Does Johnson Memorial Hospital have an emergency room?

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

Where is Johnson Memorial Hospital?

1282 Walnut Street, Dawson, MN 56232, in Lac Qui Parle County, Minnesota.

What is the phone number of Johnson Memorial Hospital?

(320) 769-4323, as listed by Medicare (CMS).

What is the Medicare star rating of Johnson Memorial Hospital?

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

Johnson Memorial Hospital — Phone, Address & ER

Quick answers

Does Johnson Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Johnson Memorial Hospital. In a medical emergency, call 911.
Where is Johnson Memorial Hospital?: 1282 Walnut Street, Dawson, MN 56232, in Lac Qui Parle County, Minnesota.
What is the phone number of Johnson Memorial Hospital?: (320) 769-4323, as listed by Medicare (CMS).
What is the Medicare star rating of Johnson Memorial Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4]

General Surgery
Emergency Medicine
Chemotherapy infusion
Wound Care
Swing Bed / Transitional Care

Conditions treated^[4]

Pneumonia
Heart failure
COPD exacerbation
Serious infections
GI obstruction
Dehydration
Acute kidney failure
Uncontrolled diabetes
Anemia
Stroke

Treatments^[4]

Chemotherapy
IV therapy
Blood transfusion
Outpatient observation
Swing bed rehabilitative care
Wound care
Hospice

Procedures^[4]

Same-day surgery
Endoscopy

Programs and centers^[4]

Swing Bed program
eEmergency (tele-emergency)
Comprehensive Advanced Life Support (CALS) certified

Emergency care (hospital website)^[4]

Emergency room	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	Suggested visiting hours 10:00 a.m.-8:30 p.m. daily; parents may visit hospitalized children any time^[5]
Parking	Visitor/patient parking at the front of the hospital; special parking for ER patients^[5]
Patient portal	MyChart (CentraCare)

Recognition^[4]

Level IV Trauma Center
Comprehensive Advanced Life Support (CALS) certified

Doctors and clinicians (27)

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

Main specialties

Doctors with a page on this site (27)

Alex J. Hannemann, MDUrology
Amanda M. ParadisNurse Practitioner
Anthony C. Nwakama, MDOrthopedic Surgery
Ayaz Virji, MDFamily Practice
Bruce W. Arvold, MDEmergency Medicine
Carla R. Lee, NPNurse Practitioner
Caroline L. Ho, MDDiagnostic Radiology
Curtis R. Louwagie, MDOphthalmology
Eduardo J. Perez, MDNeurosurgery
Erik J. Shelstad, MDFamily Practice
Glen C. Gross, MDDiagnostic Radiology
Jacklyn A. Karli, NPNurse Practitioner
Jessica M. MamerNurse Practitioner
Jon M. Sovell, CNACertified Registered Nurse Anesthetist (CRNA)
Julie A. OlsonNurse Practitioner
Kase A. Jacobs, NPNurse Practitioner
Kristina M. Rieffenberger, NPNurse Practitioner
Lindsey A. Hanson, MDFamily Practice
Lisa D. Bojado, NPNurse Practitioner
Lisa M. Baker, MDObstetrics/Gynecology
Martin H. Janning, MDOtolaryngology
Miriam V. Ragab, DOFamily Practice
Natasha M. EichornNurse Practitioner
Noah N. Chelliah, MDCardiovascular Disease (Cardiology)

And 3 more: the button below opens the full list.

Other emergency rooms nearby

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

Madison Hospital8.4 mi · Madison, MN · Critical Access Hospital
Chippewa County Hospital17 mi · Montevideo, MN · Critical Access Hospital
Sanford Canby Medical Center19 mi · Canby, MN · Critical Access Hospital
Appleton Area Health19 mi · Appleton, MN · Critical Access Hospital
Avera Granite Falls27 mi · Granite Falls, MN · Critical Access Hospital

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

Other hospitals near Dawson

Milbank Area Hospital/Avera Health32 mi · Milbank, SD · Critical Access Hospital

Hospitals in Lac Qui Parle County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Johnson Memorial Hospital & Home0.2 mi · Dawson, MN · 4 of 5 stars
Madison Healthcare Services8.4 mi · Madison, MN · 4 of 5 stars
Clarkfield Care Center16 mi · Clarkfield, MN · 4 of 5 stars

All nursing homes in the state →

Home health agencies

Madison Home Health Agency9.3 mi · Madison, MN
Clarkfield Home Health Agency17 mi · Clarkfield, MN
Sanford Canby Medical Center Home Care18 mi · Canby, MN · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

Sanford Canby Dialysis18 mi · Canby, MN

All dialysis facilities 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

Dawson Clinic1.4 mi · Dawson, MN · Rural health clinic
Lac Qui Parle Clinic of Madison Inc9.3 mi · Madison, MN · Rural health clinic
Boyd Clinic9.5 mi · Boyd, MN · Rural health clinic

Pharmacies

Dawson Drug PLLC1.4 mi · Dawson, MN · Community/retail pharmacy
Thrifty Drug Stores Inc9.3 mi · Madison, MN · Community/retail pharmacy

Assisted living nearby

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

Grace Haven Assisted Living9.3 mi · Madison, MN

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.6%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: heart attack; Readmitted within 30 days: heart failure; Readmitted within 30 days: pneumonia; Readmitted within 30 days: COPD; Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	128 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Not reported to Medicare	Sepsis patients who got all the recommended early care (SEP-1)

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

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Minnesota Best hospitals in Minnesota

