Does HCA Florida Raulerson Hospital have an emergency room?

Yes. The hospital’s official website lists an emergency room at HCA Florida Raulerson Hospital. Medicare (CMS) data does not list emergency services for it. In a medical emergency, call 911.

Where is HCA Florida Raulerson Hospital?

1796 Hwy 441 North, Okeechobee, FL 34972, in Okeechobee County, Florida.

What is the phone number of HCA Florida Raulerson Hospital?

(863) 763-2151, as listed by Medicare (CMS).

What is the Medicare star rating of HCA Florida Raulerson Hospital?

3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to HCA Florida Raulerson Hospital for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for HCA Florida Raulerson Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -1.2040; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

HCA Florida Raulerson Hospital — Phone & Address

Quick answers

Does HCA Florida Raulerson Hospital have an emergency room?: Yes. The hospital’s official website lists an emergency room at HCA Florida Raulerson Hospital. Medicare (CMS) data does not list emergency services for it. In a medical emergency, call 911.
Where is HCA Florida Raulerson Hospital?: 1796 Hwy 441 North, Okeechobee, FL 34972, in Okeechobee County, Florida.
What is the phone number of HCA Florida Raulerson Hospital?: (863) 763-2151, as listed by Medicare (CMS).
What is the Medicare star rating of HCA Florida Raulerson Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to HCA Florida Raulerson Hospital for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for HCA Florida Raulerson Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -1.2040; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^{[4][6][7][10]}

Conditions treated^[8][14][16]

Appendicitis
Bone fractures
Breast disease
Degenerative joint disease
Gallbladder disease
Heart arrhythmia
Kidney stones
Tumors or masses
Benign prostatic hyperplasia
Ankle injuries
ACL injuries
Carpal tunnel syndrome
Degenerative bone disease
Foot injuries
Joint fractures
Sports-related injuries
Work-related injuries
Cysts
Endometriosis
Heavy uterine bleeding
Uterine fibroids

Treatments^{[4][8][13][14][16][17]}

Physical, occupational and speech therapy
Incontinence therapy
Laparoscopic appendectomy
Laparoscopic cholecystectomy
Laser lithotripsy
Pacemaker or implantable cardioverter defibrillator implantation
Colon resection
Total joint replacement
Transurethral resection of the prostate
Prostatic urethral lift
Arthroscopic joint repair
Closed or open reduction of fractures
Knee replacement surgery
Pediatric arm and wrist fracture repair
Release of carpal tunnel syndrome
Ablation
Hysterectomy
Lumpectomy
Mastectomy
Tubal ligation
Salpingo-oophorectomy
Ultrasound-guided cyst aspiration
Oxygen therapy
Medicated breathing treatment

Procedures^{[4][6][7][8][9][10][13][16][17]}

3D mammography
Robotic surgery
Vascular surgery
Computed tomography (CT) scan
Bone density testing
Magnetic resonance imaging (MRI)
Nuclear medicine
Ultrasound
Breast MRI
Stereotactic breast biopsy
Cardiac stress testing
Electrocardiogram (EKG)
Electroencephalogram (EEG)
Pulmonary function tests
Transthoracic and transesophageal echocardiograms
Minimally invasive surgery
Laparoscopic surgery
Lymphedema therapy
Massage therapy
Balance retraining
Speech and swallowing therapy
Wound care

Programs and centers^{[6][8][9][11][13][14][15]}

Primary Stroke Center
InformER emergency room text updates
Patient surgery text updates
Consult-A-Nurse 24/7 nurse line
Heart health assessment
Knee and hip health risk assessments
Pediatric emergency care

Emergency care (hospital website)^[4][6][12]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center

Visiting and practical information

Visiting	Visiting hours 6 a.m. to 8:30 p.m., if the patient consents to guests^[5]
Parking	Free visitor parking available 24/7^[11]
Patient portal	MyHealthONE

Recognition^{[4][6][7][12]}

Joint Commission Gold Seal, Primary Stroke Center Certification
AHA Get With The Guidelines Stroke Rural Recognition Gold Award
Healthgrades Patient Safety Excellence Award (2018-2025)
Hospital accreditation from The Joint Commission
Primary Stroke Center designation from The Joint Commission
Accreditation from the American College of Radiology for CT, MRI, mammography, nuclear medicine and ultrasound
Accredited Clinical Laboratory, College of American Pathologists
Joint Commission Top Performer in Key Quality Measures

Doctors and clinicians (168)

168 doctors and other clinicians list HCA Florida Raulerson 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

And 144 more: the button below opens the full list.

Other emergency rooms nearby

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

HCA Florida Lawnwood Hospital32 mi · Fort Pierce, FL · Acute Care Hospital
St Lucie Medical Center33 mi · Port Saint Lucie, FL · Acute Care Hospital
Port St Lucie Hospital34 mi · Port Saint Lucie, FL · Psychiatric Hospital
Hendry Regional Medical Center36 mi · Clewiston, FL · Critical Access Hospital
Cleveland Clinic Martin North Hospital36 mi · Stuart, FL · Acute Care Hospital

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

Other hospitals near Okeechobee

Health Care District Lakeside Medical Center38 mi · Belle Glade, FL · Acute Care Hospital

Hospitals in Okeechobee County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Okeechobee Health Care Facility4.9 mi · Okeechobee, FL · 5 of 5 stars
Ardie R Copas State Veterans Nursing Home23 mi · Port Saint Lucie, FL · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Okeechobee Incorporated9.2 mi · Okeechobee, FL

All hospice providers in the state →

Home health agencies

Big Lake Home Health Services Inc16 mi · Okeechobee, FL

All home health agencies in the state →

Dialysis facilities

DaVita Big Lake Kidney Center9.2 mi · Okeechobee, FL · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Surgcenter of St Lucie21 mi · Port Saint Lucie, FL
Tradition Surgery Center21 mi · Port Saint Lucie, FL

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

Florida Community Health Centers, Inc. - Lakeshore Medical0.2 mi · Okeechobee, FL · Community health center
Florida Community Health Centers, Inc. - Dr. Fred Brown Children's Health Center0.3 mi · Okeechobee, FL · Community health center

Clinics and urgent care

Premier Rapid Care LLC9.2 mi · Okeechobee, FL · Urgent care center
Absolute Healthcare Centers, LLC16 mi · Okeechobee, FL · Urgent care center

Pharmacies

Benak Inc9.2 mi · Okeechobee, FL · Community/retail pharmacy
Heartland Discount Pharmacy LLC9.2 mi · Okeechobee, FL · Community/retail pharmacy
Publix Super Markets Inc9.2 mi · Okeechobee, FL · Community/retail pharmacy

Assisted living nearby

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

Grand Oaks9.2 mi · Okeechobee, FL

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 Raulerson 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 hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Patients got help quickly from staff	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	2 of 5 stars
Care Coordination	2 of 5 stars
Symptoms After Stay	3 of 5 stars
Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	63%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	67%National average: 80%
“Always” got help as soon as they wanted	64%National average: 64%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	83%National average: 86%
Room and bathroom “always” clean	72%National average: 73%
Completed surveys	435Response rate: 16%

