Does Heart of Texas Memorial Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Heart of Texas Memorial Hospital. In a medical emergency, call 911.

Where is Heart of Texas Memorial Hospital?

2008 Nine Road, Brady, TX 76825, in McCulloch County, Texas.

What is the phone number of Heart of Texas Memorial Hospital?

(325) 597-2901, as listed by Medicare (CMS).

What is the Medicare star rating of Heart of Texas Memorial Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Heart of Texas Memorial Hospital — Brady, TX

Quick answers

Does Heart of Texas Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Heart of Texas Memorial Hospital. In a medical emergency, call 911.
Where is Heart of Texas Memorial Hospital?: 2008 Nine Road, Brady, TX 76825, in McCulloch County, Texas.
What is the phone number of Heart of Texas Memorial Hospital?: (325) 597-2901, as listed by Medicare (CMS).
What is the Medicare star rating of Heart of Texas Memorial Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][13]

Conditions treated^[7]

Osteoporosis
Bone fractures

Treatments^[4][5][8][9]

Physical therapy
Occupational therapy
Respiratory therapy
Cardiopulmonary rehabilitation
Swing bed program
Nutrition services
Physiologic Insulin Resensitization (PIR)
Blood transfusion
IV therapy
Port-A-Cath flushes
Subcutaneous or intramuscular injections

Procedures^[4][5][7]

Radiology
Laboratory services
Diagnostic X-ray
CT scan
MRI
Ultrasound
Echocardiogram
DEXA bone density scan
GI procedures
Cataract surgery

Programs and centers^{[4][5][6][10][11]}

Physiologic Insulin Resensitization (PIR)
Coumadin Clinic
Brady Medical Clinic
Cardiac rehab
Pulmonary rehab
Pain management
Nutrition services
Respiratory therapy
Outpatient physical therapy
Outpatient occupational therapy

Emergency care (hospital website)^[4][5]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Patient portal	MyChart

Doctors and clinicians (124)

124 doctors and other clinicians list Heart of Texas Memorial 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 100 more: the button below opens the full list.

Other emergency rooms nearby

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

Concho County Hospital30 mi · Eden, TX · Critical Access Hospital
Hendrick Medical Center Brownwood47 mi · Brownwood, TX · Acute Care Hospital
Kimble Hospital47 mi · Junction, TX · Critical Access Hospital
Mid Coast Medical Center - Central49 mi · Llano, TX · Critical Access Hospital
Coleman County Medical Center Company51 mi · Coleman, TX · Critical Access Hospital

Other hospitals nearby

Ballinger Memorial Hospital56 mi · Ballinger, TX · Critical Access Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Brady West Rehab & Nursing3.4 mi · Brady, TX · 5 of 5 stars

All nursing homes 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

FHN - Brady Middle3.0 mi · Brady, TX · Community health center
FHN - Brady High3.3 mi · Brady, TX · Community health center
FHN - Brady Elementary3.3 mi · Brady, TX · Community health center

Clinics and urgent care

Brady Medical Clinic0.0 mi · Brady, TX · Rural health clinic

Pharmacies

City Drug of Brady Inc0.0 mi · Brady, TX · Community/retail pharmacy
Wal-Mart Stores Texas LLC0.0 mi · Brady, TX · Community/retail pharmacy

Assisted living nearby

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

Royal Oaks Assisted Living0.0 mi · Brady, TX

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 Heart of Texas Memorial 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.

Not reported to Medicare

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Texas Best hospitals in Texas

