Quick answers Does Lasalle General Hospital have an emergency room? Yes. The hospital’s official website lists an emergency room at Lasalle General Hospital. Medicare (CMS) data does not list emergency services for it. In a medical emergency, call 911. Where is Lasalle General Hospital? 187 Ninth St/Hwy 84 West, Jena, LA 71342, in Lasalle Parish, Louisiana. What is the phone number of Lasalle General Hospital? (318) 992-9200, as listed by Medicare (CMS). What is the Medicare star rating of Lasalle General Hospital? 1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22). Specialties and care areas[4] [5] Radiology (including Nuclear Medicine) In-Patient Acute Care Family Medicine Behavioral Health Unit (older adults) Osteoporosis Alcohol withdrawal Drug withdrawal Mental, emotional or behavioral challenges in older adults Swing Bed Program Home Health Therapies and Fitness Obesity Care Clinic Ambulance service LaSalle Behavioral Health Unit (inpatient, older adults) New Vision medical stabilization and withdrawal management (inpatient) Emergency care (hospital website)[4] [13] Visiting and practical information Doctors and clinicians (94) 94 doctors and other clinicians list Lasalle General Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.
Main specialties Doctors with a page on this site (94) Aaron D. Edwards, NP Nurse Practitioner Ahsan Raza, MD General Surgery Allison J. Edwards, NP Nurse Practitioner Allison K. Stelly, NP Nurse Practitioner Arsham Naalbandian, MD Neurology Bassam Abi-Rached, MD Hematology/Oncology Benjamin B. Close, MD Allergy/Immunology Benjamin S. McCurdy, PA Physician Assistant Brandon Coats, MD Family Practice Brian M. Smith Jr., MD Family Practice Bruce E. Rayburn, MD General Surgery Charl F. Ceronio, MD Family Practice Charles J. Brdlik, MD Diagnostic Radiology Christian J. Wold, MD Otolaryngology Christopher Smith, MD Family Practice Chukwudi B. Uchendu, MD Family Practice Clint L. Cooksey, NP Nurse Practitioner Daniel E. Crook, MD Emergency Medicine Daniel R. Oas, DO Orthopedic Surgery David A. Longmire Jr., MD Emergency Medicine David E. Barnard, MD Emergency Medicine David Robbins, MD Interventional Cardiology Deddeh M. Ballah-Leahey, MD Diagnostic Radiology Elidia A. Dewitt, NP Nurse Practitioner And 70 more: the button below opens the full list.
See all 94 clinicians Other emergency rooms nearby Hospitals that list emergency services, by straight-line distance (not driving distance).
About the Medicare star rating CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →
Medicare quality data What Lasalle General Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.
What patients said (patient survey) What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.
Not reported to Medicare
Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.
Infections caught in the hospital What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.
Central line bloodstream infections (CLABSI) Not reported to Medicare Catheter-associated urinary tract infections (CAUTI) Not reported to Medicare Surgical site infections after colon surgery Not reported to Medicare Surgical site infections after abdominal hysterectomy Not reported to Medicare MRSA bloodstream infections Not reported to Medicare Clostridioides difficile (C. diff) intestinal infections 0 No different from the national benchmark
Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.
Complications and deaths What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.
Deaths within 30 days: heart attack patients Not reported to Medicare Deaths within 30 days: heart failure patients Too few cases to report Deaths within 30 days: pneumonia patients 17.9% 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) Too few cases to report 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 Not reported to Medicare Readmitted within 30 days: heart failure Too few cases to report Readmitted within 30 days: pneumonia 16.7% 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) 137 minutes National average: 162 minutes Patients who left the emergency room before being seen (OP-22) 1% National average: 2% Sepsis patients who got all the recommended early care (SEP-1) 50% National average: 65%
Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.
See every measure on Medicare Care Compare →
ER wait times and Medicare ratings nearby How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.
Prices Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 53 common services exactly as Lasalle General Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.