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

Infections caught in the hospital

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

Surgical site infections after colon surgery	0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0No different from the national benchmark
Not reported to Medicare	Central line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.5%
Deaths within 30 days: heart failure patients	8.1%
Deaths within 30 days: pneumonia patients	17.4%
Deaths within 30 days: COPD patients	9%
Deaths within 30 days: stroke patients	9%
Serious complications (patient safety indicator PSI-90)	0.9No different from the national rate
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)
Too few cases to report	Complications after hip or knee replacement

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.8%
Readmitted within 30 days: heart attack	14.4%
Readmitted within 30 days: heart failure	22.1%
Readmitted within 30 days: pneumonia	18.2%
Readmitted within 30 days: COPD	18.8%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: hip or knee replacement

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	122 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	81%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	-1.2040Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack	0.9788Fewer readmissions than expected
Heart failure	1.0916More readmissions than expected
Pneumonia	1.0358More readmissions than expected
COPD (chronic lung disease)	1.0491More readmissions than expected
No result published	Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	41.75 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	25.00 out of 100
Person and community engagement (patient survey)	42.00 out of 100
Safety (infections and sepsis care)	100.00 out of 100
Efficiency and cost reduction (Medicare spending)	0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	1.00Same as the national median hospital

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

ER wait times and Medicare ratings nearby

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

ER wait times in Florida Best 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 Raulerson Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 86 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP	$1,499	$1,499	$94.44 – $1,274.15
New patient office visit (about 30–44 minutes): 10 of 28 insurance plan rates Aetna — ASA: $449.70 Aetna — HMO: $292.31 Aetna — HMO-Gated: $307.30 Aetna — PPO: $365.76 Aetna — PPO-NonGated: $385.24 Aetna — QHP: $260.83 AmeriHealth Caritas — HIX: $659.56 AvMed — JacksonFirstNetworkOON: $749.50 BCBS — BSLNON-PAR: $361.26 BCBS — HMO: $283.31
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	$1,499	$1,499	$237.63 – $242.64
New patient office visit (about 30–44 minutes): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $242.64 CorVel Corporation — WORKERSCOMP: $237.63 Prime Health — WORKERSCOMP: $242.64
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP	$2,283	$2,283	$143.83 – $1,940.55
New patient office visit (about 45–59 minutes): 10 of 28 insurance plan rates Aetna — ASA: $684.90 Aetna — HMO: $445.19 Aetna — HMO-Gated: $468.01 Aetna — PPO: $557.05 Aetna — PPO-NonGated: $586.73 Aetna — QHP: $397.24 AmeriHealth Caritas — HIX: $1,004.52 AvMed — JacksonFirstNetworkOON: $1,141.50 BCBS — BSLNON-PAR: $550.20 BCBS — HMO: $431.49
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	$2,283	$2,283	$253.90 – $259.24
New patient office visit (about 45–59 minutes): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $259.24 CorVel Corporation — WORKERSCOMP: $253.90 Prime Health — WORKERSCOMP: $259.24
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP	$3,424	$3,424	$215.71 – $2,910.40
New patient office visit (about 60–74 minutes): 10 of 28 insurance plan rates Aetna — ASA: $1,027.20 Aetna — HMO: $667.68 Aetna — HMO-Gated: $701.92 Aetna — PPO: $835.46 Aetna — PPO-NonGated: $879.97 Aetna — QHP: $595.78 AmeriHealth Caritas — HIX: $1,506.56 AvMed — JacksonFirstNetworkOON: $1,712 BCBS — BSLNON-PAR: $825.18 BCBS — HMO: $647.14
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	$3,424	$3,424	$212.33 – $216.80
New patient office visit (about 60–74 minutes): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $216.80 CorVel Corporation — WORKERSCOMP: $212.33 Prime Health — WORKERSCOMP: $216.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST	$1,499	$1,499	$94.44 – $1,274.15
Established patient office visit (about 20–29 minutes): 10 of 28 insurance plan rates Aetna — ASA: $449.70 Aetna — HMO: $292.31 Aetna — HMO-Gated: $307.30 Aetna — PPO: $365.76 Aetna — PPO-NonGated: $385.24 Aetna — QHP: $260.83 AmeriHealth Caritas — HIX: $659.56 AvMed — JacksonFirstNetworkOON: $749.50 BCBS — BSLNON-PAR: $361.26 BCBS — HMO: $283.31
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	$1,499	$1,499	$126.49 – $129.16
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $129.16 CorVel Corporation — WORKERSCOMP: $126.49 Prime Health — WORKERSCOMP: $129.16
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST	$2,283	$2,283	$143.83 – $1,940.55
Established patient office visit (about 30–39 minutes): 10 of 28 insurance plan rates Aetna — ASA: $684.90 Aetna — HMO: $445.19 Aetna — HMO-Gated: $468.01 Aetna — PPO: $557.05 Aetna — PPO-NonGated: $586.73 Aetna — QHP: $397.24 AmeriHealth Caritas — HIX: $1,004.52 AvMed — JacksonFirstNetworkOON: $1,141.50 BCBS — BSLNON-PAR: $550.20 BCBS — HMO: $431.49
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	$2,283	$2,283	$84.55 – $86.33
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $86.33 CorVel Corporation — WORKERSCOMP: $84.55 Prime Health — WORKERSCOMP: $86.33
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	$205.10 – $209.42
Office consultation with a specialist (moderate to high): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $209.42 CorVel Corporation — WORKERSCOMP: $205.10 Prime Health — WORKERSCOMP: $209.42
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	$70.33
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan Humana — TRICR: $70.33
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	$85.53
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan Humana — TRICR: $85.53
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	$2,071	$2,071	$561.10 – $572.91
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) In the file: LVL 3 EMER DEPT	$2,071	$2,071	$621.30 – $1,760.35
Emergency room visit (moderate): rates for 9 insurance plans Aetna — ASA: $621.30 AmeriHealth Caritas — HIX: $911.24 AvMed — JacksonFirstNetworkOON: $1,035.50 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $1,760.35 Multiplan — COMMPPOPRIMARYNETWORK: $1,553.25 Plotkin Health — COMM: $1,035.50 Prime Health Sherriff — COMM: $1,035.50 United — GlobalBenefitPlanAppendix: $931.95 United PPO — OptionsPPO: $886.39
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	$3,106	$3,106	$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) In the file: LVL 4 EMER DEPT	$3,106	$3,106	$931.80 – $2,640.10
Emergency room visit (moderately high): rates for 9 insurance plans Aetna — ASA: $931.80 AmeriHealth Caritas — HIX: $1,366.64 AvMed — JacksonFirstNetworkOON: $1,553 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $2,640.10 Multiplan — COMMPPOPRIMARYNETWORK: $2,329.50 Plotkin Health — COMM: $1,553 Prime Health Sherriff — COMM: $1,553 United — GlobalBenefitPlanAppendix: $1,397.70 United PPO — OptionsPPO: $1,329.37
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	$3,526	$3,526	$3,547 – $9,875
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) In the file: LVL 5 EMER DEPT	$3,526	$3,526	$1,057.80 – $2,997.10
Emergency room visit (high): rates for 9 insurance plans Aetna — ASA: $1,057.80 AmeriHealth Caritas — HIX: $1,551.44 AvMed — JacksonFirstNetworkOON: $1,763 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $2,997.10 Multiplan — COMMPPOPRIMARYNETWORK: $2,644.50 Plotkin Health — COMM: $1,763 Prime Health Sherriff — COMM: $1,763 United — GlobalBenefitPlanAppendix: $1,586.70 United PPO — OptionsPPO: $1,509.13

