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Acute Care Hospital

Grady Memorial Hospital

Atlanta, Georgia · Fulton County · Emergency services listed

Summary

Grady Memorial Hospital is an acute care hospital in Atlanta, Georgia. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 99 services, specialties and programs. Medicare lists 1,341 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

Call(404) 616‑1000 Directions Website Medicare profile
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Exterior of Grady Memorial Hospital
Photo: Marc Merlin, CC BY-SA 4.0, via Wikimedia Commons · source · licence

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
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
1,341Doctors and clinicians
99Services listed

Quick answers

Does Grady Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Grady Memorial Hospital. In a medical emergency, call 911.
Where is Grady Memorial Hospital?
80 Jesse Hill, Jr Drive SE, Atlanta, GA 30303, in Fulton County, Georgia.
What is the phone number of Grady Memorial Hospital?
(404) 616-1000, as listed by Medicare (CMS).
What is the Medicare star rating of Grady Memorial Hospital?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][6][7][8][10][13][15][16][17][18]

Conditions treated[6][7][8][13][14][15][16][17][18]

Treatments[6][7][8][10][15][16][17][18]

  • Thrombectomy
  • Decompressive craniectomy
  • Aneurysm clipping
  • Brain tumor resection
  • Cranioplasty
  • Epidural steroid injections
  • Botox injections
  • Coronary artery bypass graft surgery
  • Heart valve repair and replacement
  • Aortic aneurysm surgery
  • Angioplasty
  • Stent placement
  • Atherectomy
  • Valvuloplasty
  • Cardiac catheterization
  • Cardiac ablation
  • Pacemaker implantation
  • Implantable cardioverter-defibrillator implantation

Programs and centers[4][6][7][8][9][12][14][15][17]

  • Marcus Trauma Center
  • Marcus Stroke and Neuroscience Center
  • Burn Center
  • Heart & Vascular Center
  • Mobile stroke unit
  • Neurocritical Care Unit
  • TIA Clinic
  • Trauma Recovery Center
  • SAFE Center (survivors advocacy and forensic evaluation)
  • Heart failure program
  • Pulmonary Embolism Response Team (PERT)
  • Electrophysiology Lab

Emergency care (hospital website)[4][6][7]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel 1
Stroke designationJoint Commission Comprehensive Stroke Center

Visiting and practical information

VisitingVisiting hours are 8 a.m. to 10:30 p.m. daily[4]
ParkingVisitor deck off Jesse Hill Jr Drive, open 24/7; $2 per 30 minutes, max $10 per day[4]
Interpreters and languages24-hour interpreters available for trauma patients and families[6]
Patient portalMyChart

Recognition[6][7]

  • American College of Surgeons-verified Level 1 Trauma Center
  • Joint Commission Comprehensive Stroke Center

Doctors and clinicians (1,341)

1,341 doctors and other clinicians list Grady Memorial 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 (1,341)

And 1,317 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

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 Grady Memorial 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) 2 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1068%National average: 72%
Would definitely recommend the hospital69%National average: 71%
Nurses “always” communicated well75%National average: 80%
Doctors “always” communicated well79%National average: 80%
Staff “always” explained medicines before giving them56%National average: 62%
Were given information about recovery at home80%National average: 86%
Room and bathroom “always” clean65%National average: 74%
Area around the room “always” quiet at night50%National average: 60%
Completed surveys726Response rate: 8%

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)1.329No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.349Better than the national benchmark
Surgical site infections after colon surgery0.699No different from the national benchmark
Surgical site infections after abdominal hysterectomy2.807No different from the national benchmark
MRSA bloodstream infections1.302No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.293Better 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 patientsToo few cases to report
Deaths within 30 days: heart failure patients11.1%
Deaths within 30 days: pneumonia patients14.3%
Deaths within 30 days: COPD patients7.5%
Deaths within 30 days: stroke patients10.6%
Deaths within 30 days: coronary bypass surgery (CABG)Too few cases to report
Serious complications (patient safety indicator PSI-90)1.23No different from the national rate
Complications after hip or knee replacement4.1%

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 attack16.1%
Readmitted within 30 days: heart failure23.3%
Readmitted within 30 days: pneumonia17.7%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: coronary bypass surgeryToo few cases to report
Readmitted within 30 days: hip or knee replacement6.4%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)357 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)51%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in AtlantaBest hospitals in Atlanta

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Grady Memorial 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 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level 3 - Np $562 $562 $83.18 – $449.60
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $250.09
  • Aetna — Medicare: $196.70
  • Ambetter — Marketplace: $83.18
  • Amerigroup — Medicaid: $91.38
  • Anthem BCBS — HMO/POS: $411.61
  • Anthem BCBS — HPN: $449.60
  • Anthem BCBS — Pathways/Marketplace: $411.61
  • Anthem BCBS — PPO: $427.40
  • Caresource — Commercial: $83.85
  • Cigna — Commercial: $332.42
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level Bccp 3 - Np $562 $562 $83.18 – $449.60
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $250.09
  • Aetna — Medicare: $196.70
  • Ambetter — Marketplace: $83.18
  • Amerigroup — Medicaid: $91.38
  • Anthem BCBS — HMO/POS: $411.61
  • Anthem BCBS — HPN: $449.60
  • Anthem BCBS — Pathways/Marketplace: $411.61
  • Anthem BCBS — PPO: $427.40
  • Caresource — Commercial: $83.85
  • Cigna — Commercial: $332.42
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Visit Level 3 - Np $562 $562 $337.20 – $449.60
New patient office visit (about 30–44 minutes): rates for 4 insurance plans
  • Anthem BCBS — HPN: $449.60
  • Kaiser — Commercial: $426
  • Multiplan — Commercial: $432.74
  • USP Naphcare — Commercial: $337.20
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level 4 - Np $626.28 $626.28 $92.69 – $501.02
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $278.69
  • Aetna — Medicare: $219.20
  • Ambetter — Marketplace: $92.69
  • Amerigroup — Medicaid: $101.83
  • Anthem BCBS — HMO/POS: $458.69
  • Anthem BCBS — HPN: $501.02
  • Anthem BCBS — Pathways/Marketplace: $458.69
  • Anthem BCBS — PPO: $476.29
  • Caresource — Commercial: $93.44
  • Cigna — Commercial: $370.44
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level Bccp 4 - Np $626.28 $626.28 $92.69 – $501.02
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $278.69
  • Aetna — Medicare: $219.20
  • Ambetter — Marketplace: $92.69
  • Amerigroup — Medicaid: $101.83
  • Anthem BCBS — HMO/POS: $458.69
  • Anthem BCBS — HPN: $501.02
  • Anthem BCBS — Pathways/Marketplace: $458.69
  • Anthem BCBS — PPO: $476.29
  • Caresource — Commercial: $93.44
  • Cigna — Commercial: $370.44
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Visit Level 4 - Np $626.28 $626.28 $375.77 – $501.02
New patient office visit (about 45–59 minutes): rates for 4 insurance plans
  • Anthem BCBS — HPN: $501.02
  • Kaiser — Commercial: $474.72
  • Multiplan — Commercial: $482.24
  • USP Naphcare — Commercial: $375.77
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level 5-Np $739 $739 $109.37 – $591.20
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $328.86
  • Aetna — Medicare: $258.65
  • Ambetter — Marketplace: $109.37
  • Amerigroup — Medicaid: $120.16
  • Anthem BCBS — HMO/POS: $541.24
  • Anthem BCBS — HPN: $591.20
  • Anthem BCBS — Pathways/Marketplace: $541.24
  • Anthem BCBS — PPO: $562.01
  • Caresource — Commercial: $110.26
  • Cigna — Commercial: $437.12
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level Bccp 5-Np $739 $739 $109.37 – $591.20
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $328.86
  • Aetna — Medicare: $258.65
  • Ambetter — Marketplace: $109.37
  • Amerigroup — Medicaid: $120.16
  • Anthem BCBS — HMO/POS: $541.24
  • Anthem BCBS — HPN: $591.20
  • Anthem BCBS — Pathways/Marketplace: $541.24
  • Anthem BCBS — PPO: $562.01
  • Caresource — Commercial: $110.26
  • Cigna — Commercial: $437.12
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Isolation Evaluation - Np $739 $739 $109.37 – $591.20
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $328.86
  • Aetna — Medicare: $258.65
  • Ambetter — Marketplace: $109.37
  • Amerigroup — Medicaid: $120.16
  • Anthem BCBS — HMO/POS: $541.24
  • Anthem BCBS — HPN: $591.20
  • Anthem BCBS — Pathways/Marketplace: $541.24
  • Anthem BCBS — PPO: $562.01
  • Caresource — Commercial: $110.26
  • Cigna — Commercial: $437.12
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level 3-Ep $562.02 $562.02 $83.18 – $449.62
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $250.10
  • Aetna — Medicare: $196.71
  • Ambetter — Marketplace: $83.18
  • Amerigroup — Medicaid: $91.38
  • Anthem BCBS — HMO/POS: $411.62
  • Anthem BCBS — HPN: $449.62
  • Anthem BCBS — Pathways/Marketplace: $411.62
  • Anthem BCBS — PPO: $427.42
  • Caresource — Commercial: $83.85
  • Cigna — Commercial: $332.43
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level Bccp 3 - Ep $562.02 $562.02 $83.18 – $449.62
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $250.10
  • Aetna — Medicare: $196.71
  • Ambetter — Marketplace: $83.18
  • Amerigroup — Medicaid: $91.38
  • Anthem BCBS — HMO/POS: $411.62
  • Anthem BCBS — HPN: $449.62
  • Anthem BCBS — Pathways/Marketplace: $411.62
  • Anthem BCBS — PPO: $427.42
  • Caresource — Commercial: $83.85
  • Cigna — Commercial: $332.43
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Visit Level 3-Ep $562.02 $562.02 $337.21 – $449.62
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans
  • Anthem BCBS — HPN: $449.62
  • Kaiser — Commercial: $426.01
  • Multiplan — Commercial: $432.76
  • USP Naphcare — Commercial: $337.21
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level 4-Ep $573.24 $573.24 $84.84 – $458.59
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $255.09
  • Aetna — Medicare: $200.63
  • Ambetter — Marketplace: $84.84
  • Amerigroup — Medicaid: $93.21
  • Anthem BCBS — HMO/POS: $419.84
  • Anthem BCBS — HPN: $458.59
  • Anthem BCBS — Pathways/Marketplace: $419.84
  • Anthem BCBS — PPO: $435.95
  • Caresource — Commercial: $85.53
  • Cigna — Commercial: $339.07
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Visit Level Bccp 4-Ep $573.24 $573.24 $84.84 – $458.59
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $255.09
  • Aetna — Medicare: $200.63
  • Ambetter — Marketplace: $84.84
  • Amerigroup — Medicaid: $93.21
  • Anthem BCBS — HMO/POS: $419.84
  • Anthem BCBS — HPN: $458.59
  • Anthem BCBS — Pathways/Marketplace: $419.84
  • Anthem BCBS — PPO: $435.95
  • Caresource — Commercial: $85.53
  • Cigna — Commercial: $339.07
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Visit Level 4-Ep $573.24 $573.24 $343.94 – $458.59
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans
  • Anthem BCBS — HPN: $458.59
  • Kaiser — Commercial: $434.52
  • Multiplan — Commercial: $441.39
  • USP Naphcare — Commercial: $343.94
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $100.50
Office consultation with a specialist (moderate): rates for 3 insurance plans
  • Amerigroup — Medicaid: $100.50
  • Caresource — Commercial: $100.50
  • Peach State — Medicaid: $100.50
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $75.19 – $109.69
Office consultation with a specialist (moderate): rates for 2 insurance plans
  • Ambetter — Marketplace: $109.69
  • Peach State — Medicaid: $75.19
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office Consultation Level - 4 $440 $440 $65.12 – $352
Office consultation with a specialist (moderate to high): 10 of 19 insurance plan rates
  • Aetna — Commercial: $195.80
  • Aetna — Medicare: $154
  • Ambetter — Marketplace: $65.12
  • Amerigroup — Medicaid: $71.54
  • Anthem BCBS — HMO/POS: $322.26
  • Anthem BCBS — HPN: $352
  • Anthem BCBS — Pathways/Marketplace: $322.26
  • Anthem BCBS — PPO: $334.62
  • Caresource — Commercial: $65.65
  • Cigna — Commercial: $260.26
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Office Consultation Level - 4 $440 $440 $264 – $352
Office consultation with a specialist (moderate to high): rates for 4 insurance plans
  • Anthem BCBS — HPN: $352
  • Kaiser — Commercial: $333.52
  • Multiplan — Commercial: $338.80
  • USP Naphcare — Commercial: $264
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Off/op cnsltj new/est mod 40 Not listed in the file Not listed in the file $139.12
Office consultation with a specialist (moderate to high): rates for 3 insurance plans
  • Amerigroup — Medicaid: $139.12
  • Caresource — Commercial: $139.12
  • Peach State — Medicaid: $139.12
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $126.51
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • Ambetter — Marketplace: $126.51
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier EP In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $129.03
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans
  • Amerigroup — Medicaid: $129.03
  • Caresource — Commercial: $129.03
  • Peach State — Medicaid: $129.03
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $75.38
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans
  • Amerigroup — Medicaid: $75.38
  • Caresource — Commercial: $75.38
  • Peach State — Medicaid: $75.38
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $145.66
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • Ambetter — Marketplace: $145.66
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit Low Mdm $2,779 $2,779 $411.29 – $2,223.20
Emergency room visit (moderate): 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,236.66
  • Aetna — Medicare: $972.65
  • Ambetter — Marketplace: $411.29
  • Amerigroup — Medicaid: $451.87
  • Anthem BCBS — HMO/POS: $2,035.34
  • Anthem BCBS — HPN: $2,223.20
  • Anthem BCBS — Pathways/Marketplace: $2,035.34
  • Anthem BCBS — PPO: $2,113.43
  • Caresource — Commercial: $414.63
  • Cigna — Commercial: $1,643.78
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency Department Visit Low Mdm $2,779 $2,779 $1,667.40 – $2,223.20
Emergency room visit (moderate): rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,223.20
  • Kaiser — Commercial: $2,106.48
  • Multiplan — Commercial: $2,139.83
  • USP Naphcare — Commercial: $1,667.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit low mdm Not listed in the file Not listed in the file $275.49 – $2,779
Emergency room visit (moderate): 10 of 22 insurance plan rates
  • Aetna — Commercial: $1,475
  • Aetna — Medicare: $275.49
  • Ambetter — Marketplace: $275.49
  • Anthem BCBS — HMO/POS: $1,254.30
  • Anthem BCBS — Medicare: $275.49
  • Anthem BCBS — Pathways/Marketplace: $1,254.30
  • Anthem BCBS — PPO: $1,145.10
  • Caresource — Marketplace: $440.79
  • Cigna — Commercial: $2,779
  • Cigna — IFP: $384.13
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit Moderate Mdm $4,253 $4,253 $629.44 – $3,402.40
Emergency room visit (moderately high): 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,892.58
  • Aetna — Medicare: $1,488.55
  • Ambetter — Marketplace: $629.44
  • Amerigroup — Medicaid: $691.54
  • Anthem BCBS — HMO/POS: $3,114.90
  • Anthem BCBS — HPN: $3,402.40
  • Anthem BCBS — Pathways/Marketplace: $3,114.90
  • Anthem BCBS — PPO: $3,234.41
  • Caresource — Commercial: $634.55
  • Cigna — Commercial: $2,515.65
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency Department Visit Moderate Mdm $4,253 $4,253 $2,551.80 – $3,402.40
Emergency room visit (moderately high): rates for 4 insurance plans
  • Anthem BCBS — HPN: $3,402.40
  • Kaiser — Commercial: $3,223.77
  • Multiplan — Commercial: $3,274.81
  • USP Naphcare — Commercial: $2,551.80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit mod mdm Not listed in the file Not listed in the file $423.67 – $4,253
Emergency room visit (moderately high): 10 of 22 insurance plan rates
  • Aetna — Commercial: $2,694
  • Aetna — Medicare: $423.67
  • Ambetter — Marketplace: $423.67
  • Anthem BCBS — HMO/POS: $2,890.83
  • Anthem BCBS — Medicare: $423.67
  • Anthem BCBS — Pathways/Marketplace: $2,890.83
  • Anthem BCBS — PPO: $3,002.01
  • Caresource — Marketplace: $677.87
  • Cigna — Commercial: $4,253
  • Cigna — IFP: $596.29
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency Department Visit High Mdm $6,238 $6,238 $923.22 – $4,990.40
Emergency room visit (high): 10 of 19 insurance plan rates
  • Aetna — Commercial: $2,775.91
  • Aetna — Medicare: $2,183.30
  • Ambetter — Marketplace: $923.22
  • Amerigroup — Medicaid: $1,014.30
  • Anthem BCBS — HMO/POS: $4,568.71
  • Anthem BCBS — HPN: $4,990.40
  • Anthem BCBS — Pathways/Marketplace: $4,568.71
  • Anthem BCBS — PPO: $4,744
  • Caresource — Commercial: $930.71
  • Cigna — Commercial: $3,689.78
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency Department Visit High Mdm $6,238 $6,238 $3,742.80 – $4,990.40
Emergency room visit (high): rates for 4 insurance plans
  • Anthem BCBS — HPN: $4,990.40
  • Kaiser — Commercial: $4,728.40
  • Multiplan — Commercial: $4,803.26
  • USP Naphcare — Commercial: $3,742.80
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit hi mdm Not listed in the file Not listed in the file $610.01 – $6,238
Emergency room visit (high): 10 of 22 insurance plan rates
  • Aetna — Commercial: $3,686
  • Aetna — Medicare: $610.01
  • Ambetter — Marketplace: $610.01
  • Anthem BCBS — HMO/POS: $4,664
  • Anthem BCBS — Medicare: $610.01
  • Anthem BCBS — Pathways/Marketplace: $4,664
  • Anthem BCBS — PPO: $4,402.96
  • Caresource — Marketplace: $976.01
  • Cigna — Commercial: $6,238
  • Cigna — IFP: $864.73