What the prices mean Hospital charge The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount. Cash price The price the hospital offers if you pay yourself, without insurance (“discounted cash price”). Insurance rates The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance. Hospital and doctor fees A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services. How to use hospital prices: estimates, financial assistance and your rights →
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: IM OFFICE VISIT - NEW LEVEL 3 99203 $134 $80.40 $38 New patient office visit (about 30–44 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $38 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $38 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $38 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $38 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $38 Medicaid Louisiana IP OP — Default : $38 UHC Community Plan LA MCD Rep — Medicaid Replacement : $38 New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFF VST-NEW-INTER(30MIN) 99203 $134 $80.40 $38 New patient office visit (about 30–44 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $38 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $38 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $38 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $38 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $38 Medicaid Louisiana IP OP — Default : $38 UHC Community Plan LA MCD Rep — Medicaid Replacement : $38 New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: IM OFFICE VISIT - NEW LEVEL 4 99204 $203 $121.80 $57 New patient office visit (about 45–59 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFF VST-NEW-EXTEND(45MIN) 99204 $203 $121.80 $57 New patient office visit (about 45–59 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: IM OFFICE VISIT - NEW LEVEL 5 99205 $251 $150.60 $57 New patient office visit (about 60–74 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFF VST-NEW-COMP(60MIN) 99205 $251 $150.60 $57 New patient office visit (about 60–74 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: IM OFFICE VISIT - EST LEVEL 3 99213 $97 $58.20 $38 Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $38 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $38 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $38 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $38 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $38 Medicaid Louisiana IP OP — Default : $38 UHC Community Plan LA MCD Rep — Medicaid Replacement : $38 Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: IM PHYSICAL ABILITIES EXAM 99213 $250 $150 $38 Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $38 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $38 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $38 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $38 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $38 Medicaid Louisiana IP OP — Default : $38 UHC Community Plan LA MCD Rep — Medicaid Replacement : $38 Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFF VST-EST-INTER(15MIN) 99213 $97 $58.20 $38 Established patient office visit (about 20–29 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $38 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $38 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $38 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $38 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $38 Medicaid Louisiana IP OP — Default : $38 UHC Community Plan LA MCD Rep — Medicaid Replacement : $38 Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: IM OFFICE VISIT - EST LEVEL 4 99214 $194 $116.40 $57 Established patient office visit (about 30–39 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFF VST-EST-EXTEND(25MIN) 99214 $194 $116.40 $57 Established patient office visit (about 30–39 minutes): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $57 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $57 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $57 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $57 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $57 Medicaid Louisiana IP OP — Default : $57 UHC Community Plan LA MCD Rep — Medicaid Replacement : $57 Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFFICE CONSULTATION DETAILED $202 $121.20 $129.14 Office consultation with a specialist (moderate): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $129.14 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $129.14 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $129.14 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $129.14 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $129.14 Medicaid Louisiana IP OP — Default : $129.14 UHC Community Plan LA MCD Rep — Medicaid Replacement : $129.14 Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFFICE CONSULTATION COMPREHENSIVE $230 $138 $147.04 Office consultation with a specialist (moderate to high): rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $147.04 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $147.04 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $147.04 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $147.04 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $147.04 Medicaid Louisiana IP OP — Default : $147.04 UHC Community Plan LA MCD Rep — Medicaid Replacement : $147.04 Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PREVENTIVE - NEW 18-39 YEARS $145 $87 $92.70 Preventive checkup, new patient, age 18–39: rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $92.70 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $92.70 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $92.70 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $92.70 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $92.70 Medicaid Louisiana IP OP — Default : $92.70 UHC Community Plan LA MCD Rep — Medicaid Replacement : $92.70 Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PM-INIT/NEW (AGE 18-39) 99385 $145 $87 $92.70 Preventive checkup, new patient, age 18–39: rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $92.70 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $92.70 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $92.70 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $92.70 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $92.70 Medicaid Louisiana IP OP — Default : $92.70 UHC Community Plan LA MCD Rep — Medicaid Replacement : $92.70 Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PREVENTIVE - NEW 40-64 YEARS $178 $106.80 $113.80 Preventive checkup, new patient, age 40–64: rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $113.80 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $113.80 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $113.80 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $113.80 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $113.80 Medicaid Louisiana IP OP — Default : $113.80 UHC Community Plan LA MCD Rep — Medicaid Replacement : $113.80 Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PM INIT/NEW PT AGES 40 TO 64 YRS 99386 $178 $106.80 $113.80 Preventive checkup, new patient, age 40–64: rates for 7 insurance plans Aetna Better Health LA — Medicaid Replacement : $113.80 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $113.80 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $113.80 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $113.80 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $113.80 Medicaid Louisiana IP OP — Default : $113.80 