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
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	$1,430	$1,430	$8.46
Basic metabolic panel (blood test): 10 of 35 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: $202.96 Centurion — GVT: $9.31 Cigna Healthspring — MCR: $9.05 CorVel Corporation — WORKERSCOMP: $198.78 Devoted Health — MCR: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM	$1,430	$1,430	$122.98 – $1,215.50
Basic metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — ASA: $429 AmeriHealth Caritas — HIX: $629.20 AvMed — ASOEO: $429 AvMed — Empower: $357.50 AvMed — Engage: $357.50 AvMed — Flex: $357.50 AvMed — Focus: $357.50 AvMed — FullyInsured: $357.50 AvMed — HIX: $171.60 AvMed — JacksonFirstNetworkOON: $715
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL	$25	$25	$2.15 – $21.25
Comprehensive metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — ASA: $7.50 AmeriHealth Caritas — HIX: $11 AvMed — ASOEO: $7.50 AvMed — Empower: $6.25 AvMed — Engage: $6.25 AvMed — Flex: $6.25 AvMed — Focus: $6.25 AvMed — FullyInsured: $6.25 AvMed — HIX: $3 AvMed — JacksonFirstNetworkOON: $12.50
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 35 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: $301.68 Centurion — GVT: $11.62 Cigna Healthspring — MCR: $11.30 CorVel Corporation — WORKERSCOMP: $295.46 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 35 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: $227.87 Centurion — GVT: $52.59 Cigna Healthspring — MCR: $51.16 CorVel Corporation — WORKERSCOMP: $223.17 Devoted Health — MCR: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$1,130	$1,130	$97.18 – $960.50
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates Aetna — ASA: $339 AmeriHealth Caritas — HIX: $497.20 AvMed — ASOEO: $339 AvMed — Empower: $282.50 AvMed — Engage: $282.50 AvMed — Flex: $282.50 AvMed — Focus: $282.50 AvMed — FullyInsured: $282.50 AvMed — HIX: $135.60 AvMed — JacksonFirstNetworkOON: $565
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	Not listed in the file	Not listed in the file	$13.39
Cholesterol panel (lipid panel): 10 of 35 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: $205.74 Centurion — GVT: $14.73 Cigna Healthspring — MCR: $14.33 CorVel Corporation — WORKERSCOMP: $201.49 Devoted Health — MCR: $13.39
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	$1,455	$1,455	$8.03 – $95.91
Kidney function panel: 10 of 35 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: $151.30 Centurion — GVT: $9.55 Cigna Healthspring — MCR: $9.29 CorVel Corporation — WORKERSCOMP: $148.18 Devoted Health — MCR: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$1,455	$1,455	$125.13 – $1,236.75
Kidney function panel: 10 of 25 insurance plan rates Aetna — ASA: $436.50 AmeriHealth Caritas — HIX: $640.20 AvMed — ASOEO: $436.50 AvMed — Empower: $363.75 AvMed — Engage: $363.75 AvMed — Flex: $363.75 AvMed — Focus: $363.75 AvMed — FullyInsured: $363.75 AvMed — HIX: $174.60 AvMed — JacksonFirstNetworkOON: $727.50
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	$1,818	$1,818	$8.17
Liver function panel: 10 of 35 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: $244.48 Centurion — GVT: $8.99 Cigna Healthspring — MCR: $8.74 CorVel Corporation — WORKERSCOMP: $239.44 Devoted Health — MCR: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$1,818	$1,818	$156.35 – $1,545.30
Liver function panel: 10 of 25 insurance plan rates Aetna — ASA: $545.40 AmeriHealth Caritas — HIX: $799.92 AvMed — ASOEO: $545.40 AvMed — Empower: $454.50 AvMed — Engage: $454.50 AvMed — Flex: $454.50 AvMed — Focus: $454.50 AvMed — FullyInsured: $454.50 AvMed — HIX: $218.16 AvMed — JacksonFirstNetworkOON: $909
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,	$575	$575	$103.01 – $105.18
Urine test (automated, with microscope): 10 of 35 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: $105.18 Centurion — GVT: $3.49 Cigna Healthspring — MCR: $3.39 CorVel Corporation — WORKERSCOMP: $103.01 Devoted Health — MCR: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$575	$575	$49.45 – $488.75
Urine test (automated, with microscope): 10 of 25 insurance plan rates Aetna — ASA: $172.50 AmeriHealth Caritas — HIX: $253 AvMed — ASOEO: $172.50 AvMed — Empower: $143.75 AvMed — Engage: $143.75 AvMed — Flex: $143.75 AvMed — Focus: $143.75 AvMed — FullyInsured: $143.75 AvMed — HIX: $69 AvMed — JacksonFirstNetworkOON: $287.50
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: KETONES UR MANUAL	$154	$154	$13.24 – $130.90
Urine test (manual, without microscope): 10 of 25 insurance plan rates Aetna — ASA: $46.20 AmeriHealth Caritas — HIX: $67.76 AvMed — ASOEO: $46.20 AvMed — Empower: $38.50 AvMed — Engage: $38.50 AvMed — Flex: $38.50 AvMed — Focus: $38.50 AvMed — FullyInsured: $38.50 AvMed — HIX: $18.48 AvMed — JacksonFirstNetworkOON: $77
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA W O MICRO MANUAL	$20	$20	$1.72 – $17
Urine test (manual, without microscope): 10 of 25 insurance plan rates Aetna — ASA: $6 AmeriHealth Caritas — HIX: $8.80 AvMed — ASOEO: $6 AvMed — Empower: $5 AvMed — Engage: $5 AvMed — Flex: $5 AvMed — Focus: $5 AvMed — FullyInsured: $5 AvMed — HIX: $2.40 AvMed — JacksonFirstNetworkOON: $10
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 35 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: $34.13 Centurion — GVT: $3.83 Cigna Healthspring — MCR: $3.72 CorVel Corporation — WORKERSCOMP: $33.43 Devoted Health — MCR: $3.48
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,	$129	$129	$2.25
Urine test (automated, without microscope): 10 of 35 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: $79.34 Centurion — GVT: $2.48 Cigna Healthspring — MCR: $2.41 CorVel Corporation — WORKERSCOMP: $77.70 Devoted Health — MCR: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO	$129	$129	$11.09 – $109.65
Urine test (automated, without microscope): 10 of 25 insurance plan rates Aetna — ASA: $38.70 AmeriHealth Caritas — HIX: $56.76 AvMed — ASOEO: $38.70 AvMed — Empower: $32.25 AvMed — Engage: $32.25 AvMed — Flex: $32.25 AvMed — Focus: $32.25 AvMed — FullyInsured: $32.25 AvMed — HIX: $15.48 AvMed — JacksonFirstNetworkOON: $64.50
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total	$833	$833	$18.39
PSA (prostate specific antigen) blood test: 10 of 32 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	$833	$833	$71.64 – $708.05
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates Aetna — ASA: $249.90 AmeriHealth Caritas — HIX: $366.52 AvMed — ASOEO: $249.90 AvMed — Empower: $208.25 AvMed — Engage: $208.25 AvMed — Flex: $208.25 AvMed — Focus: $208.25 AvMed — FullyInsured: $208.25 AvMed — HIX: $99.96 AvMed — JacksonFirstNetworkOON: $416.50
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total UNSCHEDULED	$833	$833	$140.05 – $143
PSA (prostate specific antigen) blood test: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $143 CorVel Corporation — WORKERSCOMP: $140.05 Prime Health — WORKERSCOMP: $143
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH)	$1,174	$1,174	$16.80
Thyroid stimulating hormone (TSH) test: 10 of 32 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: TSH	$1,174	$1,174	$100.96 – $997.90
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates Aetna — ASA: $352.20 AmeriHealth Caritas — HIX: $516.56 AvMed — ASOEO: $352.20 AvMed — Empower: $293.50 AvMed — Engage: $293.50 AvMed — Flex: $293.50 AvMed — Focus: $293.50 AvMed — FullyInsured: $293.50 AvMed — HIX: $140.88 AvMed — JacksonFirstNetworkOON: $587
