Does Granville Health Systems have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Granville Health Systems. In a medical emergency, call 911.

Where is Granville Health Systems?

1010 College St, Oxford, NC 27565, in Granville County, North Carolina.

What is the phone number of Granville Health Systems?

(919) 690-3000, as listed by Medicare (CMS).

What is the Medicare star rating of Granville Health Systems?

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

Granville Health Systems — Oxford, NC

Quick answers

Does Granville Health Systems have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Granville Health Systems. In a medical emergency, call 911.
Where is Granville Health Systems?: 1010 College St, Oxford, NC 27565, in Granville County, North Carolina.
What is the phone number of Granville Health Systems?: (919) 690-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Granville Health Systems?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Birthing Center
Imaging/Radiology
Surgical Services
Laboratory
Intensive Care Unit
Sleep Medicine

Conditions treated^[4]

Sleep-related disorders

Procedures^[4]

Digital & 3D Mammography
Surgical services
Laboratory services
Radiology and imaging

Programs and centers^[4]

Childbirth education and breastfeeding support classes
Birthing Center
Intensive Care Unit
Childbirth education classes

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Parking	Free parking for patients and visitors at Granville Medical Center, available 24 hours a day, seven days a week^[5]

Doctors and clinicians (173)

173 doctors and other clinicians list Granville Health Systems 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 (173)

Abhyudaya Joshi, MDInternal Medicine
Adam B. BrewerPhysician Assistant
Adam M. Flowe, CNACertified Registered Nurse Anesthetist (CRNA)
Adeel M. Siddiqui, MDInternal Medicine
Ahren C. Rittershaus, MDPathology
Akiva D. Gimpelevich, DOObstetrics/Gynecology
Albin J. Abraham, MDGastroenterology
Alexa K. NambaFamily Practice
Alexia EdwardsNurse Practitioner
Alexie D. RiofrioDiagnostic Radiology
Alyssa R. Krueger, DOFamily Practice
Amarnath A. Kathresal, MDNephrology
Amber H. Eberhart, PAPhysician Assistant
Amr H. Wardeh, MDDiagnostic Radiology
Andrew I. Choi, MDDiagnostic Radiology
Andrew R. Zimmerman, PAPhysician Assistant
Anil Nagavalli, DODiagnostic Radiology
Anita E. RogersPhysician Assistant
Anna V. White, PAPhysician Assistant
April E. Welborn, MDPsychiatry
Arash Chehrazi, MDDiagnostic Radiology
Ashish Singh, MDCritical Care (Intensivists)
Ashley G. Merritt, MDDiagnostic Radiology
Ashley M. Currin, NPNurse Practitioner

And 149 more: the button below opens the full list.

Other emergency rooms nearby

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

Maria Parham Medical Center10 mi · Henderson, NC · Acute Care Hospital
Central Regional Hospital17 mi · Butner, NC · Psychiatric Hospital
Person Memorial Hospital22 mi · Roxboro, NC · Acute Care Hospital
Duke Regional Hospital26 mi · Durham, NC · Acute Care Hospital
Durham VA Medical Center29 mi · Durham, NC · Federal/VA Acute Care Hospital

Other hospitals nearby

North Carolina Specialty Hospital26 mi · Durham, NC · Acute Care Hospital
Select Specialty Hospital Durham Inc26 mi · Durham, NC · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Brantwood Nh & Retirement Center0.0 mi · Oxford, NC · 4 of 5 stars
Oxford Health and Rehabilitation Center0.3 mi · Oxford, NC · 1 of 5 stars
Senior Citizens Home7.8 mi · Henderson, NC · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Kindred Hospice3.9 mi · Oxford, NC
Community Home Care of Vance County10 mi · Henderson, NC · 4 of 5 stars
Medi Home Health and Hospice22 mi · Roxboro, NC

All hospice providers in the state →

Home health agencies

3HC10 mi · Henderson, NC
Bayada Home Health Care, Inc22 mi · Roxboro, NC
Duke Home Health24 mi · Durham, NC

All home health agencies in the state →

Dialysis facilities

FMC Dialysis Services Neuse River3.9 mi · Oxford, NC · 3 of 5 stars
FMS Dialysis Services of Oxford3.9 mi · Oxford, NC · 3 of 5 stars
DaVita Vance County Dialysis10 mi · Henderson, NC · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

James E Davis Ambulatory Surg24 mi · Durham, NC
Triangle Vascular Surgery Center24 mi · Durham, NC
W.F. Endoscopy Center, LLC24 mi · Wake Forest, NC

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

Granville Vance District Health Department Granville County location (GCHD)0.1 mi · Oxford, NC · Community health center
Carolina Fellows Family Dentistry - GVCH Dental Clinic1.5 mi · Oxford, NC · Community health center
Granville Vance District Health Department - Vance County Location (VCHD)8.1 mi · Henderson, NC · Community health center

Clinics and urgent care

Granville Internal Medicine and Geriatrics3.9 mi · Oxford, NC · Rural health clinic
Mainstreet and Kidsstreet of North Carolina PLLC3.9 mi · Oxford, NC · Urgent care center
Mainstreet Family Care - Oxford3.9 mi · Oxford, NC · Rural health clinic

Pharmacies

Best Care3.9 mi · Oxford, NC · Pharmacy
North Carolina CVS Pharmacy LLC3.9 mi · Oxford, NC · Pharmacy
Professional Pharmacy of Oxford3.9 mi · Oxford, NC · Pharmacy

Assisted living nearby

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

Dunmore Senior Living of Oxford3.9 mi · Oxford, NC
Heritage Meadows Long Term Care3.9 mi · Oxford, NC
Toney Rest Home3.9 mi · Oxford, NC
Tre' More Manor ALF3.9 mi · Oxford, NC

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	66%National average: 72%
Would definitely recommend the hospital	64%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	60%National average: 74%
Area around the room “always” quiet at night	59%National average: 60%
Completed surveys	118Response rate: 14%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.418No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	12.1%
Deaths within 30 days: pneumonia patients	16.4%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	16.9%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.37No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	20.6%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	19.6%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	191 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	82%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 North Carolina Best hospitals in North Carolina

