Does Jackson County Regional Health Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Jackson County Regional Health Center. In a medical emergency, call 911.

Where is Jackson County Regional Health Center?

700 W Grove St, Maquoketa, IA 52060, in Jackson County, Iowa.

What is the phone number of Jackson County Regional Health Center?

(563) 652-2474, as listed by Medicare (CMS).

What is the Medicare star rating of Jackson County Regional Health Center?

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.

Jackson County Regional Health Center

Quick answers

Does Jackson County Regional Health Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Jackson County Regional Health Center. In a medical emergency, call 911.
Where is Jackson County Regional Health Center?: 700 W Grove St, Maquoketa, IA 52060, in Jackson County, Iowa.
What is the phone number of Jackson County Regional Health Center?: (563) 652-2474, as listed by Medicare (CMS).
What is the Medicare star rating of Jackson County Regional Health Center?: 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][5][7][8]

Treatments^[4][5]

Physical therapy
Occupational therapy
Speech therapy
Cardiac rehabilitation
Pulmonary rehabilitation
Inpatient and skilled care
Ambulance service (paramedic level)

Procedures^[4][7]

Cataract surgery
Endoscopy
CT scan
MRI
Digital mammography
Bone densitometry
Echocardiography
Nuclear medicine imaging
Ultrasound
X-ray

Programs and centers^[4]

Diabetes education
Cardiac rehabilitation
Pulmonary rehabilitation
Infection prevention
Script Assist
SHIIP Medicare counseling
Fitness center

Emergency care (hospital website)^[5]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	No current visitor restrictions; cafeteria lunch 11:30 a.m.-1 p.m. Regular visiting hours not stated^[6]
Patient portal	MyChart

Recognition^[5]

Level IV Community Trauma Center

Doctors and clinicians (115)

115 doctors and other clinicians list Jackson County Regional Health Center 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 (115)

Adam Osborne, CNACertified Registered Nurse Anesthetist (CRNA)
Adiba M. SirojevaNurse Practitioner
Aditya Sukhwal, MDFamily Practice
Ahmad El-Hattab, MDGeneral Surgery
Alethia GrahamNurse Practitioner
Alexander K. Chung, MDHospitalist
Alison E. Fraehlich, MDHospitalist
Allie T. ThornburgPhysician Assistant
Amanda J. PetersonNurse Practitioner
Amanda River, MDEmergency Medicine
Amy M. Kibler, DOFamily Practice
Andrew D. Bries, MDSports Medicine
Andrew Pugely, MDOrthopedic Surgery
Angela K. VervoortPhysician Assistant
Ann E. PattersonNurse Practitioner
Ann M. Leland, CNACertified Registered Nurse Anesthetist (CRNA)
Anoop Aggarwal, MDHematology/Oncology
Arjun K. Ramesh, MDAnesthesiology
Ashley R. CaesNurse Practitioner
Ashley S. Skrocki, CNACertified Registered Nurse Anesthetist (CRNA)
Benjamin B. Kumor, MDFamily Practice
Benjamin D. Acton, DOGeneral Surgery
Benjamin Holler, MDFamily Practice
Benjamin J. Janson, MDOphthalmology

And 91 more: the button below opens the full list.

Other emergency rooms nearby

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

MercyOne Genesis Dewitt Medical Center18 mi · Dewitt, IA · Critical Access Hospital
Midwest Medical Center28 mi · Galena, IL · Critical Access Hospital
MercyOne Clinton Medical Center29 mi · Clinton, IA · Acute Care Hospital
MercyOne Dubuque Medical Center29 mi · Dubuque, IA · Acute Care Hospital
Jones Regional Medical Center30 mi · Anamosa, IA · Critical Access Hospital

Other hospitals nearby

Finley Hospital33 mi · Dubuque, IA · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Maquoketa Care Center0.3 mi · Maquoketa, IA · 3 of 5 stars
Jackson Ridge Healthcare Center0.6 mi · Maquoketa, IA · 3 of 5 stars
Mill Valley Care Center17 mi · Bellevue, IA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Jackson County1.9 mi · Maquoketa, IA · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Open Arms Home Health Care, L L C25 mi · Dubuque, IA

All home health agencies 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.