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) UNSCHEDULED	$1,174	$1,174	$163.54 – $166.99
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $166.99 CorVel Corporation — WORKERSCOMP: $163.54 Prime Health — WORKERSCOMP: $166.99
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 35 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: $145.76 Centurion — GVT: $8.55 Cigna Healthspring — MCR: $8.31 CorVel Corporation — WORKERSCOMP: $142.76 Devoted Health — MCR: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED	$25	$25	$2.15 – $21.25
Complete blood count (CBC), automated: 10 of 25 insurance plan rates Aetna — ASA: $7.50 AmeriHealth Caritas — HIX: $11 AvMed — ASOEO: $7.50 AvMed — Empower: $6.25 AvMed — Engage: $6.25 AvMed — Flex: $6.25 AvMed — Focus: $6.25 AvMed — FullyInsured: $6.25 AvMed — HIX: $3 AvMed — JacksonFirstNetworkOON: $12.50
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	$5.99 – $71.49
Complete blood count (CBC), automated: 10 of 32 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	$112.04 – $114.40
Complete blood count (CBC), automated: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $114.40 CorVel Corporation — WORKERSCOMP: $112.04 Prime Health — WORKERSCOMP: $114.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time;	$561	$561	$4.29
Blood clotting time test (prothrombin time, PT): 10 of 32 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: PROTIME	$561	$561	$48.25 – $476.85
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates Aetna — ASA: $168.30 AmeriHealth Caritas — HIX: $246.84 AvMed — ASOEO: $168.30 AvMed — Empower: $140.25 AvMed — Engage: $140.25 AvMed — Flex: $140.25 AvMed — Focus: $140.25 AvMed — FullyInsured: $140.25 AvMed — HIX: $67.32 AvMed — JacksonFirstNetworkOON: $280.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; UNSCHEDULED	$561	$561	$92.16 – $94.10
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $94.10 CorVel Corporation — WORKERSCOMP: $92.16 Prime Health — WORKERSCOMP: $94.10
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood	$630	$630	$6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 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: PTT	$630	$630	$54.18 – $535.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates Aetna — ASA: $189 AmeriHealth Caritas — HIX: $277.20 AvMed — ASOEO: $189 AvMed — Empower: $157.50 AvMed — Engage: $157.50 AvMed — Flex: $157.50 AvMed — Focus: $157.50 AvMed — FullyInsured: $157.50 AvMed — HIX: $75.60 AvMed — JacksonFirstNetworkOON: $315
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	$630	$630	$116.56 – $119.01
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $119.01 CorVel Corporation — WORKERSCOMP: $116.56 Prime Health — WORKERSCOMP: $119.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT	$8,145	$8,145	$700.47 – $6,923.25
CT scan of the head or brain, without contrast: 10 of 16 insurance plan rates Aetna — ASA: $2,443.50 AmeriHealth Caritas — HIX: $3,583.80 AvMed — JacksonFirstNetworkOON: $4,072.50 Freedom Health — MGMCR: $700.47 Health Sun Health Plan — MGMCR: $1,734.88 Molina — HIX: $2,199.15 Molina — MCR: $1,547.55 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $6,923.25 Multiplan — COMMPPOPRIMARYNETWORK: $6,108.75 Optimum — MGMCR: $700.47
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	$8,145	$8,145	$1,087 – $1,539
CT scan of the head or brain, without contrast: 10 of 14 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	$8,145	$8,145	$1,922.74 – $1,963.22
CT scan of the head or brain, without contrast: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $1,963.22 CorVel Corporation — WORKERSCOMP: $1,922.74 Prime Health — WORKERSCOMP: $1,963.22
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	$13,866	$13,866	$625.80 – $4,112
MRI of the brain, before and after contrast: 10 of 17 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: $3,438.41
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$13,866	$13,866	$1,192.48 – $11,786.10
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — ASA: $4,159.80 AmeriHealth Caritas — HIX: $6,101.04 AvMed — JacksonFirstNetworkOON: $6,933 Freedom Health — MGMCR: $1,192.48 Health Sun Health Plan — MGMCR: $2,953.46 Molina — HIX: $3,743.82 Molina — MCR: $2,634.54 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $11,786.10 Multiplan — COMMPPOPRIMARYNETWORK: $10,399.50 Optimum — MGMCR: $1,192.48
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V	$1,547	$1,547	$133.04 – $1,314.95
Chest X-ray, 2 views: 10 of 25 insurance plan rates Aetna — ASA: $464.10 AmeriHealth Caritas — HIX: $680.68 AvMed — ASOEO: $464.10 AvMed — Empower: $386.75 AvMed — Engage: $386.75 AvMed — Flex: $386.75 AvMed — Focus: $386.75 AvMed — FullyInsured: $386.75 AvMed — HIX: $185.64 AvMed — JacksonFirstNetworkOON: $773.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views	$1,547	$1,547	$137.53
Chest X-ray, 2 views: rates for 6 insurance plans United — AllPayerAppendix: $137.53 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$1,547	$1,547	$413.82 – $422.53
Chest X-ray, 2 views: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $422.53 CorVel Corporation — WORKERSCOMP: $413.82 Prime Health — WORKERSCOMP: $422.53
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS	$3,123	$3,123	$268.58 – $2,654.55
X-ray of the lower spine, at least 4 views: 10 of 25 insurance plan rates Aetna — ASA: $936.90 AmeriHealth Caritas — HIX: $1,374.12 AvMed — ASOEO: $936.90 AvMed — Empower: $780.75 AvMed — Engage: $780.75 AvMed — Flex: $780.75 AvMed — Focus: $780.75 AvMed — FullyInsured: $780.75 AvMed — HIX: $374.76 AvMed — JacksonFirstNetworkOON: $1,561.50
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	$3,123	$3,123	$185.25
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans United — AllPayerAppendix: $185.25 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$3,123	$3,123	$728.26 – $743.59
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $743.59 CorVel Corporation — WORKERSCOMP: $728.26 Prime Health — WORKERSCOMP: $743.59
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	$11,587	$11,587	$391.22 – $4,112
MRI of the lower back (lumbar spine), without contrast: 10 of 17 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: $2,394.06
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$11,587	$11,587	$996.48 – $9,848.95
MRI of the lower back (lumbar spine), without contrast: 10 of 16 insurance plan rates Aetna — ASA: $3,476.10 AmeriHealth Caritas — HIX: $5,098.28 AvMed — JacksonFirstNetworkOON: $5,793.50 Freedom Health — MGMCR: $996.48 Health Sun Health Plan — MGMCR: $2,468.03 Molina — HIX: $3,128.49 Molina — MCR: $2,201.53 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $9,848.95 Multiplan — COMMPPOPRIMARYNETWORK: $8,690.25 Optimum — MGMCR: $996.48
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$10,557	$10,557	$907.90 – $8,973.45
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates Aetna — ASA: $3,167.10 AmeriHealth Caritas — HIX: $4,645.08 AvMed — JacksonFirstNetworkOON: $5,278.50 Freedom Health — MGMCR: $907.90 Health Sun Health Plan — MGMCR: $2,248.64 Molina — HIX: $2,850.39 Molina — MCR: $2,005.83 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $8,973.45 Multiplan — COMMPPOPRIMARYNETWORK: $7,917.75 Optimum — MGMCR: $907.90
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s)	$10,557	$10,557	$303.54 – $4,112