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 55 common services exactly as Granville Health Systems lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E&M,NEW PT, PSYCHMD-PROF LVL 3	$164	$131.20	$94.79 – $164
New patient office visit (about 30–44 minutes): rates for 9 insurance plans AETNA — AETNA: $138.74 BCBS — BCBS: $94.79 CIGNA — CIGNA: $118.90 HUMANA — HUMANA: $131.20 MEDCOST — MEDCOST: $101.52 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $164 SELF PAY — SELF PAY: $131.20 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $164 UNITED HEALTHCARE — UNITED HEALTHCARE: $129.56
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PMC MD INITIAL LEVEL 3	$250	$200	$144.50 – $250
New patient office visit (about 30–44 minutes): rates for 9 insurance plans AETNA — AETNA: $211.50 BCBS — BCBS: $144.50 CIGNA — CIGNA: $181.25 HUMANA — HUMANA: $200 MEDCOST — MEDCOST: $154.75 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $250 SELF PAY — SELF PAY: $200 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $250 UNITED HEALTHCARE — UNITED HEALTHCARE: $197.50
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM MD INTERME-NEW PT	$255	$204	$147.39 – $255
New patient office visit (about 30–44 minutes): rates for 9 insurance plans AETNA — AETNA: $215.73 BCBS — BCBS: $147.39 CIGNA — CIGNA: $184.88 HUMANA — HUMANA: $204 MEDCOST — MEDCOST: $157.84 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $255 SELF PAY — SELF PAY: $204 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $255 UNITED HEALTHCARE — UNITED HEALTHCARE: $201.45
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E&M,NEW PT PSYCHMD PROF LVL 4	$336	$268.80	$194.21 – $336
New patient office visit (about 45–59 minutes): rates for 9 insurance plans AETNA — AETNA: $284.26 BCBS — BCBS: $194.21 CIGNA — CIGNA: $243.60 HUMANA — HUMANA: $268.80 MEDCOST — MEDCOST: $207.98 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $336 SELF PAY — SELF PAY: $268.80 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $336 UNITED HEALTHCARE — UNITED HEALTHCARE: $265.44
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PMC MD INITIAL LEVEL 4	$320	$256	$184.96 – $320
New patient office visit (about 45–59 minutes): rates for 9 insurance plans AETNA — AETNA: $270.72 BCBS — BCBS: $184.96 CIGNA — CIGNA: $232 HUMANA — HUMANA: $256 MEDCOST — MEDCOST: $198.08 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $320 SELF PAY — SELF PAY: $256 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $320 UNITED HEALTHCARE — UNITED HEALTHCARE: $252.80
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM MD EXT SER-NEW PT	$357	$285.60	$206.35 – $357
New patient office visit (about 45–59 minutes): rates for 9 insurance plans AETNA — AETNA: $302.02 BCBS — BCBS: $206.35 CIGNA — CIGNA: $258.82 HUMANA — HUMANA: $285.60 MEDCOST — MEDCOST: $220.98 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $357 SELF PAY — SELF PAY: $285.60 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $357 UNITED HEALTHCARE — UNITED HEALTHCARE: $282.03
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E&M,NEW PT PSYCHMD PROF LVL 5	$575	$460	$332.35 – $575
New patient office visit (about 60–74 minutes): rates for 9 insurance plans AETNA — AETNA: $486.45 BCBS — BCBS: $332.35 CIGNA — CIGNA: $416.88 HUMANA — HUMANA: $460 MEDCOST — MEDCOST: $355.93 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $575 SELF PAY — SELF PAY: $460 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $575 UNITED HEALTHCARE — UNITED HEALTHCARE: $454.25
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PMC MD INITIAL LEVEL 5	$400	$320	$231.20 – $400
New patient office visit (about 60–74 minutes): rates for 9 insurance plans AETNA — AETNA: $338.40 BCBS — BCBS: $231.20 CIGNA — CIGNA: $290 HUMANA — HUMANA: $320 MEDCOST — MEDCOST: $247.60 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $400 SELF PAY — SELF PAY: $320 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $400 UNITED HEALTHCARE — UNITED HEALTHCARE: $316
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM MD COMPREH-NEW PT	$311	$248.80	$179.76 – $311
New patient office visit (about 60–74 minutes): rates for 9 insurance plans AETNA — AETNA: $263.11 BCBS — BCBS: $179.76 CIGNA — CIGNA: $225.47 HUMANA — HUMANA: $248.80 MEDCOST — MEDCOST: $192.51 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $311 SELF PAY — SELF PAY: $248.80 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $311 UNITED HEALTHCARE — UNITED HEALTHCARE: $245.69
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E&M,PSYCHMD, LEVEL 3 PROF	$260	$208	$150.28 – $260
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans AETNA — AETNA: $219.96 BCBS — BCBS: $150.28 CIGNA — CIGNA: $188.50 HUMANA — HUMANA: $208 MEDCOST — MEDCOST: $160.94 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $260 SELF PAY — SELF PAY: $208 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $260 UNITED HEALTHCARE — UNITED HEALTHCARE: $205.40
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PMC MD EST FOLLOW-UP LEVEL 3	$91	$72.80	$52.60 – $91
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans AETNA — AETNA: $76.99 BCBS — BCBS: $52.60 CIGNA — CIGNA: $65.97 HUMANA — HUMANA: $72.80 MEDCOST — MEDCOST: $56.33 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $91 SELF PAY — SELF PAY: $72.80 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $91 UNITED HEALTHCARE — UNITED HEALTHCARE: $71.89
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM MD INTER-ESTAB PT	$201	$160.80	$116.18 – $201
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans AETNA — AETNA: $170.05 BCBS — BCBS: $116.18 CIGNA — CIGNA: $145.72 HUMANA — HUMANA: $160.80 MEDCOST — MEDCOST: $124.42 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $201 SELF PAY — SELF PAY: $160.80 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $201 UNITED HEALTHCARE — UNITED HEALTHCARE: $158.79
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E&M,PSYCH MD, LEVEL 4 PROF	$420	$336	$242.76 – $420
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans AETNA — AETNA: $355.32 BCBS — BCBS: $242.76 CIGNA — CIGNA: $304.50 HUMANA — HUMANA: $336 MEDCOST — MEDCOST: $259.98 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $420 SELF PAY — SELF PAY: $336 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $420 UNITED HEALTHCARE — UNITED HEALTHCARE: $331.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PMC MD EST FOLLOW-UP LEVEL 4	$141	$112.80	$81.50 – $141
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans AETNA — AETNA: $119.29 BCBS — BCBS: $81.50 CIGNA — CIGNA: $102.22 HUMANA — HUMANA: $112.80 MEDCOST — MEDCOST: $87.28 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $141 SELF PAY — SELF PAY: $112.80 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $141 UNITED HEALTHCARE — UNITED HEALTHCARE: $111.39
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM MD EXT-ESTAB PAT	$252	$201.60	$145.66 – $252
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans AETNA — AETNA: $213.19 BCBS — BCBS: $145.66 CIGNA — CIGNA: $182.70 HUMANA — HUMANA: $201.60 MEDCOST — MEDCOST: $155.99 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $252 SELF PAY — SELF PAY: $201.60 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $252 UNITED HEALTHCARE — UNITED HEALTHCARE: $199.08
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHMD,OP CONSULT MOD 40MINS	$350	$280	$202.30 – $350
Office consultation with a specialist (moderate to high): rates for 9 insurance plans AETNA — AETNA: $296.10 BCBS — BCBS: $202.30 CIGNA — CIGNA: $253.75 HUMANA — HUMANA: $280 MEDCOST — MEDCOST: $216.65 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $350 SELF PAY — SELF PAY: $280 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $350 UNITED HEALTHCARE — UNITED HEALTHCARE: $276.50
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHMD,OP CONSULT MOD 40MINS	$350	$280	$216.65 – $350
Office consultation with a specialist (moderate to high): rates for 7 insurance plans AETNA — AETNA: $296.10 CIGNA — CIGNA: $253.75 HUMANA — HUMANA: $280 MEDCOST — MEDCOST: $216.65 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $350 SELF PAY — SELF PAY: $280 UNITED HEALTHCARE — UNITED HEALTHCARE: $276.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 3	$1,750	$1,400	$276.40 – $1,750
Emergency room visit (moderate): 10 of 15 insurance plan rates AETNA — AETNA: $1,480.50 AETNA MEDICARE — AETNA MEDICARE: $278.56 AMBETTER (MCR) — AMBETTER (MCR): $270.45 BCBS — BCBS: $1,011.50 CIGNA — CIGNA: $1,268.75 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $550 HUMANA — HUMANA: $1,400 HUMANA MEDICARE — HUMANA MEDICARE: $273.15 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $270.45 MEDCOST — MEDCOST: $1,083.25
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 3	$1,750	$1,400	$1,083.25 – $1,750
Emergency room visit (moderate): rates for 7 insurance plans AETNA — AETNA: $1,480.50 CIGNA — CIGNA: $1,268.75 HUMANA — HUMANA: $1,400 MEDCOST — MEDCOST: $1,083.25 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $1,750 SELF PAY — SELF PAY: $1,400 UNITED HEALTHCARE — UNITED HEALTHCARE: $1,382.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY ROOM-LEVEL 3 W/PROC	$1,750	$1,400	$276.40 – $1,750
Emergency room visit (moderate): 10 of 15 insurance plan rates AETNA — AETNA: $1,480.50 AETNA MEDICARE — AETNA MEDICARE: $278.56 AMBETTER (MCR) — AMBETTER (MCR): $270.45 BCBS — BCBS: $1,011.50 CIGNA — CIGNA: $1,268.75 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $550 HUMANA — HUMANA: $1,400 HUMANA MEDICARE — HUMANA MEDICARE: $273.15 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $270.45 MEDCOST — MEDCOST: $1,083.25
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 4	$2,250	$1,800	$422.49 – $2,250
Emergency room visit (moderately high): 10 of 15 insurance plan rates AETNA — AETNA: $1,903.50 AETNA MEDICARE — AETNA MEDICARE: $425.79 AMBETTER (MCR) — AMBETTER (MCR): $413.39 BCBS — BCBS: $1,300.50 CIGNA — CIGNA: $1,631.25 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $550 HUMANA — HUMANA: $1,800 HUMANA MEDICARE — HUMANA MEDICARE: $417.52 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $413.39 MEDCOST — MEDCOST: $1,392.75
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HSP ER DETAIL H&E MOD COMPLEX	$460	$368	$265.88 – $460
Emergency room visit (moderately high): 10 of 15 insurance plan rates AETNA — AETNA: $389.16 AETNA MEDICARE — AETNA MEDICARE: $425.79 AMBETTER (MCR) — AMBETTER (MCR): $413.39 BCBS — BCBS: $265.88 CIGNA — CIGNA: $333.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $421.66 HUMANA — HUMANA: $368 HUMANA MEDICARE — HUMANA MEDICARE: $417.52 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $413.39 MEDCOST — MEDCOST: $284.74
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 4	$2,250	$1,800	$1,392.75 – $2,250
Emergency room visit (moderately high): rates for 7 insurance plans AETNA — AETNA: $1,903.50 CIGNA — CIGNA: $1,631.25 HUMANA — HUMANA: $1,800 MEDCOST — MEDCOST: $1,392.75 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $2,250 SELF PAY — SELF PAY: $1,800 UNITED HEALTHCARE — UNITED HEALTHCARE: $1,777.50
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 5	$3,090	$2,472	$550 – $3,090
Emergency room visit (high): 10 of 15 insurance plan rates AETNA — AETNA: $2,614.14 AETNA MEDICARE — AETNA MEDICARE: $607.71 AMBETTER (MCR) — AMBETTER (MCR): $590.01 BCBS — BCBS: $1,786.02 CIGNA — CIGNA: $2,240.25 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $550 HUMANA — HUMANA: $2,472 HUMANA MEDICARE — HUMANA MEDICARE: $595.91 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $590.01 MEDCOST — MEDCOST: $1,912.71
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY ROOM-LEVEL 5	$3,090	$2,472	$1,912.71 – $3,090
Emergency room visit (high): rates for 7 insurance plans AETNA — AETNA: $2,614.14 CIGNA — CIGNA: $2,240.25 HUMANA — HUMANA: $2,472 MEDCOST — MEDCOST: $1,912.71 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $3,090 SELF PAY — SELF PAY: $2,472 UNITED HEALTHCARE — UNITED HEALTHCARE: $2,441.10
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY ROOM-LEVEL 5 W/PROC	$3,090	$2,472	$550 – $3,090
Emergency room visit (high): 10 of 15 insurance plan rates AETNA — AETNA: $2,614.14 AETNA MEDICARE — AETNA MEDICARE: $607.71 AMBETTER (MCR) — AMBETTER (MCR): $590.01 BCBS — BCBS: $1,786.02 CIGNA — CIGNA: $2,240.25 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $550 HUMANA — HUMANA: $2,472 HUMANA MEDICARE — HUMANA MEDICARE: $595.91 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $590.01 MEDCOST — MEDCOST: $1,912.71

