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Acute Care Hospital

HCA Florida Aventura Hospital

Aventura, Florida · Miami-Dade County · Emergency services listed

Summary

HCA Florida Aventura Hospital is an acute care hospital in Aventura, Florida. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 150 services, specialties and programs. Medicare lists 368 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(305) 682‑7000 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
493Beds (hospital website)
368Doctors and clinicians
150Services listed

Quick answers

Does HCA Florida Aventura Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at HCA Florida Aventura Hospital. In a medical emergency, call 911.
Where is HCA Florida Aventura Hospital?
20900 Biscayne Blvd, Aventura, FL 33180, in Miami-Dade County, Florida.
What is the phone number of HCA Florida Aventura Hospital?
(305) 682-7000, as listed by Medicare (CMS).
What is the Medicare star rating of HCA Florida Aventura Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][13]

Conditions treated[5][9][10][12][14][16][17][18]

Treatments[5][7][9][10][12][13][14][16][17]

Procedures[4][5][10][12][14][15][16][17]

Programs and centers[4][5][6][9][10][13][14][16]

  • Orthopedics & Spine Institute
  • Trauma center
  • Cancer clinical trials
  • Inpatient rehabilitation center
  • Center for Cardiac and Vascular Medicine
  • Structural heart program
  • EP lab
  • Breast Diagnostic Center
  • Osteoporosis Program
  • Orthopedic and spine patient navigator
  • Stroke prevention clinical study (GORE REDUCE)
  • Comprehensive Cancer Center

Emergency care (hospital website)[4][8][11][13]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel II
Stroke designationComprehensive Stroke Center; Thrombectomy Capable Stroke Center

Visiting and practical information

VisitingVisiting hours 6 a.m.-9 p.m., seven days a week[6]
ParkingTwo visitor garages (North and West); valet Mon-Fri 8 a.m.-7 p.m[6]
Patient portalMyHealthONE

Recognition[4][11][13][14][17]

  • Level II Trauma Center (State of Florida)
  • Joint Commission hospital accreditation
  • Commission on Cancer accreditation
  • Hospital accreditation from The Joint Commission
  • Advanced Comprehensive Stroke Center (The Joint Commission)
  • Thrombectomy Capable Stroke Center designation (The Joint Commission)
  • Level II Trauma Center Certification (Florida Department of Health)
  • Level II Trauma Center Verification (American College of Surgeons)
  • Joint Commission certification for total hip and knee replacements
  • Healthgrades America's 50 Best Hospitals, Vascular Surgery (top 1% clinical outcomes) 2026

Doctors and clinicians (368)

368 doctors and other clinicians list HCA Florida Aventura 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 (368)

And 344 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night4 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 well74%National average: 80%
Doctors “always” communicated well77%National average: 80%
Staff “always” explained medicines before giving them55%National average: 62%
Were given information about recovery at home80%National average: 86%
Room and bathroom “always” clean72%National average: 74%
Area around the room “always” quiet at night67%National average: 60%
Completed surveys720Response rate: 18%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.478No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0Better than the national benchmark
Surgical site infections after colon surgery0.268No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.42No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients14.2%
Deaths within 30 days: heart failure patients9.2%
Deaths within 30 days: pneumonia patients12.9%
Deaths within 30 days: COPD patients7.9%
Deaths within 30 days: stroke patients10.1%
Deaths within 30 days: coronary bypass surgery (CABG)Too few cases to report
Serious complications (patient safety indicator PSI-90)0.89No different from the national rate
Complications after hip or knee replacement3.8%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.6%
Readmitted within 30 days: heart failure23%
Readmitted within 30 days: pneumonia17.5%
Readmitted within 30 days: COPD18.4%
Readmitted within 30 days: coronary bypass surgery10.6%
Readmitted within 30 days: hip or knee replacement5.3%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)135 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)76%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in FloridaBest hospitals in Florida

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as HCA Florida Aventura Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP $1,373 $1,373 $796.34
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates
  • Aetna — ASA: $416.40
  • Aetna — HMO-Gated: $247.06
  • Aetna — PPO-NonGated: $284.54
  • Aetna — QHP: $185.99
  • AIDS Healthcare — MGMCD: $1,665.60
  • AIDS Healthcare — MGMCR: $305.36
  • BCBS — BSLNON-PAR: $319.24
  • BCBS — HMO: $181.83
  • BCBS — MBN: $142.96
  • BCBS — MCRHMO: $88.83
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) 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 $275.34 – $281.14
New patient office visit (about 30–44 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $281.14
  • CorVel Corporation — WORKERSCOMP: $275.34
  • Prime Health — WORKERSCOMP: $281.14
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP $1,707 $1,707 $990.06
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates
  • Aetna — ASA: $519.30
  • Aetna — HMO-Gated: $308.12
  • Aetna — PPO-NonGated: $354.86
  • Aetna — QHP: $231.95
  • AIDS Healthcare — MGMCD: $2,077.20
  • AIDS Healthcare — MGMCR: $380.82
  • BCBS — BSLNON-PAR: $398.13
  • BCBS — HMO: $226.76
  • BCBS — MBN: $178.29
  • BCBS — MCRHMO: $110.78
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) 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 $152 – $155.20
New patient office visit (about 45–59 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $155.20
  • CorVel Corporation — WORKERSCOMP: $152
  • Prime Health — WORKERSCOMP: $155.20
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP $1,887 $1,887 $120.77 – $2,264.40
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates
  • Aetna — ASA: $566.10
  • Aetna — HMO-Gated: $335.89
  • Aetna — PPO-NonGated: $386.83
  • Aetna — QHP: $252.86
  • AIDS Healthcare — MGMCD: $2,264.40
  • AIDS Healthcare — MGMCR: $415.14
  • BCBS — BSLNON-PAR: $434.01
  • BCBS — HMO: $247.20
  • BCBS — MBN: $194.36
  • BCBS — MCRHMO: $120.77
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) 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 $1,887 $1,887 $198.55 – $202.73
New patient office visit (about 60–74 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $202.73
  • CorVel Corporation — WORKERSCOMP: $198.55
  • Prime Health — WORKERSCOMP: $202.73
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST $1,206 $1,206 $77.18 – $1,447.20
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates
  • Aetna — ASA: $361.80
  • Aetna — HMO-Gated: $214.67
  • Aetna — PPO-NonGated: $247.23
  • Aetna — QHP: $161.60
  • AIDS Healthcare — MGMCD: $1,447.20
  • AIDS Healthcare — MGMCR: $265.32
  • BCBS — BSLNON-PAR: $277.38
  • BCBS — HMO: $157.99
  • BCBS — MBN: $124.22
  • BCBS — MCRHMO: $77.18
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) 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 $59.85 – $61.11
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $61.11
  • CorVel Corporation — WORKERSCOMP: $59.85
  • Prime Health — WORKERSCOMP: $61.11
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST $1,543 $1,543 $98.75 – $1,851.60
Established patient office visit (about 30–39 minutes): 10 of 33 insurance plan rates
  • Aetna — ASA: $462.90
  • Aetna — HMO-Gated: $274.65
  • Aetna — PPO-NonGated: $316.31
  • Aetna — QHP: $206.76
  • AIDS Healthcare — MGMCD: $1,851.60
  • AIDS Healthcare — MGMCR: $339.46
  • BCBS — BSLNON-PAR: $354.89
  • BCBS — HMO: $202.13
  • BCBS — MBN: $158.93
  • BCBS — MCRHMO: $98.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) 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 $91.20 – $93.12
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $93.12
  • CorVel Corporation — WORKERSCOMP: $91.20
  • Prime Health — WORKERSCOMP: $93.12
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $372.17 – $380.01
Office consultation with a specialist (moderate): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $380.01
  • CorVel Corporation — WORKERSCOMP: $372.17
  • Prime Health — WORKERSCOMP: $380.01
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $182.40 – $186.24
Office consultation with a specialist (moderate to high): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $186.24
  • CorVel Corporation — WORKERSCOMP: $182.40
  • Prime Health — WORKERSCOMP: $186.24
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $73.27
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • Humana — TRICR: $73.27
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $89.23
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • Humana — TRICR: $89.23
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT $3,217 $3,217 $514.72 – $3,860.40
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — ASA: $965.10
  • AIDS Healthcare — MGMCD: $3,860.40
  • AvMed — JacksonFirstNetworkOON: $1,608.50
  • AvMed — JHSSelectHMO: $1,608.50
  • AvMed — MDCSelectOON: $1,608.50
  • Freedom Health — MGMCD: $514.72
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $2,734.45
  • Multiplan — COMMPPOPRIMARYNETWORK: $2,412.75
  • Plotkin Health — COMM: $1,608.50
  • Prime Health Sherriff — COMM: $1,608.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) 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 $800 – $4,285
Emergency room visit (moderate): 10 of 21 insurance plan rates
  • AmeriHealth Caritas — HIX: $1,750
  • AvMed — ASOEO: $3,721
  • AvMed — FullyInsured: $3,356
  • AvMed — HIX: $1,621
  • BCBS — BSLNON-PAR: $3,401
  • BCBS — HMO: $2,465
  • BCBS — MBN: $1,989
  • BCBS — NWB: $2,746
  • BCBS — PHS: $3,401
  • BCBS — PPO: $2,746
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier ER In the file: LVL 3 FREE STD EMER DEPT $3,520 $3,520 $563.20 – $4,224
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — ASA: $1,056
  • AIDS Healthcare — MGMCD: $4,224
  • AvMed — JacksonFirstNetworkOON: $1,760
  • AvMed — JHSSelectHMO: $1,760
  • AvMed — MDCSelectOON: $1,760
  • Freedom Health — MGMCD: $563.20
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $2,992
  • Multiplan — COMMPPOPRIMARYNETWORK: $2,640
  • Plotkin Health — COMM: $1,760
  • Prime Health Sherriff — COMM: $1,760
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT $4,072 $4,072 $651.52 – $4,886.40
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — ASA: $1,221.60
  • AIDS Healthcare — MGMCD: $4,886.40
  • AvMed — JacksonFirstNetworkOON: $2,036
  • AvMed — JHSSelectHMO: $2,036
  • AvMed — MDCSelectOON: $2,036
  • Freedom Health — MGMCD: $651.52
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $3,461.20
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,054
  • Plotkin Health — COMM: $2,036
  • Prime Health Sherriff — COMM: $2,036
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) 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 $947.44 – $967.39
Emergency room visit (moderately high): 10 of 21 insurance plan rates
  • AmeriHealth Caritas — HIX: $2,062
  • AvMed — ASOEO: $4,359
  • AvMed — FullyInsured: $3,933
  • AvMed — HIX: $1,950
  • BCBS — BSLNON-PAR: $3,599
  • BCBS — HMO: $2,981
  • BCBS — MBN: $2,398
  • BCBS — NWB: $3,274
  • BCBS — PHS: $3,599
  • BCBS — PPO: $3,274
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier ER In the file: LVL 4 FREE STD EMER DEPT $4,072 $4,072 $651.52 – $4,886.40
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — ASA: $1,221.60
  • AIDS Healthcare — MGMCD: $4,886.40
  • AvMed — JacksonFirstNetworkOON: $2,036
  • AvMed — JHSSelectHMO: $2,036
  • AvMed — MDCSelectOON: $2,036
  • Freedom Health — MGMCD: $651.52
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $3,461.20
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,054
  • Plotkin Health — COMM: $2,036
  • Prime Health Sherriff — COMM: $2,036
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT $5,902 $5,902 $944.32 – $7,082.40
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — ASA: $1,770.60
  • AIDS Healthcare — MGMCD: $7,082.40
  • AvMed — JacksonFirstNetworkOON: $2,951
  • AvMed — JHSSelectHMO: $2,951
  • AvMed — MDCSelectOON: $2,951
  • Freedom Health — MGMCD: $944.32
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $5,016.70
  • Multiplan — COMMPPOPRIMARYNETWORK: $4,426.50
  • Plotkin Health — COMM: $2,951
  • Prime Health Sherriff — COMM: $2,951
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) 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 $800 – $4,650
Emergency room visit (high): 10 of 21 insurance plan rates
  • AmeriHealth Caritas — HIX: $3,126
  • AvMed — ASOEO: $7,734
  • AvMed — FullyInsured: $6,974
  • AvMed — HIX: $3,459
  • BCBS — BSLNON-PAR: $3,599
  • BCBS — HMO: $2,981
  • BCBS — MBN: $2,398
  • BCBS — NWB: $3,274
  • BCBS — PHS: $3,599
  • BCBS — PPO: $3,274
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier ER In the file: LVL 5 FREE STD EMER DEPT $5,847 $5,847 $935.52 – $7,016.40
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — ASA: $1,754.10
  • AIDS Healthcare — MGMCD: $7,016.40
  • AvMed — JacksonFirstNetworkOON: $2,923.50
  • AvMed — JHSSelectHMO: $2,923.50
  • AvMed — MDCSelectOON: $2,923.50
  • Freedom Health — MGMCD: $935.52
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $4,969.95
  • Multiplan — COMMPPOPRIMARYNETWORK: $4,385.25
  • Plotkin Health — COMM: $2,923.50
  • Prime Health Sherriff — COMM: $2,923.50