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 67 common services exactly as Johnson Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 67 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: NEW PT LEVEL 3 OFFICE/OTHER OUTPT VISIT EVAL AND MGMT, LOW LEVEL MDM OR 30 MIN MET OR EXCEEDED	$169.74	$144.28	$65.57 – $166.70
New patient office visit (about 30–44 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $65.57 Blue Cross Blue Shield of MN — All Commercial Plans: $166.70 Blue Cross Blue Shield of MN — HMO: $141.39 Blue Cross Blue Shield of MN — Medicare Advantage: $88.16 Medicare A MN J6 — All Plans: $88.16 United Healthcare — All Commercial Plans: $156.16 United Healthcare — Medicare Advantage: $67.90
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: CLINICAL NURSING LEVEL 3 (NP)	$333.12	$283.15	$128.68 – $327.16
New patient office visit (about 30–44 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $128.68 Blue Cross Blue Shield of MN — All Commercial Plans: $327.16 Blue Cross Blue Shield of MN — HMO: $277.49 Blue Cross Blue Shield of MN — Medicare Advantage: $173.02 Medicare A MN J6 — All Plans: $173.02 United Healthcare — All Commercial Plans: $306.47 United Healthcare — Medicare Advantage: $133.25
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: NEW PT LEVEL 4 OFFICE/OTHER OUTPT VISIT EVAL AND MGMT, MODERATE LEVEL MDM OR 45 MIN MET OR EXCEEDED	$169.74	$144.28	$65.57 – $166.70
New patient office visit (about 45–59 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $65.57 Blue Cross Blue Shield of MN — All Commercial Plans: $166.70 Blue Cross Blue Shield of MN — HMO: $141.39 Blue Cross Blue Shield of MN — Medicare Advantage: $88.16 Medicare A MN J6 — All Plans: $88.16 United Healthcare — All Commercial Plans: $156.16 United Healthcare — Medicare Advantage: $67.90
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: CLINICAL NURSING LEVEL 4 (NP)	$444.52	$377.84	$171.72 – $436.56
New patient office visit (about 45–59 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $171.72 Blue Cross Blue Shield of MN — All Commercial Plans: $436.56 Blue Cross Blue Shield of MN — HMO: $370.29 Blue Cross Blue Shield of MN — Medicare Advantage: $230.89 Medicare A MN J6 — All Plans: $230.89 United Healthcare — All Commercial Plans: $408.96 United Healthcare — Medicare Advantage: $177.81
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: NEW PT LEVEL 5 OFFICE/OTHER OUTPT VISIT EVAL AND MGMT, HIGH LEVEL MDM OR 60 MIN MET OR EXCEEDED	$169.74	$144.28	$65.57 – $166.70
New patient office visit (about 60–74 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $65.57 Blue Cross Blue Shield of MN — All Commercial Plans: $166.70 Blue Cross Blue Shield of MN — HMO: $141.39 Blue Cross Blue Shield of MN — Medicare Advantage: $88.16 Medicare A MN J6 — All Plans: $88.16 United Healthcare — All Commercial Plans: $156.16 United Healthcare — Medicare Advantage: $67.90
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: CLINICAL NURSING LEVEL 5 (NP)	$554.85	$471.62	$214.34 – $544.92
New patient office visit (about 60–74 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $214.34 Blue Cross Blue Shield of MN — All Commercial Plans: $544.92 Blue Cross Blue Shield of MN — HMO: $462.19 Blue Cross Blue Shield of MN — Medicare Advantage: $288.19 Medicare A MN J6 — All Plans: $288.19 United Healthcare — All Commercial Plans: $510.46 United Healthcare — Medicare Advantage: $221.94
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: EST PT LEVEL 3 OFFICE/OTHER OUTPT VISIT EVAL AND MGMT, LOW LEVEL MDM OR 20 MIN MET OR EXCEEDED	$169.74	$144.28	$65.57 – $166.70
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $65.57 Blue Cross Blue Shield of MN — All Commercial Plans: $166.70 Blue Cross Blue Shield of MN — HMO: $141.39 Blue Cross Blue Shield of MN — Medicare Advantage: $88.16 Medicare A MN J6 — All Plans: $88.16 United Healthcare — All Commercial Plans: $156.16 United Healthcare — Medicare Advantage: $67.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: CLINICAL NURSING LEVEL 3 (EP)	$266.29	$226.35	$102.87 – $261.52
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $102.87 Blue Cross Blue Shield of MN — All Commercial Plans: $261.52 Blue Cross Blue Shield of MN — HMO: $221.82 Blue Cross Blue Shield of MN — Medicare Advantage: $138.31 Medicare A MN J6 — All Plans: $138.31 United Healthcare — All Commercial Plans: $244.99 United Healthcare — Medicare Advantage: $106.52
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: EST PT LEVEL 4 OFFICE/OTHER OUTPT VISIT EVAL AND MGMT, MODERATE LEVEL MDM OR 30 MIN MET OR EXCEEDED	$169.74	$144.28	$65.57 – $166.70
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $65.57 Blue Cross Blue Shield of MN — All Commercial Plans: $166.70 Blue Cross Blue Shield of MN — HMO: $141.39 Blue Cross Blue Shield of MN — Medicare Advantage: $88.16 Medicare A MN J6 — All Plans: $88.16 United Healthcare — All Commercial Plans: $156.16 United Healthcare — Medicare Advantage: $67.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: CLINICAL NURSING LEVEL 4 (EP)	$355.40	$302.09	$137.29 – $349.04
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $137.29 Blue Cross Blue Shield of MN — All Commercial Plans: $349.04 Blue Cross Blue Shield of MN — HMO: $296.05 Blue Cross Blue Shield of MN — Medicare Advantage: $184.59 Medicare A MN J6 — All Plans: $184.59 United Healthcare — All Commercial Plans: $326.97 United Healthcare — Medicare Advantage: $142.16
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFFICE OR OUTPT CONSULT, NEW OR EST PT, LOW MDM OR 30-39 MINS (PBB)	$222.79	$189.37	$86.06 – $218.80
Office consultation with a specialist (moderate): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $86.06 Blue Cross Blue Shield of MN — All Commercial Plans: $218.80 Blue Cross Blue Shield of MN — HMO: $185.58 Blue Cross Blue Shield of MN — Medicare Advantage: $115.72 Medicare A MN J6 — All Plans: $115.72 United Healthcare — All Commercial Plans: $204.97 United Healthcare — Medicare Advantage: $89.12
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFFICE OR OUTPT CONSULT, NEW OR EST PT, MODERATE MDM OR 40-54 MINS (PBB)	$275.83	$234.46	$106.55 – $270.89
Office consultation with a specialist (moderate to high): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $106.55 Blue Cross Blue Shield of MN — All Commercial Plans: $270.89 Blue Cross Blue Shield of MN — HMO: $229.77 Blue Cross Blue Shield of MN — Medicare Advantage: $143.27 Medicare A MN J6 — All Plans: $143.27 United Healthcare — All Commercial Plans: $253.76 United Healthcare — Medicare Advantage: $110.33
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: INITIAL PREVENTIVE CARE 18 - 39 YRS (RHC)	$336.31	$285.86	$129.92 – $330.29
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $129.92 Blue Cross Blue Shield of MN — All Commercial Plans: $330.29 Blue Cross Blue Shield of MN — HMO: $280.15 Blue Cross Blue Shield of MN — Medicare Advantage: $174.68 Medicare A MN J6 — All Plans: $174.68 United Healthcare — Medicare Advantage: $134.52
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: INITIAL PREVENTIVE CARE 40 - 64 YRS (RHC)	$335.24	$284.95	$129.50 – $329.24
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $129.50 Blue Cross Blue Shield of MN — All Commercial Plans: $329.24 Blue Cross Blue Shield of MN — HMO: $279.25 Blue Cross Blue Shield of MN — Medicare Advantage: $174.13 Medicare A MN J6 — All Plans: $174.13 United Healthcare — Medicare Advantage: $134.10
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: EMERGENT LEVEL 3	$703.78	$598.21	$271.87 – $691.18
Emergency room visit (moderate): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $271.87 Blue Cross Blue Shield of MN — All Commercial Plans: $691.18 Blue Cross Blue Shield of MN — HMO: $586.25 Blue Cross Blue Shield of MN — Medicare Advantage: $365.54 Medicare A MN J6 — All Plans: $365.54 United Healthcare — All Commercial Plans: $647.48 United Healthcare — Medicare Advantage: $281.51
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: EMERGENCY DEPARTMENT VISIT, LIMITED MDM (PRO CAH)	$186.72	$158.71	$51.82 – $127.58
Emergency room visit (moderate): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $51.82 Blue Cross Blue Shield of MN — All Commercial Plans: $127.58 Blue Cross Blue Shield of MN — HMO: $115.58 Blue Cross Blue Shield of MN — Medicare Advantage: $63.74 Medicare A MN J6 — All Plans: $96.98 United Healthcare — All Commercial Plans: $120.26 United Healthcare — Medicare Advantage: $65.04
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: EMERGENT LEVEL 4	$1,238.07	$1,052.36	$478.27 – $1,215.91
Emergency room visit (moderately high): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $478.27 Blue Cross Blue Shield of MN — All Commercial Plans: $1,215.91 Blue Cross Blue Shield of MN — HMO: $1,031.31 Blue Cross Blue Shield of MN — Medicare Advantage: $643.06 Medicare A MN J6 — All Plans: $643.06 United Healthcare — All Commercial Plans: $1,139.02 United Healthcare — Medicare Advantage: $495.23
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: EMERGENCY DEPARTMENT VISIT, MODERATE MDM (PRO CAH)	$350.10	$297.59	$88.15 – $228.04
Emergency room visit (moderately high): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $88.15 Blue Cross Blue Shield of MN — All Commercial Plans: $217.13 Blue Cross Blue Shield of MN — HMO: $197.21 Blue Cross Blue Shield of MN — Medicare Advantage: $108.24 Medicare A MN J6 — All Plans: $181.84 United Healthcare — All Commercial Plans: $228.04 United Healthcare — Medicare Advantage: $110.45
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: EMERGENT LEVEL 5	$1,801.41	$1,531.20	$695.88 – $1,769.16
Emergency room visit (high): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $695.88 Blue Cross Blue Shield of MN — All Commercial Plans: $1,769.16 Blue Cross Blue Shield of MN — HMO: $1,500.57 Blue Cross Blue Shield of MN — Medicare Advantage: $935.66 Medicare A MN J6 — All Plans: $935.66 United Healthcare — All Commercial Plans: $1,657.30 United Healthcare — Medicare Advantage: $720.56
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: EMERGENCY DEPARTMENT VISIT, HIGH MDM (PRO CAH)	$503.93	$428.34	$128.48 – $336.02
Emergency room visit (high): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $128.48 Blue Cross Blue Shield of MN — All Commercial Plans: $314.64 Blue Cross Blue Shield of MN — HMO: $285.95 Blue Cross Blue Shield of MN — Medicare Advantage: $157.48 Medicare A MN J6 — All Plans: $261.74 United Healthcare — All Commercial Plans: $336.02 United Healthcare — Medicare Advantage: $160.69