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Chem 8, Metabolic Panel $345 $345 $51.06 – $276
Basic metabolic panel (blood test): 10 of 19 insurance plan rates
  • Aetna — Commercial: $153.52
  • Aetna — Medicare: $120.75
  • Ambetter — Marketplace: $51.06
  • Amerigroup — Medicaid: $56.10
  • Anthem BCBS — HMO/POS: $252.68
  • Anthem BCBS — HPN: $276
  • Anthem BCBS — Pathways/Marketplace: $252.68
  • Anthem BCBS — PPO: $262.37
  • Caresource — Commercial: $51.47
  • Cigna — Commercial: $204.07
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Panel $420.90 $420.90 $62.29 – $336.72
Basic metabolic panel (blood test): 10 of 19 insurance plan rates
  • Aetna — Commercial: $187.30
  • Aetna — Medicare: $147.31
  • Ambetter — Marketplace: $62.29
  • Amerigroup — Medicaid: $68.44
  • Anthem BCBS — HMO/POS: $308.27
  • Anthem BCBS — HPN: $336.72
  • Anthem BCBS — Pathways/Marketplace: $308.27
  • Anthem BCBS — PPO: $320.09
  • Caresource — Commercial: $62.80
  • Cigna — Commercial: $248.96
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Chem 8, Metabolic Panel $345 $345 $207 – $276
Basic metabolic panel (blood test): rates for 4 insurance plans
  • Anthem BCBS — HPN: $276
  • Kaiser — Commercial: $261.51
  • Multiplan — Commercial: $265.65
  • USP Naphcare — Commercial: $207
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Metabolic Panel $472 $472 $69.86 – $377.60
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates
  • Aetna — Commercial: $210.04
  • Aetna — Medicare: $165.20
  • Ambetter — Marketplace: $69.86
  • Amerigroup — Medicaid: $76.75
  • Anthem BCBS — HMO/POS: $345.69
  • Anthem BCBS — HPN: $377.60
  • Anthem BCBS — Pathways/Marketplace: $345.69
  • Anthem BCBS — PPO: $358.96
  • Caresource — Commercial: $70.42
  • Cigna — Commercial: $279.19
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp, Metabolic Panel $573.85 $573.85 $84.93 – $459.08
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates
  • Aetna — Commercial: $255.36
  • Aetna — Medicare: $200.85
  • Ambetter — Marketplace: $84.93
  • Amerigroup — Medicaid: $93.31
  • Anthem BCBS — HMO/POS: $420.29
  • Anthem BCBS — HPN: $459.08
  • Anthem BCBS — Pathways/Marketplace: $420.29
  • Anthem BCBS — PPO: $436.41
  • Caresource — Commercial: $85.62
  • Cigna — Commercial: $339.43
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comp Metabolic Panel $472 $472 $283.20 – $377.60
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • Anthem BCBS — HPN: $377.60
  • Kaiser — Commercial: $357.78
  • Multiplan — Commercial: $363.44
  • USP Naphcare — Commercial: $283.20
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel Not listed in the file Not listed in the file $57.37
Obstetric blood test panel: 10 of 28 insurance plan rates
  • Aetna — Commercial: $88.06
  • Aetna — Medicare: $47.81
  • Ambetter — Marketplace: $47.81
  • Amerigroup — Medicaid: $28.08
  • Anthem BCBS — HMO/POS: $47.81
  • Anthem BCBS — Medicare: $47.81
  • Anthem BCBS — Pathways/Marketplace: $47.81
  • Anthem BCBS — PPO: $47.81
  • Caresource — Commercial: $28.08
  • Caresource — Marketplace: $76.50
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetric panel Not listed in the file Not listed in the file $47.81 – $76.50
Obstetric blood test panel: 10 of 15 insurance plan rates
  • Aetna — Medicare: $47.81
  • Ambetter — Marketplace: $47.81
  • Anthem BCBS — Medicare: $47.81
  • Caresource — Marketplace: $76.50
  • Cigna — Medicare: $47.81
  • Clear Spring Health — Medicare: $50.20
  • Clover — Medicare: $50.20
  • Humana — Medicare: $47.81
  • Kaiser — Medicare: $47.81
  • Medicare — Medicare: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Chem 3, Lipid Panel $293.25 $293.25 $43.40 – $234.60
Cholesterol panel (lipid panel): 10 of 19 insurance plan rates
  • Aetna — Commercial: $130.50
  • Aetna — Medicare: $102.64
  • Ambetter — Marketplace: $43.40
  • Amerigroup — Medicaid: $47.68
  • Anthem BCBS — HMO/POS: $214.78
  • Anthem BCBS — HPN: $234.60
  • Anthem BCBS — Pathways/Marketplace: $214.78
  • Anthem BCBS — PPO: $223.02
  • Caresource — Commercial: $43.75
  • Cigna — Commercial: $173.46
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Chem 3, Lipid Panel $293.25 $293.25 $175.95 – $234.60
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • Anthem BCBS — HPN: $234.60
  • Kaiser — Commercial: $222.28
  • Multiplan — Commercial: $225.80
  • USP Naphcare — Commercial: $175.95
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel Not listed in the file Not listed in the file $16.07
Cholesterol panel (lipid panel): 10 of 28 insurance plan rates
  • Aetna — Commercial: $24.65
  • Aetna — Medicare: $13.39
  • Ambetter — Marketplace: $13.39
  • Amerigroup — Medicaid: $16.85
  • Anthem BCBS — HMO/POS: $13.39
  • Anthem BCBS — Medicare: $13.39
  • Anthem BCBS — Pathways/Marketplace: $13.39
  • Anthem BCBS — PPO: $13.39
  • Caresource — Commercial: $16.85
  • Caresource — Marketplace: $21.42
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Panel $362.25 $362.25 $53.61 – $289.80
Kidney function panel: 10 of 19 insurance plan rates
  • Aetna — Commercial: $161.20
  • Aetna — Medicare: $126.79
  • Ambetter — Marketplace: $53.61
  • Amerigroup — Medicaid: $58.90
  • Anthem BCBS — HMO/POS: $265.31
  • Anthem BCBS — HPN: $289.80
  • Anthem BCBS — Pathways/Marketplace: $265.31
  • Anthem BCBS — PPO: $275.49
  • Caresource — Commercial: $54.05
  • Cigna — Commercial: $214.27
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Panel $362.25 $362.25 $217.35 – $289.80
Kidney function panel: rates for 4 insurance plans
  • Anthem BCBS — HPN: $289.80
  • Kaiser — Commercial: $274.59
  • Multiplan — Commercial: $278.93
  • USP Naphcare — Commercial: $217.35
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $10.42
Kidney function panel: 10 of 28 insurance plan rates
  • Aetna — Commercial: $15.98
  • Aetna — Medicare: $8.68
  • Ambetter — Marketplace: $8.68
  • Amerigroup — Medicaid: $10.92
  • Anthem BCBS — HMO/POS: $13.19
  • Anthem BCBS — Medicare: $8.68
  • Anthem BCBS — Pathways/Marketplace: $13.19
  • Anthem BCBS — PPO: $13.19
  • Caresource — Commercial: $10.92
  • Caresource — Marketplace: $13.89
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Profile $373 $373 $55.20 – $298.40
Liver function panel: 10 of 19 insurance plan rates
  • Aetna — Commercial: $165.98
  • Aetna — Medicare: $130.55
  • Ambetter — Marketplace: $55.20
  • Amerigroup — Medicaid: $60.65
  • Anthem BCBS — HMO/POS: $273.19
  • Anthem BCBS — HPN: $298.40
  • Anthem BCBS — Pathways/Marketplace: $273.19
  • Anthem BCBS — PPO: $283.67
  • Caresource — Commercial: $55.65
  • Cigna — Commercial: $220.63
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hepatic Profile $373 $373 $223.80 – $298.40
Liver function panel: rates for 4 insurance plans
  • Anthem BCBS — HPN: $298.40
  • Kaiser — Commercial: $282.73
  • Multiplan — Commercial: $287.21
  • USP Naphcare — Commercial: $223.80
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel Not listed in the file Not listed in the file $9.80
Liver function panel: 10 of 28 insurance plan rates
  • Aetna — Commercial: $15.04
  • Aetna — Medicare: $8.17
  • Ambetter — Marketplace: $8.17
  • Amerigroup — Medicaid: $10.28
  • Anthem BCBS — HMO/POS: $8.17
  • Anthem BCBS — Medicare: $8.17
  • Anthem BCBS — Pathways/Marketplace: $8.17
  • Anthem BCBS — PPO: $8.17
  • Caresource — Commercial: $10.28
  • Caresource — Marketplace: $13.07
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis With Microscopy $213 $213 $31.52 – $170.40
Urine test (automated, with microscope): 10 of 19 insurance plan rates
  • Aetna — Commercial: $94.78
  • Aetna — Medicare: $74.55
  • Ambetter — Marketplace: $31.52
  • Amerigroup — Medicaid: $34.63
  • Anthem BCBS — HMO/POS: $156
  • Anthem BCBS — HPN: $170.40
  • Anthem BCBS — Pathways/Marketplace: $156
  • Anthem BCBS — PPO: $161.99
  • Caresource — Commercial: $31.78
  • Cigna — Commercial: $125.99
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis With Microscopy $213 $213 $127.80 – $170.40
Urine test (automated, with microscope): rates for 4 insurance plans
  • Anthem BCBS — HPN: $170.40
  • Kaiser — Commercial: $161.45
  • Multiplan — Commercial: $164.01
  • USP Naphcare — Commercial: $127.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $3.80
Urine test (automated, with microscope): 10 of 28 insurance plan rates
  • Aetna — Commercial: $5.84
  • Aetna — Medicare: $3.17
  • Ambetter — Marketplace: $3.17
  • Amerigroup — Medicaid: $3.99
  • Anthem BCBS — HMO/POS: $4.82
  • Anthem BCBS — Medicare: $3.17
  • Anthem BCBS — Pathways/Marketplace: $4.82
  • Anthem BCBS — PPO: $4.82
  • Caresource — Commercial: $3.99
  • Caresource — Marketplace: $5.07
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $4.18
Urine test (manual, without microscope): 10 of 28 insurance plan rates
  • Aetna — Commercial: $6.40
  • Aetna — Medicare: $3.48
  • Ambetter — Marketplace: $3.48
  • Amerigroup — Medicaid: $3.21
  • Anthem BCBS — HMO/POS: $3.89
  • Anthem BCBS — Medicare: $3.48
  • Anthem BCBS — Pathways/Marketplace: $3.89
  • Anthem BCBS — PPO: $3.89
  • Caresource — Commercial: $3.21
  • Caresource — Marketplace: $5.57
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $3.48 – $5.57
Urine test (manual, without microscope): 10 of 15 insurance plan rates
  • Aetna — Medicare: $3.48
  • Ambetter — Marketplace: $3.48
  • Anthem BCBS — Medicare: $3.48
  • Caresource — Marketplace: $5.57
  • Cigna — Medicare: $3.48
  • Clear Spring Health — Medicare: $3.65
  • Clover — Medicare: $3.65
  • Humana — Medicare: $3.48
  • Kaiser — Medicare: $3.48
  • Medicare — Medicare: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis $182 $182 $26.94 – $145.60
Urine test (automated, without microscope): 10 of 19 insurance plan rates
  • Aetna — Commercial: $80.99
  • Aetna — Medicare: $63.70
  • Ambetter — Marketplace: $26.94
  • Amerigroup — Medicaid: $29.59
  • Anthem BCBS — HMO/POS: $133.30
  • Anthem BCBS — HPN: $145.60
  • Anthem BCBS — Pathways/Marketplace: $133.30
  • Anthem BCBS — PPO: $138.41
  • Caresource — Commercial: $27.15
  • Cigna — Commercial: $107.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, Top $182 $182 $26.94 – $145.60
Urine test (automated, without microscope): 10 of 19 insurance plan rates
  • Aetna — Commercial: $80.99
  • Aetna — Medicare: $63.70
  • Ambetter — Marketplace: $26.94
  • Amerigroup — Medicaid: $29.59
  • Anthem BCBS — HMO/POS: $133.30
  • Anthem BCBS — HPN: $145.60
  • Anthem BCBS — Pathways/Marketplace: $133.30
  • Anthem BCBS — PPO: $138.41
  • Caresource — Commercial: $27.15
  • Cigna — Commercial: $107.65
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis $182 $182 $109.20 – $145.60
Urine test (automated, without microscope): rates for 4 insurance plans
  • Anthem BCBS — HPN: $145.60
  • Kaiser — Commercial: $137.96
  • Multiplan — Commercial: $140.14
  • USP Naphcare — Commercial: $109.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostatic Antigen $343 $343 $50.76 – $274.40
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates
  • Aetna — Commercial: $152.64
  • Aetna — Medicare: $120.05
  • Ambetter — Marketplace: $50.76
  • Amerigroup — Medicaid: $55.77
  • Anthem BCBS — HMO/POS: $251.21
  • Anthem BCBS — HPN: $274.40
  • Anthem BCBS — Pathways/Marketplace: $251.21
  • Anthem BCBS — PPO: $260.85
  • Caresource — Commercial: $51.18
  • Cigna — Commercial: $202.88
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Prostatic Antigen $343 $343 $205.80 – $274.40
PSA (prostate specific antigen) blood test: rates for 4 insurance plans
  • Anthem BCBS — HPN: $274.40
  • Kaiser — Commercial: $259.99
  • Multiplan — Commercial: $264.11
  • USP Naphcare — Commercial: $205.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total Not listed in the file Not listed in the file $22.07
PSA (prostate specific antigen) blood test: 10 of 28 insurance plan rates
  • Aetna — Commercial: $33.88
  • Aetna — Medicare: $18.39
  • Ambetter — Marketplace: $18.39
  • Amerigroup — Medicaid: $23.13
  • Anthem BCBS — HMO/POS: $18.39
  • Anthem BCBS — Medicare: $18.39
  • Anthem BCBS — Pathways/Marketplace: $18.39
  • Anthem BCBS — PPO: $18.39
  • Caresource — Commercial: $23.13
  • Caresource — Marketplace: $29.42
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh,Serum-Irma $257.60 $257.60 $38.12 – $206.08
Thyroid stimulating hormone (TSH) test: 10 of 19 insurance plan rates
  • Aetna — Commercial: $114.63
  • Aetna — Medicare: $90.16
  • Ambetter — Marketplace: $38.12
  • Amerigroup — Medicaid: $41.89
  • Anthem BCBS — HMO/POS: $188.67
  • Anthem BCBS — HPN: $206.08
  • Anthem BCBS — Pathways/Marketplace: $188.67
  • Anthem BCBS — PPO: $195.90
  • Caresource — Commercial: $38.43
  • Cigna — Commercial: $152.37
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Tsh,Serum-Irma $257.60 $257.60 $154.56 – $206.08
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • Anthem BCBS — HPN: $206.08
  • Kaiser — Commercial: $195.26
  • Multiplan — Commercial: $198.35
  • USP Naphcare — Commercial: $154.56
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $20.16
Thyroid stimulating hormone (TSH) test: 10 of 28 insurance plan rates
  • Aetna — Commercial: $30.94
  • Aetna — Medicare: $16.80
  • Ambetter — Marketplace: $16.80
  • Amerigroup — Medicaid: $21.12
  • Anthem BCBS — HMO/POS: $16.80
  • Anthem BCBS — Medicare: $16.80
  • Anthem BCBS — Pathways/Marketplace: $16.80
  • Anthem BCBS — PPO: $16.80
  • Caresource — Commercial: $21.12
  • Caresource — Marketplace: $26.88
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc, Plat & Diff, Idp $194 $194 $28.71 – $155.20
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates
  • Aetna — Commercial: $86.33
  • Aetna — Medicare: $67.90
  • Ambetter — Marketplace: $28.71
  • Amerigroup — Medicaid: $31.54
  • Anthem BCBS — HMO/POS: $142.09
  • Anthem BCBS — HPN: $155.20
  • Anthem BCBS — Pathways/Marketplace: $142.09
  • Anthem BCBS — PPO: $147.54
  • Caresource — Commercial: $28.94
  • Cigna — Commercial: $114.75
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc, Plat & Diff $282.90 $282.90 $41.87 – $226.32
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates
  • Aetna — Commercial: $125.89
  • Aetna — Medicare: $99.01
  • Ambetter — Marketplace: $41.87
  • Amerigroup — Medicaid: $46
  • Anthem BCBS — HMO/POS: $207.20
  • Anthem BCBS — HPN: $226.32
  • Anthem BCBS — Pathways/Marketplace: $207.20
  • Anthem BCBS — PPO: $215.15
  • Caresource — Commercial: $42.21
  • Cigna — Commercial: $167.34
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cbc, Plat & Diff, Idp $194 $194 $116.40 – $155.20
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • Anthem BCBS — HPN: $155.20
  • Kaiser — Commercial: $147.05
  • Multiplan — Commercial: $149.38
  • USP Naphcare — Commercial: $116.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc & Plat $209.30 $209.30 $30.98 – $167.44
Complete blood count (CBC), automated: 10 of 19 insurance plan rates
  • Aetna — Commercial: $93.14
  • Aetna — Medicare: $73.26
  • Ambetter — Marketplace: $30.98
  • Amerigroup — Medicaid: $34.03
  • Anthem BCBS — HMO/POS: $153.29
  • Anthem BCBS — HPN: $167.44
  • Anthem BCBS — Pathways/Marketplace: $153.29
  • Anthem BCBS — PPO: $159.17
  • Caresource — Commercial: $31.23
  • Cigna — Commercial: $123.80
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cbc & Plat $209.30 $209.30 $125.58 – $167.44
Complete blood count (CBC), automated: rates for 4 insurance plans
  • Anthem BCBS — HPN: $167.44
  • Kaiser — Commercial: $158.65
  • Multiplan — Commercial: $161.16
  • USP Naphcare — Commercial: $125.58
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $7.76
Complete blood count (CBC), automated: 10 of 28 insurance plan rates
  • Aetna — Commercial: $11.91
  • Aetna — Medicare: $6.47
  • Ambetter — Marketplace: $6.47
  • Amerigroup — Medicaid: $8.14
  • Anthem BCBS — HMO/POS: $9.83
  • Anthem BCBS — Medicare: $6.47
  • Anthem BCBS — Pathways/Marketplace: $9.83
  • Anthem BCBS — PPO: $9.83
  • Caresource — Commercial: $8.14
  • Caresource — Marketplace: $10.35
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt(Prothrombin Time) $129 $129 $19.09 – $103.20
Blood clotting time test (prothrombin time, PT): 10 of 19 insurance plan rates
  • Aetna — Commercial: $57.40
  • Aetna — Medicare: $45.15
  • Ambetter — Marketplace: $19.09
  • Amerigroup — Medicaid: $20.98
  • Anthem BCBS — HMO/POS: $94.48
  • Anthem BCBS — HPN: $103.20
  • Anthem BCBS — Pathways/Marketplace: $94.48
  • Anthem BCBS — PPO: $98.10
  • Caresource — Commercial: $19.25
  • Cigna — Commercial: $76.30
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt,Coumadin Therapy $182.85 $182.85 $27.06 – $146.28
Blood clotting time test (prothrombin time, PT): 10 of 19 insurance plan rates
  • Aetna — Commercial: $81.37
  • Aetna — Medicare: $64
  • Ambetter — Marketplace: $27.06
  • Amerigroup — Medicaid: $29.73
  • Anthem BCBS — HMO/POS: $133.92
  • Anthem BCBS — HPN: $146.28
  • Anthem BCBS — Pathways/Marketplace: $133.92
  • Anthem BCBS — PPO: $139.06
  • Caresource — Commercial: $27.28
  • Cigna — Commercial: $108.16
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Pt(Prothrombin Time) $129 $129 $77.40 – $103.20
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans
  • Anthem BCBS — HPN: $103.20
  • Kaiser — Commercial: $97.78
  • Multiplan — Commercial: $99.33
  • USP Naphcare — Commercial: $77.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Appt, Hepzyme-Treated $153 $153 $22.64 – $122.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates
  • Aetna — Commercial: $68.09
  • Aetna — Medicare: $53.55
  • Ambetter — Marketplace: $22.64
  • Amerigroup — Medicaid: $24.88
  • Anthem BCBS — HMO/POS: $112.06
  • Anthem BCBS — HPN: $122.40
  • Anthem BCBS — Pathways/Marketplace: $112.06
  • Anthem BCBS — PPO: $116.36
  • Caresource — Commercial: $22.83
  • Cigna — Commercial: $90.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Aptt Heparin Therapy $153 $153 $22.64 – $122.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates
  • Aetna — Commercial: $68.09
  • Aetna — Medicare: $53.55
  • Ambetter — Marketplace: $22.64
  • Amerigroup — Medicaid: $24.88
  • Anthem BCBS — HMO/POS: $112.06
  • Anthem BCBS — HPN: $122.40
  • Anthem BCBS — Pathways/Marketplace: $112.06
  • Anthem BCBS — PPO: $116.36
  • Caresource — Commercial: $22.83
  • Cigna — Commercial: $90.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt-Saline $153 $153 $22.64 – $122.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates
  • Aetna — Commercial: $68.09
  • Aetna — Medicare: $53.55
  • Ambetter — Marketplace: $22.64
  • Amerigroup — Medicaid: $24.88
  • Anthem BCBS — HMO/POS: $112.06
  • Anthem BCBS — HPN: $122.40
  • Anthem BCBS — Pathways/Marketplace: $112.06
  • Anthem BCBS — PPO: $116.36
  • Caresource — Commercial: $22.83
  • Cigna — Commercial: $90.50