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM $1,571 $1,571 $135.11 – $1,885.20
Basic metabolic panel (blood test): 10 of 31 insurance plan rates
  • Aetna — ASA: $471.30
  • AIDS Healthcare — MGMCD: $1,885.20
  • AIDS Healthcare — MGMCR: $345.62
  • AvMed — ASOEO: $392.75
  • AvMed — Empower: $424.17
  • AvMed — Engage: $424.17
  • AvMed — Flex: $424.17
  • AvMed — Focus: $424.17
  • AvMed — FullyInsured: $345.62
  • AvMed — HIX: $172.81
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) 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 $8.38 – $12.69
Basic metabolic panel (blood test): 10 of 40 insurance plan rates
  • Aetna — MCR: $8.97
  • Align — MCR: $9.05
  • American Health Plan — MCR: $8.97
  • AmeriHealth Caritas — HIX: $12.69
  • AmeriHealth Caritas — MGMCR: $10.15
  • AvMed — MCR: $9.14
  • BCBS — MCRHMO: $8.63
  • BCBS — MCRPPO: $8.63
  • CareWorks (Rockport) — WORKERSCOMP: $235.17
  • Centurion — GVT: $9.31
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL $1,643 $1,643 $952.94
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates
  • Aetna — ASA: $492.90
  • AIDS Healthcare — MGMCD: $1,971.60
  • AIDS Healthcare — MGMCR: $361.46
  • AvMed — ASOEO: $410.75
  • AvMed — Empower: $443.61
  • AvMed — Engage: $443.61
  • AvMed — Flex: $443.61
  • AvMed — Focus: $443.61
  • AvMed — FullyInsured: $361.46
  • AvMed — HIX: $180.73
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) 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 40 insurance plan rates
  • Aetna — MCR: $11.19
  • Align — MCR: $11.30
  • American Health Plan — MCR: $11.19
  • AmeriHealth Caritas — HIX: $15.84
  • AmeriHealth Caritas — MGMCR: $12.67
  • AvMed — MCR: $11.40
  • BCBS — MCRHMO: $10.77
  • BCBS — MCRPPO: $10.77
  • CareWorks (Rockport) — WORKERSCOMP: $349.54
  • Centurion — GVT: $11.62
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or Not listed in the file Not listed in the file $47.81
Obstetric blood test panel: 10 of 40 insurance plan rates
  • Aetna — MCR: $50.68
  • Align — MCR: $51.16
  • American Health Plan — MCR: $50.68
  • AmeriHealth Caritas — HIX: $71.72
  • AmeriHealth Caritas — MGMCR: $57.37
  • AvMed — MCR: $51.63
  • BCBS — MCRHMO: $48.77
  • BCBS — MCRPPO: $48.77
  • CareWorks (Rockport) — WORKERSCOMP: $264.02
  • Centurion — GVT: $52.59
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $1,509 $1,509 $875.22
Cholesterol panel (lipid panel): 10 of 31 insurance plan rates
  • Aetna — ASA: $452.70
  • AIDS Healthcare — MGMCD: $1,810.80
  • AIDS Healthcare — MGMCR: $331.98
  • AvMed — ASOEO: $377.25
  • AvMed — Empower: $407.43
  • AvMed — Engage: $407.43
  • AvMed — Flex: $407.43
  • AvMed — Focus: $407.43
  • AvMed — FullyInsured: $331.98
  • AvMed — HIX: $165.99
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) 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 40 insurance plan rates
  • Aetna — MCR: $14.19
  • Align — MCR: $14.33
  • American Health Plan — MCR: $14.19
  • AmeriHealth Caritas — HIX: $20.09
  • AmeriHealth Caritas — MGMCR: $16.07
  • AvMed — MCR: $14.46
  • BCBS — MCRHMO: $13.66
  • BCBS — MCRPPO: $13.66
  • CareWorks (Rockport) — WORKERSCOMP: $238.38
  • Centurion — GVT: $14.73
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL $1,643 $1,643 $952.94
Kidney function panel: 10 of 31 insurance plan rates
  • Aetna — ASA: $492.90
  • AIDS Healthcare — MGMCD: $1,971.60
  • AIDS Healthcare — MGMCR: $361.46
  • AvMed — ASOEO: $410.75
  • AvMed — Empower: $443.61
  • AvMed — Engage: $443.61
  • AvMed — Flex: $443.61
  • AvMed — Focus: $443.61
  • AvMed — FullyInsured: $361.46
  • AvMed — HIX: $180.73
Kidney function panel CPT 80069 · Outpatient (no overnight stay) 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 40 insurance plan rates
  • Aetna — MCR: $9.20
  • Align — MCR: $9.29
  • American Health Plan — MCR: $9.20
  • AmeriHealth Caritas — HIX: $13.02
  • AmeriHealth Caritas — MGMCR: $10.42
  • AvMed — MCR: $9.37
  • BCBS — MCRHMO: $8.85
  • BCBS — MCRPPO: $8.85
  • CareWorks (Rockport) — WORKERSCOMP: $175.31
  • Centurion — GVT: $9.55
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL $2,358 $2,358 $202.79 – $2,829.60
Liver function panel: 10 of 31 insurance plan rates
  • Aetna — ASA: $707.40
  • AIDS Healthcare — MGMCD: $2,829.60
  • AIDS Healthcare — MGMCR: $518.76
  • AvMed — ASOEO: $589.50
  • AvMed — Empower: $636.66
  • AvMed — Engage: $636.66
  • AvMed — Flex: $636.66
  • AvMed — Focus: $636.66
  • AvMed — FullyInsured: $518.76
  • AvMed — HIX: $259.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) 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 40 insurance plan rates
  • Aetna — MCR: $8.66
  • Align — MCR: $8.74
  • American Health Plan — MCR: $8.66
  • AmeriHealth Caritas — HIX: $12.25
  • AmeriHealth Caritas — MGMCR: $9.80
  • AvMed — MCR: $8.82
  • BCBS — MCRHMO: $8.33
  • BCBS — MCRPPO: $8.33
  • CareWorks (Rockport) — WORKERSCOMP: $283.27
  • Centurion — GVT: $8.99
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO $710 $710 $411.80
Urine test (automated, with microscope): 10 of 31 insurance plan rates
  • Aetna — ASA: $213
  • AIDS Healthcare — MGMCD: $852
  • AIDS Healthcare — MGMCR: $156.20
  • AvMed — ASOEO: $177.50
  • AvMed — Empower: $191.70
  • AvMed — Engage: $191.70
  • AvMed — Flex: $191.70
  • AvMed — Focus: $191.70
  • AvMed — FullyInsured: $156.20
  • AvMed — HIX: $78.10
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) 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 $3.17
Urine test (automated, with microscope): 10 of 40 insurance plan rates
  • Aetna — MCR: $3.36
  • Align — MCR: $3.39
  • American Health Plan — MCR: $3.36
  • AmeriHealth Caritas — HIX: $4.75
  • AmeriHealth Caritas — MGMCR: $3.80
  • AvMed — MCR: $3.42
  • BCBS — MCRHMO: $3.23
  • BCBS — MCRPPO: $3.23
  • CareWorks (Rockport) — WORKERSCOMP: $121.86
  • Centurion — GVT: $3.49
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $448 $448 $3.45 – $5.22
Urine test (manual, without microscope): 10 of 40 insurance plan rates
  • Aetna — MCR: $3.69
  • Align — MCR: $3.72
  • American Health Plan — MCR: $3.69
  • AmeriHealth Caritas — HIX: $5.22
  • AmeriHealth Caritas — MGMCR: $4.18
  • AvMed — MCR: $3.76
  • BCBS — MCRHMO: $3.55
  • BCBS — MCRPPO: $3.55
  • CareWorks (Rockport) — WORKERSCOMP: $39.55
  • Centurion — GVT: $3.83
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA W O MICRO MANUAL $448 $448 $38.53 – $537.60
Urine test (manual, without microscope): 10 of 31 insurance plan rates
  • Aetna — ASA: $134.40
  • AIDS Healthcare — MGMCD: $537.60
  • AIDS Healthcare — MGMCR: $98.56
  • AvMed — ASOEO: $112
  • AvMed — Empower: $120.96
  • AvMed — Engage: $120.96
  • AvMed — Flex: $120.96
  • AvMed — Focus: $120.96
  • AvMed — FullyInsured: $98.56
  • AvMed — HIX: $49.28
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO $448 $448 $38.53 – $537.60
Urine test (automated, without microscope): 10 of 31 insurance plan rates
  • Aetna — ASA: $134.40
  • AIDS Healthcare — MGMCD: $537.60
  • AIDS Healthcare — MGMCR: $98.56
