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Acute Care Hospital

Harris Regional Hospital

Sylva, North Carolina · Jackson County · Emergency services listed

Harris Regional Hospital is an acute care hospital at 68 Hospital Rd, Sylva, NC 28779. Phone: (828) 586-7000. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Harris Regional Hospital is an acute care hospital in Sylva, North Carolina. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 64 services, specialties and programs. Medicare lists 313 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

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Exterior of Harris Regional Hospital
Photo: Harrison Keely, CC BY 4.0, via Wikimedia Commons · source · license

Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
86Beds (hospital website)
64Services listed

Quick answers

Does Harris Regional Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Harris Regional Hospital. In a medical emergency, call 911.
Where is Harris Regional Hospital?
68 Hospital Rd, Sylva, NC 28779, in Jackson County, North Carolina.
What is the phone number of Harris Regional Hospital?
(828) 586-7000, as listed by Medicare (CMS).
What is the Medicare star rating of Harris Regional Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Harris Regional Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Harris Regional Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0629; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][5][6][9][10]

Treatments[5][7][10][12][14]

Procedures[8][9]

  • Laparoscopic, laser and endoscopic surgery
  • Outpatient surgery
  • Sexual assault kit collection
  • Forensic photography
  • Physical evidence collection

Programs and centers[4][5][6][8][10][12][13][15]

  • Chest pain care (ACC Chest Pain Center)
  • Community Paramedicine Program
  • Forensic Nurse Services
  • Home Care Services
  • Cancer Care (Harris Regional Cancer Center)
  • Labor and Delivery
  • Rehabilitation Services

Emergency care (hospital website)[6]

Emergency roomYes
Open 24/7Yes
Stroke designationAcute Stroke Ready Hospital

Recognition[6]

  • Chest Pain Center accreditation (American College of Cardiology)
  • Acute Stroke Ready Hospital Certification (Joint Commission, American Heart Association, American Stroke Association)

Doctors and clinicians (313)

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

Main specialties

Doctors with a page on this site (313)

And 289 more: the button below opens the full list.

Other emergency rooms nearby

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

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Sylva

Hospitals in Jackson County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Restfulness of Environment4 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1065%National average: 72%
Would definitely recommend the hospital66%National average: 71%
Nurses “always” communicated well79%National average: 80%
Doctors “always” communicated well79%National average: 80%
“Always” got help as soon as they wanted59%National average: 64%
Staff “always” explained medicines before giving them53%National average: 62%
Were given information about recovery at home85%National average: 86%
Room and bathroom “always” clean62%National average: 73%
Completed surveys357Response rate: 19%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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.

Surgical site infections after colon surgery0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.177No different from the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 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 failure patients11.4%
Deaths within 30 days: pneumonia patients17.3%
Deaths within 30 days: COPD patients8.2%
Deaths within 30 days: stroke patients9.5%
Serious complications (patient safety indicator PSI-90)1.13No different from the national rate
Complications after hip or knee replacement4.9%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)
Too few cases to reportDeaths within 30 days: heart attack patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)15.9%
Readmitted within 30 days: heart failure20.6%
Readmitted within 30 days: pneumonia17%
Readmitted within 30 days: COPD19.7%
Readmitted within 30 days: hip or knee replacement5.1%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 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)172 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)74%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Harris Regional Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score0.0629Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart failure0.9804Fewer readmissions than expected
Pneumonia0.9753Fewer readmissions than expected
COPD (chronic lung disease)0.9683Fewer readmissions than expected
Hip or knee replacement0.9318Fewer readmissions than expected
No result publishedHeart attack; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score28.50 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)25.00 out of 100
Person and community engagement (patient survey)47.00 out of 100
Safety (infections and sepsis care)42.00 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.06Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

