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Acute Care Hospital

Henry Ford Macomb Hospital

Clinton Township, Michigan · Macomb County · Emergency services listed

Summary

Henry Ford Macomb Hospital is an acute care hospital in Clinton Township, Michigan. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 47 services, specialties and programs. Medicare lists 1,464 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
361Beds (hospital website)
47Services listed

Quick answers

Does Henry Ford Macomb Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Henry Ford Macomb Hospital. In a medical emergency, call 911.
Where is Henry Ford Macomb Hospital?
15855 Nineteen Mile Rd, Clinton Township, MI 48038, in Macomb County, Michigan.
What is the phone number of Henry Ford Macomb Hospital?
(586) 263-2300, as listed by Medicare (CMS).
What is the Medicare star rating of Henry Ford Macomb Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][8]

Conditions treated[4]

Treatments[4]

  • Inpatient and outpatient rehabilitation
  • Speech-language pathology
  • Hospice
  • Home health care

Procedures[4][5]

Programs and centers[5][8][9]

  • Heart & Vascular Institute
  • Joint Replacement Center
  • Birthing Center
  • Spine Center
  • Inpatient rehabilitation unit
  • Emergency medicine residency

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

Emergency roomYes
Open 24/7Yes
Stroke designationPrimary Stroke Center

Visiting and practical information

VisitingRegular visiting hours 5 a.m.-8 p.m.; after-hours visits need care team approval; two visitors at a time, age 12 and up[6]
ParkingSelf-parking is free near entrances and the ER; valet at the south entrance is $5[7]

Doctors and clinicians (1,464)

1,464 doctors and other clinicians list Henry Ford Macomb Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (1,464)

And 1,440 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

  • Groesbeck3.1 mi · Clinton Township, MI · Community health center
  • Mount Clemens3.4 mi · Mount Clemens, MI · Community health center
  • Advantage Health6.5 mi · Warren, MI · Community health center

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1063%National average: 72%
Would definitely recommend the hospital66%National average: 71%
Nurses “always” communicated well74%National average: 80%
Doctors “always” communicated well71%National average: 80%
Staff “always” explained medicines before giving them53%National average: 62%
Were given information about recovery at home83%National average: 86%
Room and bathroom “always” clean63%National average: 74%
Area around the room “always” quiet at night47%National average: 60%
Completed surveys1,144Response rate: 28%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.832No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0Better than the national benchmark
Surgical site infections after colon surgery0.881No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.485No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.316Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients10.5%
Deaths within 30 days: heart failure patients11.1%
Deaths within 30 days: pneumonia patients13.3%
Deaths within 30 days: COPD patients9.6%
Deaths within 30 days: stroke patients12.2%
Deaths within 30 days: coronary bypass surgery (CABG)2.9%
Serious complications (patient safety indicator PSI-90)0.8No different from the national rate
Complications after hip or knee replacement5.6%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.5%
Readmitted within 30 days: heart failure19.8%
Readmitted within 30 days: pneumonia17.9%
Readmitted within 30 days: COPD19.9%
Readmitted within 30 days: coronary bypass surgery11.4%
Readmitted within 30 days: hip or knee replacement5.8%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)306 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)69%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

Prices

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

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP VISIT NEW LVL 3 $195 $103.09 $45.58 – $173.57
New patient office visit (about 30–44 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $142.51
  • Aetna — Medicare Advantage-FAC: $74.70
  • Aetna — Medicare Advantage-NONFAC: $119.18
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $76.48
  • Aetna Better Health — Medicaid HMO-Child-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $76.48
  • Amerihealth Caritas — Dual Products-FAC: $73.21
  • Amerihealth Caritas — Dual Products-NONFAC: $116.80
  • BC3NP — Medicaid HMO: $108.06
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 3 (MD/SA) $195 $103.09 $45.58 – $173.57
New patient office visit (about 30–44 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $142.51
  • Aetna — Medicare Advantage-FAC: $74.70
  • Aetna — Medicare Advantage-NONFAC: $119.18
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $76.48
  • Aetna Better Health — Medicaid HMO-Child-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $76.48
  • Amerihealth Caritas — Dual Products-FAC: $73.21
  • Amerihealth Caritas — Dual Products-NONFAC: $116.80
  • BC3NP — Medicaid HMO: $108.06
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 3 (TELHLTH) $195 $103.09 $45.58 – $173.57
New patient office visit (about 30–44 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $142.51
  • Aetna — Medicare Advantage-FAC: $74.70
  • Aetna — Medicare Advantage-NONFAC: $119.18
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $76.48
  • Aetna Better Health — Medicaid HMO-Child-FAC: $46.49
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $76.48
  • Amerihealth Caritas — Dual Products-FAC: $73.21
  • Amerihealth Caritas — Dual Products-NONFAC: $116.80
  • BC3NP — Medicaid HMO: $108.06
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 4 $283 $167.85 $74.55 – $265.78
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $212.14
  • Aetna — Medicare Advantage-FAC: $121.63
  • Aetna — Medicare Advantage-NONFAC: $179.97
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $115.36
  • Aetna Better Health — Medicaid HMO-Child-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $115.36
  • Amerihealth Caritas — Dual Products-FAC: $119.20
  • Amerihealth Caritas — Dual Products-NONFAC: $176.37
  • BC3NP — Medicaid HMO: $115
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 4 (MD/SA) $283 $167.85 $74.55 – $265.78
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $212.14
  • Aetna — Medicare Advantage-FAC: $121.63
  • Aetna — Medicare Advantage-NONFAC: $179.97
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $115.36
  • Aetna Better Health — Medicaid HMO-Child-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $115.36
  • Amerihealth Caritas — Dual Products-FAC: $119.20
  • Amerihealth Caritas — Dual Products-NONFAC: $176.37
  • BC3NP — Medicaid HMO: $115
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 4 (TELHLTH) $283 $167.85 $74.55 – $265.78
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $212.14
  • Aetna — Medicare Advantage-FAC: $121.63
  • Aetna — Medicare Advantage-NONFAC: $179.97
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $115.36
  • Aetna Better Health — Medicaid HMO-Child-FAC: $76.04
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $115.36
  • Amerihealth Caritas — Dual Products-FAC: $119.20
  • Amerihealth Caritas — Dual Products-NONFAC: $176.37
  • BC3NP — Medicaid HMO: $115
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP VISIT NEW LVL 5 $368 $231.11 $102.24 – $329.32
New patient office visit (about 60–74 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $280.31
  • Aetna — Medicare Advantage-FAC: $167.47
  • Aetna — Medicare Advantage-NONFAC: $241.29
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $154.04
  • Aetna Better Health — Medicaid HMO-Child-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $154.04
  • Amerihealth Caritas — Dual Products-FAC: $164.12
  • Amerihealth Caritas — Dual Products-NONFAC: $236.46
  • BC3NP — Medicaid HMO: $115
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 5 SA (MD/SA) $368 $231.11 $102.24 – $329.32
New patient office visit (about 60–74 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $280.31
  • Aetna — Medicare Advantage-FAC: $167.47
  • Aetna — Medicare Advantage-NONFAC: $241.29
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $154.04
  • Aetna Better Health — Medicaid HMO-Child-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $154.04
  • Amerihealth Caritas — Dual Products-FAC: $164.12
  • Amerihealth Caritas — Dual Products-NONFAC: $236.46
  • BC3NP — Medicaid HMO: $115
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT NEW LVL 5 (TELHLTH) $368 $231.11 $102.24 – $329.32
New patient office visit (about 60–74 minutes): 10 of 86 insurance plan rates
  • Aetna — All Products-NONFAC: $280.31
  • Aetna — Medicare Advantage-FAC: $167.47
  • Aetna — Medicare Advantage-NONFAC: $241.29
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $154.04
  • Aetna Better Health — Medicaid HMO-Child-FAC: $104.28
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $154.04
  • Amerihealth Caritas — Dual Products-FAC: $164.12
  • Amerihealth Caritas — Dual Products-NONFAC: $236.46
  • BC3NP — Medicaid HMO: $115
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT EST LVL 3 SA (MD/SA) $146 $81.60 $36.64 – $115.27
Established patient office visit (about 20–29 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $114.48
  • Aetna — Medicare Advantage-FAC: $59.13
  • Aetna — Medicare Advantage-NONFAC: $95.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $61.92
  • Aetna Better Health — Medicaid HMO-Child-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $61.92
  • Amerihealth Caritas — Dual Products-FAC: $57.95
  • Amerihealth Caritas — Dual Products-NONFAC: $93.64
  • BC3NP — Medicaid HMO: $87.68
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP VISIT EST LVL 3 $146 $81.60 $36.64 – $115.27
Established patient office visit (about 20–29 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $114.48
  • Aetna — Medicare Advantage-FAC: $59.13
  • Aetna — Medicare Advantage-NONFAC: $95.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $61.92
  • Aetna Better Health — Medicaid HMO-Child-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $61.92
  • Amerihealth Caritas — Dual Products-FAC: $57.95
  • Amerihealth Caritas — Dual Products-NONFAC: $93.64
  • BC3NP — Medicaid HMO: $87.68
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT EST LVL 3 (TELHLTH) $146 $81.60 $36.64 – $115.27
Established patient office visit (about 20–29 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $114.48
  • Aetna — Medicare Advantage-FAC: $59.13
  • Aetna — Medicare Advantage-NONFAC: $95.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $61.92
  • Aetna Better Health — Medicaid HMO-Child-FAC: $37.37
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $61.92
  • Amerihealth Caritas — Dual Products-FAC: $57.95
  • Amerihealth Caritas — Dual Products-NONFAC: $93.64
  • BC3NP — Medicaid HMO: $87.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT EST LVL 4 SA (MD/SA) $207 $120.28 $53.89 – $170.25
Established patient office visit (about 30–39 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $162.19
  • Aetna — Medicare Advantage-FAC: $87.16
  • Aetna — Medicare Advantage-NONFAC: $136.48
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $88.21
  • Aetna Better Health — Medicaid HMO-Child-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $88.21
  • Amerihealth Caritas — Dual Products-FAC: $85.42
  • Amerihealth Caritas — Dual Products-NONFAC: $133.75
  • BC3NP — Medicaid HMO: $87.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP VISIT EST LVL 4 $207 $120.28 $53.89 – $170.25
Established patient office visit (about 30–39 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $162.19
  • Aetna — Medicare Advantage-FAC: $87.16
  • Aetna — Medicare Advantage-NONFAC: $136.48
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $88.21
  • Aetna Better Health — Medicaid HMO-Child-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $88.21
  • Amerihealth Caritas — Dual Products-FAC: $85.42
  • Amerihealth Caritas — Dual Products-NONFAC: $133.75
  • BC3NP — Medicaid HMO: $87.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFC/OP VISIT EST LVL 4 (TELHLTH) $207 $120.28 $53.89 – $170.25
Established patient office visit (about 30–39 minutes): 10 of 88 insurance plan rates
  • Aetna — All Products-NONFAC: $162.19
  • Aetna — Medicare Advantage-FAC: $87.16
  • Aetna — Medicare Advantage-NONFAC: $136.48
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $88.21
  • Aetna Better Health — Medicaid HMO-Child-FAC: $54.97
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $88.21
  • Amerihealth Caritas — Dual Products-FAC: $85.42
  • Amerihealth Caritas — Dual Products-NONFAC: $133.75
  • BC3NP — Medicaid HMO: $87.68
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE CONSULTATION LVL 3 $216 $111 $55.81 – $186.65
Office consultation with a specialist (moderate): 10 of 53 insurance plan rates
  • Aetna — All Products-NONFAC: $151.36
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $56.93
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $73.22
  • Aetna Better Health — Medicaid HMO-Child-FAC: $56.93
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $73.22
  • Amerihealth Caritas — Dual Products-FAC: $86.40
  • Amerihealth Caritas — Dual Products-NONFAC: $86.40
  • Blue Cross — BCBSM Commercial: $179.49
  • Blue Cross — BCN Commercial-FAC: $140.07
  • Blue Cross — BCN Commercial-NONFAC: $180.02
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30 Not listed in the file Not listed in the file $184.37 – $211.43
Office consultation with a specialist (moderate): rates for 4 insurance plans
  • HAP — HAP HMO_AHL_Fully Insured: $184.37
  • HAP — Self-Funded: $211.43
  • Humana Military — Tricare: $80.69
  • Priority Health — Commercial: $185.05
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier P In the file: PR OFFICE CONSULTATION LVL 3 $108 Not listed in the file $43.20 – $75.60
Office consultation with a specialist (moderate): 10 of 11 insurance plan rates
  • Amerihealth Caritas — Dual Products-FAC: $43.20
  • Amerihealth Caritas — Dual Products-NONFAC: $43.20
  • Blue Cross — BCN Medicare Advantage -FAC: $70.20
  • Blue Cross — BCN Medicare Advantage -NONFAC: $70.20
  • Blue Cross — Medicare Plus Blue-FAC: $70.20
  • Blue Cross — Medicare Plus Blue-NONFAC: $70.20
  • HAP — HAP HMO_AHL_Fully-Insured: $54
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-FAC: $54
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-NONFAC: $54
  • HAP — Self-Funded: $54
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE CONSULTATION LVL 4 $288 $189 $85.20 – $273.92
Office consultation with a specialist (moderate to high): 10 of 53 insurance plan rates
  • Aetna — All Products-NONFAC: $217.06
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $86.90
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $104.72
  • Aetna Better Health — Medicaid HMO-Child-FAC: $86.90
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $104.72
  • Amerihealth Caritas — Dual Products-FAC: $115.20
  • Amerihealth Caritas — Dual Products-NONFAC: $115.20
  • Blue Cross — BCBSM Commercial: $256.18
  • Blue Cross — BCN Commercial-FAC: $212.51
  • Blue Cross — BCN Commercial-NONFAC: $256.18
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40 Not listed in the file Not listed in the file $248.41 – $310.29
Office consultation with a specialist (moderate to high): rates for 4 insurance plans
  • HAP — HAP HMO_AHL_Fully Insured: $270.56
  • HAP — Self-Funded: $310.29
  • Humana Military — Tricare: $121.92
  • Priority Health — Commercial: $248.41
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier P In the file: PR OFFICE CONSULTATION LVL 4 $165 Not listed in the file $66 – $115.50
Office consultation with a specialist (moderate to high): 10 of 11 insurance plan rates
  • Amerihealth Caritas — Dual Products-FAC: $66
  • Amerihealth Caritas — Dual Products-NONFAC: $66
  • Blue Cross — BCN Medicare Advantage -FAC: $107.25
  • Blue Cross — BCN Medicare Advantage -NONFAC: $107.25
  • Blue Cross — Medicare Plus Blue-FAC: $107.25
  • Blue Cross — Medicare Plus Blue-NONFAC: $107.25
  • HAP — HAP HMO_AHL_Fully-Insured: $82.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-FAC: $82.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-NONFAC: $82.50
  • HAP — Self-Funded: $82.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PREVENTIVE NEW PATIENT 18-39 YRS $248 $154 $68.62 – $197.44
Preventive checkup, new patient, age 18–39: 10 of 53 insurance plan rates
  • Aetna — All Products-NONFAC: $166.79
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $70.38
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $101.36
  • Aetna Better Health — Medicaid HMO-Child-FAC: $70.38
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $101.36
  • Amerihealth Caritas — Dual Products-FAC: $99.20
  • Amerihealth Caritas — Dual Products-NONFAC: $99.20
  • BC3NP — Medicaid HMO: $68.62
  • Blue Cross — BCBSM Commercial: $150.35
  • Blue Cross — BCN Commercial-FAC: $151.52
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39 Not listed in the file Not listed in the file $68.62 – $223.65
Preventive checkup, new patient, age 18–39: rates for 9 insurance plans
  • BC3NP — Medicaid HMO: $68.62
  • BCN — HMO: $126.30
  • Blue Cross — BCBSM Commercial: $126.30
  • Blue Cross — BCBSM GM Connected Care: $199.54
  • Blue Cross — BCN Commercial: $126.30
  • HAP — HAP HMO_AHL_Fully Insured: $195.02
  • HAP — Self-Funded: $223.65
  • Humana Military — Tricare: $85.96
  • Priority Health — Commercial: $212.93
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier P In the file: PR PREVENTIVE NEW PATIENT 18-39 YRS $115 Not listed in the file $46 – $80.50
Preventive checkup, new patient, age 18–39: 10 of 11 insurance plan rates
  • Amerihealth Caritas — Dual Products-FAC: $46
  • Amerihealth Caritas — Dual Products-NONFAC: $46
  • Blue Cross — BCN Medicare Advantage -FAC: $74.75
  • Blue Cross — BCN Medicare Advantage -NONFAC: $74.75
  • Blue Cross — Medicare Plus Blue-FAC: $74.75
  • Blue Cross — Medicare Plus Blue-NONFAC: $74.75
  • HAP — HAP HMO_AHL_Fully-Insured: $57.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-FAC: $57.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-NONFAC: $57.50
  • HAP — Self-Funded: $57.50
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PREVENTIVE NEW PATIENT 40-64 YRS $286 $172 $84.51 – $228.81
Preventive checkup, new patient, age 40–64: 10 of 52 insurance plan rates
  • Aetna — All Products-NONFAC: $192.54
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $86.20
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $119.44
  • Aetna Better Health — Medicaid HMO-Child-FAC: $86.20
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $119.44
  • Amerihealth Caritas — Dual Products-FAC: $114.40
  • Amerihealth Caritas — Dual Products-NONFAC: $114.40
  • BC3NP — Medicaid HMO: $108.06
  • Blue Cross — BCBSM Commercial: $173.27
  • Blue Cross — BCN Commercial-FAC: $174.44
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64 Not listed in the file Not listed in the file $108.06 – $259.19
Preventive checkup, new patient, age 40–64: rates for 9 insurance plans
  • BC3NP — Medicaid HMO: $108.06
  • BCN — HMO: $137.23
  • Blue Cross — BCBSM Commercial: $137.23
  • Blue Cross — BCBSM GM Connected Care: $216.81
  • Blue Cross — BCN Commercial: $137.23
  • HAP — HAP HMO_AHL_Fully Insured: $226.01
  • HAP — Self-Funded: $259.19
  • Humana Military — Tricare: $103.91
  • Priority Health — Commercial: $231.93
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier P In the file: PR PREVENTIVE NEW PATIENT 40-64 YRS $115 Not listed in the file $46 – $80.50
Preventive checkup, new patient, age 40–64: 10 of 11 insurance plan rates
  • Amerihealth Caritas — Dual Products-FAC: $46
  • Amerihealth Caritas — Dual Products-NONFAC: $46
  • Blue Cross — BCN Medicare Advantage -FAC: $74.75
  • Blue Cross — BCN Medicare Advantage -NONFAC: $74.75
  • Blue Cross — Medicare Plus Blue-FAC: $74.75
  • Blue Cross — Medicare Plus Blue-NONFAC: $74.75
  • HAP — HAP HMO_AHL_Fully-Insured: $57.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-FAC: $57.50
  • HAP — Medicare Advantage HMO/PPO-NonPhysician-NONFAC: $57.50
  • HAP — Self-Funded: $57.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LVL III $211 $105 $44.30 – $125.40
Emergency room visit (moderate): 10 of 73 insurance plan rates
  • Aetna — All Products-NONFAC: $93.96
  • Aetna — Medicare Advantage-FAC: $73.73
  • Aetna — Medicare Advantage-NONFAC: $73.73
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $45.19
  • Aetna Better Health — Medicaid HMO-Child-FAC: $45.19
  • Amerihealth Caritas — Dual Products-FAC: $72.26
  • Amerihealth Caritas — Dual Products-NONFAC: $72.26
  • Blue Cross — BCBSM Commercial: $112.38
  • Blue Cross — BCN Commercial-FAC: $112.38
  • Blue Cross — BCN Commercial-NONFAC: $112.38
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LEVEL III (TELHLTH) $211 $105 $44.30 – $125.40
Emergency room visit (moderate): 10 of 73 insurance plan rates
  • Aetna — All Products-NONFAC: $93.96
  • Aetna — Medicare Advantage-FAC: $73.73
  • Aetna — Medicare Advantage-NONFAC: $73.73
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $45.19
  • Aetna Better Health — Medicaid HMO-Child-FAC: $45.19
  • Amerihealth Caritas — Dual Products-FAC: $72.26
  • Amerihealth Caritas — Dual Products-NONFAC: $72.26
  • Blue Cross — BCBSM Commercial: $112.38
  • Blue Cross — BCN Commercial-FAC: $112.38
  • Blue Cross — BCN Commercial-NONFAC: $112.38
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EMERGENCY ROOM VISIT LEVEL 3 $1,068 $375.36 $50.13 – $881.28
Emergency room visit (moderate): 10 of 43 insurance plan rates
  • Aetna — Commercial: $682.99
  • Aetna — Dual Products: $299.20
  • Aetna — Medicare Advantage: $272
  • Aetna Better Health — Medicaid HMO: $148.78
  • Amerihealth Caritas — Dual Products: $266.56
  • BCN — HMO: $562.70
  • Blue Cross — BCBSM Commercial: $562.70
  • Blue Cross — BCBSM GM Connected Care: $576.68
  • Blue Cross — BCN Advantage: $272
  • Blue Cross — BCN Commercial: $562.70
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LVL IV $401 $179 $75.40 – $223.41
Emergency room visit (moderately high): 10 of 73 insurance plan rates
  • Aetna — All Products-NONFAC: $157.89
  • Aetna — Medicare Advantage-FAC: $125.73
  • Aetna — Medicare Advantage-NONFAC: $125.73
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $76.91
  • Aetna Better Health — Medicaid HMO-Child-FAC: $76.91
  • Amerihealth Caritas — Dual Products-FAC: $123.22
  • Amerihealth Caritas — Dual Products-NONFAC: $123.22
  • Blue Cross — BCBSM Commercial: $191.20
  • Blue Cross — BCN Commercial-FAC: $191.74
  • Blue Cross — BCN Commercial-NONFAC: $191.74
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LEVEL IV (TELHLTH) $401 $179 $75.40 – $223.41
Emergency room visit (moderately high): 10 of 73 insurance plan rates
  • Aetna — All Products-NONFAC: $157.89
  • Aetna — Medicare Advantage-FAC: $125.73
  • Aetna — Medicare Advantage-NONFAC: $125.73
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $76.91
  • Aetna Better Health — Medicaid HMO-Child-FAC: $76.91
  • Amerihealth Caritas — Dual Products-FAC: $123.22
  • Amerihealth Caritas — Dual Products-NONFAC: $123.22
  • Blue Cross — BCBSM Commercial: $191.20
  • Blue Cross — BCN Commercial-FAC: $191.74
  • Blue Cross — BCN Commercial-NONFAC: $191.74
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EMERGENCY ROOM VISIT LEVEL 4 $1,731 $573.75 $815.47 – $1,349.31
Emergency room visit (moderately high): 10 of 43 insurance plan rates
  • Aetna — Commercial: $1,106.97
  • Aetna — Dual Products: $457.34
  • Aetna — Medicare Advantage: $415.76
  • Aetna Better Health — Medicaid HMO: $227.41
  • Amerihealth Caritas — Dual Products: $407.44
  • BCN — HMO: $965.42
  • Blue Cross — BCBSM Commercial: $965.42
  • Blue Cross — BCBSM GM Connected Care: $989.41
  • Blue Cross — BCN Advantage: $415.76
  • Blue Cross — BCN Commercial: $965.42
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LVL V $590 $262 $109.27 – $329.07
Emergency room visit (high): 10 of 75 insurance plan rates
  • Aetna — All Products-NONFAC: $230.01
  • Aetna — Medicare Advantage-FAC: $181.58
  • Aetna — Medicare Advantage-NONFAC: $181.58
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $111.46
  • Aetna Better Health — Medicaid HMO-Child-FAC: $111.46
  • Amerihealth Caritas — Dual Products-FAC: $177.95
  • Amerihealth Caritas — Dual Products-NONFAC: $177.95
  • Blue Cross — BCBSM Commercial: $276.95
  • Blue Cross — BCN Commercial-FAC: $278.02
  • Blue Cross — BCN Commercial-NONFAC: $278.02
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPT VISIT LEVEL V (TELHLTH) $590 $262 $109.27 – $329.07
Emergency room visit (high): 10 of 75 insurance plan rates
  • Aetna — All Products-NONFAC: $230.01
  • Aetna — Medicare Advantage-FAC: $181.58
  • Aetna — Medicare Advantage-NONFAC: $181.58
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $111.46
  • Aetna Better Health — Medicaid HMO-Child-FAC: $111.46
  • Amerihealth Caritas — Dual Products-FAC: $177.95
  • Amerihealth Caritas — Dual Products-NONFAC: $177.95
  • Blue Cross — BCBSM Commercial: $276.95
  • Blue Cross — BCN Commercial-FAC: $278.02
  • Blue Cross — BCN Commercial-NONFAC: $278.02
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EMERGENCY ROOM VISIT LEVEL 5 $2,639 $818.88 $1,243.23 – $2,057.10
Emergency room visit (high): 10 of 43 insurance plan rates
  • Aetna — Commercial: $1,687.64
  • Aetna — Dual Products: $652.73
  • Aetna — Medicare Advantage: $593.39
  • Aetna Better Health — Medicaid HMO: $324.57
  • Amerihealth Caritas — Dual Products: $581.52
  • BCN — HMO: $1,393.11
  • Blue Cross — BCBSM Commercial: $1,393.11
  • Blue Cross — BCBSM GM Connected Care: $1,427.73
  • Blue Cross — BCN Advantage: $593.39
  • Blue Cross — BCN Commercial: $1,393.11