CT scan of the pelvis, with contrast: 10 of 14 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	$10,557	$10,557	$2,642.87 – $2,698.51
CT scan of the pelvis, with contrast: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $2,698.51 CorVel Corporation — WORKERSCOMP: $2,642.87 Prime Health — WORKERSCOMP: $2,698.51
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 17 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: $2,269.52
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	$10,786	$10,786	$927.60 – $9,168.10
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — ASA: $3,235.80 AmeriHealth Caritas — HIX: $4,745.84 AvMed — JacksonFirstNetworkOON: $5,393 Freedom Health — MGMCR: $927.60 Health Sun Health Plan — MGMCR: $2,297.42 Molina — HIX: $2,912.22 Molina — MCR: $2,049.34 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $9,168.10 Multiplan — COMMPPOPRIMARYNETWORK: $8,089.50 Optimum — MGMCR: $927.60
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	$10,786	$10,786	$927.60 – $9,168.10
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — ASA: $3,235.80 AmeriHealth Caritas — HIX: $4,745.84 AvMed — JacksonFirstNetworkOON: $5,393 Freedom Health — MGMCR: $927.60 Health Sun Health Plan — MGMCR: $2,297.42 Molina — HIX: $2,912.22 Molina — MCR: $2,049.34 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $9,168.10 Multiplan — COMMPPOPRIMARYNETWORK: $8,089.50 Optimum — MGMCR: $927.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT	$21,100	$21,100	$1,814.60 – $17,935
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — ASA: $6,330 AmeriHealth Caritas — HIX: $9,284 AvMed — JacksonFirstNetworkOON: $10,550 Freedom Health — MGMCR: $1,814.60 Health Sun Health Plan — MGMCR: $4,494.30 Molina — HIX: $5,697 Molina — MCR: $4,009 Multiplan — COMMPPOCOMPLEMENTARYNETWORK: $17,935 Multiplan — COMMPPOPRIMARYNETWORK: $15,825 Optimum — MGMCR: $1,814.60
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)	$21,100	$21,100	$1,087 – $1,539
CT scan of the abdomen and pelvis, with contrast: 10 of 14 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	$21,100	$21,100	$4,262.93 – $4,352.67
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $4,352.67 CorVel Corporation — WORKERSCOMP: $4,262.93 Prime Health — WORKERSCOMP: $4,352.67
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$3,940	$3,940	$338.84 – $3,349
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates Aetna — ASA: $1,182 AmeriHealth Caritas — HIX: $1,733.60 AvMed — ASOEO: $1,182 AvMed — Empower: $985 AvMed — Engage: $985 AvMed — Flex: $985 AvMed — Focus: $985 AvMed — FullyInsured: $985 AvMed — HIX: $472.80 AvMed — JacksonFirstNetworkOON: $1,970
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete	$3,940	$3,940	$185.25
Ultrasound of the abdomen, complete: rates for 6 insurance plans United — AllPayerAppendix: $185.25 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$3,940	$3,940	$1,286.65 – $1,313.74
Ultrasound of the abdomen, complete: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $1,313.74 CorVel Corporation — WORKERSCOMP: $1,286.65 Prime Health — WORKERSCOMP: $1,313.74
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI	$3,258	$3,258	$280.19 – $2,769.30
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates Aetna — ASA: $977.40 AmeriHealth Caritas — HIX: $1,433.52 AvMed — ASOEO: $977.40 AvMed — Empower: $814.50 AvMed — Engage: $814.50 AvMed — Flex: $814.50 AvMed — Focus: $814.50 AvMed — FullyInsured: $814.50 AvMed — HIX: $390.96 AvMed — JacksonFirstNetworkOON: $1,629
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	$3,258	$3,258	$850.24 – $868.14
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans CareWorks (Rockport) — WORKERSCOMP: $868.14 CorVel Corporation — WORKERSCOMP: $850.24 Prime Health — WORKERSCOMP: $868.14 United — AllPayerAppendix: $185.25 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$3,471	$3,471	$298.51 – $2,950.35
Transvaginal ultrasound: 10 of 25 insurance plan rates Aetna — ASA: $1,041.30 AmeriHealth Caritas — HIX: $1,527.24 AvMed — ASOEO: $1,041.30 AvMed — Empower: $867.75 AvMed — Engage: $867.75 AvMed — Flex: $867.75 AvMed — Focus: $867.75 AvMed — FullyInsured: $867.75 AvMed — HIX: $416.52 AvMed — JacksonFirstNetworkOON: $1,735.50
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal	$3,471	$3,471	$185.25
Transvaginal ultrasound: rates for 6 insurance plans United — AllPayerAppendix: $185.25 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$3,471	$3,471	$874.63 – $893.04
Transvaginal ultrasound: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $893.04 CorVel Corporation — WORKERSCOMP: $874.63 Prime Health — WORKERSCOMP: $893.04
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 30 insurance plan rates Aetna — MCR: $87.52 American Health Plan — MCR: $87.52 AmeriHealth Caritas — MGMCR: $99.08 BCBS — MCRHMO: $84.22 BCBS — MCRPPO: $84.22 Centurion — GVT: $90.83 Cigna Healthspring — MCR: $88.35 Devoted Health — MCR: $82.57 Florida Complete Care — MCR: $88.35 HUMANA — MGMCRHMO: $82.57
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT	$1,295	$1,295	$111.37 – $1,100.75
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates Aetna — ASA: $388.50 AmeriHealth Caritas — HIX: $569.80 AvMed — ASOEO: $388.50 AvMed — Empower: $323.75 AvMed — Engage: $323.75 AvMed — Flex: $323.75 AvMed — Focus: $323.75 AvMed — FullyInsured: $323.75 AvMed — HIX: $155.40 AvMed — JacksonFirstNetworkOON: $647.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT	$1,295	$1,295	$111.37 – $1,100.75
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates Aetna — ASA: $388.50 AmeriHealth Caritas — HIX: $569.80 AvMed — ASOEO: $388.50 AvMed — Empower: $323.75 AvMed — Engage: $323.75 AvMed — Flex: $323.75 AvMed — Focus: $323.75 AvMed — FullyInsured: $323.75 AvMed — HIX: $155.40 AvMed — JacksonFirstNetworkOON: $647.50
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,482	$1,482	$198.71
Diagnostic mammogram, both breasts: 10 of 30 insurance plan rates Aetna — MCR: $112.42 American Health Plan — MCR: $112.42 AmeriHealth Caritas — MGMCR: $127.27 BCBS — MCRHMO: $108.18 BCBS — MCRPPO: $108.18 Centurion — GVT: $116.67 Cigna Healthspring — MCR: $113.48 Devoted Health — MCR: $106.06 Florida Complete Care — MCR: $113.48 HUMANA — MGMCRHMO: $106.06
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI	$1,482	$1,482	$127.45 – $1,259.70
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates Aetna — ASA: $444.60 AmeriHealth Caritas — HIX: $652.08 AvMed — ASOEO: $444.60 AvMed — Empower: $370.50 AvMed — Engage: $370.50 AvMed — Flex: $370.50 AvMed — Focus: $370.50 AvMed — FullyInsured: $370.50 AvMed — HIX: $177.84 AvMed — JacksonFirstNetworkOON: $741
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$1,185	$1,185	$86.49 – $965.33
Screening mammogram, both breasts: 10 of 30 insurance plan rates Aetna — MCR: $92.60 American Health Plan — MCR: $92.60 AmeriHealth Caritas — MGMCR: $104.83 BCBS — MCRHMO: $89.11 BCBS — MCRPPO: $89.11 Centurion — GVT: $96.10 Cigna Healthspring — MCR: $93.48 Devoted Health — MCR: $87.36 Florida Complete Care — MCR: $93.48 HUMANA — MGMCRHMO: $87.36
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI	$1,185	$1,185	$101.91 – $1,007.25
Screening mammogram, both breasts: 10 of 25 insurance plan rates Aetna — ASA: $355.50 AmeriHealth Caritas — HIX: $521.40 AvMed — ASOEO: $355.50 AvMed — Empower: $296.25 AvMed — Engage: $296.25 AvMed — Flex: $296.25 AvMed — Focus: $296.25 AvMed — FullyInsured: $296.25 AvMed — HIX: $142.20 AvMed — JacksonFirstNetworkOON: $592.50