Clinics and urgent care

MercyOne Genesis Dewitt Family Medicine18 mi · De Witt, IA · Rural health clinic
UnityPoint Health-Family Medicine Clinic-Clarence22 mi · Clarence, IA · Rural health clinic

Pharmacies

Maquoketa Pharmacy Inc1.9 mi · Maquoketa, IA · Pharmacy
Walmart Inc.1.9 mi · Maquoketa, IA · Community/retail pharmacy

Assisted living nearby

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

Clover Ridge Place1.9 mi · Maquoketa, IA

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 Jackson County Regional Health Center 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	73%National average: 72%
Would definitely recommend the hospital	80%National average: 71%
Nurses “always” communicated well	91%National average: 80%
Doctors “always” communicated well	92%National average: 80%
Staff “always” explained medicines before giving them	76%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	95%National average: 74%
Area around the room “always” quiet at night	83%National average: 60%
Completed surveys	26Response rate: 27%

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	21.7%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.7%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	77 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	81%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Iowa Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 56 common services exactly as Jackson County Regional Health Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: JC PAIN NEW LEVEL 3	$167	$167	$72.61 – $185.27
New patient office visit (about 30–44 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $140.11 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $125.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $141.95 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $125.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $77.59 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $76.82 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $76.82 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $76.82 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $73.48 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $73.48
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: GHS NEW PAT EXPANDED PROBLEM LOW COMPLEX W PROC	$191	$191	$72.61 – $185.27
New patient office visit (about 30–44 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $160.25 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $143.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $162.35 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $143.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $88.74 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $87.86 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $87.86 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $87.86 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $84.04 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $84.04
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: GHS NEW PAT EXPANDED PROBLEM LOW COMPLEX	$191	$191	$72.61 – $185.27
New patient office visit (about 30–44 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $160.25 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $143.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $162.35 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $143.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $88.74 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $87.86 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $87.86 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $87.86 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $84.04 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $84.04
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: GHS NEW PAT DETAILED MODERATE COMPLEX W PROC	$248	$248	$107.83 – $266.75
New patient office visit (about 45–59 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $208.07 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $186 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $210.80 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $186 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $115.22 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $114.08 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $114.08 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $114.08 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $109.12 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $109.12
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: GHS NEW PAT DETAILED MODERATE COMPLEXITY	$248	$248	$107.83 – $266.75
New patient office visit (about 45–59 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $208.07 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $186 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $210.80 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $186 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $115.22 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $114.08 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $114.08 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $114.08 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $109.12 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $109.12
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: JC PAIN NEW LEVEL 4	$275	$275	$107.83 – $266.75
New patient office visit (about 45–59 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $230.73 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $206.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $233.75 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $206.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $127.77 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $126.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $126.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $126.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $121 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $121
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: GHS NEW PAT COMPREHENSIVE HIGH COMPLEX W PROC	$279	$279	$120.87 – $270.63
New patient office visit (about 60–74 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $234.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $209.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $237.15 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $209.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $128.34 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.76 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $122.76
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: GHS NEW PAT COMPREHENSIVE HIGH COMPLEXITY	$279	$279	$120.87 – $270.63
New patient office visit (about 60–74 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $234.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $209.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $237.15 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $209.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $128.34 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.76 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $122.76
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: JC PAIN NEW LEVEL 5	$278	$278	$120.87 – $270.63
New patient office visit (about 60–74 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $233.24 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $208.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $236.30 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $208.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.16 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $127.88 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $127.88 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $127.88 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.32 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $122.32
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: GHS ESTAB PAT EXPANDED PROBLEM LOW COMPLEX	$204	$204	$83.48 – $197.88
Established patient office visit (about 20–29 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $171.16 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $153 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $173.40 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $153 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $94.78 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $93.84 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $93.84 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $93.84 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $89.76 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $89.76
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: GHS ESTAB PAT EXPANDED PROBLEM LOW COMPLEX W PROC	$204	$204	$83.48 – $197.88
Established patient office visit (about 20–29 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $171.16 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $153 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $173.40 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $153 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $94.78 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $93.84 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $93.84 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $93.84 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $89.76 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $89.76
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: JC PAIN EST LEVEL 3	$192	$192	$83.48 – $197.88
Established patient office visit (about 20–29 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $161.09 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $144 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $163.20 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $144 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $89.20 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $88.32 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $88.32 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $88.32 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $84.48 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $84.48
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: GHS ESTAB PAT DETAILED MODERATE COMPLEX W PROC	$284	$284	$97.83 – $275.48
Established patient office visit (about 30–39 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $238.28 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $213 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $241.40 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $213 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $131.95 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $130.64 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $130.64 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $130.64 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $124.96 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $124.96
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: GHS ESTAB PAT DETAILED MODERATE COMPLEX	$284	$284	$97.83 – $275.48
Established patient office visit (about 30–39 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $238.28 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $213 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $241.40 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $213 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $131.95 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $130.64 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $130.64 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $130.64 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $124.96 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $124.96
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: JC PAIN EST LEVEL 4	$225	$225	$97.83 – $275.48
Established patient office visit (about 30–39 minutes): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $188.78 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $168.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $191.25 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $168.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $104.54 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $103.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $103.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $103.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $99 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $99
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: GHS ASSAULT EXAMINOR	$266	$266	$61.18 – $662.51
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $223.17 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $199.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $226.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $199.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $61.79 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $61.18 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $61.18 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $61.18 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $117.04 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $117.04
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE 3 W DIAG THER PROC	$683	$683	$61.18 – $662.51
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $573.04 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $512.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $580.55 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $512.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $158.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $157.09 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $157.09 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $157.09 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $300.52 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $300.52
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE LEVEL 3	$683	$683	$61.18 – $662.51
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $573.04 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $512.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $580.55 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $512.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $158.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $157.09 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $157.09 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $157.09 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $300.52 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $300.52
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE 4 W DIAG THER PROC	$1,142	$1,142	$262.66 – $1,107.74
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $958.14 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $856.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $970.70 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $856.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $265.29 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $262.66 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $262.66 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $262.66 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $502.48 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $502.48
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE LEVEL 4	$1,142	$1,142	$262.66 – $1,107.74
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $958.14 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $856.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $970.70 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $856.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $265.29 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $262.66 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $262.66 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $262.66 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $502.48 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $502.48
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: GHS LEVEL 4 W PROCEDURE	$357	$357	$123.10 – $582
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $299.52 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $267.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $303.45 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $267.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $165.86 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $164.22 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $164.22 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $164.22 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $123.10 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $123.10
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE 5 W DIAG THER PROC	$1,508	$1,508	$346.84 – $1,462.76
Emergency room visit (high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,265.21 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,131 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,281.80 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,131 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $350.31 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $346.84 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $346.84 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $346.84 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $663.52 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $663.52
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: GHS EMERGENCY CARE LEVEL 5	$1,508	$1,508	$346.84 – $1,462.76
Emergency room visit (high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,265.21 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,131 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,281.80 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,131 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $350.31 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $346.84 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $346.84 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $346.84 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $663.52 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $663.52
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: GHS LEVEL 5 W PROCEDURE	$525	$525	$179.01 – $721.68
Emergency room visit (high): 10 of 18 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $440.48 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $393.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $446.25 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $393.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $243.92 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $241.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $241.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $241.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $179.01 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $179.01