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB BASIC METABOLIC PANEL (TOT CA) $56 $11.67 $4.42 – $43.68
Basic metabolic panel (blood test): 10 of 41 insurance plan rates
  • Aetna — Commercial: $14.77
  • Aetna — Dual Products: $9.31
  • Aetna — Medicare Advantage: $8.46
  • Aetna Better Health — Medicaid HMO: $4.51
  • Amerihealth Caritas — Dual Products: $22.40
  • BCN — HMO: $13.24
  • Blue Cross — BCBSM Commercial: $13.24
  • Blue Cross — BCBSM GM Connected Care: $12.78
  • Blue Cross — BCN Advantage: $8.46
  • Blue Cross — BCN Commercial: $13.24
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BASIC METABOLIC PNL TOTAL CA Not listed in the file $11.67 $8.46 – $11.67
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $11.42
  • WellCare — Medicare Advantage: $8.46
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB COMP METABOLIC PROFILE $72 $14.57 $5.52 – $56.16
Comprehensive metabolic panel (blood test): 10 of 41 insurance plan rates
  • Aetna — Commercial: $18.43
  • Aetna — Dual Products: $11.62
  • Aetna — Medicare Advantage: $10.56
  • Aetna Better Health — Medicaid HMO: $5.63
  • Amerihealth Caritas — Dual Products: $28.80
  • BCN — HMO: $23.16
  • Blue Cross — BCBSM Commercial: $23.16
  • Blue Cross — BCBSM GM Connected Care: $22.36
  • Blue Cross — BCN Advantage: $10.56
  • Blue Cross — BCN Commercial: $23.16
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPREHEN METABOLIC PANEL Not listed in the file $14.57 $10.56 – $14.57
Comprehensive metabolic panel (blood test): rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $14.26
  • WellCare — Medicare Advantage: $10.56
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $10.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL Not listed in the file $65.98 $45.42 – $65.98
Obstetric blood test panel: 10 of 36 insurance plan rates
  • Aetna — Commercial: $83.46
  • Aetna — Dual Products: $52.59
  • Aetna — Medicare Advantage: $47.81
  • Aetna Better Health — Medicaid HMO: $25.50
  • BCN — HMO: $65.99
  • Blue Cross — BCBSM Commercial: $65.99
  • Blue Cross — BCBSM GM Connected Care: $63.71
  • Blue Cross — BCN Advantage: $47.81
  • Blue Cross — BCN Commercial: $65.99
  • Blue Cross — Medicare Plus Blue: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB LIPID PROFILE $81 $18.48 $7 – $63.18
Cholesterol panel (lipid panel): 10 of 41 insurance plan rates
  • Aetna — Commercial: $23.37
  • Aetna — Dual Products: $14.73
  • Aetna — Medicare Advantage: $13.39
  • Aetna Better Health — Medicaid HMO: $7.14
  • Amerihealth Caritas — Dual Products: $32.40
  • BCN — HMO: $17.66
  • Blue Cross — BCBSM Commercial: $17.66
  • Blue Cross — BCBSM GM Connected Care: $17.05
  • Blue Cross — BCN Advantage: $13.39
  • Blue Cross — BCN Commercial: $17.66
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: LIPID PANEL Not listed in the file $18.48 $13.39 – $18.48
Cholesterol panel (lipid panel): rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $18.08
  • WellCare — Medicare Advantage: $13.39
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB RENAL FUNCTION PANEL $57 $11.98 $4.54 – $30.53
Kidney function panel: 10 of 41 insurance plan rates
  • Aetna — Commercial: $15.16
  • Aetna — Dual Products: $9.55
  • Aetna — Medicare Advantage: $8.68
  • Aetna Better Health — Medicaid HMO: $4.63
  • Amerihealth Caritas — Dual Products: $22.80
  • BCN — HMO: $16.53
  • Blue Cross — BCBSM Commercial: $16.53
  • Blue Cross — BCBSM GM Connected Care: $15.96
  • Blue Cross — BCN Advantage: $8.68
  • Blue Cross — BCN Commercial: $16.53
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: RENAL FUNCTION PANEL Not listed in the file $11.98 $8.68 – $11.98
Kidney function panel: rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $11.72
  • WellCare — Medicare Advantage: $8.68
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB HEPATIC FUNCTN PANEL $54 $11.27 $4.27 – $42.12
Liver function panel: 10 of 41 insurance plan rates
  • Aetna — Commercial: $14.26
  • Aetna — Dual Products: $8.99
  • Aetna — Medicare Advantage: $8.17
  • Aetna Better Health — Medicaid HMO: $4.36
  • Amerihealth Caritas — Dual Products: $21.60
  • BCN — HMO: $11.57
  • Blue Cross — BCBSM Commercial: $11.57
  • Blue Cross — BCBSM GM Connected Care: $11.17
  • Blue Cross — BCN Advantage: $8.17
  • Blue Cross — BCN Commercial: $11.57
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB URINALYSIS AUTO W/ MICROSCOPE $21 $4.37 $1.66 – $16.38
Urine test (automated, with microscope): 10 of 41 insurance plan rates
  • Aetna — Commercial: $5.53
  • Aetna — Dual Products: $3.49
  • Aetna — Medicare Advantage: $3.17
  • Aetna Better Health — Medicaid HMO: $1.69
  • Amerihealth Caritas — Dual Products: $8.40
  • BCN — HMO: $3.63
  • Blue Cross — BCBSM Commercial: $3.63
  • Blue Cross — BCBSM GM Connected Care: $3.50
  • Blue Cross — BCN Advantage: $3.17
  • Blue Cross — BCN Commercial: $3.63
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB URINALYS NONAUTO W/O MICROSCOPE $18 $4.80 $1.82 – $14.04
Urine test (manual, without microscope): 10 of 41 insurance plan rates
  • Aetna — Commercial: $6.08
  • Aetna — Dual Products: $3.83
  • Aetna — Medicare Advantage: $3.48
  • Aetna Better Health — Medicaid HMO: $1.86
  • Amerihealth Caritas — Dual Products: $7.20
  • BCN — HMO: $3.98
  • Blue Cross — BCBSM Commercial: $3.98
  • Blue Cross — BCBSM GM Connected Care: $3.84
  • Blue Cross — BCN Advantage: $3.48
  • Blue Cross — BCN Commercial: $3.98
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB URINALYSIS MACRO AUTO $17 $3.11 $1.18 – $13.26
Urine test (automated, without microscope): 10 of 41 insurance plan rates
  • Aetna — Commercial: $3.93
  • Aetna — Dual Products: $2.48
  • Aetna — Medicare Advantage: $2.25
  • Aetna Better Health — Medicaid HMO: $1.20
  • Amerihealth Caritas — Dual Products: $6.80
  • BCN — HMO: $2.58
  • Blue Cross — BCBSM Commercial: $2.58
  • Blue Cross — BCBSM GM Connected Care: $2.49
  • Blue Cross — BCN Advantage: $2.25
  • Blue Cross — BCN Commercial: $2.58
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: URINALYSIS AUTO W/O SCOPE Not listed in the file $3.11 $2.25 – $3.11
Urine test (automated, without microscope): rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $3.04
  • WellCare — Medicare Advantage: $2.25
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB PSA TOTAL $124 $25.38 $9.62 – $64.68
PSA (prostate specific antigen) blood test: 10 of 41 insurance plan rates
  • Aetna — Commercial: $32.10
  • Aetna — Dual Products: $20.23
  • Aetna — Medicare Advantage: $18.39
  • Aetna Better Health — Medicaid HMO: $9.81
  • Amerihealth Caritas — Dual Products: $49.60
  • BCN — HMO: $21.03
  • Blue Cross — BCBSM Commercial: $21.03
  • Blue Cross — BCBSM GM Connected Care: $20.30
  • Blue Cross — BCN Advantage: $18.39
  • Blue Cross — BCN Commercial: $21.03
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB THYROID STIM HORMONE-TSH $113 $23.18 $8.79 – $73.43
Thyroid stimulating hormone (TSH) test: 10 of 41 insurance plan rates
  • Aetna — Commercial: $29.33
  • Aetna — Dual Products: $18.48
  • Aetna — Medicare Advantage: $16.80
  • Aetna Better Health — Medicaid HMO: $8.96
  • Amerihealth Caritas — Dual Products: $45.20
  • BCN — HMO: $19.21
  • Blue Cross — BCBSM Commercial: $19.21
  • Blue Cross — BCBSM GM Connected Care: $18.55
  • Blue Cross — BCN Advantage: $16.80
  • Blue Cross — BCN Commercial: $19.21
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: ASSAY THYROID STIM HORMONE Not listed in the file $23.18 $16.80 – $23.18
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $22.68
  • WellCare — Medicare Advantage: $16.80
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB CBC AUTO & AUTO DIFF WBC $52 $10.72 $4.06 – $34.09
Complete blood count (CBC) with differential: 10 of 41 insurance plan rates
  • Aetna — Commercial: $13.56
  • Aetna — Dual Products: $8.55
  • Aetna — Medicare Advantage: $7.77
  • Aetna Better Health — Medicaid HMO: $4.14
  • Amerihealth Caritas — Dual Products: $20.80
  • BCN — HMO: $8.89
  • Blue Cross — BCBSM Commercial: $8.89
  • Blue Cross — BCBSM GM Connected Care: $8.58
  • Blue Cross — BCN Advantage: $7.77
  • Blue Cross — BCN Commercial: $8.89
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPLETE CBC W/AUTO DIFF WBC Not listed in the file $10.72 $7.77 – $10.72
Complete blood count (CBC) with differential: rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $10.49
  • WellCare — Medicare Advantage: $7.77
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB CBC INCL PLATELETS $43 $8.93 $3.38 – $22.75
Complete blood count (CBC), automated: 10 of 41 insurance plan rates
  • Aetna — Commercial: $11.30
  • Aetna — Dual Products: $7.12
  • Aetna — Medicare Advantage: $6.47
  • Aetna Better Health — Medicaid HMO: $3.45
  • Amerihealth Caritas — Dual Products: $17.20
  • BCN — HMO: $7.40
  • Blue Cross — BCBSM Commercial: $7.40
  • Blue Cross — BCBSM GM Connected Care: $7.14
  • Blue Cross — BCN Advantage: $6.47
  • Blue Cross — BCN Commercial: $7.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB PROTHROMBIN TIME $25 $5.92 $2.24 – $19.50
Blood clotting time test (prothrombin time, PT): 10 of 41 insurance plan rates
  • Aetna — Commercial: $7.50
  • Aetna — Dual Products: $4.72
  • Aetna — Medicare Advantage: $4.29
  • Aetna Better Health — Medicaid HMO: $2.29
  • Amerihealth Caritas — Dual Products: $10
  • BCN — HMO: $4.91
  • Blue Cross — BCBSM Commercial: $4.91
  • Blue Cross — BCBSM GM Connected Care: $4.74
  • Blue Cross — BCN Advantage: $4.29
  • Blue Cross — BCN Commercial: $4.91
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: PROTHROMBIN TIME Not listed in the file $5.92 $4.29 – $5.92
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans
  • Meridian — Ambetter From Meridian: $5.79
  • WellCare — Medicare Advantage: $4.29
  • WellCare — Wellcare Meridian Dual Align (HMO D-SNP): $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB LAB PART THROMBOPLASTIN (PTT) $57 $8.29 $3.14 – $37.59
Blood clotting test (partial thromboplastin time, PTT): 10 of 41 insurance plan rates
  • Aetna — Commercial: $10.49
  • Aetna — Dual Products: $6.61
  • Aetna — Medicare Advantage: $6.01
  • Aetna Better Health — Medicaid HMO: $3.21
  • Amerihealth Caritas — Dual Products: $22.80
  • BCN — HMO: $6.88
  • Blue Cross — BCBSM Commercial: $6.88
  • Blue Cross — BCBSM GM Connected Care: $6.64
  • Blue Cross — BCN Advantage: $6.01
  • Blue Cross — BCN Commercial: $6.88