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Head/Brain CT W/O Dye Ect $4,026 $4,026 $595.85 – $3,220.80
CT scan of the head or brain, without contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,791.57
  • Aetna — Medicare: $1,409.10
  • Ambetter — Marketplace: $595.85
  • Amerigroup — Medicaid: $654.63
  • Anthem BCBS — HMO/POS: $2,948.64
  • Anthem BCBS — HPN: $3,220.80
  • Anthem BCBS — Pathways/Marketplace: $2,948.64
  • Anthem BCBS — PPO: $3,061.77
  • Caresource — Commercial: $600.68
  • Cigna — Commercial: $2,381.38
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Head/Brain CT W/O Dye Ect $4,026 $4,026 $2,415.60 – $3,220.80
CT scan of the head or brain, without contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $3,220.80
  • Kaiser — Commercial: $3,051.71
  • Multiplan — Commercial: $3,100.02
  • USP Naphcare — Commercial: $2,415.60
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $528.15
CT scan of the head or brain, without contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $1,475
  • Aetna — Medicare: $105.81
  • Ambetter — Marketplace: $105.81
  • Anthem BCBS — HMO/POS: $785.72
  • Anthem BCBS — Medicare: $105.81
  • Anthem BCBS — Pathways/Marketplace: $785.72
  • Anthem BCBS — PPO: $785.72
  • Caresource — Marketplace: $169.29
  • Cigna — IFP: $148.02
  • Cigna — Medicare: $105.81
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain W&WO Dye $7,610 $7,610 $1,126.28 – $6,088
MRI of the brain, before and after contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $3,386.45
  • Aetna — Medicare: $2,663.50
  • Ambetter — Marketplace: $1,126.28
  • Amerigroup — Medicaid: $1,237.39
  • Anthem BCBS — HMO/POS: $5,573.56
  • Anthem BCBS — HPN: $6,088
  • Anthem BCBS — Pathways/Marketplace: $5,573.56
  • Anthem BCBS — PPO: $5,787.40
  • Caresource — Commercial: $1,135.41
  • Cigna — Commercial: $4,501.32
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Brain W&WO Dye $7,610 $7,610 $4,566 – $6,088
MRI of the brain, before and after contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $6,088
  • Kaiser — Commercial: $5,768.38
  • Multiplan — Commercial: $5,859.70
  • USP Naphcare — Commercial: $4,566
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $1,786.43
MRI of the brain, before and after contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $2,163
  • Aetna — Medicare: $355.33
  • Ambetter — Marketplace: $355.33
  • Anthem BCBS — HMO/POS: $1,171.15
  • Anthem BCBS — Medicare: $355.33
  • Anthem BCBS — Pathways/Marketplace: $1,171.15
  • Anthem BCBS — PPO: $1,171.15
  • Caresource — Marketplace: $568.53
  • Cigna — IFP: $517.75
  • Cigna — Medicare: $355.33
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-Ray Exam Chest 2 View $787 $787 $116.48 – $629.60
Chest X-ray, 2 views: 10 of 19 insurance plan rates
  • Aetna — Commercial: $350.22
  • Aetna — Medicare: $275.45
  • Ambetter — Marketplace: $116.48
  • Amerigroup — Medicaid: $127.97
  • Anthem BCBS — HMO/POS: $576.40
  • Anthem BCBS — HPN: $629.60
  • Anthem BCBS — Pathways/Marketplace: $576.40
  • Anthem BCBS — PPO: $598.51
  • Caresource — Commercial: $117.42
  • Cigna — Commercial: $465.51
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: X-Ray Exam Chest 2 View $787 $787 $472.20 – $629.60
Chest X-ray, 2 views: rates for 4 insurance plans
  • Anthem BCBS — HPN: $629.60
  • Kaiser — Commercial: $596.55
  • Multiplan — Commercial: $605.99
  • USP Naphcare — Commercial: $472.20
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $185.87
Chest X-ray, 2 views: 10 of 26 insurance plan rates
  • Aetna — Commercial: $54.21
  • Aetna — Medicare: $87.60
  • Ambetter — Marketplace: $87.60
  • Anthem BCBS — HMO/POS: $49.06
  • Anthem BCBS — Medicare: $87.60
  • Anthem BCBS — Pathways/Marketplace: $49.06
  • Anthem BCBS — PPO: $49.06
  • Caresource — Marketplace: $140.16
  • Cigna — IFP: $122.33
  • Cigna — Medicare: $87.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lumbosacral Spine 4+View Rdg $1,428 $1,428 $211.34 – $1,142.40
X-ray of the lower spine, at least 4 views: 10 of 19 insurance plan rates
  • Aetna — Commercial: $635.46
  • Aetna — Medicare: $499.80
  • Ambetter — Marketplace: $211.34
  • Amerigroup — Medicaid: $232.19
  • Anthem BCBS — HMO/POS: $1,045.87
  • Anthem BCBS — HPN: $1,142.40
  • Anthem BCBS — Pathways/Marketplace: $1,045.87
  • Anthem BCBS — PPO: $1,085.99
  • Caresource — Commercial: $213.06
  • Cigna — Commercial: $844.66
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lumbosacral Spine 4+View Rdg $1,428 $1,428 $856.80 – $1,142.40
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans
  • Anthem BCBS — HPN: $1,142.40
  • Kaiser — Commercial: $1,082.42
  • Multiplan — Commercial: $1,099.56
  • USP Naphcare — Commercial: $856.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $528.15
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates
  • Aetna — Commercial: $89.86
  • Aetna — Medicare: $105.81
  • Ambetter — Marketplace: $105.81
  • Anthem BCBS — HMO/POS: $94.35
  • Anthem BCBS — Medicare: $105.81
  • Anthem BCBS — Pathways/Marketplace: $94.35
  • Anthem BCBS — PPO: $94.35
  • Caresource — Marketplace: $169.29
  • Cigna — IFP: $148.02
  • Cigna — Medicare: $105.81
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lumbar Spine W/O Dye $4,804 $4,804 $710.99 – $3,843.20
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $2,137.78
  • Aetna — Medicare: $1,681.40
  • Ambetter — Marketplace: $710.99
  • Amerigroup — Medicaid: $781.13
  • Anthem BCBS — HMO/POS: $3,518.45
  • Anthem BCBS — HPN: $3,843.20
  • Anthem BCBS — Pathways/Marketplace: $3,518.45
  • Anthem BCBS — PPO: $3,653.44
  • Caresource — Commercial: $716.76
  • Cigna — Commercial: $2,841.57
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Lumbar Spine W/O Dye $4,804 $4,804 $2,882.40 – $3,843.20
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $3,843.20
  • Kaiser — Commercial: $3,641.43
  • Multiplan — Commercial: $3,699.08
  • USP Naphcare — Commercial: $2,882.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $1,116.25
MRI of the lower back (lumbar spine), without contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $2,163
  • Aetna — Medicare: $240.50
  • Ambetter — Marketplace: $240.50
  • Anthem BCBS — HMO/POS: $1,171.15
  • Anthem BCBS — Medicare: $240.50
  • Anthem BCBS — Pathways/Marketplace: $1,171.15
  • Anthem BCBS — PPO: $1,171.15
  • Caresource — Marketplace: $384.80
  • Cigna — IFP: $329.89
  • Cigna — Medicare: $240.50
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pelvis CT W/Dye Bct $5,705 $5,705 $844.34 – $4,564
CT scan of the pelvis, with contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $2,538.72
  • Aetna — Medicare: $1,996.75
  • Ambetter — Marketplace: $844.34
  • Amerigroup — Medicaid: $927.63
  • Anthem BCBS — HMO/POS: $4,178.34
  • Anthem BCBS — HPN: $4,564
  • Anthem BCBS — Pathways/Marketplace: $4,178.34
  • Anthem BCBS — PPO: $4,338.65
  • Caresource — Commercial: $851.19
  • Cigna — Commercial: $3,374.51
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Pelvis CT W/Dye Bct $5,705 $5,705 $3,423 – $4,564
CT scan of the pelvis, with contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $4,564
  • Kaiser — Commercial: $4,324.39
  • Multiplan — Commercial: $4,392.85
  • USP Naphcare — Commercial: $3,423
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $866.54
CT scan of the pelvis, with contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $1,475
  • Aetna — Medicare: $177.12
  • Ambetter — Marketplace: $177.12
  • Anthem BCBS — HMO/POS: $785.72
  • Anthem BCBS — Medicare: $177.12
  • Anthem BCBS — Pathways/Marketplace: $785.72
  • Anthem BCBS — PPO: $785.72
  • Caresource — Marketplace: $283.39
  • Cigna — IFP: $247.36
  • Cigna — Medicare: $177.12
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Joint Lower Ext W/O Dye $5,034.70 $5,034.70 $745.14 – $4,027.76
MRI of a leg joint (such as the knee), without contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $2,240.44
  • Aetna — Medicare: $1,762.14
  • Ambetter — Marketplace: $745.14
  • Amerigroup — Medicaid: $818.64
  • Anthem BCBS — HMO/POS: $3,687.41
  • Anthem BCBS — HPN: $4,027.76
  • Anthem BCBS — Pathways/Marketplace: $3,687.41
  • Anthem BCBS — PPO: $3,828.89
  • Caresource — Commercial: $751.18
  • Cigna — Commercial: $2,978.03
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Joint Lower Ext W/O Dye $5,034.70 $5,034.70 $3,020.82 – $4,027.76
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $4,027.76
  • Kaiser — Commercial: $3,816.30
  • Multiplan — Commercial: $3,876.72
  • USP Naphcare — Commercial: $3,020.82
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $1,116.25
MRI of a leg joint (such as the knee), without contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $2,163
  • Aetna — Medicare: $240.50
  • Ambetter — Marketplace: $240.50
  • Anthem BCBS — HMO/POS: $1,171.15
  • Anthem BCBS — Medicare: $240.50
  • Anthem BCBS — Pathways/Marketplace: $1,171.15
  • Anthem BCBS — PPO: $1,171.15
  • Caresource — Marketplace: $384.80
  • Cigna — IFP: $329.89
  • Cigna — Medicare: $240.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT, Abd and Pelvis W/Contrast $10,272 $10,272 $1,520.26 – $8,217.60
CT scan of the abdomen and pelvis, with contrast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $4,571.04
  • Aetna — Medicare: $3,595.20
  • Ambetter — Marketplace: $1,520.26
  • Amerigroup — Medicaid: $1,670.23
  • Anthem BCBS — HMO/POS: $7,523.21
  • Anthem BCBS — HPN: $8,217.60
  • Anthem BCBS — Pathways/Marketplace: $7,523.21
  • Anthem BCBS — PPO: $7,811.86
  • Caresource — Commercial: $1,532.58
  • Cigna — Commercial: $6,075.89
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT, Abd and Pelvis W/Contrast $10,272 $10,272 $6,163.20 – $8,217.60
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $8,217.60
  • Kaiser — Commercial: $7,786.18
  • Multiplan — Commercial: $7,909.44
  • USP Naphcare — Commercial: $6,163.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $1,786.43
CT scan of the abdomen and pelvis, with contrast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $1,475
  • Aetna — Medicare: $355.33
  • Ambetter — Marketplace: $355.33
  • Anthem BCBS — HMO/POS: $785.72
  • Anthem BCBS — Medicare: $355.33
  • Anthem BCBS — Pathways/Marketplace: $785.72
  • Anthem BCBS — PPO: $785.72
  • Caresource — Marketplace: $568.53
  • Cigna — IFP: $517.75
  • Cigna — Medicare: $355.33
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abd, Rt W/Image $2,181 $2,181 $322.79 – $1,744.80
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates
  • Aetna — Commercial: $970.54
  • Aetna — Medicare: $763.35
  • Ambetter — Marketplace: $322.79
  • Amerigroup — Medicaid: $354.63
  • Anthem BCBS — HMO/POS: $1,597.36
  • Anthem BCBS — HPN: $1,744.80
  • Anthem BCBS — Pathways/Marketplace: $1,597.36
  • Anthem BCBS — PPO: $1,658.65
  • Caresource — Commercial: $325.41
  • Cigna — Commercial: $1,290.06
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Abd, Rt W/Image $2,181 $2,181 $1,308.60 – $1,744.80
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • Anthem BCBS — HPN: $1,744.80
  • Kaiser — Commercial: $1,653.20
  • Multiplan — Commercial: $1,679.37
  • USP Naphcare — Commercial: $1,308.60
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $250.18
Ultrasound of the abdomen, complete: 10 of 26 insurance plan rates
  • Aetna — Commercial: $196.81
  • Aetna — Medicare: $105.81
  • Ambetter — Marketplace: $105.81
  • Anthem BCBS — HMO/POS: $236.95
  • Anthem BCBS — Medicare: $105.81
  • Anthem BCBS — Pathways/Marketplace: $236.95
  • Anthem BCBS — PPO: $236.95
  • Caresource — Marketplace: $169.29
  • Cigna — IFP: $148.02
  • Cigna — Medicare: $105.81
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >/= 14 Wks Sngl Fetus $1,552.99 $1,552.99 $229.84 – $1,242.39
Pregnancy ultrasound (after the first trimester): 10 of 19 insurance plan rates
  • Aetna — Commercial: $691.08
  • Aetna — Medicare: $543.55
  • Ambetter — Marketplace: $229.84
  • Amerigroup — Medicaid: $252.52
  • Anthem BCBS — HMO/POS: $1,137.41
  • Anthem BCBS — HPN: $1,242.39
  • Anthem BCBS — Pathways/Marketplace: $1,137.41
  • Anthem BCBS — PPO: $1,181.05
  • Caresource — Commercial: $231.71
  • Cigna — Commercial: $918.59
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB US >/= 14 Wks Sngl Fetus $1,552.99 $1,552.99 $931.79 – $1,242.39
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans
  • Anthem BCBS — HPN: $1,242.39
  • Kaiser — Commercial: $1,177.17
  • Multiplan — Commercial: $1,195.80
  • USP Naphcare — Commercial: $931.79
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us > 14 wks sngl fetus Not listed in the file Not listed in the file $250.18
Pregnancy ultrasound (after the first trimester): 10 of 26 insurance plan rates
  • Aetna — Commercial: $218.69
  • Aetna — Medicare: $105.81
  • Ambetter — Marketplace: $105.81
  • Anthem BCBS — HMO/POS: $239.50
  • Anthem BCBS — Medicare: $105.81
  • Anthem BCBS — Pathways/Marketplace: $239.50
  • Anthem BCBS — PPO: $239.50
  • Caresource — Marketplace: $169.29
  • Cigna — IFP: $148.02
  • Cigna — Medicare: $105.81
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal $1,562.85 $1,562.85 $231.30 – $1,250.28
Transvaginal ultrasound: 10 of 19 insurance plan rates
  • Aetna — Commercial: $695.47
  • Aetna — Medicare: $547
  • Ambetter — Marketplace: $231.30
  • Amerigroup — Medicaid: $254.12
  • Anthem BCBS — HMO/POS: $1,144.63
  • Anthem BCBS — HPN: $1,250.28
  • Anthem BCBS — Pathways/Marketplace: $1,144.63
  • Anthem BCBS — PPO: $1,188.55
  • Caresource — Commercial: $233.18
  • Cigna — Commercial: $924.43
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US Transvaginal $1,562.85 $1,562.85 $937.71 – $1,250.28
Transvaginal ultrasound: rates for 4 insurance plans
  • Anthem BCBS — HPN: $1,250.28
  • Kaiser — Commercial: $1,184.64
  • Multiplan — Commercial: $1,203.39
  • USP Naphcare — Commercial: $937.71
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $250.18
Transvaginal ultrasound: 10 of 26 insurance plan rates
  • Aetna — Commercial: $215.45
  • Aetna — Medicare: $105.81
  • Ambetter — Marketplace: $105.81
  • Anthem BCBS — HMO/POS: $211.68
  • Anthem BCBS — Medicare: $105.81
  • Anthem BCBS — Pathways/Marketplace: $211.68
  • Anthem BCBS — PPO: $211.68
  • Caresource — Marketplace: $169.29
  • Cigna — IFP: $148.02
  • Cigna — Medicare: $105.81
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx Mammo Incl Cad Uni $892.40 $892.40 $132.08 – $713.92
Diagnostic mammogram, one breast: 10 of 19 insurance plan rates
  • Aetna — Commercial: $397.12
  • Aetna — Medicare: $312.34
  • Ambetter — Marketplace: $132.08
  • Amerigroup — Medicaid: $145.10
  • Anthem BCBS — HMO/POS: $653.59
  • Anthem BCBS — HPN: $713.92
  • Anthem BCBS — Pathways/Marketplace: $653.59
  • Anthem BCBS — PPO: $678.67
  • Caresource — Commercial: $133.15
  • Cigna — Commercial: $527.85
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Dx Mammo Incl Cad Uni $892.40 $892.40 $535.44 – $713.92
Diagnostic mammogram, one breast: rates for 4 insurance plans
  • Anthem BCBS — HPN: $713.92
  • Kaiser — Commercial: $676.44
  • Multiplan — Commercial: $687.15
  • USP Naphcare — Commercial: $535.44
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $204.01
Diagnostic mammogram, one breast: 10 of 26 insurance plan rates
  • Aetna — Commercial: $212.21
  • Aetna — Medicare: $121.91
  • Ambetter — Marketplace: $84.90
  • Anthem BCBS — HMO/POS: $236.28
  • Anthem BCBS — Medicare: $121.91
  • Anthem BCBS — Pathways/Marketplace: $236.28
  • Anthem BCBS — PPO: $236.28
  • Caresource — Marketplace: $195.06
  • Cigna — IFP: $113.10
  • Cigna — Medicare: $121.91
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx Mammo Incl Cad Bi $1,146 $1,146 $169.61 – $916.80
Diagnostic mammogram, both breasts: 10 of 19 insurance plan rates
  • Aetna — Commercial: $509.97
  • Aetna — Medicare: $401.10
  • Ambetter — Marketplace: $169.61
  • Amerigroup — Medicaid: $186.34
  • Anthem BCBS — HMO/POS: $839.33
  • Anthem BCBS — HPN: $916.80
  • Anthem BCBS — Pathways/Marketplace: $839.33
  • Anthem BCBS — PPO: $871.53
  • Caresource — Commercial: $170.98
  • Cigna — Commercial: $677.86
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Dx Mammo Incl Cad Bi $1,146 $1,146 $687.60 – $916.80
Diagnostic mammogram, both breasts: rates for 4 insurance plans
  • Anthem BCBS — HPN: $916.80
  • Kaiser — Commercial: $868.67
  • Multiplan — Commercial: $882.42
  • USP Naphcare — Commercial: $687.60
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $260.06
Diagnostic mammogram, both breasts: 10 of 26 insurance plan rates
  • Aetna — Commercial: $271.38
  • Aetna — Medicare: $153.54
  • Ambetter — Marketplace: $108.12
  • Anthem BCBS — HMO/POS: $302.23
  • Anthem BCBS — Medicare: $153.54
  • Anthem BCBS — Pathways/Marketplace: $302.23
  • Anthem BCBS — PPO: $302.23
  • Caresource — Marketplace: $245.66
  • Cigna — IFP: $145.08
  • Cigna — Medicare: $153.54
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr Mammo Bi Incl Cad $748.65 $748.65 $110.80 – $598.92
Screening mammogram, both breasts: 10 of 19 insurance plan rates
  • Aetna — Commercial: $333.15
  • Aetna — Medicare: $262.03
  • Ambetter — Marketplace: $110.80
  • Amerigroup — Medicaid: $121.73
  • Anthem BCBS — HMO/POS: $548.31
  • Anthem BCBS — HPN: $598.92
  • Anthem BCBS — Pathways/Marketplace: $548.31
  • Anthem BCBS — PPO: $569.35
  • Caresource — Commercial: $111.70
  • Cigna — Commercial: $442.83
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Scr Mammo Bi Incl Cad $748.65 $748.65 $449.19 – $598.92
Screening mammogram, both breasts: rates for 4 insurance plans
  • Anthem BCBS — HPN: $598.92
  • Kaiser — Commercial: $567.48
  • Multiplan — Commercial: $576.46
  • USP Naphcare — Commercial: $449.19
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $214.90
Screening mammogram, both breasts: 10 of 26 insurance plan rates
  • Aetna — Commercial: $224.37
  • Aetna — Medicare: $89.37
  • Ambetter — Marketplace: $89.37
  • Anthem BCBS — HMO/POS: $249.62
  • Anthem BCBS — Medicare: $89.37
  • Anthem BCBS — Pathways/Marketplace: $249.62
  • Anthem BCBS — PPO: $249.62
  • Caresource — Marketplace: $142.99
  • Cigna — IFP: $119.56
  • Cigna — Medicare: $89.37