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$367	$293.60	$8.04 – $367
Basic metabolic panel (blood test): 10 of 15 insurance plan rates AETNA — AETNA: $310.48 AETNA MEDICARE — AETNA MEDICARE: $8.71 AMBETTER (MCR) — AMBETTER (MCR): $8.46 BCBS — BCBS: $212.13 CIGNA — CIGNA: $266.07 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $8.63 HUMANA — HUMANA: $293.60 HUMANA MEDICARE — HUMANA MEDICARE: $8.54 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $8.46 MEDCOST — MEDCOST: $227.17
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$367	$293.60	$227.17 – $367
Basic metabolic panel (blood test): rates for 7 insurance plans AETNA — AETNA: $310.48 CIGNA — CIGNA: $266.07 HUMANA — HUMANA: $293.60 MEDCOST — MEDCOST: $227.17 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $367 SELF PAY — SELF PAY: $293.60 UNITED HEALTHCARE — UNITED HEALTHCARE: $289.93
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BASIC METABOLIC PANEL W/MOD 59	$356	$284.80	$8.04 – $356
Basic metabolic panel (blood test): 10 of 15 insurance plan rates AETNA — AETNA: $301.18 AETNA MEDICARE — AETNA MEDICARE: $8.71 AMBETTER (MCR) — AMBETTER (MCR): $8.46 BCBS — BCBS: $205.77 CIGNA — CIGNA: $258.10 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $8.63 HUMANA — HUMANA: $284.80 HUMANA MEDICARE — HUMANA MEDICARE: $8.54 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $8.46 MEDCOST — MEDCOST: $220.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$489	$391.20	$10.03 – $489
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates AETNA — AETNA: $413.69 AETNA MEDICARE — AETNA MEDICARE: $10.88 AMBETTER (MCR) — AMBETTER (MCR): $10.56 BCBS — BCBS: $282.64 CIGNA — CIGNA: $354.52 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $10.77 HUMANA — HUMANA: $391.20 HUMANA MEDICARE — HUMANA MEDICARE: $10.67 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $10.56 MEDCOST — MEDCOST: $302.69
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$489	$391.20	$302.69 – $489
Comprehensive metabolic panel (blood test): rates for 7 insurance plans AETNA — AETNA: $413.69 CIGNA — CIGNA: $354.52 HUMANA — HUMANA: $391.20 MEDCOST — MEDCOST: $302.69 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $489 SELF PAY — SELF PAY: $391.20 UNITED HEALTHCARE — UNITED HEALTHCARE: $386.31
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPREHEN METABOLIC PANEL W/91	$465	$372	$10.03 – $465
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates AETNA — AETNA: $393.39 AETNA MEDICARE — AETNA MEDICARE: $10.88 AMBETTER (MCR) — AMBETTER (MCR): $10.56 BCBS — BCBS: $268.77 CIGNA — CIGNA: $337.13 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $10.77 HUMANA — HUMANA: $372 HUMANA MEDICARE — HUMANA MEDICARE: $10.67 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $10.56 MEDCOST — MEDCOST: $287.83
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$258	$206.40	$45.42 – $258
Obstetric blood test panel: 10 of 15 insurance plan rates AETNA — AETNA: $218.27 AETNA MEDICARE — AETNA MEDICARE: $49.24 AMBETTER (MCR) — AMBETTER (MCR): $47.81 BCBS — BCBS: $149.12 CIGNA — CIGNA: $187.05 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $48.77 HUMANA — HUMANA: $206.40 HUMANA MEDICARE — HUMANA MEDICARE: $48.29 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $47.81 MEDCOST — MEDCOST: $159.70
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$258	$206.40	$159.70 – $258
Obstetric blood test panel: rates for 7 insurance plans AETNA — AETNA: $218.27 CIGNA — CIGNA: $187.05 HUMANA — HUMANA: $206.40 MEDCOST — MEDCOST: $159.70 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $258 SELF PAY — SELF PAY: $206.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $203.82
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL W/CALC LDL	$400	$320	$12.72 – $400
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates AETNA — AETNA: $338.40 AETNA MEDICARE — AETNA MEDICARE: $13.79 AMBETTER (MCR) — AMBETTER (MCR): $13.39 BCBS — BCBS: $231.20 CIGNA — CIGNA: $290 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $13.66 HUMANA — HUMANA: $320 HUMANA MEDICARE — HUMANA MEDICARE: $13.52 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $13.39 MEDCOST — MEDCOST: $247.60
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CRISK-HEALTH FAIR ONLY	$18	$14.40	$10.40 – $18
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates AETNA — AETNA: $15.23 AETNA MEDICARE — AETNA MEDICARE: $13.79 AMBETTER (MCR) — AMBETTER (MCR): $13.39 BCBS — BCBS: $10.40 CIGNA — CIGNA: $13.05 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $13.66 HUMANA — HUMANA: $14.40 HUMANA MEDICARE — HUMANA MEDICARE: $13.52 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $13.39 MEDCOST — MEDCOST: $11.14
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL W/CALC LDL	$400	$320	$247.60 – $400
Cholesterol panel (lipid panel): rates for 7 insurance plans AETNA — AETNA: $338.40 CIGNA — CIGNA: $290 HUMANA — HUMANA: $320 MEDCOST — MEDCOST: $247.60 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $400 SELF PAY — SELF PAY: $320 UNITED HEALTHCARE — UNITED HEALTHCARE: $316
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$361	$288.80	$8.25 – $361
Kidney function panel: 10 of 15 insurance plan rates AETNA — AETNA: $305.41 AETNA MEDICARE — AETNA MEDICARE: $8.94 AMBETTER (MCR) — AMBETTER (MCR): $8.68 BCBS — BCBS: $208.66 CIGNA — CIGNA: $261.72 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $8.85 HUMANA — HUMANA: $288.80 HUMANA MEDICARE — HUMANA MEDICARE: $8.77 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $8.68 MEDCOST — MEDCOST: $223.46
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$361	$288.80	$223.46 – $361
Kidney function panel: rates for 7 insurance plans AETNA — AETNA: $305.41 CIGNA — CIGNA: $261.72 HUMANA — HUMANA: $288.80 MEDCOST — MEDCOST: $223.46 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $361 SELF PAY — SELF PAY: $288.80 UNITED HEALTHCARE — UNITED HEALTHCARE: $285.19
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$412	$329.60	$7.76 – $412
Liver function panel: 10 of 15 insurance plan rates AETNA — AETNA: $348.55 AETNA MEDICARE — AETNA MEDICARE: $8.42 AMBETTER (MCR) — AMBETTER (MCR): $8.17 BCBS — BCBS: $238.14 CIGNA — CIGNA: $298.70 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $8.33 HUMANA — HUMANA: $329.60 HUMANA MEDICARE — HUMANA MEDICARE: $8.25 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $8.17 MEDCOST — MEDCOST: $255.03
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$412	$329.60	$255.03 – $412
Liver function panel: rates for 7 insurance plans AETNA — AETNA: $348.55 CIGNA — CIGNA: $298.70 HUMANA — HUMANA: $329.60 MEDCOST — MEDCOST: $255.03 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $412 SELF PAY — SELF PAY: $329.60 UNITED HEALTHCARE — UNITED HEALTHCARE: $325.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS W/MICROSCOPY,AUTOM	$31	$24.80	$3.01 – $31
Urine test (automated, with microscope): 10 of 15 insurance plan rates AETNA — AETNA: $26.23 AETNA MEDICARE — AETNA MEDICARE: $3.27 AMBETTER (MCR) — AMBETTER (MCR): $3.17 BCBS — BCBS: $17.92 CIGNA — CIGNA: $22.47 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $3.23 HUMANA — HUMANA: $24.80 HUMANA MEDICARE — HUMANA MEDICARE: $3.20 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $3.17 MEDCOST — MEDCOST: $19.19
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS W/MICROSCOPY,AUTOM	$31	$24.80	$19.19 – $31
Urine test (automated, with microscope): rates for 7 insurance plans AETNA — AETNA: $26.23 CIGNA — CIGNA: $22.47 HUMANA — HUMANA: $24.80 MEDCOST — MEDCOST: $19.19 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $31 SELF PAY — SELF PAY: $24.80 UNITED HEALTHCARE — UNITED HEALTHCARE: $24.49
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GTT-URINE 1/2 HR COMP	$9	$7.20	$3.31 – $9
Urine test (manual, without microscope): 10 of 15 insurance plan rates AETNA — AETNA: $7.61 AETNA MEDICARE — AETNA MEDICARE: $3.58 AMBETTER (MCR) — AMBETTER (MCR): $3.48 BCBS — BCBS: $5.20 CIGNA — CIGNA: $6.52 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $3.55 HUMANA — HUMANA: $7.20 HUMANA MEDICARE — HUMANA MEDICARE: $3.51 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $3.48 MEDCOST — MEDCOST: $5.57
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GTT-URINE 1 HR COMP	$9	$7.20	$3.31 – $9
Urine test (manual, without microscope): 10 of 15 insurance plan rates AETNA — AETNA: $7.61 AETNA MEDICARE — AETNA MEDICARE: $3.58 AMBETTER (MCR) — AMBETTER (MCR): $3.48 BCBS — BCBS: $5.20 CIGNA — CIGNA: $6.52 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $3.55 HUMANA — HUMANA: $7.20 HUMANA MEDICARE — HUMANA MEDICARE: $3.51 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $3.48 MEDCOST — MEDCOST: $5.57
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GTT-URINE 2 HR COMP	$9	$7.20	$3.31 – $9
Urine test (manual, without microscope): 10 of 15 insurance plan rates AETNA — AETNA: $7.61 AETNA MEDICARE — AETNA MEDICARE: $3.58 AMBETTER (MCR) — AMBETTER (MCR): $3.48 BCBS — BCBS: $5.20 CIGNA — CIGNA: $6.52 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $3.55 HUMANA — HUMANA: $7.20 HUMANA MEDICARE — HUMANA MEDICARE: $3.51 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $3.48 MEDCOST — MEDCOST: $5.57
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS W/O MICROSCOPY,AUTO	$19	$15.20	$2.14 – $19
Urine test (automated, without microscope): 10 of 15 insurance plan rates AETNA — AETNA: $16.07 AETNA MEDICARE — AETNA MEDICARE: $2.32 AMBETTER (MCR) — AMBETTER (MCR): $2.25 BCBS — BCBS: $10.98 CIGNA — CIGNA: $13.78 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $2.29 HUMANA — HUMANA: $15.20 HUMANA MEDICARE — HUMANA MEDICARE: $2.27 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $2.25 MEDCOST — MEDCOST: $11.76
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS W/O MICROSCOPY,AUTO	$19	$15.20	$11.76 – $19
Urine test (automated, without microscope): rates for 7 insurance plans AETNA — AETNA: $16.07 CIGNA — CIGNA: $13.78 HUMANA — HUMANA: $15.20 MEDCOST — MEDCOST: $11.76 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $19 SELF PAY — SELF PAY: $15.20 UNITED HEALTHCARE — UNITED HEALTHCARE: $15.01
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA,TOTAL-DIAG	$309	$247.20	$17.47 – $309
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates AETNA — AETNA: $261.41 AETNA MEDICARE — AETNA MEDICARE: $18.94 AMBETTER (MCR) — AMBETTER (MCR): $18.39 BCBS — BCBS: $178.60 CIGNA — CIGNA: $224.03 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $18.76 HUMANA — HUMANA: $247.20 HUMANA MEDICARE — HUMANA MEDICARE: $18.57 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $18.39 MEDCOST — MEDCOST: $191.27
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA,TOTAL-DIAG	$309	$247.20	$191.27 – $309
PSA (prostate specific antigen) blood test: rates for 7 insurance plans AETNA — AETNA: $261.41 CIGNA — CIGNA: $224.03 HUMANA — HUMANA: $247.20 MEDCOST — MEDCOST: $191.27 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $309 SELF PAY — SELF PAY: $247.20 UNITED HEALTHCARE — UNITED HEALTHCARE: $244.11
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH SERUM	$412	$329.60	$15.96 – $412
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates AETNA — AETNA: $348.55 AETNA MEDICARE — AETNA MEDICARE: $17.30 AMBETTER (MCR) — AMBETTER (MCR): $16.80 BCBS — BCBS: $238.14 CIGNA — CIGNA: $298.70 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $17.14 HUMANA — HUMANA: $329.60 HUMANA MEDICARE — HUMANA MEDICARE: $16.97 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $16.80 MEDCOST — MEDCOST: $255.03
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH SERUM	$412	$329.60	$255.03 – $412
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans AETNA — AETNA: $348.55 CIGNA — CIGNA: $298.70 HUMANA — HUMANA: $329.60 MEDCOST — MEDCOST: $255.03 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $412 SELF PAY — SELF PAY: $329.60 UNITED HEALTHCARE — UNITED HEALTHCARE: $325.48
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: TSH SERUM W/MOD 91	$343	$274.40	$15.96 – $343
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates AETNA — AETNA: $290.18 AETNA MEDICARE — AETNA MEDICARE: $17.30 AMBETTER (MCR) — AMBETTER (MCR): $16.80 BCBS — BCBS: $198.25 CIGNA — CIGNA: $248.67 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $17.14 HUMANA — HUMANA: $274.40 HUMANA MEDICARE — HUMANA MEDICARE: $16.97 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $16.80 MEDCOST — MEDCOST: $212.32
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/DIFF	$300	$240	$7.38 – $300
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates AETNA — AETNA: $253.80 AETNA MEDICARE — AETNA MEDICARE: $8 AMBETTER (MCR) — AMBETTER (MCR): $7.77 BCBS — BCBS: $173.40 CIGNA — CIGNA: $217.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $7.93 HUMANA — HUMANA: $240 HUMANA MEDICARE — HUMANA MEDICARE: $7.85 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $7.77 MEDCOST — MEDCOST: $185.70
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W/DIFF	$300	$240	$185.70 – $300
Complete blood count (CBC) with differential: rates for 7 insurance plans AETNA — AETNA: $253.80 CIGNA — CIGNA: $217.50 HUMANA — HUMANA: $240 MEDCOST — MEDCOST: $185.70 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $300 SELF PAY — SELF PAY: $240 UNITED HEALTHCARE — UNITED HEALTHCARE: $237
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: CBC W/DIFF W/MOD 91	$287	$229.60	$7.38 – $287
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates AETNA — AETNA: $242.80 AETNA MEDICARE — AETNA MEDICARE: $8 AMBETTER (MCR) — AMBETTER (MCR): $7.77 BCBS — BCBS: $165.89 CIGNA — CIGNA: $208.07 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $7.93 HUMANA — HUMANA: $229.60 HUMANA MEDICARE — HUMANA MEDICARE: $7.85 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $7.77 MEDCOST — MEDCOST: $177.65
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SBC (CBC W/OUT DIFF)	$33	$26.40	$6.15 – $33
Complete blood count (CBC), automated: 10 of 15 insurance plan rates AETNA — AETNA: $27.92 AETNA MEDICARE — AETNA MEDICARE: $6.66 AMBETTER (MCR) — AMBETTER (MCR): $6.47 BCBS — BCBS: $19.07 CIGNA — CIGNA: $23.93 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $6.60 HUMANA — HUMANA: $26.40 HUMANA MEDICARE — HUMANA MEDICARE: $6.53 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $6.47 MEDCOST — MEDCOST: $20.43
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/OUT DIFF	$274	$219.20	$6.15 – $274
Complete blood count (CBC), automated: 10 of 15 insurance plan rates AETNA — AETNA: $231.80 AETNA MEDICARE — AETNA MEDICARE: $6.66 AMBETTER (MCR) — AMBETTER (MCR): $6.47 BCBS — BCBS: $158.37 CIGNA — CIGNA: $198.65 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $6.60 HUMANA — HUMANA: $219.20 HUMANA MEDICARE — HUMANA MEDICARE: $6.53 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $6.47 MEDCOST — MEDCOST: $169.61
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SBC (CBC W/OUT DIFF)	$33	$26.40	$20.43 – $33
Complete blood count (CBC), automated: rates for 7 insurance plans AETNA — AETNA: $27.92 CIGNA — CIGNA: $23.93 HUMANA — HUMANA: $26.40 MEDCOST — MEDCOST: $20.43 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $33 SELF PAY — SELF PAY: $26.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $26.07
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT/PROTHROMBIN TIME	$91	$72.80	$4.08 – $91
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates AETNA — AETNA: $76.99 AETNA MEDICARE — AETNA MEDICARE: $4.42 AMBETTER (MCR) — AMBETTER (MCR): $4.29 BCBS — BCBS: $52.60 CIGNA — CIGNA: $65.97 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $4.38 HUMANA — HUMANA: $72.80 HUMANA MEDICARE — HUMANA MEDICARE: $4.33 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $4.29 MEDCOST — MEDCOST: $56.33
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT/PROTHROMBIN TIME	$91	$72.80	$56.33 – $91
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans AETNA — AETNA: $76.99 CIGNA — CIGNA: $65.97 HUMANA — HUMANA: $72.80 MEDCOST — MEDCOST: $56.33 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $91 SELF PAY — SELF PAY: $72.80 UNITED HEALTHCARE — UNITED HEALTHCARE: $71.89
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: PT/PROTHROMBINE TIME W/MOD 91	$44	$35.20	$4.08 – $44
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates AETNA — AETNA: $37.22 AETNA MEDICARE — AETNA MEDICARE: $4.42 AMBETTER (MCR) — AMBETTER (MCR): $4.29 BCBS — BCBS: $25.43 CIGNA — CIGNA: $31.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $4.38 HUMANA — HUMANA: $35.20 HUMANA MEDICARE — HUMANA MEDICARE: $4.33 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $4.29 MEDCOST — MEDCOST: $27.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT/APTT	$93	$74.40	$5.71 – $93
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates AETNA — AETNA: $78.68 AETNA MEDICARE — AETNA MEDICARE: $6.19 AMBETTER (MCR) — AMBETTER (MCR): $6.01 BCBS — BCBS: $53.75 CIGNA — CIGNA: $67.42 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $6.13 HUMANA — HUMANA: $74.40 HUMANA MEDICARE — HUMANA MEDICARE: $6.07 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $6.01 MEDCOST — MEDCOST: $57.57
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PTT/APTT	$93	$74.40	$57.57 – $93
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans AETNA — AETNA: $78.68 CIGNA — CIGNA: $67.42 HUMANA — HUMANA: $74.40 MEDCOST — MEDCOST: $57.57 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $93 SELF PAY — SELF PAY: $74.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $73.47
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: PTT/APTT W/MOD 91	$88	$70.40	$5.71 – $88
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates AETNA — AETNA: $74.45 AETNA MEDICARE — AETNA MEDICARE: $6.19 AMBETTER (MCR) — AMBETTER (MCR): $6.01 BCBS — BCBS: $50.86 CIGNA — CIGNA: $63.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $6.13 HUMANA — HUMANA: $70.40 HUMANA MEDICARE — HUMANA MEDICARE: $6.07 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $6.01 MEDCOST — MEDCOST: $54.47