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PANEL	$196	$166.60	$17.22 – $180.32
Basic metabolic panel (blood test): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $17.22 Blue Cross Blue Shield of MN — All Commercial Plans: $43.06 Blue Cross Blue Shield of MN — HMO: $86.53 Blue Cross Blue Shield of MN — Medicare Advantage: $101.80 Medicare A MN J6 — All Plans: $101.80 United Healthcare — All Commercial Plans: $180.32 United Healthcare — Medicare Advantage: $78.40
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHENSIVE METABOLIC PANEL	$258	$219.30	$21.50 – $237.36
Comprehensive metabolic panel (blood test): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $21.50 Blue Cross Blue Shield of MN — All Commercial Plans: $53.75 Blue Cross Blue Shield of MN — HMO: $107.91 Blue Cross Blue Shield of MN — Medicare Advantage: $134.01 Medicare A MN J6 — All Plans: $134.01 United Healthcare — All Commercial Plans: $237.36 United Healthcare — Medicare Advantage: $103.20
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL	$160	$136	$27.26 – $147.20
Cholesterol panel (lipid panel): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $27.26 Blue Cross Blue Shield of MN — All Commercial Plans: $68.16 Blue Cross Blue Shield of MN — HMO: $108.93 Blue Cross Blue Shield of MN — Medicare Advantage: $83.10 Medicare A MN J6 — All Plans: $83.10 United Healthcare — All Commercial Plans: $147.20 United Healthcare — Medicare Advantage: $64
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL WITH DIRECT LDL	$167	$141.95	$27.26 – $153.64
Cholesterol panel (lipid panel): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $27.26 Blue Cross Blue Shield of MN — All Commercial Plans: $68.16 Blue Cross Blue Shield of MN — HMO: $108.93 Blue Cross Blue Shield of MN — Medicare Advantage: $86.74 Medicare A MN J6 — All Plans: $86.74 United Healthcare — All Commercial Plans: $153.64 United Healthcare — Medicare Advantage: $66.80
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL	$181	$153.85	$69.92 – $177.76
Kidney function panel: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $69.92 Blue Cross Blue Shield of MN — All Commercial Plans: $177.76 Blue Cross Blue Shield of MN — HMO: $150.77 Blue Cross Blue Shield of MN — Medicare Advantage: $94.01 Medicare A MN J6 — All Plans: $94.01 United Healthcare — All Commercial Plans: $166.52 United Healthcare — Medicare Advantage: $72.40
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL	$175	$148.75	$67.60 – $171.87
Liver function panel: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $67.60 Blue Cross Blue Shield of MN — All Commercial Plans: $171.87 Blue Cross Blue Shield of MN — HMO: $145.78 Blue Cross Blue Shield of MN — Medicare Advantage: $90.90 Medicare A MN J6 — All Plans: $90.90 United Healthcare — All Commercial Plans: $161 United Healthcare — Medicare Advantage: $70
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS, AUTOMATED, WITH MICROSCOPY	$83	$70.55	$32.06 – $81.51
Urine test (automated, with microscope): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $32.06 Blue Cross Blue Shield of MN — All Commercial Plans: $81.51 Blue Cross Blue Shield of MN — HMO: $69.14 Blue Cross Blue Shield of MN — Medicare Advantage: $43.11 Medicare A MN J6 — All Plans: $43.11 United Healthcare — All Commercial Plans: $76.36 United Healthcare — Medicare Advantage: $33.20
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS, MACROSCOPIC, AUTOMATED	$57	$48.45	$22.02 – $55.98
Urine test (automated, without microscope): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $22.02 Blue Cross Blue Shield of MN — All Commercial Plans: $55.98 Blue Cross Blue Shield of MN — HMO: $47.48 Blue Cross Blue Shield of MN — Medicare Advantage: $29.61 Medicare A MN J6 — All Plans: $29.61 United Healthcare — All Commercial Plans: $52.44 United Healthcare — Medicare Advantage: $22.80
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS WITH MACROSCOPIC, REFLEX TO MICROSCOPIC (MANUAL MICROSCOPIC)	$57	$48.45	$22.02 – $55.98
Urine test (automated, without microscope): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $22.02 Blue Cross Blue Shield of MN — All Commercial Plans: $55.98 Blue Cross Blue Shield of MN — HMO: $47.48 Blue Cross Blue Shield of MN — Medicare Advantage: $29.61 Medicare A MN J6 — All Plans: $29.61 United Healthcare — All Commercial Plans: $52.44 United Healthcare — Medicare Advantage: $22.80
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA, DIAGNOSTIC	$191	$162.35	$73.78 – $187.58
PSA (prostate specific antigen) blood test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $73.78 Blue Cross Blue Shield of MN — All Commercial Plans: $187.58 Blue Cross Blue Shield of MN — HMO: $159.10 Blue Cross Blue Shield of MN — Medicare Advantage: $99.21 Medicare A MN J6 — All Plans: $99.21 United Healthcare — All Commercial Plans: $175.72 United Healthcare — Medicare Advantage: $76.40
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA, SCREENING	$191	$162.35	$73.78 – $187.58
PSA (prostate specific antigen) blood test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $73.78 Blue Cross Blue Shield of MN — All Commercial Plans: $187.58 Blue Cross Blue Shield of MN — HMO: $159.10 Blue Cross Blue Shield of MN — Medicare Advantage: $99.21 Medicare A MN J6 — All Plans: $99.21 United Healthcare — All Commercial Plans: $175.72 United Healthcare — Medicare Advantage: $76.40
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · modifier 90 In the file: PROSTATESPECIFICANTIGEN(PSA);TOTAL(MAYO),Reference Laboratory	$191	$162.35	$73.78 – $187.58
