Medical emergency?Emergency? Call 911. Nearest emergency roomsNearest ERs

Critical Access Hospital

Higgins General Hospital

Bremen, Georgia · Haralson County · Emergency services listed

  • 200 Allen Memorial Drive, Bremen, GA 30110 · Directions
  • (770) 812‑2000
  • Emergency room: yes · per the hospital’s website · Median ER time 2 h 12 min (CMS)
  • Medicare overall rating: not rated
  • Hospital type: Critical Access Hospital · Ownership: Government - Hospital District or Authority

Higgins General Hospital is a critical access hospital at 200 Allen Memorial Drive, Bremen, GA 30110. Phone: (770) 812-2000. Its official website lists an emergency room.

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Higgins General Hospital is a critical access hospital in Bremen, Georgia. Its official website lists an emergency room (Medicare data does not list emergency services). Its official website lists 10 services, specialties and programs. Medicare lists 149 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is a critical access hospital?

A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types

Compare

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
Not ratedNot rated by CMSMedicare rating
25Beds (hospital website)
10Services listed

Quick answers

Does Higgins General Hospital have an emergency room?
Yes. The hospital’s official website lists an emergency room at Higgins General Hospital. Medicare (CMS) data does not list emergency services for it. In a medical emergency, call 911.
Where is Higgins General Hospital?
200 Allen Memorial Drive, Bremen, GA 30110, in Haralson County, Georgia.
What is the phone number of Higgins General Hospital?
(770) 812-2000, as listed by Medicare (CMS).
What is the Medicare star rating of Higgins General Hospital?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas[4]

Treatments[4]

Procedures[4]

  • Outpatient surgery

Programs and centers[4]

  • Swing Bed Program
  • Comprehensive Rehabilitation Program

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes
Stroke designationAcute Stroke Ready Hospital

Visiting and practical information

Patient portalMyChart

Recognition[4]

  • Acute Stroke Ready Hospital

Doctors and clinicians (149)

149 doctors and other clinicians list Higgins General 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 (149)

And 125 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Bremen

Hospitals in Haralson County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

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 Higgins General 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) 5 of 5 stars
Overall rating of the hospital5 of 5 stars
Would recommend the hospital5 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff5 of 5 stars
Staff explained medicines5 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean5 of 5 stars
Restfulness of Environment5 of 5 stars
Care Coordination5 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1086%National average: 72%
Would definitely recommend the hospital85%National average: 71%
Nurses “always” communicated well88%National average: 80%
Doctors “always” communicated well83%National average: 80%
“Always” got help as soon as they wanted78%National average: 64%
Staff “always” explained medicines before giving them78%National average: 62%
Were given information about recovery at home92%National average: 86%
Room and bathroom “always” clean89%National average: 73%
Completed surveys113Response rate: 30%

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

Infections caught in the hospital

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

Clostridioides difficile (C. diff) intestinal infections0No different from the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)16.1%
Readmitted within 30 days: pneumonia17.3%
Not reported to MedicareReadmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to reportReadmitted within 30 days: heart failure; Readmitted within 30 days: COPD

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)132 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Too few cases to reportSepsis patients who got all the recommended early care (SEP-1)

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

Not reported to Medicare: complications and deaths. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