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB CT HEAD / BRAIN W/O CONTRST $1,327 $143.75 $44.21 – $1,534
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $264.44
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $166.48
  • Blue Cross — BCBSM Commercial: $166.48
  • Blue Cross — BCBSM GM Connected Care: $160.71
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $166.48
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR CT HEAD/BRAIN W/O CONTRAST $157 $55.49 $25.13 – $66.23
CT scan of the head or brain, without contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $64.73
  • Aetna — Medicare Advantage-FAC: $40.21
  • Aetna — Medicare Advantage-NONFAC: $40.21
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $25.63
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $25.63
  • Aetna Better Health — Medicaid HMO-Child-FAC: $25.63
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $25.63
  • Amerihealth Caritas — Dual Products-FAC: $39.41
  • Amerihealth Caritas — Dual Products-NONFAC: $39.41
  • Blue Cross — BCBSM Commercial: $63.38
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB MRI BRAIN/STEM W&W/O CONTRST $4,982 $479.72 $139.43 – $1,899
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $850.44
  • Aetna — Dual Products: $382.38
  • Aetna — Medicare Advantage: $347.62
  • Aetna Better Health — Medicaid HMO: $190.14
  • Amerihealth Caritas — Dual Products: $340.67
  • BCN — HMO: $525.43
  • Blue Cross — BCBSM Commercial: $525.43
  • Blue Cross — BCBSM GM Connected Care: $507.24
  • Blue Cross — BCN Advantage: $347.62
  • Blue Cross — BCN Commercial: $525.43
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR MRI BRAIN STEM COMBO $420 $148.03 $67.10 – $178.82
MRI of the brain, before and after contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $174.85
  • Aetna — Medicare Advantage-FAC: $107.27
  • Aetna — Medicare Advantage-NONFAC: $107.27
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $68.44
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $68.44
  • Aetna Better Health — Medicaid HMO-Child-FAC: $68.44
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $68.44
  • Amerihealth Caritas — Dual Products-FAC: $105.12
  • Amerihealth Caritas — Dual Products-NONFAC: $105.12
  • Blue Cross — BCBSM Commercial: $170.96
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB X-RAY CHEST 2 VWS $258 $119.66 $15.29 – $159.55
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $61.43
  • Aetna — Dual Products: $95.38
  • Aetna — Medicare Advantage: $86.71
  • Aetna Better Health — Medicaid HMO: $47.43
  • Amerihealth Caritas — Dual Products: $84.98
  • BCN — HMO: $56.84
  • Blue Cross — BCBSM Commercial: $56.84
  • Blue Cross — BCBSM GM Connected Care: $54.88
  • Blue Cross — BCN Advantage: $86.71
  • Blue Cross — BCN Commercial: $56.84
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB X-RAY CHEST EXAM 2 VIEWS IN HOME $308 $119.66 $15.29 – $159.55
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $61.43
  • Aetna — Dual Products: $95.38
  • Aetna — Medicare Advantage: $86.71
  • Aetna Better Health — Medicaid HMO: $47.43
  • Amerihealth Caritas — Dual Products: $84.98
  • BCN — HMO: $56.84
  • Blue Cross — BCBSM Commercial: $56.84
  • Blue Cross — BCBSM GM Connected Care: $54.88
  • Blue Cross — BCN Advantage: $86.71
  • Blue Cross — BCN Commercial: $56.84
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR X-RAY CHEST EXAM 2 VIEWS $40 $14.02 $6.39 – $17.12
Chest X-ray, 2 views: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $15.44
  • Aetna — Medicare Advantage-FAC: $10.16
  • Aetna — Medicare Advantage-NONFAC: $10.16
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $6.52
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $6.52
  • Aetna Better Health — Medicaid HMO-Child-FAC: $6.52
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $6.52
  • Amerihealth Caritas — Dual Products-FAC: $9.96
  • Amerihealth Caritas — Dual Products-NONFAC: $9.96
  • Blue Cross — BCBSM Commercial: $16.51
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB X-RAY SPINE LUMBOSACRAL 4+ VWS $348 $143.75 $34.84 – $239.59
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $102.56
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $95.83
  • Blue Cross — BCBSM Commercial: $95.83
  • Blue Cross — BCBSM GM Connected Care: $92.52
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $95.83
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB X-RAY SPINE LUMBOSACRAL 4+ VWS IN HOME $398 $143.75 $26.90 – $191.67
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $102.56
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $95.83
  • Blue Cross — BCBSM Commercial: $95.83
  • Blue Cross — BCBSM GM Connected Care: $92.52
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $95.83
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR X-RAY LUMBAR SPINE 4 VW $58 $17.97 $8.09 – $20.97
X-ray of the lower spine, at least 4 views: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $18.39
  • Aetna — Medicare Advantage-FAC: $13.02
  • Aetna — Medicare Advantage-NONFAC: $13.02
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $8.25
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $8.25
  • Aetna Better Health — Medicaid HMO-Child-FAC: $8.25
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $8.25
  • Amerihealth Caritas — Dual Products-FAC: $12.76
  • Amerihealth Caritas — Dual Products-NONFAC: $12.76
  • Blue Cross — BCBSM Commercial: $19.71
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB MRI LUMBAR SPINE W/O CONTRAST $2,834 $328.08 $109.89 – $546.80
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $488.44
  • Aetna — Dual Products: $261.52
  • Aetna — Medicare Advantage: $237.74
  • Aetna Better Health — Medicaid HMO: $130.04
  • Amerihealth Caritas — Dual Products: $232.99
  • BCN — HMO: $302.92
  • Blue Cross — BCBSM Commercial: $302.92
  • Blue Cross — BCBSM GM Connected Care: $292.43
  • Blue Cross — BCN Advantage: $237.74
  • Blue Cross — BCN Commercial: $302.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR MRI LUMBAR SPINE W/O CONTRAST $275 $96.17 $43.67 – $115.35
MRI of the lower back (lumbar spine), without contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $113.33
  • Aetna — Medicare Advantage-FAC: $69.69
  • Aetna — Medicare Advantage-NONFAC: $69.69
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $44.54
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $44.54
  • Aetna Better Health — Medicaid HMO-Child-FAC: $44.54
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $44.54
  • Amerihealth Caritas — Dual Products-FAC: $68.30
  • Amerihealth Caritas — Dual Products-NONFAC: $68.30
  • Blue Cross — BCBSM Commercial: $111.31
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB CT PELVIS W/ CONTRAST $2,278 $241.18 $98.71 – $401.97
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $673
  • Aetna — Dual Products: $192.25
  • Aetna — Medicare Advantage: $174.77
  • Aetna Better Health — Medicaid HMO: $95.59
  • Amerihealth Caritas — Dual Products: $171.27
  • BCN — HMO: $427.98
  • Blue Cross — BCBSM Commercial: $427.98
  • Blue Cross — BCBSM GM Connected Care: $413.16
  • Blue Cross — BCN Advantage: $174.77
  • Blue Cross — BCN Commercial: $427.98
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR CT PELVIS W/CONTRAST $215 $75.32 $34.08 – $89.95
CT scan of the pelvis, with contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $88.50
  • Aetna — Medicare Advantage-FAC: $54.58
  • Aetna — Medicare Advantage-NONFAC: $54.58
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $34.76
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $34.76
  • Aetna Better Health — Medicaid HMO-Child-FAC: $34.76
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $34.76
  • Amerihealth Caritas — Dual Products-FAC: $53.49
  • Amerihealth Caritas — Dual Products-NONFAC: $53.49
  • Blue Cross — BCBSM Commercial: $86.81
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB MRI JNT LOW EXTRM W/O CONTRAST $2,940 $328.08 $93.24 – $1,899
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $555.44
  • Aetna — Dual Products: $261.52
  • Aetna — Medicare Advantage: $237.74
  • Aetna Better Health — Medicaid HMO: $130.04
  • Amerihealth Caritas — Dual Products: $232.99
  • BCN — HMO: $347.58
  • Blue Cross — BCBSM Commercial: $347.58
  • Blue Cross — BCBSM GM Connected Care: $335.54
  • Blue Cross — BCN Advantage: $237.74
  • Blue Cross — BCN Commercial: $347.58
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR MRI LOWER EXTREM JT $251 $88.07 $40.04 – $105.41
MRI of a leg joint (such as the knee), without contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $103.58
  • Aetna — Medicare Advantage-FAC: $63.82
  • Aetna — Medicare Advantage-NONFAC: $63.82
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $40.84
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $40.84
  • Aetna Better Health — Medicaid HMO-Child-FAC: $40.84
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $40.84
  • Amerihealth Caritas — Dual Products-FAC: $62.54
  • Amerihealth Caritas — Dual Products-NONFAC: $62.54
  • Blue Cross — BCBSM Commercial: $101.73
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB CT ABDOMEN & PELVIS W/CONTRAST $3,981 $479.72 $142.32 – $1,534
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $877.81
  • Aetna — Dual Products: $382.38
  • Aetna — Medicare Advantage: $347.62
  • Aetna Better Health — Medicaid HMO: $190.14
  • Amerihealth Caritas — Dual Products: $340.67
  • BCN — HMO: $536.81
  • Blue Cross — BCBSM Commercial: $536.81
  • Blue Cross — BCBSM GM Connected Care: $518.22
  • Blue Cross — BCN Advantage: $347.62
  • Blue Cross — BCN Commercial: $536.81
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR CT ABDOMEN & PELVIS W/CONTRAST $530 $118.16 $53.46 – $142.38
CT scan of the abdomen and pelvis, with contrast: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $139.25
  • Aetna — Medicare Advantage-FAC: $85.62
  • Aetna — Medicare Advantage-NONFAC: $85.62
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $54.53
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $54.53
  • Aetna Better Health — Medicaid HMO-Child-FAC: $54.53
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $54.53
  • Amerihealth Caritas — Dual Products-FAC: $83.91
  • Amerihealth Caritas — Dual Products-NONFAC: $83.91
  • Blue Cross — BCBSM Commercial: $135.81
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB US ABDOMEN COMPLETE $783 $143.75 $58.84 – $239.59
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • Aetna — Commercial: $207.57
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $188.40
  • Blue Cross — BCBSM Commercial: $188.40
  • Blue Cross — BCBSM GM Connected Care: $181.88
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $188.40
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB US ABDOMEN COMPLETE IN HOME $833 $143.75 $58.84 – $239.59
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • Aetna — Commercial: $207.57
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $188.40
  • Blue Cross — BCBSM Commercial: $188.40
  • Blue Cross — BCBSM GM Connected Care: $181.88
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $188.40
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR US ABDOMEN B-SCAN &/OR REAL TIME COMPLETE $148 $52.43 $23.86 – $62.93
Ultrasound of the abdomen, complete: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $56.79
  • Aetna — Medicare Advantage-FAC: $37.99
  • Aetna — Medicare Advantage-NONFAC: $37.99
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $24.34
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $24.34
  • Aetna Better Health — Medicaid HMO-Child-FAC: $24.34
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $24.34
  • Amerihealth Caritas — Dual Products-FAC: $37.23
  • Amerihealth Caritas — Dual Products-NONFAC: $37.23
  • Blue Cross — BCBSM Commercial: $60.18
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB US >= 14 WKS COMPLETE $827 $143.75 $58.84 – $239.59
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • Aetna — Commercial: $234.01
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $211.96
  • Blue Cross — BCBSM Commercial: $211.96
  • Blue Cross — BCBSM GM Connected Care: $204.62
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $211.96
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB US >= 14 WKS COMPLETE IN HOME $877 $143.75 $58.84 – $239.59
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • Aetna — Commercial: $234.01
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $211.96
  • Blue Cross — BCBSM Commercial: $211.96
  • Blue Cross — BCBSM GM Connected Care: $204.62
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $211.96
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR US OB =>14 WKS SINGLE FETUS $186 $65.94 $30.03 – $77.83
Pregnancy ultrasound (after the first trimester): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $70.11
  • Aetna — Medicare Advantage-FAC: $47.78
  • Aetna — Medicare Advantage-NONFAC: $47.78
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $30.63
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $30.63
  • Aetna Better Health — Medicaid HMO-Child-FAC: $30.63
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $30.63
  • Amerihealth Caritas — Dual Products-FAC: $46.82
  • Amerihealth Caritas — Dual Products-NONFAC: $46.82
  • Blue Cross — BCBSM Commercial: $74.56
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB US TRANSVAGINAL $739 $143.75 $55.86 – $315.58
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • Aetna — Commercial: $229.47
  • Aetna — Dual Products: $114.59
  • Aetna — Medicare Advantage: $104.17
  • Aetna Better Health — Medicaid HMO: $56.98
  • Amerihealth Caritas — Dual Products: $102.09
  • BCN — HMO: $207.08
  • Blue Cross — BCBSM Commercial: $207.08
  • Blue Cross — BCBSM GM Connected Care: $199.91
  • Blue Cross — BCN Advantage: $104.17
  • Blue Cross — BCN Commercial: $207.08
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR US TRANSVAGINAL NON-OB $128 $45.55 $20.66 – $54.09
Transvaginal ultrasound: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $49.30
  • Aetna — Medicare Advantage-FAC: $33.01
  • Aetna — Medicare Advantage-NONFAC: $33.01
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $21.07
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $21.07
  • Aetna Better Health — Medicaid HMO-Child-FAC: $21.07
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $21.07
  • Amerihealth Caritas — Dual Products-FAC: $32.35
  • Amerihealth Caritas — Dual Products-NONFAC: $32.35
  • Blue Cross — BCBSM Commercial: $51.66
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB DIAGNOSTIC MAMMOGRAM CAD UNILAT $410 $115.09 $77.60 – $201.73
Diagnostic mammogram, one breast: 10 of 41 insurance plan rates
  • Aetna — Commercial: $229.47
  • Aetna — Dual Products: $184.92
  • Aetna — Medicare Advantage: $168.11
  • Aetna Better Health — Medicaid HMO: $44.49
  • Amerihealth Caritas — Dual Products: $164
  • BC3NP — Medicaid HMO: $81.01
  • BCN — HMO: $213.58
  • Blue Cross — BCBSM Commercial: $213.58
  • Blue Cross — BCBSM GM Connected Care: $206.18
  • Blue Cross — BCN Advantage: $168.11
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR DIAGNOSTIC MAMMOGRAM CAD UNILAT $120 $53.20 $24.07 – $62.93
Diagnostic mammogram, one breast: 10 of 83 insurance plan rates
  • Aetna — All Products-NONFAC: $56.79
  • Aetna — Medicare Advantage-FAC: $38.55
  • Aetna — Medicare Advantage-NONFAC: $38.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $24.55
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $24.55
  • Aetna Better Health — Medicaid HMO-Child-FAC: $24.55
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $24.55
  • Amerihealth Caritas — Dual Products-FAC: $37.78
  • Amerihealth Caritas — Dual Products-NONFAC: $37.78
  • BC3NP — Medicaid HMO: $36.68
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB DIAGNOSTIC MAMMOGRAPM CAD BILAT $469 $147.89 $98.73 – $255.70
Diagnostic mammogram, both breasts: 10 of 41 insurance plan rates
  • Aetna — Commercial: $292.48
  • Aetna — Dual Products: $234.39
  • Aetna — Medicare Advantage: $213.08
  • Aetna Better Health — Medicaid HMO: $57.17
  • Amerihealth Caritas — Dual Products: $187.60
  • BC3NP — Medicaid HMO: $103.11
  • BCN — HMO: $272.05
  • Blue Cross — BCBSM Commercial: $272.05
  • Blue Cross — BCBSM GM Connected Care: $262.63
  • Blue Cross — BCN Advantage: $213.08
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR DIAGNOSTIC MAMMOGRAPM CAD BILAT $185 $65.40 $29.61 – $77.28
Diagnostic mammogram, both breasts: 10 of 83 insurance plan rates
  • Aetna — All Products-NONFAC: $69.69
  • Aetna — Medicare Advantage-FAC: $47.39
  • Aetna — Medicare Advantage-NONFAC: $47.39
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $30.20
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $30.20
  • Aetna Better Health — Medicaid HMO-Child-FAC: $30.20
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $30.20
  • Amerihealth Caritas — Dual Products-FAC: $46.44
  • Amerihealth Caritas — Dual Products-NONFAC: $46.44
  • BC3NP — Medicaid HMO: $44.91
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB SCREEN MAMMOGRAM CAD BILAT 2-VWS EA BREAST $393 $121.76 $81.49 – $206.81
Screening mammogram, both breasts: 10 of 41 insurance plan rates
  • Aetna — Commercial: $242.58
  • Aetna — Dual Products: $189.57
  • Aetna — Medicare Advantage: $172.34
  • Aetna Better Health — Medicaid HMO: $47.06
  • Amerihealth Caritas — Dual Products: $157.20
  • BC3NP — Medicaid HMO: $85.15
  • BCN — HMO: $224.95
  • Blue Cross — BCBSM Commercial: $224.95
  • Blue Cross — BCBSM GM Connected Care: $217.16
  • Blue Cross — BCN Advantage: $172.34
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB SCREEN MAMMOGRAM UNILAT INCL CAD WHEN PERFORMED (MOD52) $374 $121.76 $81.49 – $206.81
Screening mammogram, both breasts: 10 of 41 insurance plan rates
  • Aetna — Commercial: $242.58
  • Aetna — Dual Products: $189.57
  • Aetna — Medicare Advantage: $172.34
  • Aetna Better Health — Medicaid HMO: $47.06
  • Amerihealth Caritas — Dual Products: $149.60
  • BC3NP — Medicaid HMO: $85.15
  • BCN — HMO: $224.95
  • Blue Cross — BCBSM Commercial: $224.95
  • Blue Cross — BCBSM GM Connected Care: $217.16
  • Blue Cross — BCN Advantage: $172.34
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR SCREEN MAMMOGRAM CAD BILAT 2-VWS EA BREAST $139 $49.22 $22.37 – $59.60
Screening mammogram, both breasts: 10 of 83 insurance plan rates
  • Aetna — All Products-NONFAC: $53.79
  • Aetna — Medicare Advantage-FAC: $35.67
  • Aetna — Medicare Advantage-NONFAC: $35.67
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $22.82
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $22.82
  • Aetna Better Health — Medicaid HMO-Child-FAC: $22.82
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $22.82
  • Amerihealth Caritas — Dual Products-FAC: $34.96
  • Amerihealth Caritas — Dual Products-NONFAC: $34.96
  • BC3NP — Medicaid HMO: $34.78