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance 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	$346.06 – $353.34
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans CareWorks (Rockport) — WORKERSCOMP: $353.34 CorVel Corporation — WORKERSCOMP: $346.06 Humana — TRICR: $12.87 Prime Health — WORKERSCOMP: $353.34 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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	$17,386 – $20,050
Left heart catheterization (diagnostic): 10 of 30 insurance plan rates Aetna — HMO: $17,386 Aetna — HMO-Gated: $18,299 Aetna — PPO: $19,050 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
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	Not listed in the file	Not listed in the file	$7,350 – $55,583
Heart rhythm study (electrophysiology evaluation): 10 of 35 insurance plan rates Aetna — HMO: $22,052 Aetna — HMO-Gated: $23,210 Aetna — PPO: $24,383 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
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters,	Not listed in the file	Not listed in the file	$27,403.61 – $27,980.53
Heart rhythm study with ablation for atrial fibrillation: 10 of 35 insurance plan rates Aetna — HMO: $22,052 Aetna — HMO-Gated: $23,210 Aetna — PPO: $24,383 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
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY >4 PAR	$17,561	$17,561	$1,510.25 – $14,926.85
Sleep study (overnight, in a sleep lab): 10 of 37 insurance plan rates Aetna — ASA: $5,268.30 AmeriHealth Caritas — HIX: $7,726.84 AvMed — ASOEO: $5,268.30 AvMed — Empower: $4,390.25 AvMed — Engage: $4,390.25 AvMed — Flex: $4,390.25 AvMed — Focus: $4,390.25 AvMed — FullyInsured: $4,390.25 AvMed — HIX: $2,107.32 AvMed — JacksonFirstNetworkOON: $8,780.50
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	$17,561	$17,561	$8,300
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans CareWorks (Rockport) — WORKERSCOMP: $5,123.02 CorVel Corporation — WORKERSCOMP: $5,017.39 Prime Health — WORKERSCOMP: $5,123.02 United — AllPayerAppendix: $8,300 Aetna — HMO: 19.5% (a percentage in the contract, not a dollar amount) Aetna — HMO-Gated: 20.5% (a percentage in the contract, not a dollar amount) Aetna — PPO: 24.4% (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