PSA (prostate specific antigen) blood test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $73.78 Blue Cross Blue Shield of MN — All Commercial Plans: $187.58 Blue Cross Blue Shield of MN — HMO: $159.10 Blue Cross Blue Shield of MN — Medicare Advantage: $99.21 Medicare A MN J6 — All Plans: $99.21 United Healthcare — All Commercial Plans: $175.72 United Healthcare — Medicare Advantage: $76.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: THYROID STIMULATING HORMONE	$164	$139.40	$34.20 – $150.88
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $34.20 Blue Cross Blue Shield of MN — All Commercial Plans: $85.51 Blue Cross Blue Shield of MN — HMO: $136.41 Blue Cross Blue Shield of MN — Medicare Advantage: $85.18 Medicare A MN J6 — All Plans: $85.18 United Healthcare — All Commercial Plans: $150.88 United Healthcare — Medicare Advantage: $65.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 90 In the file: TSH,SENSITIVE,S(MAYO),Reference Laboratory	$164	$139.40	$34.20 – $150.88
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $34.20 Blue Cross Blue Shield of MN — All Commercial Plans: $85.51 Blue Cross Blue Shield of MN — HMO: $136.41 Blue Cross Blue Shield of MN — Medicare Advantage: $85.18 Medicare A MN J6 — All Plans: $85.18 United Healthcare — All Commercial Plans: $150.88 United Healthcare — Medicare Advantage: $65.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 90 In the file: THYROIDSTIMULATINGHORMONESENSITIVE(MAYO),Reference Laboratory	$164	$139.40	$34.20 – $150.88
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $34.20 Blue Cross Blue Shield of MN — All Commercial Plans: $85.51 Blue Cross Blue Shield of MN — HMO: $136.41 Blue Cross Blue Shield of MN — Medicare Advantage: $85.18 Medicare A MN J6 — All Plans: $85.18 United Healthcare — All Commercial Plans: $150.88 United Healthcare — Medicare Advantage: $65.60
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC WITH DIFFERENTIAL AND PLATELET COUNT	$153	$130.05	$15.82 – $140.76
Complete blood count (CBC) with differential: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $15.82 Blue Cross Blue Shield of MN — All Commercial Plans: $39.55 Blue Cross Blue Shield of MN — HMO: $79.40 Blue Cross Blue Shield of MN — Medicare Advantage: $79.47 Medicare A MN J6 — All Plans: $79.47 United Healthcare — All Commercial Plans: $140.76 United Healthcare — Medicare Advantage: $61.20
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM WITH PLATELET COUNT	$118	$100.30	$45.58 – $115.89
Complete blood count (CBC), automated: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $45.58 Blue Cross Blue Shield of MN — All Commercial Plans: $115.89 Blue Cross Blue Shield of MN — HMO: $98.29 Blue Cross Blue Shield of MN — Medicare Advantage: $61.29 Medicare A MN J6 — All Plans: $61.29 United Healthcare — All Commercial Plans: $108.56 United Healthcare — Medicare Advantage: $47.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTHROMBIN TIME	$80	$68	$30.90 – $78.57
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $30.90 Blue Cross Blue Shield of MN — All Commercial Plans: $78.57 Blue Cross Blue Shield of MN — HMO: $66.64 Blue Cross Blue Shield of MN — Medicare Advantage: $41.55 Medicare A MN J6 — All Plans: $41.55 United Healthcare — All Commercial Plans: $73.60 United Healthcare — Medicare Advantage: $32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier 90 In the file: PROTHROMBINTIMEFORTHROMBOPHILIAPROFILE(MAYO),Reference Laboratory	$80	$68	$30.90 – $78.57
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $30.90 Blue Cross Blue Shield of MN — All Commercial Plans: $78.57 Blue Cross Blue Shield of MN — HMO: $66.64 Blue Cross Blue Shield of MN — Medicare Advantage: $41.55 Medicare A MN J6 — All Plans: $41.55 United Healthcare — All Commercial Plans: $73.60 United Healthcare — Medicare Advantage: $32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier 90 In the file: PROTHOMBINTIMEFORLUPUSANTICOAGULANTPROFILE(MAYO),Reference Laboratory	$80	$68	$30.90 – $78.57
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $30.90 Blue Cross Blue Shield of MN — All Commercial Plans: $78.57 Blue Cross Blue Shield of MN — HMO: $66.64 Blue Cross Blue Shield of MN — Medicare Advantage: $41.55 Medicare A MN J6 — All Plans: $41.55 United Healthcare — All Commercial Plans: $73.60 United Healthcare — Medicare Advantage: $32
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)	$100	$85	$38.63 – $98.21
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $38.63 Blue Cross Blue Shield of MN — All Commercial Plans: $98.21 Blue Cross Blue Shield of MN — HMO: $83.30 Blue Cross Blue Shield of MN — Medicare Advantage: $51.94 Medicare A MN J6 — All Plans: $51.94 United Healthcare — All Commercial Plans: $92 United Healthcare — Medicare Advantage: $40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier 90 In the file: THROMBOPLASTINTIME,PARTIAL;PLASMAORWHOLEBLOOD(MAYO),Reference Laboratory	$100	$85	$38.63 – $98.21
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $38.63 Blue Cross Blue Shield of MN — All Commercial Plans: $98.21 Blue Cross Blue Shield of MN — HMO: $83.30 Blue Cross Blue Shield of MN — Medicare Advantage: $51.94 Medicare A MN J6 — All Plans: $51.94 United Healthcare — All Commercial Plans: $92 United Healthcare — Medicare Advantage: $40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier 90 In the file: THROMBOPLASTINTIME,PARTIAL(PTT);PLASMAORWHOLEBLOOD(MAYO),Reference Laboratory	$142	$120.70	$54.85 – $139.46
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $54.85 Blue Cross Blue Shield of MN — All Commercial Plans: $139.46 Blue Cross Blue Shield of MN — HMO: $118.29 Blue Cross Blue Shield of MN — Medicare Advantage: $73.75 Medicare A MN J6 — All Plans: $73.75 United Healthcare — All Commercial Plans: $130.64 United Healthcare — Medicare Advantage: $56.80

