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Acute Care Hospital

HCA Florida Lawnwood Hospital

Fort Pierce, Florida · St. Lucie County · Emergency services listed

Summary

HCA Florida Lawnwood Hospital is an acute care hospital in Fort Pierce, Florida. Medicare data lists emergency services. CMS overall star rating: 1 of 5 stars. Its official website lists 117 services, specialties and programs. Medicare lists 434 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(772) 461‑4000 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
1 of 5 stars1 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
497Beds (hospital website)
434Doctors and clinicians
117Services listed

Quick answers

Does HCA Florida Lawnwood Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at HCA Florida Lawnwood Hospital. In a medical emergency, call 911.
Where is HCA Florida Lawnwood Hospital?
1700 S 23rd St, Fort Pierce, FL 34950, in St. Lucie County, Florida.
What is the phone number of HCA Florida Lawnwood Hospital?
(772) 461-4000, as listed by Medicare (CMS).
What is the Medicare star rating of HCA Florida Lawnwood Hospital?
1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][8][16][17][18]

Conditions treated[7][9][10][13][15][16][17][18][19][21]

Treatments[8][10][13][15][17][18][19]

Procedures[13][14][15][16][17][19][20][21]

Programs and centers[4][7][9][10][11][15][17][20][21][22]

  • Level III NICU
  • Pediatric emergency room
  • Heart Institute
  • Level II Trauma Center
  • Stroke Center
  • Level III neonatal intensive care unit
  • FastTrack ER
  • Trauma injury prevention program
  • Inpatient physical rehabilitation center
  • Lung cancer screening program
  • Bariatric surgery program
  • Enhanced Surgical Recovery Program
  • Patient surgery text updates

Emergency care (hospital website)[4][9][12][15]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel II
Stroke designationThrombectomy-capable certification (The Joint Commission)

Visiting and practical information

VisitingVisiting hours 6 a.m. to 8 p.m., if the patient consents to visitors[6]
ParkingTram from front or outpatient entrance to parking lot; security officers on duty 24/7 in lots[11]
Interpreters and languagesAT&T Language Line 24/7, interpreters in 140+ languages; 24-hour sign language access[11]
Patient portalMyHealthONE

Recognition[4][10][12][15]

  • Level II Trauma Center
  • Thrombectomy-Capable certification (The Joint Commission)
  • Healthgrades 50 Best Hospitals for Vascular Surgery
  • Healthgrades Vascular Surgery Excellence Award
  • Healthgrades Five-Star Recipient for Vaginal Delivery
  • Hospital accreditation from The Joint Commission
  • Top Performer designation from The Joint Commission
  • Acute Thrombectomy Capable Stroke Center certification from The Joint Commission
  • Rehabilitation program accreditation from CARF
  • America's 50 Best Vascular Surgery from Healthgrades 2026
  • Five-Star Recipient for Carotid Surgery from Healthgrades 2026
  • Five-Star Recipient for Defibrillator Procedures from Healthgrades 2026
  • Five-Star Recipient for Gallbladder Surgery from Healthgrades 2026
  • Five-Star Recipient for Hip Fracture Treatment from Healthgrades 2026
  • Five-Star Recipient for Treatment of Diabetic Emergencies from Healthgrades 2026
  • Five-Star Recipient for Treatment of Heart Failure from Healthgrades 2026
  • Vascular Surgery Excellence Award from Healthgrades 2026
  • Patient Safety Excellence Award from Healthgrades 2026

Doctors and clinicians (434)

434 doctors and other clinicians list HCA Florida Lawnwood 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 (434)

And 410 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 Lawnwood 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 hospital2 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well1 of 5 stars
Staff explained medicines1 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1056%National average: 72%
Would definitely recommend the hospital60%National average: 71%
Nurses “always” communicated well72%National average: 80%
Doctors “always” communicated well67%National average: 80%
Staff “always” explained medicines before giving them46%National average: 62%
Were given information about recovery at home81%National average: 86%
Room and bathroom “always” clean61%National average: 74%
Area around the room “always” quiet at night43%National average: 60%
Completed surveys667Response 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)0.496No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.123Better than the national benchmark
Surgical site infections after colon surgery1.754No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.341No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.014Better 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 patients12.8%
Deaths within 30 days: heart failure patients9.8%
Deaths within 30 days: pneumonia patients17.6%
Deaths within 30 days: COPD patients10.3%
Deaths within 30 days: stroke patients14.6%
Deaths within 30 days: coronary bypass surgery (CABG)2.7%
Serious complications (patient safety indicator PSI-90)1No different from the national rate
Complications after hip or knee replacement3.4%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack16.4%
Readmitted within 30 days: heart failure22.7%
Readmitted within 30 days: pneumonia17.6%
Readmitted within 30 days: COPD22.5%
Readmitted within 30 days: coronary bypass surgery10%
Readmitted within 30 days: hip or knee replacement5.9%

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)128 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 Lawnwood 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 $509 $509 $36.65 – $432.65
New patient office visit (about 30–44 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $152.70
  • Aetna — HMO-Gated: $104.34
  • Aetna — PPO-NonGated: $130.81
  • Aetna — QHP: $88.57
  • AmeriHealth Caritas — HIX: $223.96
  • BCBS — BSLNON-PAR: $122.67
  • BCBS — HMO: $96.20
  • BCBS — MBN: $82.46
  • BCBS — MCRHMO: $36.65
  • BCBS — NWB: $102.31
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 $84.55 – $86.33
New patient office visit (about 30–44 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $86.33
  • CorVel Corporation — WORKERSCOMP: $84.55
  • Prime Health — WORKERSCOMP: $86.33
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP $646 $646 $46.51 – $549.10
New patient office visit (about 45–59 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $193.80
  • Aetna — HMO-Gated: $132.43
  • Aetna — PPO-NonGated: $166.02
  • Aetna — QHP: $112.40
  • AmeriHealth Caritas — HIX: $284.24
  • BCBS — BSLNON-PAR: $155.69
  • BCBS — HMO: $122.09
  • BCBS — MBN: $104.65
  • BCBS — MCRHMO: $46.51
  • BCBS — NWB: $129.85
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 $281.12 – $287.04
New patient office visit (about 45–59 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $287.04
  • CorVel Corporation — WORKERSCOMP: $281.12
  • Prime Health — WORKERSCOMP: $287.04
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP $1,265 $1,265 $91.08 – $1,075.25
New patient office visit (about 60–74 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $379.50
  • Aetna — HMO-Gated: $259.32
  • Aetna — PPO-NonGated: $325.11
  • Aetna — QHP: $220.11
  • AmeriHealth Caritas — HIX: $556.60
  • BCBS — BSLNON-PAR: $304.87
  • BCBS — HMO: $239.09
  • BCBS — MBN: $204.93
  • BCBS — MCRHMO: $91.08
  • BCBS — NWB: $254.26
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 Not listed in the file Not listed in the file $235.11 – $240.06
New patient office visit (about 60–74 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $240.06
  • CorVel Corporation — WORKERSCOMP: $235.11
  • Prime Health — WORKERSCOMP: $240.06
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST $509 $509 $36.65 – $432.65
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $152.70
  • Aetna — HMO-Gated: $104.34
  • Aetna — PPO-NonGated: $130.81
  • Aetna — QHP: $88.57
  • AmeriHealth Caritas — HIX: $223.96
  • BCBS — BSLNON-PAR: $122.67
  • BCBS — HMO: $96.20
  • BCBS — MBN: $82.46
  • BCBS — MCRHMO: $36.65
  • BCBS — NWB: $102.31
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 $140.06 – $143.01
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $143.01
  • CorVel Corporation — WORKERSCOMP: $140.06
  • Prime Health — WORKERSCOMP: $143.01
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST $646 $646 $46.51 – $549.10
Established patient office visit (about 30–39 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $193.80
  • Aetna — HMO-Gated: $132.43
  • Aetna — PPO-NonGated: $166.02
  • Aetna — QHP: $112.40
  • AmeriHealth Caritas — HIX: $284.24
  • BCBS — BSLNON-PAR: $155.69
  • BCBS — HMO: $122.09
  • BCBS — MBN: $104.65
  • BCBS — MCRHMO: $46.51
  • BCBS — NWB: $129.85
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 $185.08 – $188.98
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $188.98
  • CorVel Corporation — WORKERSCOMP: $185.08
  • Prime Health — WORKERSCOMP: $188.98
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 $111.15 – $113.49
Office consultation with a specialist (moderate): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $113.49
  • CorVel Corporation — WORKERSCOMP: $111.15
  • Prime Health — WORKERSCOMP: $113.49
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 $174.80 – $178.48
Office consultation with a specialist (moderate to high): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $178.48
  • CorVel Corporation — WORKERSCOMP: $174.80
  • Prime Health — WORKERSCOMP: $178.48
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 $70.58
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • Humana — TRICR: $70.58
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 $85.86
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • Humana — TRICR: $85.86
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT $4,499 $4,499 $1,349.70 – $3,824.15
Emergency room visit (moderate): rates for 10 insurance plans
  • Aetna — ASA: $1,349.70
  • AmeriHealth Caritas — HIX: $1,979.56
  • AvMed — JacksonFirstNetworkOON: $2,249.50
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $3,824.15
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,374.25
  • Office of Sheiff Highland Co — GVT: $1,574.65
  • Plotkin Health — COMM: $2,249.50
  • Prime Health Sherriff — COMM: $2,249.50
  • United — GlobalBenefitPlanAppendix: $2,024.55
  • United PPO — OptionsPPO: $1,925.57
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 – $7,272
Emergency room visit (moderate): 10 of 26 insurance plan rates
  • AvMed — ASOEO: $8,681
  • AvMed — Empower: $7,828
  • AvMed — Engage: $7,828
  • AvMed — Flex: $7,828
  • AvMed — Focus: $7,828
  • AvMed — FullyInsured: $7,828
  • AvMed — HIX: $1,707
  • AvMed — Select: $7,828
  • BCBS — BSLNON-PAR: $4,007
  • BCBS — HMO: $4,051
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier ER In the file: LVL 3 FREE STD EMER DEPT $4,499 $4,499 $1,349.70 – $3,824.15
Emergency room visit (moderate): rates for 10 insurance plans
  • Aetna — ASA: $1,349.70
  • AmeriHealth Caritas — HIX: $1,979.56
  • AvMed — JacksonFirstNetworkOON: $2,249.50
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $3,824.15
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,374.25
  • Office of Sheiff Highland Co — GVT: $1,574.65
  • Plotkin Health — COMM: $2,249.50
  • Prime Health Sherriff — COMM: $2,249.50
  • United — GlobalBenefitPlanAppendix: $2,024.55
  • United PPO — OptionsPPO: $1,925.57
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT $5,504 $5,504 $1,651.20 – $4,678.40
Emergency room visit (moderately high): rates for 10 insurance plans
  • Aetna — ASA: $1,651.20
  • AmeriHealth Caritas — HIX: $2,421.76
  • AvMed — JacksonFirstNetworkOON: $2,752
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $4,678.40
  • Multiplan — COMMPPOPRIMARYNETWORK: $4,128
  • Office of Sheiff Highland Co — GVT: $1,926.40
  • Plotkin Health — COMM: $2,752
  • Prime Health Sherriff — COMM: $2,752
  • United — GlobalBenefitPlanAppendix: $2,476.80
  • United PPO — OptionsPPO: $2,355.71
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 $800 – $7,272
Emergency room visit (moderately high): 10 of 26 insurance plan rates
  • AvMed — ASOEO: $9,710
  • AvMed — Empower: $8,755
  • AvMed — Engage: $8,755
  • AvMed — Flex: $8,755
  • AvMed — Focus: $8,755
  • AvMed — FullyInsured: $8,755
  • AvMed — HIX: $2,002
  • AvMed — Select: $8,755
  • BCBS — BSLNON-PAR: $4,679
  • BCBS — HMO: $5,652
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier ER In the file: LVL 4 FREE STD EMER DEPT $5,504 $5,504 $1,651.20 – $4,678.40
Emergency room visit (moderately high): rates for 10 insurance plans
  • Aetna — ASA: $1,651.20
  • AmeriHealth Caritas — HIX: $2,421.76
  • AvMed — JacksonFirstNetworkOON: $2,752
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $4,678.40
  • Multiplan — COMMPPOPRIMARYNETWORK: $4,128
  • Office of Sheiff Highland Co — GVT: $1,926.40
  • Plotkin Health — COMM: $2,752
  • Prime Health Sherriff — COMM: $2,752
  • United — GlobalBenefitPlanAppendix: $2,476.80
  • United PPO — OptionsPPO: $2,355.71
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT $5,217 $5,217 $1,565.10 – $4,434.45
Emergency room visit (high): rates for 10 insurance plans
  • Aetna — ASA: $1,565.10
  • AmeriHealth Caritas — HIX: $2,295.48
  • AvMed — JacksonFirstNetworkOON: $2,608.50
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $4,434.45
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,912.75
  • Office of Sheiff Highland Co — GVT: $1,825.95
  • Plotkin Health — COMM: $2,608.50
  • Prime Health Sherriff — COMM: $2,608.50
  • United — GlobalBenefitPlanAppendix: $2,347.65
  • United PPO — OptionsPPO: $2,232.88
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 – $7,272
Emergency room visit (high): 10 of 26 insurance plan rates
  • AvMed — ASOEO: $9,875
  • AvMed — Empower: $8,903
  • AvMed — Engage: $8,903
  • AvMed — Flex: $8,903
  • AvMed — Focus: $8,903
  • AvMed — FullyInsured: $8,903
  • AvMed — HIX: $3,547
  • AvMed — Select: $8,903
  • BCBS — BSLNON-PAR: $4,679
  • BCBS — HMO: $5,652
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier ER In the file: LVL 5 FREE STD EMER DEPT $5,217 $5,217 $1,565.10 – $4,434.45
Emergency room visit (high): rates for 10 insurance plans
  • Aetna — ASA: $1,565.10
  • AmeriHealth Caritas — HIX: $2,295.48
  • AvMed — JacksonFirstNetworkOON: $2,608.50
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $4,434.45
  • Multiplan — COMMPPOPRIMARYNETWORK: $3,912.75
  • Office of Sheiff Highland Co — GVT: $1,825.95
  • Plotkin Health — COMM: $2,608.50
  • Prime Health Sherriff — COMM: $2,608.50
  • United — GlobalBenefitPlanAppendix: $2,347.65
  • United PPO — OptionsPPO: $2,232.88