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

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

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

Show the prices of 66 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN $252 $100.80 Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN $246 $98.40 Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN $150 $60 Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN $369 $147.60 Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN $492 $196.80 Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN $343 $137.20 Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN $123 $49.20 Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN $111 $44.40 Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $256 $102.40 Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN $171 $68.40 Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN $206 $82.40 Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
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 $120 $48 Not listed in the file
Office consultation with a specialist (moderate): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
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 $150 $60 Not listed in the file
Office consultation with a specialist (moderate to high): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $1,237 $494.80 $120 – $283
Emergency room visit (moderate): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $283
  • PeachState — Medicaid CMO: $120
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM $127 $50.80 $283
Emergency room visit (moderate): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $283
  • PeachState — Medicaid CMO: $120
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $1,237 $494.80 $120 – $283
Emergency room visit (moderate): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $283
  • PeachState — Medicaid CMO: $120
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $2,001 $800.40 $300 – $845
Emergency room visit (moderately high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $845
  • PeachState — Medicaid CMO: $300
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM $241 $96.40 $845
Emergency room visit (moderately high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $845
  • PeachState — Medicaid CMO: $300
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $2,001 $800.40 $300 – $845
Emergency room visit (moderately high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $845
  • PeachState — Medicaid CMO: $300
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,132 $852.80 $400 – $1,056
Emergency room visit (high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $1,056
  • PeachState — Medicaid CMO: $400
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM $355 $142 $1,056
Emergency room visit (high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $1,056
  • PeachState — Medicaid CMO: $400
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,132 $852.80 $400 – $1,056
Emergency room visit (high): 10 of 19 insurance plan rates
  • Amerigroup — Medicaid CMO: $1,056
  • PeachState — Medicaid CMO: $400
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)

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: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $180 $72 Not listed in the file
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA $75 $30 Not listed in the file
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $180 $72 Not listed in the file
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL $258 $103.20 Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $280 $112 Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $560 $224 Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC BLOOD TEST PANEL $292 $116.80 Not listed in the file
Obstetric blood test panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL $578 $231.20 Not listed in the file
Obstetric blood test panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $164 $65.60 Not listed in the file
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $58 $23.20 Not listed in the file
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $180 $72 Not listed in the file
Kidney function panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $189 $75.60 Not listed in the file
Liver function panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $218 $87.20 Not listed in the file
Liver function panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: LIVER FUNCTION BLOOD TEST PANEL $189 $75.60 Not listed in the file
Liver function panel: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $150 $60 Not listed in the file
Urine test (automated, with microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE $71 $28.40 Not listed in the file
Urine test (automated, with microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $150 $60 Not listed in the file
Urine test (automated, with microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE $30 $12 Not listed in the file
Urine test (manual, without microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST $117 $46.80 Not listed in the file
Urine test (automated, without microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE $101 $40.40 Not listed in the file
Urine test (automated, without microscope): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $191 $76.40 Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL $113 $45.20 Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GA In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $191 $76.40 Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $182 $72.80 Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE $142 $56.80 Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $182 $72.80 Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $150 $60 Not listed in the file
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC $144 $57.60 Not listed in the file
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $150 $60 Not listed in the file
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED $37 $14.80 Not listed in the file
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $121 $48.40 Not listed in the file
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $121 $48.40 Not listed in the file
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $103 $41.20 Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME $95 $38 Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: BLOOD TEST; CLOTTING TIME $95 $38 Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $105 $42 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $315 $126 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $105 $42 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)