UHC Community Plan LA MCD Rep — Medicaid Replacement : $113.80 Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ER PROCEDURE LEVEL 3 $1,542 $925.20 $242.24 – $985.80 Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $985.80 Aetna Medicare Advantage — Medicare Advantage : $242.24 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $985.80 Blue Advantage of LA — Medicare Advantage : $242.24 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $985.80 Healthy Blue Dual Advantage — Medicare Advantage : $242.24 Humana — Medicare Advantage : $242.24 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $985.80 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $985.80 Magnolia Health Plan MCR Adv — Medicare Advantage : $242.24 Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: LEVEL 3 O/P ER * $264 $158.40 $168.78 – $242.24 Emergency room visit (moderate): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $168.78 Aetna Medicare Advantage — Medicare Advantage : $242.24 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $168.78 Blue Advantage of LA — Medicare Advantage : $242.24 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $168.78 Healthy Blue Dual Advantage — Medicare Advantage : $242.24 Humana — Medicare Advantage : $242.24 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $168.78 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $168.78 Magnolia Health Plan MCR Adv — Medicare Advantage : $242.24 Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: LEVEL 4 O/P ER * $421 $252.60 $269.15 – $370.27 Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $269.15 Aetna Medicare Advantage — Medicare Advantage : $370.27 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $269.15 Blue Advantage of LA — Medicare Advantage : $370.27 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $269.15 Healthy Blue Dual Advantage — Medicare Advantage : $370.27 Humana — Medicare Advantage : $370.27 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $269.15 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $269.15 Magnolia Health Plan MCR Adv — Medicare Advantage : $370.27 Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ER PROCEDURE LEVEL 4 $2,753 $1,651.80 $370.27 – $1,759.99 Emergency room visit (moderately high): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $1,759.99 Aetna Medicare Advantage — Medicare Advantage : $370.27 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $1,759.99 Blue Advantage of LA — Medicare Advantage : $370.27 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $1,759.99 Healthy Blue Dual Advantage — Medicare Advantage : $370.27 Humana — Medicare Advantage : $370.27 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $1,759.99 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $1,759.99 Magnolia Health Plan MCR Adv — Medicare Advantage : $370.27 Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ER PROCEDURE LEVEL 5 $3,524 $2,114.40 $528.46 – $2,252.89 Emergency room visit (high): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $2,252.89 Aetna Medicare Advantage — Medicare Advantage : $528.46 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $2,252.89 Blue Advantage of LA — Medicare Advantage : $528.46 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $2,252.89 Healthy Blue Dual Advantage — Medicare Advantage : $528.46 Humana — Medicare Advantage : $528.46 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $2,252.89 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $2,252.89 Magnolia Health Plan MCR Adv — Medicare Advantage : $528.46 Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: LEVEL 5 O/P ER $626 $375.60 $400.20 – $528.46 Emergency room visit (high): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $400.20 Aetna Medicare Advantage — Medicare Advantage : $528.46 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $400.20 Blue Advantage of LA — Medicare Advantage : $528.46 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $400.20 Healthy Blue Dual Advantage — Medicare Advantage : $528.46 Humana — Medicare Advantage : $528.46 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $400.20 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $400.20 Magnolia Health Plan MCR Adv — Medicare Advantage : $528.46
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 $101 $60.60 $8.29 – $8.46 Basic metabolic panel (blood test): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $8.46 Aetna Medicare Advantage — Medicare Advantage : $8.29 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $8.46 Blue Advantage of LA — Medicare Advantage : $8.29 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $8.46 Healthy Blue Dual Advantage — Medicare Advantage : $8.29 Humana — Medicare Advantage : $8.29 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $8.46 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $8.46 Magnolia Health Plan MCR Adv — Medicare Advantage : $8.29 Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PANEL FREQUENCY $101 $60.60 $8.29 – $8.46 Basic metabolic panel (blood test): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $8.46 Aetna Medicare Advantage — Medicare Advantage : $8.29 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $8.46 Blue Advantage of LA — Medicare Advantage : $8.29 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $8.46 Healthy Blue Dual Advantage — Medicare Advantage : $8.29 Humana — Medicare Advantage : $8.29 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $8.46 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $8.46 Magnolia Health Plan MCR Adv — Medicare Advantage : $8.29 Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHENSIVE METABOLIC PANEL $128 $76.80 $10.35 – $10.56 Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $10.56 Aetna Medicare Advantage — Medicare Advantage : $10.35 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $10.56 Blue Advantage of LA — Medicare Advantage : $10.35 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $10.56 Healthy Blue Dual Advantage — Medicare Advantage : $10.35 Humana — Medicare Advantage : $10.35 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $10.56 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $10.56 Magnolia Health Plan MCR Adv — Medicare Advantage : $10.35 Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHENSIVE METABOLIC PANEL FREQUENCY $128 $76.80 $10.35 – $10.56 Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $10.56 Aetna Medicare Advantage — Medicare Advantage : $10.35 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $10.56 Blue Advantage of LA — Medicare Advantage : $10.35 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $10.56 Healthy Blue Dual Advantage — Medicare Advantage : $10.35 Humana — Medicare Advantage : $10.35 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $10.56 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $10.56 Magnolia Health Plan MCR Adv — Medicare Advantage : $10.35 Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL $158 $94.80 $13.12 – $13.39 Cholesterol panel (lipid panel): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $13.39 Aetna Medicare Advantage — Medicare Advantage : $13.12 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $13.39 Blue Advantage of LA — Medicare Advantage : $13.12 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $13.39 Healthy Blue Dual Advantage — Medicare Advantage : $13.12 Humana — Medicare Advantage : $13.12 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $13.39 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $13.39 Magnolia Health Plan MCR Adv — Medicare