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 $1,665 $1,665 $143.19 – $1,415.25
Basic metabolic panel (blood test): 10 of 27 insurance plan rates
  • Aetna — ASA: $499.50
  • AmeriHealth Caritas — HIX: $732.60
  • AvMed — ASOEO: $499.50
  • AvMed — Empower: $416.25
  • AvMed — Engage: $416.25
  • AvMed — Flex: $416.25
  • AvMed — Focus: $416.25
  • AvMed — FullyInsured: $416.25
  • AvMed — HIX: $199.80
  • AvMed — JacksonFirstNetworkOON: $832.50
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 $8.46
Basic metabolic panel (blood test): 10 of 34 insurance plan rates
  • Aetna — MCR: $8.97
  • American Health Plan — MCR: $8.97
  • AmeriHealth Caritas — MGMCR: $10.15
  • BCBS — MCRHMO: $8.63
  • BCBS — MCRPPO: $8.63
  • CareWorks (Rockport) — WORKERSCOMP: $224.73
  • Centurion — GVT: $9.31
  • Cigna Healthspring — MCR: $9.05
  • CorVel Corporation — WORKERSCOMP: $220.10
  • Devoted Health — MCR: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL $1,717 $1,717 $147.66 – $1,459.45
Comprehensive metabolic panel (blood test): 10 of 27 insurance plan rates
  • Aetna — ASA: $515.10
  • AmeriHealth Caritas — HIX: $755.48
  • AvMed — ASOEO: $515.10
  • AvMed — Empower: $429.25
  • AvMed — Engage: $429.25
  • AvMed — Flex: $429.25
  • AvMed — Focus: $429.25
  • AvMed — FullyInsured: $429.25
  • AvMed — HIX: $206.04
  • AvMed — JacksonFirstNetworkOON: $858.50
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 34 insurance plan rates
  • Aetna — MCR: $11.19
  • American Health Plan — MCR: $11.19
  • AmeriHealth Caritas — MGMCR: $12.67
  • BCBS — MCRHMO: $10.77
  • BCBS — MCRPPO: $10.77
  • CareWorks (Rockport) — WORKERSCOMP: $334.03
  • Centurion — GVT: $11.62
  • Cigna Healthspring — MCR: $11.30
  • CorVel Corporation — WORKERSCOMP: $327.14
  • Devoted Health — MCR: $10.56
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 34 insurance plan rates
  • Aetna — MCR: $50.68
  • American Health Plan — MCR: $50.68
  • AmeriHealth Caritas — MGMCR: $57.37
  • BCBS — MCRHMO: $48.77
  • BCBS — MCRPPO: $48.77
  • CareWorks (Rockport) — WORKERSCOMP: $252.32
  • Centurion — GVT: $52.59
  • Cigna Healthspring — MCR: $51.16
  • CorVel Corporation — WORKERSCOMP: $247.11
  • Devoted Health — MCR: $47.81
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 $964 $964 $13.39
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates
  • Aetna — MCR: $14.19
  • American Health Plan — MCR: $14.19
  • AmeriHealth Caritas — MGMCR: $16.07
  • BCBS — MCRHMO: $13.66
  • BCBS — MCRPPO: $13.66
  • CareWorks (Rockport) — WORKERSCOMP: $227.79
  • Centurion — GVT: $14.73
  • Cigna Healthspring — MCR: $14.33
  • CorVel Corporation — WORKERSCOMP: $223.10
  • Devoted Health — MCR: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $964 $964 $82.90 – $819.40
Cholesterol panel (lipid panel): 10 of 27 insurance plan rates
  • Aetna — ASA: $289.20
  • AmeriHealth Caritas — HIX: $424.16
  • AvMed — ASOEO: $289.20
  • AvMed — Empower: $241
  • AvMed — Engage: $241
  • AvMed — Flex: $241
  • AvMed — Focus: $241
  • AvMed — FullyInsured: $241
  • AvMed — HIX: $115.68
  • AvMed — JacksonFirstNetworkOON: $482
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 $1,938 $1,938 $8.64 – $87.23
Kidney function panel: 10 of 34 insurance plan rates
  • Aetna — MCR: $9.20
  • American Health Plan — MCR: $9.20
  • AmeriHealth Caritas — MGMCR: $10.42
  • BCBS — MCRHMO: $8.85
  • BCBS — MCRPPO: $8.85
  • CareWorks (Rockport) — WORKERSCOMP: $167.53
  • Centurion — GVT: $9.55
  • Cigna Healthspring — MCR: $9.29
  • CorVel Corporation — WORKERSCOMP: $164.07
  • Devoted Health — MCR: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL $1,938 $1,938 $166.67 – $1,647.30
Kidney function panel: 10 of 27 insurance plan rates
  • Aetna — ASA: $581.40
  • AmeriHealth Caritas — HIX: $852.72
  • AvMed — ASOEO: $581.40
  • AvMed — Empower: $484.50
  • AvMed — Engage: $484.50
  • AvMed — Flex: $484.50
  • AvMed — Focus: $484.50
  • AvMed — FullyInsured: $484.50
  • AvMed — HIX: $232.56
  • AvMed — JacksonFirstNetworkOON: $969
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 $1,938 $1,938 $8.17
Liver function panel: 10 of 34 insurance plan rates
  • Aetna — MCR: $8.66
  • American Health Plan — MCR: $8.66
  • AmeriHealth Caritas — MGMCR: $9.80
  • BCBS — MCRHMO: $8.33
  • BCBS — MCRPPO: $8.33
  • CareWorks (Rockport) — WORKERSCOMP: $270.70
  • Centurion — GVT: $8.99
  • Cigna Healthspring — MCR: $8.74
  • CorVel Corporation — WORKERSCOMP: $265.12
  • Devoted Health — MCR: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL $1,938 $1,938 $166.67 – $1,647.30
Liver function panel: 10 of 27 insurance plan rates
  • Aetna — ASA: $581.40
  • AmeriHealth Caritas — HIX: $852.72
  • AvMed — ASOEO: $581.40
  • AvMed — Empower: $484.50
  • AvMed — Engage: $484.50
  • AvMed — Flex: $484.50
  • AvMed — Focus: $484.50
  • AvMed — FullyInsured: $484.50
  • AvMed — HIX: $232.56
  • AvMed — JacksonFirstNetworkOON: $969
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO $949 $949 $81.61 – $806.65
Urine test (automated, with microscope): 10 of 27 insurance plan rates
  • Aetna — ASA: $284.70
  • AmeriHealth Caritas — HIX: $417.56
  • AvMed — ASOEO: $284.70
  • AvMed — Empower: $237.25
  • AvMed — Engage: $237.25
  • AvMed — Flex: $237.25
  • AvMed — Focus: $237.25
  • AvMed — FullyInsured: $237.25
  • AvMed — HIX: $113.88
  • AvMed — JacksonFirstNetworkOON: $474.50
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 $114.05 – $116.45
Urine test (automated, with microscope): 10 of 34 insurance plan rates
  • Aetna — MCR: $3.36
  • American Health Plan — MCR: $3.36
  • AmeriHealth Caritas — MGMCR: $3.80
  • BCBS — MCRHMO: $3.23
  • BCBS — MCRPPO: $3.23
  • CareWorks (Rockport) — WORKERSCOMP: $116.45
  • Centurion — GVT: $3.49
  • Cigna Healthspring — MCR: $3.39
  • CorVel Corporation — WORKERSCOMP: $114.05
  • Devoted Health — MCR: $3.17
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, Not listed in the file Not listed in the file $3.48
Urine test (manual, without microscope): 10 of 34 insurance plan rates
  • Aetna — MCR: $3.69
  • American Health Plan — MCR: $3.69
  • AmeriHealth Caritas — MGMCR: $4.18
  • BCBS — MCRHMO: $3.55
  • BCBS — MCRPPO: $3.55
  • CareWorks (Rockport) — WORKERSCOMP: $37.79
  • Centurion — GVT: $3.83
  • Cigna Healthspring — MCR: $3.72
  • CorVel Corporation — WORKERSCOMP: $37.01
  • Devoted Health — MCR: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO $949 $949 $81.61 – $806.65
Urine test (automated, without microscope): 10 of 27 insurance plan rates
  • Aetna — ASA: $284.70
  • AmeriHealth Caritas — HIX: $417.56
  • AvMed — ASOEO: $284.70
  • AvMed — Empower: $237.25
  • AvMed — Engage: $237.25
  • AvMed — Flex: $237.25
  • AvMed — Focus: $237.25
  • AvMed — FullyInsured: $237.25
  • AvMed — HIX: $113.88
  • AvMed — JacksonFirstNetworkOON: $474.50
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 34 insurance plan rates
  • Aetna — MCR: $2.39
  • American Health Plan — MCR: $2.39
  • AmeriHealth Caritas — MGMCR: $2.70
  • BCBS — MCRHMO: $2.29
  • BCBS — MCRPPO: $2.29
  • CareWorks (Rockport) — WORKERSCOMP: $87.85
  • Centurion — GVT: $2.48
  • Cigna Healthspring — MCR: $2.41
  • CorVel Corporation — WORKERSCOMP: $86.04
  • Devoted Health — MCR: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total $1,050 $1,050 $18.31 – $184.82
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates
  • Aetna — MCR: $19.49
  • American Health Plan — MCR: $19.49
  • AmeriHealth Caritas — MGMCR: $22.07
  • BCBS — MCRHMO: $18.76
  • BCBS — MCRPPO: $18.76
  • Centurion — GVT: $20.23
  • Cigna Healthspring — MCR: $19.68
  • Devoted Health — MCR: $18.39
  • Florida Complete Care — MCR: $19.68
  • HUMANA — MGMCRHMO: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL $1,050 $1,050 $90.30 – $892.50
PSA (prostate specific antigen) blood test: 10 of 27 insurance plan rates
  • Aetna — ASA: $315
  • AmeriHealth Caritas — HIX: $462
  • AvMed — ASOEO: $315
  • AvMed — Empower: $262.50
  • AvMed — Engage: $262.50
  • AvMed — Flex: $262.50
  • AvMed — Focus: $262.50
  • AvMed — FullyInsured: $262.50
  • AvMed — HIX: $126
  • AvMed — JacksonFirstNetworkOON: $525
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total UNSCHEDULED $1,050 $1,050 $155.07 – $158.33
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $158.33
  • CorVel Corporation — WORKERSCOMP: $155.07
  • Prime Health — WORKERSCOMP: $158.33
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH $1,126 $1,126 $96.84 – $957.10
Thyroid stimulating hormone (TSH) test: 10 of 27 insurance plan rates
  • Aetna — ASA: $337.80
  • AmeriHealth Caritas — HIX: $495.44
  • AvMed — ASOEO: $337.80
  • AvMed — Empower: $281.50
  • AvMed — Engage: $281.50
  • AvMed — Flex: $281.50
  • AvMed — Focus: $281.50
  • AvMed — FullyInsured: $281.50
  • AvMed — HIX: $135.12
  • AvMed — JacksonFirstNetworkOON: $563
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 31 insurance plan rates
  • Aetna — MCR: $17.81
  • American Health Plan — MCR: $17.81
  • AmeriHealth Caritas — MGMCR: $20.16
  • BCBS — MCRHMO: $17.14
  • BCBS — MCRPPO: $17.14
  • Centurion — GVT: $18.48
  • Cigna Healthspring — MCR: $17.98
  • Devoted Health — MCR: $16.80
  • Florida Complete Care — MCR: $17.98
  • HUMANA — MGMCRHMO: $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 $181.08 – $184.89
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $184.89
  • CorVel Corporation — WORKERSCOMP: $181.08
  • Prime Health — WORKERSCOMP: $184.89
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 34 insurance plan rates
  • Aetna — MCR: $8.24
  • American Health Plan — MCR: $8.24
  • AmeriHealth Caritas — MGMCR: $9.32
  • BCBS — MCRHMO: $7.93
  • BCBS — MCRPPO: $7.93
  • CareWorks (Rockport) — WORKERSCOMP: $161.40
  • Centurion — GVT: $8.55
  • Cigna Healthspring — MCR: $8.31
  • CorVel Corporation — WORKERSCOMP: $158.07
  • Devoted Health — MCR: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED $824 $824 $70.86 – $700.40
Complete blood count (CBC), automated: 10 of 27 insurance plan rates
  • Aetna — ASA: $247.20
  • AmeriHealth Caritas — HIX: $362.56
  • AvMed — ASOEO: $247.20
  • AvMed — Empower: $206
  • AvMed — Engage: $206
  • AvMed — Flex: $206
  • AvMed — Focus: $206
  • AvMed — FullyInsured: $206
  • AvMed — HIX: $98.88
  • AvMed — JacksonFirstNetworkOON: $412
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 31 insurance plan rates
  • Aetna — MCR: $6.86
  • American Health Plan — MCR: $6.86
  • AmeriHealth Caritas — MGMCR: $7.76
  • BCBS — MCRHMO: $6.60
  • BCBS — MCRPPO: $6.60
  • Centurion — GVT: $7.12
  • Cigna Healthspring — MCR: $6.92
  • Devoted Health — MCR: $6.47
  • Florida Complete Care — MCR: $6.92
  • HUMANA — MGMCRHMO: $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 $124.05 – $126.66
Complete blood count (CBC), automated: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $126.66
  • CorVel Corporation — WORKERSCOMP: $124.05
  • Prime Health — WORKERSCOMP: $126.66
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME $619 $619 $53.23 – $526.15
Blood clotting time test (prothrombin time, PT): 10 of 27 insurance plan rates
  • Aetna — ASA: $185.70
  • AmeriHealth Caritas — HIX: $272.36
  • AvMed — ASOEO: $185.70
  • AvMed — Empower: $154.75
  • AvMed — Engage: $154.75
  • AvMed — Flex: $154.75
  • AvMed — Focus: $154.75
  • AvMed — FullyInsured: $154.75
  • AvMed — HIX: $74.28
  • AvMed — JacksonFirstNetworkOON: $309.50
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 31 insurance plan rates
  • Aetna — MCR: $4.55
  • American Health Plan — MCR: $4.55
  • AmeriHealth Caritas — MGMCR: $5.15
  • BCBS — MCRHMO: $4.38
  • BCBS — MCRPPO: $4.38
  • Centurion — GVT: $4.72
  • Cigna Healthspring — MCR: $4.59
  • Devoted Health — MCR: $4.29
  • Florida Complete Care — MCR: $4.59
  • HUMANA — MGMCRHMO: $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 $102.05 – $104.20
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $104.20
  • CorVel Corporation — WORKERSCOMP: $102.05
  • Prime Health — WORKERSCOMP: $104.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT $623 $623 $53.58 – $529.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 27 insurance plan rates
  • Aetna — ASA: $186.90
  • AmeriHealth Caritas — HIX: $274.12
  • AvMed — ASOEO: $186.90
  • AvMed — Empower: $155.75
  • AvMed — Engage: $155.75
  • AvMed — Flex: $155.75
  • AvMed — Focus: $155.75
  • AvMed — FullyInsured: $155.75
  • AvMed — HIX: $74.76
  • AvMed — JacksonFirstNetworkOON: $311.50
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 31 insurance plan rates
  • Aetna — MCR: $6.37
  • American Health Plan — MCR: $6.37
  • AmeriHealth Caritas — MGMCR: $7.21
  • BCBS — MCRHMO: $6.13
  • BCBS — MCRPPO: $6.13
  • Centurion — GVT: $6.61
  • Cigna Healthspring — MCR: $6.43
  • Devoted Health — MCR: $6.01
  • Florida Complete Care — MCR: $6.43
  • HUMANA — MGMCRHMO: $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 $129.06 – $131.77
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $131.77
  • CorVel Corporation — WORKERSCOMP: $129.06
  • Prime Health — WORKERSCOMP: $131.77