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE Not listed in the file $21.40 $17.71 – $60.83
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans
  • Aetna — Commercial: $44.32
  • BCN — HMO: $17.71
  • Blue Cross — BCBSM Commercial: $17.71
  • Blue Cross — BCBSM GM Connected Care: $27.99
  • Blue Cross — BCN Commercial: $17.71
  • HAP — HAP HMO_AHL_Fully Insured: $29
  • HAP — Self-Funded: $33.26
  • Humana Military — Tricare: $13.14
  • Priority Health — Commercial: $60.83
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB CATH LT HEART W/INJ FOR LV GRAM $6,388 $4,457.77 $551.61 – $10,266
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,853
  • Aetna — Dual Products: $3,553.30
  • Aetna — Medicare Advantage: $3,230.27
  • Aetna Better Health — Medicaid HMO: $1,766.90
  • Amerihealth Caritas — Dual Products: $3,165.66
  • BCN — HMO: $1,756.76
  • Blue Cross — BCBSM Commercial: $1,756.76
  • Blue Cross — BCBSM GM Connected Care: $2,775.54
  • Blue Cross — BCN Advantage: $3,230.27
  • Blue Cross — BCN Commercial: $1,756.76
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR LEFT HEART CATH W/VENTRICULOGRAPHY $810 $343.14 $147.40 – $527.92
Left heart catheterization (diagnostic): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $387.83
  • Aetna — Medicare Advantage-FAC: $248.65
  • Aetna — Medicare Advantage-NONFAC: $248.65
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $150.35
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $150.35
  • Aetna Better Health — Medicaid HMO-Child-FAC: $150.35
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $150.35
  • Amerihealth Caritas — Dual Products-FAC: $243.68
  • Amerihealth Caritas — Dual Products-NONFAC: $243.68
  • Blue Cross — BCBSM Commercial: $366.96
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EP COMP RT AV W/O ARRHYTHMIA $12,683 $10,724.84 $4,064.56 – $17,874.73
Heart rhythm study (electrophysiology evaluation): 10 of 41 insurance plan rates
  • Aetna — Commercial: $6,853
  • Aetna — Dual Products: $8,548.78
  • Aetna — Medicare Advantage: $7,771.62
  • Aetna Better Health — Medicaid HMO: $4,250.93
  • Amerihealth Caritas — Dual Products: $7,616.19
  • BCN — HMO: $12,683
  • Blue Cross — BCBSM Commercial: $12,683
  • Blue Cross — BCBSM GM Connected Care: $12,683
  • Blue Cross — BCN Advantage: $7,771.62
  • Blue Cross — BCN Commercial: $12,683
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $1,553 $555.70 $239.63 – $866.85
Heart rhythm study (electrophysiology evaluation): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $636.16
  • Aetna — Medicare Advantage-FAC: $402.68
  • Aetna — Medicare Advantage-NONFAC: $402.68
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $244.42
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $244.42
  • Aetna Better Health — Medicaid HMO-Child-FAC: $244.42
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $244.42
  • Amerihealth Caritas — Dual Products-FAC: $394.63
  • Amerihealth Caritas — Dual Products-NONFAC: $394.63
  • Blue Cross — BCBSM Commercial: $596.51
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR CMPRHENSV EP EVAL INCL TRANSEPT CATH ATRIAL FIB W/PULM VEIN $3,870 $1,230.88 $514.40 – $1,821.04
Heart rhythm study with ablation for atrial fibrillation: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $1,581.38
  • Aetna — Medicare Advantage-FAC: $891.94
  • Aetna — Medicare Advantage-NONFAC: $891.94
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $524.69
  • Aetna Better Health — Medicaid HMO-Child-FAC: $524.69
  • Amerihealth Caritas — Dual Products-FAC: $874.10
  • Amerihealth Caritas — Dual Products-NONFAC: $874.10
  • Blue Cross — BCBSM Commercial: $1,474.77
  • Blue Cross — BCN Commercial-FAC: $1,476.37
  • Blue Cross — BCN Commercial-NONFAC: $1,476.37
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB COMPREHENSIVE EPHYS EVAL TRNSPTL TX ATRIAL FIB W/ISOLATED PUL $19,889 $35,940.54 $606.42 – $47,920.72
Heart rhythm study with ablation for atrial fibrillation: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,853
  • Aetna — Dual Products: $28,648.25
  • Aetna — Medicare Advantage: $26,043.87
  • Aetna Better Health — Medicaid HMO: $14,245.51
  • Amerihealth Caritas — Dual Products: $25,522.99
  • BCN — HMO: $646.74
  • Blue Cross — BCBSM Commercial: $646.74
  • Blue Cross — BCBSM GM Connected Care: $1,021.80
  • Blue Cross — BCN Advantage: $26,043.87
  • Blue Cross — BCN Commercial: $646.74
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB POLYSMGM 4+ PARMTR ATTNDED $3,173 $1,180.80 $366.02 – $1,788.78
Sleep study (overnight, in a sleep lab): 10 of 42 insurance plan rates
  • Aetna — Commercial: $959.30
  • Aetna — Dual Products: $941.22
  • Aetna — Medicare Advantage: $855.65
  • Aetna Better Health — Medicaid HMO: $468.03
  • Amerihealth Caritas — Dual Products: $838.54
  • BCN — HMO: $1,132.19
  • Blue Cross — BCBSM Commercial: $1,132.19
  • Blue Cross — BCBSM GM Connected Care: $1,788.78
  • Blue Cross — BCN Advantage: $855.65
  • Blue Cross — BCN Commercial: $1,132.19
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR POLYSOMNOGRAPHY =>PARAM $380 $166.83 $76.25 – $240.02
Sleep study (overnight, in a sleep lab): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $165.64
  • Aetna — Medicare Advantage-FAC: $120.89
  • Aetna — Medicare Advantage-NONFAC: $120.89
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $77.78
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $77.78
  • Aetna Better Health — Medicaid HMO-Child-FAC: $77.78
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $77.78
  • Amerihealth Caritas — Dual Products-FAC: $118.47
  • Amerihealth Caritas — Dual Products-NONFAC: $118.47
  • Blue Cross — BCBSM Commercial: $145.74