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 · Inpatient or outpatient In the file: CT HEAD ROUTINE WO IV CONTRAST	$1,985	$1,687.25	$217.47 – $1,826.20
CT scan of the head or brain, without contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $217.47 Blue Cross Blue Shield of MN — All Commercial Plans: $434.93 Blue Cross Blue Shield of MN — HMO: $533.43 Blue Cross Blue Shield of MN — Medicare Advantage: $1,031.01 Medicare A MN J6 — All Plans: $1,031.01 United Healthcare — All Commercial Plans: $1,826.20 United Healthcare — Medicare Advantage: $794
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI HEAD WO W CONTRAST	$3,489.30	$2,965.91	$725.69 – $3,210.16
MRI of the brain, before and after contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $725.69 Blue Cross Blue Shield of MN — All Commercial Plans: $1,451.38 Blue Cross Blue Shield of MN — HMO: $1,867.01 Blue Cross Blue Shield of MN — Medicare Advantage: $1,812.34 Medicare A MN J6 — All Plans: $1,812.34 United Healthcare — All Commercial Plans: $3,210.16 United Healthcare — Medicare Advantage: $1,395.72
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST PA AND LAT	$377.68	$321.03	$151.07 – $377.68
Chest X-ray, 2 views: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $181.02 Blue Cross Blue Shield of MN — All Commercial Plans: $362.04 Blue Cross Blue Shield of MN — HMO: $377.68 Blue Cross Blue Shield of MN — Medicare Advantage: $196.17 Medicare A MN J6 — All Plans: $196.17 United Healthcare — All Commercial Plans: $347.47 United Healthcare — Medicare Advantage: $151.07
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST PA WITH DECUB	$427.54	$363.41	$171.02 – $427.54
Chest X-ray, 2 views: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $181.02 Blue Cross Blue Shield of MN — All Commercial Plans: $362.04 Blue Cross Blue Shield of MN — HMO: $427.54 Blue Cross Blue Shield of MN — Medicare Advantage: $222.07 Medicare A MN J6 — All Plans: $222.07 United Healthcare — All Commercial Plans: $393.34 United Healthcare — Medicare Advantage: $171.02
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR LUMBAR SPINE W OBLIQ 4 OR MORE VIEWS	$439.21	$373.33	$169.67 – $431.35
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $169.67 Blue Cross Blue Shield of MN — All Commercial Plans: $431.35 Blue Cross Blue Shield of MN — HMO: $365.86 Blue Cross Blue Shield of MN — Medicare Advantage: $228.12 Medicare A MN J6 — All Plans: $228.12 United Healthcare — All Commercial Plans: $404.07 United Healthcare — Medicare Advantage: $175.68
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE LIMITED	$3,271	$2,780.35	$496.32 – $3,009.32
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $496.32 Blue Cross Blue Shield of MN — All Commercial Plans: $992.63 Blue Cross Blue Shield of MN — HMO: $1,190.04 Blue Cross Blue Shield of MN — Medicare Advantage: $1,698.96 Medicare A MN J6 — All Plans: $1,698.96 United Healthcare — All Commercial Plans: $3,009.32 United Healthcare — Medicare Advantage: $1,308.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE ROUTINE WO CONTRAST	$2,927.02	$2,487.97	$496.32 – $2,692.86
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $496.32 Blue Cross Blue Shield of MN — All Commercial Plans: $992.63 Blue Cross Blue Shield of MN — HMO: $1,190.04 Blue Cross Blue Shield of MN — Medicare Advantage: $1,520.29 Medicare A MN J6 — All Plans: $1,520.29 United Healthcare — All Commercial Plans: $2,692.86 United Healthcare — Medicare Advantage: $1,170.81
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W IV CONTRAST	$2,519	$2,141.15	$364.85 – $2,317.48
CT scan of the pelvis, with contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $364.85 Blue Cross Blue Shield of MN — All Commercial Plans: $729.70 Blue Cross Blue Shield of MN — HMO: $891.77 Blue Cross Blue Shield of MN — Medicare Advantage: $1,308.37 Medicare A MN J6 — All Plans: $1,308.37 United Healthcare — All Commercial Plans: $2,317.48 United Healthcare — Medicare Advantage: $1,007.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: MRILOWEREXTREMITYLTANYJTROUTINEWOCONTRAST,left	$3,033	$2,578.05	$496.32 – $2,790.36
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $496.32 Blue Cross Blue Shield of MN — All Commercial Plans: $992.63 Blue Cross Blue Shield of MN — HMO: $1,190.04 Blue Cross Blue Shield of MN — Medicare Advantage: $1,575.34 Medicare A MN J6 — All Plans: $1,575.34 United Healthcare — All Commercial Plans: $2,790.36 United Healthcare — Medicare Advantage: $1,213.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: MRILOWEREXTREMITYRTANYJTROUTINEWOCONTRAST,right	$3,033	$2,578.05	$496.32 – $2,790.36
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $496.32 Blue Cross Blue Shield of MN — All Commercial Plans: $992.63 Blue Cross Blue Shield of MN — HMO: $1,190.04 Blue Cross Blue Shield of MN — Medicare Advantage: $1,575.34 Medicare A MN J6 — All Plans: $1,575.34 United Healthcare — All Commercial Plans: $2,790.36 United Healthcare — Medicare Advantage: $1,213.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD AND PELVIS WITH IV CONTRAST	$3,714.21	$3,157.08	$725.69 – $3,417.07
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $725.69 Blue Cross Blue Shield of MN — All Commercial Plans: $1,451.38 Blue Cross Blue Shield of MN — HMO: $1,867.01 Blue Cross Blue Shield of MN — Medicare Advantage: $1,929.16 Medicare A MN J6 — All Plans: $1,929.16 United Healthcare — All Commercial Plans: $3,417.07 United Healthcare — Medicare Advantage: $1,485.68
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABD COMPLETE	$1,041.80	$885.53	$402.45 – $1,023.15
Ultrasound of the abdomen, complete: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $402.45 Blue Cross Blue Shield of MN — All Commercial Plans: $1,023.15 Blue Cross Blue Shield of MN — HMO: $867.82 Blue Cross Blue Shield of MN — Medicare Advantage: $541.11 Medicare A MN J6 — All Plans: $541.11 United Healthcare — All Commercial Plans: $958.46 United Healthcare — Medicare Advantage: $416.72
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB OVER 14 WKS COMP	$890.10	$756.59	$343.85 – $874.17
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $343.85 Blue Cross Blue Shield of MN — All Commercial Plans: $874.17 Blue Cross Blue Shield of MN — HMO: $741.45 Blue Cross Blue Shield of MN — Medicare Advantage: $462.32 Medicare A MN J6 — All Plans: $462.32 United Healthcare — All Commercial Plans: $818.89 United Healthcare — Medicare Advantage: $356.04
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL NON OB	$900.70	$765.60	$347.94 – $884.58
Transvaginal ultrasound: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $347.94 Blue Cross Blue Shield of MN — All Commercial Plans: $884.58 Blue Cross Blue Shield of MN — HMO: $750.28 Blue Cross Blue Shield of MN — Medicare Advantage: $467.82 Medicare A MN J6 — All Plans: $467.82 United Healthcare — All Commercial Plans: $828.64 United Healthcare — Medicare Advantage: $360.28
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MAMMO DIAG UNI	$478.47	$406.70	$184.83 – $469.91
Diagnostic mammogram, one breast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $184.83 Blue Cross Blue Shield of MN — All Commercial Plans: $469.91 Blue Cross Blue Shield of MN — HMO: $398.57 Blue Cross Blue Shield of MN — Medicare Advantage: $248.52 Medicare A MN J6 — All Plans: $248.52 United Healthcare — All Commercial Plans: $440.19 United Healthcare — Medicare Advantage: $191.39
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MAMMO DIAG W IMPLANTS UNI	$478.47	$406.70	$184.83 – $469.91
Diagnostic mammogram, one breast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $184.83 Blue Cross Blue Shield of MN — All Commercial Plans: $469.91 Blue Cross Blue Shield of MN — HMO: $398.57 Blue Cross Blue Shield of MN — Medicare Advantage: $248.52 Medicare A MN J6 — All Plans: $248.52 United Healthcare — All Commercial Plans: $440.19 United Healthcare — Medicare Advantage: $191.39
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MAMMO DIAG POST CLIP OR WIRE PLACEMENT	$464.53	$394.85	$179.45 – $456.21
Diagnostic mammogram, one breast: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $179.45 Blue Cross Blue Shield of MN — All Commercial Plans: $456.21 Blue Cross Blue Shield of MN — HMO: $386.95 Blue Cross Blue Shield of MN — Medicare Advantage: $241.28 Medicare A MN J6 — All Plans: $241.28 United Healthcare — All Commercial Plans: $427.37 United Healthcare — Medicare Advantage: $185.81
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMO DIAG BIL	$601.53	$511.30	$232.37 – $590.76
Diagnostic mammogram, both breasts: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $232.37 Blue Cross Blue Shield of MN — All Commercial Plans: $590.76 Blue Cross Blue Shield of MN — HMO: $501.07 Blue Cross Blue Shield of MN — Medicare Advantage: $312.43 Medicare A MN J6 — All Plans: $312.43 United Healthcare — All Commercial Plans: $553.41 United Healthcare — Medicare Advantage: $240.61
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMO DIAG W IMPLANTS BIL	$601.53	$511.30	$232.37 – $590.76
Diagnostic mammogram, both breasts: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $232.37 Blue Cross Blue Shield of MN — All Commercial Plans: $590.76 Blue Cross Blue Shield of MN — HMO: $501.07 Blue Cross Blue Shield of MN — Medicare Advantage: $312.43 Medicare A MN J6 — All Plans: $312.43 United Healthcare — All Commercial Plans: $553.41 United Healthcare — Medicare Advantage: $240.61
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMMO SCREEN BIL	$516.66	$439.16	$91.71 – $516.66
Screening mammogram, both breasts: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $144.27 Blue Cross Blue Shield of MN — All Commercial Plans: $516.66 Blue Cross Blue Shield of MN — HMO: $516.66 Blue Cross Blue Shield of MN — Medicare Advantage: $91.71 Medicare A MN J6 — All Plans: $91.71 United Healthcare — All Commercial Plans: $475.33 United Healthcare — Medicare Advantage: $127.98
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMMO SCREEN W IMPLANTS BIL	$516.66	$439.16	$91.71 – $516.66
Screening mammogram, both breasts: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $144.27 Blue Cross Blue Shield of MN — All Commercial Plans: $516.66 Blue Cross Blue Shield of MN — HMO: $516.66 Blue Cross Blue Shield of MN — Medicare Advantage: $91.71 Medicare A MN J6 — All Plans: $91.71 United Healthcare — All Commercial Plans: $475.33 United Healthcare — Medicare Advantage: $127.98
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52 In the file: MAMMOSCREENWIMPLANTSUNI,reduced services	$516.66	$439.16	$91.71 – $516.66
Screening mammogram, both breasts: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $144.27 Blue Cross Blue Shield of MN — All Commercial Plans: $516.66 Blue Cross Blue Shield of MN — HMO: $516.66 Blue Cross Blue Shield of MN — Medicare Advantage: $91.71 Medicare A MN J6 — All Plans: $91.71 United Healthcare — All Commercial Plans: $475.33 United Healthcare — Medicare Advantage: $127.98