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEAD W/O CONTRAST	$3,960	$3,168	$105.86 – $3,960
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,350.16 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $2,288.88 CIGNA — CIGNA: $2,871 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $3,168 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $2,451.24
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEAD W/O CONTRAST	$3,960	$3,168	$2,451.24 – $3,960
CT scan of the head or brain, without contrast: rates for 7 insurance plans AETNA — AETNA: $3,350.16 CIGNA — CIGNA: $2,871 HUMANA — HUMANA: $3,168 MEDCOST — MEDCOST: $2,451.24 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $3,960 SELF PAY — SELF PAY: $3,168 UNITED HEALTHCARE — UNITED HEALTHCARE: $3,128.40
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: HEAD W/O CONTRAST-REDUCE SVC52	$3,844	$3,075.20	$52.93 – $3,844
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,252.02 AETNA MEDICARE — AETNA MEDICARE: $53.34 AMBETTER (MCR) — AMBETTER (MCR): $51.79 BCBS — BCBS: $2,221.83 CIGNA — CIGNA: $2,786.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $52.83 HUMANA — HUMANA: $3,075.20 HUMANA MEDICARE — HUMANA MEDICARE: $52.31 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $51.79 MEDCOST — MEDCOST: $2,379.44
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W&WO CONTRAST	$5,988	$4,790.40	$353.24 – $5,988
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates AETNA — AETNA: $5,065.85 AETNA MEDICARE — AETNA MEDICARE: $356.01 AMBETTER (MCR) — AMBETTER (MCR): $345.64 BCBS — BCBS: $3,461.06 CIGNA — CIGNA: $4,341.30 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $352.55 HUMANA — HUMANA: $4,790.40 HUMANA MEDICARE — HUMANA MEDICARE: $349.10 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $345.64 MEDCOST — MEDCOST: $3,706.57
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN W&WO CONTRAST	$5,988	$4,790.40	$3,706.57 – $5,988
MRI of the brain, before and after contrast: rates for 7 insurance plans AETNA — AETNA: $5,065.85 CIGNA — CIGNA: $4,341.30 HUMANA — HUMANA: $4,790.40 MEDCOST — MEDCOST: $3,706.57 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $5,988 SELF PAY — SELF PAY: $4,790.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $4,730.52
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI BRAIN W&WO CONTRAST	$408	$326.40	$235.82 – $408
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates AETNA — AETNA: $345.17 AETNA MEDICARE — AETNA MEDICARE: $356.01 AMBETTER (MCR) — AMBETTER (MCR): $345.64 BCBS — BCBS: $235.82 CIGNA — CIGNA: $295.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $352.55 HUMANA — HUMANA: $326.40 HUMANA MEDICARE — HUMANA MEDICARE: $349.10 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $345.64 MEDCOST — MEDCOST: $252.55
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 2VIEWS - ROUTINE	$700	$560	$88.12 – $700
Chest X-ray, 2 views: 10 of 15 insurance plan rates AETNA — AETNA: $592.20 AETNA MEDICARE — AETNA MEDICARE: $88.81 AMBETTER (MCR) — AMBETTER (MCR): $86.22 BCBS — BCBS: $404.60 CIGNA — CIGNA: $507.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $87.94 HUMANA — HUMANA: $560 HUMANA MEDICARE — HUMANA MEDICARE: $87.08 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $86.22 MEDCOST — MEDCOST: $433.30
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST LAT DEC/SPECIAL VIEW	$236	$188.80	$88.12 – $236
Chest X-ray, 2 views: 10 of 15 insurance plan rates AETNA — AETNA: $199.66 AETNA MEDICARE — AETNA MEDICARE: $88.81 AMBETTER (MCR) — AMBETTER (MCR): $86.22 BCBS — BCBS: $136.41 CIGNA — CIGNA: $171.10 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $87.94 HUMANA — HUMANA: $188.80 HUMANA MEDICARE — HUMANA MEDICARE: $87.08 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $86.22 MEDCOST — MEDCOST: $146.08
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 2-VIEW (HEALTH DEPT)	$77	$61.60	$44.51 – $88.12
Chest X-ray, 2 views: 10 of 15 insurance plan rates AETNA — AETNA: $65.14 AETNA MEDICARE — AETNA MEDICARE: $88.81 AMBETTER (MCR) — AMBETTER (MCR): $86.22 BCBS — BCBS: $44.51 CIGNA — CIGNA: $55.82 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $87.94 HUMANA — HUMANA: $61.60 HUMANA MEDICARE — HUMANA MEDICARE: $87.08 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $86.22 MEDCOST — MEDCOST: $47.66
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBOSACRAL SPINE MIN 4VIEWS	$309	$247.20	$105.86 – $309
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates AETNA — AETNA: $261.41 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $178.60 CIGNA — CIGNA: $224.03 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $247.20 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $191.27
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *TO L-S SP AP OBLS LAT SC	$190	$152	$105.86 – $190
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates AETNA — AETNA: $160.74 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $109.82 CIGNA — CIGNA: $137.75 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $152 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $117.61
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LUMBOSACRAL SPINE MIN 4VIEWS	$309	$247.20	$191.27 – $309
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans AETNA — AETNA: $261.41 CIGNA — CIGNA: $224.03 HUMANA — HUMANA: $247.20 MEDCOST — MEDCOST: $191.27 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $309 SELF PAY — SELF PAY: $247.20 UNITED HEALTHCARE — UNITED HEALTHCARE: $244.11
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE WO CONTRAST	$4,728	$3,782.40	$241.59 – $4,728
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,999.89 AETNA MEDICARE — AETNA MEDICARE: $243.48 AMBETTER (MCR) — AMBETTER (MCR): $236.39 BCBS — BCBS: $2,732.78 CIGNA — CIGNA: $3,427.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $241.12 HUMANA — HUMANA: $3,782.40 HUMANA MEDICARE — HUMANA MEDICARE: $238.75 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $236.39 MEDCOST — MEDCOST: $2,926.63
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE WO CONTRAST	$4,728	$3,782.40	$2,926.63 – $4,728
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans AETNA — AETNA: $3,999.89 CIGNA — CIGNA: $3,427.80 HUMANA — HUMANA: $3,782.40 MEDCOST — MEDCOST: $2,926.63 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $4,728 SELF PAY — SELF PAY: $3,782.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $3,735.12
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI LUMBAR SPINE WO CONTRAST	$266	$212.80	$153.75 – $266
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $225.04 AETNA MEDICARE — AETNA MEDICARE: $243.48 AMBETTER (MCR) — AMBETTER (MCR): $236.39 BCBS — BCBS: $153.75 CIGNA — CIGNA: $192.85 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $241.12 HUMANA — HUMANA: $212.80 HUMANA MEDICARE — HUMANA MEDICARE: $238.75 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $236.39 MEDCOST — MEDCOST: $164.65
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PELVIS WITH CONTRAST	$3,575	$2,860	$177.60 – $3,575
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,024.45 AETNA MEDICARE — AETNA MEDICARE: $178.98 AMBETTER (MCR) — AMBETTER (MCR): $173.77 BCBS — BCBS: $2,066.35 CIGNA — CIGNA: $2,591.88 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $177.25 HUMANA — HUMANA: $2,860 HUMANA MEDICARE — HUMANA MEDICARE: $175.51 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $173.77 MEDCOST — MEDCOST: $2,212.93
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PELVIS WITH CONTRAST	$3,575	$2,860	$2,212.93 – $3,575
CT scan of the pelvis, with contrast: rates for 7 insurance plans AETNA — AETNA: $3,024.45 CIGNA — CIGNA: $2,591.88 HUMANA — HUMANA: $2,860 MEDCOST — MEDCOST: $2,212.93 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $3,575 SELF PAY — SELF PAY: $2,860 UNITED HEALTHCARE — UNITED HEALTHCARE: $2,824.25
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: PELVIS WITH CONTRAST	$207	$165.60	$119.65 – $207
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates AETNA — AETNA: $175.12 AETNA MEDICARE — AETNA MEDICARE: $178.98 AMBETTER (MCR) — AMBETTER (MCR): $173.77 BCBS — BCBS: $119.65 CIGNA — CIGNA: $150.07 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $177.25 HUMANA — HUMANA: $165.60 HUMANA MEDICARE — HUMANA MEDICARE: $175.51 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $173.77 MEDCOST — MEDCOST: $128.13
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOWER EXT JNT WO CONT-LT	$4,728	$3,782.40	$241.59 – $4,728
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,999.89 AETNA MEDICARE — AETNA MEDICARE: $243.48 AMBETTER (MCR) — AMBETTER (MCR): $236.39 BCBS — BCBS: $2,732.78 CIGNA — CIGNA: $3,427.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $241.12 HUMANA — HUMANA: $3,782.40 HUMANA MEDICARE — HUMANA MEDICARE: $238.75 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $236.39 MEDCOST — MEDCOST: $2,926.63
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOWER EXT JNT WO CONT-RT	$4,728	$3,782.40	$241.59 – $4,728
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates AETNA — AETNA: $3,999.89 AETNA MEDICARE — AETNA MEDICARE: $243.48 AMBETTER (MCR) — AMBETTER (MCR): $236.39 BCBS — BCBS: $2,732.78 CIGNA — CIGNA: $3,427.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $241.12 HUMANA — HUMANA: $3,782.40 HUMANA MEDICARE — HUMANA MEDICARE: $238.75 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $236.39 MEDCOST — MEDCOST: $2,926.63
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LOWER EXT JNT WO CONT-LT	$4,728	$3,782.40	$2,926.63 – $4,728
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans AETNA — AETNA: $3,999.89 CIGNA — CIGNA: $3,427.80 HUMANA — HUMANA: $3,782.40 MEDCOST — MEDCOST: $2,926.63 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $4,728 SELF PAY — SELF PAY: $3,782.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $3,735.12