Service	Hospital charge	Cash price	Insurance 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	$28.34 – $316.25
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates Aetna — MCR: $30.34 American Health Plan — MCR: $30.34 AmeriHealth Caritas — MGMCR: $34.34 BCBS — MCRHMO: $29.19 BCBS — MCRPPO: $29.19 CareWorks (Rockport) — WORKERSCOMP: $32.98 Centurion — GVT: $31.48 Cigna Healthspring — MCR: $30.62 CorVel Corporation — WORKERSCOMP: $32.30 Devoted Health — MCR: $28.62
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO\|CO In the file: THER EXERCIS 15 MIN OTCO	$597	$597	$51.34 – $507.45
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 30 insurance plan rates Aetna — ASA: $179.10 AmeriHealth Caritas — HIX: $262.68 AvMed — ASOEO: $179.10 AvMed — Empower: $149.25 AvMed — Engage: $149.25 AvMed — Flex: $149.25 AvMed — Focus: $149.25 AvMed — FullyInsured: $149.25 AvMed — HIX: $71.64 AvMed — JacksonFirstNetworkOON: $298.50
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT	$694	$694	$59.68 – $589.90
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 30 insurance plan rates Aetna — ASA: $208.20 AmeriHealth Caritas — HIX: $305.36 AvMed — ASOEO: $208.20 AvMed — Empower: $173.50 AvMed — Engage: $173.50 AvMed — Flex: $173.50 AvMed — Focus: $173.50 AvMed — FullyInsured: $173.50 AvMed — HIX: $83.28 AvMed — JacksonFirstNetworkOON: $347
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	$566	$566	$95.04 – $1,060.80
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates Aetna — MCR: $101.76 American Health Plan — MCR: $101.76 AmeriHealth Caritas — MGMCR: $115.20 BCBS — MCRHMO: $97.92 BCBS — MCRPPO: $97.92 CareWorks (Rockport) — WORKERSCOMP: $92.15 Centurion — GVT: $105.60 Cigna Healthspring — MCR: $102.72 CorVel Corporation — WORKERSCOMP: $90.25 Devoted Health — MCR: $96
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX	$566	$566	$48.68 – $481.10
Physical therapy evaluation (low complexity): 10 of 30 insurance plan rates Aetna — ASA: $169.80 AmeriHealth Caritas — HIX: $249.04 AvMed — ASOEO: $169.80 AvMed — Empower: $141.50 AvMed — Engage: $141.50 AvMed — Flex: $141.50 AvMed — Focus: $141.50 AvMed — FullyInsured: $141.50 AvMed — HIX: $67.92 AvMed — JacksonFirstNetworkOON: $283
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	$566	$566	$84.48 – $933.50
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna — MCR: $89.55 American Health Plan — MCR: $89.55 AmeriHealth Caritas — MGMCR: $101.38 BCBS — MCRHMO: $86.17 BCBS — MCRPPO: $86.17 Centurion — GVT: $92.93 Cigna Healthspring — MCR: $90.39 Devoted Health — MCR: $84.48 Florida Complete Care — MCR: $90.39 HUMANA — MGMCRHMO: $84.48
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	$550	$550	$95.04 – $1,060.80
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates Aetna — MCR: $101.76 American Health Plan — MCR: $101.76 AmeriHealth Caritas — MGMCR: $115.20 BCBS — MCRHMO: $97.92 BCBS — MCRPPO: $97.92 CareWorks (Rockport) — WORKERSCOMP: $92.15 Centurion — GVT: $105.60 Cigna Healthspring — MCR: $102.72 CorVel Corporation — WORKERSCOMP: $90.25 Devoted Health — MCR: $96
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX	$550	$550	$47.30 – $467.50
Physical therapy evaluation (moderate complexity): 10 of 30 insurance plan rates Aetna — ASA: $165 AmeriHealth Caritas — HIX: $242 AvMed — ASOEO: $165 AvMed — Empower: $137.50 AvMed — Engage: $137.50 AvMed — Flex: $137.50 AvMed — Focus: $137.50 AvMed — FullyInsured: $137.50 AvMed — HIX: $66 AvMed — JacksonFirstNetworkOON: $275
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	$550	$550	$84.48 – $933.50
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates Aetna — MCR: $89.55 American Health Plan — MCR: $89.55 AmeriHealth Caritas — MGMCR: $101.38 BCBS — MCRHMO: $86.17 BCBS — MCRPPO: $86.17 Centurion — GVT: $92.93 Cigna Healthspring — MCR: $90.39 Devoted Health — MCR: $84.48 Florida Complete Care — MCR: $90.39 HUMANA — MGMCRHMO: $84.48
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	$1,131	$1,131	$95.04 – $1,060.80
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates Aetna — MCR: $101.76 American Health Plan — MCR: $101.76 AmeriHealth Caritas — MGMCR: $115.20 BCBS — MCRHMO: $97.92 BCBS — MCRPPO: $97.92 CareWorks (Rockport) — WORKERSCOMP: $92.15 Centurion — GVT: $105.60 Cigna Healthspring — MCR: $102.72 CorVel Corporation — WORKERSCOMP: $90.25 Devoted Health — MCR: $96
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX	$1,131	$1,131	$97.27 – $961.35
Physical therapy evaluation (high complexity): 10 of 30 insurance plan rates Aetna — ASA: $339.30 AmeriHealth Caritas — HIX: $497.64 AvMed — ASOEO: $339.30 AvMed — Empower: $282.75 AvMed — Engage: $282.75 AvMed — Flex: $282.75 AvMed — Focus: $282.75 AvMed — FullyInsured: $282.75 AvMed — HIX: $135.72 AvMed — JacksonFirstNetworkOON: $565.50
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	$1,131	$1,131	$84.48 – $933.50
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates Aetna — MCR: $89.55 American Health Plan — MCR: $89.55 AmeriHealth Caritas — MGMCR: $101.38 BCBS — MCRHMO: $86.17 BCBS — MCRPPO: $86.17 Centurion — GVT: $92.93 Cigna Healthspring — MCR: $90.39 Devoted Health — MCR: $84.48 Florida Complete Care — MCR: $90.39 HUMANA — MGMCRHMO: $84.48
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient UNSCHEDULED	Not listed in the file	Not listed in the file	$211.43 – $215.88
Psychotherapy, 30 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $215.88 CorVel Corporation — WORKERSCOMP: $211.43 Prime Health — WORKERSCOMP: $215.88
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient SCHEDULED	Not listed in the file	Not listed in the file	$67.45 – $68.87
Psychotherapy, 30 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $68.87 CorVel Corporation — WORKERSCOMP: $67.45 Prime Health — WORKERSCOMP: $68.87
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient SCHEDULED	Not listed in the file	Not listed in the file	$89.30 – $91.18
Psychotherapy, 45 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $91.18 CorVel Corporation — WORKERSCOMP: $89.30 Prime Health — WORKERSCOMP: $91.18
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient UNSCHEDULED	Not listed in the file	Not listed in the file	$211.43 – $215.88
Psychotherapy, 45 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $215.88 CorVel Corporation — WORKERSCOMP: $211.43 Prime Health — WORKERSCOMP: $215.88
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient SCHEDULED	Not listed in the file	Not listed in the file	$133.95 – $136.77
Psychotherapy, 60 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $136.77 CorVel Corporation — WORKERSCOMP: $133.95 Prime Health — WORKERSCOMP: $136.77
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient UNSCHEDULED	Not listed in the file	Not listed in the file	$211.43 – $215.88
Psychotherapy, 60 minutes: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $215.88 CorVel Corporation — WORKERSCOMP: $211.43 Prime Health — WORKERSCOMP: $215.88
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes UNSCHEDULED	Not listed in the file	Not listed in the file	$211.43 – $215.88
Family psychotherapy, without the patient: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $215.88 CorVel Corporation — WORKERSCOMP: $211.43 Prime Health — WORKERSCOMP: $215.88
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes SCHEDULED	Not listed in the file	Not listed in the file	$108.30 – $110.58
Family psychotherapy, without the patient: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $110.58 CorVel Corporation — WORKERSCOMP: $108.30 Prime Health — WORKERSCOMP: $110.58
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes SCHEDULED	Not listed in the file	Not listed in the file	$112.10 – $114.46
Family psychotherapy, with the patient: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $114.46 CorVel Corporation — WORKERSCOMP: $112.10 Prime Health — WORKERSCOMP: $114.46
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) SCHEDULED	Not listed in the file	Not listed in the file	$30.40 – $31.04
Group psychotherapy: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $31.04 CorVel Corporation — WORKERSCOMP: $30.40 Prime Health — WORKERSCOMP: $31.04
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) UNSCHEDULED	Not listed in the file	Not listed in the file	$211.43 – $215.88
Group psychotherapy: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $215.88 CorVel Corporation — WORKERSCOMP: $211.43 Prime Health — WORKERSCOMP: $215.88