Advantage : $13.12 Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL $99 $59.40 $8.51 – $8.68 Kidney function panel: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $8.68 Aetna Medicare Advantage — Medicare Advantage : $8.51 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $8.68 Blue Advantage of LA — Medicare Advantage : $8.51 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $8.68 Healthy Blue Dual Advantage — Medicare Advantage : $8.51 Humana — Medicare Advantage : $8.51 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $8.68 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $8.68 Magnolia Health Plan MCR Adv — Medicare Advantage : $8.51 Liver function panel CPT 80076 · Inpatient or outpatient In the file: LIVER PANEL (HEPATIC FUNCTION PANEL) $156 $93.60 $8.01 – $8.17 Liver function panel: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $8.17 Aetna Medicare Advantage — Medicare Advantage : $8.01 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $8.17 Blue Advantage of LA — Medicare Advantage : $8.01 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $8.17 Healthy Blue Dual Advantage — Medicare Advantage : $8.01 Humana — Medicare Advantage : $8.01 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $8.17 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $8.17 Magnolia Health Plan MCR Adv — Medicare Advantage : $8.01 Liver function panel CPT 80076 · Inpatient or outpatient In the file: LIVER PANEL (HEPATIC FUNCTION) FREQUENCY $156 $93.60 $8.01 – $8.17 Liver function panel: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $8.17 Aetna Medicare Advantage — Medicare Advantage : $8.01 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $8.17 Blue Advantage of LA — Medicare Advantage : $8.01 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $8.17 Healthy Blue Dual Advantage — Medicare Advantage : $8.01 Humana — Medicare Advantage : $8.01 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $8.17 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $8.17 Magnolia Health Plan MCR Adv — Medicare Advantage : $8.01 Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: .MICROSCOPIC EXAM, URINE $57 $34.20 $3.11 – $3.17 Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $3.17 Aetna Medicare Advantage — Medicare Advantage : $3.11 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $3.17 Blue Advantage of LA — Medicare Advantage : $3.11 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $3.17 Healthy Blue Dual Advantage — Medicare Advantage : $3.11 Humana — Medicare Advantage : $3.11 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $3.17 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $3.17 Magnolia Health Plan MCR Adv — Medicare Advantage : $3.11 Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS WITH MICROSCOPIC $57 $34.20 $3.11 – $3.17 Urine test (automated, with microscope): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $3.17 Aetna Medicare Advantage — Medicare Advantage : $3.11 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $3.17 Blue Advantage of LA — Medicare Advantage : $3.11 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $3.17 Healthy Blue Dual Advantage — Medicare Advantage : $3.11 Humana — Medicare Advantage : $3.11 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $3.17 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $3.17 Magnolia Health Plan MCR Adv — Medicare Advantage : $3.11 Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: IM URINALYSIS DIPTICK,CLIA waived test $8.35 $5.01 $2.20 – $2.25 Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $2.25 Aetna Medicare Advantage — Medicare Advantage : $2.20 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $2.25 Blue Advantage of LA — Medicare Advantage : $2.20 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $2.25 Healthy Blue Dual Advantage — Medicare Advantage : $2.20 Humana — Medicare Advantage : $2.20 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $2.25 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $2.25 Magnolia Health Plan MCR Adv — Medicare Advantage : $2.20 Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: UA (URINALYSIS DIPSTICK PANEL),CLIA waived test $44.04 $26.42 $2.20 – $2.25 Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $2.25 Aetna Medicare Advantage — Medicare Advantage : $2.20 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $2.25 Blue Advantage of LA — Medicare Advantage : $2.20 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $2.25 Healthy Blue Dual Advantage — Medicare Advantage : $2.20 Humana — Medicare Advantage : $2.20 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $2.25 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $2.25 Magnolia Health Plan MCR Adv — Medicare Advantage : $2.20 Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: LAB DIP STICK URINE,CLIA waived test $14 $8.40 $1.95 – $2.25 Urine test (automated, without microscope): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $2.25 Aetna Medicare Advantage — Medicare Advantage : $1.95 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $2.25 Blue Advantage of LA — Medicare Advantage : $1.95 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $2.25 Healthy Blue Dual Advantage — Medicare Advantage : $1.95 Humana — Medicare Advantage : $1.95 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $2.25 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $2.25 Magnolia Health Plan MCR Adv — Medicare Advantage : $1.95 PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA (SERIAL MONITOR) $134 $80.40 $18.02 – $18.39 PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $18.39 Aetna Medicare Advantage — Medicare Advantage : $18.02 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $18.39 Blue Advantage of LA — Medicare Advantage : $18.02 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $18.39 Healthy Blue Dual Advantage — Medicare Advantage : $18.02 Humana — Medicare Advantage : $18.02 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $18.39 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $18.39 Magnolia Health Plan MCR Adv — Medicare Advantage : $18.02 PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA DIAGNOSTIC $134 $80.40 $18.02 – $18.39 PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $18.39 Aetna Medicare Advantage — Medicare Advantage : $18.02 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $18.39 Blue Advantage of LA — Medicare Advantage : $18.02 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $18.39 Healthy Blue Dual Advantage — Medicare Advantage : $18.02 Humana — Medicare Advantage : $18.02 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $18.39 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $18.39 Magnolia Health Plan MCR Adv — Medicare Advantage : $18.02 PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA 3RD GEN $134 $80.40 $18.02 – $18.39 PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $18.39 Aetna Medicare Advantage — Medicare Advantage : $18.02 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $18.39 Blue Advantage of LA — Medicare Advantage : $18.02 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $18.39 Healthy Blue Dual Advantage — Medicare Advantage : $18.02 Humana — Medicare Advantage : $18.02 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $18.39 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $18.39 Magnolia Health Plan MCR Adv — Medicare Advantage : $18.02 Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: THYROID STIMULATING HORMONE $198 $118.80 $16.46 – $16.80 Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $16.80 