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOMNOGRAPHY	$4,368.23	$3,713	$1,687.45 – $4,290.04
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $1,687.45 Blue Cross Blue Shield of MN — All Commercial Plans: $4,290.04 Blue Cross Blue Shield of MN — HMO: $3,638.74 Blue Cross Blue Shield of MN — Medicare Advantage: $2,268.86 Medicare A MN J6 — All Plans: $2,268.86 United Healthcare — All Commercial Plans: $4,018.77 United Healthcare — Medicare Advantage: $1,747.29
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier 26 In the file: POLYSOMNOGRAPHYINTERP6YRSOROLDER(PROCAH),Professional Component	$1,472.90	$1,251.97	$92.45 – $765.03
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $92.45 Blue Cross Blue Shield of MN — All Commercial Plans: $219.58 Blue Cross Blue Shield of MN — HMO: $190.08 Blue Cross Blue Shield of MN — Medicare Advantage: $115.63 Medicare A MN J6 — All Plans: $765.03 United Healthcare — All Commercial Plans: $244.12 United Healthcare — Medicare Advantage: $117.99

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: OTEXERCISE(ROM,STRENGTH,FLEX)(15MIN),Indicatesthataservicewasperformedunderanoutpatientoccupationaltherapyplan	$135.80	$115.43	$54.32 – $135.80
Physical therapy: therapeutic exercise (each 15 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $82.70 Blue Cross Blue Shield of MN — All Commercial Plans: $135.80 Blue Cross Blue Shield of MN — HMO: $135.80 Blue Cross Blue Shield of MN — Medicare Advantage: $70.53 Medicare A MN J6 — All Plans: $70.53 United Healthcare — All Commercial Plans: $124.94 United Healthcare — Medicare Advantage: $54.32
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP In the file: PTEXERCISE(ROM,STRENGTH,FLEX)(15MIN),Physicaltherapistsserviceshavebeenprovided	$141.10	$119.94	$56.44 – $141.10
Physical therapy: therapeutic exercise (each 15 minutes): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $82.70 Blue Cross Blue Shield of MN — All Commercial Plans: $141.10 Blue Cross Blue Shield of MN — HMO: $141.10 Blue Cross Blue Shield of MN — Medicare Advantage: $73.28 Medicare A MN J6 — All Plans: $73.28 United Healthcare — All Commercial Plans: $129.81 United Healthcare — Medicare Advantage: $56.44
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: PTEVALLOWCOMPLEXITY,Physicaltherapistsserviceshavebeenprovided	$225.97	$192.07	$90.39 – $225.97
Physical therapy evaluation (low complexity): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $225.97 Blue Cross Blue Shield of MN — All Commercial Plans: $225.97 Blue Cross Blue Shield of MN — HMO: $225.97 Blue Cross Blue Shield of MN — Medicare Advantage: $117.36 Medicare A MN J6 — All Plans: $117.36 United Healthcare — All Commercial Plans: $207.89 United Healthcare — Medicare Advantage: $90.39
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: PTEVALMODERATECOMPLEXITY,Physicaltherapistsserviceshavebeenprovided	$282.20	$239.87	$109.01 – $277.15
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $109.01 Blue Cross Blue Shield of MN — All Commercial Plans: $277.15 Blue Cross Blue Shield of MN — HMO: $235.07 Blue Cross Blue Shield of MN — Medicare Advantage: $146.58 Medicare A MN J6 — All Plans: $146.58 United Healthcare — All Commercial Plans: $259.62 United Healthcare — Medicare Advantage: $112.88
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: PTEVALHIGHCOMPLEXITY,Physicaltherapistsserviceshavebeenprovided	$344.79	$293.07	$133.19 – $338.62
Physical therapy evaluation (high complexity): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $133.19 Blue Cross Blue Shield of MN — All Commercial Plans: $338.62 Blue Cross Blue Shield of MN — HMO: $287.21 Blue Cross Blue Shield of MN — Medicare Advantage: $179.09 Medicare A MN J6 — All Plans: $179.09 United Healthcare — All Commercial Plans: $317.21 United Healthcare — Medicare Advantage: $137.92
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PSYCHOTHERAPY, 30 MINUTES WITH PATIENT (RHC)	$190	$161.50	$73.40 – $186.60
Psychotherapy, 30 minutes: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $73.40 Blue Cross Blue Shield of MN — All Commercial Plans: $186.60 Blue Cross Blue Shield of MN — HMO: $158.27 Blue Cross Blue Shield of MN — Medicare Advantage: $98.69 Medicare A MN J6 — All Plans: $98.69 United Healthcare — All Commercial Plans: $174.80 United Healthcare — Medicare Advantage: $76
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PSYCHOTHERAPY, 45 MINUTES WITH PATIENT (RHC)	$235	$199.75	$90.78 – $230.79
Psychotherapy, 45 minutes: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $90.78 Blue Cross Blue Shield of MN — All Commercial Plans: $230.79 Blue Cross Blue Shield of MN — HMO: $195.76 Blue Cross Blue Shield of MN — Medicare Advantage: $122.06 Medicare A MN J6 — All Plans: $122.06 United Healthcare — All Commercial Plans: $216.20 United Healthcare — Medicare Advantage: $94
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: PSYCHOTHERAPY, 60 MINUTES WITH PATIENT (RHC)	$278.51	$236.73	$107.59 – $273.52
Psychotherapy, 60 minutes: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $107.59 Blue Cross Blue Shield of MN — All Commercial Plans: $273.52 Blue Cross Blue Shield of MN — HMO: $232 Blue Cross Blue Shield of MN — Medicare Advantage: $144.66 Medicare A MN J6 — All Plans: $144.66 United Healthcare — All Commercial Plans: $256.23 United Healthcare — Medicare Advantage: $111.40
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT), 50 MIN (RHC)	$228.17	$193.94	$88.14 – $224.09
Family psychotherapy, with the patient: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $88.14 Blue Cross Blue Shield of MN — All Commercial Plans: $224.09 Blue Cross Blue Shield of MN — HMO: $190.07 Blue Cross Blue Shield of MN — Medicare Advantage: $118.51 Medicare A MN J6 — All Plans: $118.51 United Healthcare — All Commercial Plans: $209.92 United Healthcare — Medicare Advantage: $91.27