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $13.97 – $25.09
Electrocardiogram (ECG/EKG) with reading: 10 of 18 insurance plan rates
  • Aetna — Medicare: $13.97
  • Ambetter — Marketplace: $13.97
  • Amerigroup — Medicaid: $25.09
  • Anthem BCBS — Medicare: $13.97
  • Caresource — Commercial: $25.09
  • Caresource — Marketplace: $22.35
  • Cigna — Medicare: $13.97
  • Clear Spring Health — Medicare: $14.67
  • Clover — Medicare: $14.67
  • Humana — Medicare: $13.97
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $13.97 – $37.62
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans
  • Aetna — Commercial: $37.62
  • Ambetter — Marketplace: $13.97
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lhc W/V Gram $24,190 $24,190 $3,580.12 – $19,352
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates
  • Aetna — Commercial: $10,764.55
  • Aetna — Medicare: $8,466.50
  • Ambetter — Marketplace: $3,580.12
  • Amerigroup — Medicaid: $3,933.29
  • Anthem BCBS — HMO/POS: $17,716.76
  • Anthem BCBS — HPN: $19,352
  • Anthem BCBS — Pathways/Marketplace: $17,716.76
  • Anthem BCBS — PPO: $18,396.50
  • Caresource — Commercial: $3,609.15
  • Cigna — Commercial: $14,308.38
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lhc W/V Gram $24,190 $24,190 $14,514 – $19,352
Left heart catheterization (diagnostic): rates for 4 insurance plans
  • Anthem BCBS — HPN: $19,352
  • Kaiser — Commercial: $18,336.02
  • Multiplan — Commercial: $18,626.30
  • USP Naphcare — Commercial: $14,514
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $1,466.33 – $10,807
Left heart catheterization (diagnostic): 10 of 25 insurance plan rates
  • Aetna — Commercial: $10,807
  • Aetna — Medicare: $3,200.20
  • Ambetter — Marketplace: $3,200.20
  • Anthem BCBS — HMO/POS: $1,466.33
  • Anthem BCBS — Medicare: $3,200.20
  • Anthem BCBS — Pathways/Marketplace: $1,466.33
  • Anthem BCBS — PPO: $1,466.33
  • Caresource — Marketplace: $5,120.33
  • Cigna — IFP: $4,386.95
  • Cigna — Medicare: $3,200.20
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete Eps W/Oinduction of Arrhythmia $16,101 $16,101 $2,382.95 – $12,880.80
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates
  • Aetna — Commercial: $7,164.94
  • Aetna — Medicare: $5,635.35
  • Ambetter — Marketplace: $2,382.95
  • Amerigroup — Medicaid: $2,618.02
  • Anthem BCBS — HMO/POS: $11,792.37
  • Anthem BCBS — HPN: $12,880.80
  • Anthem BCBS — Pathways/Marketplace: $11,792.37
  • Anthem BCBS — PPO: $12,244.81
  • Caresource — Commercial: $2,402.27
  • Cigna — Commercial: $9,523.74
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Complete Eps W/Oinduction of Arrhythmia $16,101 $16,101 $9,660.60 – $12,880.80
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans
  • Anthem BCBS — HPN: $12,880.80
  • Kaiser — Commercial: $12,204.56
  • Multiplan — Commercial: $12,397.77
  • USP Naphcare — Commercial: $9,660.60
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $5,814 – $13,967.24
Heart rhythm study (electrophysiology evaluation): 10 of 22 insurance plan rates
  • Aetna — Commercial: $5,978
  • Aetna — Medicare: $7,549.86
  • Ambetter — Marketplace: $7,549.86
  • Anthem BCBS — Medicare: $7,549.86
  • Caresource — Marketplace: $12,079.78
  • Cigna — IFP: $10,054.31
  • Cigna — Medicare: $7,549.86
  • Clear Spring Health — Medicare: $7,927.35
  • Clover — Medicare: $7,927.35
  • Humana — Medicare: $7,549.86
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Ep Eval Inc Trans Sept Cath, Insert Elect Cath, Induct Arrhyth, $71,012 $71,012 $10,509.78 – $56,809.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates
  • Aetna — Commercial: $31,600.34
  • Aetna — Medicare: $24,854.20
  • Ambetter — Marketplace: $10,509.78
  • Amerigroup — Medicaid: $11,546.55
  • Anthem BCBS — HMO/POS: $52,009.19
  • Anthem BCBS — HPN: $56,809.60
  • Anthem BCBS — Pathways/Marketplace: $52,009.19
  • Anthem BCBS — PPO: $54,004.63
  • Caresource — Commercial: $10,594.99
  • Cigna — Commercial: $42,003.60
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comp Ep Eval Inc Trans Sept Cath, Insert Elect Cath, Induct Arrhyth, $71,012 $71,012 $42,607.20 – $56,809.60
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans
  • Anthem BCBS — HPN: $56,809.60
  • Kaiser — Commercial: $53,827.10
  • Multiplan — Commercial: $54,679.24
  • USP Naphcare — Commercial: $42,607.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib Not listed in the file Not listed in the file $5,978 – $45,156.02
Heart rhythm study with ablation for atrial fibrillation: 10 of 25 insurance plan rates
  • Aetna — Commercial: $5,978
  • Aetna — Medicare: $24,408.66
  • Ambetter — Marketplace: $24,408.66
  • Anthem BCBS — HMO/POS: $14,570.60
  • Anthem BCBS — Medicare: $24,408.66
  • Anthem BCBS — Pathways/Marketplace: $14,570.60
  • Anthem BCBS — PPO: $15,725
  • Caresource — Marketplace: $39,053.85
  • Cigna — IFP: $31,974.85
  • Cigna — Medicare: $24,408.66
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnography $7,176 $7,176 $1,062.05 – $5,740.80
Sleep study (overnight, in a sleep lab): 10 of 19 insurance plan rates
  • Aetna — Commercial: $3,193.32
  • Aetna — Medicare: $2,511.60
  • Ambetter — Marketplace: $1,062.05
  • Amerigroup — Medicaid: $1,166.82
  • Anthem BCBS — HMO/POS: $5,255.70
  • Anthem BCBS — HPN: $5,740.80
  • Anthem BCBS — Pathways/Marketplace: $5,255.70
  • Anthem BCBS — PPO: $5,457.35
  • Caresource — Commercial: $1,070.66
  • Cigna — Commercial: $4,244.60
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Polysomnography $7,176 $7,176 $4,305.60 – $5,740.80
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans
  • Anthem BCBS — HPN: $5,740.80
  • Kaiser — Commercial: $5,439.41
  • Multiplan — Commercial: $5,525.52
  • USP Naphcare — Commercial: $4,305.60
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $1,012.26 – $3,502.34
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates
  • Aetna — Commercial: $1,487
  • Aetna — Medicare: $1,012.26
  • Ambetter — Marketplace: $1,012.26
  • Anthem BCBS — HMO/POS: $3,372.63
  • Anthem BCBS — Medicare: $1,012.26
  • Anthem BCBS — Pathways/Marketplace: $3,372.63
  • Anthem BCBS — PPO: $3,502.34
  • Caresource — Marketplace: $1,619.62
  • Cigna — IFP: $1,407.60
  • Cigna — Medicare: $1,012.26