Prices

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

What the prices mean

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

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

Office and emergency visits

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: Office/Outpatient New Low Mdm 30 Minutes	$241.37	$120.69	$97.99 – $389.40
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — PPO/HMO: $205.16 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $389.40 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC Outpt Vist Lev 3 New 30mi	$387.40	$193.70	$170.46 – $389.40
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $329.29 Aetna Medicaid — Medicaid: $232.44 Aetna-Medicare Advantage — Medicare Advantage: $170.46 Amerigroup Medicaid — Medicaid: $232.44 BCBS — PPO/HMO/PPS: $389.40 BCBS Medicaid — Medicaid: $232.44 BCBS-Medicare Advantage — Medicare Advantage: $170.46 Firstcare Medicaid — Medicaid: $232.44 Humana-Medicare Advantage — Medicare Advantage: $170.46 Superior Medicaid — Medicaid: $232.44
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC New OP Visit - Intermed	$387.40	$193.70	$50 – $348.66
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $329.29 Aetna Medicaid — Medicaid: $232.44 Aetna-Medicare Advantage — Medicare Advantage: $170.46 Amerigroup Medicaid — Medicaid: $232.44 BCBS — PPO/HMO/PPS: $50 BCBS Medicaid — Medicaid: $232.44 BCBS-Medicare Advantage — Medicare Advantage: $170.46 Firstcare Medicaid — Medicaid: $232.44 Humana-Medicare Advantage — Medicare Advantage: $170.46 Superior Medicaid — Medicaid: $232.44
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$315	$157.50	$97.99 – $656.75
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — PPO/HMO: $267.75 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $656.75 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC Outpt Vist Lev 4 New 45 M	$655.90	$327.95	$288.60 – $656.75
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $557.52 Aetna Medicaid — Medicaid: $393.54 Aetna-Medicare Advantage — Medicare Advantage: $288.60 Amerigroup Medicaid — Medicaid: $393.54 BCBS — PPO/HMO/PPS: $656.75 BCBS Medicaid — Medicaid: $393.54 BCBS-Medicare Advantage — Medicare Advantage: $288.60 Firstcare Medicaid — Medicaid: $393.54 Humana-Medicare Advantage — Medicare Advantage: $288.60 Superior Medicaid — Medicaid: $393.54
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Hths Ops OP Visit Np L-4	$655.90	$327.95	$50 – $590.31
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $557.52 Aetna Medicaid — Medicaid: $393.54 Aetna-Medicare Advantage — Medicare Advantage: $288.60 Amerigroup Medicaid — Medicaid: $393.54 BCBS — PPO/HMO/PPS: $50 BCBS Medicaid — Medicaid: $393.54 BCBS-Medicare Advantage — Medicare Advantage: $288.60 Firstcare Medicaid — Medicaid: $393.54 Humana-Medicare Advantage — Medicare Advantage: $288.60 Superior Medicaid — Medicaid: $393.54
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Office/Outpatient New High Mdm 60 Minutes	$400	$200	$97.99 – $857.75
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna — PPO/HMO: $340 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $857.75 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HC New Patient Level 5	$300	$150	$132 – $857.75
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $255 Aetna Medicaid — Medicaid: $180 Aetna-Medicare Advantage — Medicare Advantage: $132 Amerigroup Medicaid — Medicaid: $180 BCBS — PPO/HMO/PPS: $857.75 BCBS Medicaid — Medicaid: $180 BCBS-Medicare Advantage — Medicare Advantage: $132 Firstcare Medicaid — Medicaid: $180 Humana-Medicare Advantage — Medicare Advantage: $132 Superior Medicaid — Medicaid: $180
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Hths Ops OP Visit Np L-5	$300	$150	$50 – $270
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $255 Aetna Medicaid — Medicaid: $180 Aetna-Medicare Advantage — Medicare Advantage: $132 Amerigroup Medicaid — Medicaid: $180 BCBS — PPO/HMO/PPS: $50 BCBS Medicaid — Medicaid: $180 BCBS-Medicare Advantage — Medicare Advantage: $132 Firstcare Medicaid — Medicaid: $180 Humana-Medicare Advantage — Medicare Advantage: $132 Superior Medicaid — Medicaid: $180
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office/Outpatient Established Low Mdm 20 Min	$180	$90	$97.99 – $260.20
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna — PPO/HMO: $153 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $260.20 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Hths Ops OP Visit Est Pt L-3	$259.50	$129.75	$23.94 – $233.55
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $220.58 Aetna Medicaid — Medicaid: $23.94 Aetna-Medicare Advantage — Medicare Advantage: $114.18 Amerigroup Medicaid — Medicaid: $23.94 BCBS — PPO/HMO/PPS: $50 BCBS Medicaid — Medicaid: $23.94 BCBS-Medicare Advantage — Medicare Advantage: $114.18 Firstcare Medicaid — Medicaid: $23.94 Humana-Medicare Advantage — Medicare Advantage: $114.18 Superior Medicaid — Medicaid: $23.94
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC Outpatient Visit L3 Est	$259.50	$129.75	$23.94 – $260.20
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $220.58 Aetna Medicaid — Medicaid: $23.94 Aetna-Medicare Advantage — Medicare Advantage: $114.18 Amerigroup Medicaid — Medicaid: $23.94 BCBS — PPO/HMO/PPS: $260.20 BCBS Medicaid — Medicaid: $23.94 BCBS-Medicare Advantage — Medicare Advantage: $114.18 Firstcare Medicaid — Medicaid: $23.94 Humana-Medicare Advantage — Medicare Advantage: $114.18 Superior Medicaid — Medicaid: $23.94
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office/Outpatient Established Mod Mdm 30 Min	$235	$117.50	$97.99 – $398.35
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna — PPO/HMO: $199.75 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $398.35 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Hths Ops OP Visit Est Pt L-4	$400.05	$200.03	$47.68 – $360.05
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $340.04 Aetna Medicaid — Medicaid: $47.68 Aetna-Medicare Advantage — Medicare Advantage: $176.02 Amerigroup Medicaid — Medicaid: $47.68 BCBS — PPO/HMO/PPS: $50 BCBS Medicaid — Medicaid: $47.68 BCBS-Medicare Advantage — Medicare Advantage: $176.02 Firstcare Medicaid — Medicaid: $47.68 Humana-Medicare Advantage — Medicare Advantage: $176.02 Superior Medicaid — Medicaid: $47.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC Estab OP Visit - Exten	$400.05	$200.03	$47.68 – $398.35
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — PPO/HMO: $340.04 Aetna Medicaid — Medicaid: $47.68 Aetna-Medicare Advantage — Medicare Advantage: $176.02 Amerigroup Medicaid — Medicaid: $47.68 BCBS — PPO/HMO/PPS: $398.35 BCBS Medicaid — Medicaid: $47.68 BCBS-Medicare Advantage — Medicare Advantage: $176.02 Firstcare Medicaid — Medicaid: $47.68 Humana-Medicare Advantage — Medicare Advantage: $176.02 Superior Medicaid — Medicaid: $47.68
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office/OP Consltj New/Est Pt Low Mdm 30 Minutes	$185	$92.50	$97.99 – $484.50
Office consultation with a specialist (moderate): 10 of 15 insurance plan rates Aetna — PPO/HMO: $157.25 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $484.50 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) In the file: Office/OP Consltj New/Est Pt Low Mdm 30 Minutes	$185	$92.50	$157.25
Office consultation with a specialist (moderate): rates for 2 insurance plans Aetna — PPO/HMO: $157.25 BCBS — PPO/HMO/PPS: $157.25
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes	$275	$137.50	$97.99 – $778.80
Office consultation with a specialist (moderate to high): 10 of 15 insurance plan rates Aetna — PPO/HMO: $233.75 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $778.80 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) In the file: Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes	$275	$137.50	$233.75
Office consultation with a specialist (moderate to high): rates for 2 insurance plans Aetna — PPO/HMO: $233.75 BCBS — PPO/HMO/PPS: $233.75
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial Preventive Medicine New Pt Age 18-39yrs	$260.05	$130.03	$97.99 – $497.05
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates Aetna — PPO/HMO: $221.04 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $497.05 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) In the file: Initial Preventive Medicine New Pt Age 18-39yrs	$260.05	$130.03	$221.04
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans Aetna — PPO/HMO: $221.04 BCBS — PPO/HMO/PPS: $221.04
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial Preventive Medicine New Patient 40-64yrs	$291.90	$145.95	$97.99 – $604.70
Preventive checkup, new patient, age 40–64: 10 of 15 insurance plan rates Aetna — PPO/HMO: $248.12 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $227.20 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $604.70 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $227.20 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $227.20 Superior Medicaid — Medicaid: $97.99
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) In the file: Initial Preventive Medicine New Patient 40-64yrs	$291.90	$145.95	$248.12
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans Aetna — PPO/HMO: $248.12 BCBS — PPO/HMO/PPS: $248.12
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC Level 3 Emergency Care	$830.67	$415.34	$274.12 – $800
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — PPO/HMO: $706.07 Aetna Medicaid — Medicaid: $274.12 Aetna-Medicare Advantage — Medicare Advantage: $365.49 Amerigroup Medicaid — Medicaid: $274.12 BCBS — PPO/HMO/PPS: $624.44 BCBS Medicaid — Medicaid: $274.12 BCBS-Medicare Advantage — Medicare Advantage: $365.49 Firstcare Medicaid — Medicaid: $274.12 Humana-Medicare Advantage — Medicare Advantage: $365.49 Superior Medicaid — Medicaid: $274.12
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Hths Edp ER L-3 Physician	$201.87	$100.94	$88.82 – $800
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — PPO/HMO: $171.59 Aetna Medicaid — Medicaid: $121.12 Aetna-Medicare Advantage — Medicare Advantage: $88.82 Amerigroup Medicaid — Medicaid: $121.12 BCBS — PPO/HMO/PPS: $624.44 BCBS Medicaid — Medicaid: $121.12 BCBS-Medicare Advantage — Medicare Advantage: $88.82 Firstcare Medicaid — Medicaid: $121.12 Humana-Medicare Advantage — Medicare Advantage: $88.82 Superior Medicaid — Medicaid: $121.12
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency Department Visit Low Mdm	$210.69	$105.35	$92.70 – $800
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — PPO/HMO: $179.09 Aetna Medicaid — Medicaid: $126.41 Aetna-Medicare Advantage — Medicare Advantage: $92.70 Amerigroup Medicaid — Medicaid: $126.41 BCBS — PPO/HMO/PPS: $624.44 BCBS Medicaid — Medicaid: $126.41 BCBS-Medicare Advantage — Medicare Advantage: $92.70 Firstcare Medicaid — Medicaid: $126.41 Humana-Medicare Advantage — Medicare Advantage: $92.70 Superior Medicaid — Medicaid: $126.41
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC Level 4 Emergency Care	$1,277.46	$638.73	$421.56 – $1,500
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — PPO/HMO: $1,085.84 Aetna Medicaid — Medicaid: $421.56 Aetna-Medicare Advantage — Medicare Advantage: $562.08 Amerigroup Medicaid — Medicaid: $421.56 BCBS — PPO/HMO/PPS: $1,013.26 BCBS Medicaid — Medicaid: $421.56 BCBS-Medicare Advantage — Medicare Advantage: $562.08 Firstcare Medicaid — Medicaid: $421.56 Humana-Medicare Advantage — Medicare Advantage: $562.08 Superior Medicaid — Medicaid: $421.56
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency Department Visit Moderate Mdm	$356.73	$178.37	$156.96 – $1,500
Emergency room visit (moderately high): 10 of 13 insurance plan rates Aetna — PPO/HMO: $303.22 Aetna Medicaid — Medicaid: $214.04 Aetna-Medicare Advantage — Medicare Advantage: $156.96 Amerigroup Medicaid — Medicaid: $214.04 BCBS — PPO/HMO/PPS: $1,013.26 BCBS Medicaid — Medicaid: $214.04 BCBS-Medicare Advantage — Medicare Advantage: $156.96 Firstcare Medicaid — Medicaid: $214.04 Humana-Medicare Advantage — Medicare Advantage: $156.96 Superior Medicaid — Medicaid: $214.04
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Hths Edp ER L-4 Physician	$344.43	$172.22	$151.55 – $1,500
Emergency room visit (moderately high): 10 of 13 insurance plan rates Aetna — PPO/HMO: $292.77 Aetna Medicaid — Medicaid: $206.66 Aetna-Medicare Advantage — Medicare Advantage: $151.55 Amerigroup Medicaid — Medicaid: $206.66 BCBS — PPO/HMO/PPS: $1,013.26 BCBS Medicaid — Medicaid: $206.66 BCBS-Medicare Advantage — Medicare Advantage: $151.55 Firstcare Medicaid — Medicaid: $206.66 Humana-Medicare Advantage — Medicare Advantage: $151.55 Superior Medicaid — Medicaid: $206.66
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC Trauma W/O Prenotification Level V	$1,839.30	$919.65	$606.97 – $1,700
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — PPO/HMO: $1,563.41 Aetna Medicaid — Medicaid: $606.97 Aetna-Medicare Advantage — Medicare Advantage: $809.29 Amerigroup Medicaid — Medicaid: $606.97 BCBS — PPO/HMO/PPS: $1,484.42 BCBS Medicaid — Medicaid: $606.97 BCBS-Medicare Advantage — Medicare Advantage: $809.29 Firstcare Medicaid — Medicaid: $606.97 Humana-Medicare Advantage — Medicare Advantage: $809.29 Superior Medicaid — Medicaid: $606.97
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC Level 5 Emergency Care	$1,839.30	$919.65	$606.97 – $1,700
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — PPO/HMO: $1,563.41 Aetna Medicaid — Medicaid: $606.97 Aetna-Medicare Advantage — Medicare Advantage: $809.29 Amerigroup Medicaid — Medicaid: $606.97 BCBS — PPO/HMO/PPS: $1,484.42 BCBS Medicaid — Medicaid: $606.97 BCBS-Medicare Advantage — Medicare Advantage: $809.29 Firstcare Medicaid — Medicaid: $606.97 Humana-Medicare Advantage — Medicare Advantage: $809.29 Superior Medicaid — Medicaid: $606.97
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Department Visit High Mdm	$516.75	$258.38	$227.37 – $1,700
Emergency room visit (high): 10 of 13 insurance plan rates Aetna — PPO/HMO: $439.24 Aetna Medicaid — Medicaid: $310.05 Aetna-Medicare Advantage — Medicare Advantage: $227.37 Amerigroup Medicaid — Medicaid: $310.05 BCBS — PPO/HMO/PPS: $1,484.42 BCBS Medicaid — Medicaid: $310.05 BCBS-Medicare Advantage — Medicare Advantage: $227.37 Firstcare Medicaid — Medicaid: $310.05 Humana-Medicare Advantage — Medicare Advantage: $227.37 Superior Medicaid — Medicaid: $310.05