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 $9,975 $9,975 $857.85 – $8,478.75
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $2,992.50
  • AmeriHealth Caritas — HIX: $4,389
  • AvMed — JacksonFirstNetworkOON: $4,987.50
  • Evernorth BH — COMM: $7,980
  • Freedom Health — MGMCR: $857.85
  • Health Sun Health Plan — MGMCR: $2,124.68
  • Molina — HIX: $2,693.25
  • Molina — MCR: $1,895.25
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $8,478.75
  • Multiplan — COMMPPOPRIMARYNETWORK: $7,481.25
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 – $4,112
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates
  • Aetna — QHP: $1,087
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $926
  • AvMed — Select: $3,710
  • United — AllPayerAppendix: $185.25
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 $2,128.95 – $2,173.77
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $2,173.77
  • CorVel Corporation — WORKERSCOMP: $2,128.95
  • Prime Health — WORKERSCOMP: $2,173.77
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT $11,636 $11,636 $1,000.70 – $9,890.60
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $3,490.80
  • AmeriHealth Caritas — HIX: $5,119.84
  • AvMed — JacksonFirstNetworkOON: $5,818
  • Evernorth BH — COMM: $9,308.80
  • Freedom Health — MGMCR: $1,000.70
  • Health Sun Health Plan — MGMCR: $2,478.47
  • Molina — HIX: $3,141.72
  • Molina — MCR: $2,210.84
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $9,890.60
  • Multiplan — COMMPPOPRIMARYNETWORK: $8,727
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 $11,636 $11,636 $625.80 – $4,112
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates
  • Aetna — QHP: $1,499
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $1,132
  • AvMed — Select: $3,710
  • CareWorks (Rockport) — WORKERSCOMP: $3,807.15
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V $2,523 $2,523 $216.98 – $2,144.55
Chest X-ray, 2 views: 10 of 27 insurance plan rates
  • Aetna — ASA: $756.90
  • AmeriHealth Caritas — HIX: $1,110.12
  • AvMed — ASOEO: $756.90
  • AvMed — Empower: $630.75
  • AvMed — Engage: $630.75
  • AvMed — Flex: $630.75
  • AvMed — Focus: $630.75
  • AvMed — FullyInsured: $630.75
  • AvMed — HIX: $302.76
  • AvMed — JacksonFirstNetworkOON: $1,261.50
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: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $458.20 – $467.85
Chest X-ray, 2 views: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $467.85
  • CorVel Corporation — WORKERSCOMP: $458.20
  • Prime Health — WORKERSCOMP: $467.85
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS $3,924 $3,924 $337.46 – $3,335.40
X-ray of the lower spine, at least 4 views: 10 of 27 insurance plan rates
  • Aetna — ASA: $1,177.20
  • AmeriHealth Caritas — HIX: $1,726.56
  • AvMed — ASOEO: $1,177.20
  • AvMed — Empower: $981
  • AvMed — Engage: $981
  • AvMed — Flex: $981
  • AvMed — Focus: $981
  • AvMed — FullyInsured: $981
  • AvMed — HIX: $470.88
  • AvMed — JacksonFirstNetworkOON: $1,962
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: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $806.36 – $823.34
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $823.34
  • CorVel Corporation — WORKERSCOMP: $806.36
  • Prime Health — WORKERSCOMP: $823.34
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT $7,057 $7,057 $606.90 – $5,998.45
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $2,117.10
  • AmeriHealth Caritas — HIX: $3,105.08
  • AvMed — JacksonFirstNetworkOON: $3,528.50
  • Evernorth BH — COMM: $5,645.60
  • Freedom Health — MGMCR: $606.90
  • Health Sun Health Plan — MGMCR: $1,503.14
  • Molina — HIX: $1,905.39
  • Molina — MCR: $1,340.83
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $5,998.45
  • Multiplan — COMMPPOPRIMARYNETWORK: $5,292.75
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 $7,057 $7,057 $391.22 – $4,112
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates
  • Aetna — QHP: $1,499
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $1,132
  • AvMed — Select: $3,710
  • CareWorks (Rockport) — WORKERSCOMP: $2,650.81
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST $10,844 $10,844 $932.58 – $9,217.40
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $3,253.20
  • AmeriHealth Caritas — HIX: $4,771.36
  • AvMed — JacksonFirstNetworkOON: $5,422
  • Evernorth BH — COMM: $8,675.20
  • Freedom Health — MGMCR: $932.58
  • Health Sun Health Plan — MGMCR: $2,309.77
  • Molina — HIX: $2,927.88
  • Molina — MCR: $2,060.36
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $9,217.40
  • Multiplan — COMMPPOPRIMARYNETWORK: $8,133
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 – $4,112
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — QHP: $1,087
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $926
  • AvMed — Select: $3,710
  • United — AllPayerAppendix: $303.54
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 $2,926.30 – $2,987.91
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $2,987.91
  • CorVel Corporation — WORKERSCOMP: $2,926.30
  • Prime Health — WORKERSCOMP: $2,987.91
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 – $4,112
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates
  • Aetna — QHP: $1,499
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $1,132
  • AvMed — Select: $3,710
  • CareWorks (Rockport) — WORKERSCOMP: $2,512.91
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 $11,813 $11,813 $1,015.92 – $10,041.05
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $3,543.90
  • AmeriHealth Caritas — HIX: $5,197.72
  • AvMed — JacksonFirstNetworkOON: $5,906.50
  • Evernorth BH — COMM: $9,450.40
  • Freedom Health — MGMCR: $1,015.92
  • Health Sun Health Plan — MGMCR: $2,516.17
  • Molina — HIX: $3,189.51
  • Molina — MCR: $2,244.47
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $10,041.05
  • Multiplan — COMMPPOPRIMARYNETWORK: $8,859.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LW JNT W/O CONT RT $11,813 $11,813 $1,015.92 – $10,041.05
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $3,543.90
  • AmeriHealth Caritas — HIX: $5,197.72
  • AvMed — JacksonFirstNetworkOON: $5,906.50
  • Evernorth BH — COMM: $9,450.40
  • Freedom Health — MGMCR: $1,015.92
  • Health Sun Health Plan — MGMCR: $2,516.17
  • Molina — HIX: $3,189.51
  • Molina — MCR: $2,244.47
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $10,041.05
  • Multiplan — COMMPPOPRIMARYNETWORK: $8,859.75
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT $24,040 $24,040 $2,067.44 – $20,434
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates
  • Aetna — ASA: $7,212
  • AmeriHealth Caritas — HIX: $10,577.60
  • AvMed — JacksonFirstNetworkOON: $12,020
  • Evernorth BH — COMM: $19,232
  • Freedom Health — MGMCR: $2,067.44
  • Health Sun Health Plan — MGMCR: $5,120.52
  • Molina — HIX: $6,490.80
  • Molina — MCR: $4,567.60
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $20,434
  • Multiplan — COMMPPOPRIMARYNETWORK: $18,030
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 $1,087 – $1,539
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — QHP: $1,087
  • AvMed — ASOEO: $4,112
  • AvMed — Empower: $3,710
  • AvMed — Engage: $3,710
  • AvMed — Flex: $3,710
  • AvMed — Focus: $3,710
  • AvMed — FullyInsured: $3,710
  • AvMed — HIX: $926
  • AvMed — Select: $3,710
  • United — AllPayerAppendix: $625.80
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 $4,720.10 – $4,819.47
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $4,819.47
  • CorVel Corporation — WORKERSCOMP: $4,720.10
  • Prime Health — WORKERSCOMP: $4,819.47
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $3,571 $3,571 $307.11 – $3,035.35
Ultrasound of the abdomen, complete: 10 of 27 insurance plan rates
  • Aetna — ASA: $1,071.30
  • AmeriHealth Caritas — HIX: $1,571.24
  • AvMed — ASOEO: $1,071.30
  • AvMed — Empower: $892.75
  • AvMed — Engage: $892.75
  • AvMed — Flex: $892.75
  • AvMed — Focus: $892.75
  • AvMed — FullyInsured: $892.75
  • AvMed — HIX: $428.52
  • AvMed — JacksonFirstNetworkOON: $1,785.50
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: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $1,424.63 – $1,454.62
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,454.62
  • CorVel Corporation — WORKERSCOMP: $1,424.63
  • Prime Health — WORKERSCOMP: $1,454.62
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI $3,019 $3,019 $259.63 – $2,566.15
Pregnancy ultrasound (after the first trimester): 10 of 27 insurance plan rates
  • Aetna — ASA: $905.70
  • AmeriHealth Caritas — HIX: $1,328.36
  • AvMed — ASOEO: $905.70
  • AvMed — Empower: $754.75
  • AvMed — Engage: $754.75
  • AvMed — Flex: $754.75
  • AvMed — Focus: $754.75
  • AvMed — FullyInsured: $754.75
  • AvMed — HIX: $362.28
  • AvMed — JacksonFirstNetworkOON: $1,509.50
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 Not listed in the file Not listed in the file $185.25
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $961.24
  • CorVel Corporation — WORKERSCOMP: $941.42
  • Prime Health — WORKERSCOMP: $961.24
  • United — AllPayerAppendix: $185.25
  • Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL $3,322 $3,322 $285.69 – $2,823.70
Transvaginal ultrasound: 10 of 27 insurance plan rates
  • Aetna — ASA: $996.60
  • AmeriHealth Caritas — HIX: $1,461.68
  • AvMed — ASOEO: $996.60
  • AvMed — Empower: $830.50
  • AvMed — Engage: $830.50
  • AvMed — Flex: $830.50
  • AvMed — Focus: $830.50
  • AvMed — FullyInsured: $830.50
  • AvMed — HIX: $398.64
  • AvMed — JacksonFirstNetworkOON: $1,661
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: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $968.43 – $988.82
Transvaginal ultrasound: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $988.82
  • CorVel Corporation — WORKERSCOMP: $968.43
  • Prime Health — WORKERSCOMP: $988.82
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 29 insurance plan rates
  • Aetna — MCR: $92.81
  • American Health Plan — MCR: $92.81
  • AmeriHealth Caritas — MGMCR: $105.07
  • BCBS — MCRHMO: $89.31
  • BCBS — MCRPPO: $89.31
  • Centurion — GVT: $96.32
  • Cigna Healthspring — MCR: $93.69
  • Devoted Health — MCR: $87.56
  • Florida Complete Care — MCR: $93.69
  • HUMANA — MGMCRHMO: $87.56
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT $458 $458 $39.39 – $389.30
Diagnostic mammogram, one breast: 10 of 27 insurance plan rates
  • Aetna — ASA: $137.40
  • AmeriHealth Caritas — HIX: $201.52
  • AvMed — ASOEO: $137.40
  • AvMed — Empower: $114.50
  • AvMed — Engage: $114.50
  • AvMed — Flex: $114.50
  • AvMed — Focus: $114.50
  • AvMed — FullyInsured: $114.50
  • AvMed — HIX: $54.96
  • AvMed — JacksonFirstNetworkOON: $229
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT $458 $458 $39.39 – $389.30
Diagnostic mammogram, one breast: 10 of 27 insurance plan rates
  • Aetna — ASA: $137.40
  • AmeriHealth Caritas — HIX: $201.52
  • AvMed — ASOEO: $137.40
  • AvMed — Empower: $114.50
  • AvMed — Engage: $114.50
  • AvMed — Flex: $114.50
  • AvMed — Focus: $114.50
  • AvMed — FullyInsured: $114.50
  • AvMed — HIX: $54.96
  • AvMed — JacksonFirstNetworkOON: $229
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $367 $367 $198.71
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates
  • Aetna — MCR: $119.28
  • American Health Plan — MCR: $119.28
  • AmeriHealth Caritas — MGMCR: $135.04
  • BCBS — MCRHMO: $114.78
  • BCBS — MCRPPO: $114.78
  • Centurion — GVT: $123.78
  • Cigna Healthspring — MCR: $120.41
  • Devoted Health — MCR: $112.53
  • Florida Complete Care — MCR: $120.41
  • HUMANA — MGMCRHMO: $112.53
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI $367 $367 $31.56 – $311.95
Diagnostic mammogram, both breasts: 10 of 27 insurance plan rates
  • Aetna — ASA: $110.10
  • AmeriHealth Caritas — HIX: $161.48
  • AvMed — ASOEO: $110.10
  • AvMed — Empower: $91.75
  • AvMed — Engage: $91.75
  • AvMed — Flex: $91.75
  • AvMed — Focus: $91.75
  • AvMed — FullyInsured: $91.75
  • AvMed — HIX: $44.04
  • AvMed — JacksonFirstNetworkOON: $183.50
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI $367 $367 $31.56 – $311.95
Screening mammogram, both breasts: 10 of 27 insurance plan rates
  • Aetna — ASA: $110.10
  • AmeriHealth Caritas — HIX: $161.48
  • AvMed — ASOEO: $110.10
  • AvMed — Empower: $91.75
  • AvMed — Engage: $91.75
  • AvMed — Flex: $91.75
  • AvMed — Focus: $91.75
  • AvMed — FullyInsured: $91.75
  • AvMed — HIX: $44.04
  • AvMed — JacksonFirstNetworkOON: $183.50
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 Not listed in the file Not listed in the file $164.31
Screening mammogram, both breasts: 10 of 29 insurance plan rates
  • Aetna — MCR: $98.20
  • American Health Plan — MCR: $98.20
  • AmeriHealth Caritas — MGMCR: $111.17
  • BCBS — MCRHMO: $94.49
  • BCBS — MCRPPO: $94.49
  • Centurion — GVT: $101.90
  • Cigna Healthspring — MCR: $99.12
  • Devoted Health — MCR: $92.64
  • Florida Complete Care — MCR: $99.12
  • HUMANA — MGMCRHMO: $92.64
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 52 In the file: MAMMO SCR CAD 1BRST $367 $367 $31.56 – $311.95
Screening mammogram, both breasts: 10 of 27 insurance plan rates
  • Aetna — ASA: $110.10
  • AmeriHealth Caritas — HIX: $161.48
  • AvMed — ASOEO: $110.10
  • AvMed — Empower: $91.75
  • AvMed — Engage: $91.75
  • AvMed — Flex: $91.75
  • AvMed — Focus: $91.75
  • AvMed — FullyInsured: $91.75
  • AvMed — HIX: $44.04
  • AvMed — JacksonFirstNetworkOON: $183.50