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABD/PELVIS CT W/CONT BOTH REG	$8,500	$6,800	$353.24 – $8,500
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates AETNA — AETNA: $7,191 AETNA MEDICARE — AETNA MEDICARE: $356.01 AMBETTER (MCR) — AMBETTER (MCR): $345.64 BCBS — BCBS: $4,913 CIGNA — CIGNA: $6,162.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $352.55 HUMANA — HUMANA: $6,800 HUMANA MEDICARE — HUMANA MEDICARE: $349.10 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $345.64 MEDCOST — MEDCOST: $5,261.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ENTEROGRAPHY CT W/CONTRAST	$7,170	$5,736	$353.24 – $7,170
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates AETNA — AETNA: $6,065.82 AETNA MEDICARE — AETNA MEDICARE: $356.01 AMBETTER (MCR) — AMBETTER (MCR): $345.64 BCBS — BCBS: $4,144.26 CIGNA — CIGNA: $5,198.25 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $352.55 HUMANA — HUMANA: $5,736 HUMANA MEDICARE — HUMANA MEDICARE: $349.10 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $345.64 MEDCOST — MEDCOST: $4,438.23
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ABD/PELVIS CT W/CONT BOTH REG	$8,500	$6,800	$5,261.50 – $8,500
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans AETNA — AETNA: $7,191 CIGNA — CIGNA: $6,162.50 HUMANA — HUMANA: $6,800 MEDCOST — MEDCOST: $5,261.50 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $8,500 SELF PAY — SELF PAY: $6,800 UNITED HEALTHCARE — UNITED HEALTHCARE: $6,715
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMEN SONOGRAM-COMPLETE STU	$1,100	$880	$105.86 – $1,100
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates AETNA — AETNA: $930.60 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $635.80 CIGNA — CIGNA: $797.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $880 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $680.90
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ABDOMEN SONOGRAM-COMPLETE STU	$1,100	$880	$680.90 – $1,100
Ultrasound of the abdomen, complete: rates for 7 insurance plans AETNA — AETNA: $930.60 CIGNA — CIGNA: $797.50 HUMANA — HUMANA: $880 MEDCOST — MEDCOST: $680.90 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $1,100 SELF PAY — SELF PAY: $880 UNITED HEALTHCARE — UNITED HEALTHCARE: $869
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: ABDOMEN SONOGRAM-COMPLETE STU	$144	$115.20	$83.23 – $144
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates AETNA — AETNA: $121.82 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $83.23 CIGNA — CIGNA: $104.40 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $115.20 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $89.14
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB SONOGRAM-COMPLETE >=14WKS	$1,400	$1,120	$105.86 – $1,400
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates AETNA — AETNA: $1,184.40 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $809.20 CIGNA — CIGNA: $1,015 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $1,120 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $866.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB SONOGRAM-COMPLETE >=14WKS	$1,400	$1,120	$866.60 – $1,400
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans AETNA — AETNA: $1,184.40 CIGNA — CIGNA: $1,015 HUMANA — HUMANA: $1,120 MEDCOST — MEDCOST: $866.60 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $1,400 SELF PAY — SELF PAY: $1,120 UNITED HEALTHCARE — UNITED HEALTHCARE: $1,106
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: OB SONOGRAM-COMPLETE >=14WKS	$179	$143.20	$103.46 – $179
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates AETNA — AETNA: $151.43 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $103.46 CIGNA — CIGNA: $129.78 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $143.20 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $110.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PELVIC SONOGRAM-TRANSVAGINAL	$1,100	$880	$105.86 – $1,100
Transvaginal ultrasound: 10 of 15 insurance plan rates AETNA — AETNA: $930.60 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $635.80 CIGNA — CIGNA: $797.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $880 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $680.90
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PELVIC SONOGRAM-TRANSVAGINAL	$1,100	$880	$680.90 – $1,100
Transvaginal ultrasound: rates for 7 insurance plans AETNA — AETNA: $930.60 CIGNA — CIGNA: $797.50 HUMANA — HUMANA: $880 MEDCOST — MEDCOST: $680.90 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $1,100 SELF PAY — SELF PAY: $880 UNITED HEALTHCARE — UNITED HEALTHCARE: $869
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: PELVIC SONOGRAM-TRANSVAGINAL	$124	$99.20	$71.67 – $124
Transvaginal ultrasound: 10 of 15 insurance plan rates AETNA — AETNA: $104.90 AETNA MEDICARE — AETNA MEDICARE: $106.69 AMBETTER (MCR) — AMBETTER (MCR): $103.58 BCBS — BCBS: $71.67 CIGNA — CIGNA: $89.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.65 HUMANA — HUMANA: $99.20 HUMANA MEDICARE — HUMANA MEDICARE: $104.62 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $103.58 MEDCOST — MEDCOST: $76.76
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO DIAG UNILATERAL KOMEN	$56	$44.80	$32.37 – $57.68
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates AETNA — AETNA: $47.38 AETNA MEDICARE — AETNA MEDICARE: $57.68 AMBETTER (MCR) — AMBETTER (MCR): $56 BCBS — BCBS: $32.37 CIGNA — CIGNA: $40.60 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $57.12 HUMANA — HUMANA: $44.80 HUMANA MEDICARE — HUMANA MEDICARE: $56.56 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $56 MEDCOST — MEDCOST: $34.66
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO UNILATERAL-HEALTH DEPT	$71	$56.80	$41.04 – $73.13
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates AETNA — AETNA: $60.07 AETNA MEDICARE — AETNA MEDICARE: $73.13 AMBETTER (MCR) — AMBETTER (MCR): $71 BCBS — BCBS: $41.04 CIGNA — CIGNA: $51.48 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $72.42 HUMANA — HUMANA: $56.80 HUMANA MEDICARE — HUMANA MEDICARE: $71.71 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $71 MEDCOST — MEDCOST: $43.95
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO 2D DIAG UNILATERAL-RT	$412	$329.60	$76.28 – $412
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates AETNA — AETNA: $348.55 AETNA MEDICARE — AETNA MEDICARE: $82.71 AMBETTER (MCR) — AMBETTER (MCR): $80.30 BCBS — BCBS: $238.14 CIGNA — CIGNA: $298.70 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $81.91 HUMANA — HUMANA: $329.60 HUMANA MEDICARE — HUMANA MEDICARE: $81.10 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $80.30 MEDCOST — MEDCOST: $255.03
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO 2D DIAGNOSTIC BILATERAL	$618	$494.40	$97.80 – $618
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $522.83 AETNA MEDICARE — AETNA MEDICARE: $106.04 AMBETTER (MCR) — AMBETTER (MCR): $102.95 BCBS — BCBS: $357.20 CIGNA — CIGNA: $448.05 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $105.01 HUMANA — HUMANA: $494.40 HUMANA MEDICARE — HUMANA MEDICARE: $103.98 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $102.95 MEDCOST — MEDCOST: $382.54
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO DIAG BIL DIG-KOMEN	$56	$44.80	$32.37 – $57.68
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $47.38 AETNA MEDICARE — AETNA MEDICARE: $57.68 AMBETTER (MCR) — AMBETTER (MCR): $56 BCBS — BCBS: $32.37 CIGNA — CIGNA: $40.60 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $57.12 HUMANA — HUMANA: $44.80 HUMANA MEDICARE — HUMANA MEDICARE: $56.56 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $56 MEDCOST — MEDCOST: $34.66
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO BIL DIAG DIG-HEALTH DPT	$87	$69.60	$50.29 – $89.61
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $73.60 AETNA MEDICARE — AETNA MEDICARE: $89.61 AMBETTER (MCR) — AMBETTER (MCR): $87 BCBS — BCBS: $50.29 CIGNA — CIGNA: $63.07 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $88.74 HUMANA — HUMANA: $69.60 HUMANA MEDICARE — HUMANA MEDICARE: $87.87 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $87 MEDCOST — MEDCOST: $53.85
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMOGRAPHY SCREEN-VOUCHER	$64	$51.20	$36.99 – $65.92
Screening mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $54.14 AETNA MEDICARE — AETNA MEDICARE: $65.92 AMBETTER (MCR) — AMBETTER (MCR): $64 BCBS — BCBS: $36.99 CIGNA — CIGNA: $46.40 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $65.28 HUMANA — HUMANA: $51.20 HUMANA MEDICARE — HUMANA MEDICARE: $64.64 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $64 MEDCOST — MEDCOST: $39.62
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO 2D SCR BILAT MURDOCH	$94	$75.20	$54.33 – $94
Screening mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $79.52 AETNA MEDICARE — AETNA MEDICARE: $87.53 AMBETTER (MCR) — AMBETTER (MCR): $84.98 BCBS — BCBS: $54.33 CIGNA — CIGNA: $68.15 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $86.68 HUMANA — HUMANA: $75.20 HUMANA MEDICARE — HUMANA MEDICARE: $85.83 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $84.98 MEDCOST — MEDCOST: $58.19
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *MAMMO BIL SCR DIG W/C-HLT DPT	$71	$56.80	$41.04 – $73.13
Screening mammogram, both breasts: 10 of 15 insurance plan rates AETNA — AETNA: $60.07 AETNA MEDICARE — AETNA MEDICARE: $73.13 AMBETTER (MCR) — AMBETTER (MCR): $71 BCBS — BCBS: $41.04 CIGNA — CIGNA: $51.48 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $72.42 HUMANA — HUMANA: $56.80 HUMANA MEDICARE — HUMANA MEDICARE: $71.71 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $71 MEDCOST — MEDCOST: $43.95