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: HC Basic Metabolic Panel	$116	$58	$11.59 – $98.60
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — PPO/HMO: $98.60 Aetna Medicaid — Medicaid: $11.59 Aetna-Medicare Advantage — Medicare Advantage: $51.04 Amerigroup Medicaid — Medicaid: $11.59 BCBS — PPO/HMO/PPS: $46.98 BCBS Medicaid — Medicaid: $11.59 BCBS-Medicare Advantage — Medicare Advantage: $51.04 Firstcare Medicaid — Medicaid: $11.59 Humana-Medicare Advantage — Medicare Advantage: $51.04 Superior Medicaid — Medicaid: $11.59
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: HC Basic Metabolic Panel	$116	$58	$98.60
Basic metabolic panel (blood test): rates for 2 insurance plans Aetna — PPO/HMO: $98.60 BCBS — PPO/HMO/PPS: $98.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HC Comp. Metabolic Panel	$200	$100	$19.85 – $170
Comprehensive metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — PPO/HMO: $170 Aetna Medicaid — Medicaid: $19.85 Aetna-Medicare Advantage — Medicare Advantage: $88 Amerigroup Medicaid — Medicaid: $19.85 BCBS — PPO/HMO/PPS: $58.68 BCBS Medicaid — Medicaid: $19.85 BCBS-Medicare Advantage — Medicare Advantage: $88 Firstcare Medicaid — Medicaid: $19.85 Humana-Medicare Advantage — Medicare Advantage: $88 Superior Medicaid — Medicaid: $19.85
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: HC Comp. Metabolic Panel	$200	$100	$170
Comprehensive metabolic panel (blood test): rates for 2 insurance plans Aetna — PPO/HMO: $170 BCBS — PPO/HMO/PPS: $170
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HC Lipid Panel	$165	$82.50	$18.35 – $140.25
Cholesterol panel (lipid panel): 10 of 14 insurance plan rates Aetna — PPO/HMO: $140.25 Aetna Medicaid — Medicaid: $18.35 Aetna-Medicare Advantage — Medicare Advantage: $72.60 Amerigroup Medicaid — Medicaid: $18.35 BCBS — PPO/HMO/PPS: $74.39 BCBS Medicaid — Medicaid: $18.35 BCBS-Medicare Advantage — Medicare Advantage: $72.60 Firstcare Medicaid — Medicaid: $18.35 Humana-Medicare Advantage — Medicare Advantage: $72.60 Superior Medicaid — Medicaid: $18.35
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: HC Lipid Panel	$165	$82.50	$140.25
Cholesterol panel (lipid panel): rates for 2 insurance plans Aetna — PPO/HMO: $140.25 BCBS — PPO/HMO/PPS: $140.25
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HC Renal Function Panel	$279	$139.50	$11.89 – $237.15
Kidney function panel: 10 of 14 insurance plan rates Aetna — PPO/HMO: $237.15 Aetna Medicaid — Medicaid: $11.89 Aetna-Medicare Advantage — Medicare Advantage: $122.76 Amerigroup Medicaid — Medicaid: $11.89 BCBS — PPO/HMO/PPS: $48.24 BCBS Medicaid — Medicaid: $11.89 BCBS-Medicare Advantage — Medicare Advantage: $122.76 Firstcare Medicaid — Medicaid: $11.89 Humana-Medicare Advantage — Medicare Advantage: $122.76 Superior Medicaid — Medicaid: $11.89
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: HC Renal Function Panel	$279	$139.50	$237.15
Kidney function panel: rates for 2 insurance plans Aetna — PPO/HMO: $237.15 BCBS — PPO/HMO/PPS: $237.15
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HC Hepatic Function Panel	$138	$69	$11.19 – $117.30
Liver function panel: 10 of 14 insurance plan rates Aetna — PPO/HMO: $117.30 Aetna Medicaid — Medicaid: $11.19 Aetna-Medicare Advantage — Medicare Advantage: $60.72 Amerigroup Medicaid — Medicaid: $11.19 BCBS — PPO/HMO/PPS: $45.41 BCBS Medicaid — Medicaid: $11.19 BCBS-Medicare Advantage — Medicare Advantage: $60.72 Firstcare Medicaid — Medicaid: $11.19 Humana-Medicare Advantage — Medicare Advantage: $60.72 Superior Medicaid — Medicaid: $11.19
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HC Hepatic Function Panel	$138	$69	$117.30
Liver function panel: rates for 2 insurance plans Aetna — PPO/HMO: $117.30 BCBS — PPO/HMO/PPS: $117.30
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HC Urinalysis-Auto W/Micro	$48	$24	$4.34 – $65
Urine test (automated, with microscope): 10 of 14 insurance plan rates Aetna — PPO/HMO: $40.80 Aetna Medicaid — Medicaid: $4.34 Aetna-Medicare Advantage — Medicare Advantage: $21.12 Amerigroup Medicaid — Medicaid: $4.34 BCBS — PPO/HMO/PPS: $17.64 BCBS Medicaid — Medicaid: $4.34 BCBS-Medicare Advantage — Medicare Advantage: $21.12 Firstcare Medicaid — Medicaid: $4.34 Humana-Medicare Advantage — Medicare Advantage: $21.12 Superior Medicaid — Medicaid: $4.34
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urnls Dip Stick/Tablet Reagent Auto Microscopy	$24	$12	$4.34 – $65
Urine test (automated, with microscope): 10 of 14 insurance plan rates Aetna — PPO/HMO: $20.40 Aetna Medicaid — Medicaid: $4.34 Aetna-Medicare Advantage — Medicare Advantage: $10.56 Amerigroup Medicaid — Medicaid: $4.34 BCBS — PPO/HMO/PPS: $17.64 BCBS Medicaid — Medicaid: $4.34 BCBS-Medicare Advantage — Medicare Advantage: $10.56 Firstcare Medicaid — Medicaid: $4.34 Humana-Medicare Advantage — Medicare Advantage: $10.56 Superior Medicaid — Medicaid: $4.34
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: HC Urinalysis-Auto W/Micro	$48	$24	$40.80
Urine test (automated, with microscope): rates for 2 insurance plans Aetna — PPO/HMO: $40.80 BCBS — PPO/HMO/PPS: $40.80
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp	$19	$9.50	$4.77 – $65
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — PPO/HMO: $16.15 Aetna Medicaid — Medicaid: $4.77 Aetna-Medicare Advantage — Medicare Advantage: $8.36 Amerigroup Medicaid — Medicaid: $4.77 BCBS — PPO/HMO/PPS: $15.66 BCBS Medicaid — Medicaid: $4.77 BCBS-Medicare Advantage — Medicare Advantage: $8.36 Firstcare Medicaid — Medicaid: $4.77 Humana-Medicare Advantage — Medicare Advantage: $8.36 Superior Medicaid — Medicaid: $4.77
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp	$19	$9.50	$16.15
Urine test (manual, without microscope): rates for 2 insurance plans Aetna — PPO/HMO: $16.15 BCBS — PPO/HMO/PPS: $16.15
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$19	$9.50	$3.08 – $65
Urine test (automated, without microscope): 10 of 14 insurance plan rates Aetna — PPO/HMO: $16.15 Aetna Medicaid — Medicaid: $3.08 Aetna-Medicare Advantage — Medicare Advantage: $8.36 Amerigroup Medicaid — Medicaid: $3.08 BCBS — PPO/HMO/PPS: $12.47 BCBS Medicaid — Medicaid: $3.08 BCBS-Medicare Advantage — Medicare Advantage: $8.36 Firstcare Medicaid — Medicaid: $3.08 Humana-Medicare Advantage — Medicare Advantage: $8.36 Superior Medicaid — Medicaid: $3.08
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC Urinalysis,Auto W/O Micro	$29	$14.50	$3.08 – $65
Urine test (automated, without microscope): 10 of 14 insurance plan rates Aetna — PPO/HMO: $24.65 Aetna Medicaid — Medicaid: $3.08 Aetna-Medicare Advantage — Medicare Advantage: $12.76 Amerigroup Medicaid — Medicaid: $3.08 BCBS — PPO/HMO/PPS: $12.47 BCBS Medicaid — Medicaid: $3.08 BCBS-Medicare Advantage — Medicare Advantage: $12.76 Firstcare Medicaid — Medicaid: $3.08 Humana-Medicare Advantage — Medicare Advantage: $12.76 Superior Medicaid — Medicaid: $3.08
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$19	$9.50	$16.15
Urine test (automated, without microscope): rates for 2 insurance plans Aetna — PPO/HMO: $16.15 BCBS — PPO/HMO/PPS: $16.15
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC Prostate Spec Ag-Psa	$202.32	$101.16	$25.19 – $171.97
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — PPO/HMO: $171.97 Aetna Medicaid — Medicaid: $25.19 Aetna-Medicare Advantage — Medicare Advantage: $89.02 Amerigroup Medicaid — Medicaid: $25.19 BCBS — PPO/HMO/PPS: $102.20 BCBS Medicaid — Medicaid: $25.19 BCBS-Medicare Advantage — Medicare Advantage: $89.02 Firstcare Medicaid — Medicaid: $25.19 Humana-Medicare Advantage — Medicare Advantage: $89.02 Superior Medicaid — Medicaid: $25.19
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) In the file: HC Prostate Spec Ag-Psa	$202.32	$101.16	$171.97
PSA (prostate specific antigen) blood test: rates for 2 insurance plans Aetna — PPO/HMO: $171.97 BCBS — PPO/HMO/PPS: $171.97
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC Thyroid Stimulating Hor	$184.80	$92.40	$23.02 – $157.08
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — PPO/HMO: $157.08 Aetna Medicaid — Medicaid: $23.02 Aetna-Medicare Advantage — Medicare Advantage: $81.31 Amerigroup Medicaid — Medicaid: $23.02 BCBS — PPO/HMO/PPS: $93.38 BCBS Medicaid — Medicaid: $23.02 BCBS-Medicare Advantage — Medicare Advantage: $81.31 Firstcare Medicaid — Medicaid: $23.02 Humana-Medicare Advantage — Medicare Advantage: $81.31 Superior Medicaid — Medicaid: $23.02
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: HC Thyroid Stimulating Hor	$184.80	$92.40	$157.08
Thyroid stimulating hormone (TSH) test: rates for 2 insurance plans Aetna — PPO/HMO: $157.08 BCBS — PPO/HMO/PPS: $157.08
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC Cbc-Auto & Wbc Differ	$86	$43	$10.64 – $73.10
Complete blood count (CBC) with differential: 10 of 14 insurance plan rates Aetna — PPO/HMO: $73.10 Aetna Medicaid — Medicaid: $10.64 Aetna-Medicare Advantage — Medicare Advantage: $37.84 Amerigroup Medicaid — Medicaid: $10.64 BCBS — PPO/HMO/PPS: $43.16 BCBS Medicaid — Medicaid: $10.64 BCBS-Medicare Advantage — Medicare Advantage: $37.84 Firstcare Medicaid — Medicaid: $10.64 Humana-Medicare Advantage — Medicare Advantage: $37.84 Superior Medicaid — Medicaid: $10.64
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: HC Cbc-Auto & Wbc Differ	$86	$43	$73.10
Complete blood count (CBC) with differential: rates for 2 insurance plans Aetna — PPO/HMO: $73.10 BCBS — PPO/HMO/PPS: $73.10
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HC Cbc - Automated	$71	$35.50	$8.86 – $65
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — PPO/HMO: $60.35 Aetna Medicaid — Medicaid: $8.86 Aetna-Medicare Advantage — Medicare Advantage: $31.24 Amerigroup Medicaid — Medicaid: $8.86 BCBS — PPO/HMO/PPS: $35.91 BCBS Medicaid — Medicaid: $8.86 BCBS-Medicare Advantage — Medicare Advantage: $31.24 Firstcare Medicaid — Medicaid: $8.86 Humana-Medicare Advantage — Medicare Advantage: $31.24 Superior Medicaid — Medicaid: $8.86
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: HC Cbc - Automated	$71	$35.50	$60.35
Complete blood count (CBC), automated: rates for 2 insurance plans Aetna — PPO/HMO: $60.35 BCBS — PPO/HMO/PPS: $60.35
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC Pt-D	$80	$40	$5.88 – $68
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — PPO/HMO: $68 Aetna Medicaid — Medicaid: $5.88 Aetna-Medicare Advantage — Medicare Advantage: $35.20 Amerigroup Medicaid — Medicaid: $5.88 BCBS — PPO/HMO/PPS: $21.83 BCBS Medicaid — Medicaid: $5.88 BCBS-Medicare Advantage — Medicare Advantage: $35.20 Firstcare Medicaid — Medicaid: $5.88 Humana-Medicare Advantage — Medicare Advantage: $35.20 Superior Medicaid — Medicaid: $5.88
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC Prothrombin Time (Pt)	$80	$40	$5.88 – $68
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — PPO/HMO: $68 Aetna Medicaid — Medicaid: $5.88 Aetna-Medicare Advantage — Medicare Advantage: $35.20 Amerigroup Medicaid — Medicaid: $5.88 BCBS — PPO/HMO/PPS: $21.83 BCBS Medicaid — Medicaid: $5.88 BCBS-Medicare Advantage — Medicare Advantage: $35.20 Firstcare Medicaid — Medicaid: $5.88 Humana-Medicare Advantage — Medicare Advantage: $35.20 Superior Medicaid — Medicaid: $5.88
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: HC Pt-D	$80	$40	$68
Blood clotting time test (prothrombin time, PT): rates for 2 insurance plans Aetna — PPO/HMO: $68 BCBS — PPO/HMO/PPS: $68
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC Ptt-D Heparin Reflex Bill	$232	$116	$8.23 – $197.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — PPO/HMO: $197.20 Aetna Medicaid — Medicaid: $8.23 Aetna-Medicare Advantage — Medicare Advantage: $102.08 Amerigroup Medicaid — Medicaid: $8.23 BCBS — PPO/HMO/PPS: $33.39 BCBS Medicaid — Medicaid: $8.23 BCBS-Medicare Advantage — Medicare Advantage: $102.08 Firstcare Medicaid — Medicaid: $8.23 Humana-Medicare Advantage — Medicare Advantage: $102.08 Superior Medicaid — Medicaid: $8.23
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC Ptt	$66	$33	$8.23 – $65
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — PPO/HMO: $56.10 Aetna Medicaid — Medicaid: $8.23 Aetna-Medicare Advantage — Medicare Advantage: $29.04 Amerigroup Medicaid — Medicaid: $8.23 BCBS — PPO/HMO/PPS: $33.39 BCBS Medicaid — Medicaid: $8.23 BCBS-Medicare Advantage — Medicare Advantage: $29.04 Firstcare Medicaid — Medicaid: $8.23 Humana-Medicare Advantage — Medicare Advantage: $29.04 Superior Medicaid — Medicaid: $8.23
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: HC Ptt-D Heparin Reflex Bill	$232	$116	$197.20
Blood clotting test (partial thromboplastin time, PTT): rates for 2 insurance plans Aetna — PPO/HMO: $197.20 BCBS — PPO/HMO/PPS: $197.20