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR THERAPEUTIC EXERCISE EA 15 MIN $111 $39.76 $18.53 – $46.29
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 67 insurance plan rates
  • Aetna — All Products-NONFAC: $27.86
  • Aetna — Medicare Advantage-FAC: $28.81
  • Aetna — Medicare Advantage-NONFAC: $28.81
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $18.90
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $18.90
  • Amerihealth Caritas — Dual Products-FAC: $28.23
  • Amerihealth Caritas — Dual Products-NONFAC: $28.23
  • Blue Cross — BCBSM Commercial: $31.42
  • Blue Cross — BCN Commercial-FAC: $31.77
  • Blue Cross — BCN Commercial-NONFAC: $31.77
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT THERAPEUTIC EXERCISE EA 15 MIN $118 $39.76 $47.20 – $91.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 40 insurance plan rates
  • Aetna — Commercial: $75.46
  • Aetna — Dual Products: $41.04
  • Aetna — Medicare Advantage: $37.31
  • Aetna Better Health — Medicaid HMO: $15.37
  • Amerihealth Caritas — Dual Products: $47.20
  • BCN — HMO: $48.33
  • Blue Cross — BCBSM Commercial: $48.33
  • Blue Cross — BCBSM GM Connected Care: $44.97
  • Blue Cross — BCN Advantage: $37.31
  • Blue Cross — BCN Commercial: $48.33
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB OT THERAPEUTIC EXERCISE EA 15 MIN $118 $39.76 $26.56 – $44.77
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 40 insurance plan rates
  • Aetna — Commercial: $75.46
  • Aetna — Dual Products: $41.04
  • Aetna — Medicare Advantage: $37.31
  • Aetna Better Health — Medicaid HMO: $15.37
  • Amerihealth Caritas — Dual Products: $47.20
  • BCN — HMO: $48.33
  • Blue Cross — BCBSM Commercial: $48.33
  • Blue Cross — BCBSM GM Connected Care: $44.97
  • Blue Cross — BCN Advantage: $37.31
  • Blue Cross — BCN Commercial: $48.33
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL/LOW COMPLEXITY $300 $133.14 $90.56 – $151.72
Physical therapy evaluation (low complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $191.85
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $120
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL LOW COMPLEX 20 MIN (VIDEO) $300 $133.14 $90.56 – $151.72
Physical therapy evaluation (low complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $191.85
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $120
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL/ MOD COMPLEXITY $338 $133.14 $90.56 – $151.72
Physical therapy evaluation (moderate complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $216.15
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $135.20
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL MOD COMPLEX 30 MIN (VIDEO) $338 $133.14 $90.56 – $151.72
Physical therapy evaluation (moderate complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $216.15
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $135.20
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL/ HIGH COMPLEXITY $377 $133.14 $90.56 – $151.72
Physical therapy evaluation (high complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $241.09
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $150.80
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB PT EVAL HIGH COMPLEX 45 MIN (VIDEO) $377 $133.14 $90.56 – $151.72
Physical therapy evaluation (high complexity): 10 of 40 insurance plan rates
  • Aetna — Commercial: $241.09
  • Aetna — Dual Products: $139.07
  • Aetna — Medicare Advantage: $126.43
  • Aetna Better Health — Medicaid HMO: $51.47
  • Amerihealth Caritas — Dual Products: $150.80
  • BCN — HMO: $142.79
  • Blue Cross — BCBSM Commercial: $142.79
  • Blue Cross — BCBSM GM Connected Care: $132.85
  • Blue Cross — BCN Advantage: $126.43
  • Blue Cross — BCN Commercial: $142.79
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY PATIENT 30 MINUTES $112 $95.98 $44.30 – $134.98
Psychotherapy, 30 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $107.84
  • Aetna — Medicare Advantage-FAC: $69.55
  • Aetna — Medicare Advantage-NONFAC: $85.34
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $45.19
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $55.83
  • Aetna Better Health — Medicaid HMO-Child-FAC: $47.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $58.09
  • Amerihealth Caritas — Dual Products-FAC: $68.16
  • Amerihealth Caritas — Dual Products-NONFAC: $83.63
  • Blue Cross — BCBSM Commercial: $98.70
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCH THERAPY PATIENT 30 MIN (HFWY) $112 $95.98 $44.30 – $134.98
Psychotherapy, 30 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $107.84
  • Aetna — Medicare Advantage-FAC: $69.55
  • Aetna — Medicare Advantage-NONFAC: $85.34
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $45.19
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $55.83
  • Aetna Better Health — Medicaid HMO-Child-FAC: $47.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $58.09
  • Amerihealth Caritas — Dual Products-FAC: $68.16
  • Amerihealth Caritas — Dual Products-NONFAC: $83.63
  • Blue Cross — BCBSM Commercial: $98.70
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SA PSYCH THERAPY PATIENT 30 MIN $112 $95.98 $44.30 – $134.98
Psychotherapy, 30 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $107.84
  • Aetna — Medicare Advantage-FAC: $69.55
  • Aetna — Medicare Advantage-NONFAC: $85.34
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $45.19
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $55.83
  • Aetna Better Health — Medicaid HMO-Child-FAC: $47.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $58.09
  • Amerihealth Caritas — Dual Products-FAC: $68.16
  • Amerihealth Caritas — Dual Products-NONFAC: $83.63
  • Blue Cross — BCBSM Commercial: $98.70
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY PATIENT 45 MINUTES $163 $127.11 $58.58 – $179.36
Psychotherapy, 45 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.88
  • Aetna — Medicare Advantage-FAC: $92.11
  • Aetna — Medicare Advantage-NONFAC: $113.39
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $59.75
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $74.08
  • Aetna Better Health — Medicaid HMO-Child-FAC: $63.17
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $77.08
  • Amerihealth Caritas — Dual Products-FAC: $90.27
  • Amerihealth Caritas — Dual Products-NONFAC: $111.12
  • Blue Cross — BCBSM Commercial: $130.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCH THERAPY PATIENT 45 MIN (HFWY) $163 $127.11 $58.58 – $179.36
Psychotherapy, 45 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.88
  • Aetna — Medicare Advantage-FAC: $92.11
  • Aetna — Medicare Advantage-NONFAC: $113.39
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $59.75
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $74.08
  • Aetna Better Health — Medicaid HMO-Child-FAC: $63.17
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $77.08
  • Amerihealth Caritas — Dual Products-FAC: $90.27
  • Amerihealth Caritas — Dual Products-NONFAC: $111.12
  • Blue Cross — BCBSM Commercial: $130.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SA PSYCH THERAPY W/PATIENT 45 MIN $163 $127.11 $58.58 – $179.36
Psychotherapy, 45 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.88
  • Aetna — Medicare Advantage-FAC: $92.11
  • Aetna — Medicare Advantage-NONFAC: $113.39
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $59.75
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $74.08
  • Aetna Better Health — Medicaid HMO-Child-FAC: $63.17
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $77.08
  • Amerihealth Caritas — Dual Products-FAC: $90.27
  • Amerihealth Caritas — Dual Products-NONFAC: $111.12
  • Blue Cross — BCBSM Commercial: $130.20
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY PATIENT 60 MINUTES $306 $186.91 $86.27 – $263.15
Psychotherapy, 60 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $209.94
  • Aetna — Medicare Advantage-FAC: $135.44
  • Aetna — Medicare Advantage-NONFAC: $166.06
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $88
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $108.63
  • Aetna Better Health — Medicaid HMO-Child-FAC: $93
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $113.03
  • Amerihealth Caritas — Dual Products-FAC: $132.73
  • Amerihealth Caritas — Dual Products-NONFAC: $162.74
  • Blue Cross — BCBSM Commercial: $191.94
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCH THERAPY PATIENT 60 MIN (HFWY) $306 $186.91 $86.27 – $263.15
Psychotherapy, 60 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $209.94
  • Aetna — Medicare Advantage-FAC: $135.44
  • Aetna — Medicare Advantage-NONFAC: $166.06
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $88
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $108.63
  • Aetna Better Health — Medicaid HMO-Child-FAC: $93
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $113.03
  • Amerihealth Caritas — Dual Products-FAC: $132.73
  • Amerihealth Caritas — Dual Products-NONFAC: $162.74
  • Blue Cross — BCBSM Commercial: $191.94
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SA PSYCH THERAPY PATIENT 60 MIN $225 $186.91 $86.27 – $263.15
Psychotherapy, 60 minutes: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $209.94
  • Aetna — Medicare Advantage-FAC: $135.44
  • Aetna — Medicare Advantage-NONFAC: $166.06
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $88
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $108.63
  • Aetna Better Health — Medicaid HMO-Child-FAC: $93
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $113.03
  • Amerihealth Caritas — Dual Products-FAC: $132.73
  • Amerihealth Caritas — Dual Products-NONFAC: $162.74
  • Blue Cross — BCBSM Commercial: $191.94
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/O PT 50 MINS $193 $137.52 $68.87 – $194.07
Family psychotherapy, without the patient: 10 of 70 insurance plan rates
  • Aetna — All Products-NONFAC: $137.09
  • Aetna — Medicare Advantage-FAC: $99.65
  • Aetna — Medicare Advantage-NONFAC: $106.10
  • Amerihealth Caritas — Dual Products-FAC: $97.66
  • Amerihealth Caritas — Dual Products-NONFAC: $103.98
  • Blue Cross — BCBSM Commercial: $156.05
  • Blue Cross — BCN Commercial-FAC: $161.91
  • Blue Cross — BCN Commercial-NONFAC: $162.44
  • Blue Cross — BCN Medicare Advantage -FAC: $99.65
  • Blue Cross — BCN Medicare Advantage -NONFAC: $106.10
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCH THERAPY W/O PTNT 50 MIN (HFWY) $193 $137.52 $68.87 – $194.07
Family psychotherapy, without the patient: 10 of 70 insurance plan rates
  • Aetna — All Products-NONFAC: $137.09
  • Aetna — Medicare Advantage-FAC: $99.65
  • Aetna — Medicare Advantage-NONFAC: $106.10
  • Amerihealth Caritas — Dual Products-FAC: $97.66
  • Amerihealth Caritas — Dual Products-NONFAC: $103.98
  • Blue Cross — BCBSM Commercial: $156.05
  • Blue Cross — BCN Commercial-FAC: $161.91
  • Blue Cross — BCN Commercial-NONFAC: $162.44
  • Blue Cross — BCN Medicare Advantage -FAC: $99.65
  • Blue Cross — BCN Medicare Advantage -NONFAC: $106.10
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SA FAMILY PSYCHOTHERAPY W/O PT 50 MINS $193 $137.52 $68.87 – $194.07
Family psychotherapy, without the patient: 10 of 70 insurance plan rates
  • Aetna — All Products-NONFAC: $137.09
  • Aetna — Medicare Advantage-FAC: $99.65
  • Aetna — Medicare Advantage-NONFAC: $106.10
  • Amerihealth Caritas — Dual Products-FAC: $97.66
  • Amerihealth Caritas — Dual Products-NONFAC: $103.98
  • Blue Cross — BCBSM Commercial: $156.05
  • Blue Cross — BCN Commercial-FAC: $161.91
  • Blue Cross — BCN Commercial-NONFAC: $162.44
  • Blue Cross — BCN Medicare Advantage -FAC: $99.65
  • Blue Cross — BCN Medicare Advantage -NONFAC: $106.10
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W PT 50 MINS $195 $142.28 $65.60 – $202.22
Family psychotherapy, with the patient: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.83
  • Aetna — Medicare Advantage-FAC: $103.10
  • Aetna — Medicare Advantage-NONFAC: $109.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $66.91
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $71.26
  • Aetna Better Health — Medicaid HMO-Child-FAC: $70.73
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $74.94
  • Amerihealth Caritas — Dual Products-FAC: $101.04
  • Amerihealth Caritas — Dual Products-NONFAC: $107.36
  • Blue Cross — BCBSM Commercial: $128.94
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCH THERAPY W/ PTNT 50 MIN (HFWY) $195 $142.28 $65.60 – $202.22
Family psychotherapy, with the patient: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.83
  • Aetna — Medicare Advantage-FAC: $103.10
  • Aetna — Medicare Advantage-NONFAC: $109.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $66.91
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $71.26
  • Aetna Better Health — Medicaid HMO-Child-FAC: $70.73
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $74.94
  • Amerihealth Caritas — Dual Products-FAC: $101.04
  • Amerihealth Caritas — Dual Products-NONFAC: $107.36
  • Blue Cross — BCBSM Commercial: $128.94
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SA FAMILY PSYCH THERAPY W/PATIENT 50 MIN $195 $142.28 $65.60 – $202.22
Family psychotherapy, with the patient: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $142.83
  • Aetna — Medicare Advantage-FAC: $103.10
  • Aetna — Medicare Advantage-NONFAC: $109.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $66.91
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $71.26
  • Aetna Better Health — Medicaid HMO-Child-FAC: $70.73
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $74.94
  • Amerihealth Caritas — Dual Products-FAC: $101.04
  • Amerihealth Caritas — Dual Products-NONFAC: $107.36
  • Blue Cross — BCBSM Commercial: $128.94
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR GROUP PSYCHOTHERAPY $103 $33.88 $15.55 – $58.78
Group psychotherapy: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $38.39
  • Aetna — Medicare Advantage-FAC: $24.55
  • Aetna — Medicare Advantage-NONFAC: $30.36
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $15.86
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $19.77
  • Aetna Better Health — Medicaid HMO-Child-FAC: $16.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $20.56
  • Amerihealth Caritas — Dual Products-FAC: $24.06
  • Amerihealth Caritas — Dual Products-NONFAC: $29.75
  • Blue Cross — BCBSM Commercial: $34.86
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR DIDACTIC GROUP PSYCHIATRY $103 $33.88 $15.55 – $58.78
Group psychotherapy: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $38.39
  • Aetna — Medicare Advantage-FAC: $24.55
  • Aetna — Medicare Advantage-NONFAC: $30.36
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $15.86
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $19.77
  • Aetna Better Health — Medicaid HMO-Child-FAC: $16.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $20.56
  • Amerihealth Caritas — Dual Products-FAC: $24.06
  • Amerihealth Caritas — Dual Products-NONFAC: $29.75
  • Blue Cross — BCBSM Commercial: $34.86
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR GROUP PSYCH THERAPY (HFWY) $103 $33.88 $15.55 – $58.78
Group psychotherapy: 10 of 97 insurance plan rates
  • Aetna — All Products-NONFAC: $38.39
  • Aetna — Medicare Advantage-FAC: $24.55
  • Aetna — Medicare Advantage-NONFAC: $30.36
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $15.86
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $19.77
  • Aetna Better Health — Medicaid HMO-Child-FAC: $16.77
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $20.56
  • Amerihealth Caritas — Dual Products-FAC: $24.06
  • Amerihealth Caritas — Dual Products-NONFAC: $29.75
  • Blue Cross — BCBSM Commercial: $34.86