  • AvMed — ASOEO: $112
  • AvMed — Empower: $120.96
  • AvMed — Engage: $120.96
  • AvMed — Flex: $120.96
  • AvMed — Focus: $120.96
  • AvMed — FullyInsured: $98.56
  • AvMed — HIX: $49.28
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) 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 $2.25
Urine test (automated, without microscope): 10 of 40 insurance plan rates
  • Aetna — MCR: $2.39
  • Align — MCR: $2.41
  • American Health Plan — MCR: $2.39
  • AmeriHealth Caritas — HIX: $3.38
  • AmeriHealth Caritas — MGMCR: $2.70
  • AvMed — MCR: $2.43
  • BCBS — MCRHMO: $2.29
  • BCBS — MCRPPO: $2.29
  • CareWorks (Rockport) — WORKERSCOMP: $91.93
  • Centurion — GVT: $2.48
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL $190 $190 $110.20
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates
  • Aetna — ASA: $57
  • AIDS Healthcare — MGMCD: $228
  • AIDS Healthcare — MGMCR: $41.80
  • AvMed — ASOEO: $47.50
  • AvMed — Empower: $51.30
  • AvMed — Engage: $51.30
  • AvMed — Flex: $51.30
  • AvMed — Focus: $51.30
  • AvMed — FullyInsured: $41.80
  • AvMed — HIX: $20.90
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) 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 37 insurance plan rates
  • Aetna — MCR: $19.49
  • Align — MCR: $19.68
  • American Health Plan — MCR: $19.49
  • AmeriHealth Caritas — HIX: $27.59
  • AmeriHealth Caritas — MGMCR: $22.07
  • AvMed — MCR: $19.86
  • BCBS — MCRHMO: $18.76
  • BCBS — MCRPPO: $18.76
  • Centurion — GVT: $20.23
  • Cigna HealthSpring — MGMCR: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total UNSCHEDULED Not listed in the file Not listed in the file $162.27 – $165.69
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $165.69
  • CorVel Corporation — WORKERSCOMP: $162.27
  • Prime Health — WORKERSCOMP: $165.69
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH $1,038 $1,038 $602.04
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates
  • Aetna — ASA: $311.40
  • AIDS Healthcare — MGMCD: $1,245.60
  • AIDS Healthcare — MGMCR: $228.36
  • AvMed — ASOEO: $259.50
  • AvMed — Empower: $280.26
  • AvMed — Engage: $280.26
  • AvMed — Flex: $280.26
  • AvMed — Focus: $280.26
  • AvMed — FullyInsured: $228.36
  • AvMed — HIX: $114.18
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) Not listed in the file Not listed in the file $16.80
Thyroid stimulating hormone (TSH) test: 10 of 37 insurance plan rates
  • Aetna — MCR: $17.81
  • Align — MCR: $17.98
  • American Health Plan — MCR: $17.81
  • AmeriHealth Caritas — HIX: $25.20
  • AmeriHealth Caritas — MGMCR: $20.16
  • AvMed — MCR: $18.14
  • BCBS — MCRHMO: $17.14
  • BCBS — MCRPPO: $17.14
  • Centurion — GVT: $18.48
  • Cigna HealthSpring — MGMCR: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) UNSCHEDULED Not listed in the file Not listed in the file $189.49 – $193.48
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $193.48
  • CorVel Corporation — WORKERSCOMP: $189.49
  • Prime Health — WORKERSCOMP: $193.48
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) 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 40 insurance plan rates
  • Aetna — MCR: $8.24
  • Align — MCR: $8.31
  • American Health Plan — MCR: $8.24
  • AmeriHealth Caritas — HIX: $11.65
  • AmeriHealth Caritas — MGMCR: $9.32
  • AvMed — MCR: $8.39
  • BCBS — MCRHMO: $7.93
  • BCBS — MCRPPO: $7.93
  • CareWorks (Rockport) — WORKERSCOMP: $168.90
  • Centurion — GVT: $8.55
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED $943 $943 $81.10 – $1,131.60
Complete blood count (CBC), automated: 10 of 31 insurance plan rates
  • Aetna — ASA: $282.90
  • AIDS Healthcare — MGMCD: $1,131.60
  • AIDS Healthcare — MGMCR: $207.46
  • AvMed — ASOEO: $235.75
  • AvMed — Empower: $254.61
  • AvMed — Engage: $254.61
  • AvMed — Flex: $254.61
  • AvMed — Focus: $254.61
  • AvMed — FullyInsured: $207.46
  • AvMed — HIX: $103.73
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) 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 $6.47
Complete blood count (CBC), automated: 10 of 37 insurance plan rates
  • Aetna — MCR: $6.86
  • Align — MCR: $6.92
  • American Health Plan — MCR: $6.86
  • AmeriHealth Caritas — HIX: $9.71
  • AmeriHealth Caritas — MGMCR: $7.76
  • AvMed — MCR: $6.99
  • BCBS — MCRHMO: $6.60
  • BCBS — MCRPPO: $6.60
  • Centurion — GVT: $7.12
  • Cigna HealthSpring — MGMCR: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) UNSCHEDULED Not listed in the file Not listed in the file $129.82 – $132.55
Complete blood count (CBC), automated: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $132.55
  • CorVel Corporation — WORKERSCOMP: $129.82
  • Prime Health — WORKERSCOMP: $132.55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME $751 $751 $435.58
Blood clotting time test (prothrombin time, PT): 10 of 31 insurance plan rates
  • Aetna — ASA: $225.30
  • AIDS Healthcare — MGMCD: $901.20
  • AIDS Healthcare — MGMCR: $165.22
  • AvMed — ASOEO: $187.75
  • AvMed — Empower: $202.77
  • AvMed — Engage: $202.77
  • AvMed — Flex: $202.77
  • AvMed — Focus: $202.77
  • AvMed — FullyInsured: $165.22
  • AvMed — HIX: $82.61
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) 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 37 insurance plan rates
  • Aetna — MCR: $4.55
  • Align — MCR: $4.59
  • American Health Plan — MCR: $4.55
  • AmeriHealth Caritas — HIX: $6.44
  • AmeriHealth Caritas — MGMCR: $5.15
  • AvMed — MCR: $4.63
  • BCBS — MCRHMO: $4.38
  • BCBS — MCRPPO: $4.38
  • Centurion — GVT: $4.72
  • Cigna HealthSpring — MGMCR: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; UNSCHEDULED Not listed in the file Not listed in the file $106.78 – $109.03
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $109.03
  • CorVel Corporation — WORKERSCOMP: $106.78
  • Prime Health — WORKERSCOMP: $109.03
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT $775 $775 $66.65 – $930
Blood clotting test (partial thromboplastin time, PTT): 10 of 31 insurance plan rates
  • Aetna — ASA: $232.50
  • AIDS Healthcare — MGMCD: $930
  • AIDS Healthcare — MGMCR: $170.50
  • AvMed — ASOEO: $193.75
  • AvMed — Empower: $209.25
  • AvMed — Engage: $209.25
  • AvMed — Flex: $209.25
  • AvMed — Focus: $209.25
  • AvMed — FullyInsured: $170.50
  • AvMed — HIX: $85.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood Not listed in the file Not listed in the file $6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 37 insurance plan rates
  • Aetna — MCR: $6.37
  • Align — MCR: $6.43
  • American Health Plan — MCR: $6.37
  • AmeriHealth Caritas — HIX: $9.02
  • AmeriHealth Caritas — MGMCR: $7.21
  • AvMed — MCR: $6.49
  • BCBS — MCRHMO: $6.13
  • BCBS — MCRPPO: $6.13
  • Centurion — GVT: $6.61
  • Cigna HealthSpring — MGMCR: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood UNSCHEDULED Not listed in the file Not listed in the file $135.05 – $137.90
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $137.90
  • CorVel Corporation — WORKERSCOMP: $135.05
  • Prime Health — WORKERSCOMP: $137.90