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 UNSCHEDULED Not listed in the file Not listed in the file $383.17 – $391.24
Electrocardiogram (ECG/EKG) with reading: rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $391.24
  • CorVel Corporation — WORKERSCOMP: $383.17
  • Humana — TRICR: $13.20
  • Prime Health — WORKERSCOMP: $391.24
  • Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $18,299 – $20,050
Left heart catheterization (diagnostic): 10 of 28 insurance plan rates
  • Aetna — HMO-Gated: $18,299
  • Aetna — PPO-NonGated: $20,050
  • Aetna — QHP: $14,238
  • AvMed — ASOEO: $22,212
  • AvMed — Empower: $20,033
  • AvMed — Engage: $20,033
  • AvMed — Flex: $20,033
  • AvMed — Focus: $20,033
  • AvMed — FullyInsured: $20,033
  • AvMed — HIX: $7,545
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital 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 $2,900
Left heart catheterization (diagnostic): rates for 1 insurance plan
  • Freedom Health — MGMCD: $2,900
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 $37,360 $37,360 $6,000 – $58,053
Heart rhythm study (electrophysiology evaluation): 10 of 33 insurance plan rates
  • Aetna — HMO-Gated: $23,210
  • Aetna — PPO-NonGated: $25,663
  • Aetna — QHP: $18,060
  • AvMed — ASOEO: $51,007
  • AvMed — Empower: $45,995
  • AvMed — Engage: $45,995
  • AvMed — Flex: $45,995
  • AvMed — Focus: $45,995
  • AvMed — FullyInsured: $45,995
  • AvMed — HIX: $24,969
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP W/O ARRHYTHMIA $37,360 $37,360 $4,856.80 – $31,756
Heart rhythm study (electrophysiology evaluation): 10 of 14 insurance plan rates
  • Aetna — ASA: $11,208
  • AmeriHealth Caritas — HIX: $16,438.40
  • AvMed — JacksonFirstNetworkOON: $18,680
  • Evernorth BH — COMM: $29,888
  • Freedom Health — MGMCD: $5,977.60
  • Molina — MCR: $7,098.40
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $31,756
  • Multiplan — COMMPPOPRIMARYNETWORK: $28,020
  • Office of Sheiff Highland Co — GVT: $13,076
  • Plotkin Health — COMM: $18,680
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, $105,610 $105,610 $10,180 – $58,053
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates
  • Aetna — HMO-Gated: $23,210
  • Aetna — PPO-NonGated: $25,663
  • Aetna — QHP: $18,060
  • AvMed — ASOEO: $51,007
  • AvMed — Empower: $45,995
  • AvMed — Engage: $45,995
  • AvMed — Flex: $45,995
  • AvMed — Focus: $45,995
  • AvMed — FullyInsured: $45,995
  • AvMed — HIX: $24,969
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COM EP REPO CTH TX AFIB $105,610 $105,610 $13,729.30 – $89,768.50
Heart rhythm study with ablation for atrial fibrillation: 10 of 14 insurance plan rates
  • Aetna — ASA: $31,683
  • AmeriHealth Caritas — HIX: $46,468.40
  • AvMed — JacksonFirstNetworkOON: $52,805
  • Evernorth BH — COMM: $84,488
  • Freedom Health — MGMCD: $16,897.60
  • Molina — MCR: $20,065.90
  • Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $89,768.50
  • Multiplan — COMMPPOPRIMARYNETWORK: $79,207.50
  • Office of Sheiff Highland Co — GVT: $36,963.50
  • Plotkin Health — COMM: $52,805
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 Not listed in the file Not listed in the file $8,300
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $5,672.42
  • CorVel Corporation — WORKERSCOMP: $5,555.47
  • Prime Health — WORKERSCOMP: $5,672.42
  • United — AllPayerAppendix: $8,300
  • Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount)
  • Aetna — PPO-NonGated: 25.7% (a percentage in the contract, not a dollar amount)
  • Aetna — QHP: 17.4% (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 $33.25 – $33.95
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates
  • Aetna — MCR: $31.28
  • American Health Plan — MCR: $31.28
  • AmeriHealth Caritas — MGMCR: $35.41
  • BCBS — MCRHMO: $30.10
  • BCBS — MCRPPO: $30.10
  • CareWorks (Rockport) — WORKERSCOMP: $33.95
  • Centurion — GVT: $32.46
  • Cigna Healthspring — MCR: $31.58
  • CorVel Corporation — WORKERSCOMP: $33.25
  • Devoted Health — MCR: $29.51
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP|CQ In the file: THER EXERCIS 15 MIN PTCQ $429 $429 $36.89 – $364.65
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $128.70
  • AmeriHealth Caritas — HIX: $188.76
  • AvMed — ASOEO: $128.70
  • AvMed — Empower: $107.25
  • AvMed — Engage: $107.25
  • AvMed — Flex: $107.25
  • AvMed — Focus: $107.25
  • AvMed — FullyInsured: $107.25
  • AvMed — HIX: $51.48
  • AvMed — JacksonFirstNetworkOON: $214.50
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT $429 $429 $36.89 – $364.65
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates
  • Aetna — ASA: $128.70
  • AmeriHealth Caritas — HIX: $188.76
  • AvMed — ASOEO: $128.70
  • AvMed — Empower: $107.25
  • AvMed — Engage: $107.25
  • AvMed — Flex: $107.25
  • AvMed — Focus: $107.25
  • AvMed — FullyInsured: $107.25
  • AvMed — HIX: $51.48
  • AvMed — JacksonFirstNetworkOON: $214.50
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 $868 $868 $95.77 – $992.24
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates
  • Aetna — MCR: $104.65
  • American Health Plan — MCR: $104.65
  • AmeriHealth Caritas — MGMCR: $118.48
  • BCBS — MCRHMO: $100.70
  • BCBS — MCRPPO: $100.70
  • CareWorks (Rockport) — WORKERSCOMP: $95.06
  • Centurion — GVT: $108.60
  • Cigna Healthspring — MCR: $105.64
  • CorVel Corporation — WORKERSCOMP: $93.10
  • Devoted Health — MCR: $98.73
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX $868 $868 $74.65 – $737.80
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates
  • Aetna — ASA: $260.40
  • AmeriHealth Caritas — HIX: $381.92
  • AvMed — ASOEO: $260.40
  • AvMed — Empower: $217
  • AvMed — Engage: $217
  • AvMed — Flex: $217
  • AvMed — Focus: $217
  • AvMed — FullyInsured: $217
  • AvMed — HIX: $104.16
  • AvMed — JacksonFirstNetworkOON: $434
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 $868 $868 $86.88 – $873.16
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates
  • Aetna — MCR: $92.09
  • American Health Plan — MCR: $92.09
  • AmeriHealth Caritas — MGMCR: $104.26
  • BCBS — MCRHMO: $88.62
  • BCBS — MCRPPO: $88.62
  • Centurion — GVT: $95.57
  • Cigna Healthspring — MCR: $92.96
  • Devoted Health — MCR: $86.88
  • Florida Complete Care — MCR: $92.96
  • HUMANA — MGMCRHMO: $86.88
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 $1,155 $1,155 $93.10 – $95.06
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates
  • Aetna — MCR: $104.65
  • American Health Plan — MCR: $104.65
  • AmeriHealth Caritas — MGMCR: $118.48
  • BCBS — MCRHMO: $100.70
  • BCBS — MCRPPO: $100.70
  • CareWorks (Rockport) — WORKERSCOMP: $95.06
  • Centurion — GVT: $108.60
  • Cigna Healthspring — MCR: $105.64
  • CorVel Corporation — WORKERSCOMP: $93.10
  • Devoted Health — MCR: $98.73
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX $1,155 $1,155 $99.33 – $981.75
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates
  • Aetna — ASA: $346.50
  • AmeriHealth Caritas — HIX: $508.20
  • AvMed — ASOEO: $346.50
  • AvMed — Empower: $288.75
  • AvMed — Engage: $288.75
  • AvMed — Flex: $288.75
  • AvMed — Focus: $288.75
  • AvMed — FullyInsured: $288.75
  • AvMed — HIX: $138.60
  • AvMed — JacksonFirstNetworkOON: $577.50