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP8	$65	$65	$28.26 – $134.83
Basic metabolic panel (blood test): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $54.54 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $48.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $55.25 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $48.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $30.20 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $29.90 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $29.90 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $29.90 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $28.60
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL	$139	$139	$28.26 – $134.83
Basic metabolic panel (blood test): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $116.62 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $104.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $118.15 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $104.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $64.58 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $63.94 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $63.94 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $63.94 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $61.16
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL	$190	$190	$58.06 – $184.30
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $159.41 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $142.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $161.50 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $142.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $88.27 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $87.40 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $87.40 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $87.40 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $83.60
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL W REFLEX DIRECT LDL	$134	$134	$58.06 – $129.98
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $112.43 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $100.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $113.90 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $100.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $62.26 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $61.64 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $61.64 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $61.64 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $58.96
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: ADD-ON NMR LIPO-LIPID PROFILE	$101	$101	$43.91 – $129.98
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $84.74 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $75.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $85.85 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $75.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $46.92 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $46.46 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $46.46 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $46.46 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $44.44
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$134	$134	$43.91 – $129.98
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $112.43 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $100.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $113.90 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $100.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $62.26 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $61.64 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $61.64 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $61.64 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $58.96
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENALPNL10	$66	$66	$28.70 – $166.84
Kidney function panel: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $55.37 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $49.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $56.10 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $49.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $30.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $30.36 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $30.36 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $30.36 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $29.04
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$172	$172	$28.70 – $166.84
Kidney function panel: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $144.31 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $129 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $146.20 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $129 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $79.91 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $79.12 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $79.12 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $79.12 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $75.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION	$143	$143	$58.06 – $138.71
Liver function panel: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $119.98 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $107.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $121.55 IL_BLUECROSS — BLUE CROSS OF IL: $121.10 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $107.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $66.44 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $65.78 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $65.78 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $65.78 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $62.92
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA ROUTINE W MICRO AND CULTURE IF INDICATED IRIS	$62	$62	$26.74 – $60.14
Urine test (automated, with microscope): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $52.02 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $46.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $52.70 IL_BLUECROSS — BLUE CROSS OF IL: $37 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $46.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $28.81 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $28.52 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $28.52 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $28.52 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $27.28
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: URINALYSIS MACROSCOPIC W REFLEX TO CANDS	$33	$33	$14.35 – $32.01
Urine test (manual, without microscope): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $27.69 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $24.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $28.05 IL_BLUECROSS — BLUE CROSS OF IL: $28.59 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $24.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $15.33 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $15.18 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $15.18 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $15.18 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $14.52
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: URINALYSIS MACROSCOPIC WITH REFLEX	$34	$34	$14.78 – $32.98
Urine test (automated, without microscope): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $28.53 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $25.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $28.90 IL_BLUECROSS — BLUE CROSS OF IL: $28.59 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $25.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $15.80 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $15.64 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $15.64 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $15.64 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $14.96
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA TOTAL REFLEX TO FREE-SENDOUT	$220	$220	$48.70 – $213.40
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $184.58 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $165 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $187 IL_BLUECROSS — BLUE CROSS OF IL: $116.90 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $165 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $102.21 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $101.20 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $101.20 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $101.20 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $96.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: ADD-ON PSA T+F-PSA TOT	$164	$164	$48.70 – $213.40
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $137.60 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $123 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $139.40 IL_BLUECROSS — BLUE CROSS OF IL: $116.90 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $123 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $76.19 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $75.44 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $75.44 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $75.44 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $72.16
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROSTATE SPECIFIC AG - SENDOUT	$112	$112	$48.70 – $213.40
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $93.97 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $84 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $95.20 IL_BLUECROSS — BLUE CROSS OF IL: $116.90 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $84 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $52.04 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $51.52 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $51.52 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $51.52 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $49.28
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: THYROID CASCADE PROFILE - SENDOUT	$125	$125	$48.13 – $180.42
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $104.88 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $93.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $106.25 IL_BLUECROSS — BLUE CROSS OF IL: $74.85 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $93.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $58.08 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $57.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $57.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $57.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $55
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: ADD-ON TSH	$155	$155	$48.13 – $180.42
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $130.05 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $116.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $131.75 IL_BLUECROSS — BLUE CROSS OF IL: $74.85 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $116.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $72.01 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $71.30 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $71.30 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $71.30 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $68.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH-SENDOUT	$124	$124	$48.13 – $180.42
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $104.04 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $93 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $105.40 IL_BLUECROSS — BLUE CROSS OF IL: $74.85 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $93 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $57.61 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $57.04 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $57.04 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $57.04 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $54.56
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: BILL ONLY - CBC PLATELET AUTOMATED DIFFERENTIAL	$131	$131	$28.27 – $127.07
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $109.91 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $98.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $111.35 IL_BLUECROSS — BLUE CROSS OF IL: $53.82 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $98.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $60.86 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $60.26 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $60.26 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $60.26 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $57.64
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBCPLTNODIFF	$50	$50	$21.74 – $77.60
Complete blood count (CBC), automated: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $41.95 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $37.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $42.50 IL_BLUECROSS — BLUE CROSS OF IL: $53.82 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $37.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $23.23 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $23 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $23 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $23 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $22
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HEMOGRAM CBC PLT W O DIFF	$80	$80	$21.74 – $77.60
Complete blood count (CBC), automated: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $67.12 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $60 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $68 IL_BLUECROSS — BLUE CROSS OF IL: $53.82 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $60 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $37.17 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $36.80 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $36.80 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $36.80 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $35.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME	$87	$87	$8.26 – $99.91
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $72.99 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $65.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $73.95 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $65.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $40.42 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $40.02 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $40.02 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $40.02 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $38.28
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ADD-ON APSPRO-PT	$19	$19	$8.26 – $99.91
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $15.94 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $14.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $16.15 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $14.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $8.83 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $8.74 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $8.74 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $8.74 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $8.36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: ADD-ON THROMBOSIS-PROTHROMBIN TIME	$103	$103	$8.26 – $99.91
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $86.42 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $77.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $87.55 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $77.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $47.85 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $47.38 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $47.38 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $47.38 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $45.32
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: ADD-ON THROM VKA-APTT	$168	$168	$11.30 – $205.64
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $140.95 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $126 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $142.80 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $126 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $78.05 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $77.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $77.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $77.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $73.92
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PARTIAL THROMBOPLASTIN TIME	$103	$103	$11.30 – $205.64
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $86.42 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $77.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $87.55 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $77.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $47.85 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $47.38 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $47.38 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $47.38 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $45.32
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: ADD-ON VONWILL SCRN- APTT	$212	$212	$11.30 – $205.64
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $177.87 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $159 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $180.20 IL_BLUECROSS — BLUE CROSS OF IL: $36.16 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $159 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $98.50 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $97.52 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $97.52 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $97.52 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $93.28