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) In the file: CT HEAD/BRAIN W/O CONT $7,611 $7,611 $654.55 – $9,133.20
CT scan of the head or brain, without contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $2,283.30
  • AIDS Healthcare — MGMCD: $9,133.20
  • AIDS Healthcare — MGMCR: $1,674.42
  • AvMed — Empower: $2,054.97
  • AvMed — Engage: $2,054.97
  • AvMed — Flex: $2,054.97
  • AvMed — Focus: $2,054.97
  • AvMed — JacksonFirstNetworkOON: $3,805.50
  • AvMed — JHSSelectHMO: $3,805.50
  • AvMed — MDCSelectOON: $3,805.50
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material Not listed in the file Not listed in the file $185.25 – $2,469
CT scan of the head or brain, without contrast: rates for 7 insurance plans
  • Aetna — QHP: $809
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $879
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material UNSCHEDULED Not listed in the file Not listed in the file $2,227.81 – $2,274.71
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $2,274.71
  • CorVel Corporation — WORKERSCOMP: $2,227.81
  • Prime Health — WORKERSCOMP: $2,274.71
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT $12,738 $12,738 $1,095.47 – $15,285.60
MRI of the brain, before and after contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $3,821.40
  • AIDS Healthcare — MGMCD: $15,285.60
  • AIDS Healthcare — MGMCR: $2,802.36
  • AvMed — Empower: $3,439.26
  • AvMed — Engage: $3,439.26
  • AvMed — Flex: $3,439.26
  • AvMed — Focus: $3,439.26
  • AvMed — JacksonFirstNetworkOON: $6,369
  • AvMed — JHSSelectHMO: $6,369
  • AvMed — MDCSelectOON: $6,369
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $12,738 $12,738 $625.80 – $2,469
MRI of the brain, before and after contrast: rates for 10 insurance plans
  • Aetna — QHP: $1,116
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $1,075
  • CareWorks (Rockport) — WORKERSCOMP: $3,983.94
  • CorVel Corporation — WORKERSCOMP: $3,901.79
  • Prime Health — WORKERSCOMP: $3,983.94
  • United — AllPayerAppendix: $625.80
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V $1,524 $1,524 $883.92
Chest X-ray, 2 views: 10 of 31 insurance plan rates
  • Aetna — ASA: $457.20
  • AIDS Healthcare — MGMCD: $1,828.80
  • AIDS Healthcare — MGMCR: $335.28
  • AvMed — ASOEO: $381
  • AvMed — Empower: $411.48
  • AvMed — Engage: $411.48
  • AvMed — Flex: $411.48
  • AvMed — Focus: $411.48
  • AvMed — FullyInsured: $335.28
  • AvMed — HIX: $167.64
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file $137.53
Chest X-ray, 2 views: rates for 4 insurance plans
  • United — AllPayerAppendix: $137.53
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views UNSCHEDULED Not listed in the file Not listed in the file $479.48 – $489.58
Chest X-ray, 2 views: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $489.58
  • CorVel Corporation — WORKERSCOMP: $479.48
  • Prime Health — WORKERSCOMP: $489.58
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS $2,140 $2,140 $1,241.20
X-ray of the lower spine, at least 4 views: 10 of 31 insurance plan rates
  • Aetna — ASA: $642
  • AIDS Healthcare — MGMCD: $2,568
  • AIDS Healthcare — MGMCR: $470.80
  • AvMed — ASOEO: $535
  • AvMed — Empower: $577.80
  • AvMed — Engage: $577.80
  • AvMed — Flex: $577.80
  • AvMed — Focus: $577.80
  • AvMed — FullyInsured: $470.80
  • AvMed — HIX: $235.40
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file $185.25
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (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) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views UNSCHEDULED Not listed in the file Not listed in the file $843.80 – $861.56
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $861.56
  • CorVel Corporation — WORKERSCOMP: $843.80
  • Prime Health — WORKERSCOMP: $861.56
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT $7,279 $7,279 $625.99 – $8,734.80
MRI of the lower back (lumbar spine), without contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $2,183.70
  • AIDS Healthcare — MGMCD: $8,734.80
  • AIDS Healthcare — MGMCR: $1,601.38
  • AvMed — Empower: $1,965.33
  • AvMed — Engage: $1,965.33
  • AvMed — Flex: $1,965.33
  • AvMed — Focus: $1,965.33
  • AvMed — JacksonFirstNetworkOON: $3,639.50
  • AvMed — JHSSelectHMO: $3,639.50
  • AvMed — MDCSelectOON: $3,639.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $7,279 $7,279 $391.22 – $2,469
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans
  • Aetna — QHP: $1,116
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $1,075
  • CareWorks (Rockport) — WORKERSCOMP: $2,773.90
  • CorVel Corporation — WORKERSCOMP: $2,716.71
  • Prime Health — WORKERSCOMP: $2,773.90
  • United — AllPayerAppendix: $391.22
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST $9,305 $9,305 $5,396.90
CT scan of the pelvis, with contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $2,791.50
  • AIDS Healthcare — MGMCD: $11,166
  • AIDS Healthcare — MGMCR: $2,047.10
  • AvMed — Empower: $2,512.35
  • AvMed — Engage: $2,512.35
  • AvMed — Flex: $2,512.35
  • AvMed — Focus: $2,512.35
  • AvMed — JacksonFirstNetworkOON: $4,652.50
  • AvMed — JHSSelectHMO: $4,652.50
  • AvMed — MDCSelectOON: $4,652.50
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $303.54 – $2,469
CT scan of the pelvis, with contrast: rates for 7 insurance plans
  • Aetna — QHP: $809
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $879
  • United — AllPayerAppendix: $303.54
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s) UNSCHEDULED Not listed in the file Not listed in the file $3,062.18 – $3,126.65
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $3,126.65
  • CorVel Corporation — WORKERSCOMP: $3,062.18
  • Prime Health — WORKERSCOMP: $3,126.65
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) 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 $391.22 – $2,469
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • Aetna — QHP: $1,116
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $1,075
  • CareWorks (Rockport) — WORKERSCOMP: $2,629.59
  • CorVel Corporation — WORKERSCOMP: $2,575.37
  • Prime Health — WORKERSCOMP: $2,629.59
  • United — AllPayerAppendix: $391.22
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (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) · modifier LT In the file: MRI LW JNT W/O CONT LT $7,279 $7,279 $4,221.82
MRI of a leg joint (such as the knee), without contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $2,183.70
  • AIDS Healthcare — MGMCD: $8,734.80
  • AIDS Healthcare — MGMCR: $1,601.38
  • AvMed — Empower: $1,965.33
  • AvMed — Engage: $1,965.33
  • AvMed — Flex: $1,965.33
  • AvMed — Focus: $1,965.33
  • AvMed — JacksonFirstNetworkOON: $3,639.50
  • AvMed — JHSSelectHMO: $3,639.50
  • AvMed — MDCSelectOON: $3,639.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier 50 In the file: MRI LW JNT W/O CONT BI $10,922 $10,922 $6,334.76
MRI of a leg joint (such as the knee), without contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $3,276.60
  • AIDS Healthcare — MGMCD: $13,106.40
  • AIDS Healthcare — MGMCR: $2,402.84
  • AvMed — Empower: $2,948.94
  • AvMed — Engage: $2,948.94
  • AvMed — Flex: $2,948.94
  • AvMed — Focus: $2,948.94
  • AvMed — JacksonFirstNetworkOON: $5,461
  • AvMed — JHSSelectHMO: $5,461
  • AvMed — MDCSelectOON: $5,461
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT $18,238 $18,238 $1,568.47 – $21,885.60
CT scan of the abdomen and pelvis, with contrast: 10 of 28 insurance plan rates
  • Aetna — ASA: $5,471.40
  • AIDS Healthcare — MGMCD: $21,885.60
  • AIDS Healthcare — MGMCR: $4,012.36
  • AvMed — Empower: $4,924.26
  • AvMed — Engage: $4,924.26
  • AvMed — Flex: $4,924.26
  • AvMed — Focus: $4,924.26
  • AvMed — JacksonFirstNetworkOON: $9,119
  • AvMed — JHSSelectHMO: $9,119
  • AvMed — MDCSelectOON: $9,119
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s) Not listed in the file Not listed in the file $809 – $1,539
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans
  • Aetna — QHP: $809
  • AvMed — ASOEO: $2,469
  • AvMed — FullyInsured: $2,225
  • AvMed — HIX: $879
  • United — AllPayerAppendix: $625.80
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s) UNSCHEDULED Not listed in the file Not listed in the file $4,939.28 – $5,043.26
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $5,043.26
  • CorVel Corporation — WORKERSCOMP: $4,939.28
  • Prime Health — WORKERSCOMP: $5,043.26
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $3,147 $3,147 $270.64 – $3,776.40
Ultrasound of the abdomen, complete: 10 of 31 insurance plan rates
  • Aetna — ASA: $944.10
  • AIDS Healthcare — MGMCD: $3,776.40
  • AIDS Healthcare — MGMCR: $692.34
  • AvMed — ASOEO: $786.75
  • AvMed — Empower: $849.69
  • AvMed — Engage: $849.69
  • AvMed — Flex: $849.69
  • AvMed — Focus: $849.69
  • AvMed — FullyInsured: $692.34
  • AvMed — HIX: $346.17
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete Not listed in the file Not listed in the file $185.25
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete UNSCHEDULED Not listed in the file Not listed in the file $1,490.79 – $1,522.17
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,522.17
  • CorVel Corporation — WORKERSCOMP: $1,490.79
  • Prime Health — WORKERSCOMP: $1,522.17
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI $320.43 $320.43 $185.85
Pregnancy ultrasound (after the first trimester): 10 of 31 insurance plan rates
  • Aetna — ASA: $96.13
  • AIDS Healthcare — MGMCD: $384.52
  • AIDS Healthcare — MGMCR: $70.49
  • AvMed — ASOEO: $80.11
  • AvMed — Empower: $86.52
  • AvMed — Engage: $86.52
  • AvMed — Flex: $86.52
  • AvMed — Focus: $86.52
  • AvMed — FullyInsured: $70.49
  • AvMed — HIX: $35.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $320.43 $320.43 $185.25
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,005.87
  • CorVel Corporation — WORKERSCOMP: $985.13
  • Prime Health — WORKERSCOMP: $1,005.87
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL $1,823 $1,823 $156.78 – $2,187.60
Transvaginal ultrasound: 10 of 31 insurance plan rates
  • Aetna — ASA: $546.90
  • AIDS Healthcare — MGMCD: $2,187.60
  • AIDS Healthcare — MGMCR: $401.06
  • AvMed — ASOEO: $455.75
  • AvMed — Empower: $492.21
  • AvMed — Engage: $492.21
  • AvMed — Flex: $492.21
  • AvMed — Focus: $492.21
  • AvMed — FullyInsured: $401.06
  • AvMed — HIX: $200.53
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $185.25
Transvaginal ultrasound: rates for 4 insurance plans
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal UNSCHEDULED Not listed in the file Not listed in the file $1,013.40 – $1,034.74
Transvaginal ultrasound: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,034.74
  • CorVel Corporation — WORKERSCOMP: $1,013.40
  • Prime Health — WORKERSCOMP: $1,034.74
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral Not listed in the file Not listed in the file $155.41
Diagnostic mammogram, one breast: 10 of 34 insurance plan rates
  • Aetna — MCR: $95.61
  • Align — MCR: $96.51
  • American Health Plan — MCR: $95.61
  • AmeriHealth Caritas — MGMCR: $108.24
  • AvMed — MCR: $97.42
  • BCBS — MCRHMO: $92
  • BCBS — MCRPPO: $92
  • Centurion — GVT: $99.22
  • Cigna HealthSpring — MGMCR: $90.20
  • Devoted Health — MCR: $90.20
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT $1,550 $1,550 $133.30 – $1,860
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • Aetna — ASA: $465
  • AIDS Healthcare — MGMCD: $1,860
  • AIDS Healthcare — MGMCR: $341
  • AvMed — ASOEO: $387.50
  • AvMed — Empower: $418.50
  • AvMed — Engage: $418.50
  • AvMed — Flex: $418.50
  • AvMed — Focus: $418.50
  • AvMed — FullyInsured: $341
  • AvMed — HIX: $170.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT $1,550 $1,550 $133.30 – $1,860
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • Aetna — ASA: $465
  • AIDS Healthcare — MGMCD: $1,860
  • AIDS Healthcare — MGMCR: $341
  • AvMed — ASOEO: $387.50
  • AvMed — Empower: $418.50
  • AvMed — Engage: $418.50
  • AvMed — Flex: $418.50
  • AvMed — Focus: $418.50
  • AvMed — FullyInsured: $341
  • AvMed — HIX: $170.50
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $1,861 $1,861 $198.71
Diagnostic mammogram, both breasts: 10 of 34 insurance plan rates
  • Aetna — MCR: $123.04
  • Align — MCR: $124.21
  • American Health Plan — MCR: $123.04
  • AmeriHealth Caritas — MGMCR: $139.30
  • AvMed — MCR: $125.37
  • BCBS — MCRHMO: $118.40
  • BCBS — MCRPPO: $118.40
  • Centurion — GVT: $127.69
  • Cigna HealthSpring — MGMCR: $116.08
  • Devoted Health — MCR: $116.08
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI $1,861 $1,861 $160.05 – $2,233.20
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates
  • Aetna — ASA: $558.30
  • AIDS Healthcare — MGMCD: $2,233.20
  • AIDS Healthcare — MGMCR: $409.42
  • AvMed — ASOEO: $465.25
  • AvMed — Empower: $502.47
  • AvMed — Engage: $502.47
  • AvMed — Flex: $502.47
  • AvMed — Focus: $502.47
  • AvMed — FullyInsured: $409.42
  • AvMed — HIX: $204.71
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $1,479 $1,479 $92.57 – $128.82
Screening mammogram, both breasts: 10 of 34 insurance plan rates
  • Aetna — MCR: $101.15
  • Align — MCR: $102.10
  • American Health Plan — MCR: $101.15
  • AmeriHealth Caritas — MGMCR: $114.50
  • AvMed — MCR: $103.05
  • BCBS — MCRHMO: $97.33
  • BCBS — MCRPPO: $97.33
  • Centurion — GVT: $104.96
  • Cigna HealthSpring — MGMCR: $95.42
  • Devoted Health — MCR: $95.42
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI $1,479 $1,479 $857.82
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • Aetna — ASA: $443.70
  • AIDS Healthcare — MGMCD: $1,774.80
  • AIDS Healthcare — MGMCR: $325.38
  • AvMed — ASOEO: $369.75
  • AvMed — Empower: $399.33
  • AvMed — Engage: $399.33
  • AvMed — Flex: $399.33
  • AvMed — Focus: $399.33
  • AvMed — FullyInsured: $325.38
  • AvMed — HIX: $162.69