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exercise Each 15 Minutes $403.65 $403.65 $59.74 – $322.92
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $179.62
  • Aetna — Medicare: $141.28
  • Ambetter — Marketplace: $59.74
  • Amerigroup — Medicaid: $65.63
  • Anthem BCBS — HMO/POS: $295.63
  • Anthem BCBS — HPN: $322.92
  • Anthem BCBS — Pathways/Marketplace: $295.63
  • Anthem BCBS — PPO: $306.98
  • Caresource — Commercial: $60.22
  • Cigna — Commercial: $238.76
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic Exercise Ea 15min $386.10 $386.10 $57.14 – $308.88
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates
  • Aetna — Commercial: $171.81
  • Aetna — Medicare: $135.14
  • Ambetter — Marketplace: $57.14
  • Amerigroup — Medicaid: $62.78
  • Anthem BCBS — HMO/POS: $282.78
  • Anthem BCBS — HPN: $308.88
  • Anthem BCBS — Pathways/Marketplace: $282.78
  • Anthem BCBS — PPO: $293.63
  • Caresource — Commercial: $57.61
  • Cigna — Commercial: $228.38
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Exercise Each 15 Minutes $403.65 $403.65 $242.19 – $322.92
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans
  • Anthem BCBS — HPN: $322.92
  • Kaiser — Commercial: $305.97
  • Multiplan — Commercial: $310.81
  • USP Naphcare — Commercial: $242.19
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Low Complex $726 $726 $107.45 – $580.80
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates
  • Aetna — Commercial: $323.07
  • Aetna — Medicare: $254.10
  • Ambetter — Marketplace: $107.45
  • Amerigroup — Medicaid: $118.05
  • Anthem BCBS — HMO/POS: $531.72
  • Anthem BCBS — HPN: $580.80
  • Anthem BCBS — Pathways/Marketplace: $531.72
  • Anthem BCBS — PPO: $552.12
  • Caresource — Commercial: $108.32
  • Cigna — Commercial: $429.43
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Pt Eval Low Complex $726 $726 $435.60 – $580.80
Physical therapy evaluation (low complexity): rates for 4 insurance plans
  • Anthem BCBS — HPN: $580.80
  • Kaiser — Commercial: $550.31
  • Multiplan — Commercial: $559.02
  • USP Naphcare — Commercial: $435.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $69.34 – $182.99
Physical therapy evaluation (low complexity): 10 of 18 insurance plan rates
  • Aetna — Commercial: $182.99
  • Aetna — Medicare: $98.03
  • Ambetter — Marketplace: $98.03
  • Anthem BCBS — Medicare: $98.03
  • Caresource — Marketplace: $156.85
  • Cigna — IFP: $160
  • Cigna — Medicare: $98.03
  • Clear Spring Health — Medicare: $102.93
  • Clover — Medicare: $102.93
  • Humana — Medicare: $98.03
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Mod Complex $743 $743 $109.96 – $594.40
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates
  • Aetna — Commercial: $330.64
  • Aetna — Medicare: $260.05
  • Ambetter — Marketplace: $109.96
  • Amerigroup — Medicaid: $120.81
  • Anthem BCBS — HMO/POS: $544.17
  • Anthem BCBS — HPN: $594.40
  • Anthem BCBS — Pathways/Marketplace: $544.17
  • Anthem BCBS — PPO: $565.05
  • Caresource — Commercial: $110.86
  • Cigna — Commercial: $439.48
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Pt Eval Mod Complex $743 $743 $445.80 – $594.40
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans
  • Anthem BCBS — HPN: $594.40
  • Kaiser — Commercial: $563.19
  • Multiplan — Commercial: $572.11
  • USP Naphcare — Commercial: $445.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $69.34 – $182.99
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates
  • Aetna — Commercial: $182.99
  • Aetna — Medicare: $98.03
  • Ambetter — Marketplace: $98.03
  • Anthem BCBS — Medicare: $98.03
  • Caresource — Marketplace: $156.85
  • Cigna — IFP: $160
  • Cigna — Medicare: $98.03
  • Clear Spring Health — Medicare: $102.93
  • Clover — Medicare: $102.93
  • Humana — Medicare: $98.03
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval High Complex $806.50 $806.50 $119.36 – $645.20
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates
  • Aetna — Commercial: $358.89
  • Aetna — Medicare: $282.27
  • Ambetter — Marketplace: $119.36
  • Amerigroup — Medicaid: $131.14
  • Anthem BCBS — HMO/POS: $590.68
  • Anthem BCBS — HPN: $645.20
  • Anthem BCBS — Pathways/Marketplace: $590.68
  • Anthem BCBS — PPO: $613.34
  • Caresource — Commercial: $120.33
  • Cigna — Commercial: $477.04
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Pt Eval High Complex $806.50 $806.50 $483.90 – $645.20
Physical therapy evaluation (high complexity): rates for 4 insurance plans
  • Anthem BCBS — HPN: $645.20
  • Kaiser — Commercial: $611.33
  • Multiplan — Commercial: $621
  • USP Naphcare — Commercial: $483.90
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $69.34 – $182.99
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates
  • Aetna — Commercial: $182.99
  • Aetna — Medicare: $98.03
  • Ambetter — Marketplace: $98.03
  • Anthem BCBS — Medicare: $98.03
  • Caresource — Marketplace: $156.85
  • Cigna — IFP: $160
  • Cigna — Medicare: $98.03
  • Clear Spring Health — Medicare: $102.93
  • Clover — Medicare: $102.93
  • Humana — Medicare: $98.03
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Individual Psychotherapy 30 Mins $541 $541 $80.07 – $432.80
Psychotherapy, 30 minutes: 10 of 19 insurance plan rates
  • Aetna — Commercial: $240.74
  • Aetna — Medicare: $189.35
  • Ambetter — Marketplace: $80.07
  • Amerigroup — Medicaid: $87.97
  • Anthem BCBS — HMO/POS: $396.23
  • Anthem BCBS — HPN: $432.80
  • Anthem BCBS — Pathways/Marketplace: $396.23
  • Anthem BCBS — PPO: $411.43
  • Caresource — Commercial: $80.72
  • Cigna — Commercial: $320
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Individual Psychotherapy 30 Mins $541 $541 $324.60 – $432.80
Psychotherapy, 30 minutes: rates for 4 insurance plans
  • Anthem BCBS — HPN: $432.80
  • Kaiser — Commercial: $410.08
  • Multiplan — Commercial: $416.57
  • USP Naphcare — Commercial: $324.60
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $53.22 – $110.46
Psychotherapy, 30 minutes: 10 of 18 insurance plan rates
  • Aetna — Medicare: $69.04
  • Ambetter — Marketplace: $69.04
  • Amerigroup — Medicaid: $53.22
  • Anthem BCBS — Medicare: $69.04
  • Caresource — Commercial: $53.22
  • Caresource — Marketplace: $110.46
  • Cigna — Medicare: $69.04
  • Clear Spring Health — Medicare: $72.49
  • Clover — Medicare: $72.49
  • Humana — Medicare: $69.04
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Individual Psychotherapy 45 Min $541 $541 $80.07 – $432.80
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates
  • Aetna — Commercial: $240.74
  • Aetna — Medicare: $189.35
  • Ambetter — Marketplace: $80.07
  • Amerigroup — Medicaid: $87.97
  • Anthem BCBS — HMO/POS: $396.23
  • Anthem BCBS — HPN: $432.80
  • Anthem BCBS — Pathways/Marketplace: $396.23
  • Anthem BCBS — PPO: $411.43
  • Caresource — Commercial: $80.72
  • Cigna — Commercial: $320
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Individual Psychotherapy 45 Min $541 $541 $324.60 – $432.80
Psychotherapy, 45 minutes: rates for 4 insurance plans
  • Anthem BCBS — HPN: $432.80
  • Kaiser — Commercial: $410.08
  • Multiplan — Commercial: $416.57
  • USP Naphcare — Commercial: $324.60
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $68.44 – $145.71
Psychotherapy, 45 minutes: 10 of 18 insurance plan rates
  • Aetna — Medicare: $91.07
  • Ambetter — Marketplace: $91.07
  • Amerigroup — Medicaid: $68.44
  • Anthem BCBS — Medicare: $91.07
  • Caresource — Commercial: $68.44
  • Caresource — Marketplace: $145.71
  • Cigna — Medicare: $91.07
  • Clear Spring Health — Medicare: $95.62
  • Clover — Medicare: $95.62
  • Humana — Medicare: $91.07
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Individual Psychotherapy 60 Min $658 $658 $97.38 – $526.40
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates
  • Aetna — Commercial: $292.81
  • Aetna — Medicare: $230.30
  • Ambetter — Marketplace: $97.38
  • Amerigroup — Medicaid: $106.99
  • Anthem BCBS — HMO/POS: $481.92
  • Anthem BCBS — HPN: $526.40
  • Anthem BCBS — Pathways/Marketplace: $481.92
  • Anthem BCBS — PPO: $500.41
  • Caresource — Commercial: $98.17
  • Cigna — Commercial: $389.21
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Individual Psychotherapy 60 Min $658 $658 $394.80 – $526.40
Psychotherapy, 60 minutes: rates for 4 insurance plans
  • Anthem BCBS — HPN: $526.40
  • Kaiser — Commercial: $498.76
  • Multiplan — Commercial: $506.66
  • USP Naphcare — Commercial: $394.80
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $111.16 – $215.76
Psychotherapy, 60 minutes: 10 of 18 insurance plan rates
  • Aetna — Medicare: $134.85
  • Ambetter — Marketplace: $134.85
  • Amerigroup — Medicaid: $111.16
  • Anthem BCBS — Medicare: $134.85
  • Caresource — Commercial: $111.16
  • Caresource — Marketplace: $215.76
  • Cigna — Medicare: $134.85
  • Clear Spring Health — Medicare: $141.59
  • Clover — Medicare: $141.59
  • Humana — Medicare: $134.85
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Psychotherapy W/O Patient Present 50 Min $1,054 $1,054 $155.99 – $843.20
Family psychotherapy, without the patient: 10 of 19 insurance plan rates
  • Aetna — Commercial: $469.03
  • Aetna — Medicare: $368.90
  • Ambetter — Marketplace: $155.99
  • Amerigroup — Medicaid: $171.38
  • Anthem BCBS — HMO/POS: $771.95
  • Anthem BCBS — HPN: $843.20
  • Anthem BCBS — Pathways/Marketplace: $771.95
  • Anthem BCBS — PPO: $801.57
  • Caresource — Commercial: $157.26
  • Cigna — Commercial: $623.44
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Family Psychotherapy W/O Patient Present 50 Min $1,054 $1,054 $632.40 – $843.20
Family psychotherapy, without the patient: rates for 4 insurance plans
  • Anthem BCBS — HPN: $843.20
  • Kaiser — Commercial: $798.93
  • Multiplan — Commercial: $811.58
  • USP Naphcare — Commercial: $632.40
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $79.36 – $295.75
Family psychotherapy, without the patient: 10 of 17 insurance plan rates
  • Aetna — Medicare: $159.86
  • Ambetter — Marketplace: $159.86
  • Anthem BCBS — Medicare: $159.86
  • Caresource — Marketplace: $255.78
  • Cigna — IFP: $214.65
  • Cigna — Medicare: $159.86
  • Clear Spring Health — Medicare: $167.86
  • Clover — Medicare: $167.86
  • Humana — Medicare: $159.86
  • Kaiser — Medicare: $159.86
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psy Family Therapy W Pt $1,054 $1,054 $155.99 – $843.20
Family psychotherapy, with the patient: 10 of 19 insurance plan rates
  • Aetna — Commercial: $469.03
  • Aetna — Medicare: $368.90
  • Ambetter — Marketplace: $155.99
  • Amerigroup — Medicaid: $171.38
  • Anthem BCBS — HMO/POS: $771.95
  • Anthem BCBS — HPN: $843.20
  • Anthem BCBS — Pathways/Marketplace: $771.95
  • Anthem BCBS — PPO: $801.57
  • Caresource — Commercial: $157.26
  • Cigna — Commercial: $623.44
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Psy Family Therapy W Pt $1,054 $1,054 $632.40 – $843.20
Family psychotherapy, with the patient: rates for 4 insurance plans
  • Anthem BCBS — HPN: $843.20
  • Kaiser — Commercial: $798.93
  • Multiplan — Commercial: $811.58
  • USP Naphcare — Commercial: $632.40
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $94.38 – $164.40
Family psychotherapy, with the patient: 10 of 18 insurance plan rates
  • Aetna — Medicare: $102.75
  • Ambetter — Marketplace: $102.75
  • Amerigroup — Medicaid: $94.38
  • Anthem BCBS — Medicare: $102.75
  • Caresource — Commercial: $94.38
  • Caresource — Marketplace: $164.40
  • Cigna — Medicare: $102.75
  • Clear Spring Health — Medicare: $107.89
  • Clover — Medicare: $107.89
  • Humana — Medicare: $102.75
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $24.33 – $38.93
Group psychotherapy: 10 of 18 insurance plan rates
  • Aetna — Medicare: $24.33
  • Ambetter — Marketplace: $24.33
  • Amerigroup — Medicaid: $30.74
  • Anthem BCBS — Medicare: $24.33
  • Caresource — Commercial: $30.74
  • Caresource — Marketplace: $38.93
  • Cigna — Medicare: $24.33
  • Clear Spring Health — Medicare: $25.55
  • Clover — Medicare: $25.55
  • Humana — Medicare: $24.33
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $26.67 – $170.27
Group psychotherapy: 10 of 17 insurance plan rates
  • Aetna — Medicare: $92.04
  • Ambetter — Marketplace: $92.04
  • Anthem BCBS — Medicare: $92.04
  • Caresource — Marketplace: $147.26
  • Cigna — IFP: $120
  • Cigna — Medicare: $92.04
  • Clear Spring Health — Medicare: $96.64
  • Clover — Medicare: $96.64
  • Humana — Medicare: $92.04
  • Kaiser — Medicare: $92.04