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD STROKE ALERT	$1,994	$1,994	$343.13 – $1,934.18
CT scan of the head or brain, without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,672.97 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,495.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,694.90 IL_BLUECROSS — BLUE CROSS OF IL: $343.13 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,495.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $926.41 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $917.24 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $917.24 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $917.24 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $877.36
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD W OUT CONTRAST	$97	$97	$42.06 – $938.56
CT scan of the head or brain, without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $81.38 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $72.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $82.45 IL_BLUECROSS — BLUE CROSS OF IL: $343.13 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $72.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $45.07 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $44.62 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $44.62 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $44.62 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $42.06
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MR BRAIN W WO CONTRAST	$5,062	$5,062	$1,014.59 – $4,910.14
MRI of the brain, before and after contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $4,247.02 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $3,796.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $4,302.70 IL_BLUECROSS — BLUE CROSS OF IL: $1,077.32 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $3,796.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $2,351.81 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $2,328.52 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $2,328.52 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $2,328.52 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $2,227.28
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: PORT CHEST 2 VWS	$338	$338	$92.51 – $327.86
Chest X-ray, 2 views: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $283.58 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $253.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $287.30 IL_BLUECROSS — BLUE CROSS OF IL: $92.51 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $253.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $157.03 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $155.48 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $155.48 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $155.48 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $148.72
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: PORT CHEST 2 VIEWS	$25	$25	$10.74 – $143.81
Chest X-ray, 2 views: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $20.98 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $18.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $21.25 IL_BLUECROSS — BLUE CROSS OF IL: $92.51 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $18.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $11.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $11.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $11.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $11.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $10.74
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: SPINE LUMBAR 5 VWS	$591	$591	$92.51 – $573.27
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $495.85 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $443.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $502.35 IL_BLUECROSS — BLUE CROSS OF IL: $92.51 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $443.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $274.58 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $271.86 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $271.86 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $271.86 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $260.04
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: AFC GENERIC ADD-ON GHS MRI SPINE LUMBAR W O C	$2,925	$2,925	$736.50 – $2,837.25
MRI of the lower back (lumbar spine), without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $2,454.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $2,193.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $2,486.25 IL_BLUECROSS — BLUE CROSS OF IL: $790.54 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $2,193.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,358.96 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,345.50 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,345.50 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,345.50 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,287
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MR SPINE LUMBAR WO CONTRAST	$169	$169	$73.20 – $810.72
MRI of the lower back (lumbar spine), without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $141.79 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $126.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $143.65 IL_BLUECROSS — BLUE CROSS OF IL: $790.54 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $126.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $78.52 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $77.74 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $77.74 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $77.74 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $73.20
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W CONTRAST	$2,502	$2,502	$842.68 – $2,426.94
CT scan of the pelvis, with contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $2,099.18 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,876.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $2,126.70 IL_BLUECROSS — BLUE CROSS OF IL: $842.68 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,876.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,162.43 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,150.92 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,150.92 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,150.92 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,100.88
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MR ANKLE JOINT W O CONTRAST - BIL	$4,035	$4,035	$736.50 – $3,913.95
MRI of a leg joint (such as the knee), without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,385.37 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $3,026.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $3,429.75 IL_BLUECROSS — BLUE CROSS OF IL: $867.91 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $3,026.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,874.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,856.10 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,856.10 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,856.10 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,775.40
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MR ANKLE JOINT W O CONTRAST - R	$2,973	$2,973	$736.50 – $3,913.95
MRI of a leg joint (such as the knee), without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $2,494.35 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $2,229.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $2,527.05 IL_BLUECROSS — BLUE CROSS OF IL: $867.91 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $2,229.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,381.26 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,367.58 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,367.58 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,367.58 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,308.12
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MR KNEE - BIL	$4,035	$4,035	$736.50 – $3,913.95
MRI of a leg joint (such as the knee), without contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,385.37 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $3,026.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $3,429.75 IL_BLUECROSS — BLUE CROSS OF IL: $867.91 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $3,026.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,874.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,856.10 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,856.10 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,856.10 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,775.40
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN PELVIS W CONTRAST	$4,761	$4,761	$842.68 – $4,618.17
CT scan of the abdomen and pelvis, with contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,994.48 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $3,570.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $4,046.85 IL_BLUECROSS — BLUE CROSS OF IL: $842.68 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $3,570.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $2,211.96 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $2,190.06 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $2,190.06 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $2,190.06 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $2,094.84
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN PELVIS W C	$4,439	$4,439	$842.68 – $4,618.17