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report Not listed in the file Not listed in the file $13.81
Electrocardiogram (ECG/EKG) with reading: rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $409.41
  • CorVel Corporation — WORKERSCOMP: $400.97
  • Humana — TRICR: $13.81
  • Prime Health — WORKERSCOMP: $409.41
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) 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 $3,350 – $3,850
Left heart catheterization (diagnostic): 10 of 25 insurance plan rates
  • Aetna — HMO-Gated: $9,823
  • Aetna — PPO-NonGated: $12,038
  • Aetna — QHP: $7,117
  • AIDS Healthcare — MGMCR: $3,850
  • AmeriHealth Caritas — HIX: $10,752
  • AvMed — ASOEO: $16,454
  • AvMed — FullyInsured: $14,840
  • AvMed — HIX: $7,360
  • CareWorks (Rockport) — WORKERSCOMP: $15,604.39
  • Cigna — HMO: $9,822
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP W/O ARRHYTHMIA $39,514 $39,514 $5,136.82 – $47,416.80
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates
  • Aetna — ASA: $11,854.20
  • AIDS Healthcare — MGMCD: $47,416.80
  • AvMed — Empower: $10,668.78
  • AvMed — Engage: $10,668.78
  • AvMed — Flex: $10,668.78
  • AvMed — Focus: $10,668.78
  • AvMed — JacksonFirstNetworkOON: $19,757
  • AvMed — JHSSelectHMO: $19,757
  • AvMed — MDCSelectOON: $19,757
  • AvMed — Select: $10,668.78
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor Not listed in the file Not listed in the file $6,826 – $23,692
Heart rhythm study (electrophysiology evaluation): 10 of 30 insurance plan rates
  • Aetna — HMO-Gated: $20,801
  • Aetna — PPO-NonGated: $23,692
  • Aetna — QHP: $15,071
  • AIDS Healthcare — MGMCR: $8,300
  • AmeriHealth Caritas — HIX: $30,632
  • AvMed — ASOEO: $46,072
  • AvMed — FullyInsured: $41,547
  • AvMed — HIX: $22,473
  • BCBS — BSLNON-PAR: $21,794
  • BCBS — HMO: $17,438
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COM EP REPO CTH TX AFIB $96,958 $96,958 $12,604.54 – $116,349.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 22 insurance plan rates
  • Aetna — ASA: $29,087.40
  • AIDS Healthcare — MGMCD: $116,349.60
  • AmeriHealth Caritas — HIX: $16,482.86
  • AvMed — Empower: $26,178.66
  • AvMed — Engage: $26,178.66
  • AvMed — Flex: $26,178.66
  • AvMed — Focus: $26,178.66
  • AvMed — JacksonFirstNetworkOON: $48,479
  • AvMed — JHSSelectHMO: $48,479
  • AvMed — MDCSelectOON: $48,479
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, Not listed in the file Not listed in the file $6,826 – $23,692
Heart rhythm study with ablation for atrial fibrillation: 10 of 30 insurance plan rates
  • Aetna — HMO-Gated: $20,801
  • Aetna — PPO-NonGated: $23,692
  • Aetna — QHP: $15,071
  • AIDS Healthcare — MGMCR: $8,300
  • AmeriHealth Caritas — HIX: $15,190
  • AvMed — ASOEO: $46,072
  • AvMed — FullyInsured: $41,547
  • AvMed — HIX: $22,473
  • BCBS — BSLNON-PAR: $21,794
  • BCBS — HMO: $17,438
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY >4 PAR $16,047 $16,047 $1,380.04 – $19,256.40
Sleep study (overnight, in a sleep lab): 10 of 43 insurance plan rates
  • Aetna — ASA: $4,814.10
  • AIDS Healthcare — MGMCD: $19,256.40
  • AIDS Healthcare — MGMCR: $3,530.34
  • AmeriHealth Caritas — HIX: $2,727.99
  • AvMed — ASOEO: $4,011.75
  • AvMed — Empower: $4,332.69
  • AvMed — Engage: $4,332.69
  • AvMed — Flex: $4,332.69
  • AvMed — Focus: $4,332.69
  • AvMed — FullyInsured: $3,530.34
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist $16,047 $16,047 $4,007
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $549.99
  • CorVel Corporation — WORKERSCOMP: $538.65
  • Prime Health — WORKERSCOMP: $549.99
  • United — AllPayerAppendix: $4,007
  • Aetna — HMO-Gated: 17.3% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 13.4% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) 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 $29.23 – $40.68
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 36 insurance plan rates
  • Aetna — MCR: $31.94
  • Align — MCR: $32.24
  • American Health Plan — MCR: $31.94
  • AmeriHealth Caritas — MGMCR: $36.16
  • AvMed — MCR: $32.54
  • BCBS — MCRHMO: $30.73
  • BCBS — MCRPPO: $30.73
  • CareWorks (Rockport) — WORKERSCOMP: $34.92
  • Centurion — GVT: $33.14
  • Cigna HealthSpring — MGMCR: $30.13
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO|CO In the file: THER EXERCIS 15 MIN OTCO $566 $566 $48.68 – $679.20
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 36 insurance plan rates
  • Aetna — ASA: $169.80
  • AIDS Healthcare — MGMCD: $679.20
  • AIDS Healthcare — MGMCR: $124.52
  • AmeriHealth Caritas — HIX: $96.22
  • AvMed — ASOEO: $141.50
  • AvMed — Empower: $152.82
  • AvMed — Engage: $152.82
  • AvMed — Flex: $152.82
  • AvMed — Focus: $152.82
  • AvMed — FullyInsured: $124.52
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP|CQ In the file: THER EXERCIS 15 MIN PTCQ $566 $566 $48.68 – $679.20
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 36 insurance plan rates
  • Aetna — ASA: $169.80
  • AIDS Healthcare — MGMCD: $679.20
  • AIDS Healthcare — MGMCR: $124.52
  • AmeriHealth Caritas — HIX: $96.22
  • AvMed — ASOEO: $141.50
  • AvMed — Empower: $152.82
  • AvMed — Engage: $152.82
  • AvMed — Flex: $152.82
  • AvMed — Focus: $152.82
  • AvMed — FullyInsured: $124.52
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $1,534 $1,534 $97.25 – $135.36
Physical therapy evaluation (low complexity): 10 of 36 insurance plan rates
  • Aetna — MCR: $106.29
  • Align — MCR: $107.29
  • American Health Plan — MCR: $106.29
  • AmeriHealth Caritas — MGMCR: $120.32
  • AvMed — MCR: $108.29
  • BCBS — MCRHMO: $102.28
  • BCBS — MCRPPO: $102.28
  • CareWorks (Rockport) — WORKERSCOMP: $97.97
  • Centurion — GVT: $110.30
  • Cigna HealthSpring — MGMCR: $100.27
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX $1,534 $1,534 $889.72
Physical therapy evaluation (low complexity): 10 of 36 insurance plan rates
  • Aetna — ASA: $460.20
  • AIDS Healthcare — MGMCD: $1,840.80
  • AIDS Healthcare — MGMCR: $337.48
  • AmeriHealth Caritas — HIX: $260.78
  • AvMed — ASOEO: $383.50
  • AvMed — Empower: $414.18
  • AvMed — Engage: $414.18
  • AvMed — Flex: $414.18
  • AvMed — Focus: $414.18
  • AvMed — FullyInsured: $337.48
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $1,534 $1,534 $87.36 – $119.12
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates
  • Aetna — MCR: $93.53
  • Align — MCR: $94.41
  • American Health Plan — MCR: $93.53
  • AmeriHealth Caritas — MGMCR: $105.89
  • AvMed — MCR: $95.30
  • BCBS — MCRHMO: $90
  • BCBS — MCRPPO: $90
  • Centurion — GVT: $97.06
  • Cigna HealthSpring — MGMCR: $88.24
  • Devoted Health — MCR: $88.24
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $1,534 $1,534 $95.95 – $97.97
Physical therapy evaluation (moderate complexity): 10 of 36 insurance plan rates
  • Aetna — MCR: $106.29
  • Align — MCR: $107.29
  • American Health Plan — MCR: $106.29
  • AmeriHealth Caritas — MGMCR: $120.32
  • AvMed — MCR: $108.29
  • BCBS — MCRHMO: $102.28
  • BCBS — MCRPPO: $102.28