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 $1,155 $1,155 $86.88 – $873.16
Physical therapy evaluation (moderate complexity): 10 of 24 insurance plan rates
  • Aetna — MCR: $92.09
  • American Health Plan — MCR: $92.09
  • AmeriHealth Caritas — MGMCR: $104.26
  • BCBS — MCRHMO: $88.62
  • BCBS — MCRPPO: $88.62
  • Centurion — GVT: $95.57
  • Cigna Healthspring — MCR: $92.96
  • Devoted Health — MCR: $86.88
  • Florida Complete Care — MCR: $92.96
  • HUMANA — MGMCRHMO: $86.88
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 $1,727 $1,727 $95.77 – $992.24
Physical therapy evaluation (high complexity): 10 of 31 insurance plan rates
  • Aetna — MCR: $104.65
  • American Health Plan — MCR: $104.65
  • AmeriHealth Caritas — MGMCR: $118.48
  • BCBS — MCRHMO: $100.70
  • BCBS — MCRPPO: $100.70
  • CareWorks (Rockport) — WORKERSCOMP: $95.06
  • Centurion — GVT: $108.60
  • Cigna Healthspring — MCR: $105.64
  • CorVel Corporation — WORKERSCOMP: $93.10
  • Devoted Health — MCR: $98.73
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX $1,727 $1,727 $148.52 – $1,467.95
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates
  • Aetna — ASA: $518.10
  • AmeriHealth Caritas — HIX: $759.88
  • AvMed — ASOEO: $518.10
  • AvMed — Empower: $431.75
  • AvMed — Engage: $431.75
  • AvMed — Flex: $431.75
  • AvMed — Focus: $431.75
  • AvMed — FullyInsured: $431.75
  • AvMed — HIX: $207.24
  • AvMed — JacksonFirstNetworkOON: $863.50
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 $1,727 $1,727 $86.88 – $873.16
Physical therapy evaluation (high complexity): 10 of 24 insurance plan rates
  • Aetna — MCR: $92.09
  • American Health Plan — MCR: $92.09
  • AmeriHealth Caritas — MGMCR: $104.26
  • BCBS — MCRHMO: $88.62
  • BCBS — MCRPPO: $88.62
  • Centurion — GVT: $95.57
  • Cigna Healthspring — MCR: $92.96
  • Devoted Health — MCR: $86.88
  • Florida Complete Care — MCR: $92.96
  • HUMANA — MGMCRHMO: $86.88
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: INDIV SESSION 30MIN $1,080 $1,080 $92.88 – $918
Psychotherapy, 30 minutes: 10 of 42 insurance plan rates
  • Aetna — ASA: $324
  • Aetna — HMO-Gated: $221.40
  • Aetna — PPO-NonGated: $277.56
  • Aetna — QHP: $187.92
  • AmeriHealth Caritas — HIX: $475.20
  • AvMed — ASOEO: $324
  • AvMed — Empower: $270
  • AvMed — Engage: $270
  • AvMed — Flex: $270
  • AvMed — Focus: $270
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient SCHEDULED $1,080 $1,080 $68.40 – $69.84
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $69.84
  • CorVel Corporation — WORKERSCOMP: $68.40
  • Prime Health — WORKERSCOMP: $69.84
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient UNSCHEDULED $1,080 $1,080 $234.11 – $239.04
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $239.04
  • CorVel Corporation — WORKERSCOMP: $234.11
  • Prime Health — WORKERSCOMP: $239.04
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: INDIV SESSION 45MIN $1,439 $1,439 $123.75 – $1,223.15
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates
  • Aetna — ASA: $431.70
  • Aetna — HMO-Gated: $295
  • Aetna — PPO-NonGated: $369.82
  • Aetna — QHP: $250.39
  • AmeriHealth Caritas — HIX: $633.16
  • AvMed — ASOEO: $431.70
  • AvMed — Empower: $359.75
  • AvMed — Engage: $359.75
  • AvMed — Flex: $359.75
  • AvMed — Focus: $359.75
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient SCHEDULED $1,439 $1,439 $91.20 – $93.12
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $93.12
  • CorVel Corporation — WORKERSCOMP: $91.20
  • Prime Health — WORKERSCOMP: $93.12
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient UNSCHEDULED $1,439 $1,439 $234.11 – $239.04
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $239.04
  • CorVel Corporation — WORKERSCOMP: $234.11
  • Prime Health — WORKERSCOMP: $239.04
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: INDIV SESSION 60MIN $1,751 $1,751 $150.59 – $1,488.35
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates
  • Aetna — ASA: $525.30
  • Aetna — HMO-Gated: $358.95
  • Aetna — PPO-NonGated: $450.01
  • Aetna — QHP: $304.67
  • AmeriHealth Caritas — HIX: $770.44
  • AvMed — ASOEO: $525.30
  • AvMed — Empower: $437.75
  • AvMed — Engage: $437.75
  • AvMed — Flex: $437.75
  • AvMed — Focus: $437.75
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient UNSCHEDULED $1,751 $1,751 $234.11 – $239.04
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $239.04
  • CorVel Corporation — WORKERSCOMP: $234.11
  • Prime Health — WORKERSCOMP: $239.04
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient SCHEDULED $1,751 $1,751 $136.80 – $139.68
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $139.68
  • CorVel Corporation — WORKERSCOMP: $136.80
  • Prime Health — WORKERSCOMP: $139.68
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAM WO PT 50 MIN $988 $988 $84.97 – $839.80
Family psychotherapy, without the patient: 10 of 42 insurance plan rates
  • Aetna — ASA: $296.40
  • Aetna — HMO-Gated: $202.54
  • Aetna — PPO-NonGated: $253.92
  • Aetna — QHP: $171.91
  • AmeriHealth Caritas — HIX: $434.72
  • AvMed — ASOEO: $296.40
  • AvMed — Empower: $247
  • AvMed — Engage: $247
  • AvMed — Flex: $247
  • AvMed — Focus: $247
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes SCHEDULED $988 $988 $110.20 – $112.52
Family psychotherapy, without the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $112.52
  • CorVel Corporation — WORKERSCOMP: $110.20
  • Prime Health — WORKERSCOMP: $112.52
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes UNSCHEDULED $988 $988 $234.11 – $239.04
Family psychotherapy, without the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $239.04
  • CorVel Corporation — WORKERSCOMP: $234.11
  • Prime Health — WORKERSCOMP: $239.04
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAM W PT 50 MIN $988 $988 $84.97 – $839.80
Family psychotherapy, with the patient: 10 of 42 insurance plan rates
  • Aetna — ASA: $296.40
  • Aetna — HMO-Gated: $202.54
  • Aetna — PPO-NonGated: $253.92
  • Aetna — QHP: $171.91
  • AmeriHealth Caritas — HIX: $434.72
  • AvMed — ASOEO: $296.40
  • AvMed — Empower: $247
  • AvMed — Engage: $247
  • AvMed — Flex: $247
  • AvMed — Focus: $247
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes SCHEDULED $988 $988 $114.95 – $117.37
Family psychotherapy, with the patient: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $117.37
  • CorVel Corporation — WORKERSCOMP: $114.95
  • Prime Health — WORKERSCOMP: $117.37
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP PSY GRP (NOT FAMILY) $403 $403 $34.66 – $342.55
Group psychotherapy: 10 of 33 insurance plan rates
  • Aetna — ASA: $120.90
  • Aetna — HMO-Gated: $82.61
  • Aetna — PPO-NonGated: $103.57
  • Aetna — QHP: $70.12
  • AmeriHealth Caritas — HIX: $177.32
  • AvMed — ASOEO: $120.90
  • AvMed — Empower: $100.75
  • AvMed — Engage: $100.75
  • AvMed — Flex: $100.75
  • AvMed — Focus: $100.75
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) SCHEDULED $403 $403 $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
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) UNSCHEDULED $403 $403 $234.11 – $239.04
Group psychotherapy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $239.04
  • CorVel Corporation — WORKERSCOMP: $234.11
  • Prime Health — WORKERSCOMP: $239.04

