records | Parkview Goshen Hospital — goshenhealth.com
  8. Hospital Visitor Guidelines | Parkview Goshen Hospital — goshenhealth.com
  9. Laboratory Services | Parkvew Goshen Hospital — goshenhealth.com