CT scan of the abdomen and pelvis, with contrast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,724.32 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $3,329.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $3,773.15 IL_BLUECROSS — BLUE CROSS OF IL: $842.68 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $3,329.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $2,062.36 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $2,041.94 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $2,041.94 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $2,041.94 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,953.16
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMINAL COMPLETE	$1,205	$1,205	$343.97 – $1,168.85
Ultrasound of the abdomen, complete: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,011 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $903.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,024.25 IL_BLUECROSS — BLUE CROSS OF IL: $343.97 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $903.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $559.84 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $554.30 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $554.30 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $554.30 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $530.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB COMPTWIN GEST MORE THAN 14WK	$872	$872	$275.80 – $1,127.14
Pregnancy ultrasound (after the first trimester): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $731.61 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $654 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $741.20 IL_BLUECROSS — BLUE CROSS OF IL: $304.44 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $654 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $405.13 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $401.12 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $401.12 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $401.12 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $383.68
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB COMP SINGLEGEST MORE THAN 14WK	$1,162	$1,162	$275.80 – $1,127.14
Pregnancy ultrasound (after the first trimester): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $974.92 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $871.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $987.70 IL_BLUECROSS — BLUE CROSS OF IL: $304.44 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $871.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $539.87 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $534.52 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $534.52 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $534.52 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $511.28
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANS VAG PELVIC	$518	$518	$225.23 – $502.46
Transvaginal ultrasound: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $434.60 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $388.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $440.30 IL_BLUECROSS — BLUE CROSS OF IL: $343.97 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $388.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $240.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $238.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $238.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $238.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $227.92
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANS VAGINAL PELVIC LIMITED	$518	$518	$225.23 – $502.46
Transvaginal ultrasound: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $434.60 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $388.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $440.30 IL_BLUECROSS — BLUE CROSS OF IL: $343.97 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $388.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $240.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $238.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $238.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $238.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $227.92
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: BR DIAGNOSTIC MAM R WCAD	$535	$535	$198.70 – $518.95
Diagnostic mammogram, one breast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $448.87 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $401.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $454.75 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $401.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $248.56 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $246.10 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $235.40
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: BR DIAGNOSTIC MAM L WCAD	$535	$535	$198.70 – $518.95
Diagnostic mammogram, one breast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $448.87 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $401.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $454.75 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $401.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $248.56 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $246.10 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $235.40
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAMMO UNI RT W CAD	$535	$535	$198.70 – $518.95
Diagnostic mammogram, one breast: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $448.87 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $401.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $454.75 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $401.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $248.56 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $246.10 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $246.10 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $235.40
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: JACKSON CDM	$718	$718	$210.10 – $696.46
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $602.40 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $538.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $610.30 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $538.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $333.58 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $330.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $330.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $330.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $315.92 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $315.92
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: BR DIAGNOSTIC MAM BIL WCAD	$718	$718	$210.10 – $696.46
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $602.40 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $538.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $610.30 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $538.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $333.58 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $330.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $330.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $330.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $315.92 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $315.92
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MG 3D BILATERAL EXTRA VIEWS	$713	$713	$210.10 – $696.46
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $598.21 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $534.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $606.05 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $534.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $331.26 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $327.98 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $327.98 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $327.98 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $313.72 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $313.72
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: JACKSON CDM	$583	$583	$83.26 – $585.88
Screening mammogram, both breasts: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $489.14 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $437.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $495.55 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $437.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $270.86 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $268.18 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $83.26
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO UNILATERAL LT W CAD	$583	$583	$83.26 – $585.88
Screening mammogram, both breasts: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $489.14 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $437.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $495.55 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $437.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $270.86 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $268.18 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $83.26
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: BR SCREEN MAM R WCAD	$583	$583	$83.26 – $585.88
Screening mammogram, both breasts: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $489.14 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $437.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $495.55 IL_BLUECROSS — BLUE CROSS OF IL: $344.81 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $437.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $270.86 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $268.18 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $268.18 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $83.26