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 $6,625 – $31,000
Removal of breast growth (open surgery): 10 of 35 insurance plan rates
  • Aetna — HMO-Gated: $16,103
  • Aetna — PPO-NonGated: $17,837
  • Aetna — QHP: $12,530
  • AvMed — ASOEO: $27,973
  • AvMed — Empower: $25,224
  • AvMed — Engage: $25,224
  • AvMed — Flex: $25,224
  • AvMed — Focus: $25,224
  • AvMed — FullyInsured: $25,224
  • AvMed — HIX: $10,188
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 UNSCHE Not listed in the file Not listed in the file $1,101.99 – $1,125.19
Total hip replacement: 10 of 39 insurance plan rates
  • Aetna — HMO-Gated: $31,455
  • Aetna — PPO-NonGated: $31,455
  • Aetna — QHP: $24,476
  • American Health Plan — MCR: $17,429.32
  • AvMed — ASOEO: $41,379
  • AvMed — Empower: $40,029
  • AvMed — Engage: $40,029
  • AvMed — Flex: $40,029
  • AvMed — Focus: $40,029
  • AvMed — FullyInsured: $40,029
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 $2,702 – $43,000
Total knee replacement: 10 of 42 insurance plan rates
  • Aetna — HMO-Gated: $31,455
  • Aetna — PPO-NonGated: $31,455
  • Aetna — QHP: $24,476
  • American Health Plan — MCR: $17,429.32
  • AvMed — ASOEO: $41,379
  • AvMed — Empower: $40,029
  • AvMed — Engage: $40,029
  • AvMed — Flex: $40,029
  • AvMed — Focus: $40,029
  • AvMed — FullyInsured: $40,029
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 $22,332 – $30,357
Shoulder arthroscopy: shaving of shoulder bone: 10 of 30 insurance plan rates
  • Aetna — HMO-Gated: $16,103
  • Aetna — PPO-NonGated: $17,837
  • Aetna — QHP: $12,530
  • AvMed — ASOEO: $27,973
  • AvMed — Empower: $25,224
  • AvMed — Engage: $25,224
  • AvMed — Flex: $25,224
  • AvMed — Focus: $25,224
  • AvMed — FullyInsured: $25,224
  • AvMed — HIX: $10,188
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 $3,792 – $27,973
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 35 insurance plan rates
  • Aetna — HMO-Gated: $16,103
  • Aetna — PPO-NonGated: $17,837
  • Aetna — QHP: $12,530
  • AvMed — ASOEO: $27,973
  • AvMed — Empower: $25,224
  • AvMed — Engage: $25,224
  • AvMed — Flex: $25,224
  • AvMed — Focus: $25,224
  • AvMed — FullyInsured: $25,224
  • AvMed — HIX: $10,188
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 – $15,153
Removal of tonsils and adenoids (under age 12): 10 of 28 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $24,677
  • BCBS — HMO: $23,866
  • BCBS — MBN: $21,742
  • BCBS — NWB: $23,689
  • BCBS — PHS: $24,677
  • BCBS — PPO: $23,689
  • BCBS — SBN: $23,866
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
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 – $15,153
Upper GI endoscopy (diagnostic): 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $9,396
  • BCBS — HMO: $6,542
  • BCBS — MBN: $5,523
  • BCBS — NWB: $6,634
  • BCBS — PHS: $9,396
  • BCBS — PPO: $6,634
  • BCBS — SBN: $6,542
  • CareWorks (Rockport) — WORKERSCOMP: $1,920.44
  • Cigna — HMO: $15,153
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Not listed in the file Not listed in the file $2,702 – $15,153
Upper GI endoscopy with biopsy: 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $9,396
  • BCBS — HMO: $6,542
  • BCBS — MBN: $5,523
  • BCBS — NWB: $6,634
  • BCBS — PHS: $9,396
  • BCBS — PPO: $6,634
  • BCBS — SBN: $6,542
  • CareWorks (Rockport) — WORKERSCOMP: $2,799.95
  • Cigna — HMO: $15,153
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 $1,495 – $16,600
Colonoscopy (diagnostic): 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $9,396
  • BCBS — HMO: $6,542
  • BCBS — MBN: $5,523
  • BCBS — NWB: $6,634
  • BCBS — PHS: $9,396
  • BCBS — PPO: $6,634
  • BCBS — SBN: $6,542
  • CareWorks (Rockport) — WORKERSCOMP: $1,304.47
  • Cigna — HMO: $15,153
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 – $16,600
Colonoscopy with biopsy: 10 of 28 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $11,343
  • BCBS — HMO: $7,473
  • BCBS — MBN: $6,312
  • BCBS — NWB: $7,611
  • BCBS — PHS: $11,343
  • BCBS — PPO: $7,611
  • BCBS — SBN: $7,473
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
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 $2,456.09 – $2,507.80
Colonoscopy with biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $2,507.80
  • CorVel Corporation — WORKERSCOMP: $2,456.09
  • Prime Health — WORKERSCOMP: $2,507.80
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 $3,324.48 – $3,394.47
Colonoscopy with biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $3,394.47
  • CorVel Corporation — WORKERSCOMP: $3,324.48
  • Prime Health — WORKERSCOMP: $3,394.47
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 $2,702 – $16,600
Colonoscopy with removal of polyps (snare): 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $11,343
  • BCBS — HMO: $7,473
  • BCBS — MBN: $6,312
  • BCBS — NWB: $7,611
  • BCBS — PHS: $11,343
  • BCBS — PPO: $7,611
  • BCBS — SBN: $7,473
  • CareWorks (Rockport) — WORKERSCOMP: $1,969.47
  • Cigna — HMO: $15,153
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 $1,495 – $16,600
Ultrasound of the lower bowel by endoscope: 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $11,343
  • BCBS — HMO: $7,473
  • BCBS — MBN: $6,312
  • BCBS — NWB: $7,611
  • BCBS — PHS: $11,343
  • BCBS — PPO: $7,611
  • BCBS — SBN: $7,473
  • CareWorks (Rockport) — WORKERSCOMP: $1,969.47
  • Cigna — HMO: $15,153
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 $3,509 – $12,200
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $220.19
  • CorVel Corporation — WORKERSCOMP: $215.65
  • Oscar — HIX: $4,288
  • Prime Health — WORKERSCOMP: $220.19
  • Simply Healthcare — HIX: $3,509
  • United — AllPayerAppendix: $12,200
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 $6,625 – $20,031
Gallbladder removal by laparoscope: 10 of 32 insurance plan rates
  • Aetna — HMO-Gated: $17,334
  • Aetna — PPO-NonGated: $20,031
  • Aetna — QHP: $13,489
  • AvMed — ASOEO: $24,680
  • AvMed — Empower: $22,257
  • AvMed — Engage: $22,257
  • AvMed — Flex: $22,257
  • AvMed — Focus: $22,257
  • AvMed — FullyInsured: $22,257
  • AvMed — HIX: $9,810
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 $1,360.11 – $1,388.74
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $1,388.74
  • CorVel Corporation — WORKERSCOMP: $1,360.11
  • Prime Health — WORKERSCOMP: $1,388.74
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 $245.11 – $250.27
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $250.27
  • CorVel Corporation — WORKERSCOMP: $245.11
  • Prime Health — WORKERSCOMP: $250.27
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 $2,350 – $33,200
Groin (inguinal) hernia repair, age 5 or older: 10 of 29 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $24,677
  • BCBS — HMO: $23,866
  • BCBS — MBN: $21,742
  • BCBS — NWB: $23,689
  • BCBS — PHS: $24,677
  • BCBS — PPO: $23,689
  • BCBS — SBN: $23,866
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
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 $13,156.85 – $13,433.84
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $13,433.84
  • CorVel Corporation — WORKERSCOMP: $13,156.85
  • Prime Health — WORKERSCOMP: $13,433.84
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 $4,624.06 – $4,721.41
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $4,721.41
  • CorVel Corporation — WORKERSCOMP: $4,624.06
  • Prime Health — WORKERSCOMP: $4,721.41
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 $4,905.18 – $5,008.45
Prostate biopsy: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $5,008.45
  • CorVel Corporation — WORKERSCOMP: $4,905.18
  • Prime Health — WORKERSCOMP: $5,008.45
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 $4,989 – $5,336
Prostate biopsy: rates for 2 insurance plans
  • Oscar — HIX: $5,336
  • Simply Healthcare — HIX: $4,989
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; Not listed in the file Not listed in the file $2,702 – $25,501
Prostate removal by laparoscope (radical prostatectomy): 10 of 31 insurance plan rates
  • AvMed — ASOEO: $17,277
  • AvMed — Empower: $15,580
  • AvMed — Engage: $15,580
  • AvMed — Flex: $15,580
  • AvMed — Focus: $15,580
  • AvMed — FullyInsured: $15,580
  • AvMed — HIX: $7,167
  • AvMed — Select: $15,580
  • BCBS — BSLNON-PAR: $24,677
  • BCBS — HMO: $23,866
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 Not listed in the file Not listed in the file $3,792 – $24,677
Hysteroscopy with biopsy of the uterus lining: 10 of 32 insurance plan rates
  • Aetna — HMO-Gated: $16,103
  • Aetna — PPO-NonGated: $17,837
  • Aetna — QHP: $12,530
  • AvMed — ASOEO: $17,277
  • AvMed — Empower: $15,580
  • AvMed — Engage: $15,580
  • AvMed — Flex: $15,580
  • AvMed — Focus: $15,580
  • AvMed — FullyInsured: $15,580
  • AvMed — HIX: $7,167
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 $1,495 – $15,153
Spinal injection, lower back (epidural), with imaging guidance: 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $9,396
  • BCBS — HMO: $6,542
  • BCBS — MBN: $5,523
  • BCBS — NWB: $6,634
  • BCBS — PHS: $9,396
  • BCBS — PPO: $6,634
  • BCBS — SBN: $6,542
  • CareWorks (Rockport) — WORKERSCOMP: $2,134.95
  • Cigna — HMO: $15,153
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 $1,495 – $15,153
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates
  • BCBS — BSLNON-PAR: $9,396
  • BCBS — HMO: $6,542
  • BCBS — MBN: $5,523
  • BCBS — NWB: $6,634
  • BCBS — PHS: $9,396
  • BCBS — PPO: $6,634
  • BCBS — SBN: $6,542
  • CareWorks (Rockport) — WORKERSCOMP: $3,659.03
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
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 $2,350 – $31,000
Carpal tunnel release: 10 of 29 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $15,120
  • BCBS — HMO: $12,152
  • BCBS — MBN: $10,230
  • BCBS — NWB: $12,359
  • BCBS — PHS: $15,120
  • BCBS — PPO: $12,359
  • BCBS — SBN: $12,152
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
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 $3,057.36 – $3,121.72
Carpal tunnel release: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $3,121.72
  • CorVel Corporation — WORKERSCOMP: $3,057.36
  • Prime Health — WORKERSCOMP: $3,121.72
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 $4,164.86 – $4,252.54
Carpal tunnel release: rates for 3 insurance plans
  • CareWorks (Rockport) — WORKERSCOMP: $4,252.54
  • CorVel Corporation — WORKERSCOMP: $4,164.86
  • Prime Health — WORKERSCOMP: $4,252.54
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 $4,203.87 – $4,292.38
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $7,531
  • BCBS — HMO: $4,672
  • BCBS — MBN: $3,945
  • BCBS — NWB: $4,764
  • BCBS — PHS: $7,531
  • BCBS — PPO: $4,764
  • BCBS — SBN: $4,672
  • CareWorks (Rockport) — WORKERSCOMP: $4,292.38
  • Cigna — HMO: $15,153
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 $2,702 – $15,153
Cataract removal with lens implant: 10 of 31 insurance plan rates
  • AvMed — HIX: $4,452
  • BCBS — BSLNON-PAR: $15,120
  • BCBS — HMO: $12,152
  • BCBS — MBN: $10,230
  • BCBS — NWB: $12,359
  • BCBS — PHS: $15,120
  • BCBS — PPO: $12,359
  • BCBS — SBN: $12,152
  • CareWorks (Rockport) — WORKERSCOMP: $4,595.76
  • Cigna — HMO: $15,153