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

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Harris Regional Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Show the prices of 65 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $360.69 $144.28 $55.91 – $360.69
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e Not listed in the file Not listed in the file Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 15.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 61.9% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $444.59 $177.84 $68.91 – $444.59
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e Not listed in the file Not listed in the file Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 15.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 61.9% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $528.42 $211.37 $81.91 – $528.42
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e Not listed in the file Not listed in the file Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 15.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 61.9% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history $360.69 $144.28 $55.91 – $360.69
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history Not listed in the file Not listed in the file Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 15.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 61.9% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history $447.50 $179 $69.36 – $447.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history Not listed in the file Not listed in the file Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 15.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 61.9% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $1,355.84 $542.34 $259.76 – $1,355.84
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $857.79
Emergency room visit (moderate): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $857.79
  • UHC — UHC All Payer: $1,681
  • UHC — UHC HIX: $1,357
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $1,911.56 $764.62 $399.48 – $1,911.56
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,834
Emergency room visit (moderately high): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $1,289.42
  • UHC — UHC All Payer: $1,834
  • UHC — UHC HIX: $1,480
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $2,889.13 $1,155.65 $575.17 – $2,889.13
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,601
Emergency room visit (high): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $2,239
  • UHC — UHC All Payer: $1,983
  • UHC — UHC HIX: $1,601
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch $106.43 $42.57 $7.10 – $106.43
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch Not listed in the file Not listed in the file $8.46
Basic metabolic panel (blood test): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $31.48
  • Cigna — Cigna: $8.46
  • UHC — UHC All Payer: $7.10
  • UHC — UHC HIX: $7.10
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon $108.01 $43.20 $8.86 – $108.01
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon Not listed in the file Not listed in the file $10.56
Comprehensive metabolic panel (blood test): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $33.22
  • Cigna — Cigna: $10.56
  • UHC — UHC All Payer: $8.86
  • UHC — UHC HIX: $8.86
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester $177.54 $71.02 $13.39 – $177.54
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester Not listed in the file Not listed in the file $13.39
Cholesterol panel (lipid panel): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $52.63
  • Cigna — Cigna: $13.39
  • UHC — UHC All Payer: $17.51
  • UHC — UHC HIX: $17.51
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo $106.43 $42.57 $7.28 – $106.43
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo Not listed in the file Not listed in the file $8.68
Kidney function panel: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $31.48
  • Cigna — Cigna: $8.68
  • UHC — UHC All Payer: $7.28
  • UHC — UHC HIX: $7.28
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase $106.43 $42.57 $6.85 – $106.43
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase Not listed in the file Not listed in the file $8.17
Liver function panel: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $31.48
  • Cigna — Cigna: $8.17
  • UHC — UHC All Payer: $6.85
  • UHC — UHC HIX: $6.85
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $37.44 $14.98 $2.66 – $37.44
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, Not listed in the file Not listed in the file $12.43
Urine test (automated, with microscope): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $12.43
  • Cigna — Cigna: $3.17
  • UHC — UHC All Payer: $2.66
  • UHC — UHC HIX: $2.66
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $42.22 $16.89 $1.88 – $42.22
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, Not listed in the file Not listed in the file $1.88
Urine test (automated, without microscope): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $8.83
  • Cigna — Cigna: $2.25
  • UHC — UHC All Payer: $1.88
  • UHC — UHC HIX: $1.88
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate specific antigen (PSA); total $286.76 $114.70 $15.42 – $286.76
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate specific antigen (PSA); total Not listed in the file Not listed in the file $18.39
PSA (prostate specific antigen) blood test: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $72.31
  • Cigna — Cigna: $18.39
  • UHC — UHC All Payer: $15.42
  • UHC — UHC HIX: $15.42
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH) $216.02 $86.41 $14.08 – $216.02
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH) Not listed in the file Not listed in the file $14.08
Thyroid stimulating hormone (TSH) test: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $64.04
  • Cigna — Cigna: $16.80
  • UHC — UHC All Payer: $14.08
  • UHC — UHC HIX: $14.08
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count $103.22 $41.29 $6.52 – $103.22
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count Not listed in the file Not listed in the file $7.77
Complete blood count (CBC) with differential: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $30.57
  • Cigna — Cigna: $7.77
  • UHC — UHC All Payer: $6.52
  • UHC — UHC HIX: $6.52
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) $86.27 $34.51 $5.42 – $86.27
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Not listed in the file Not listed in the file $5.42
Complete blood count (CBC), automated: 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $25.44
  • Cigna — Cigna: $6.47
  • UHC — UHC All Payer: $5.42
  • UHC — UHC HIX: $5.42