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EXCISE BREAST CYST $1,390 $600.60 $260.07 – $916.22
Removal of breast growth (open surgery): 10 of 83 insurance plan rates
  • Aetna — All Products-NONFAC: $761.71
  • Aetna — Medicare Advantage-FAC: $435.22
  • Aetna — Medicare Advantage-NONFAC: $594.76
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $265.27
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $372.82
  • Aetna Better Health — Medicaid HMO-Child-FAC: $265.27
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $372.82
  • Amerihealth Caritas — Dual Products-FAC: $426.52
  • Amerihealth Caritas — Dual Products-NONFAC: $582.86
  • BC3NP — Medicaid HMO: $515.37
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EXCISE BREAST CYST $3,528 $5,383.86 $409.21 – $8,973.11
Removal of breast growth (open surgery): 10 of 43 insurance plan rates
  • Aetna — Commercial: $4,112
  • Aetna — Dual Products: $4,291.49
  • Aetna — Medicare Advantage: $3,901.35
  • Aetna Better Health — Medicaid HMO: $2,133.97
  • Amerihealth Caritas — Dual Products: $3,823.32
  • BC3NP — Medicaid HMO: $422.72
  • BCN — HMO: $3,528
  • Blue Cross — BCBSM Commercial: $3,528
  • Blue Cross — BCBSM GM Connected Care: $3,528
  • Blue Cross — BCN Advantage: $3,901.35
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR TOTAL HIP ARTHROPLASTY $4,510 $1,712.88 $741.03 – $2,487.27
Total hip replacement: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $2,136.86
  • Aetna — Medicare Advantage-FAC: $1,241.22
  • Aetna — Medicare Advantage-NONFAC: $1,241.22
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $755.85
  • Aetna Better Health — Medicaid HMO-Child-FAC: $755.85
  • Amerihealth Caritas — Dual Products-FAC: $1,216.40
  • Amerihealth Caritas — Dual Products-NONFAC: $1,216.40
  • Blue Cross — BCBSM Commercial: $2,260.24
  • Blue Cross — BCN Commercial-FAC: $2,277.79
  • Blue Cross — BCN Commercial-NONFAC: $2,277.79
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY Not listed in the file $17,653.66 $1,239.12 – $29,422.77
Total hip replacement: 10 of 38 insurance plan rates
  • Aetna — Commercial: $5,757
  • Aetna — Dual Products: $14,071.77
  • Aetna — Medicare Advantage: $12,792.51
  • Aetna Better Health — Medicaid HMO: $6,997.27
  • Amerihealth Caritas — Dual Products: $12,536.66
  • BCN — HMO: $30,263.17
  • Blue Cross — BCBSM Commercial: $30,263.17
  • Blue Cross — BCBSM GM Connected Care: $29,537.06
  • Blue Cross — BCN Advantage: $12,792.51
  • Blue Cross — BCN Commercial: $30,263.17
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR TOTAL KNEE ARTHROPLASTY $4,510 $1,708.33 $739.32 – $2,494.61
Total knee replacement: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $2,134.69
  • Aetna — Medicare Advantage-FAC: $1,237.92
  • Aetna — Medicare Advantage-NONFAC: $1,237.92
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $754.11
  • Aetna Better Health — Medicaid HMO-Child-FAC: $754.11
  • Amerihealth Caritas — Dual Products-FAC: $1,213.16
  • Amerihealth Caritas — Dual Products-NONFAC: $1,213.16
  • Blue Cross — BCBSM Commercial: $2,256.73
  • Blue Cross — BCN Commercial-FAC: $2,274.87
  • Blue Cross — BCN Commercial-NONFAC: $2,274.87
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file $17,653.66 $1,237.44 – $29,422.77
Total knee replacement: 10 of 38 insurance plan rates
  • Aetna — Commercial: $5,757
  • Aetna — Dual Products: $14,071.77
  • Aetna — Medicare Advantage: $12,792.51
  • Aetna Better Health — Medicaid HMO: $6,997.27
  • Amerihealth Caritas — Dual Products: $12,536.66
  • BCN — HMO: $29,511.29
  • Blue Cross — BCBSM Commercial: $29,511.29
  • Blue Cross — BCBSM GM Connected Care: $28,803.22
  • Blue Cross — BCN Advantage: $12,792.51
  • Blue Cross — BCN Commercial: $29,511.29
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHROSCOPY SHLDR PART ACROMIOPLASTY $590 $220.61 $94.15 – $333.56
Shoulder arthroscopy: shaving of shoulder bone: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $286.95
  • Aetna — Medicare Advantage-FAC: $159.86
  • Aetna — Medicare Advantage-NONFAC: $159.86
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $96.03
  • Aetna Better Health — Medicaid HMO-Child-FAC: $96.03
  • Amerihealth Caritas — Dual Products-FAC: $156.66
  • Amerihealth Caritas — Dual Products-NONFAC: $156.66
  • Blue Cross — BCBSM Commercial: $214.20
  • Blue Cross — BCN Commercial-FAC: $216.30
  • Blue Cross — BCN Commercial-NONFAC: $216.30
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file $220.61 $165.48 – $4,112
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • Aetna — Commercial: $4,112
  • BCN — HMO: $5,353.18
  • Blue Cross — BCBSM Commercial: $5,353.18
  • Blue Cross — BCBSM GM Connected Care: $5,224.74
  • Blue Cross — BCN Commercial: $5,353.18
  • HAP — HAP HMO_AHL_Fully Insured: $287
  • HAP — Self-Funded: $329.13
  • Humana Military — Tricare: $165.48
  • Priority Health — Commercial: $187.58
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHROSCOPY KNEE W/MENISCECTOMY MED OR LAT W/SHAVE $1,780 $744.34 $328.87 – $1,044.35
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $899.33
  • Aetna — Medicare Advantage-FAC: $539.38
  • Aetna — Medicare Advantage-NONFAC: $539.38
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $335.45
  • Aetna Better Health — Medicaid HMO-Child-FAC: $335.45
  • Amerihealth Caritas — Dual Products-FAC: $528.59
  • Amerihealth Caritas — Dual Products-NONFAC: $528.59
  • Blue Cross — BCBSM Commercial: $965.42
  • Blue Cross — BCN Commercial-FAC: $973.61
  • Blue Cross — BCN Commercial-NONFAC: $973.61
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file $4,499.12 $522.09 – $7,498.53
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 38 insurance plan rates
  • Aetna — Commercial: $4,933
  • Aetna — Dual Products: $3,586.26
  • Aetna — Medicare Advantage: $3,260.23
  • Aetna Better Health — Medicaid HMO: $1,783.29
  • Amerihealth Caritas — Dual Products: $3,195.03
  • BCN — HMO: $5,362.93
  • Blue Cross — BCBSM Commercial: $5,362.93
  • Blue Cross — BCBSM GM Connected Care: $5,234.26
  • Blue Cross — BCN Advantage: $3,260.23
  • Blue Cross — BCN Commercial: $5,362.93
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR REMOVE TONSILS & ADENOIDS <12 Y/O $940 $373.62 $166.35 – $635.09
Removal of tonsils and adenoids (under age 12): 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $465.50
  • Aetna — Medicare Advantage-FAC: $270.74
  • Aetna — Medicare Advantage-NONFAC: $270.74
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $169.68
  • Aetna Better Health — Medicaid HMO-Child-FAC: $169.68
  • Amerihealth Caritas — Dual Products-FAC: $265.33
  • Amerihealth Caritas — Dual Products-NONFAC: $265.33
  • Blue Cross — BCBSM Commercial: $471.35
  • Blue Cross — BCN Commercial-FAC: $473.48
  • Blue Cross — BCN Commercial-NONFAC: $473.48
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file $8,139.99 $276.28 – $13,566.64
Removal of tonsils and adenoids (under age 12): 10 of 38 insurance plan rates
  • Aetna — Commercial: $4,112
  • Aetna — Dual Products: $6,488.40
  • Aetna — Medicare Advantage: $5,898.54
  • Aetna Better Health — Medicaid HMO: $3,226.39
  • Amerihealth Caritas — Dual Products: $5,780.57
  • BCN — HMO: $4,702.73
  • Blue Cross — BCBSM Commercial: $4,702.73
  • Blue Cross — BCBSM GM Connected Care: $4,589.89
  • Blue Cross — BCN Advantage: $5,898.54
  • Blue Cross — BCN Commercial: $4,702.73
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EGD TRANSORAL DIAGNOSTIC $410 $158.49 $70.50 – $471.24
Upper GI endoscopy (diagnostic): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $447.04
  • Aetna — Medicare Advantage-FAC: $114.85
  • Aetna — Medicare Advantage-NONFAC: $319.52
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $71.91
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $209.88
  • Aetna Better Health — Medicaid HMO-Child-FAC: $71.91
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $209.88
  • Amerihealth Caritas — Dual Products-FAC: $112.55
  • Amerihealth Caritas — Dual Products-NONFAC: $313.13
  • Blue Cross — BCBSM Commercial: $459.63
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EGD, FLEX. TRANSORAL ; DIAGNOSTIC $2,148 $1,247.13 $114.03 – $2,078.56
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,056
  • Aetna — Dual Products: $994.10
  • Aetna — Medicare Advantage: $903.72
  • Aetna Better Health — Medicaid HMO: $494.32
  • Amerihealth Caritas — Dual Products: $885.65
  • BCN — HMO: $1,161.65
  • Blue Cross — BCBSM Commercial: $1,161.65
  • Blue Cross — BCBSM GM Connected Care: $1,133.78
  • Blue Cross — BCN Advantage: $903.72
  • Blue Cross — BCN Commercial: $1,161.65
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EGD FLEXI TRANSORAL W/BIOPSY SINGLE/MULTIPLE $460 $177.30 $78.81 – $600.77
Upper GI endoscopy with biopsy: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $583.23
  • Aetna — Medicare Advantage-FAC: $128.48
  • Aetna — Medicare Advantage-NONFAC: $413.41
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $80.39
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $272.44
  • Aetna Better Health — Medicaid HMO-Child-FAC: $80.39
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $272.44
  • Amerihealth Caritas — Dual Products-FAC: $125.91
  • Amerihealth Caritas — Dual Products-NONFAC: $405.14
  • Blue Cross — BCBSM Commercial: $600.77
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB EGD TRANSORAL BIOPSY SINGLE/MUTIPLE $2,016 $1,247.13 $127.82 – $2,877
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $994.10
  • Aetna — Medicare Advantage: $903.72
  • Aetna Better Health — Medicaid HMO: $494.32
  • Amerihealth Caritas — Dual Products: $885.65
  • BCN — HMO: $1,409.78
  • Blue Cross — BCBSM Commercial: $1,409.78
  • Blue Cross — BCBSM GM Connected Care: $1,375.95
  • Blue Cross — BCN Advantage: $903.72
  • Blue Cross — BCN Commercial: $1,409.78
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY FLEXIBLE DIAGNOSTIC $620 $238.04 $105.01 – $626.85
Colonoscopy (diagnostic): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $530.99
  • Aetna — Medicare Advantage-FAC: $172.49
  • Aetna — Medicare Advantage-NONFAC: $378.46
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $107.11
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $245.94
  • Aetna Better Health — Medicaid HMO-Child-FAC: $107.11
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $245.94
  • Amerihealth Caritas — Dual Products-FAC: $169.04
  • Amerihealth Caritas — Dual Products-NONFAC: $370.89
  • Blue Cross — BCBSM Commercial: $542.72
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB COLONOSCOPY, FLEXIBLE DIAGNOSTIC $1,756 $1,278.72 $117.27 – $1,704.96
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $1,019.27
  • Aetna — Medicare Advantage: $926.61
  • Aetna Better Health — Medicaid HMO: $506.84
  • Amerihealth Caritas — Dual Products: $908.08
  • BCN — HMO: $1,315.79
  • Blue Cross — BCBSM Commercial: $1,315.79
  • Blue Cross — BCBSM GM Connected Care: $1,284.22
  • Blue Cross — BCN Advantage: $926.61
  • Blue Cross — BCN Commercial: $1,315.79
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SGL/MULTI $670 $256.18 $113.32 – $746.83
Colonoscopy with biopsy: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $675.61
  • Aetna — Medicare Advantage-FAC: $185.64
  • Aetna — Medicare Advantage-NONFAC: $477.34
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $115.59
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $312.20
  • Aetna Better Health — Medicaid HMO-Child-FAC: $115.59
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $312.20
  • Amerihealth Caritas — Dual Products-FAC: $181.93
  • Amerihealth Caritas — Dual Products-NONFAC: $467.79
  • Blue Cross — BCBSM Commercial: $691.85
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB COLONOSCOPY W/BIOPSY SGL/MULTI $2,184 $1,645.43 $186.93 – $2,877
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $1,311.57
  • Aetna — Medicare Advantage: $1,192.34
  • Aetna Better Health — Medicaid HMO: $652.19
  • Amerihealth Caritas — Dual Products: $1,168.49
  • BCN — HMO: $1,443.61
  • Blue Cross — BCBSM Commercial: $1,443.61
  • Blue Cross — BCBSM GM Connected Care: $1,408.97
  • Blue Cross — BCN Advantage: $1,192.34
  • Blue Cross — BCN Commercial: $1,443.61
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W RMVL LESION BY SNARE $850 $321.72 $142.50 – $842.25
Colonoscopy with removal of polyps (snare): 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $710.15
  • Aetna — Medicare Advantage-FAC: $233.13
  • Aetna — Medicare Advantage-NONFAC: $500.01
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $145.35
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $325.24
  • Aetna Better Health — Medicaid HMO-Child-FAC: $145.35
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $325.24
  • Amerihealth Caritas — Dual Products-FAC: $228.47
  • Amerihealth Caritas — Dual Products-NONFAC: $490.01
  • Blue Cross — BCBSM Commercial: $724.34
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB COLONOSCOPY W SNARE $2,204 $1,645.43 $234.87 – $2,877
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $1,311.57
  • Aetna — Medicare Advantage: $1,192.34
  • Aetna Better Health — Medicaid HMO: $652.19
  • Amerihealth Caritas — Dual Products: $1,168.49
  • BCN — HMO: $1,443.61
  • Blue Cross — BCBSM Commercial: $1,443.61
  • Blue Cross — BCBSM GM Connected Care: $1,408.97
  • Blue Cross — BCN Advantage: $1,192.34
  • Blue Cross — BCN Commercial: $1,443.61
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W/ENDOSCOPE ULSO EXAM $860 $324.70 $144.20 – $550.09
Ultrasound of the lower bowel by endoscope: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $406.90
  • Aetna — Medicare Advantage-FAC: $235.29
  • Aetna — Medicare Advantage-NONFAC: $235.29
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $147.08
  • Aetna Better Health — Medicaid HMO-Child-FAC: $147.08
  • Amerihealth Caritas — Dual Products-FAC: $230.58
  • Amerihealth Caritas — Dual Products-NONFAC: $230.58
  • Blue Cross — BCBSM Commercial: $404.24
  • Blue Cross — BCN Commercial-FAC: $405.31
  • Blue Cross — BCN Commercial-NONFAC: $405.31
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB COLONOSCOPY COLONOSCOPY W/ENDOSCOPE US EXAM $2,446 $1,645.43 $237.41 – $6,388
Ultrasound of the lower bowel by endoscope: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $1,311.57
  • Aetna — Medicare Advantage: $1,192.34
  • Aetna Better Health — Medicaid HMO: $652.19
  • Amerihealth Caritas — Dual Products: $1,168.49
  • BCN — HMO: $1,444.21
  • Blue Cross — BCBSM Commercial: $1,444.21
  • Blue Cross — BCBSM GM Connected Care: $1,409.56
  • Blue Cross — BCN Advantage: $1,192.34
  • Blue Cross — BCN Commercial: $1,444.21
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLORECTAL CA SCREEN COLONOSCOPY NOT HI RISK $620 $238.82 $105.22 – $626.85
Screening colonoscopy (not high risk): 10 of 81 insurance plan rates
  • Aetna — All Products-NONFAC: $421.18
  • Aetna — Medicare Advantage-FAC: $173.06
  • Aetna — Medicare Advantage-NONFAC: $379.02
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $107.32
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $246.16
  • Aetna Better Health — Medicaid HMO-Child-FAC: $107.32
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $246.16
  • Amerihealth Caritas — Dual Products-FAC: $169.60
  • Amerihealth Caritas — Dual Products-NONFAC: $371.44
  • Blue Cross — BCBSM Commercial: $543.25
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB CA SCREEN COLONOSCOPY - NOT HIGH RISK $1,392 $1,278.72 $117.66 – $1,704.96
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $1,019.27
  • Aetna — Medicare Advantage: $926.61
  • Aetna Better Health — Medicaid HMO: $506.84
  • Amerihealth Caritas — Dual Products: $908.08
  • BCN — HMO: $1,315.79
  • Blue Cross — BCBSM Commercial: $1,315.79
  • Blue Cross — BCBSM GM Connected Care: $1,284.22
  • Blue Cross — BCN Advantage: $926.61
  • Blue Cross — BCN Commercial: $1,315.79
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPAROSCOPIC CHOLECYSTECTOMY $2,240 $946.76 $403 – $1,491.09
Gallbladder removal by laparoscope: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $1,065.85
  • Aetna — Medicare Advantage-FAC: $686.06
  • Aetna — Medicare Advantage-NONFAC: $686.06
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $411.06
  • Aetna Better Health — Medicaid HMO-Child-FAC: $411.06
  • Amerihealth Caritas — Dual Products-FAC: $672.34
  • Amerihealth Caritas — Dual Products-NONFAC: $672.34
  • Blue Cross — BCBSM Commercial: $1,060.94
  • Blue Cross — BCN Commercial-FAC: $1,068.40
  • Blue Cross — BCN Commercial-NONFAC: $1,068.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file $8,312.83 $650.97 – $13,854.72
Gallbladder removal by laparoscope: 10 of 38 insurance plan rates
  • Aetna — Commercial: $5,757
  • Aetna — Dual Products: $6,626.17
  • Aetna — Medicare Advantage: $6,023.79
  • Aetna Better Health — Medicaid HMO: $3,294.90
  • Amerihealth Caritas — Dual Products: $5,903.31
  • BCN — HMO: $8,457.39
  • Blue Cross — BCBSM Commercial: $8,457.39
  • Blue Cross — BCBSM GM Connected Care: $8,254.47
  • Blue Cross — BCN Advantage: $6,023.79
  • Blue Cross — BCN Commercial: $8,457.39
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR REPAIR INGUINAL HERNIA 5+Y/O REDUCIBLE $1,760 $757.19 $323.97 – $1,182.20
Groin (inguinal) hernia repair, age 5 or older: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $845.01
  • Aetna — Medicare Advantage-FAC: $548.69
  • Aetna — Medicare Advantage-NONFAC: $548.69
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $330.45
  • Aetna Better Health — Medicaid HMO-Child-FAC: $330.45
  • Amerihealth Caritas — Dual Products-FAC: $537.72
  • Amerihealth Caritas — Dual Products-NONFAC: $537.72
  • Blue Cross — BCBSM Commercial: $842.57
  • Blue Cross — BCN Commercial-FAC: $848.96
  • Blue Cross — BCN Commercial-NONFAC: $848.96
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR Not listed in the file $4,923.19 $515.09 – $8,205.32
Groin (inguinal) hernia repair, age 5 or older: 10 of 37 insurance plan rates
  • Aetna — Dual Products: $3,924.28
  • Aetna — Medicare Advantage: $3,567.53
  • Aetna Better Health — Medicaid HMO: $1,951.37
  • Amerihealth Caritas — Dual Products: $3,496.18
  • BCN — HMO: $6,395.40
  • Blue Cross — BCBSM Commercial: $6,395.40
  • Blue Cross — BCBSM GM Connected Care: $6,241.95
  • Blue Cross — BCN Advantage: $3,567.53
  • Blue Cross — BCN Commercial: $6,395.40
  • Blue Cross — Medicare Plus Blue: $3,567.53
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file $342.21 – $2,777.09
Prostate biopsy: rates for 9 insurance plans
  • BCN — HMO: $2,602.43
  • Blue Cross — BCBSM Commercial: $2,602.43
  • Blue Cross — BCBSM GM Connected Care: $2,539.99
  • Blue Cross — BCN Commercial: $2,602.43
  • HAP — HAP Dual Products: $2,007.09
  • HAP — HAP HMO_AHL_Fully Insured: $342.21
  • HAP — Self-Funded: $392.45
  • Humana Military — Tricare: $120.84
  • Priority Health — Commercial: $2,777.09
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAP PROSTATECTOMY W NERVE SPARING ROBOTIC $16,000 $1,570.08 $689.91 – $5,389
Prostate removal by laparoscope (radical prostatectomy): 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $1,899.26
  • Aetna — Medicare Advantage-FAC: $1,137.74
  • Aetna — Medicare Advantage-NONFAC: $1,137.74
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $703.71
  • Aetna Better Health — Medicaid HMO-Child-FAC: $703.71
  • Amerihealth Caritas — Dual Products-FAC: $1,114.99
  • Amerihealth Caritas — Dual Products-NONFAC: $1,114.99
  • Blue Cross — BCBSM Commercial: $1,892.33
  • Blue Cross — BCN Commercial-FAC: $1,904.58
  • Blue Cross — BCN Commercial-NONFAC: $1,904.58
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file $14,616.42 $1,120.32 – $24,360.70
Prostate removal by laparoscope (radical prostatectomy): 10 of 38 insurance plan rates
  • Aetna — Commercial: $5,757
  • Aetna — Dual Products: $11,650.77
  • Aetna — Medicare Advantage: $10,591.61
  • Aetna Better Health — Medicaid HMO: $5,793.42
  • Amerihealth Caritas — Dual Products: $10,379.78
  • BCN — HMO: $23,496.25
  • Blue Cross — BCBSM Commercial: $23,496.25
  • Blue Cross — BCBSM GM Connected Care: $22,932.50
  • Blue Cross — BCN Advantage: $10,591.61
  • Blue Cross — BCN Commercial: $23,496.25
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPECTOMY W/WO D&C $750 $302.72 $130.36 – $2,106.43
Hysteroscopy with biopsy of the uterus lining: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $1,979.25
  • Aetna — Medicare Advantage-FAC: $219.36
  • Aetna — Medicare Advantage-NONFAC: $1,247.55
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $132.97
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $826.03
  • Aetna Better Health — Medicaid HMO-Child-FAC: $132.97
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $826.03
  • Amerihealth Caritas — Dual Products-FAC: $214.97
  • Amerihealth Caritas — Dual Products-NONFAC: $1,222.60
  • Blue Cross — BCBSM Commercial: $2,106.43
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB HYSTEROSCOPY BX ENDOMETRIUM AND/OR POLYPC W/WO D&C $2,385 $4,451.18 $149.15 – $5,934.90
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,112
  • Aetna — Dual Products: $3,548.03
  • Aetna — Medicare Advantage: $3,225.49
  • Aetna Better Health — Medicaid HMO: $1,764.28
  • Amerihealth Caritas — Dual Products: $3,160.98
  • BCN — HMO: $2,385
  • Blue Cross — BCBSM Commercial: $2,385
  • Blue Cross — BCBSM GM Connected Care: $2,385
  • Blue Cross — BCN Advantage: $3,225.49
  • Blue Cross — BCN Commercial: $2,385
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INJ DX/TX EPIDURAL/SUBARACH LUMB/SACRAL W/IMG GDN $320 $127.25 $56.87 – $414.08
Spinal injection, lower back (epidural), with imaging guidance: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $414.08
  • Aetna — Medicare Advantage-FAC: $92.21
  • Aetna — Medicare Advantage-NONFAC: $269.81
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $58.01
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $177.71
  • Aetna Better Health — Medicaid HMO-Child-FAC: $58.01
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $177.71
  • Amerihealth Caritas — Dual Products-FAC: $90.37
  • Amerihealth Caritas — Dual Products-NONFAC: $264.41
  • Blue Cross — BCBSM Commercial: $413.30
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB INJ DX/TX EPIDURAL/SUBARACH LUM/SACRAL W/IMAGE GDN $1,186 $970.61 $62.70 – $1,294.15
Spinal injection, lower back (epidural), with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,056
  • Aetna — Dual Products: $773.68
  • Aetna — Medicare Advantage: $703.34
  • Aetna Better Health — Medicaid HMO: $384.71
  • Amerihealth Caritas — Dual Products: $689.27
  • BCN — HMO: $990.40
  • Blue Cross — BCBSM Commercial: $990.40
  • Blue Cross — BCBSM GM Connected Care: $966.63
  • Blue Cross — BCN Advantage: $703.34
  • Blue Cross — BCN Commercial: $990.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INJ(S) NERVE BLOCK FORAMEN LUMB/SACR W/IMG GDN 1 LVL $350 $141.19 $63.47 – $394.79
Nerve root injection, lower back, with imaging guidance: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $394.79
  • Aetna — Medicare Advantage-FAC: $102.31
  • Aetna — Medicare Advantage-NONFAC: $261.86
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $64.74
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $172.29
  • Aetna Better Health — Medicaid HMO-Child-FAC: $64.74
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $172.29
  • Amerihealth Caritas — Dual Products-FAC: $100.26
  • Amerihealth Caritas — Dual Products-NONFAC: $256.62
  • Blue Cross — BCBSM Commercial: $394.12
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB INJ ANES TRANSFORM LUMB/SAC $991 $1,216.18 $102.16 – $2,056
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,056
  • Aetna — Dual Products: $969.42
  • Aetna — Medicare Advantage: $881.29
  • Aetna Better Health — Medicaid HMO: $482.05
  • Amerihealth Caritas — Dual Products: $863.66
  • BCN — HMO: $991
  • Blue Cross — BCBSM Commercial: $991
  • Blue Cross — BCBSM GM Connected Care: $991
  • Blue Cross — BCN Advantage: $881.29
  • Blue Cross — BCN Commercial: $991
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR REVISE MEDIAN NERVE AT CARPAL TUNNEL $1,400 $604.29 $269.87 – $858.28
Carpal tunnel release: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $734.61
  • Aetna — Medicare Advantage-FAC: $437.89
  • Aetna — Medicare Advantage-NONFAC: $495.26
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $275.27
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $313.95
  • Aetna Better Health — Medicaid HMO-Child-FAC: $275.27
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $313.95
  • Amerihealth Caritas — Dual Products-FAC: $429.13
  • Amerihealth Caritas — Dual Products-NONFAC: $485.35
  • Blue Cross — BCBSM Commercial: $724.34
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB REVISE MEDIAN N/CARPAL TUNNEL SURG $3,543 $2,685.07 $419.90 – $4,475.11
Carpal tunnel release: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $2,140.27
  • Aetna — Medicare Advantage: $1,945.70
  • Aetna Better Health — Medicaid HMO: $1,064.27
  • Amerihealth Caritas — Dual Products: $1,906.79
  • BCN — HMO: $3,351.09
  • Blue Cross — BCBSM Commercial: $3,351.09
  • Blue Cross — BCBSM GM Connected Care: $3,270.69
  • Blue Cross — BCN Advantage: $1,945.70
  • Blue Cross — BCN Commercial: $3,351.09
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR DISCISSION 2ND CATARACT LASER SURGERY $970 $380.19 $175.51 – $592.87
Laser treatment of clouding after cataract surgery: 10 of 82 insurance plan rates
  • Aetna — All Products-NONFAC: $554.80
  • Aetna — Medicare Advantage-FAC: $275.50
  • Aetna — Medicare Advantage-NONFAC: $333.52
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $179.02
  • Aetna Better Health — Medicaid HMO-Adult-NONFAC: $218.13
  • Aetna Better Health — Medicaid HMO-Child-FAC: $179.02
  • Aetna Better Health — Medicaid HMO-Child-NONFAC: $218.13
  • Amerihealth Caritas — Dual Products-FAC: $269.99
  • Amerihealth Caritas — Dual Products-NONFAC: $326.85
  • Blue Cross — BCBSM Commercial: $531.53
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HB DISCISSION 2ND CATARACT LASER SURGERY $1,107 $756.27 $187.32 – $1,008.36
Laser treatment of clouding after cataract surgery: 10 of 42 insurance plan rates
  • Aetna — Commercial: $2,877
  • Aetna — Dual Products: $602.82
  • Aetna — Medicare Advantage: $548.02
  • Aetna Better Health — Medicaid HMO: $299.76
  • Amerihealth Caritas — Dual Products: $537.06
  • BCN — HMO: $856.09
  • Blue Cross — BCBSM Commercial: $856.09
  • Blue Cross — BCBSM GM Connected Care: $835.55
  • Blue Cross — BCN Advantage: $548.02
  • Blue Cross — BCN Commercial: $856.09
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR RMVL CAT EXTRACAP/INSRT LENS W/O ENDO $2,000 $645.56 $295.01 – $1,205.20
Cataract removal with lens implant: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $908.03
  • Aetna — Medicare Advantage-FAC: $467.80
  • Aetna — Medicare Advantage-NONFAC: $467.80
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $300.91
  • Aetna Better Health — Medicaid HMO-Child-FAC: $300.91
  • Amerihealth Caritas — Dual Products-FAC: $458.44
  • Amerihealth Caritas — Dual Products-NONFAC: $458.44
  • Blue Cross — BCBSM Commercial: $859.62
  • Blue Cross — BCN Commercial-FAC: $859.08
  • Blue Cross — BCN Commercial-NONFAC: $859.08
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file $3,173.34 $488.99 – $5,288.90
Cataract removal with lens implant: 10 of 36 insurance plan rates
  • Aetna — Dual Products: $2,529.48
  • Aetna — Medicare Advantage: $2,299.52
  • Aetna Better Health — Medicaid HMO: $1,257.79
  • Amerihealth Caritas — Dual Products: $2,253.53
  • BCN — HMO: $5,442.41
  • Blue Cross — BCBSM Commercial: $5,442.41
  • Blue Cross — BCBSM GM Connected Care: $5,311.83
  • Blue Cross — BCN Advantage: $2,299.52
  • Blue Cross — BCN Commercial: $5,442.41
  • Blue Cross — Medicare Plus Blue: $2,299.52