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: HC CT Head WO/Contrast	$1,943.08	$971.54	$134.67 – $1,651.62
CT scan of the head or brain, without contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $1,651.62 Aetna Medicaid — Medicaid: $134.67 Aetna-Medicare Advantage — Medicare Advantage: $854.96 Amerigroup Medicaid — Medicaid: $134.67 BCBS — PPO/HMO/PPS: $763.45 BCBS Medicaid — Medicaid: $134.67 BCBS-Medicare Advantage — Medicare Advantage: $854.96 Firstcare Medicaid — Medicaid: $134.67 Humana-Medicare Advantage — Medicare Advantage: $854.96 Superior Medicaid — Medicaid: $134.67
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: HC CT Head WO/Contrast	$1,943.08	$971.54	$1,651.62
CT scan of the head or brain, without contrast: rates for 2 insurance plans Aetna — PPO/HMO: $1,651.62 BCBS — PPO/HMO/PPS: $1,651.62
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HC MRI Brain Stem W/O & With Dye	$3,175.25	$1,587.63	$464.22 – $3,043.99
MRI of the brain, before and after contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $2,698.96 Aetna Medicaid — Medicaid: $464.22 Aetna-Medicare Advantage — Medicare Advantage: $1,397.11 Amerigroup Medicaid — Medicaid: $464.22 BCBS — PPO/HMO/PPS: $3,043.99 BCBS Medicaid — Medicaid: $464.22 BCBS-Medicare Advantage — Medicare Advantage: $1,397.11 Firstcare Medicaid — Medicaid: $464.22 Humana-Medicare Advantage — Medicare Advantage: $1,397.11 Superior Medicaid — Medicaid: $464.22
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: HC MRI Brain Stem W/O & With Dye	$3,175.25	$1,587.63	$2,698.96
MRI of the brain, before and after contrast: rates for 2 insurance plans Aetna — PPO/HMO: $2,698.96 BCBS — PPO/HMO/PPS: $2,698.96
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HC Chest 2 Views	$558.67	$279.34	$109.47 – $474.87
Chest X-ray, 2 views: 10 of 14 insurance plan rates Aetna — PPO/HMO: $474.87 Aetna Medicaid — Medicaid: $109.47 Aetna-Medicare Advantage — Medicare Advantage: $245.81 Amerigroup Medicaid — Medicaid: $109.47 BCBS — PPO/HMO/PPS: $310.60 BCBS Medicaid — Medicaid: $109.47 BCBS-Medicare Advantage — Medicare Advantage: $245.81 Firstcare Medicaid — Medicaid: $109.47 Humana-Medicare Advantage — Medicare Advantage: $245.81 Superior Medicaid — Medicaid: $109.47
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: HC Chest 2 Views	$558.67	$279.34	$474.87
Chest X-ray, 2 views: rates for 2 insurance plans Aetna — PPO/HMO: $474.87 BCBS — PPO/HMO/PPS: $474.87
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HC Spine Lumbar Min 4 Vws	$501.25	$250.63	$134.67 – $572.30
X-ray of the lower spine, at least 4 views: 10 of 14 insurance plan rates Aetna — PPO/HMO: $426.06 Aetna Medicaid — Medicaid: $134.67 Aetna-Medicare Advantage — Medicare Advantage: $220.55 Amerigroup Medicaid — Medicaid: $134.67 BCBS — PPO/HMO/PPS: $572.30 BCBS Medicaid — Medicaid: $134.67 BCBS-Medicare Advantage — Medicare Advantage: $220.55 Firstcare Medicaid — Medicaid: $134.67 Humana-Medicare Advantage — Medicare Advantage: $220.55 Superior Medicaid — Medicaid: $134.67
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: HC Spine Lumbar Min 4 Vws	$501.25	$250.63	$426.06
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Aetna — PPO/HMO: $426.06 BCBS — PPO/HMO/PPS: $426.06
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HC MRI Lumbar Spine W/O Cont	$3,004	$1,502	$294.24 – $2,553.40
MRI of the lower back (lumbar spine), without contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $2,553.40 Aetna Medicaid — Medicaid: $294.24 Aetna-Medicare Advantage — Medicare Advantage: $1,321.76 Amerigroup Medicaid — Medicaid: $294.24 BCBS — PPO/HMO/PPS: $1,549.51 BCBS Medicaid — Medicaid: $294.24 BCBS-Medicare Advantage — Medicare Advantage: $1,321.76 Firstcare Medicaid — Medicaid: $294.24 Humana-Medicare Advantage — Medicare Advantage: $1,321.76 Superior Medicaid — Medicaid: $294.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: HC MRI Lumbar Spine W/O Cont	$3,004	$1,502	$2,553.40
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Aetna — PPO/HMO: $2,553.40 BCBS — PPO/HMO/PPS: $2,553.40
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HC CT Pelvis W/Contrast	$2,298.17	$1,149.09	$227.23 – $1,953.44
CT scan of the pelvis, with contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $1,953.44 Aetna Medicaid — Medicaid: $227.23 Aetna-Medicare Advantage — Medicare Advantage: $1,011.19 Amerigroup Medicaid — Medicaid: $227.23 BCBS — PPO/HMO/PPS: $1,685.78 BCBS Medicaid — Medicaid: $227.23 BCBS-Medicare Advantage — Medicare Advantage: $1,011.19 Firstcare Medicaid — Medicaid: $227.23 Humana-Medicare Advantage — Medicare Advantage: $1,011.19 Superior Medicaid — Medicaid: $227.23
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: HC CT Pelvis W/Contrast	$2,298.17	$1,149.09	$1,953.44
CT scan of the pelvis, with contrast: rates for 2 insurance plans Aetna — PPO/HMO: $1,953.44 BCBS — PPO/HMO/PPS: $1,953.44
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HC MRI Jnt of Lwr Extre W/O Dye	$2,636.50	$1,318.25	$294.24 – $2,241.03
MRI of a leg joint (such as the knee), without contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $2,241.03 Aetna Medicaid — Medicaid: $294.24 Aetna-Medicare Advantage — Medicare Advantage: $1,160.06 Amerigroup Medicaid — Medicaid: $294.24 BCBS — PPO/HMO/PPS: $1,549.51 BCBS Medicaid — Medicaid: $294.24 BCBS-Medicare Advantage — Medicare Advantage: $1,160.06 Firstcare Medicaid — Medicaid: $294.24 Humana-Medicare Advantage — Medicare Advantage: $1,160.06 Superior Medicaid — Medicaid: $294.24
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: HC MRI Jnt of Lwr Extre W/O Dye	$2,636.50	$1,318.25	$2,241.03
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans Aetna — PPO/HMO: $2,241.03 BCBS — PPO/HMO/PPS: $2,241.03
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HC CT Abd/Pelvis With Cont	$3,750.17	$1,875.09	$464.22 – $3,187.64
CT scan of the abdomen and pelvis, with contrast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $3,187.64 Aetna Medicaid — Medicaid: $464.22 Aetna-Medicare Advantage — Medicare Advantage: $1,650.07 Amerigroup Medicaid — Medicaid: $464.22 BCBS — PPO/HMO/PPS: $1,685.78 BCBS Medicaid — Medicaid: $464.22 BCBS-Medicare Advantage — Medicare Advantage: $1,650.07 Firstcare Medicaid — Medicaid: $464.22 Humana-Medicare Advantage — Medicare Advantage: $1,650.07 Superior Medicaid — Medicaid: $464.22
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: HC CT Abd/Pelvis With Cont	$3,750.17	$1,875.09	$3,187.64
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans Aetna — PPO/HMO: $3,187.64 BCBS — PPO/HMO/PPS: $3,187.64
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HC Abdomen Compl Echo B-Mode	$1,089.67	$544.84	$134.67 – $926.22
Ultrasound of the abdomen, complete: 10 of 14 insurance plan rates Aetna — PPO/HMO: $926.22 Aetna Medicaid — Medicaid: $134.67 Aetna-Medicare Advantage — Medicare Advantage: $479.45 Amerigroup Medicaid — Medicaid: $134.67 BCBS — PPO/HMO/PPS: $572.30 BCBS Medicaid — Medicaid: $134.67 BCBS-Medicare Advantage — Medicare Advantage: $479.45 Firstcare Medicaid — Medicaid: $134.67 Humana-Medicare Advantage — Medicare Advantage: $479.45 Superior Medicaid — Medicaid: $134.67
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: HC Abdomen Compl Echo B-Mode	$1,089.67	$544.84	$926.22
Ultrasound of the abdomen, complete: rates for 2 insurance plans Aetna — PPO/HMO: $926.22 BCBS — PPO/HMO/PPS: $926.22
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HC Usob>14wks Tansabd Sgl Ge	$640.78	$320.39	$134.67 – $650
Pregnancy ultrasound (after the first trimester): 10 of 14 insurance plan rates Aetna — PPO/HMO: $544.66 Aetna Medicaid — Medicaid: $134.67 Aetna-Medicare Advantage — Medicare Advantage: $281.94 Amerigroup Medicaid — Medicaid: $134.67 BCBS — PPO/HMO/PPS: $470.15 BCBS Medicaid — Medicaid: $134.67 BCBS-Medicare Advantage — Medicare Advantage: $281.94 Firstcare Medicaid — Medicaid: $134.67 Humana-Medicare Advantage — Medicare Advantage: $281.94 Superior Medicaid — Medicaid: $134.67
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: HC Usob>14wks Tansabd Sgl Ge	$640.78	$320.39	$544.66
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Aetna — PPO/HMO: $544.66 BCBS — PPO/HMO/PPS: $544.66
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HC Transvaginal Echo	$618.10	$309.05	$134.67 – $650
Transvaginal ultrasound: 10 of 14 insurance plan rates Aetna — PPO/HMO: $525.39 Aetna Medicaid — Medicaid: $134.67 Aetna-Medicare Advantage — Medicare Advantage: $271.96 Amerigroup Medicaid — Medicaid: $134.67 BCBS — PPO/HMO/PPS: $446.80 BCBS Medicaid — Medicaid: $134.67 BCBS-Medicare Advantage — Medicare Advantage: $271.96 Firstcare Medicaid — Medicaid: $134.67 Humana-Medicare Advantage — Medicare Advantage: $271.96 Superior Medicaid — Medicaid: $134.67
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: HC Transvaginal Echo	$618.10	$309.05	$525.39
Transvaginal ultrasound: rates for 2 insurance plans Aetna — PPO/HMO: $525.39 BCBS — PPO/HMO/PPS: $525.39
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC Wi Digital Diag Rt Unilat	$467	$233.50	$205.48 – $479.10
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $396.95 Aetna Medicaid — Medicaid: $280.20 Aetna-Medicare Advantage — Medicare Advantage: $205.48 Amerigroup Medicaid — Medicaid: $280.20 BCBS — PPO/HMO/PPS: $479.10 BCBS Medicaid — Medicaid: $280.20 BCBS-Medicare Advantage — Medicare Advantage: $205.48 Firstcare Medicaid — Medicaid: $280.20 Humana-Medicare Advantage — Medicare Advantage: $205.48 Superior Medicaid — Medicaid: $280.20
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC Wi Digital Diag Lt Unilat	$467	$233.50	$205.48 – $479.10
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — PPO/HMO: $396.95 Aetna Medicaid — Medicaid: $280.20 Aetna-Medicare Advantage — Medicare Advantage: $205.48 Amerigroup Medicaid — Medicaid: $280.20 BCBS — PPO/HMO/PPS: $479.10 BCBS Medicaid — Medicaid: $280.20 BCBS-Medicare Advantage — Medicare Advantage: $205.48 Firstcare Medicaid — Medicaid: $280.20 Humana-Medicare Advantage — Medicare Advantage: $205.48 Superior Medicaid — Medicaid: $280.20
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: HC Wi Digital Diag Rt Unilat	$467	$233.50	$396.95
Diagnostic mammogram, one breast: rates for 2 insurance plans Aetna — PPO/HMO: $396.95 BCBS — PPO/HMO/PPS: $396.95
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC Wi Digital Add Vws Bilat	$842.59	$421.30	$300 – $716.20
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — PPO/HMO: $716.20 Aetna Medicaid — Medicaid: $505.55 Aetna-Medicare Advantage — Medicare Advantage: $370.74 Amerigroup Medicaid — Medicaid: $505.55 BCBS — PPO/HMO/PPS: $611.90 BCBS Medicaid — Medicaid: $505.55 BCBS-Medicare Advantage — Medicare Advantage: $370.74 Firstcare Medicaid — Medicaid: $505.55 Humana-Medicare Advantage — Medicare Advantage: $370.74 Superior Medicaid — Medicaid: $505.55
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC Wi Digital Diag Mammo	$842.59	$421.30	$300 – $716.20
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — PPO/HMO: $716.20 Aetna Medicaid — Medicaid: $505.55 Aetna-Medicare Advantage — Medicare Advantage: $370.74 Amerigroup Medicaid — Medicaid: $505.55 BCBS — PPO/HMO/PPS: $611.90 BCBS Medicaid — Medicaid: $505.55 BCBS-Medicare Advantage — Medicare Advantage: $370.74 Firstcare Medicaid — Medicaid: $505.55 Humana-Medicare Advantage — Medicare Advantage: $370.74 Superior Medicaid — Medicaid: $505.55
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: HC Wi Digital Add Vws Bilat	$842.59	$421.30	$716.20
Diagnostic mammogram, both breasts: rates for 2 insurance plans Aetna — PPO/HMO: $716.20 BCBS — PPO/HMO/PPS: $716.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HC Wi Digital Screen Mammo	$696.29	$348.15	$300 – $591.85
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — PPO/HMO: $591.85 Aetna Medicaid — Medicaid: $417.77 Aetna-Medicare Advantage — Medicare Advantage: $306.37 Amerigroup Medicaid — Medicaid: $417.77 BCBS — PPO/HMO/PPS: $506.05 BCBS Medicaid — Medicaid: $417.77 BCBS-Medicare Advantage — Medicare Advantage: $306.37 Firstcare Medicaid — Medicaid: $417.77 Humana-Medicare Advantage — Medicare Advantage: $306.37 Superior Medicaid — Medicaid: $417.77
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: HC Wi Digital Screen Mammo	$696.29	$348.15	$591.85
Screening mammogram, both breasts: rates for 2 insurance plans Aetna — PPO/HMO: $591.85 BCBS — PPO/HMO/PPS: $591.85