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPH,4+PARAM,ATTEND	$1,804	$1,443.20	$869.50 – $1,804
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates AETNA — AETNA: $1,526.18 AETNA MEDICARE — AETNA MEDICARE: $876.30 AMBETTER (MCR) — AMBETTER (MCR): $850.78 BCBS — BCBS: $1,042.71 CIGNA — CIGNA: $1,307.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $867.80 HUMANA — HUMANA: $1,443.20 HUMANA MEDICARE — HUMANA MEDICARE: $859.29 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $850.78 MEDCOST — MEDCOST: $1,116.68
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPH,4+PARAM,ATTEND	$1,804	$1,443.20	$1,116.68 – $1,804
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans AETNA — AETNA: $1,526.18 CIGNA — CIGNA: $1,307.90 HUMANA — HUMANA: $1,443.20 MEDCOST — MEDCOST: $1,116.68 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $1,804 SELF PAY — SELF PAY: $1,443.20 UNITED HEALTHCARE — UNITED HEALTHCARE: $1,425.16

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THER PROC/EXERCISE EA 15 MIN	$232	$185.60	$26.62 – $232
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates AETNA — AETNA: $196.27 AETNA MEDICARE — AETNA MEDICARE: $28.86 AMBETTER (MCR) — AMBETTER (MCR): $28.02 BCBS — BCBS: $134.10 CIGNA — CIGNA: $168.20 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $28.58 HUMANA — HUMANA: $185.60 HUMANA MEDICARE — HUMANA MEDICARE: $28.30 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $28.02 MEDCOST — MEDCOST: $143.61
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THER PROC/EXERCISE EA 15MIN	$232	$185.60	$26.62 – $232
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates AETNA — AETNA: $196.27 AETNA MEDICARE — AETNA MEDICARE: $28.86 AMBETTER (MCR) — AMBETTER (MCR): $28.02 BCBS — BCBS: $134.10 CIGNA — CIGNA: $168.20 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $28.58 HUMANA — HUMANA: $185.60 HUMANA MEDICARE — HUMANA MEDICARE: $28.30 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $28.02 MEDCOST — MEDCOST: $143.61
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXERCISE EACH 15MIN	$232	$185.60	$26.62 – $232
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates AETNA — AETNA: $196.27 AETNA MEDICARE — AETNA MEDICARE: $28.86 AMBETTER (MCR) — AMBETTER (MCR): $28.02 BCBS — BCBS: $134.10 CIGNA — CIGNA: $168.20 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $28.58 HUMANA — HUMANA: $185.60 HUMANA MEDICARE — HUMANA MEDICARE: $28.30 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $28.02 MEDCOST — MEDCOST: $143.61
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION LOW COMPLEXITY	$450	$360	$89.93 – $450
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates AETNA — AETNA: $380.70 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $260.10 CIGNA — CIGNA: $326.25 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $360 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $278.55
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION LOW COMPLEXITY	$450	$360	$278.55 – $450
Physical therapy evaluation (low complexity): rates for 7 insurance plans AETNA — AETNA: $380.70 CIGNA — CIGNA: $326.25 HUMANA — HUMANA: $360 MEDCOST — MEDCOST: $278.55 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $450 SELF PAY — SELF PAY: $360 UNITED HEALTHCARE — UNITED HEALTHCARE: $355.50
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: PT EVAL LOW COMPLEXITY W/59MOD	$404	$323.20	$89.93 – $404
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates AETNA — AETNA: $341.78 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $233.51 CIGNA — CIGNA: $292.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $323.20 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $250.08
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION MODERATE COMPLEX	$460	$368	$89.93 – $460
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates AETNA — AETNA: $389.16 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $265.88 CIGNA — CIGNA: $333.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $368 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $284.74
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION MODERATE COMPLEX	$460	$368	$284.74 – $460
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans AETNA — AETNA: $389.16 CIGNA — CIGNA: $333.50 HUMANA — HUMANA: $368 MEDCOST — MEDCOST: $284.74 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $460 SELF PAY — SELF PAY: $368 UNITED HEALTHCARE — UNITED HEALTHCARE: $363.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: PT EVAL MODERATE COMPLEX W/59	$460	$368	$89.93 – $460
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates AETNA — AETNA: $389.16 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $265.88 CIGNA — CIGNA: $333.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $368 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $284.74
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION HIGH COMPLEXITY	$518	$414.40	$89.93 – $518
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates AETNA — AETNA: $438.23 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $299.40 CIGNA — CIGNA: $375.55 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $414.40 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $320.64
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION HIGH COMPLEXITY	$518	$414.40	$320.64 – $518
Physical therapy evaluation (high complexity): rates for 7 insurance plans AETNA — AETNA: $438.23 CIGNA — CIGNA: $375.55 HUMANA — HUMANA: $414.40 MEDCOST — MEDCOST: $320.64 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $518 SELF PAY — SELF PAY: $414.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $409.22
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: PT EVAL HIGH COMPLEXITY W/59	$493	$394.40	$89.93 – $493
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates AETNA — AETNA: $417.08 AETNA MEDICARE — AETNA MEDICARE: $97.50 AMBETTER (MCR) — AMBETTER (MCR): $94.66 BCBS — BCBS: $284.95 CIGNA — CIGNA: $357.43 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $96.55 HUMANA — HUMANA: $394.40 HUMANA MEDICARE — HUMANA MEDICARE: $95.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $94.66 MEDCOST — MEDCOST: $305.17
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND THERAPY-LCSW 30MIN FAC	$161	$128.80	$93.06 – $179.72
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $136.21 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $93.06 CIGNA — CIGNA: $116.72 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $128.80 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $99.66
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND THPY,30MIN LCSW PRO	$89	$71.20	$51.44 – $89
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $75.29 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $51.44 CIGNA — CIGNA: $64.52 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $71.20 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $55.09
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHMD,W/O E&M,PROF 30MIN-BWD	$118	$94.40	$68.20 – $179.72
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $99.83 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $68.20 CIGNA — CIGNA: $85.55 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $94.40 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $73.04
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND THERAPY-LCSW 45MIN FACIL	$209	$167.20	$120.80 – $209
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $176.81 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $120.80 CIGNA — CIGNA: $151.53 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $167.20 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $129.37
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND THPY,45MIN LCSW PRO	$128	$102.40	$73.98 – $128
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $108.29 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $73.98 CIGNA — CIGNA: $92.80 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $102.40 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $79.23
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHMD,W/O E&M,PROF 45MIN-BWD	$176	$140.80	$101.73 – $179.72
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $148.90 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $101.73 CIGNA — CIGNA: $127.60 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $140.80 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $108.94
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND PSYCHMD,W/O E&M FAC,60 MIN	$229	$183.20	$132.36 – $229
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $193.73 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $132.36 CIGNA — CIGNA: $166.03 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $183.20 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $141.75
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND,PSYCHMD,W/O E&M,PROF,60MIN	$460	$368	$179.72 – $460
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $389.16 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $265.88 CIGNA — CIGNA: $333.50 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $368 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $284.74
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IND THERAPY 60MIN LCSW PROF	$275	$220	$158.95 – $275
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates AETNA — AETNA: $232.65 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $158.95 CIGNA — CIGNA: $199.38 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $220 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $170.22
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THPY,PSYCHMD,W/O PT FAC	$338	$270.40	$179.72 – $338
Family psychotherapy, without the patient: 10 of 15 insurance plan rates AETNA — AETNA: $285.95 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $195.36 CIGNA — CIGNA: $245.05 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $270.40 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $209.22
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THPY,PSYCHMD,W/O PT PRO	$282	$225.60	$163 – $282
Family psychotherapy, without the patient: 10 of 15 insurance plan rates AETNA — AETNA: $238.57 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $163 CIGNA — CIGNA: $204.45 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $225.60 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $174.56
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THER W/O PT LCSW PROF	$204	$163.20	$117.91 – $204
Family psychotherapy, without the patient: 10 of 15 insurance plan rates AETNA — AETNA: $172.58 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $117.91 CIGNA — CIGNA: $147.90 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $163.20 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $126.28
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY-LCSW 60MIN FAC	$308	$246.40	$178.02 – $308
Family psychotherapy, with the patient: 10 of 15 insurance plan rates AETNA — AETNA: $260.57 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $178.02 CIGNA — CIGNA: $223.30 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $246.40 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $190.65
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THPY W/PAT-LCSW PROF	$149	$119.20	$86.12 – $149
Family psychotherapy, with the patient: 10 of 15 insurance plan rates AETNA — AETNA: $126.05 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $86.12 CIGNA — CIGNA: $108.02 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $119.20 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $92.23
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THPY,PSYCHMD, W/PT FAC	$338	$270.40	$179.72 – $338
Family psychotherapy, with the patient: 10 of 15 insurance plan rates AETNA — AETNA: $285.95 AETNA MEDICARE — AETNA MEDICARE: $181.13 AMBETTER (MCR) — AMBETTER (MCR): $175.85 BCBS — BCBS: $195.36 CIGNA — CIGNA: $245.05 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $179.37 HUMANA — HUMANA: $270.40 HUMANA MEDICARE — HUMANA MEDICARE: $177.61 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $175.85 MEDCOST — MEDCOST: $209.22
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCSW/LPC PROCESS GROUP	$108	$86.40	$62.42 – $108
Group psychotherapy: 10 of 15 insurance plan rates AETNA — AETNA: $91.37 AETNA MEDICARE — AETNA MEDICARE: $103.67 AMBETTER (MCR) — AMBETTER (MCR): $100.65 BCBS — BCBS: $62.42 CIGNA — CIGNA: $78.30 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $102.66 HUMANA — HUMANA: $86.40 HUMANA MEDICARE — HUMANA MEDICARE: $101.66 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $100.65 MEDCOST — MEDCOST: $66.85
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *ALCOHOL REHAB GROUP-CSAC	$108	$86.40	$62.42 – $108
Group psychotherapy: 10 of 15 insurance plan rates AETNA — AETNA: $91.37 AETNA MEDICARE — AETNA MEDICARE: $103.67 AMBETTER (MCR) — AMBETTER (MCR): $100.65 BCBS — BCBS: $62.42 CIGNA — CIGNA: $78.30 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $102.66 HUMANA — HUMANA: $86.40 HUMANA MEDICARE — HUMANA MEDICARE: $101.66 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $100.65 MEDCOST — MEDCOST: $66.85
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *DRUG REHAB GROUP-CSAC	$108	$86.40	$62.42 – $108
Group psychotherapy: 10 of 15 insurance plan rates AETNA — AETNA: $91.37 AETNA MEDICARE — AETNA MEDICARE: $103.67 AMBETTER (MCR) — AMBETTER (MCR): $100.65 BCBS — BCBS: $62.42 CIGNA — CIGNA: $78.30 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $102.66 HUMANA — HUMANA: $86.40 HUMANA MEDICARE — HUMANA MEDICARE: $101.66 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $100.65 MEDCOST — MEDCOST: $66.85