Aetna Medicare Advantage — Medicare Advantage : $16.46 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $16.80 Blue Advantage of LA — Medicare Advantage : $16.46 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $16.80 Healthy Blue Dual Advantage — Medicare Advantage : $16.46 Humana — Medicare Advantage : $16.46 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $16.80 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $16.80 Magnolia Health Plan MCR Adv — Medicare Advantage : $16.46 Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: .CBC W AUTO DIFFERENTIAL (CHARGE) $74 $44.40 $7.61 – $7.77 Complete blood count (CBC) with differential: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $7.77 Aetna Medicare Advantage — Medicare Advantage : $7.61 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $7.77 Blue Advantage of LA — Medicare Advantage : $7.61 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $7.77 Healthy Blue Dual Advantage — Medicare Advantage : $7.61 Humana — Medicare Advantage : $7.61 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $7.77 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $7.77 Magnolia Health Plan MCR Adv — Medicare Advantage : $7.61 Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: .CBC HEMOGRAM $65 $39 $6.34 – $6.47 Complete blood count (CBC), automated: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $6.47 Aetna Medicare Advantage — Medicare Advantage : $6.34 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $6.47 Blue Advantage of LA — Medicare Advantage : $6.34 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $6.47 Healthy Blue Dual Advantage — Medicare Advantage : $6.34 Humana — Medicare Advantage : $6.34 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $6.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $6.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $6.34 Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTIME WITH INR (PT/INR) $53 $31.80 $4.20 – $4.29 Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $4.29 Aetna Medicare Advantage — Medicare Advantage : $4.20 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $4.29 Blue Advantage of LA — Medicare Advantage : $4.20 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $4.29 Healthy Blue Dual Advantage — Medicare Advantage : $4.20 Humana — Medicare Advantage : $4.20 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $4.29 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $4.29 Magnolia Health Plan MCR Adv — Medicare Advantage : $4.20 Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTIME WITH INR (PT/INR) FREQUENCY $53 $31.80 $4.20 – $4.29 Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $4.29 Aetna Medicare Advantage — Medicare Advantage : $4.20 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $4.29 Blue Advantage of LA — Medicare Advantage : $4.20 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $4.29 Healthy Blue Dual Advantage — Medicare Advantage : $4.20 Humana — Medicare Advantage : $4.20 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $4.29 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $4.29 Magnolia Health Plan MCR Adv — Medicare Advantage : $4.20 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PARTIAL THROMBOPLASTIN TIME (PTT) $80 $48 $5.89 – $6.01 Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $6.01 Aetna Medicare Advantage — Medicare Advantage : $5.89 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $6.01 Blue Advantage of LA — Medicare Advantage : $5.89 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $6.01 Healthy Blue Dual Advantage — Medicare Advantage : $5.89 Humana — Medicare Advantage : $5.89 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $6.01 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $6.01 Magnolia Health Plan MCR Adv — Medicare Advantage : $5.89 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PT SENDOUT $80 $48 $5.89 – $6.01 Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $6.01 Aetna Medicare Advantage — Medicare Advantage : $5.89 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $6.01 Blue Advantage of LA — Medicare Advantage : $5.89 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $6.01 Healthy Blue Dual Advantage — Medicare Advantage : $5.89 Humana — Medicare Advantage : $5.89 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $6.01 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $6.01 Magnolia Health Plan MCR Adv — Medicare Advantage : $5.89 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PARTIAL THROMBOPLASTIN TIME FREQUENCY $80 $48 $5.89 – $6.01 Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $6.01 Aetna Medicare Advantage — Medicare Advantage : $5.89 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $6.01 Blue Advantage of LA — Medicare Advantage : $5.89 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $6.01 Healthy Blue Dual Advantage — Medicare Advantage : $5.89 Humana — Medicare Advantage : $5.89 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $6.01 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $6.01 Magnolia Health Plan MCR Adv — Medicare Advantage : $5.89
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 W/O $630 $378 $92.78 – $402.76 CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $402.76 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $402.76 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $402.76 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $402.76 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $402.76 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT MASTOIDS W/O $630 $378 $92.78 – $402.76 CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $402.76 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $402.76 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $402.76 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $402.76 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $402.76 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W/WO $1,433 $859.80 $309.58 – $916.12 MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $916.12 Aetna Medicare Advantage — Medicare Advantage : $309.58 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $916.12 Blue Advantage of LA — Medicare Advantage : $309.58 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $916.12 Healthy Blue Dual Advantage — Medicare Advantage : $309.58 Humana — Medicare Advantage : $309.58 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $916.12 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $916.12 Magnolia Health Plan MCR Adv — Medicare Advantage : $309.58 MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI IAC W/WO $1,433 $859.80 $309.58 – $916.12 MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $916.12 Aetna Medicare Advantage — Medicare Advantage : $309.58 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $916.12 Blue Advantage of LA — Medicare Advantage : $309.58 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $916.12 Healthy Blue Dual Advantage — Medicare Advantage : $309.58 Humana — Medicare Advantage : $309.58 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $916.12 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $916.12 Magnolia Health Plan MCR Adv — Medicare Advantage : $309.58 MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI PITUITARY W/WO $1,433 $859.80 $309.58 – $916.12 MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $916.12 Aetna Medicare Advantage — Medicare Advantage : $309.58 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $916.12 Blue Advantage of LA — Medicare