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: Ecg Routine Ecg W/Least 12 Lds W/I&R	$173.58	$86.79	$76.38 – $160
Electrocardiogram (ECG/EKG) with reading: 10 of 14 insurance plan rates Aetna — PPO/HMO: $147.54 Aetna Medicaid — Medicaid: $104.15 Aetna-Medicare Advantage — Medicare Advantage: $76.38 Amerigroup Medicaid — Medicaid: $104.15 BCBS — PPO/HMO/PPS: $77.54 BCBS Medicaid — Medicaid: $104.15 BCBS-Medicare Advantage — Medicare Advantage: $76.38 Firstcare Medicaid — Medicaid: $104.15 Humana-Medicare Advantage — Medicare Advantage: $76.38 Superior Medicaid — Medicaid: $104.15
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) In the file: Ecg Routine Ecg W/Least 12 Lds W/I&R	$173.58	$86.79	$147.54
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Aetna — PPO/HMO: $147.54 BCBS — PPO/HMO/PPS: $147.54
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: HC - Ep-Comp Ep W-O Arrythmia	$22,764.30	$11,382.15	$300 – $26,571.60
Heart rhythm study (electrophysiology evaluation): 10 of 14 insurance plan rates Aetna — PPO/HMO: $19,349.66 Aetna Medicaid — Medicaid: $13,658.58 Aetna-Medicare Advantage — Medicare Advantage: $10,016.29 Amerigroup Medicaid — Medicaid: $13,658.58 BCBS — PPO/HMO/PPS: $26,571.60 BCBS Medicaid — Medicaid: $13,658.58 BCBS-Medicare Advantage — Medicare Advantage: $10,016.29 Firstcare Medicaid — Medicaid: $13,658.58 Humana-Medicare Advantage — Medicare Advantage: $10,016.29 Superior Medicaid — Medicaid: $13,658.58
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: HC - Ep-Comp Ep W-O Arrythmia	$22,764.30	$11,382.15	$19,349.66
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans Aetna — PPO/HMO: $19,349.66 BCBS — PPO/HMO/PPS: $19,349.66
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC Polysomnography; Age 6 Years or Older, W/ Modifier 52	$3,052.17	$1,526.09	$800 – $2,594.34
Sleep study (overnight, in a sleep lab): 10 of 14 insurance plan rates Aetna — PPO/HMO: $2,594.34 Aetna Medicaid — Medicaid: $1,831.30 Aetna-Medicare Advantage — Medicare Advantage: $1,342.95 Amerigroup Medicaid — Medicaid: $1,831.30 BCBS — PPO/HMO/PPS: $2,564.25 BCBS Medicaid — Medicaid: $1,831.30 BCBS-Medicare Advantage — Medicare Advantage: $1,342.95 Firstcare Medicaid — Medicaid: $1,831.30 Humana-Medicare Advantage — Medicare Advantage: $1,342.95 Superior Medicaid — Medicaid: $1,831.30
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC Polysomnography; Age 6 Years or Older W/O Modifier 52	$3,052.17	$1,526.09	$800 – $2,594.34
Sleep study (overnight, in a sleep lab): 10 of 14 insurance plan rates Aetna — PPO/HMO: $2,594.34 Aetna Medicaid — Medicaid: $1,831.30 Aetna-Medicare Advantage — Medicare Advantage: $1,342.95 Amerigroup Medicaid — Medicaid: $1,831.30 BCBS — PPO/HMO/PPS: $2,564.25 BCBS Medicaid — Medicaid: $1,831.30 BCBS-Medicare Advantage — Medicare Advantage: $1,342.95 Firstcare Medicaid — Medicaid: $1,831.30 Humana-Medicare Advantage — Medicare Advantage: $1,342.95 Superior Medicaid — Medicaid: $1,831.30
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: HC Polysomnography; Age 6 Years or Older, W/ Modifier 52	$3,052.17	$1,526.09	$2,594.34
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Aetna — PPO/HMO: $2,594.34 BCBS — PPO/HMO/PPS: $2,594.34