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time $52.57 $21.03 $3.29 – $52.57
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time Not listed in the file Not listed in the file $4.29
Blood clotting time test (prothrombin time, PT): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $15.43
  • Cigna — Cigna: $4.29
  • UHC — UHC All Payer: $3.29
  • UHC — UHC HIX: $3.29
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time, partial (PTT); plasma or whole blood $80.10 $32.04 $5.03 – $80.10
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time, partial (PTT); plasma or whole blood Not listed in the file Not listed in the file $5.03
Blood clotting test (partial thromboplastin time, PTT): 10 of 35 insurance plan rates
  • BCBS of NC — BCBS of NC: $23.58
  • Cigna — Cigna: $6.01
  • UHC — UHC All Payer: $5.03
  • UHC — UHC HIX: $5.03
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, head or brain; without contrast material $1,568 $627.20 $99.76 – $1,568
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, head or brain; without contrast material Not listed in the file Not listed in the file $382.45
CT scan of the head or brain, without contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $382.45
  • UHC — UHC All Payer: $2,239
  • UHC — UHC HIX: $1,806
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, head or brain; without contrast material $1,568 $627.20 $99.76 – $1,568
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $5,819.33 $2,327.73 $335.04 – $5,819.33
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth Not listed in the file Not listed in the file $2,956
MRI of the brain, before and after contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $819.55
  • UHC — UHC All Payer: $3,663
  • UHC — UHC HIX: $2,956
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $5,819.33 $2,327.73 $335.04 – $5,819.33
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, chest; 2 views $475.11 $190.04 $82.60 – $475.11
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file Not listed in the file
Chest X-ray, 2 views: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Radiologic examination, chest; 2 views $475.11 $190.04 $82.60 – $475.11
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views $794.58 $317.83 $99.76 – $794.58
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file Not listed in the file
X-ray of the lower spine, at least 4 views: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views $794.58 $317.83 $99.76 – $794.58
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $3,799.60 $1,519.84 $226.77 – $3,799.60
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Not listed in the file Not listed in the file $3,663
MRI of the lower back (lumbar spine), without contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $819.55
  • UHC — UHC All Payer: $3,663
  • UHC — UHC HIX: $2,956
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $3,799.60 $1,519.84 $226.77 – $3,799.60
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, pelvis; with contrast material(s) $2,816.35 $1,126.54 $167.01 – $2,816.35
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $382.45
CT scan of the pelvis, with contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $382.45
  • UHC — UHC All Payer: $2,239
  • UHC — UHC HIX: $1,806
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, pelvis; with contrast material(s) $2,816.35 $1,126.54 $167.01 – $2,816.35
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material $3,799.60 $1,519.84 $226.77 – $3,799.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material Not listed in the file Not listed in the file $3,663
MRI of a leg joint (such as the knee), without contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $819.55
  • UHC — UHC All Payer: $3,663
  • UHC — UHC HIX: $2,956
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material $3,799.60 $1,519.84 $226.77 – $3,799.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, abdomen and pelvis; with contrast material(s) $5,631.92 $2,252.77 $335.04 – $5,631.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, abdomen and pelvis; with contrast material(s) Not listed in the file Not listed in the file $2,239
CT scan of the abdomen and pelvis, with contrast: 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $382.45
  • UHC — UHC All Payer: $2,239
  • UHC — UHC HIX: $1,806
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, abdomen and pelvis; with contrast material(s) $5,631.92 $2,252.77 $335.04 – $5,631.92
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, abdominal, real time with image documentation; complete $1,068.31 $427.32 $99.76 – $1,068.31
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, abdominal, real time with image documentation; complete Not listed in the file Not listed in the file Not listed in the file
Ultrasound of the abdomen, complete: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete $1,068.31 $427.32 $99.76 – $1,068.31
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $1,058.28 $423.31 $99.76 – $1,058.28
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day Not listed in the file Not listed in the file Not listed in the file
Pregnancy ultrasound (after the first trimester): 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $1,058.28 $423.31 $99.76 – $1,058.28
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, transvaginal $1,058.28 $423.31 $99.76 – $1,058.28
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file Not listed in the file
Transvaginal ultrasound: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, transvaginal $1,058.28 $423.31 $99.76 – $1,058.28
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral $1,045.65 $418.26 $84.10 – $1,045.65
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral Not listed in the file Not listed in the file $84.10
Diagnostic mammogram, one breast: 10 of 35 insurance plan rates
  • Cigna — Cigna: $84.10
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral $1,045.65 $418.26 $84.10 – $1,045.65
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $1,304.27 $521.71 $107.22 – $1,304.27
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Not listed in the file Not listed in the file $107.22
Diagnostic mammogram, both breasts: 10 of 35 insurance plan rates
  • Cigna — Cigna: $107.22
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $1,304.27 $521.71 $107.22 – $1,304.27
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $1,129.15 $451.66 $88.60 – $1,129.15
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Not listed in the file Not listed in the file $88.60
Screening mammogram, both breasts: 10 of 35 insurance plan rates
  • Cigna — Cigna: $88.60
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 150% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $1,129.15 $451.66 $88.60 – $1,129.15