Procedures and surgery

Service	Hospital charge	Cash price	Insurance 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	$2,350 – $26,000
Removal of breast growth (open surgery): 10 of 37 insurance plan rates Aetna — HMO: $15,300 Aetna — HMO-Gated: $16,103 Aetna — PPO: $16,947 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
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$2,702
Total hip replacement: 10 of 41 insurance plan rates Aetna — HMO: $29,886 Aetna — HMO-Gated: $31,455 Aetna — PPO: $29,886 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
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
Total knee replacement: 10 of 44 insurance plan rates Aetna — HMO: $29,886 Aetna — HMO-Gated: $31,455 Aetna — PPO: $29,886 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
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 32 insurance plan rates Aetna — HMO: $15,300 Aetna — HMO-Gated: $16,103 Aetna — PPO: $16,947 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
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	$22,332 – $30,357
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates Aetna — HMO: $15,300 Aetna — HMO-Gated: $16,103 Aetna — PPO: $16,947 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
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	$1,495 – $26,000
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	$1,495 – $15,600
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: $1,765.80 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	$1,495 – $15,600
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: $1,350.64 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 – $15,600
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: $1,178.11 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	$1,495 – $15,600
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 UNSCHEDULED	Not listed in the file	Not listed in the file	$3,002.48 – $3,065.69
Colonoscopy with biopsy: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $3,065.69 CorVel Corporation — WORKERSCOMP: $3,002.48 Prime Health — WORKERSCOMP: $3,065.69
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	$2,218.20 – $2,264.90
Colonoscopy with biopsy: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $2,264.90 CorVel Corporation — WORKERSCOMP: $2,218.20 Prime Health — WORKERSCOMP: $2,264.90
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 – $15,153
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: $1,665.24 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	$2,702 – $15,600
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: $2,264.90 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 – $11,600
Screening colonoscopy (not high risk): rates for 6 insurance plans CareWorks (Rockport) — WORKERSCOMP: $209.52 CorVel Corporation — WORKERSCOMP: $205.20 Oscar — HIX: $4,288 Prime Health — WORKERSCOMP: $209.52 Simply Healthcare — HIX: $3,509 United — AllPayerAppendix: $11,600
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 – $37,000
Gallbladder removal by laparoscope: 10 of 34 insurance plan rates Aetna — HMO: $16,469 Aetna — HMO-Gated: $17,334 Aetna — PPO: $19,032 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
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	$221.37 – $226.03
Gallbladder removal by laparoscope: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $226.03 CorVel Corporation — WORKERSCOMP: $221.37 Prime Health — WORKERSCOMP: $226.03
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	$1,228.37 – $1,254.23
Gallbladder removal by laparoscope: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $1,254.23 CorVel Corporation — WORKERSCOMP: $1,228.37 Prime Health — WORKERSCOMP: $1,254.23
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	$6,625 – $15,153
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 SCHEDULED	Not listed in the file	Not listed in the file	$4,176.18 – $4,264.10
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $4,264.10 CorVel Corporation — WORKERSCOMP: $4,176.18 Prime Health — WORKERSCOMP: $4,264.10
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	$11,882.52 – $12,132.68
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $12,132.68 CorVel Corporation — WORKERSCOMP: $11,882.52 Prime Health — WORKERSCOMP: $12,132.68
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	$4,430.08 – $4,523.34
Prostate biopsy: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $4,523.34 CorVel Corporation — WORKERSCOMP: $4,430.08 Prime Health — WORKERSCOMP: $4,523.34
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	$1,495 – $42,000
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	$6,625 – $17,837
Hysteroscopy with biopsy of the uterus lining: 10 of 34 insurance plan rates Aetna — HMO: $15,300 Aetna — HMO-Gated: $16,103 Aetna — PPO: $16,947 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
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	$1,888.41 – $1,928.17
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: $1,928.17 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	$2,702 – $11,600
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: $3,304.63 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	$6,625 – $15,153
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	$2,761.23 – $2,819.36
Carpal tunnel release: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $2,819.36 CorVel Corporation — WORKERSCOMP: $2,761.23 Prime Health — WORKERSCOMP: $2,819.36
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	$3,761.46 – $3,840.65
Carpal tunnel release: rates for 3 insurance plans CareWorks (Rockport) — WORKERSCOMP: $3,840.65 CorVel Corporation — WORKERSCOMP: $3,761.46 Prime Health — WORKERSCOMP: $3,840.65
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	$3,796.69 – $3,876.62
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: $3,876.62 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: $3,876.62 Cigna — HMO: $15,153

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance 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)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA	Not listed in the file	Not listed in the file	$7,000
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 64 insurance plan rates Aetna — HMO: $34,679 Aetna — HMO-Gated: $124,237 Aetna — MCR: $77,263.56 Aetna — PPO: $36,465 Aetna — PPO-NonGated: $136,659 Aetna — QHP: $96,672 American Health Plan — MCR: $77,263.56 AvMed — ASOEO: $3,785 AvMed — Empower: $3,414 AvMed — Engage: $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	$14,946.82
Hip or knee replacement (major joint of the leg), without major complications: 10 of 60 insurance plan rates Aetna — HMO: $54,902 Aetna — HMO-Gated: $57,784 Aetna — MCR: $15,234.26 Aetna — PPO: $62,401 Aetna — PPO-NonGated: $65,677 Aetna — QHP: $44,963 American Health Plan — MCR: $15,234.26 AvMed — ASOEO: $60,649 AvMed — Empower: $54,693 AvMed — Engage: $54,693
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	$13,940.78 – $16,527.73
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans HUMANA — MGMCRHMO: $16,527.73 HUMANA — MGMCRPPO: $13,940.78
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	$18,917.34
Neck (cervical) spinal fusion, without complications: 10 of 60 insurance plan rates Aetna — HMO: $49,413 Aetna — HMO-Gated: $52,007 Aetna — MCR: $19,281.14 Aetna — PPO: $54,353 Aetna — PPO-NonGated: $57,207 Aetna — QHP: $40,469 American Health Plan — MCR: $1,275 AvMed — ASOEO: $74,917 AvMed — Empower: $67,556 AvMed — Engage: $67,556
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	$17,644.06 – $20,918.21
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans HUMANA — MGMCRHMO: $20,918.21 HUMANA — MGMCRPPO: $17,644.06
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	$9,614.04
Uterus and ovary surgery (not for cancer), without complications: 10 of 60 insurance plan rates Aetna — HMO: $21,962 Aetna — HMO-Gated: $23,115 Aetna — MCR: $9,798.92 Aetna — PPO: $26,169 Aetna — PPO-NonGated: $27,543 Aetna — QHP: $17,987 American Health Plan — MCR: $9,798.92 AvMed — ASOEO: $46,072 AvMed — Empower: $41,547 AvMed — Engage: $41,547
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	$8,966.94 – $10,630.91
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans HUMANA — MGMCRHMO: $10,630.91 HUMANA — MGMCRPPO: $8,966.94

Source: HCA Florida Raulerson 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 type	Acute Care Hospital
Address	1796 Hwy 441 North, Okeechobee, FL 34972
County	Okeechobee County
State	Florida
Phone	(863) 763‑2151
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	3 of 5 stars
CMS Certification Number	100252
Name in Medicare records	HCA FLORIDA RAULERSON HOSPITAL
Profile level	Medicare data + hospital website
Official website	hcafloridahealthcare.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Visitor Policy — hcafloridahealthcare.com
Raulerson Hospital | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Radiologists in Okeechobee | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Surgeons in Okeechobee, FL | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
ER Physicians in Okeechobee | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Outpatient Physical Therapy in Okeechobee | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
For Visitors | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Awards and Recognition | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Cardiology | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Orthopedic Care in Okeechobee | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Patient SMS Updates | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Women's Wellness Center | HCA Florida Raulerson Hospital — hcafloridahealthcare.com
Robotic surgery specialists | HCA Florida Raulerson Hospital — hcafloridahealthcare.com

HCA Florida Raulerson Hospital

Summary

Profile from official sources

At a glance