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: HC Therapeutic Exercise	$156.75	$78.38	$68.97 – $156.10
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans Aetna — PPO/HMO: $133.24 Aetna-Medicare Advantage — Medicare Advantage: $68.97 BCBS — PPO/HMO/PPS: $156.10 BCBS-Medicare Advantage — Medicare Advantage: $68.97 Humana-Medicare Advantage — Medicare Advantage: $68.97 Triwest — Federal: $68.97 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $68.97 Veterans Assistance — Federal: $68.97
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC Therapuetic Exer. 15 Min	$156.80	$78.40	$68.99 – $156.10
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans Aetna — PPO/HMO: $133.28 Aetna-Medicare Advantage — Medicare Advantage: $68.99 BCBS — PPO/HMO/PPS: $156.10 BCBS-Medicare Advantage — Medicare Advantage: $68.99 Humana-Medicare Advantage — Medicare Advantage: $68.99 Triwest — Federal: $68.99 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $68.99 Veterans Assistance — Federal: $68.99
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC Therapeutic Exer 15 Min	$156.80	$78.40	$68.99 – $156.10
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans Aetna — PPO/HMO: $133.28 Aetna-Medicare Advantage — Medicare Advantage: $68.99 BCBS — PPO/HMO/PPS: $156.10 BCBS-Medicare Advantage — Medicare Advantage: $68.99 Humana-Medicare Advantage — Medicare Advantage: $68.99 Triwest — Federal: $68.99 United Healthcare-Commercial — PPO/HMO: $141.12 United Healthcare-Medicare Advantage — Medicare Advantage: $68.99 Veterans Assistance — Federal: $68.99
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Low (30 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (low complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Low (45 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (low complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Low (60 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (low complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Moderate (60 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Moderate (15 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC Pt Evaluation Moderate (120 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC Pt Evaluation High (120 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (high complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC Pt Evaluation High (30 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (high complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC Pt Evaluation High (75 Minutes)	$432.50	$216.25	$100 – $427.10
Physical therapy evaluation (high complexity): rates for 9 insurance plans Aetna — PPO/HMO: $367.63 Aetna-Medicare Advantage — Medicare Advantage: $190.30 BCBS — PPO/HMO/PPS: $427.10 BCBS-Medicare Advantage — Medicare Advantage: $190.30 Humana-Medicare Advantage — Medicare Advantage: $190.30 Triwest — Federal: $190.30 United Healthcare-Commercial — PPO/HMO: $100 United Healthcare-Medicare Advantage — Medicare Advantage: $190.30 Veterans Assistance — Federal: $190.30
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 30 Minutes	$125	$62.50	$55 – $500
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Aetna — PPO/HMO: $106.25 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $55 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $500 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $55 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $55 Superior Medicaid — Medicaid: $97.99
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) In the file: Psychotherapy W/Patient 30 Minutes	$125	$62.50	$106.25
Psychotherapy, 30 minutes: rates for 2 insurance plans Aetna — PPO/HMO: $106.25 BCBS — PPO/HMO/PPS: $106.25
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 45 Minutes	$150	$75	$66 – $500
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates Aetna — PPO/HMO: $127.50 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $66 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $500 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $66 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $66 Superior Medicaid — Medicaid: $97.99
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: Psychotherapy W/Patient 45 Minutes	$150	$75	$127.50
Psychotherapy, 45 minutes: rates for 2 insurance plans Aetna — PPO/HMO: $127.50 BCBS — PPO/HMO/PPS: $127.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 60 Minutes	$175	$87.50	$77 – $500
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates Aetna — PPO/HMO: $148.75 Aetna Medicaid — Medicaid: $97.99 Aetna-Medicare Advantage — Medicare Advantage: $77 Amerigroup Medicaid — Medicaid: $97.99 BCBS — PPO/HMO/PPS: $500 BCBS Medicaid — Medicaid: $97.99 BCBS-Medicare Advantage — Medicare Advantage: $77 Firstcare Medicaid — Medicaid: $97.99 Humana-Medicare Advantage — Medicare Advantage: $77 Superior Medicaid — Medicaid: $97.99
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: Psychotherapy W/Patient 60 Minutes	$175	$87.50	$148.75
Psychotherapy, 60 minutes: rates for 2 insurance plans Aetna — PPO/HMO: $148.75 BCBS — PPO/HMO/PPS: $148.75
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family Psychotherapy W/O Patient Present 50 Mins	$125	$62.50	$55 – $500
Family psychotherapy, without the patient: 10 of 14 insurance plan rates Aetna — PPO/HMO: $106.25 Aetna Medicaid — Medicaid: $75 Aetna-Medicare Advantage — Medicare Advantage: $55 Amerigroup Medicaid — Medicaid: $75 BCBS — PPO/HMO/PPS: $500 BCBS Medicaid — Medicaid: $75 BCBS-Medicare Advantage — Medicare Advantage: $55 Firstcare Medicaid — Medicaid: $75 Humana-Medicare Advantage — Medicare Advantage: $55 Superior Medicaid — Medicaid: $75
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) In the file: Family Psychotherapy W/O Patient Present 50 Mins	$125	$62.50	$106.25
Family psychotherapy, without the patient: rates for 2 insurance plans Aetna — PPO/HMO: $106.25 BCBS — PPO/HMO/PPS: $106.25
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family Psychotherapy W/Patient Present 50 Mins	$150	$75	$66 – $500
Family psychotherapy, with the patient: 10 of 14 insurance plan rates Aetna — PPO/HMO: $127.50 Aetna Medicaid — Medicaid: $90 Aetna-Medicare Advantage — Medicare Advantage: $66 Amerigroup Medicaid — Medicaid: $90 BCBS — PPO/HMO/PPS: $500 BCBS Medicaid — Medicaid: $90 BCBS-Medicare Advantage — Medicare Advantage: $66 Firstcare Medicaid — Medicaid: $90 Humana-Medicare Advantage — Medicare Advantage: $66 Superior Medicaid — Medicaid: $90
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) In the file: Family Psychotherapy W/Patient Present 50 Mins	$150	$75	$127.50
Family psychotherapy, with the patient: rates for 2 insurance plans Aetna — PPO/HMO: $127.50 BCBS — PPO/HMO/PPS: $127.50