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Excision of Cyst,Fibro Adrenoma $12,668.40 $12,668.40 $1,874.92 – $10,134.72
Removal of breast growth (open surgery): 10 of 19 insurance plan rates
  • Aetna — Commercial: $5,637.44
  • Aetna — Medicare: $4,433.94
  • Ambetter — Marketplace: $1,874.92
  • Amerigroup — Medicaid: $2,059.88
  • Anthem BCBS — HMO/POS: $9,278.34
  • Anthem BCBS — HPN: $10,134.72
  • Anthem BCBS — Pathways/Marketplace: $9,278.34
  • Anthem BCBS — PPO: $9,634.32
  • Caresource — Commercial: $1,890.13
  • Cigna — Commercial: $7,493.36
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Excision of Cyst,Fibro Adrenoma $12,668.40 $12,668.40 $7,601.04 – $10,134.72
Removal of breast growth (open surgery): rates for 4 insurance plans
  • Anthem BCBS — HPN: $10,134.72
  • Kaiser — Commercial: $9,602.65
  • Multiplan — Commercial: $9,754.67
  • USP Naphcare — Commercial: $7,601.04
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $295.63 – $7,048.47
Removal of breast growth (open surgery): 10 of 28 insurance plan rates
  • Aetna — Commercial: $3,133
  • Aetna — Medicare: $3,809.98
  • Ambetter — Marketplace: $3,809.98
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Medicare: $3,809.98
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Caresource — Marketplace: $6,095.97
  • Cigna — Commercial: $3,856
  • Cigna — IFP: $5,131.68
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $5,018 – $23,683.65
Total hip replacement: 10 of 25 insurance plan rates
  • Aetna — Commercial: $5,018
  • Aetna — Medicare: $12,801.97
  • Ambetter — Marketplace: $12,801.97
  • Anthem BCBS — HMO/POS: $11,661.30
  • Anthem BCBS — Medicare: $12,801.97
  • Anthem BCBS — Pathways/Marketplace: $11,661.30
  • Anthem BCBS — PPO: $12,600
  • Caresource — Marketplace: $20,483.15
  • Cigna — IFP: $17,718.66
  • Cigna — Medicare: $12,801.97
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Total hip arthroplasty Not listed in the file Not listed in the file $1,911.42 – $3,058.27
Total hip replacement: 10 of 18 insurance plan rates
  • Aetna — Medicare: $1,911.42
  • Ambetter — Marketplace: $1,911.42
  • Amerigroup — Medicaid: $1,990.05
  • Anthem BCBS — Medicare: $1,911.42
  • Caresource — Commercial: $1,990.05
  • Caresource — Marketplace: $3,058.27
  • Cigna — Medicare: $1,911.42
  • Clear Spring Health — Medicare: $2,006.99
  • Clover — Medicare: $2,006.99
  • Humana — Medicare: $1,911.42
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total hip arthroplasty Not listed in the file Not listed in the file $879.25 – $1,406.81
Total hip replacement: 10 of 18 insurance plan rates
  • Aetna — Medicare: $879.25
  • Ambetter — Marketplace: $879.25
  • Amerigroup — Medicaid: $915.42
  • Anthem BCBS — Medicare: $879.25
  • Caresource — Commercial: $915.42
  • Caresource — Marketplace: $1,406.81
  • Cigna — Medicare: $879.25
  • Clear Spring Health — Medicare: $923.22
  • Clover — Medicare: $923.22
  • Humana — Medicare: $879.25
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $5,018 – $23,683.65
Total knee replacement: 10 of 25 insurance plan rates
  • Aetna — Commercial: $5,018
  • Aetna — Medicare: $12,801.97
  • Ambetter — Marketplace: $12,801.97
  • Anthem BCBS — HMO/POS: $12,815.90
  • Anthem BCBS — Medicare: $12,801.97
  • Anthem BCBS — Pathways/Marketplace: $12,815.90
  • Anthem BCBS — PPO: $13,887.50
  • Caresource — Marketplace: $20,483.15
  • Cigna — IFP: $17,718.66
  • Cigna — Medicare: $12,801.97
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Total knee arthroplasty Not listed in the file Not listed in the file $1,908.95 – $3,054.31
Total knee replacement: 10 of 18 insurance plan rates
  • Aetna — Medicare: $1,908.95
  • Ambetter — Marketplace: $1,908.95
  • Amerigroup — Medicaid: $2,105.03
  • Anthem BCBS — Medicare: $1,908.95
  • Caresource — Commercial: $2,105.03
  • Caresource — Marketplace: $3,054.31
  • Cigna — Medicare: $1,908.95
  • Clear Spring Health — Medicare: $2,004.39
  • Clover — Medicare: $2,004.39
  • Humana — Medicare: $1,908.95
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total knee arthroplasty Not listed in the file Not listed in the file $878.11 – $1,404.98
Total knee replacement: 10 of 18 insurance plan rates
  • Aetna — Medicare: $878.11
  • Ambetter — Marketplace: $878.11
  • Amerigroup — Medicaid: $968.31
  • Anthem BCBS — Medicare: $878.11
  • Caresource — Commercial: $968.31
  • Caresource — Marketplace: $1,404.98
  • Cigna — Medicare: $878.11
  • Clear Spring Health — Medicare: $922.02
  • Clover — Medicare: $922.02
  • Humana — Medicare: $878.11
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $168.88 – $3,856
Shoulder arthroscopy: shaving of shoulder bone: rates for 10 insurance plans
  • Aetna — Commercial: $3,133
  • Ambetter — Marketplace: $168.88
  • Cigna — Commercial: $3,856
  • Cigna — Local Plus: $1,684
  • Oscar Health — Commercial/Marketplace: $1,750
  • UHC — Charter: $1,473
  • UHC — Commercial: $1,473
  • UHC — Core: $1,326
  • UHC — Exchange/Marketplace: $1,178
  • UHC — Surest Health: $1,473
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $253.32 – $948.48
Shoulder arthroscopy: shaving of shoulder bone: 10 of 18 insurance plan rates
  • Aetna — Medicare: $253.32
  • Ambetter — Marketplace: $253.32
  • Amerigroup — Medicaid: $948.48
  • Anthem BCBS — Medicare: $253.32
  • Caresource — Commercial: $948.48
  • Caresource — Marketplace: $405.31
  • Cigna — Medicare: $253.32
  • Clear Spring Health — Medicare: $265.99
  • Clover — Medicare: $265.99
  • Humana — Medicare: $253.32
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 80|81|82 In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $27.02 – $101.17
Shoulder arthroscopy: shaving of shoulder bone: 10 of 16 insurance plan rates
  • Aetna — Medicare: $27.02
  • Ambetter — Marketplace: $27.02
  • Amerigroup — Medicaid: $101.17
  • Caresource — Commercial: $101.17
  • Caresource — Marketplace: $43.23
  • Cigna — Medicare: $27.02
  • Clear Spring Health — Medicare: $28.37
  • Clover — Medicare: $28.37
  • Humana — Medicare: $27.02
  • Kaiser — Medicare: $27.02
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $2,401 – $6,850
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 27 insurance plan rates
  • Aetna — Commercial: $3,923
  • Aetna — Medicare: $3,228.26
  • Ambetter — Marketplace: $3,228.26
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Medicare: $3,228.26
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Caresource — Marketplace: $5,165.21
  • Cigna — Commercial: $4,877
  • Cigna — IFP: $4,357.71
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $798.20 – $1,303.68
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 18 insurance plan rates
  • Aetna — Medicare: $814.80
  • Ambetter — Marketplace: $814.80
  • Amerigroup — Medicaid: $798.20
  • Anthem BCBS — Medicare: $814.80
  • Caresource — Commercial: $798.20
  • Caresource — Marketplace: $1,303.68
  • Cigna — Medicare: $814.80
  • Clear Spring Health — Medicare: $855.54
  • Clover — Medicare: $855.54
  • Humana — Medicare: $814.80
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $367.17 – $599.69
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 18 insurance plan rates
  • Aetna — Medicare: $374.81
  • Ambetter — Marketplace: $374.81
  • Amerigroup — Medicaid: $367.17
  • Anthem BCBS — Medicare: $374.81
  • Caresource — Commercial: $367.17
  • Caresource — Marketplace: $599.69
  • Cigna — Medicare: $374.81
  • Clear Spring Health — Medicare: $393.55
  • Clover — Medicare: $393.55
  • Humana — Medicare: $374.81
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $1,684 – $10,888.81
Removal of tonsils and adenoids (under age 12): 10 of 27 insurance plan rates
  • Aetna — Commercial: $3,133
  • Aetna — Medicare: $5,885.84
  • Ambetter — Marketplace: $5,885.84
  • Anthem BCBS — HMO/POS: $7,647.19
  • Anthem BCBS — Medicare: $5,885.84
  • Anthem BCBS — Pathways/Marketplace: $7,647.19
  • Anthem BCBS — PPO: $8,327.50
  • Caresource — Marketplace: $9,417.35
  • Cigna — Commercial: $3,856
  • Cigna — IFP: $7,884.08
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $195.02 – $375.44
Removal of tonsils and adenoids (under age 12): 10 of 18 insurance plan rates
  • Aetna — Medicare: $234.65
  • Ambetter — Marketplace: $234.65
  • Amerigroup — Medicaid: $195.02
  • Anthem BCBS — Medicare: $234.65
  • Caresource — Commercial: $195.02
  • Caresource — Marketplace: $375.44
  • Cigna — Medicare: $234.65
  • Clear Spring Health — Medicare: $246.38
  • Clover — Medicare: $246.38
  • Humana — Medicare: $234.65
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Upper GI Endoscopy, Diagnosis $3,677.70 $3,677.70 $544.30 – $2,942.16
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,636.58
  • Aetna — Medicare: $1,287.20
  • Ambetter — Marketplace: $544.30
  • Amerigroup — Medicaid: $597.99
  • Anthem BCBS — HMO/POS: $2,693.55
  • Anthem BCBS — HPN: $2,942.16
  • Anthem BCBS — Pathways/Marketplace: $2,693.55
  • Anthem BCBS — PPO: $2,796.89
  • Caresource — Commercial: $548.71
  • Cigna — Commercial: $2,175.36
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Upper GI Endoscopy, Diagnosis $3,677.70 $3,677.70 $2,206.62 – $2,942.16
Upper GI endoscopy (diagnostic): rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,942.16
  • Kaiser — Commercial: $2,787.70
  • Multiplan — Commercial: $2,831.83
  • USP Naphcare — Commercial: $2,206.62
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $137.90 – $4,275
Upper GI endoscopy (diagnostic): 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,438
  • Aetna — Medicare: $932.83
  • Ambetter — Marketplace: $932.83
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $932.83
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $1,492.53
  • Cigna — Commercial: $1,871
  • Cigna — IFP: $1,220.39
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $155.21 – $4,275
Upper GI endoscopy with biopsy: 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $932.83
  • Ambetter — Marketplace: $932.83
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $932.83
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $1,492.53
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,220.39
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $133.68 – $213.89
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates
  • Aetna — Medicare: $133.68
  • Ambetter — Marketplace: $133.68
  • Amerigroup — Medicaid: $210.98
  • Anthem BCBS — Medicare: $133.68
  • Caresource — Commercial: $210.98
  • Caresource — Marketplace: $213.89
  • Cigna — Medicare: $133.68
  • Clear Spring Health — Medicare: $140.36
  • Clover — Medicare: $140.36
  • Humana — Medicare: $133.68
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $214.67 – $4,275
Colonoscopy (diagnostic): 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $907.11
  • Ambetter — Marketplace: $907.11
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $907.11
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $1,451.38
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,230.45
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $290.95
Colonoscopy (diagnostic): rates for 3 insurance plans
  • Amerigroup — Medicaid: $290.95
  • Caresource — Commercial: $290.95
  • Peach State — Medicaid: $290.95
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 53 In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $164.60 – $263.36
Colonoscopy (diagnostic): 10 of 15 insurance plan rates
  • Aetna — Medicare: $164.60
  • Ambetter — Marketplace: $164.60
  • Anthem BCBS — Medicare: $164.60
  • Caresource — Marketplace: $263.36
  • Cigna — Medicare: $164.60
  • Clear Spring Health — Medicare: $172.83
  • Clover — Medicare: $172.83
  • Humana — Medicare: $164.60
  • Kaiser — Medicare: $164.60
  • Medicare — Medicare: $164.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $231.71 – $5,612.50
Colonoscopy with biopsy: 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $1,173.14
  • Ambetter — Marketplace: $1,173.14
  • Anthem BCBS — HMO/POS: $5,537.81
  • Anthem BCBS — Medicare: $1,173.14
  • Anthem BCBS — Pathways/Marketplace: $5,537.81
  • Anthem BCBS — PPO: $5,612.50
  • Caresource — Marketplace: $1,877.02
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,588.71
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $194.54 – $315.67
Colonoscopy with biopsy: 10 of 18 insurance plan rates
  • Aetna — Medicare: $194.54
  • Ambetter — Marketplace: $194.54
  • Amerigroup — Medicaid: $315.67
  • Anthem BCBS — Medicare: $194.54
  • Caresource — Commercial: $315.67
  • Caresource — Marketplace: $311.26
  • Cigna — Medicare: $194.54
  • Clear Spring Health — Medicare: $204.27
  • Clover — Medicare: $204.27
  • Humana — Medicare: $194.54
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy W/Lesion Removal $3,659.30 $3,659.30 $541.58 – $2,927.44
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,628.39
  • Aetna — Medicare: $1,280.75
  • Ambetter — Marketplace: $541.58
  • Amerigroup — Medicaid: $595
  • Anthem BCBS — HMO/POS: $2,680.07
  • Anthem BCBS — HPN: $2,927.44
  • Anthem BCBS — Pathways/Marketplace: $2,680.07
  • Anthem BCBS — PPO: $2,782.90
  • Caresource — Commercial: $545.97
  • Cigna — Commercial: $2,164.48
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colonoscopy W/Lesion Removal $3,659.30 $3,659.30 $2,195.58 – $2,927.44
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,927.44
  • Kaiser — Commercial: $2,773.75
  • Multiplan — Commercial: $2,817.66
  • USP Naphcare — Commercial: $2,195.58
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $307.25 – $5,612.50
Colonoscopy with removal of polyps (snare): 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $1,173.14
  • Ambetter — Marketplace: $1,173.14
  • Anthem BCBS — HMO/POS: $5,537.81
  • Anthem BCBS — Medicare: $1,173.14
  • Anthem BCBS — Pathways/Marketplace: $5,537.81
  • Anthem BCBS — PPO: $5,612.50
  • Caresource — Marketplace: $1,877.02
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,588.71
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, Endoscopic Ultrasound Examination $3,501.75 $3,501.75 $518.26 – $2,801.40
Ultrasound of the lower bowel by endoscope: 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,558.28
  • Aetna — Medicare: $1,225.61
  • Ambetter — Marketplace: $518.26
  • Amerigroup — Medicaid: $569.38
  • Anthem BCBS — HMO/POS: $2,564.68
  • Anthem BCBS — HPN: $2,801.40
  • Anthem BCBS — Pathways/Marketplace: $2,564.68
  • Anthem BCBS — PPO: $2,663.08
  • Caresource — Commercial: $522.46
  • Cigna — Commercial: $2,071.29
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Colonoscopy, Endoscopic Ultrasound Examination $3,501.75 $3,501.75 $2,101.05 – $2,801.40
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,801.40
  • Kaiser — Commercial: $2,654.33
  • Multiplan — Commercial: $2,696.35
  • USP Naphcare — Commercial: $2,101.05
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $1,173.14 – $5,612.50
Ultrasound of the lower bowel by endoscope: 10 of 27 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $1,173.14
  • Ambetter — Marketplace: $1,173.14
  • Anthem BCBS — HMO/POS: $5,537.81
  • Anthem BCBS — Medicare: $1,173.14
  • Anthem BCBS — Pathways/Marketplace: $5,537.81
  • Anthem BCBS — PPO: $5,612.50
  • Caresource — Marketplace: $1,877.02
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,588.71
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $907.11 – $4,275
Screening colonoscopy (not high risk): 10 of 27 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $907.11
  • Ambetter — Marketplace: $907.11
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $907.11
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $1,451.38
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $1,230.45
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $164.60 – $263.36
Screening colonoscopy (not high risk): 10 of 15 insurance plan rates
  • Aetna — Medicare: $164.60
  • Ambetter — Marketplace: $164.60
  • Anthem BCBS — Medicare: $164.60
  • Caresource — Marketplace: $263.36
  • Cigna — Medicare: $164.60
  • Clear Spring Health — Medicare: $172.83
  • Clover — Medicare: $172.83
  • Humana — Medicare: $164.60
  • Kaiser — Medicare: $164.60
  • Medicare — Medicare: $164.60
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $4,312 – $10,739.17
Gallbladder removal by laparoscope: 10 of 27 insurance plan rates
  • Aetna — Commercial: $4,312
  • Aetna — Medicare: $5,804.96
  • Ambetter — Marketplace: $5,804.96
  • Anthem BCBS — HMO/POS: $9,900
  • Anthem BCBS — Medicare: $5,804.96
  • Anthem BCBS — Pathways/Marketplace: $9,900
  • Anthem BCBS — PPO: $6,560.22
  • Caresource — Marketplace: $9,287.93
  • Cigna — Commercial: $9,641
  • Cigna — IFP: $7,768.04
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $483.63 – $854.12
Gallbladder removal by laparoscope: 10 of 18 insurance plan rates
  • Aetna — Medicare: $533.82
  • Ambetter — Marketplace: $533.82
  • Amerigroup — Medicaid: $483.63
  • Anthem BCBS — Medicare: $533.82
  • Caresource — Commercial: $483.63
  • Caresource — Marketplace: $854.12
  • Cigna — Medicare: $533.82
  • Clear Spring Health — Medicare: $560.51
  • Clover — Medicare: $560.51
  • Humana — Medicare: $533.82
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 80|81|82 In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $95.53 – $168.71
Gallbladder removal by laparoscope: 10 of 18 insurance plan rates
  • Aetna — Medicare: $105.45
  • Ambetter — Marketplace: $105.45
  • Amerigroup — Medicaid: $95.53
  • Anthem BCBS — Medicare: $105.45
  • Caresource — Commercial: $95.53
  • Caresource — Marketplace: $168.71
  • Cigna — Medicare: $105.45
  • Clear Spring Health — Medicare: $110.72
  • Clover — Medicare: $110.72
  • Humana — Medicare: $105.45
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $2,401 – $6,850
Groin (inguinal) hernia repair, age 5 or older: 10 of 27 insurance plan rates
  • Aetna — Commercial: $3,923
  • Aetna — Medicare: $3,511.27
  • Ambetter — Marketplace: $3,511.27
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Medicare: $3,511.27
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Caresource — Marketplace: $5,618.04
  • Cigna — Commercial: $4,877
  • Cigna — IFP: $4,657.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $545.72 – $1,255.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 18 insurance plan rates
  • Aetna — Medicare: $784.89
  • Ambetter — Marketplace: $784.89
  • Amerigroup — Medicaid: $545.72
  • Anthem BCBS — Medicare: $784.89
  • Caresource — Commercial: $545.72
  • Caresource — Marketplace: $1,255.82
  • Cigna — Medicare: $784.89
  • Clear Spring Health — Medicare: $824.13
  • Clover — Medicare: $824.13
  • Humana — Medicare: $784.89
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $294.69 – $678.14
Groin (inguinal) hernia repair, age 5 or older: 10 of 18 insurance plan rates
  • Aetna — Medicare: $423.84
  • Ambetter — Marketplace: $423.84
  • Amerigroup — Medicaid: $294.69
  • Anthem BCBS — Medicare: $423.84
  • Caresource — Commercial: $294.69
  • Caresource — Marketplace: $678.14
  • Cigna — Medicare: $423.84
  • Clear Spring Health — Medicare: $445.03
  • Clover — Medicare: $445.03
  • Humana — Medicare: $423.84
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy Prostate Needle/Punch $7,634.85 $7,634.85 $1,129.96 – $6,107.88
Prostate biopsy: 10 of 19 insurance plan rates
  • Aetna — Commercial: $3,397.51
  • Aetna — Medicare: $2,672.20
  • Ambetter — Marketplace: $1,129.96
  • Amerigroup — Medicaid: $1,241.43
  • Anthem BCBS — HMO/POS: $5,591.76
  • Anthem BCBS — HPN: $6,107.88
  • Anthem BCBS — Pathways/Marketplace: $5,591.76
  • Anthem BCBS — PPO: $5,806.30
  • Caresource — Commercial: $1,139.12
  • Cigna — Commercial: $4,516.01
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy, Prostate $7,634.85 $7,634.85 $1,129.96 – $6,107.88
Prostate biopsy: 10 of 19 insurance plan rates
  • Aetna — Commercial: $3,397.51
  • Aetna — Medicare: $2,672.20
  • Ambetter — Marketplace: $1,129.96
  • Amerigroup — Medicaid: $1,241.43
  • Anthem BCBS — HMO/POS: $5,591.76
  • Anthem BCBS — HPN: $6,107.88
  • Anthem BCBS — Pathways/Marketplace: $5,591.76
  • Anthem BCBS — PPO: $5,806.30
  • Caresource — Commercial: $1,139.12
  • Cigna — Commercial: $4,516.01
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Biopsy Prostate Needle/Punch $7,634.85 $7,634.85 $4,580.91 – $6,107.88
Prostate biopsy: rates for 4 insurance plans
  • Anthem BCBS — HPN: $6,107.88
  • Kaiser — Commercial: $5,787.22
  • Multiplan — Commercial: $5,878.83
  • USP Naphcare — Commercial: $4,580.91
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $4,312 – $19,163.68
Prostate removal by laparoscope (radical prostatectomy): 10 of 25 insurance plan rates
  • Aetna — Commercial: $4,312
  • Aetna — Medicare: $10,358.75
  • Ambetter — Marketplace: $10,358.75
  • Anthem BCBS — HMO/POS: $12,815.90
  • Anthem BCBS — Medicare: $10,358.75
  • Anthem BCBS — Pathways/Marketplace: $12,815.90
  • Anthem BCBS — PPO: $13,887.50
  • Caresource — Marketplace: $16,574
  • Cigna — IFP: $13,858.29
  • Cigna — Medicare: $10,358.75
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $968.63 – $1,549.82
Prostate removal by laparoscope (radical prostatectomy): 10 of 18 insurance plan rates
  • Aetna — Medicare: $968.63
  • Ambetter — Marketplace: $968.63
  • Amerigroup — Medicaid: $1,154.99
  • Anthem BCBS — Medicare: $968.63
  • Caresource — Commercial: $1,154.99
  • Caresource — Marketplace: $1,549.82
  • Cigna — Medicare: $968.63
  • Clear Spring Health — Medicare: $1,017.07
  • Clover — Medicare: $1,017.07
  • Humana — Medicare: $968.63
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 80|81|82 In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $186.72 – $298.76
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates
  • Ambetter — Marketplace: $186.72
  • Amerigroup — Medicaid: $222.65
  • Anthem BCBS — Medicare: $186.72
  • Caresource — Commercial: $222.65
  • Caresource — Marketplace: $298.76
  • Clear Spring Health — Medicare: $196.06
  • Clover — Medicare: $196.06
  • Humana — Medicare: $186.72
  • Kaiser — Medicare: $186.72
  • Medicare — Medicare: $186.72
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy, Biopsy $13,168.20 $13,168.20 $1,948.89 – $10,534.56
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates
  • Aetna — Commercial: $5,859.85
  • Aetna — Medicare: $4,608.87
  • Ambetter — Marketplace: $1,948.89
  • Amerigroup — Medicaid: $2,141.15
  • Anthem BCBS — HMO/POS: $9,644.39
  • Anthem BCBS — HPN: $10,534.56
  • Anthem BCBS — Pathways/Marketplace: $9,644.39
  • Anthem BCBS — PPO: $10,014.42
  • Caresource — Commercial: $1,964.70
  • Cigna — Commercial: $7,788.99
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hysteroscopy, Biopsy $13,168.20 $13,168.20 $7,900.92 – $10,534.56
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans
  • Anthem BCBS — HPN: $10,534.56
  • Kaiser — Commercial: $9,981.50
  • Multiplan — Commercial: $10,139.51
  • USP Naphcare — Commercial: $7,900.92
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $222.79 – $13,168.20
Hysteroscopy with biopsy of the uterus lining: 10 of 28 insurance plan rates
  • Aetna — Commercial: $3,133
  • Aetna — Medicare: $3,163.50
  • Ambetter — Marketplace: $3,163.50
  • Anthem BCBS — HMO/POS: $13,168.20
  • Anthem BCBS — Medicare: $3,163.50
  • Anthem BCBS — Pathways/Marketplace: $13,168.20
  • Anthem BCBS — PPO: $13,168.20
  • Caresource — Marketplace: $5,061.60
  • Cigna — Commercial: $3,856
  • Cigna — IFP: $4,208.98
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj of Sub Spinal Canal Lower Back/Sacrum; W/Image $3,743.25 $3,743.25 $554 – $2,994.60
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,665.75
  • Aetna — Medicare: $1,310.14
  • Ambetter — Marketplace: $554
  • Amerigroup — Medicaid: $608.65
  • Anthem BCBS — HMO/POS: $2,741.56
  • Anthem BCBS — HPN: $2,994.60
  • Anthem BCBS — Pathways/Marketplace: $2,741.56
  • Anthem BCBS — PPO: $2,846.74
  • Caresource — Commercial: $558.49
  • Cigna — Commercial: $2,214.13
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Inj of Sub Spinal Canal Lower Back/Sacrum; W/Image $3,743.25 $3,743.25 $2,245.95 – $2,994.60
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,994.60
  • Kaiser — Commercial: $2,837.38
  • Multiplan — Commercial: $2,882.30
  • USP Naphcare — Commercial: $2,245.95
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $87.92 – $4,275
Spinal injection, lower back (epidural), with imaging guidance: 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,438
  • Aetna — Medicare: $689.03
  • Ambetter — Marketplace: $689.03
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $689.03
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $1,102.45
  • Cigna — Commercial: $1,871
  • Cigna — IFP: $931.01
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inject Anest Txforamen L/S Sng $4,064.10 $4,064.10 $601.49 – $3,251.28
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,808.52
  • Aetna — Medicare: $1,422.44
  • Ambetter — Marketplace: $601.49
  • Amerigroup — Medicaid: $660.82
  • Anthem BCBS — HMO/POS: $2,976.55
  • Anthem BCBS — HPN: $3,251.28
  • Anthem BCBS — Pathways/Marketplace: $2,976.55
  • Anthem BCBS — PPO: $3,090.75
  • Caresource — Commercial: $606.36
  • Cigna — Commercial: $2,403.92
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bil Inject Txforamen Epi L/S Sngl $5,900.81 $5,900.81 $873.32 – $4,720.65
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates
  • Aetna — Commercial: $2,625.86
  • Aetna — Medicare: $2,065.28
  • Ambetter — Marketplace: $873.32
  • Amerigroup — Medicaid: $959.47
  • Anthem BCBS — HMO/POS: $4,321.75
  • Anthem BCBS — HPN: $4,720.65
  • Anthem BCBS — Pathways/Marketplace: $4,321.75
  • Anthem BCBS — PPO: $4,487.57
  • Caresource — Commercial: $880.40
  • Cigna — Commercial: $3,490.33
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Inject Anest Txforamen L/S Sng $4,064.10 $4,064.10 $2,438.46 – $3,251.28
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans
  • Anthem BCBS — HPN: $3,251.28
  • Kaiser — Commercial: $3,080.59
  • Multiplan — Commercial: $3,129.36
  • USP Naphcare — Commercial: $2,438.46
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $311.31 – $5,612.50
Carpal tunnel release: 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $1,942.93
  • Ambetter — Marketplace: $1,942.93
  • Anthem BCBS — HMO/POS: $5,537.81
  • Anthem BCBS — Medicare: $1,942.93
  • Anthem BCBS — Pathways/Marketplace: $5,537.81
  • Anthem BCBS — PPO: $5,612.50
  • Caresource — Marketplace: $3,108.69
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $2,599.38
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $472.26 – $1,055.33
Carpal tunnel release: 10 of 18 insurance plan rates
  • Aetna — Medicare: $659.58
  • Ambetter — Marketplace: $659.58
  • Amerigroup — Medicaid: $472.26
  • Anthem BCBS — Medicare: $659.58
  • Caresource — Commercial: $472.26
  • Caresource — Marketplace: $1,055.33
  • Cigna — Medicare: $659.58
  • Clear Spring Health — Medicare: $692.56
  • Clover — Medicare: $692.56
  • Humana — Medicare: $659.58
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $239.28 – $534.70
Carpal tunnel release: 10 of 18 insurance plan rates
  • Aetna — Medicare: $334.19
  • Ambetter — Marketplace: $334.19
  • Amerigroup — Medicaid: $239.28
  • Anthem BCBS — Medicare: $334.19
  • Caresource — Commercial: $239.28
  • Caresource — Marketplace: $534.70
  • Cigna — Medicare: $334.19
  • Clear Spring Health — Medicare: $350.90
  • Clover — Medicare: $350.90
  • Humana — Medicare: $334.19
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Yag Laser Capsulotomy $2,501.25 $2,501.25 $370.18 – $2,001
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates
  • Aetna — Commercial: $1,113.06
  • Aetna — Medicare: $875.44
  • Ambetter — Marketplace: $370.18
  • Amerigroup — Medicaid: $406.70
  • Anthem BCBS — HMO/POS: $1,831.92
  • Anthem BCBS — HPN: $2,001
  • Anthem BCBS — Pathways/Marketplace: $1,831.92
  • Anthem BCBS — PPO: $1,902.20
  • Caresource — Commercial: $373.19
  • Cigna — Commercial: $1,479.49
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Yag Laser Capsulotomy $2,501.25 $2,501.25 $1,500.75 – $2,001
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans
  • Anthem BCBS — HPN: $2,001
  • Kaiser — Commercial: $1,895.95
  • Multiplan — Commercial: $1,925.96
  • USP Naphcare — Commercial: $1,500.75
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $156.97 – $4,275
Laser treatment of clouding after cataract surgery: 10 of 28 insurance plan rates
  • Aetna — Commercial: $2,891
  • Aetna — Medicare: $545.84
  • Ambetter — Marketplace: $545.84
  • Anthem BCBS — HMO/POS: $3,933.13
  • Anthem BCBS — Medicare: $545.84
  • Anthem BCBS — Pathways/Marketplace: $3,933.13
  • Anthem BCBS — PPO: $4,275
  • Caresource — Marketplace: $873.34
  • Cigna — Commercial: $2,836
  • Cigna — IFP: $782.55
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $2,269.23 – $8,847
Cataract removal with lens implant: 10 of 27 insurance plan rates
  • Aetna — Commercial: $4,312
  • Aetna — Medicare: $2,269.23
  • Ambetter — Marketplace: $2,269.23
  • Anthem BCBS — HMO/POS: $5,154.24
  • Anthem BCBS — Medicare: $2,269.23
  • Anthem BCBS — Pathways/Marketplace: $5,154.24
  • Anthem BCBS — PPO: $5,154.24
  • Caresource — Marketplace: $3,630.77
  • Cigna — Commercial: $8,847
  • Cigna — IFP: $3,137.34
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $784.85 – $1,255.75
Cataract removal with lens implant: 10 of 18 insurance plan rates
  • Aetna — Medicare: $784.85
  • Ambetter — Marketplace: $784.85
  • Amerigroup — Medicaid: $966.53
  • Anthem BCBS — Medicare: $784.85
  • Caresource — Commercial: $966.53
  • Caresource — Marketplace: $1,255.75
  • Cigna — Medicare: $784.85
  • Clear Spring Health — Medicare: $824.09
  • Clover — Medicare: $824.09
  • Humana — Medicare: $784.85
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $366.26 – $586.02
Cataract removal with lens implant: 10 of 18 insurance plan rates
  • Aetna — Medicare: $366.26
  • Ambetter — Marketplace: $366.26
  • Amerigroup — Medicaid: $451.05
  • Anthem BCBS — Medicare: $366.26
  • Caresource — Commercial: $451.05
  • Caresource — Marketplace: $586.02
  • Cigna — Medicare: $366.26
  • Clear Spring Health — Medicare: $384.57
  • Clover — Medicare: $384.57
  • Humana — Medicare: $366.26