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY,PROSTATE;NEEDLE/PUNCH	$673	$538.40	$388.99 – $673
Prostate biopsy: rates for 9 insurance plans AETNA — AETNA: $569.36 BCBS — BCBS: $388.99 CIGNA — CIGNA: $487.93 HUMANA — HUMANA: $538.40 MEDCOST — MEDCOST: $416.59 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $673 SELF PAY — SELF PAY: $538.40 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $673 UNITED HEALTHCARE — UNITED HEALTHCARE: $531.67
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY,PROSTATE;NEEDLE/PUNCH	$673	$538.40	$416.59 – $673
Prostate biopsy: rates for 7 insurance plans AETNA — AETNA: $569.36 CIGNA — CIGNA: $487.93 HUMANA — HUMANA: $538.40 MEDCOST — MEDCOST: $416.59 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $673 SELF PAY — SELF PAY: $538.40 UNITED HEALTHCARE — UNITED HEALTHCARE: $531.67
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: BIOPSY,PROSTATE; NEEDLE/PUNCH	$300	$240	$173.40 – $300
Prostate biopsy: rates for 9 insurance plans AETNA — AETNA: $253.80 BCBS — BCBS: $173.40 CIGNA — CIGNA: $217.50 HUMANA — HUMANA: $240 MEDCOST — MEDCOST: $185.70 NON CONTRACTED (100% POC) — NON CONTRACTED (100 POC): $300 SELF PAY — SELF PAY: $240 TRICARE/CHAMPUS (MCR) — TRICARE/CHAMPUS (MCR): $300 UNITED HEALTHCARE — UNITED HEALTHCARE: $237