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe $21,218.58 $8,487.43 $3,017.44 – $21,218.58
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe Not listed in the file Not listed in the file $14,436
Left heart catheterization (diagnostic): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $17,886
  • UHC — UHC HIX: $14,436
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe $21,218.58 $8,487.43 $3,017.44 – $21,218.58
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist $5,587.04 $2,234.82 $954.45 – $5,587.04
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist Not listed in the file Not listed in the file Not listed in the file
Sleep study (overnight, in a sleep lab): 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist $5,587.04 $2,234.82 $954.45 – $5,587.04

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib $225.46 $90.18 $27.65 – $225.46
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib Not listed in the file Not listed in the file $105
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $136.59
  • Cigna — Cigna: $105
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 31.79% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $290.26 $116.10 $92.27 – $290.26
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact Not listed in the file Not listed in the file $105
Physical therapy evaluation (low complexity): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $136.59
  • Cigna — Cigna: $105
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 31.79% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $434.48 $173.79 $94.11 – $434.48
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or Not listed in the file Not listed in the file $136.59
Physical therapy evaluation (moderate complexity): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $136.59
  • Cigna — Cigna: $105
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 31.79% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $580.38 $232.15 $94.11 – $580.38
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o Not listed in the file Not listed in the file $105
Physical therapy evaluation (high complexity): 10 of 35 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $136.59
  • Cigna — Cigna: $105
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 31.79% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19 $21,919.74 $8,767.89 $3,592.40 – $21,919.74
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19 Not listed in the file Not listed in the file $10,010
Removal of breast growth (open surgery): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $10,010
  • UHC — UHC HIX: $8,078
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft $52,925.59 $21,170.24 $12,070.88 – $52,925.59
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft Not listed in the file Not listed in the file $21,759
Total hip replacement: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $26,961
  • UHC — UHC HIX: $21,759
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) $53,657.80 $21,463.12 $12,070.88 – $53,657.80
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) Not listed in the file Not listed in the file $21,759
Total knee replacement: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $26,961
  • UHC — UHC HIX: $21,759
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele $15,913.27 $6,365.31 $689 – $15,913.27
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele Not listed in the file Not listed in the file $689
Shoulder arthroscopy: shaving of shoulder bone: rates for 10 insurance plans
  • UHC — UHC All Payer: $854
  • UHC — UHC HIX: $689
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 48.7% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula $29,633.42 $11,853.37 $3,043.90 – $29,633.42
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula Not listed in the file Not listed in the file $10,968
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $13,589
  • UHC — UHC HIX: $10,968
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy and adenoidectomy; younger than age 12 $23,189.07 $9,275.63 $5,549.72 – $23,189.07
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy and adenoidectomy; younger than age 12 Not listed in the file Not listed in the file $8,078
Removal of tonsils and adenoids (under age 12): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $10,010