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAM	$3,856	$3,856	$1,676.59 – $3,740.32
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,235.18 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $2,892 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $3,277.60 IL_BLUECROSS — BLUE CROSS OF IL: $1,740.03 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $2,892 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,791.50 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,773.76 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,773.76 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,773.76 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,696.64
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAM DISCONTINUE	$3,856	$3,856	$1,676.59 – $3,740.32
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $3,235.18 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $2,892 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $3,277.60 IL_BLUECROSS — BLUE CROSS OF IL: $1,740.03 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $2,892 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,791.50 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,773.76 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,773.76 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,773.76 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $1,696.64

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPEUTIC EXERC 15M PT KX	$137	$137	$59.57 – $201.84
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $114.94 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $102.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $116.45 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $102.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $63.65 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $63.02 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $60.28
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPEUTIC EXERC 15M OT KX	$137	$137	$59.57 – $201.84
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $114.94 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $102.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $116.45 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $102.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $63.65 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $63.02 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $60.28
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THERAPEUTIC EXERC 15M PT	$137	$137	$59.57 – $201.84
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $114.94 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $102.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $116.45 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $102.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $63.65 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $63.02 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $63.02 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $60.28
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMPLEX 30M KX	$263	$263	$114.35 – $255.11
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $220.66 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $197.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $223.55 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $197.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $122.19 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $120.98 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $115.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMPLEX 15 MIN KX	$263	$263	$114.35 – $255.11
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $220.66 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $197.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $223.55 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $197.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $122.19 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $120.98 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $115.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMPLEX 30M	$263	$263	$114.35 – $255.11
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $220.66 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $197.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $223.55 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $197.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $122.19 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $120.98 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $120.98 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $115.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MOD COMPLEX 30M	$279	$279	$121.31 – $270.63
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $234.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $209.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $237.15 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $209.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $128.34 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.76
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MOD COMPLEX 30M KX	$279	$279	$121.31 – $270.63
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $234.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $209.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $237.15 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $209.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $128.34 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.76
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MOD COMPLEX 15 MIN KX	$279	$279	$121.31 – $270.63
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $234.08 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $209.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $237.15 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $209.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $129.62 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $128.34 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $128.34 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $122.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEX 30M KX	$296	$296	$128.70 – $287.12
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $248.34 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $222 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $251.60 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $222 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $137.52 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $136.16 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $130.24
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEX 15 MIN KX	$296	$296	$128.70 – $287.12
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $248.34 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $222 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $251.60 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $222 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $137.52 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $136.16 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $130.24
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEX 30M	$296	$296	$128.70 – $287.12
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $248.34 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $222 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $251.60 IL_BLUECROSS — BLUE CROSS OF IL: $201.84 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $222 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $137.52 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $136.16 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $136.16 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $130.24