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: CT HEAD/BRAIN W/O DYE $87 $34.80 Not listed in the file
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $4,514 $1,805.60 Not listed in the file
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $2,257 $902.80 Not listed in the file
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE $6,824 $2,729.60 Not listed in the file
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS $554 $221.60 Not listed in the file
Chest X-ray, 2 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS $22 $8.80 Not listed in the file
Chest X-ray, 2 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $855 $342 Not listed in the file
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS $463 $185.20 Not listed in the file
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE $4,122 $1,648.80 Not listed in the file
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST $3,996 $1,598.40 Not listed in the file
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE $4,596 $1,838.40 Not listed in the file
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE $5,205 $2,082 Not listed in the file
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST $188 $75.20 Not listed in the file
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $7,293 $2,917.20 Not listed in the file
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $7,293 $2,917.20 Not listed in the file
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $1,996 $798.40 Not listed in the file
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE $2,085 $834 Not listed in the file
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $1,002 $400.80 Not listed in the file
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS $1,053 $421.20 Not listed in the file
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $1,277 $510.80 Not listed in the file
Transvaginal ultrasound: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB $1,469 $587.60 Not listed in the file
Transvaginal ultrasound: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $1,277 $510.80 Not listed in the file
Transvaginal ultrasound: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI $571 $228.40 Not listed in the file
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI $841 $336.40 Not listed in the file
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD $388 $155.20 Not listed in the file
Screening mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY $593 $237.20 Not listed in the file
Screening mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SCREENING MAMMOGRAPHY $388 $155.20 Not listed in the file
Screening mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY $11,845 $4,738 Not listed in the file
Left heart catheterization (diagnostic): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION $10,971 $4,388.40 Not listed in the file
Heart rhythm study (electrophysiology evaluation): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB $24,666 $9,866.40 Not listed in the file
Heart rhythm study with ablation for atrial fibrillation: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM $1,935 $774 Not listed in the file
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES $146 $58.40 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_G0_GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $146 $58.40 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $146 $58.40 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN $304 $121.60 Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $304 $121.60 Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $608 $243.20 Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN $321 $128.40 Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $321 $128.40 Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_KX In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $321 $128.40 Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN $342 $136.80 Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $342 $136.80 Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_KX In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $342 $136.80 Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES $239 $95.60 Not listed in the file
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES $180 $72 Not listed in the file
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES $486 $194.40 $380
Psychotherapy, 60 minutes: 10 of 17 insurance plan rates
  • CareSource — Medicaid CMO: $380
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN $227 $90.80 Not listed in the file
Family psychotherapy, without the patient: 10 of 16 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN $333 $133.20 $380
Family psychotherapy, with the patient: 10 of 17 insurance plan rates
  • CareSource — Medicaid CMO: $380
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY $17 $6.80 $380
Group psychotherapy: 10 of 17 insurance plan rates
  • CareSource — Medicaid CMO: $380
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $17,354 $6,941.60 Not listed in the file
Removal of breast growth (open surgery): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH $2,802 $1,120.80 Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $2,851 $1,140.40 Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE $3,715 $1,486 Not listed in the file
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,762 $704.80 Not listed in the file
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,339.68 $535.87 Not listed in the file
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $7,669 $3,067.60 Not listed in the file
Colonoscopy (diagnostic): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,072 $1,628.80 Not listed in the file
Colonoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,306.50 $922.60 Not listed in the file
Colonoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,227 $1,290.80 Not listed in the file
Colonoscopy with biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $2,851 $1,140.40 Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $2,306.50 $922.60 Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $1,339.66 $535.86 Not listed in the file
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $14,832 $5,932.80 Not listed in the file
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $16,869 $6,747.60 Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $14,056 $5,622.40 Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE $4,802 $1,920.80 Not listed in the file
Prostate biopsy: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC $1,631 $652.40 Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $2,915 $1,166 Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $2,149 $859.60 Not listed in the file
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL $2,381 $952.40 Not listed in the file
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $6,505 $2,602 Not listed in the file
Cataract removal with lens implant: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $6,699 $2,679.60 Not listed in the file
Cataract removal with lens implant: 10 of 17 insurance plan rates
  • Aetna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Alliant Health Plans — Solocare Exchange: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO,POS: 75% (a percentage in the contract, not a dollar amount)
  • Anthem — Pathway.Pathway X: 60% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 78% (a percentage in the contract, not a dollar amount)
  • Cigna — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)
  • Clover Health — Medicare Advantage: 20% (a percentage in the contract, not a dollar amount)

Source: Higgins General Hospital’s standard charges file (tanner.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 24, 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 typeCritical Access Hospital
Address200 Allen Memorial Drive, Bremen, GA 30110
CountyHaralson County
StateGeorgia
Phone(770) 812‑2000
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall ratingNot rated by CMS
CMS Certification Number111320
Name in Medicare recordsHIGGINS GENERAL HOSPITAL
Profile levelMedicare data + hospital website
Official websitetanner.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Higgins General Hospital | Tanner Health System - Tanner Health — tanner.org