  • UHC — UHC HIX: $8,078
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep $5,367.67 $2,147.07 $879.56 – $5,367.67
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep Not listed in the file Not listed in the file $3,711
Upper GI endoscopy (diagnostic): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $5,666.06 $2,266.42 $879.56 – $5,666.06
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Not listed in the file Not listed in the file $3,711
Upper GI endoscopy with biopsy: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) $5,580.37 $2,232.15 $855.31 – $5,580.37
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Not listed in the file Not listed in the file $4,598
Colonoscopy (diagnostic): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with biopsy, single or multiple $5,580.37 $2,232.15 $1,106.14 – $5,580.37
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with biopsy, single or multiple Not listed in the file Not listed in the file $4,598
Colonoscopy with biopsy: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique $5,580.37 $2,232.15 $1,106.14 – $5,580.37
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Not listed in the file Not listed in the file $4,598
Colonoscopy with removal of polyps (snare): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and $6,138.41 $2,455.36 $1,106.14 – $6,138.41
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and Not listed in the file Not listed in the file $3,711
Ultrasound of the lower bowel by endoscope: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk $5,846.12 $2,338.45 $855.31 – $5,846.12
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk Not listed in the file Not listed in the file $2,094
Screening colonoscopy (not high risk): 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $2,595
  • UHC — UHC HIX: $2,094
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy, surgical; cholecystectomy $35,275.96 $14,110.38 $5,473.45 – $35,275.96
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy, surgical; cholecystectomy Not listed in the file Not listed in the file $21,222
Gallbladder removal by laparoscope: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $21,222
  • UHC — UHC HIX: $17,128
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Repair initial inguinal hernia, age 5 years or older; reducible $28,610.60 $11,444.24 $3,310.75 – $28,610.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Repair initial inguinal hernia, age 5 years or older; reducible Not listed in the file Not listed in the file $13,589
Groin (inguinal) hernia repair, age 5 or older: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $13,589
  • UHC — UHC HIX: $10,968
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy, prostate; needle or punch, single or multiple, any approach $3,485.31 $1,394.12 $1,260.99 – $3,485.31
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy, prostate; needle or punch, single or multiple, any approach Not listed in the file Not listed in the file $4,598
Prostate biopsy: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $4,598
  • UHC — UHC HIX: $3,711
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C $29,983.20 $11,993.28 $2,982.84 – $29,983.20
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C Not listed in the file Not listed in the file $10,010
Hysteroscopy with biopsy of the uterus lining: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $10,010
  • UHC — UHC HIX: $8,078
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur $3,170.42 $1,268.17 $649.68 – $3,170.42
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur Not listed in the file Not listed in the file Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — Blue Cross Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Care Improvement — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing $4,246.52 $1,698.61 $835.22 – $4,246.52
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing Not listed in the file Not listed in the file $2,094
Nerve root injection, lower back, with imaging guidance: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $2,595
  • UHC — UHC HIX: $2,094
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing $4,246.52 $1,698.61 $835.22 – $4,246.52
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel $10,637.24 $4,254.90 $1,831.97 – $10,637.24