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,394.62 – $3,831.39
Vaginal delivery, with care before and after: 10 of 18 insurance plan rates
  • Aetna — Medicare: $2,394.62
  • Ambetter — Marketplace: $2,394.62
  • Amerigroup — Medicaid: $2,470.87
  • Anthem BCBS — Medicare: $2,394.62
  • Caresource — Commercial: $2,470.87
  • Caresource — Marketplace: $3,831.39
  • Cigna — Medicare: $2,394.62
  • Clear Spring Health — Medicare: $2,514.35
  • Clover — Medicare: $2,514.35
  • Humana — Medicare: $2,394.62
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $1,644.08 – $6,850
Vaginal delivery, with care before and after: rates for 5 insurance plans
  • Ambetter — Marketplace: $2,394.62
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Peach State — Medicaid: $1,644.08
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $2,664.76 – $4,263.62
Cesarean delivery (C-section), with care before and after: 10 of 18 insurance plan rates
  • Aetna — Medicare: $2,664.76
  • Ambetter — Marketplace: $2,664.76
  • Amerigroup — Medicaid: $2,752.40
  • Anthem BCBS — Medicare: $2,664.76
  • Caresource — Commercial: $2,752.40
  • Caresource — Marketplace: $4,263.62
  • Cigna — Medicare: $2,664.76
  • Clear Spring Health — Medicare: $2,798
  • Clover — Medicare: $2,798
  • Humana — Medicare: $2,664.76
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $1,640.22 – $6,850
Cesarean delivery (C-section), with care before and after: rates for 5 insurance plans
  • Ambetter — Marketplace: $2,664.76
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Peach State — Medicaid: $1,640.22
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,513.49 – $4,021.58
Vaginal delivery after a previous C-section, with care before and after: 10 of 18 insurance plan rates
  • Aetna — Medicare: $2,513.49
  • Ambetter — Marketplace: $2,513.49
  • Amerigroup — Medicaid: $2,595.61
  • Anthem BCBS — Medicare: $2,513.49
  • Caresource — Commercial: $2,595.61
  • Caresource — Marketplace: $4,021.58
  • Cigna — Medicare: $2,513.49
  • Clear Spring Health — Medicare: $2,639.16
  • Clover — Medicare: $2,639.16
  • Humana — Medicare: $2,513.49
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $1,687.15 – $6,850
Vaginal delivery after a previous C-section, with care before and after: rates for 5 insurance plans
  • Ambetter — Marketplace: $2,513.49
  • Anthem BCBS — HMO/POS: $6,592.50
  • Anthem BCBS — Pathways/Marketplace: $6,592.50
  • Anthem BCBS — PPO: $6,850
  • Peach State — Medicaid: $1,687.15