  • CareWorks (Rockport) — WORKERSCOMP: $97.97
  • Centurion — GVT: $110.30
  • Cigna HealthSpring — MGMCR: $100.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX $1,534 $1,534 $889.72
Physical therapy evaluation (moderate complexity): 10 of 36 insurance plan rates
  • Aetna — ASA: $460.20
  • AIDS Healthcare — MGMCD: $1,840.80
  • AIDS Healthcare — MGMCR: $337.48
  • AmeriHealth Caritas — HIX: $260.78
  • AvMed — ASOEO: $383.50
  • AvMed — Empower: $414.18
  • AvMed — Engage: $414.18
  • AvMed — Flex: $414.18
  • AvMed — Focus: $414.18
  • AvMed — FullyInsured: $337.48
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $1,534 $1,534 $87.36 – $119.12
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates
  • Aetna — MCR: $93.53
  • Align — MCR: $94.41
  • American Health Plan — MCR: $93.53
  • AmeriHealth Caritas — MGMCR: $105.89
  • AvMed — MCR: $95.30
  • BCBS — MCRHMO: $90
  • BCBS — MCRPPO: $90
  • Centurion — GVT: $97.06
  • Cigna HealthSpring — MGMCR: $88.24
  • Devoted Health — MCR: $88.24
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,534 $1,534 $97.25 – $135.36
Physical therapy evaluation (high complexity): 10 of 36 insurance plan rates
  • Aetna — MCR: $106.29
  • Align — MCR: $107.29
  • American Health Plan — MCR: $106.29
  • AmeriHealth Caritas — MGMCR: $120.32
  • AvMed — MCR: $108.29
  • BCBS — MCRHMO: $102.28
  • BCBS — MCRPPO: $102.28
  • CareWorks (Rockport) — WORKERSCOMP: $97.97
  • Centurion — GVT: $110.30
  • Cigna HealthSpring — MGMCR: $100.27
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX $1,534 $1,534 $889.72
Physical therapy evaluation (high complexity): 10 of 36 insurance plan rates
  • Aetna — ASA: $460.20
  • AIDS Healthcare — MGMCD: $1,840.80
  • AIDS Healthcare — MGMCR: $337.48
  • AmeriHealth Caritas — HIX: $260.78
  • AvMed — ASOEO: $383.50
  • AvMed — Empower: $414.18
  • AvMed — Engage: $414.18
  • AvMed — Flex: $414.18
  • AvMed — Focus: $414.18
  • AvMed — FullyInsured: $337.48
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,534 $1,534 $87.36 – $119.12
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates
  • Aetna — MCR: $93.53
  • Align — MCR: $94.41
  • American Health Plan — MCR: $93.53
  • AmeriHealth Caritas — MGMCR: $105.89
  • AvMed — MCR: $95.30
  • BCBS — MCRHMO: $90
  • BCBS — MCRPPO: $90
  • Centurion — GVT: $97.06
  • Cigna HealthSpring — MGMCR: $88.24
  • Devoted Health — MCR: $88.24
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: INDIV SESSION 30MIN $531 $531 $45.67 – $637.20
Psychotherapy, 30 minutes: 10 of 46 insurance plan rates
  • Aetna — ASA: $159.30
  • Aetna — HMO-Gated: $94.52
  • Aetna — PPO-NonGated: $108.86
  • Aetna — QHP: $71.15
  • AIDS Healthcare — MGMCD: $637.20
  • AIDS Healthcare — MGMCR: $116.82
  • AmeriHealth Caritas — HIX: $90.27
  • AvMed — ASOEO: $132.75
  • AvMed — Empower: $143.37
  • AvMed — Engage: $143.37
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient SCHEDULED Not listed in the file Not listed in the file $70.30 – $71.78
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $71.78
  • CorVel Corporation — WORKERSCOMP: $70.30
  • Prime Health — WORKERSCOMP: $71.78
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: INDIV SESSION 45MIN $531 $531 $307.98
Psychotherapy, 45 minutes: 10 of 46 insurance plan rates
  • Aetna — ASA: $159.30
  • Aetna — HMO-Gated: $94.52
  • Aetna — PPO-NonGated: $108.86
  • Aetna — QHP: $71.15
  • AIDS Healthcare — MGMCD: $637.20
  • AIDS Healthcare — MGMCR: $116.82
  • AmeriHealth Caritas — HIX: $90.27
  • AvMed — ASOEO: $132.75
  • AvMed — Empower: $143.37
  • AvMed — Engage: $143.37
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient SCHEDULED Not listed in the file Not listed in the file $94.05 – $96.03
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $96.03
  • CorVel Corporation — WORKERSCOMP: $94.05
  • Prime Health — WORKERSCOMP: $96.03
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: INDIV SESSION 60MIN $870 $870 $74.82 – $1,044
Psychotherapy, 60 minutes: 10 of 46 insurance plan rates
  • Aetna — ASA: $261
  • Aetna — HMO-Gated: $94.52
  • Aetna — PPO-NonGated: $108.86
  • Aetna — QHP: $116.58
  • AIDS Healthcare — MGMCD: $1,044
  • AIDS Healthcare — MGMCR: $191.40
  • AmeriHealth Caritas — HIX: $147.90
  • AvMed — ASOEO: $217.50
  • AvMed — Empower: $234.90
  • AvMed — Engage: $234.90
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient SCHEDULED Not listed in the file Not listed in the file $140.60 – $143.56
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $143.56
  • CorVel Corporation — WORKERSCOMP: $140.60
  • Prime Health — WORKERSCOMP: $143.56
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAM WO PT 50 MIN $870 $870 $504.60
Family psychotherapy, without the patient: 10 of 46 insurance plan rates
  • Aetna — ASA: $261
  • Aetna — HMO-Gated: $154.86
  • Aetna — PPO-NonGated: $178.35
  • Aetna — QHP: $116.58
  • AIDS Healthcare — MGMCD: $1,044
  • AIDS Healthcare — MGMCR: $191.40
  • AmeriHealth Caritas — HIX: $147.90
  • AvMed — ASOEO: $217.50
  • AvMed — Empower: $234.90
  • AvMed — Engage: $234.90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Family psychotherapy, without the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes SCHEDULED Not listed in the file Not listed in the file $113.05 – $115.43
Family psychotherapy, without the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $115.43
  • CorVel Corporation — WORKERSCOMP: $113.05
  • Prime Health — WORKERSCOMP: $115.43
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAM W PT 50 MIN $870 $870 $504.60
Family psychotherapy, with the patient: 10 of 46 insurance plan rates
  • Aetna — ASA: $261
  • Aetna — HMO-Gated: $94.52
  • Aetna — PPO-NonGated: $108.86
  • Aetna — QHP: $116.58
  • AIDS Healthcare — MGMCD: $1,044
  • AIDS Healthcare — MGMCR: $191.40
  • AmeriHealth Caritas — HIX: $147.90
  • AvMed — ASOEO: $217.50
  • AvMed — Empower: $234.90
  • AvMed — Engage: $234.90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Family psychotherapy, with the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP PSY GRP (NOT FAMILY) $431 $431 $249.98
Group psychotherapy: 10 of 38 insurance plan rates
  • Aetna — ASA: $129.30
  • Aetna — HMO-Gated: $76.72
  • Aetna — PPO-NonGated: $88.36
  • Aetna — QHP: $57.75
  • AIDS Healthcare — MGMCD: $517.20
  • AIDS Healthcare — MGMCR: $94.82
  • AmeriHealth Caritas — HIX: $73.27
  • AvMed — ASOEO: $107.75
  • AvMed — Empower: $116.37
  • AvMed — Engage: $116.37
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) UNSCHEDULED Not listed in the file Not listed in the file $244.98 – $250.13
Group psychotherapy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.13
  • CorVel Corporation — WORKERSCOMP: $244.98
  • Prime Health — WORKERSCOMP: $250.13
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) SCHEDULED Not listed in the file Not listed in the file $30.40 – $31.04
Group psychotherapy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $31.04
  • CorVel Corporation — WORKERSCOMP: $30.40
  • Prime Health — WORKERSCOMP: $31.04