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: EXCISION CYST, FIBROADENOMA, BENIGN/MALIGNANT, 1 OR MORE LESIONS (PRO CAH)	$2,056.51	$1,748.03	$430.08 – $1,187.54
Removal of breast growth (open surgery): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $430.08 Blue Cross Blue Shield of MN — All Commercial Plans: $1,187.54 Blue Cross Blue Shield of MN — HMO: $864.40 Blue Cross Blue Shield of MN — Medicare Advantage: $537.72 Medicare A MN J6 — All Plans: $1,068.15 United Healthcare — All Commercial Plans: $953.38 United Healthcare — Medicare Advantage: $548.69
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: ARTHROPLASTY, ACETABULAR & PROXIMAL FEMORAL PROSTHETIC REPLCMT W OR W/O AUTOGRAFT/ALLOGRAFT (PRO CAH)	$6,305.66	$5,359.81	$845.25 – $3,275.16
Total hip replacement: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $845.25 Blue Cross Blue Shield of MN — All Commercial Plans: $2,407.59 Blue Cross Blue Shield of MN — HMO: $2,132.53 Blue Cross Blue Shield of MN — Medicare Advantage: $1,056.49 Medicare A MN J6 — All Plans: $3,275.16 United Healthcare — All Commercial Plans: $2,633.08 United Healthcare — Medicare Advantage: $1,078.05
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPART W/WO PATELLA RESURFACE (PRO CAH)	$3,328.96	$2,829.62	$843.68 – $2,632.10
Total knee replacement: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $843.68 Blue Cross Blue Shield of MN — All Commercial Plans: $2,402.06 Blue Cross Blue Shield of MN — HMO: $2,129.79 Blue Cross Blue Shield of MN — Medicare Advantage: $1,054.51 Medicare A MN J6 — All Plans: $1,729.06 United Healthcare — All Commercial Plans: $2,632.10 United Healthcare — Medicare Advantage: $1,076.03
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: ARTHROSCOPY,SHOULDER;DECOMP SUBACROMIAL SP W PART ACROMIOPLASTY,W CORACOACROMIAL LIG REL (PRO CAH)	$478.95	$407.11	$105.56 – $339.90
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $105.56 Blue Cross Blue Shield of MN — All Commercial Plans: $305.88 Blue Cross Blue Shield of MN — HMO: $282.11 Blue Cross Blue Shield of MN — Medicare Advantage: $132.18 Medicare A MN J6 — All Plans: $248.76 United Healthcare — All Commercial Plans: $339.90 United Healthcare — Medicare Advantage: $134.88
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: KNEE ARTHROSCOPY; W/ MENISCECTOMY, MEDIAL OR LATERAL (PRO CAH)	$1,761.11	$1,496.94	$383.99 – $1,068.50
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $383.99 Blue Cross Blue Shield of MN — All Commercial Plans: $1,068.50 Blue Cross Blue Shield of MN — HMO: $911.52 Blue Cross Blue Shield of MN — Medicare Advantage: $479.96 Medicare A MN J6 — All Plans: $914.72 United Healthcare — All Commercial Plans: $1,060.28 United Healthcare — Medicare Advantage: $489.75
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12 (PRO CAH)	$1,239	$1,053.15	$195.92 – $643.54
Removal of tonsils and adenoids (under age 12): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $195.92 Blue Cross Blue Shield of MN — All Commercial Plans: $540.48 Blue Cross Blue Shield of MN — HMO: $486.98 Blue Cross Blue Shield of MN — Medicare Advantage: $245 Medicare A MN J6 — All Plans: $643.54 United Healthcare — All Commercial Plans: $572.82 United Healthcare — Medicare Advantage: $250
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: EGD, FLEXIBLE, TRANSORAL; DIAG, INCL COLLECT SPECIMEN BRUSH/WASH (PRO CAH)	$998.31	$848.56	$254.07 – $668.51
Upper GI endoscopy (diagnostic): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $254.07 Blue Cross Blue Shield of MN — All Commercial Plans: $668.51 Blue Cross Blue Shield of MN — HMO: $467.81 Blue Cross Blue Shield of MN — Medicare Advantage: $317.68 Medicare A MN J6 — All Plans: $518.52 United Healthcare — All Commercial Plans: $514.44 United Healthcare — Medicare Advantage: $324.16
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD WITH BIOPSY	$3,082.98	$2,620.53	$1,233.19 – $3,082.98
Upper GI endoscopy with biopsy: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $1,886.62 Blue Cross Blue Shield of MN — All Commercial Plans: $3,082.98 Blue Cross Blue Shield of MN — HMO: $3,082.98 Blue Cross Blue Shield of MN — Medicare Advantage: $1,601.30 Medicare A MN J6 — All Plans: $1,601.30 United Healthcare — All Commercial Plans: $2,836.34 United Healthcare — Medicare Advantage: $1,233.19
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE (PRO CAH)	$1,183.96	$1,006.37	$330.81 – $867.81
Upper GI endoscopy with biopsy: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $330.81 Blue Cross Blue Shield of MN — All Commercial Plans: $867.81 Blue Cross Blue Shield of MN — HMO: $604.75 Blue Cross Blue Shield of MN — Medicare Advantage: $413.69 Medicare A MN J6 — All Plans: $614.95 United Healthcare — All Commercial Plans: $691.32 United Healthcare — Medicare Advantage: $422.13
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY	$2,519.64	$2,141.69	$1,007.86 – $2,519.64
Colonoscopy (diagnostic): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $1,934.40 Blue Cross Blue Shield of MN — All Commercial Plans: $2,519.64 Blue Cross Blue Shield of MN — HMO: $2,519.64 Blue Cross Blue Shield of MN — Medicare Advantage: $1,308.70 Medicare A MN J6 — All Plans: $1,308.70 United Healthcare — All Commercial Plans: $2,318.07 United Healthcare — Medicare Advantage: $1,007.86
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION SPECIMEN(S) BY BRUSHING OR WASHING (PRO CAH)	$1,124.55	$955.87	$294.67 – $783.38
Colonoscopy (diagnostic): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $294.67 Blue Cross Blue Shield of MN — All Commercial Plans: $783.38 Blue Cross Blue Shield of MN — HMO: $554.91 Blue Cross Blue Shield of MN — Medicare Advantage: $368.42 Medicare A MN J6 — All Plans: $584.09 United Healthcare — All Commercial Plans: $629.08 United Healthcare — Medicare Advantage: $375.94
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE (PRO CAH)	$1,465.10	$1,245.34	$376.40 – $994.45
Colonoscopy with biopsy: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $376.40 Blue Cross Blue Shield of MN — All Commercial Plans: $994.45 Blue Cross Blue Shield of MN — HMO: $702.26 Blue Cross Blue Shield of MN — Medicare Advantage: $470.64 Medicare A MN J6 — All Plans: $760.97 United Healthcare — All Commercial Plans: $811.30 United Healthcare — Medicare Advantage: $480.25
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: COLONOSCOPY, FLEXIBLE;WITH REMOVAL OF TUMOR,POLYP,OR OTHER LESION SNARE TECHNIQUE (PRO CAH)	$1,465.10	$1,245.34	$390.27 – $1,035.98