Advantage : $309.58 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $916.12 Healthy Blue Dual Advantage — Medicare Advantage : $309.58 Humana — Medicare Advantage : $309.58 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $916.12 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $916.12 Magnolia Health Plan MCR Adv — Medicare Advantage : $309.58 Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST PA & LAT $179 $107.40 $77.22 – $114.43 Chest X-ray, 2 views: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $114.43 Aetna Medicare Advantage — Medicare Advantage : $77.22 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $114.43 Blue Advantage of LA — Medicare Advantage : $77.22 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $114.43 Healthy Blue Dual Advantage — Medicare Advantage : $77.22 Humana — Medicare Advantage : $77.22 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $114.43 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $114.43 Magnolia Health Plan MCR Adv — Medicare Advantage : $77.22 X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR LUMBAR SPINE W/ OBLIQUES $242 $145.20 $92.78 – $154.71 X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $154.71 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $154.71 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $154.71 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $154.71 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $154.71 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI SACRUM W/O $1,213 $727.80 $211.73 – $775.47 MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $775.47 Aetna Medicare Advantage — Medicare Advantage : $211.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $775.47 Blue Advantage of LA — Medicare Advantage : $211.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $775.47 Healthy Blue Dual Advantage — Medicare Advantage : $211.73 Humana — Medicare Advantage : $211.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $775.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $775.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $211.73 MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR W/O $1,213 $727.80 $211.73 – $775.47 MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $775.47 Aetna Medicare Advantage — Medicare Advantage : $211.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $775.47 Blue Advantage of LA — Medicare Advantage : $211.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $775.47 Healthy Blue Dual Advantage — Medicare Advantage : $211.73 Humana — Medicare Advantage : $211.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $775.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $775.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $211.73 CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/ $995 $597 $155.64 – $636.10 CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $636.10 Aetna Medicare Advantage — Medicare Advantage : $155.64 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $636.10 Blue Advantage of LA — Medicare Advantage : $155.64 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $636.10 Healthy Blue Dual Advantage — Medicare Advantage : $155.64 Humana — Medicare Advantage : $155.64 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $636.10 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $636.10 Magnolia Health Plan MCR Adv — Medicare Advantage : $155.64 MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: MRI KNEE LT W/O,Left side (Used to identify procedures performed on the left side of the body) $1,213 $727.80 $211.73 – $775.47 MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $775.47 Aetna Medicare Advantage — Medicare Advantage : $211.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $775.47 Blue Advantage of LA — Medicare Advantage : $211.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $775.47 Healthy Blue Dual Advantage — Medicare Advantage : $211.73 Humana — Medicare Advantage : $211.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $775.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $775.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $211.73 MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: MRI KNEE RT W/O,Right side (Used to identify procedures performed on the right side of the body) $1,213 $727.80 $211.73 – $775.47 MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $775.47 Aetna Medicare Advantage — Medicare Advantage : $211.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $775.47 Blue Advantage of LA — Medicare Advantage : $211.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $775.47 Healthy Blue Dual Advantage — Medicare Advantage : $211.73 Humana — Medicare Advantage : $211.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $775.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $775.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $211.73 MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: MRI ANKLE LT W/O,Left side (Used to identify procedures performed on the left side of the body) $1,213 $727.80 $211.73 – $775.47 MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $775.47 Aetna Medicare Advantage — Medicare Advantage : $211.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $775.47 Blue Advantage of LA — Medicare Advantage : $211.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $775.47 Healthy Blue Dual Advantage — Medicare Advantage : $211.73 Humana — Medicare Advantage : $211.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $775.47 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $775.47 Magnolia Health Plan MCR Adv — Medicare Advantage : $211.73 CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PEL W/ IV ONLY $995 $597 $309.58 – $636.10 CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $636.10 Aetna Medicare Advantage — Medicare Advantage : $309.58 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $636.10 Blue Advantage of LA — Medicare Advantage : $309.58 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $636.10 Healthy Blue Dual Advantage — Medicare Advantage : $309.58 Humana — Medicare Advantage : $309.58 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $636.10 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $636.10 Magnolia Health Plan MCR Adv — Medicare Advantage : $309.58 CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD/PEL W/ ORAL/IV $995 $597 $309.58 – $636.10 CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $636.10 Aetna Medicare Advantage — Medicare Advantage : $309.58 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $636.10 Blue Advantage of LA — Medicare Advantage : $309.58 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $636.10 Healthy Blue Dual Advantage — Medicare Advantage : $309.58 Humana — Medicare Advantage : $309.58 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $636.10 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $636.10 Magnolia Health Plan MCR Adv — Medicare Advantage : $309.58 Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN COMPLETE $497 $298.20 $92.78 – $317.73 Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $317.73 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $317.73 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $317.73 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $317.73 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $317.73 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB 2ND/3RD TRIMESTER LIMITED $491 $294.60 $92.78 – $313.90 Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $313.90 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $313.90 