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 $2,702 – $15,153
Vaginal delivery, with care before and after: 10 of 25 insurance plan rates
  • AvMed — HIX: $4,452
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
  • Cigna — PPO: $15,153
  • Freedom Health — MGMCD: $1,495
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Molina — HIX: $2,702
  • Molina — MCR: $1,950
  • Optimum — MGMCR: $2,350
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 $2,702 – $15,153
Cesarean delivery (C-section), with care before and after: 10 of 25 insurance plan rates
  • AvMed — HIX: $4,452
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
  • Cigna — PPO: $15,153
  • Freedom Health — MGMCD: $1,495
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Molina — HIX: $2,702
  • Molina — MCR: $1,950
  • Optimum — MGMCR: $2,350
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 – $15,153
Vaginal delivery after a previous C-section, with care before and after: 10 of 25 insurance plan rates
  • AvMed — HIX: $4,452
  • Cigna — HMO: $15,153
  • Cigna — NewBusinessNBN: $11,166
  • Cigna — PPO: $15,153
  • Freedom Health — MGMCD: $1,495
  • Freedom Health — MGMCR: $2,350
  • Health Sun Health Plan — MGMCR: $2,050
  • Molina — HIX: $2,702
  • Molina — MCR: $1,950
  • Optimum — MGMCR: $2,350