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel Not listed in the file Not listed in the file $8,078
Carpal tunnel release: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $10,010
  • UHC — UHC HIX: $8,078
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga $8,450.14 $3,380.05 $2,139.64 – $8,450.14
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga Not listed in the file Not listed in the file $10,010
Cataract removal with lens implant: 10 of 35 insurance plan rates
  • UHC — UHC All Payer: $10,010
  • UHC — UHC HIX: $8,078
  • Advantra — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 44.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Americas First Choice — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 43.56% (a percentage in the contract, not a dollar amount)
  • BCBS of NC — BCBS of NC: 36.18% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: spinal fusion except cervical $142,388.43 $56,955.37 $65,356.29 – $142,388.43
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: spinal fusion except cervical Not listed in the file Not listed in the file Not listed in the file
Spinal fusion (not neck), without major complications: rates for 5 insurance plans
  • Aetna — Aetna: 45.9% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 49.49% (a percentage in the contract, not a dollar amount)
  • Kanawha — Kanawha: 80% (a percentage in the contract, not a dollar amount)
  • Medcost — MedCost: 76.3% (a percentage in the contract, not a dollar amount)
  • Prime Health — Prime Health: 85% (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 $64,244.49 $25,697.79 $13,447.90 – $64,244.48
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 $14,370.77
Hip or knee replacement (major joint of the leg), without major complications: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: $14,370.77
  • Aetna — Managed Medicare 100%: $14,370.77
  • American Progressive — Managed Medicare 100%: $14,370.77
  • Americas First Choice — Managed Medicare 100%: $14,370.77
  • AmeriHealth Caritas Health Plan — AmeriHealth: $16,863.86
  • BCBS of NC — BCBS of NC: $17,039.26
  • BCBS of NC — Blue Cross Medicare Advantage: $13,447.90
  • Care Improvement — Managed Medicare 100%: $14,370.77
  • Care Plus — Managed Medicare 100%: $14,370.77
  • CareSource — CareSource HIX: $32,334.23
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 $67,527.27 $27,010.91 $8,549.45 – $67,527.27
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 $11,294.44
Uterus and ovary surgery (not for cancer), without complications: 10 of 35 insurance plan rates
  • Advantra — Managed Medicare 100%: $9,136.17
  • Aetna — Managed Medicare 100%: $9,136.17
  • American Progressive — Managed Medicare 100%: $9,136.17
  • Americas First Choice — Managed Medicare 100%: $9,136.17
  • AmeriHealth Caritas Health Plan — AmeriHealth: $10,721.14
  • BCBS of NC — BCBS of NC: $10,832.65
  • BCBS of NC — Blue Cross Medicare Advantage: $8,549.45
  • Care Improvement — Managed Medicare 100%: $9,136.17
  • Care Plus — Managed Medicare 100%: $9,136.17
  • CareSource — CareSource HIX: $20,556.37

Source: Harris Regional Hospital’s standard charges file (myharrisregional.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 10, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address68 Hospital Rd, Sylva, NC 28779
CountyJackson County
StateNorth Carolina
Phone(828) 586‑7000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number340016
Name in Medicare recordsHARRIS REGIONAL HOSPITAL
Profile levelMedicare data + hospital website
Official websitemyharrisregional.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

  1. Harris Regional Hospital — myharrisregional.com
  2. Services — myharrisregional.com
  3. Emergency Room — myharrisregional.com
  4. Medical Imaging Services | Sylva, NC — myharrisregional.com
  5. Forensic Nurse Services | Harris Regional Hospital — myharrisregional.com
  6. Surgical Services & General Surgery | Sylva, NC — myharrisregional.com
  7. Rehabilitation Services | Sylva, NC — myharrisregional.com
  8. Women's Health | Sylva, NC — myharrisregional.com
  9. Community Paramedicine Program — myharrisregional.com
  10. Heart Screenings & Imaging | Sylva, NC — myharrisregional.com
  11. Home Care Services | Sylva, NC — myharrisregional.com