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) 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 $11,754
Removal of breast growth (open surgery): 10 of 37 insurance plan rates
  • Aetna — HMO-Gated: $12,057
  • Aetna — PPO-NonGated: $13,830
  • Aetna — QHP: $8,736
  • AIDS Healthcare — MGMCR: $3,950
  • AmeriHealth Caritas — HIX: $8,727
  • AvMed — ASOEO: $22,212
  • AvMed — FullyInsured: $20,033
  • AvMed — HIX: $9,935
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
Total hip replacement CPT 27130 · Outpatient (no overnight stay) 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 $1,950 – $41,379
Total hip replacement: 10 of 43 insurance plan rates
  • Aetna — HMO-Gated: $31,455
  • Aetna — PPO-NonGated: $31,455
  • Aetna — QHP: $22,787
  • AIDS Healthcare — MGMCR: $2,450
  • Align — MCR: $12,000
  • American Health Plan — MCR: $17,429.32
  • AmeriHealth Caritas — HIX: $35,069
  • AvMed — ASOEO: $41,379
  • AvMed — FullyInsured: $40,029
  • AvMed — HIX: $22,856
Total knee replacement CPT 27447 · Outpatient (no overnight stay) 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 $2,050 – $45,224
Total knee replacement: 10 of 46 insurance plan rates
  • Aetna — HMO-Gated: $31,455
  • Aetna — PPO-NonGated: $31,455
  • Aetna — QHP: $22,787
  • AIDS Healthcare — MGMCR: $2,450
  • Align — MCR: $12,000
  • American Health Plan — MCR: $17,429.32
  • AmeriHealth Caritas — HIX: $35,069
  • AvMed — ASOEO: $41,379
  • AvMed — FullyInsured: $40,029
  • AvMed — HIX: $22,856
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) 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 $3,792 – $22,212
Shoulder arthroscopy: shaving of shoulder bone: 10 of 32 insurance plan rates
  • Aetna — HMO-Gated: $12,057
  • Aetna — PPO-NonGated: $13,830
  • Aetna — QHP: $8,736
  • AIDS Healthcare — MGMCR: $3,950
  • AmeriHealth Caritas — HIX: $3,251
  • AvMed — ASOEO: $22,212
  • AvMed — FullyInsured: $20,033
  • AvMed — HIX: $9,935
  • CareWorks (Rockport) — WORKERSCOMP: $4,154.97
  • Cigna — HMO: $6,802
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) 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 $4,963 – $13,830
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates
  • Aetna — HMO-Gated: $12,057
  • Aetna — PPO-NonGated: $13,830
  • Aetna — QHP: $8,736
  • AIDS Healthcare — MGMCR: $3,950
  • AmeriHealth Caritas — HIX: $9,539
  • AvMed — ASOEO: $22,212
  • AvMed — FullyInsured: $20,033
  • AvMed — HIX: $9,935
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12 Not listed in the file Not listed in the file $2,702 – $6,802
Removal of tonsils and adenoids (under age 12): 10 of 29 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $8,727
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
  • BCBS — MBN: $13,617
  • BCBS — NWB: $17,548
  • BCBS — PHS: $18,507
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12 Other Surgical Services Not listed in the file Not listed in the file $2,750
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan
  • Medica HealthCare — MCR: $2,750
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) 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 $2,702 – $6,802
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $4,739
  • BCBS — HMO: $3,299
  • BCBS — MBN: $2,625
  • BCBS — NWB: $3,339
  • BCBS — PHS: $4,739
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple SCHEDULED Not listed in the file Not listed in the file $1,532.66 – $1,564.93
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $4,739
  • BCBS — HMO: $3,299
  • BCBS — MBN: $2,625
  • BCBS — NWB: $3,339
  • BCBS — PHS: $4,739
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) 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 $2,702 – $6,802
Colonoscopy (diagnostic): 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $4,739
  • BCBS — HMO: $3,299
  • BCBS — MBN: $2,625
  • BCBS — NWB: $3,339
  • BCBS — PHS: $4,739
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple Not listed in the file Not listed in the file $2,702 – $5,754
Colonoscopy with biopsy: 10 of 29 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $5,469
  • BCBS — HMO: $4,880
  • BCBS — MBN: $3,781
  • BCBS — NWB: $4,708
  • BCBS — PHS: $5,469
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple UNSCHEDULED Not listed in the file Not listed in the file $3,478.85 – $3,552.09
Colonoscopy with biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $3,552.09
  • CorVel Corporation — WORKERSCOMP: $3,478.85
  • Prime Health — WORKERSCOMP: $3,552.09
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple SCHEDULED Not listed in the file Not listed in the file $2,570.14 – $2,624.25
Colonoscopy with biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $2,624.25
  • CorVel Corporation — WORKERSCOMP: $2,570.14
  • Prime Health — WORKERSCOMP: $2,624.25
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) 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 $2,050 – $6,802
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $5,469
  • BCBS — HMO: $4,880
  • BCBS — MBN: $3,781
  • BCBS — NWB: $4,708
  • BCBS — PHS: $5,469
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) 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 $2,702 – $6,802
Ultrasound of the lower bowel by endoscope: 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $5,414
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $5,469
  • BCBS — HMO: $4,880
  • BCBS — MBN: $3,781
  • BCBS — NWB: $4,708
  • BCBS — PHS: $5,469
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) 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 $1,982 – $4,220
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • AmeriHealth Caritas — HIX: $3,689
  • CareWorks (Rockport) — WORKERSCOMP: $233.77
  • CorVel Corporation — WORKERSCOMP: $228.95
  • Oscar — HIX: $2,194
  • Prime Health — WORKERSCOMP: $233.77
  • Simply Healthcare — HIX: $1,982
  • United — AllPayerAppendix: $4,220
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy Not listed in the file Not listed in the file $4,963 – $11,556
Gallbladder removal by laparoscope: 10 of 32 insurance plan rates
  • Aetna — HMO-Gated: $9,629
  • Aetna — PPO-NonGated: $11,556
  • Aetna — QHP: $6,978
  • AmeriHealth Caritas — HIX: $13,315
  • AvMed — ASOEO: $21,390
  • AvMed — FullyInsured: $19,290
  • AvMed — HIX: $9,566
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
  • BCBS — MBN: $13,617
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy UNSCHEDULED Not listed in the file Not listed in the file $1,423.26 – $1,453.22
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,453.22
  • CorVel Corporation — WORKERSCOMP: $1,423.26
  • Prime Health — WORKERSCOMP: $1,453.22
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy SCHEDULED Not listed in the file Not listed in the file $256.49 – $261.89
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $261.89
  • CorVel Corporation — WORKERSCOMP: $256.49
  • Prime Health — WORKERSCOMP: $261.89
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible Not listed in the file Not listed in the file $4,963 – $11,128
Groin (inguinal) hernia repair, age 5 or older: 10 of 30 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $9,539
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
  • BCBS — MBN: $13,617
  • BCBS — NWB: $17,548
  • BCBS — PHS: $18,507
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible UNSCHEDULED Not listed in the file Not listed in the file $13,767.78 – $14,057.63
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $14,057.63
  • CorVel Corporation — WORKERSCOMP: $13,767.78
  • Prime Health — WORKERSCOMP: $14,057.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible SCHEDULED Not listed in the file Not listed in the file $4,838.77 – $4,940.64
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $4,940.64
  • CorVel Corporation — WORKERSCOMP: $4,838.77
  • Prime Health — WORKERSCOMP: $4,940.64
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach Not listed in the file Not listed in the file $2,820 – $5,414
Prostate biopsy: rates for 3 insurance plans
  • AmeriHealth Caritas — HIX: $5,414
  • Oscar — HIX: $3,120
  • Simply Healthcare — HIX: $2,820
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach SCHEDULED Not listed in the file Not listed in the file $5,132.95 – $5,241.02
Prostate biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $5,241.02
  • CorVel Corporation — WORKERSCOMP: $5,132.95
  • Prime Health — WORKERSCOMP: $5,241.02
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; Other Surgica Not listed in the file Not listed in the file $2,750
Prostate removal by laparoscope (radical prostatectomy): 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $22,880
  • AvMed — ASOEO: $15,633
  • AvMed — FullyInsured: $14,096
  • AvMed — HIX: $9,566
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
  • BCBS — MBN: $13,617
  • BCBS — NWB: $17,548
  • BCBS — PHS: $18,507
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C Complex Surgery Not listed in the file Not listed in the file $11,754
Hysteroscopy with biopsy of the uterus lining: 10 of 34 insurance plan rates
  • Aetna — HMO-Gated: $12,057
  • Aetna — PPO-NonGated: $13,830
  • Aetna — QHP: $8,736
  • AIDS Healthcare — MGMCR: $3,950
  • AmeriHealth Caritas — HIX: $8,727
  • AvMed — ASOEO: $15,633
  • AvMed — FullyInsured: $14,096
  • AvMed — HIX: $9,566
  • BCBS — BSLNON-PAR: $18,507
  • BCBS — HMO: $16,920
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) 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 $2,750
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $3,689
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $4,739
  • BCBS — HMO: $3,299
  • BCBS — MBN: $2,625
  • BCBS — NWB: $3,339
  • BCBS — PHS: $4,739
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) 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 $2,702 – $6,802
Nerve root injection, lower back, with imaging guidance: 10 of 30 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $3,689
  • BCBS — BSLNON-PAR: $4,739
  • BCBS — HMO: $3,299
  • BCBS — MBN: $2,625
  • BCBS — NWB: $3,339
  • BCBS — PHS: $4,739
  • BCBS — PPO: $3,339
  • BCBS — SBN: $3,299
  • CareWorks (Rockport) — WORKERSCOMP: $2,181.70
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel Not listed in the file Not listed in the file $2,450 – $9,710
Carpal tunnel release: 10 of 30 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $8,727
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $7,288
  • BCBS — HMO: $7,480
  • BCBS — MBN: $5,866
  • BCBS — NWB: $7,384
  • BCBS — PHS: $7,288
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel UNSCHEDULED Not listed in the file Not listed in the file $4,358.25 – $4,450
Carpal tunnel release: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $4,450
  • CorVel Corporation — WORKERSCOMP: $4,358.25
  • Prime Health — WORKERSCOMP: $4,450
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel SCHEDULED Not listed in the file Not listed in the file $3,199.32 – $3,266.68
Carpal tunnel release: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $3,266.68
  • CorVel Corporation — WORKERSCOMP: $3,199.32
  • Prime Health — WORKERSCOMP: $3,266.68
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or Not listed in the file Not listed in the file $1,982 – $6,802
Laser treatment of clouding after cataract surgery: 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $3,689
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $4,010
  • BCBS — HMO: $2,855
  • BCBS — MBN: $2,205
  • BCBS — NWB: $2,782
  • BCBS — PHS: $4,010
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) 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 $2,750
Cataract removal with lens implant: 10 of 33 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AmeriHealth Caritas — HIX: $8,727
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • BCBS — BSLNON-PAR: $7,288
  • BCBS — HMO: $7,480
  • BCBS — MBN: $5,866
  • BCBS — NWB: $7,384
  • BCBS — PHS: $7,288