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: HC Hths Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$11,487.84	$5,743.92	$5,054.65 – $11,456.93
Removal of breast growth (open surgery): rates for 9 insurance plans Aetna — PPO/HMO: $9,764.66 Aetna-Medicare Advantage — Medicare Advantage: $5,054.65 BCBS — PPO/HMO/PPS: $11,456.93 BCBS-Medicare Advantage — Medicare Advantage: $5,054.65 Humana-Medicare Advantage — Medicare Advantage: $5,054.65 Triwest — Federal: $5,054.65 United Healthcare-Commercial — PPO/HMO: $10,339.06 United Healthcare-Medicare Advantage — Medicare Advantage: $5,054.65 Veterans Assistance — Federal: $5,054.65
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: HC Hths Mii Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$1,200.15	$600.08	$528.07 – $11,456.93
Removal of breast growth (open surgery): rates for 8 insurance plans Aetna — PPO/HMO: $1,020.13 Aetna-Medicare Advantage — Medicare Advantage: $528.07 BCBS — PPO/HMO/PPS: $11,456.93 BCBS-Medicare Advantage — Medicare Advantage: $528.07 Humana-Medicare Advantage — Medicare Advantage: $528.07 Triwest — Federal: $528.07 United Healthcare-Commercial — PPO/HMO: $1,080.14 Veterans Assistance — Federal: $528.07
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: HC Hths Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$11,487.84	$5,743.92	$9,764.66
Removal of breast growth (open surgery): rates for 2 insurance plans Aetna — PPO/HMO: $9,764.66 BCBS — PPO/HMO/PPS: $9,764.66
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Hths Egd Dx W/WO Coll	$2,812.68	$1,406.34	$1,237.58 – $3,122.66
Upper GI endoscopy (diagnostic): rates for 9 insurance plans Aetna — PPO/HMO: $2,390.78 Aetna-Medicare Advantage — Medicare Advantage: $1,237.58 BCBS — PPO/HMO/PPS: $3,122.66 BCBS-Medicare Advantage — Medicare Advantage: $1,237.58 Humana-Medicare Advantage — Medicare Advantage: $1,237.58 Triwest — Federal: $1,237.58 United Healthcare-Commercial — PPO/HMO: $2,531.41 United Healthcare-Medicare Advantage — Medicare Advantage: $1,237.58 Veterans Assistance — Federal: $1,237.58
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: Hths Egd Dx W/WO Coll	$2,812.68	$1,406.34	$2,390.78
Upper GI endoscopy (diagnostic): rates for 2 insurance plans Aetna — PPO/HMO: $2,390.78 BCBS — PPO/HMO/PPS: $2,390.78
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Hths Egd W/ Regular Biopsy	$3,929.60	$1,964.80	$1,729.02 – $3,536.64
Upper GI endoscopy with biopsy: rates for 9 insurance plans Aetna — PPO/HMO: $3,340.16 Aetna-Medicare Advantage — Medicare Advantage: $1,729.02 BCBS — PPO/HMO/PPS: $3,122.66 BCBS-Medicare Advantage — Medicare Advantage: $1,729.02 Humana-Medicare Advantage — Medicare Advantage: $1,729.02 Triwest — Federal: $1,729.02 United Healthcare-Commercial — PPO/HMO: $3,536.64 United Healthcare-Medicare Advantage — Medicare Advantage: $1,729.02 Veterans Assistance — Federal: $1,729.02
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd Transoral Biopsy Single/Multiple	$1,128.81	$564.41	$496.68 – $3,122.66
Upper GI endoscopy with biopsy: rates for 9 insurance plans Aetna — PPO/HMO: $959.49 Aetna-Medicare Advantage — Medicare Advantage: $496.68 BCBS — PPO/HMO/PPS: $3,122.66 BCBS-Medicare Advantage — Medicare Advantage: $496.68 Humana-Medicare Advantage — Medicare Advantage: $496.68 Triwest — Federal: $496.68 United Healthcare-Commercial — PPO/HMO: $1,015.93 United Healthcare-Medicare Advantage — Medicare Advantage: $496.68 Veterans Assistance — Federal: $496.68
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Hths Mps Edg W / Regular Biopsy	$388.44	$194.22	$170.91 – $3,122.66
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — PPO/HMO: $330.17 Aetna-Medicare Advantage — Medicare Advantage: $170.91 BCBS — PPO/HMO/PPS: $3,122.66 BCBS-Medicare Advantage — Medicare Advantage: $170.91 Humana-Medicare Advantage — Medicare Advantage: $170.91 Triwest — Federal: $170.91 United Healthcare-Commercial — PPO/HMO: $349.60 Veterans Assistance — Federal: $170.91
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Hths Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$3,739.68	$1,869.84	$1,645.46 – $3,365.71
Colonoscopy (diagnostic): rates for 9 insurance plans Aetna — PPO/HMO: $3,178.73 Aetna-Medicare Advantage — Medicare Advantage: $1,645.46 BCBS — PPO/HMO/PPS: $2,981.92 BCBS-Medicare Advantage — Medicare Advantage: $1,645.46 Humana-Medicare Advantage — Medicare Advantage: $1,645.46 Triwest — Federal: $1,645.46 United Healthcare-Commercial — PPO/HMO: $3,365.71 United Healthcare-Medicare Advantage — Medicare Advantage: $1,645.46 Veterans Assistance — Federal: $1,645.46
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,017.45	$508.73	$447.68 – $2,981.92
Colonoscopy (diagnostic): rates for 9 insurance plans Aetna — PPO/HMO: $864.83 Aetna-Medicare Advantage — Medicare Advantage: $447.68 BCBS — PPO/HMO/PPS: $2,981.92 BCBS-Medicare Advantage — Medicare Advantage: $447.68 Humana-Medicare Advantage — Medicare Advantage: $447.68 Triwest — Federal: $447.68 United Healthcare-Commercial — PPO/HMO: $915.71 United Healthcare-Medicare Advantage — Medicare Advantage: $447.68 Veterans Assistance — Federal: $447.68
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Hths Mps Colonoscopy Dx W/WO Coll	$519.48	$259.74	$228.57 – $2,981.92
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — PPO/HMO: $441.56 Aetna-Medicare Advantage — Medicare Advantage: $228.57 BCBS — PPO/HMO/PPS: $2,981.92 BCBS-Medicare Advantage — Medicare Advantage: $228.57 Humana-Medicare Advantage — Medicare Advantage: $228.57 Triwest — Federal: $228.57 United Healthcare-Commercial — PPO/HMO: $467.53 Veterans Assistance — Federal: $228.57
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Hths Colonoscopy W/Biopsy Single/Multiple	$4,873	$2,436.50	$2,144.12 – $4,385.70
Colonoscopy with biopsy: rates for 9 insurance plans Aetna — PPO/HMO: $4,142.05 Aetna-Medicare Advantage — Medicare Advantage: $2,144.12 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $2,144.12 Humana-Medicare Advantage — Medicare Advantage: $2,144.12 Triwest — Federal: $2,144.12 United Healthcare-Commercial — PPO/HMO: $4,385.70 United Healthcare-Medicare Advantage — Medicare Advantage: $2,144.12 Veterans Assistance — Federal: $2,144.12
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy W/Biopsy Single/Multiple	$1,298.58	$649.29	$571.38 – $3,932.84
Colonoscopy with biopsy: rates for 9 insurance plans Aetna — PPO/HMO: $1,103.79 Aetna-Medicare Advantage — Medicare Advantage: $571.38 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $571.38 Humana-Medicare Advantage — Medicare Advantage: $571.38 Triwest — Federal: $571.38 United Healthcare-Commercial — PPO/HMO: $1,168.72 United Healthcare-Medicare Advantage — Medicare Advantage: $571.38 Veterans Assistance — Federal: $571.38
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Hths Mps Colonoscopy W/Bx	$565.05	$282.53	$248.62 – $3,932.84
Colonoscopy with biopsy: rates for 8 insurance plans Aetna — PPO/HMO: $480.29 Aetna-Medicare Advantage — Medicare Advantage: $248.62 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $248.62 Humana-Medicare Advantage — Medicare Advantage: $248.62 Triwest — Federal: $248.62 United Healthcare-Commercial — PPO/HMO: $508.55 Veterans Assistance — Federal: $248.62
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$1,358.13	$679.07	$597.58 – $3,932.84
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans Aetna — PPO/HMO: $1,154.41 Aetna-Medicare Advantage — Medicare Advantage: $597.58 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $597.58 Humana-Medicare Advantage — Medicare Advantage: $597.58 Triwest — Federal: $597.58 United Healthcare-Commercial — PPO/HMO: $1,222.32 United Healthcare-Medicare Advantage — Medicare Advantage: $597.58 Veterans Assistance — Federal: $597.58
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: HC Hths Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$4,873	$2,436.50	$2,144.12 – $4,385.70
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans Aetna — PPO/HMO: $4,142.05 Aetna-Medicare Advantage — Medicare Advantage: $2,144.12 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $2,144.12 Humana-Medicare Advantage — Medicare Advantage: $2,144.12 Triwest — Federal: $2,144.12 United Healthcare-Commercial — PPO/HMO: $4,385.70 United Healthcare-Medicare Advantage — Medicare Advantage: $2,144.12 Veterans Assistance — Federal: $2,144.12
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Hths Mps Colonoscopy W/Polyp	$712.47	$356.24	$313.49 – $3,932.84
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans Aetna — PPO/HMO: $605.60 Aetna-Medicare Advantage — Medicare Advantage: $313.49 BCBS — PPO/HMO/PPS: $3,932.84 BCBS-Medicare Advantage — Medicare Advantage: $313.49 Humana-Medicare Advantage — Medicare Advantage: $313.49 Triwest — Federal: $313.49 United Healthcare-Commercial — PPO/HMO: $641.22 Veterans Assistance — Federal: $313.49
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Hths Colonpy Not High Risk Scr	$3,819.40	$1,909.70	$1,680.54 – $3,437.46
Screening colonoscopy (not high risk): rates for 9 insurance plans Aetna — PPO/HMO: $3,246.49 Aetna-Medicare Advantage — Medicare Advantage: $1,680.54 BCBS — PPO/HMO/PPS: $2,981.92 BCBS-Medicare Advantage — Medicare Advantage: $1,680.54 Humana-Medicare Advantage — Medicare Advantage: $1,680.54 Triwest — Federal: $1,680.54 United Healthcare-Commercial — PPO/HMO: $3,437.46 United Healthcare-Medicare Advantage — Medicare Advantage: $1,680.54 Veterans Assistance — Federal: $1,680.54
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: HC Hths M2 Colon Ca Scrn Not Hi Rsk Ind	$520.38	$260.19	$228.97 – $2,981.92
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — PPO/HMO: $442.32 Aetna-Medicare Advantage — Medicare Advantage: $228.97 BCBS — PPO/HMO/PPS: $2,981.92 BCBS-Medicare Advantage — Medicare Advantage: $228.97 Humana-Medicare Advantage — Medicare Advantage: $228.97 Triwest — Federal: $228.97 United Healthcare-Commercial — PPO/HMO: $468.34 Veterans Assistance — Federal: $228.97
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: HC Hths M2 Colon Ca Scrn Not Hi Rsk Ind	$520.38	$260.19	$442.32
Screening colonoscopy (not high risk): rates for 2 insurance plans Aetna — PPO/HMO: $442.32 BCBS — PPO/HMO/PPS: $442.32
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy Surg Cholecystectomy	$1,892.64	$946.32	$832.76 – $18,852.46
Gallbladder removal by laparoscope: rates for 9 insurance plans Aetna — PPO/HMO: $1,608.74 Aetna-Medicare Advantage — Medicare Advantage: $832.76 BCBS — PPO/HMO/PPS: $18,852.46 BCBS-Medicare Advantage — Medicare Advantage: $832.76 Humana-Medicare Advantage — Medicare Advantage: $832.76 Triwest — Federal: $832.76 United Healthcare-Commercial — PPO/HMO: $1,703.38 United Healthcare-Medicare Advantage — Medicare Advantage: $832.76 Veterans Assistance — Federal: $832.76