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: OR EXC CYST OPEN 1 OR MORE LES	$1,402	$1,402	$609.59 – $3,889.63
Removal of breast growth (open surgery): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,176.28 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,051.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,191.70 IL_BLUECROSS — BLUE CROSS OF IL: $3,889.63 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,051.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $651.37 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $644.92 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $644.92 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $644.92 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $616.88
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL BREAST LESION	$1,618	$1,618	$577.62 – $3,889.63
Removal of breast growth (open surgery): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,357.50 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,213.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,375.30 IL_BLUECROSS — BLUE CROSS OF IL: $3,889.63 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,213.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $751.72 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $744.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $744.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $744.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $577.62
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: TONSILLECTOMY ADEN >AGE12	$1,205	$1,205	$268.97 – $5,177.20
Removal of tonsils and adenoids (under age 12): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,011 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $903.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,024.25 IL_BLUECROSS — BLUE CROSS OF IL: $5,177.20 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $903.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $559.84 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $554.30 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $554.30 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $554.30 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $268.97
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS ADENOIDS <12 YO	$767	$767	$268.97 – $5,177.20
Removal of tonsils and adenoids (under age 12): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $643.51 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $575.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $651.95 IL_BLUECROSS — BLUE CROSS OF IL: $5,177.20 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $575.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $356.35 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $352.82 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $352.82 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $352.82 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $268.97
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: UPPER GI ENDOSCOPY DIAG	$923	$923	$332.49 – $3,275.70
Upper GI endoscopy (diagnostic): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $774.40 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $692.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $784.55 IL_BLUECROSS — BLUE CROSS OF IL: $3,275.70 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $692.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $428.83 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $424.58 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $424.58 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $424.58 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $332.49
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: UPPER GI ENDOSCOPY BIOPSY	$1,227	$1,227	$431.41 – $3,275.70
Upper GI endoscopy with biopsy: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,029.45 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $920.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,042.95 IL_BLUECROSS — BLUE CROSS OF IL: $3,275.70 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $920.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $570.06 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $564.42 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $564.42 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $564.42 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $431.41
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: COLONOSCOPY	$1,874	$1,874	$389.64 – $3,504.45
Colonoscopy (diagnostic): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,572.29 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,405.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,592.90 IL_BLUECROSS — BLUE CROSS OF IL: $3,504.45 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,405.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $870.66 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $862.04 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $862.04 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $862.04 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $389.64
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY	$2,298	$2,298	$494.77 – $3,504.45
Colonoscopy with biopsy: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,928.02 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,723.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,953.30 IL_BLUECROSS — BLUE CROSS OF IL: $3,504.45 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,723.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,067.65 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,057.08 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,057.08 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,057.08 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $494.77
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: LESION REMOVAL COLONOSCOP SNARE	$2,153	$2,153	$516.71 – $3,999.80
Colonoscopy with removal of polyps (snare): 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,806.37 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,614.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,830.05 IL_BLUECROSS — BLUE CROSS OF IL: $3,999.80 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,614.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,000.28 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $990.38 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $990.38 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $990.38 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $516.71
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLON CA SCRN NOT HI RISK	$1,128	$1,128	$389.79 – $3,504.45
Screening colonoscopy (not high risk): 10 of 20 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $946.39 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $846 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $958.80 IL_BLUECROSS — BLUE CROSS OF IL: $3,504.45 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $846 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $524.07 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $518.88 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $518.88 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $518.88 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $389.79
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECT	$3,518	$3,518	$628.34 – $12,373.63
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $2,951.60 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $2,638.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $2,990.30 IL_BLUECROSS — BLUE CROSS OF IL: $12,373.63 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $2,638.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,634.46 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,618.28 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,618.28 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,618.28 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $628.34
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: REPAIR INGUINAL HERNIA	$2,571	$2,571	$505.58 – $9,227.45
Groin (inguinal) hernia repair, age 5 or older: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $2,157.07 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,928.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $2,185.35 IL_BLUECROSS — BLUE CROSS OF IL: $8,354.49 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,928.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $1,194.49 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $1,182.66 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $1,182.66 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $1,182.66 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $505.58
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE-CLINIC	$715	$715	$310.88 – $4,765.95
Prostate biopsy: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $599.89 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $536.25 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $607.75 IL_BLUECROSS — BLUE CROSS OF IL: $4,765.95 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $536.25 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $332.19 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $328.90 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $328.90 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $328.90 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $314.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: LUMBAR SACRAL SINGLE W FLUOROSCY JC	$1,045	$1,045	$454.37 – $1,730.78
Spinal injection, lower back (epidural), with imaging guidance: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $876.76 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $783.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $888.25 IL_BLUECROSS — BLUE CROSS OF IL: $1,730.78 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $783.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $485.51 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $480.70 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $480.70 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $480.70 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $459.80
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: INJ TRANSFORAMINAL LUMB SINGLE UNI	$2,014	$2,014	$875.69 – $3,138.61
Nerve root injection, lower back, with imaging guidance: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,689.75 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,510.50 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,711.90 IL_BLUECROSS — BLUE CROSS OF IL: $3,138.61 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,510.50 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $935.70 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $926.44 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $926.44 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $926.44 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $886.16
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: NEUROPLASTY-MED NERVE CT	$1,621	$1,621	$490.85 – $3,838.32
Carpal tunnel release: 10 of 21 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $1,360.02 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $1,215.75 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $1,377.85 IL_BLUECROSS — BLUE CROSS OF IL: $3,787.02 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $1,215.75 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $753.12 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $745.66 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $745.66 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $745.66 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $490.85