Source: Grady Memorial Hospital’s standard charges file (gradyhealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 1, 2026.

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
Address80 Jesse Hill, Jr Drive SE, Atlanta, GA 30303
CountyFulton County
StateGeorgia
Phone(404) 616‑1000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number110079
Name in Medicare recordsGRADY MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Official websitegradyhealth.org
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. Grady Memorial Hospital | Grady Health — gradyhealth.org
  2. Level I Trauma Center & Emergency Care in Atlanta | Grady Health — gradyhealth.org
  3. Stroke and Neuroscience Center Services | Grady Health — gradyhealth.org
  4. Outpatient Neurology Services | Grady Health — gradyhealth.org
  5. 24/7 SAFE & Rape Crisis Center | Grady Health — gradyhealth.org
  6. Imaging and Radiology Center: Diagnostic Imaging | Grady Health — gradyhealth.org
  7. Trauma Recovery Care | Grady Health — gradyhealth.org
  8. Heart & Vascular Center: Expert Cardiovascular Care | Grady Health — gradyhealth.org
  9. Heart Failure Clinic & Advanced Heart Care | Grady Health — gradyhealth.org
  10. Cardiac Catheterization & Interventional Cardiology | Grady Health — gradyhealth.org
  11. Heart and Vascular Surgery: CABG, Valve & Aortic Procedures | Grady Health — gradyhealth.org
  12. Atlanta Electrophysiology Care | Grady Health — gradyhealth.org
  13. Vascular Treatments in Atlanta | Grady Health — gradyhealth.org