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Hths Laparoscopic Cholecystectomy	$23,455	$11,727.50	$10,320.20 – $21,109.50
Gallbladder removal by laparoscope: rates for 9 insurance plans Aetna — PPO/HMO: $19,936.75 Aetna-Medicare Advantage — Medicare Advantage: $10,320.20 BCBS — PPO/HMO/PPS: $18,852.46 BCBS-Medicare Advantage — Medicare Advantage: $10,320.20 Humana-Medicare Advantage — Medicare Advantage: $10,320.20 Triwest — Federal: $10,320.20 United Healthcare-Commercial — PPO/HMO: $21,109.50 United Healthcare-Medicare Advantage — Medicare Advantage: $10,320.20 Veterans Assistance — Federal: $10,320.20
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Hths Mps Laparoscopic Cholecystectomy	$1,892.64	$946.32	$832.76 – $18,852.46
Gallbladder removal by laparoscope: rates for 8 insurance plans Aetna — PPO/HMO: $1,608.74 Aetna-Medicare Advantage — Medicare Advantage: $832.76 BCBS — PPO/HMO/PPS: $18,852.46 BCBS-Medicare Advantage — Medicare Advantage: $832.76 Humana-Medicare Advantage — Medicare Advantage: $832.76 Triwest — Federal: $832.76 United Healthcare-Commercial — PPO/HMO: $1,703.38 Veterans Assistance — Federal: $832.76
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: HC Hths Destroy Internal Hemorrhoids	$10,587.18	$5,293.59	$4,658.36 – $12,226.87
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans Aetna — PPO/HMO: $8,999.10 Aetna-Medicare Advantage — Medicare Advantage: $4,658.36 BCBS — PPO/HMO/PPS: $12,226.87 BCBS-Medicare Advantage — Medicare Advantage: $4,658.36 Humana-Medicare Advantage — Medicare Advantage: $4,658.36 Triwest — Federal: $4,658.36 United Healthcare-Commercial — PPO/HMO: $9,528.46 United Healthcare-Medicare Advantage — Medicare Advantage: $4,658.36 Veterans Assistance — Federal: $4,658.36
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: HC Hths Mii Destroy Internal Hemorrhoids	$1,502.10	$751.05	$660.92 – $12,226.87
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans Aetna — PPO/HMO: $1,276.79 Aetna-Medicare Advantage — Medicare Advantage: $660.92 BCBS — PPO/HMO/PPS: $12,226.87 BCBS-Medicare Advantage — Medicare Advantage: $660.92 Humana-Medicare Advantage — Medicare Advantage: $660.92 Triwest — Federal: $660.92 United Healthcare-Commercial — PPO/HMO: $1,351.89 Veterans Assistance — Federal: $660.92
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: HC Hths Mii Destroy Internal Hemorrhoids	$1,502.10	$751.05	$1,276.79
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans Aetna — PPO/HMO: $1,276.79 BCBS — PPO/HMO/PPS: $1,276.79
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn	$284.31	$142.16	$125.10 – $2,282.20
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans Aetna — PPO/HMO: $241.66 Aetna-Medicare Advantage — Medicare Advantage: $125.10 BCBS — PPO/HMO/PPS: $2,282.20 BCBS-Medicare Advantage — Medicare Advantage: $125.10 Humana-Medicare Advantage — Medicare Advantage: $125.10 Triwest — Federal: $125.10 United Healthcare-Commercial — PPO/HMO: $255.88 United Healthcare-Medicare Advantage — Medicare Advantage: $125.10 Veterans Assistance — Federal: $125.10
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC Inject Spine L/S	$2,511	$1,255.50	$1,104.84 – $2,282.20
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans Aetna — PPO/HMO: $2,134.35 Aetna-Medicare Advantage — Medicare Advantage: $1,104.84 BCBS — PPO/HMO/PPS: $2,282.20 BCBS-Medicare Advantage — Medicare Advantage: $1,104.84 Humana-Medicare Advantage — Medicare Advantage: $1,104.84 Triwest — Federal: $1,104.84 United Healthcare-Commercial — PPO/HMO: $2,259.90 United Healthcare-Medicare Advantage — Medicare Advantage: $1,104.84 Veterans Assistance — Federal: $1,104.84
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Hths Pain Njx Interlaminar Lmbr/Sac	$281.79	$140.90	$123.99 – $2,282.20
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans Aetna — PPO/HMO: $239.52 Aetna-Medicare Advantage — Medicare Advantage: $123.99 BCBS — PPO/HMO/PPS: $2,282.20 BCBS-Medicare Advantage — Medicare Advantage: $123.99 Humana-Medicare Advantage — Medicare Advantage: $123.99 Triwest — Federal: $123.99 United Healthcare-Commercial — PPO/HMO: $253.61 Veterans Assistance — Federal: $123.99
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC CT Nerve Root Blk Trans Lum	$3,321	$1,660.50	$1,461.24 – $2,988.90
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans Aetna — PPO/HMO: $2,822.85 Aetna-Medicare Advantage — Medicare Advantage: $1,461.24 BCBS — PPO/HMO/PPS: $2,823.16 BCBS-Medicare Advantage — Medicare Advantage: $1,461.24 Humana-Medicare Advantage — Medicare Advantage: $1,461.24 Triwest — Federal: $1,461.24 United Healthcare-Commercial — PPO/HMO: $2,988.90 United Healthcare-Medicare Advantage — Medicare Advantage: $1,461.24 Veterans Assistance — Federal: $1,461.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$741.15	$370.58	$326.11 – $2,823.16
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans Aetna — PPO/HMO: $629.98 Aetna-Medicare Advantage — Medicare Advantage: $326.11 BCBS — PPO/HMO/PPS: $2,823.16 BCBS-Medicare Advantage — Medicare Advantage: $326.11 Humana-Medicare Advantage — Medicare Advantage: $326.11 Triwest — Federal: $326.11 United Healthcare-Commercial — PPO/HMO: $667.04 United Healthcare-Medicare Advantage — Medicare Advantage: $326.11 Veterans Assistance — Federal: $326.11
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Hths Pain Inj Foramen Epidural L/S	$315.33	$157.67	$138.75 – $2,823.16
Nerve root injection, lower back, with imaging guidance: rates for 8 insurance plans Aetna — PPO/HMO: $268.03 Aetna-Medicare Advantage — Medicare Advantage: $138.75 BCBS — PPO/HMO/PPS: $2,823.16 BCBS-Medicare Advantage — Medicare Advantage: $138.75 Humana-Medicare Advantage — Medicare Advantage: $138.75 Triwest — Federal: $138.75 United Healthcare-Commercial — PPO/HMO: $283.80 Veterans Assistance — Federal: $138.75
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Hths Discission 2nd Mem Cataract	$10,109.30	$5,054.65	$2,049.52 – $9,098.37
Laser treatment of clouding after cataract surgery: rates for 9 insurance plans Aetna — PPO/HMO: $8,592.91 Aetna-Medicare Advantage — Medicare Advantage: $4,448.09 BCBS — PPO/HMO/PPS: $2,049.52 BCBS-Medicare Advantage — Medicare Advantage: $4,448.09 Humana-Medicare Advantage — Medicare Advantage: $4,448.09 Triwest — Federal: $4,448.09 United Healthcare-Commercial — PPO/HMO: $9,098.37 United Healthcare-Medicare Advantage — Medicare Advantage: $4,448.09 Veterans Assistance — Federal: $4,448.09
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: HC Capsulotomy-Yag Laser	$10,109	$5,054.50	$2,049.52 – $9,098.10
Laser treatment of clouding after cataract surgery: rates for 9 insurance plans Aetna — PPO/HMO: $8,592.65 Aetna-Medicare Advantage — Medicare Advantage: $4,447.96 BCBS — PPO/HMO/PPS: $2,049.52 BCBS-Medicare Advantage — Medicare Advantage: $4,447.96 Humana-Medicare Advantage — Medicare Advantage: $4,447.96 Triwest — Federal: $4,447.96 United Healthcare-Commercial — PPO/HMO: $9,098.10 United Healthcare-Medicare Advantage — Medicare Advantage: $4,447.96 Veterans Assistance — Federal: $4,447.96
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: HC Hths Mii Capsulotomy-Yag Laser	$865.32	$432.66	$380.74 – $2,049.52
Laser treatment of clouding after cataract surgery: rates for 8 insurance plans Aetna — PPO/HMO: $735.52 Aetna-Medicare Advantage — Medicare Advantage: $380.74 BCBS — PPO/HMO/PPS: $2,049.52 BCBS-Medicare Advantage — Medicare Advantage: $380.74 Humana-Medicare Advantage — Medicare Advantage: $380.74 Triwest — Federal: $380.74 United Healthcare-Commercial — PPO/HMO: $778.79 Veterans Assistance — Federal: $380.74
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Hths Cataract, Extracapsular	$10,109.30	$5,054.65	$4,448.09 – $9,098.37
Cataract removal with lens implant: rates for 9 insurance plans Aetna — PPO/HMO: $8,592.91 Aetna-Medicare Advantage — Medicare Advantage: $4,448.09 BCBS — PPO/HMO/PPS: $8,068.58 BCBS-Medicare Advantage — Medicare Advantage: $4,448.09 Humana-Medicare Advantage — Medicare Advantage: $4,448.09 Triwest — Federal: $4,448.09 United Healthcare-Commercial — PPO/HMO: $9,098.37 United Healthcare-Medicare Advantage — Medicare Advantage: $4,448.09 Veterans Assistance — Federal: $4,448.09
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: HC Hths Mii Cataract, Extracapsular	$1,517.79	$758.90	$667.83 – $8,068.58
Cataract removal with lens implant: rates for 8 insurance plans Aetna — PPO/HMO: $1,290.12 Aetna-Medicare Advantage — Medicare Advantage: $667.83 BCBS — PPO/HMO/PPS: $8,068.58 BCBS-Medicare Advantage — Medicare Advantage: $667.83 Humana-Medicare Advantage — Medicare Advantage: $667.83 Triwest — Federal: $667.83 United Healthcare-Commercial — PPO/HMO: $1,366.01 Veterans Assistance — Federal: $667.83
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) In the file: HC Hths Mii Cataract, Extracapsular	$1,517.79	$758.90	$1,290.12
Cataract removal with lens implant: rates for 2 insurance plans Aetna — PPO/HMO: $1,290.12 BCBS — PPO/HMO/PPS: $1,290.12

Source: Heart of Texas Memorial Hospital’s standard charges file (heartoftexashealthcare.slicedhealth.io, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 17, 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	Critical Access Hospital
Address	2008 Nine Road, Brady, TX 76825
County	McCulloch County
State	Texas
Phone	(325) 597‑2901
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	451348
Name in Medicare records	HEART OF TEXAS MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Heart of Texas Healthcare System
Official website	heartoftexashealthcare.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Heart of Texas Healthcare System — heartoftexashealthcare.org
Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Cardiopulmonary Rehab | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Radiology | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Laboratory | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Physiologic Insulin Resensitization | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Occupational Therapy | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Physical Therapy | Services | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
About Us | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org
Specialists | Heart of Texas Healthcare System | Brady, Texas - McCulloch County — heartoftexashealthcare.org

Heart of Texas Memorial Hospital

Summary

Profile from official sources

At a glance