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: ROUTINE OB CARE	$8,124	$8,124	$2,413.29 – $7,880.28
Cesarean delivery (C-section), with care before and after: 10 of 20 insurance plan rates AETNA_COVENTRY — AETNA COVENTRY: $6,816.04 CASH_PAY_W_DISCOUNT — CASH DISCOUNT: $6,093 HEALTH_CHOICES — HEALTH CHOICES - PREFERRED HEALTH CHOICES: $6,905.40 MAHP — MEDICAL ASSOCIATES HEALTH PLAN: $6,093 MCO_AMERIGROUP — MANAGED CARE IOWA MEDICAID: $3,774.41 MCO_AMERIHEALTH — MANAGED CARE IOWA MEDICAID: $3,737.04 MCO_IA_TOTALCARE — MANAGED CARE IOWA MEDICAID: $3,737.04 MCO_UNITEDHEALTHCARE — MANAGED CARE IOWA MEDICAID: $3,737.04 MCR_COVENTRY_HC — COVENTRY MEDICARE ADVANTAGE: $2,413.29 MCR_HUMANA — HUMANA MEDICARE ADVANTAGE: $2,413.29

Source: Jackson County Regional Health Center’s standard charges file (jcrhc.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on August 11, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	700 W Grove St, Maquoketa, IA 52060
County	Jackson County
State	Iowa
Phone	(563) 652‑2474
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	Not rated by CMS
CMS Certification Number	161329
Name in Medicare records	JACKSON COUNTY REGIONAL HEALTH CENTER
Profile level	Medicare data + hospital website
Official website	jcrhc.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

Better Health Close To Home - Jackson County Regional Health Center — jcrhc.org
24-HR Emergency Services - Jackson County Regional Health Center — jcrhc.org
Visitor Information - Jackson County Regional Health Center — jcrhc.org
Surgical Services - Jackson County Regional Health Center — jcrhc.org
Clinics - Jackson County Regional Health Center — jcrhc.org