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $313.90 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $313.90 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $313.90 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL NON-OB $478 $286.80 $92.78 – $305.59 Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $305.59 Aetna Medicare Advantage — Medicare Advantage : $92.78 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $305.59 Blue Advantage of LA — Medicare Advantage : $92.78 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $305.59 Healthy Blue Dual Advantage — Medicare Advantage : $92.78 Humana — Medicare Advantage : $92.78 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $305.59 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $305.59 Magnolia Health Plan MCR Adv — Medicare Advantage : $92.78 Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MM 2D BILATERAL SCREENING $400 $240 $79.11 – $255.72 Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $255.72 Aetna Medicare Advantage — Medicare Advantage : $79.11 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $255.72 Blue Advantage of LA — Medicare Advantage : $79.11 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $255.72 Healthy Blue Dual Advantage — Medicare Advantage : $79.11 Humana — Medicare Advantage : $79.11 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $255.72 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $255.72 Magnolia Health Plan MCR Adv — Medicare Advantage : $79.11 Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MM MG MAMMO BILAT SCREENING W/CAD $400 $240 $79.11 – $255.72 Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $255.72 Aetna Medicare Advantage — Medicare Advantage : $79.11 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $255.72 Blue Advantage of LA — Medicare Advantage : $79.11 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $255.72 Healthy Blue Dual Advantage — Medicare Advantage : $79.11 Humana — Medicare Advantage : $79.11 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $255.72 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $255.72 Magnolia Health Plan MCR Adv — Medicare Advantage : $79.11 Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MM 3D BILATERAL SCREENING $400 $240 $79.11 – $255.72 Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $255.72 Aetna Medicare Advantage — Medicare Advantage : $79.11 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $255.72 Blue Advantage of LA — Medicare Advantage : $79.11 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $255.72 Healthy Blue Dual Advantage — Medicare Advantage : $79.11 Humana — Medicare Advantage : $79.11 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $255.72 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $255.72 Magnolia Health Plan MCR Adv — Medicare Advantage : $79.11
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 GP In the file: PT THERAPEUTIC EX 15 MIN,Services delivered under an outpatient physical therapy plan of care $108 $64.80 $11 – $26.92 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $11 Aetna Medicare Advantage — Medicare Advantage : $26.92 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $11 Blue Advantage of LA — Medicare Advantage : $26.92 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $11 Healthy Blue Dual Advantage — Medicare Advantage : $26.92 Humana — Medicare Advantage : $26.92 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $11 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $11 Magnolia Health Plan MCR Adv — Medicare Advantage : $26.92 Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: OT THER EX 15 MIN,Services delivered under an outpatient occupational therapy plan of care $108 $64.80 $11 – $26.92 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $11 Aetna Medicare Advantage — Medicare Advantage : $26.92 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $11 Blue Advantage of LA — Medicare Advantage : $26.92 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $11 Healthy Blue Dual Advantage — Medicare Advantage : $26.92 Humana — Medicare Advantage : $26.92 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $11 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $11 Magnolia Health Plan MCR Adv — Medicare Advantage : $26.92 Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GN In the file: ST THER EX EA 15 MIN,Services delivered under an outpatient speech language pathology plan of care $108 $64.80 $11 – $26.92 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $11 Aetna Medicare Advantage — Medicare Advantage : $26.92 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $11 Blue Advantage of LA — Medicare Advantage : $26.92 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $11 Healthy Blue Dual Advantage — Medicare Advantage : $26.92 Humana — Medicare Advantage : $26.92 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $11 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $11 Magnolia Health Plan MCR Adv — Medicare Advantage : $26.92 Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: PT EVALUATION: LOW COMPLEXITY,Services delivered under an outpatient physical therapy plan of care $150 $90 $58.94 – $90.70 Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $58.94 Aetna Medicare Advantage — Medicare Advantage : $90.70 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $58.94 Blue Advantage of LA — Medicare Advantage : $90.70 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $58.94 Healthy Blue Dual Advantage — Medicare Advantage : $90.70 Humana — Medicare Advantage : $90.70 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $58.94 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $58.94 Magnolia Health Plan MCR Adv — Medicare Advantage : $90.70 Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: PT EVALUATION: MODERATE COMPLEXITY,Services delivered under an outpatient physical therapy plan of care $150 $90 $58.94 – $90.70 Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $58.94 Aetna Medicare Advantage — Medicare Advantage : $90.70 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $58.94 Blue Advantage of LA — Medicare Advantage : $90.70 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $58.94 Healthy Blue Dual Advantage — Medicare Advantage : $90.70 Humana — Medicare Advantage : $90.70 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $58.94 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $58.94 Magnolia Health Plan MCR Adv — Medicare Advantage : $90.70 Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: PT EVALUATION: HIGH COMPLEXITY,Services delivered under an outpatient physical therapy plan of care $150 $90 $58.94 – $90.70 Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $58.94 Aetna Medicare Advantage — Medicare Advantage : $90.70 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $58.94 Blue Advantage of LA — Medicare Advantage : $90.70 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $58.94 Healthy Blue Dual Advantage — Medicare Advantage : $90.70 Humana — Medicare Advantage : $90.70 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $58.94 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $58.94 Magnolia Health Plan MCR Adv — Medicare Advantage : $90.70 Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PSYCHOTHERAPY 30 MINUTES $150 $90 $95.90 – $157.51 Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $95.90 Aetna Medicare Advantage — Medicare Advantage : $157.51 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $95.90 Blue Advantage of LA — Medicare Advantage : $157.51 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $95.90 Healthy Blue Dual Advantage — Medicare Advantage : $157.51 Humana — Medicare Advantage : $157.51 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $95.90 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $95.90 Magnolia Health Plan MCR Adv — Medicare Advantage : $157.51 Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PSYCHOTHERAPY 45 MINUTES $160 $96 $102.29 – $157.51 Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $102.29 Aetna Medicare Advantage — Medicare Advantage : $157.51 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $102.29 Blue Advantage of LA — Medicare Advantage : $157.51 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $102.29 Healthy Blue Dual Advantage — Medicare Advantage : $157.51 Humana — Medicare Advantage : $157.51 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $102.29 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $102.29 Magnolia Health Plan MCR Adv — Medicare Advantage : $157.51 Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: PSYCHOTHERAPY 60 MINUTES $175 $105 $111.88 – $157.51 Psychotherapy, 60 minutes: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $111.88 Aetna Medicare Advantage — Medicare Advantage : $157.51 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $111.88 Blue Advantage of LA — Medicare Advantage : $157.51 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $111.88 Healthy Blue Dual Advantage — Medicare Advantage : $157.51 Humana — Medicare Advantage : $157.51 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $111.88 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $111.88 Magnolia Health Plan MCR Adv — Medicare Advantage : $157.51
Procedures and surgery Service Hospital charge Cash price Insurance rates (lowest – highest) Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: EGD DIAGNOSTIC $1,303 $781.80 $349.65 – $804.84 Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $349.65 Aetna Medicare Advantage — Medicare Advantage : $804.84 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $349.65 Blue Advantage of LA — Medicare Advantage : $804.84 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $349.65 Healthy Blue Dual Advantage — Medicare Advantage : $804.84 Humana — Medicare Advantage : $804.84 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $349.65 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $349.65 Magnolia Health Plan MCR Adv — Medicare Advantage : $804.84 Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD W/BIOPSY $1,542 $925.20 $468.30 – $804.84 Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $804.84 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $804.84 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $804.84 Humana — Medicare Advantage : $804.84 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $804.84 Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY $1,246 $747.60 $468.30 – $825.23 Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $825.23 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $825.23 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $825.23 Humana — Medicare Advantage : $825.23 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $825.23 Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY SCREENING $1,246 $747.60 $468.30 – $825.23 Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $825.23 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $825.23 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $825.23 Humana — Medicare Advantage : $825.23 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $825.23 Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY W/ BIOPSY $1,445 $867 $468.30 – $1,061.88 Colonoscopy with biopsy: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $1,061.88 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $1,061.88 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $1,061.88 Humana — Medicare Advantage : $1,061.88 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $1,061.88 Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: COLONOSCOPY-BIOPSY BY SNA $1,445 $867 $468.30 – $1,061.88 Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $1,061.88 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $1,061.88 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $1,061.88 Humana — Medicare Advantage : $1,061.88 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $1,061.88 Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAP CHOLE $3,304 $1,982.40 $535.50 – $5,364.73 Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $535.50 Aetna Medicare Advantage — Medicare Advantage : $5,364.73 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $535.50 Blue Advantage of LA — Medicare Advantage : $5,364.73 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $535.50 Healthy Blue Dual Advantage — Medicare Advantage : $5,364.73 Humana — Medicare Advantage : $5,364.73 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $535.50 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $535.50 Magnolia Health Plan MCR Adv — Medicare Advantage : $5,364.73 Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PRP I/HERN INIT REDUC >5 $5,082 $3,049.20 $661.50 – $3,177.20 Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $661.50 Aetna Medicare Advantage — Medicare Advantage : $3,177.20 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $661.50 Blue Advantage of LA — Medicare Advantage : $3,177.20 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $661.50 Healthy Blue Dual Advantage — Medicare Advantage : $3,177.20 Humana — Medicare Advantage : $3,177.20 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $661.50 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $661.50 Magnolia Health Plan MCR Adv — Medicare Advantage : $3,177.20 Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HYSTERSCOPY; BIOPSEY $3,353 $2,011.80 $535.50 – $2,872.59 Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $535.50 Aetna Medicare Advantage — Medicare Advantage : $2,872.59 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $535.50 Blue Advantage of LA — Medicare Advantage : $2,872.59 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $535.50 Healthy Blue Dual Advantage — Medicare Advantage : $2,872.59 Humana — Medicare Advantage : $2,872.59 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $535.50 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $535.50 Magnolia Health Plan MCR Adv — Medicare Advantage : $2,872.59 Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: CARPAL TUNNEL RELEASE O/R $2,912 $1,747.20 $468.30 – $1,732.83 Carpal tunnel release: 10 of 20 insurance plan rates Aetna Better Health LA — Medicaid Replacement : $468.30 Aetna Medicare Advantage — Medicare Advantage : $1,732.83 AmeriHealth Caritas Louisiana MCD Rep — Medicaid Replacement : $468.30 Blue Advantage of LA — Medicare Advantage : $1,732.83 Healthy Blue Community Care of LA MCD — Medicaid Replacement : $468.30 Healthy Blue Dual Advantage — Medicare Advantage : $1,732.83 Humana — Medicare Advantage : $1,732.83 Humana Healthy Horizons MCD Rep — Medicaid Replacement : $468.30 Louisiana Healthcare Connections MCD Rep — Medicaid Replacement : $468.30 Magnolia Health Plan MCR Adv — Medicare Advantage : $1,732.83
Source: Lasalle General Hospital’s standard charges file (lasallegeneralhospital.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 1, 2026. The hospital’s price transparency page →
Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS) . We show a selection of common services; the file has every item and service.