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$4,157 – $79,940.68
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 14 insurance plan rates AETNA MEDICARE — AETNA MEDICARE: $79,940.68 AMBETTER (MCR) — AMBETTER (MCR): $77,612.31 BCBS — BCBS: $4,157 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $79,164.56 HUMANA MEDICARE — HUMANA MEDICARE: $78,388.43 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $77,612.31 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE: $71,403.33 AETNA — AETNA: 84.6% (a percentage in the contract, not a dollar amount) CIGNA — CIGNA: 72.5% (a percentage in the contract, not a dollar amount) HUMANA — HUMANA: 80% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$2,702 – $31,911.60
Spinal fusion (not neck), without major complications: 10 of 14 insurance plan rates AETNA MEDICARE — AETNA MEDICARE: $31,911.60 AMBETTER (MCR) — AMBETTER (MCR): $30,982.14 BCBS — BCBS: $2,702 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $31,601.78 HUMANA MEDICARE — HUMANA MEDICARE: $31,291.96 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $30,982.14 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE: $28,503.57 AETNA — AETNA: 84.6% (a percentage in the contract, not a dollar amount) CIGNA — CIGNA: 72.5% (a percentage in the contract, not a dollar amount) HUMANA — HUMANA: 80% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$4,157 – $18,783.51
Hip or knee replacement (major joint of the leg), without major complications: 10 of 14 insurance plan rates AETNA MEDICARE — AETNA MEDICARE: $18,783.51 AMBETTER (MCR) — AMBETTER (MCR): $18,236.42 BCBS — BCBS: $4,157 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $18,601.15 HUMANA MEDICARE — HUMANA MEDICARE: $18,418.78 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $18,236.42 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE: $16,777.51 AETNA — AETNA: 84.6% (a percentage in the contract, not a dollar amount) CIGNA — CIGNA: 72.5% (a percentage in the contract, not a dollar amount) HUMANA — HUMANA: 80% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,702 – $22,606.37
Neck (cervical) spinal fusion, without complications: 10 of 14 insurance plan rates AETNA MEDICARE — AETNA MEDICARE: $22,606.37 AMBETTER (MCR) — AMBETTER (MCR): $21,947.93 BCBS — BCBS: $2,702 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $22,386.89 HUMANA MEDICARE — HUMANA MEDICARE: $22,167.41 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $21,947.93 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE: $20,192.10 AETNA — AETNA: 84.6% (a percentage in the contract, not a dollar amount) CIGNA — CIGNA: 72.5% (a percentage in the contract, not a dollar amount) HUMANA — HUMANA: 80% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,702 – $13,700
Uterus and ovary surgery (not for cancer), without complications: 10 of 14 insurance plan rates AETNA MEDICARE — AETNA MEDICARE: $13,700 AMBETTER (MCR) — AMBETTER (MCR): $13,300.97 BCBS — BCBS: $2,702 GATEWAY HEALTH MEDICARE — GATEWAY HEALTH MEDICARE: $13,566.99 HUMANA MEDICARE — HUMANA MEDICARE: $13,433.98 MANAGED MEDICARE (100% POM) — MANAGED MEDICARE (100 PerCent POM): $13,300.97 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE: $12,236.89 AETNA — AETNA: 84.6% (a percentage in the contract, not a dollar amount) CIGNA — CIGNA: 72.5% (a percentage in the contract, not a dollar amount) HUMANA — HUMANA: 80% (a percentage in the contract, not a dollar amount)

Source: Granville Health Systems’s standard charges file (ghshospital.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 5, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1010 College St, Oxford, NC 27565
County	Granville County
State	North Carolina
Phone	(919) 690‑3000
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	340127
Name in Medicare records	GRANVILLE HEALTH SYSTEMS
Profile level	Medicare data + hospital website
Name on the hospital’s website	Granville Medical Center
Official website	ghshospital.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Granville Medical Center — ghshospital.org
Services and Amenities at Granville Health System | GHS — ghshospital.org
Inpatient and Outpatient Services | Granville Health System — ghshospital.org

Granville Health Systems

Summary

Profile from official sources

At a glance