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR VAGINAL DELIVERY W/FULL ROUTINE CARE $5,120 $3,358.99 $2,018.37 – $4,300.01
Vaginal delivery, with care before and after: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $3,500
  • Aetna — Medicare Advantage-FAC: $2,434.05
  • Aetna — Medicare Advantage-NONFAC: $2,434.05
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $2,136.65
  • Aetna Better Health — Medicaid HMO-Child-FAC: $2,136.65
  • Amerihealth Caritas — Dual Products-FAC: $2,385.37
  • Amerihealth Caritas — Dual Products-NONFAC: $2,385.37
  • Blue Cross — BCBSM Commercial: $3,504.67
  • Blue Cross — BCN Commercial-FAC: $3,504.67
  • Blue Cross — BCN Commercial-NONFAC: $3,504.67
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE Not listed in the file $3,358.99 $2,691.86 – $12,764.10
Vaginal delivery, with care before and after: rates for 8 insurance plans
  • BCN — HMO: $12,764.10
  • Blue Cross — BCBSM Commercial: $12,764.10
  • Blue Cross — BCBSM GM Connected Care: $12,457.85
  • Blue Cross — BCN Commercial: $12,764.10
  • HAP — HAP HMO_AHL_Fully Insured: $4,247.33
  • HAP — Self-Funded: $4,870.88
  • Humana Military — Tricare: $2,374.55
  • Priority Health — Commercial: $2,691.86
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR CESAREAN DELIVERY W/FULL ROUTINE CARE $5,520 $3,792.01 $2,262.86 – $4,822.34
Cesarean delivery (C-section), with care before and after: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $3,500
  • Aetna — Medicare Advantage-FAC: $2,747.83
  • Aetna — Medicare Advantage-NONFAC: $2,747.83
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $2,394.92
  • Aetna Better Health — Medicaid HMO-Child-FAC: $2,394.92
  • Amerihealth Caritas — Dual Products-FAC: $2,692.87
  • Amerihealth Caritas — Dual Products-NONFAC: $2,692.87
  • Blue Cross — BCBSM Commercial: $3,504.67
  • Blue Cross — BCN Commercial-FAC: $3,504.67
  • Blue Cross — BCN Commercial-NONFAC: $3,504.67
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY Not listed in the file $3,792.01 $2,897.15 – $14,167.98
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • BCN — HMO: $14,167.98
  • Blue Cross — BCBSM Commercial: $14,167.98
  • Blue Cross — BCBSM GM Connected Care: $13,828.04
  • Blue Cross — BCN Commercial: $14,167.98
  • HAP — HAP HMO_AHL_Fully Insured: $4,763.27
  • HAP — Self-Funded: $5,462.56
  • Humana Military — Tricare: $2,662.19
  • Priority Health — Commercial: $2,897.15
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR VAGINAL DELIVERY (VBAC) W/FULL ROUTINE CARE $5,720 $3,579.68 $2,136.51 – $4,555.80
Vaginal delivery after a previous C-section, with care before and after: 10 of 69 insurance plan rates
  • Aetna — All Products-NONFAC: $3,500
  • Aetna — Medicare Advantage-FAC: $2,593.97
  • Aetna — Medicare Advantage-NONFAC: $2,593.97
  • Aetna Better Health — Medicaid HMO-Adult-FAC: $2,257.94
  • Aetna Better Health — Medicaid HMO-Child-FAC: $2,257.94
  • Amerihealth Caritas — Dual Products-FAC: $2,542.09
  • Amerihealth Caritas — Dual Products-NONFAC: $2,542.09
  • Blue Cross — BCBSM Commercial: $3,679.92
  • Blue Cross — BCN Commercial-FAC: $3,679.92
  • Blue Cross — BCN Commercial-NONFAC: $3,679.92
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY Not listed in the file $3,579.68 $2,726.07 – $13,435.31
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans
  • BCN — HMO: $13,435.31
  • Blue Cross — BCBSM Commercial: $13,435.31
  • Blue Cross — BCBSM GM Connected Care: $13,112.95
  • Blue Cross — BCN Commercial: $13,435.31
  • HAP — HAP HMO_AHL_Fully Insured: $4,499.99
  • HAP — Self-Funded: $5,160.62
  • Humana Military — Tricare: $2,513.54
  • Priority Health — Commercial: $2,726.07