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care Not listed in the file Not listed in the file $2,050 – $6,802
Vaginal delivery, with care before and after: 10 of 26 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • Cigna — HMO: $6,802
  • Cigna — PPO: $6,802
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Medica HealthCare — MCR: $2,750
  • MMM of FL (Health Advantage Plan) — MCR: $2,250
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care Not listed in the file Not listed in the file $2,050 – $6,802
Cesarean delivery (C-section), with care before and after: 10 of 26 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • Cigna — HMO: $6,802
  • Cigna — PPO: $6,802
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Medica HealthCare — MCR: $2,750
  • MMM of FL (Health Advantage Plan) — MCR: $2,250
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p Not listed in the file Not listed in the file $2,702 – $6,802
Vaginal delivery after a previous C-section, with care before and after: 10 of 26 insurance plan rates
  • AIDS Healthcare — MGMCR: $2,450
  • AvMed — ASOEO: $9,710
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $4,342
  • Cigna — HMO: $6,802
  • Cigna — PPO: $6,802
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Medica HealthCare — MCR: $2,750
  • MMM of FL (Health Advantage Plan) — MCR: $2,250

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Not listed in the file Not listed in the file $7,000 – $106,828.28
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 76 insurance plan rates
  • Aetna — HMO-Gated: $106,874
  • Aetna — MCR: $99,331.56
  • Aetna — PPO-NonGated: $124,237
  • Aetna — QHP: $79,958
  • AIDS Healthcare — MGMCR: $102,142.83
  • Align — MCR: $1,275
  • American Health Plan — MCR: $99,331.56
  • AmeriHealth Caritas — HIX: $103,961.82
  • AmeriHealth Caritas — MGMCR: $98,394.47
  • AvMed — ASOEO: $3,290
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Not listed in the file Not listed in the file $22,709.38
Hip or knee replacement (major joint of the leg), without major complications: 10 of 73 insurance plan rates
  • Aetna — HMO-Gated: $46,678
  • Aetna — MCR: $21,115.74
  • Aetna — PPO-NonGated: $57,784
  • Aetna — QHP: $35,042
  • AIDS Healthcare — MGMCR: $21,713.36
  • Align — MCR: $21,514.15
  • American Health Plan — MCR: $21,115.74
  • AmeriHealth Caritas — HIX: $20,498.42
  • AmeriHealth Caritas — MGMCR: $20,916.54
  • AvMed — ASOEO: $56,193
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Trauma Not listed in the file Not listed in the file $22,908.59
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $22,908.59
  • HUMANA — MGMCRPPO: $22,908.59
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $28,197.42
Neck (cervical) spinal fusion, without complications: 10 of 73 insurance plan rates
  • Aetna — HMO-Gated: $34,601
  • Aetna — MCR: $26,218.65
  • Aetna — PPO-NonGated: $52,007
  • Aetna — QHP: $25,396
  • AIDS Healthcare — MGMCR: $26,960.69
  • Align — MCR: $1,275
  • American Health Plan — MCR: $26,218.65
  • AmeriHealth Caritas — HIX: $51,542
  • AmeriHealth Caritas — MGMCR: $25,971.31
  • AvMed — ASOEO: $3,290
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Trauma Not listed in the file Not listed in the file $28,444.77
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $28,444.77
  • HUMANA — MGMCRPPO: $28,444.77
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $15,338.44
Uterus and ovary surgery (not for cancer), without complications: 10 of 73 insurance plan rates
  • Aetna — HMO-Gated: $18,031
  • Aetna — MCR: $14,262.06
  • Aetna — PPO-NonGated: $23,114
  • Aetna — QHP: $13,397
  • AIDS Healthcare — MGMCR: $14,665.70
  • Align — MCR: $1,275
  • American Health Plan — MCR: $14,262.06
  • AmeriHealth Caritas — HIX: $13,184.92
  • AmeriHealth Caritas — MGMCR: $14,127.51
  • AvMed — ASOEO: $3,290
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Trauma Not listed in the file Not listed in the file $15,472.99
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $15,472.99
  • HUMANA — MGMCRPPO: $15,472.99

Source: HCA Florida Aventura Hospital’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 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
Address20900 Biscayne Blvd, Aventura, FL 33180
CountyMiami-Dade County
StateFlorida
Phone(305) 682‑7000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
CMS Certification Number100131
Name in Medicare recordsHCA FLORIDA AVENTURA HOSPITAL
Profile levelMedicare data + hospital website
Official websitehcafloridahealthcare.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. HCA Florida Aventura Hospital — hcafloridahealthcare.com
  2. Specialties — hcafloridahealthcare.com
  3. For Visitors — hcafloridahealthcare.com
  4. Medical Imaging Center | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  5. ER in South FL | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  6. Inpatient physical rehabilitation | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  7. Cardiology Program in Miami | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  8. Awards and Recognition | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  9. Neurological Center in Aventura | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  10. Stroke Center in Aventura, FL | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  11. Orthopedic Surgeons in Aventura, FL | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  12. Surgery Center in Aventura, FL | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  13. Women's Health Care in Aventura | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  14. Joint Care Center in Aventura | HCA Florida Aventura Hospital — hcafloridahealthcare.com
  15. Shoulder Specialists in Miami | HCA Florida Aventura Hospital — hcafloridahealthcare.com