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 $13,000 – $83,712.29
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 65 insurance plan rates
  • Aetna — HMO-Gated: $124,237
  • Aetna — MCR: $85,322.15
  • Aetna — PPO-NonGated: $136,659
  • Aetna — QHP: $96,672
  • American Health Plan — MCR: $85,322.15
  • AvMed — ASOEO: $3,785
  • AvMed — Empower: $3,414
  • AvMed — Engage: $3,414
  • AvMed — Flex: $3,414
  • AvMed — Focus: $3,414
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 $17,983.95
Hip or knee replacement (major joint of the leg), without major complications: 10 of 61 insurance plan rates
  • Aetna — HMO-Gated: $57,784
  • Aetna — MCR: $18,329.80
  • Aetna — PPO-NonGated: $65,677
  • Aetna — QHP: $44,963
  • American Health Plan — MCR: $18,329.80
  • AvMed — ASOEO: $3,785
  • AvMed — Empower: $3,414
  • AvMed — Engage: $3,414
  • AvMed — Flex: $3,414
  • AvMed — Focus: $3,414
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 $16,773.49 – $19,886.10
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $19,886.10
  • HUMANA — MGMCRPPO: $16,773.49
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 $22,272.16
Neck (cervical) spinal fusion, without complications: 10 of 61 insurance plan rates
  • Aetna — HMO-Gated: $52,007
  • Aetna — MCR: $22,700.47
  • Aetna — PPO-NonGated: $57,207
  • Aetna — QHP: $40,469
  • American Health Plan — MCR: $22,700.47
  • AvMed — ASOEO: $3,785
  • AvMed — Empower: $3,414
  • AvMed — Engage: $3,414
  • AvMed — Flex: $3,414
  • AvMed — Focus: $3,414
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 $20,773.07 – $24,627.87
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $24,627.87
  • HUMANA — MGMCRPPO: $20,773.07
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 $12,224.48
Uterus and ovary surgery (not for cancer), without complications: 10 of 61 insurance plan rates
  • Aetna — HMO-Gated: $23,115
  • Aetna — MCR: $12,459.57
  • Aetna — PPO-NonGated: $27,543
  • Aetna — QHP: $17,987
  • American Health Plan — MCR: $12,459.57
  • AvMed — ASOEO: $3,785
  • AvMed — Empower: $3,414
  • AvMed — Engage: $3,414
  • AvMed — Flex: $3,414
  • AvMed — Focus: $3,414
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 $11,401.68 – $13,517.46
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans
  • HUMANA — MGMCRHMO: $13,517.46
  • HUMANA — MGMCRPPO: $11,401.68

Source: HCA Florida Lawnwood 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
Address1700 S 23rd St, Fort Pierce, FL 34950
CountySt. Lucie County
StateFlorida
Phone(772) 461‑4000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating1 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number100246
Name in Medicare recordsHCA FLORIDA LAWNWOOD 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 Lawnwood Hospital — hcafloridahealthcare.com
  2. About Us — hcafloridahealthcare.com
  3. Visitor Policy — hcafloridahealthcare.com
  4. Level II Trauma Care | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  5. Diagnostic Radiology | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  6. Emergency Services in Ft. Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  7. Inpatient Physical Rehab Center in Fort Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  8. Visitor Information | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  9. Awards and Recognition | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  10. Heart Center in St. Lucie County | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  11. Cardiovascular Surgery | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  12. Stroke Treatment in Fort Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  13. Heart arrhythmia in St. Lucie County | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  14. Lung cancer | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  15. Neurological care | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  16. Orthopedic Doctors in Fort Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  17. Surgical Specialists in Fort Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  18. Weight Loss Doctors in Fort Pierce | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com
  19. Patient SMS Updates | HCA Florida Lawnwood Hospital — hcafloridahealthcare.com