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $67,582.62 – $209,025.78
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 35 insurance plan rates
  • Aetna — Commercial: $129,661.23
  • Aetna — Dual Products: $73,985.18
  • Aetna — Medicare Advantage: $71,139.60
  • Amerihealth Caritas — Dual Products: $69,716.81
  • BCN — HMO: $184,358.24
  • Blue Cross — BCBSM Commercial: $184,358.24
  • Blue Cross — BCBSM GM Connected Care: $209,025.78
  • Blue Cross — BCN Advantage: $71,139.60
  • Blue Cross — BCN Commercial: $184,358.24
  • Blue Cross — Medicare Plus Blue: $71,139.60
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $13,609.95 – $38,052.62
Hip or knee replacement (major joint of the leg), without major complications: 10 of 28 insurance plan rates
  • Aetna — Dual Products: $14,899.31
  • Aetna — Medicare Advantage: $14,326.26
  • Amerihealth Caritas — Dual Products: $14,039.73
  • BCN — HMO: $33,561.96
  • Blue Cross — BCBSM Commercial: $33,561.96
  • Blue Cross — BCBSM GM Connected Care: $38,052.62
  • Blue Cross — BCN Advantage: $14,326.26
  • Blue Cross — BCN Commercial: $33,561.96
  • Blue Cross — Medicare Plus Blue: $14,326.26
  • HAP — HAP Dual Products: $14,326.26
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC Not listed in the file Not listed in the file $13,609.95 – $38,052.62
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans
  • Aetna — Commercial: $25,565.64
  • Cofinity — Commercial: $20,023.91
  • HAP — HAP HMO_AHL_Fully Insured: $28,470.56
  • HAP — Self-Funded: $18,752.77
  • Nomi — All Products: $27,118.41
  • Multiplan — All Products: 66% (a percentage in the contract, not a dollar amount)
  • Priority Health — Priority Cigna: 77.95% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $17,131.21 – $40,643.12
Neck (cervical) spinal fusion, without complications: 10 of 35 insurance plan rates
  • Aetna — Commercial: $32,356.99
  • Aetna — Dual Products: $18,754.16
  • Aetna — Medicare Advantage: $18,032.85
  • Amerihealth Caritas — Dual Products: $17,672.19
  • BCN — HMO: $35,846.75
  • Blue Cross — BCBSM Commercial: $35,846.75
  • Blue Cross — BCBSM GM Connected Care: $40,643.12
  • Blue Cross — BCN Advantage: $18,032.85
  • Blue Cross — BCN Commercial: $35,846.75
  • Blue Cross — Medicare Plus Blue: $18,032.85
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $8,880.58 – $23,974.25
Uterus and ovary surgery (not for cancer), without complications: 10 of 35 insurance plan rates
  • Aetna — Commercial: $16,444.24
  • Aetna — Dual Products: $9,721.90
  • Aetna — Medicare Advantage: $9,347.98
  • Amerihealth Caritas — Dual Products: $9,161.02
  • BCN — HMO: $21,145
  • Blue Cross — BCBSM Commercial: $21,145
  • Blue Cross — BCBSM GM Connected Care: $23,974.25
  • Blue Cross — BCN Advantage: $9,347.98
  • Blue Cross — BCN Commercial: $21,145
  • Blue Cross — Medicare Plus Blue: $9,347.98

Source: Henry Ford Macomb Hospital’s standard charges file (henryford.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 28, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address15855 Nineteen Mile Rd, Clinton Township, MI 48038
CountyMacomb County
StateMichigan
Phone(586) 263‑2300
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number230047
Name in Medicare recordsHENRY FORD MACOMB HOSPITAL
Profile levelMedicare data + hospital website
Official websitehenryford.com
CorrectionsReport an error or suggest an update →

Sources

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

  1. Henry Ford Macomb Hospital — henryford.com
  2. About Henry Ford Macomb Hospital — henryford.com
  3. Visiting Hours — henryford.com
  4. Parking — henryford.com
  5. Henry Ford Macomb Hospital | Henry Ford Health — henryford.com
  6. Our Training Programs | Emergency Care | Henry Ford Health — henryford.com