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $390.27 Blue Cross Blue Shield of MN — All Commercial Plans: $1,035.98 Blue Cross Blue Shield of MN — HMO: $737.32 Blue Cross Blue Shield of MN — Medicare Advantage: $487.76 Medicare A MN J6 — All Plans: $760.97 United Healthcare — All Commercial Plans: $846.88 United Healthcare — Medicare Advantage: $497.71
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: COLORECTAL CANCER SCREENING;COLONOSCOPY NOT HIGH RISK PATIENT (PRO CAH)	$1,124.55	$955.87	$294.67 – $694.92
Screening colonoscopy (not high risk): rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $294.67 Blue Cross Blue Shield of MN — All Commercial Plans: $694.92 Blue Cross Blue Shield of MN — HMO: $555.45 Blue Cross Blue Shield of MN — Medicare Advantage: $368.52 Medicare A MN J6 — All Plans: $584.09 United Healthcare — All Commercial Plans: $629.08 United Healthcare — Medicare Advantage: $376.04
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY (PRO CAH)	$1,732.45	$1,472.58	$450.78 – $1,309.33
Gallbladder removal by laparoscope: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $450.78 Blue Cross Blue Shield of MN — All Commercial Plans: $1,309.33 Blue Cross Blue Shield of MN — HMO: $1,098.86 Blue Cross Blue Shield of MN — Medicare Advantage: $563.51 Medicare A MN J6 — All Plans: $899.84 United Healthcare — All Commercial Plans: $1,256.56 United Healthcare — Medicare Advantage: $575.01
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE (PRO CAH)	$2,063.45	$1,753.93	$364.61 – $1,071.76
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $364.61 Blue Cross Blue Shield of MN — All Commercial Plans: $1,052.59 Blue Cross Blue Shield of MN — HMO: $873.17 Blue Cross Blue Shield of MN — Medicare Advantage: $455.75 Medicare A MN J6 — All Plans: $1,071.76 United Healthcare — All Commercial Plans: $997.06 United Healthcare — Medicare Advantage: $465.05
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HYSTEROSCOPY, SURGICAL; W/SAMPLING, W/W/O D&C (PRO CAH)	$1,919.92	$1,631.93	$997.21 – $2,778.40
Hysteroscopy with biopsy of the uterus lining: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $1,007.65 Blue Cross Blue Shield of MN — All Commercial Plans: $1,885.97 Blue Cross Blue Shield of MN — HMO: $1,727.93 Blue Cross Blue Shield of MN — Medicare Advantage: $1,259.46 Medicare A MN J6 — All Plans: $997.21 United Healthcare — All Commercial Plans: $2,778.40 United Healthcare — Medicare Advantage: $1,285.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: XR EPIDURAL LUMBAR OR SACRAL INJ	$1,722.90	$1,464.47	$665.56 – $1,692.06
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $665.56 Blue Cross Blue Shield of MN — All Commercial Plans: $1,692.06 Blue Cross Blue Shield of MN — HMO: $1,435.18 Blue Cross Blue Shield of MN — Medicare Advantage: $894.88 Medicare A MN J6 — All Plans: $894.88 United Healthcare — All Commercial Plans: $1,585.07 United Healthcare — Medicare Advantage: $689.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: INJ(S), SUBSTANCE(S), WO NEUROLYTIC SUB, W NEEDLE/CATH, INTRLMNR EPID/SUBARACHNOID, LMBR/SAC;IMG GDN	$1,722.90	$1,464.47	$665.56 – $1,692.06
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $665.56 Blue Cross Blue Shield of MN — All Commercial Plans: $1,692.06 Blue Cross Blue Shield of MN — HMO: $1,435.18 Blue Cross Blue Shield of MN — Medicare Advantage: $894.88 Medicare A MN J6 — All Plans: $894.88 United Healthcare — All Commercial Plans: $1,585.07 United Healthcare — Medicare Advantage: $689.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: INJ, DX OR THERAPEUTIC SUBST, W/O NEUROLYTIC SUB, EPID/SUBARACH; LUMBAR/SACRAL; WITH IMAGIN (PRO CAH)	$453.20	$385.22	$215.83 – $493.62
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $215.83 Blue Cross Blue Shield of MN — All Commercial Plans: $445.19 Blue Cross Blue Shield of MN — HMO: $407.88 Blue Cross Blue Shield of MN — Medicare Advantage: $269.77 Medicare A MN J6 — All Plans: $235.40 United Healthcare — All Commercial Plans: $493.62 United Healthcare — Medicare Advantage: $275.28
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, W IMG GD; LMBR/SAC, SINGLE LEVEL	$2,029.10	$1,724.74	$783.84 – $1,992.78
Nerve root injection, lower back, with imaging guidance: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $783.84 Blue Cross Blue Shield of MN — All Commercial Plans: $1,992.78 Blue Cross Blue Shield of MN — HMO: $1,690.24 Blue Cross Blue Shield of MN — Medicare Advantage: $1,053.91 Medicare A MN J6 — All Plans: $1,053.91 United Healthcare — All Commercial Plans: $1,866.77 United Healthcare — Medicare Advantage: $811.64
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: NEUROPLASTY AND/OR TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL (PRO CAH)	$1,617	$1,374.45	$366.70 – $999.99
Carpal tunnel release: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $366.70 Blue Cross Blue Shield of MN — All Commercial Plans: $999.99 Blue Cross Blue Shield of MN — HMO: $751.56 Blue Cross Blue Shield of MN — Medicare Advantage: $458.35 Medicare A MN J6 — All Plans: $839.87 United Healthcare — All Commercial Plans: $842.84 United Healthcare — Medicare Advantage: $467.70
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: CATARACT LASER PROCEDURE	$1,533.67	$1,303.62	$592.46 – $1,506.22
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans BCBSMN Blue Plus MCD Rep Plan DOS after 1/1/19 — All Plans: $592.46 Blue Cross Blue Shield of MN — All Commercial Plans: $1,506.22 Blue Cross Blue Shield of MN — HMO: $1,277.55 Blue Cross Blue Shield of MN — Medicare Advantage: $796.59 Medicare A MN J6 — All Plans: $796.59 United Healthcare — All Commercial Plans: $1,410.98 United Healthcare — Medicare Advantage: $613.47

Source: Johnson Memorial Hospital’s standard charges file (jmhsmn.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 8, 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	1282 Walnut Street, Dawson, MN 56232
County	Lac Qui Parle County
State	Minnesota
Phone	(320) 769‑4323
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	241314
Name in Medicare records	JOHNSON MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Johnson Memorial Hospital (Johnson Memorial Health Services)
Official website	jmhsmn.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Hospital - Johnson Memorial Health Services — jmhsmn.org
Visitors Information - Johnson Memorial Health Services — jmhsmn.org

Johnson Memorial Hospital

Summary

Profile from official sources

At a glance